Dr. Mildred Thornton Stahlman, a Vanderbilt University pediatrician whose research into fatal lung diseases in newborns led to life-saving treatments and the creation of one of the first neonatal intensive care units in 1961, died Saturday at her home in Brentwood , Tennessee. She was 101 years old.
His death was confirmed by Eva Hill, wife of Dr. Stahlman's nephew, George Hill.
On October 31, 1961, Dr. Stahlman placed a gasping premature baby into a miniature iron lung machine, also known as a negative-pressure ventilator, of the kind used for children with polio. The machine worked by opening the baby's fragile chest muscles to help draw in air. The child survived.
That initial success, along with the results of Dr. Stahlman's studies on newborn lambs, helped launch a new era in the treatment of respiratory and lung diseases, a leading cause of death in premature babies. Immature lungs lack surfactant, a soapy chemical that lines the air sacs. Without surfactant, the tiny sacs collapse.
Shortly after her first success, Dr. Dr. Stahlman reported that, by 1965, she had used the iron lung machine, augmented with positive pressure, to save 11 of 26 children at Vanderbilt. By the 1970s, negative pressure tanks were abandoned for positive pressure machines that worked by inflating the lungs. In the 1990s, the use of surfactants extracted from animal lungs significantly improved the survival of children with serious illnesses requiring mechanical ventilation.
“Millie was one of the first to push the limits of the viability of premature infants in a thoughtful and scientific way,” said Dr. Linda Mayes, Yale professor of child psychiatry, pediatrics and psychology and president of the Yale Child Study Center who he trained under Dr. Stahlman. “You were a physician-scientist long before that phrase became popular.”
In the early days of neonatology, Dr. Stahlman was one of the few doctors in the world who knew how to insert tiny catheters into newborns’ umbilical vessels to monitor oxygen levels in their blood, Sarah DiGregorio wrote in her book, “Early: An Intimate History of Premature Birth and What It Teaches Us About Being Human.” The procedure was vital to ensuring that the babies had enough oxygen to keep them alive, but not so much that they would go blind.
Dr. Stahlman, a petite, intimidating woman with piercing blue eyes and a tight bun, was known for her fierce dedication to her patients and students. Many of her students recall the so-called Milly rounds, when they visited every newborn on the wards and were expected to know every detail about each child, from precise lab values to the family's home life.
“Her severity was shocking to the mostly male staff, especially for a woman who was just 5 feet tall and weighed 90 pounds,” said Dr. Elizabeth Perkett, a retired professor of pediatric pulmonology at Vanderbilt University and the University of New Mexico.
Dr. Stahlman’s research also included studying normal and abnormal lung physiology in newborn lambs. For a time, pregnant ewes grazed in a Vanderbilt yard.
“She was struck by the fact that some near-term, non-premature babies had hyaline membrane disease,” the old name for respiratory distress syndrome, said Dr. Hakan Sundell, professor emeritus of pediatrics at Vanderbilt University and director of the animal laboratory.
In 1973, Dr. Stahlman began an outreach program, training nurses in rural areas and overseeing the creation of a mobile medical van that stabilized children traveling from community hospitals to Vanderbilt. A former bread truck was renovated with a fan, monitors and heat lights. Within a year, neonatal deaths dropped by 24 percent, his team reported in the February 1979 issue of the Southern Medical Journal.
Dr. Stahlman also pioneered follow-up therapy for premature babies, monitoring them from infancy to monitor psychological and physical development.
“She led the way in research and innovation, and she was also very forward-thinking, understanding the ethical issues and limitations of the technology,” said Dr. Pradeep N. Mally, chief of the Division of Neonatology at NYU Langone Health and a neonatologist . at New York University Langone Hassenfeld Children's Hospital.
Mildred Thornton Stahlman was born July 31, 1922, in Nashville, to Mildred Porter (Thornton) Stahlman and James Geddes Stahlman, Publisher of The Nashville Banner.
Dr. Stahlman graduated from Vanderbilt University in 1943 and was one of three women out of 47 students to graduate from Vanderbilt University Medical School in 1946.
He served a year as an intern at Lakeside Hospital in Cleveland, followed by a year as a pediatric intern at Boston Children's Hospital, completing his pediatric residency at Vanderbilt. He studied pediatric cardiopulmonary physiology for a year at the Karolinska Institute in Sweden, and completed a cardiology residency at La Rabida Children's Hospital in Chicago.
Dr. Stahlman returned to Vanderbilt in 1951 and became director of the Division of Neonatology in 1961, a position she held until 1989.
In addition to his clinical and laboratory work on premature infants, his concern has extended to the impact of poverty on disease, rampant health inequities, and the harms of profit-driven models of medical care.
“Prematurity has become largely a social rather than a medical disease in the United States,” he wrote in 2005 in the Journal of Perinatology. “The rapid rise of for-profit hospitals, in which the interests of shareholders prevailed over the interests of our patients, was followed by for-profit neonatology, and this was a truly profitable business.”
Dr. Stahlman was a member of the Institute of Medicine and president of the American Pediatric Society from 1984 to 1985. Among her many awards, she received the Virginia Apgar Award from the American Academy of Pediatrics and the John Howland Medal from the American Pediatrics Society. .
He had no immediate survivors.
Today, Martha Lott, the first baby that Dr. Stahlman put the iron lung in the machine, she's a nurse in the very place where her life was saved. “I knew the story and was tested for years,” Ms. said. Mrs Lott. The Dr. Stahlman was his godmother, he said.
“I think they assumed I would have problems,” in relation to the audacious treatment. It was not so. “It's amazing,” she added, “how much technology has changed in the last 60 years.”