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In Their Own Words: NIH Researchers Recall the Early Years of AIDS
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Interview with Dr. John l. Gallin

This is an interview with Dr. John I. Gallin of the National Institute of Allergy and Infectious Diseases on 23 June 1993 in Dr. Gallin's office in the NIH Clinical Center. The interviewers are Dr. Victoria A. Harden, Director, NIH Historical Office, and Mr. Dennis Rodrigues, Program Analyst, NIH Historical Office. Dr. Gallin was provided with a list of questions in advance of the interview. MaryAnn Guerra, Chief, Administrative Management Branch, for the NIAID intramural program, participated in a portion of the interview.

Harden: Let us begin by asking you to give us some information about your background. I ask physicians what influenced them to go into medicine and, in your case, into medical research as well. Please trace your life briefly up to coming to your present position.

Gallin: I was born in New York City on 25 March 1943. My father was an attorney, my mother was a housewife. I was the second of two children. My older brother subsequently entered dentistry. Throughout my youth, I had a strong interest in science, which was directed towards clinical science. When I was a tenth grader, my mother became acutely ill with severe hemoptysis. I woke up and saw the blood on the rug. She was wheeled to the ambulance. I was very impressed by this and, following that event, wanted to become a doctor. I went to Amherst College, where I graduated cum laude. In college, I became more involved in research. I was introduced to the laboratory in the summer of 1964, after my junior year, when I worked with Dr. Paul J. Van De Mark at Cornell University, Ithaca, New York. At college I majored in biology and did a thesis with Dr. Edward R. Leadbetter. At Amherst also I fell in love with Elaine Klimerman [Gallin], who subsequently received a Ph.D. and became my closest colleague, best friend, and wife now for almost 26 years. I published a number of papers as a college student and actually applied for admission to several Ph.D. programs.

One day in my senior year at Amherst, after I had been accepted into several graduate programs, my father came and had lunch with me. He said, “Why don't you go to medical school? You can then do whatever you want, but you will have more influence and more flexibility in what you pursue.” I listened to him and went to medical school (Cornell University Medical School). I was an intern and a resident at Bellevue [Hospital, New York]. I came to the NIH in my first appointment in 1971 as a clinical associate. After three years in the Laboratory of Clinical Investigation, of which Dr. Sheldon M. Wolff was the laboratory chief, I went back to Bellevue Hospital as their senior chief resident in medicine. I returned to NIH as a senior investigator.

Harden: When you were at Cornell, did you meet Dr. [Anthony] Fauci?

Gallin: No.

Harden: You met him at the NIH?

Gallin: I met him here. I will tell you about that shortly.

Harden: Fine.

Gallin: At Cornell, I continued my research interests. In the summers, I worked in several laboratories. One of these, when I was at an earlier stage of my student life, was run by Dr. William M. O'Leary, who was a microbiologist. Later, in my last year, I worked in the Division of Infectious Diseases in the Department of Medicine at Cornell, which was then headed by Dr. Edward Hook. It was an outstanding division. Within it were Dr. Donald Kaye, who is now Chief of Medicine at the Medical College of Pennsylvania, and Ed Hook, who subsequently became Chief of Medicine at the University of Virginia at Charlottesville. The fellows under them at that time were Drs. Gerald L. Mandell, current President of the Infectious Diseases Society of America, Merle A. Sande, immediate Past President of the Infectious Diseases Society of America, and Glen Cobbs, all of whom were my mentors as a student. They had a big impact on my pursuing a career in infectious diseases.

Other people also had a big influence that senior year. They included Dr. Walsh McDermott at Cornell, Dr. James Hirsch of Rockefeller University, and also [Dr.] René Dubos. Dr. Hook organized Friday luncheons with these people and these meetings had an enormous influence on me in terms of my recognizing the subspeciality of infectious diseases as one that I wanted to pursue. My years at medical school were very happy. I got married, we had our first child, and I wrote two papers that were published in the New England Journal of Medicine.

