Lifetime Achievement Award: Dr. William Northway, Jr

Dr. Northway is a Stanford legacy, who was born and raised in Palo Alto. His father served as the chair of physical medicine and rehabilitation at Stanford, and his mother was a nurse at Stanford-Lane Hospital before her marriage. He attended Palo Alto High School and Stanford University for his undergraduate and medical degrees. At Stanford, he met Drs. Henry Jones and Henry Kaplan and decided to become a radiologist. After medical school, Dr. Northway headed to the East Coast to complete an internship in internal medicine at the New York Hospital (Cornell University). He returned to Stanford in 1958 to begin his residency in radiology and encountered Dr. Robert Evans, the first pediatric radiologist at Stanford, and Dr. Herb Abrams. Both were critical to his interest in becoming an academic pediatric radiologist.

After finishing his residency in 1961, he enlisted in the air force and was stationed at Keesler Air Force Base Hospital in Biloxi, Mississippi, as the assistant director of the Department of Radiology from 1961 to 1963: "I spent two years in the United States Air Force as a captain and as one of two radiologists at a 500-bed hospital." At Keesler, he met and married his wife, Linda. In 1963, Dr. Northway obtained a fellowship at the Hopital des Enfants-Maladies in Paris, France, with the assistance of Dr. Robert Evans and Professor Jacques Lefevre, the leading French pediatric radiologist at the Hopital des Enfants-Maladies. Through Dr. Kaplan, he also secured a James Picker Foundation Fellowship for support.

Working at the Hopital des Enfants-Maladies was an enlightening experience, according to Dr. Northway: "The hospital had about 500 beds at the time, and it was repudiated to be the largest and oldest children's hospital in the world. Many of my patients had been flown in from the French colonies in Africa, so I saw things that you wouldn't see in the United States, like scurvy, which is caused by vitamin C deficiency; rickets, which is caused by vitamin D deficiency; and tuberculosis (TB) of the spine and other areas. They also had a large ward of patients with congenital bone dysplasias that no one had categorized yet."

He returned to Stanford in 1964 as an instructor in radiology and held a faculty position at Stanford throughout the rest of his 34-year career. Over the years, Dr. Northway has seen a multitude of changes. When he began in the Stanford Department of Radiology, children were not separated from adult patients for radiologic purposes. Also, radiotherapy, nuclear medicine, and diagnostic radiology were still one department when he was the director of the Division of Diagnostic Radiology from 1976 to 1981.

Most memorable were the technological advances. In the 1970s, CT and ultrasound technologies were primitive, but developing, Dr. Northway recalled: "We were just starting to have ultrasound and CT at that time. Initially, Dr. Zatz, who was developing the ultrasound technique, immersed the body part to be examined in water, and he reached in the water bath with the ultrasound equipment to make the images."

Teaching has changed as well. When Dr. Northway presented at grand rounds early in his career, he and his colleagues always presented with X-rays, lab results, and the patient, who is rarely involved with grand rounds today because of privacy issues. These changes in teaching have made it exciting but challenging. "Someone said once that by the time you have been out of medical school for 10 years only 10% of what you learned will still be in effect. When I was in medical school, they hadn't discovered DNA! The fun of teaching is passing on new knowledge," Dr. Northway asserted. Even amidst all the revolutionary changes, Dr. Northway had time to complete his research, in part, because the chair, Henry Kaplan, had established a policy that allowed each new tenure track faculty member to spend two days a week on research and three days on clinical care.

This protected research time allowed Dr. Northway to make a discovery that would permanently alter the treatment of premature infants with respiratory failure or hyaline membrane disease/respiratory distress syndrome (RDS). When he arrived at Stanford in 1964, pediatricians were just beginning to use very high levels of oxygen to treat premature infants with RDS. When a colleague asked him to look at a series of chest X-rays from treated premature infants, Dr. Northway was puzzled by the appearance of cystic changes in the lungs. After ruling out staphylococcus pneumonia, he examined all the infant charts, nursing notes, and pathology and concluded that the lung changes were related to pulmonary oxygen toxicity.

Dr. Northway's findings were published in a seminal article entitled, "Pulmonary Disease Following Respirator Therapy of Hyaline Membrane Disease (Bronchopulmonary Dsyplasia)," in The New England Journal of Medicine (1967 Feb 16;276(7):357-68). His many research studies on BPD helped advance the therapy of premature infants with respiratory failure by promoting the lowering of therapeutic oxygen concentrations. This, along with lower ventilator pressures and other advances in neonatology, significantly decreased the mortality rate for premature infants with respiratory failure.

In 1998, Dr. Northway retired from a 34-year academic career. During the same year, he was selected as the "Pioneer Session Honoree" by the Society for Pediatric Radiology (SPR) for his important contributions to the development of pediatric radiology. In 2003, he was awarded the SPR Gold Medal. In honor of his distinguished career, Dr. Northway also received the 2005 J.E. Wallace Sterling Lifetime Alumni Achievement Award, which is bestowed annually by the Stanford Medical Alumni Association in recognition of "exceptional lifetime achievement" in medicine. He continues to serve our Department as an active emeritus professor of radiology and pediatrics.