When I was at Bellevue, I was very impressed by the flexibility and freedom that we had as interns and residents. I was greatly influenced there by several other people. [Dr.] Saul J. Farber, who was Chairman of Medicine and is still Chairman of Medicine there, became a mentor who instilled the importance of maintaining a clinical presence throughout my career; [Dr.] H. Sherwood Lawrence, who discovered transfer factor, which in its time was a very exciting discovery in infectious diseases, and who served as an example of doing clinical research and busy medical service; and [Dr.] Gerald Weissmann, who was a leader of neutrophil biology; all contributed to my development. Dr. Weissmann had a major influence on my interest in phagocytic cells, a research area which I have pursued subsequently. It was at NYU that I met a fellow medical resident, the late [Dr.] Ira M. Goldstein, with whom I subsequently edited the first two editions of Inflammation: Basic Principles and Clinical Correlates.

When I came to NIH, I went to work with [Dr.] Harry R. Kimball in the Laboratory of Clinical Investigation. He was interested in phagocytic cells, but in the middle of my first year, after I had been assigned to him, he decided to leave NIH and go into private practice in Yakima, Washington. He subsequently has had an illustrious career and is now President of the American Board of Internal Medicine. His leaving NIH provided a great opportunity for me, because everybody who was interested in phagocytic cells seems to have left that year and I was all by myself. Dr. Wolff asked me, “What do you want to do?” I said, “I will continue doing what I am doing.” He gave me a little space and a few resources, and he said, “Have fun.” That is what I did, and it worked out well.

At the beginning of my second year, which would have been around 1 July 1972, when Harry Kimball left, there was a vacant laboratory which had two modules, 500 square feet, and one office. On that day, 1 July, Tony [Dr. Anthony S.] Fauci came back to NIH, having finished his chief residency at the New York Hospital. He was across the hall from where I worked. Dr. Fauci's laboratory was a total mess, because people had raided it while he was gone and stolen all of the equipment. It looked like a pigsty. He was very upset because he thought he was coming into this well-equipped new facility that was going to be really clean, and it was a disaster. I remember walking over there, introducing myself to him, and saying “Would you like some help?" We cleaned up his laboratory, and that was the beginning of a long-lasting friendship. I was always impressed because no matter when I came in to work, Tony Fauci was in that tiny little office or in his laboratory doing his work. We often had long conversations on Saturdays and Sundays about many things.

Harden: You and Dr. Fauci are close personal friends, as well as colleagues, I believe.

Gallin: Right. We talk about our research, we play tennis, and we do some fishing together. It is very nice.

Harden: Could you elaborate a little about your research? Did you remain in the laboratory?

Gallin: I remained in the laboratory. As a clinical associate, I was very lucky because I was adopted by all the senior staff, and I felt totally free to interact with all of them. What I did was to get into a lot of projects utilizing what I thought were the talents of the various senior people and learning from them. Also, because I had some backgound in the laboratory before I came to NIH, I was able to conceive and design my own projects. I was very fortunate in getting into a position of independence very early in my career. My wife and I also worked and published together. I had the support of my senior mentors.

Harden: You were doing research on infectious diseases, but you must also have been involved in that wave of new developments in immunology that happened in the 1970s.

Gallin: Yes, I was different though because nobody ever really understood what I was doing. I can still remember a colleague saying to me, “Why are you doing that work on neutrophils? You are never going to do anything that is clinically relevant.” I also remember my interview before coming to NIH as a clinical associate. I interviewed at two laboratories: [Dr.] Shelly Wolff's laboratory and [Dr.] Donald Fredrickson's laboratory. Dr. Fredrickson was then chief of the Laboratory of Molecular Diseases of the Heart Institute [National Heart, Lung, and Blood Institute] with Dr. [Robert I.] Levy. The reason I interviewed with Fredrickson and Levy was because I had published some papers on the effect of infections on serum lipids in the New England Journal of Medicine as a student. I can still remember that Don Fredrickson looked at me and said, “Why would you pursue a career in infectious diseases? It has all been done. We have the antibiotics.” I said, “Gee, I do not think so.” I have subsequently reminded him of that interview. He denied it completely and claimed, “I never said that," but he did. You do not forget interviews when you are at that junior level.

Harden: Could you comment on the thrust of your research in this period?

Gallin: My work at that time was very much on how phagocytic cells crawled out of the bloodstream and into the tissues. There they are the first element of the host defense system against infection. What Shelly Wolff did that I thought was most outstanding was recognizing the importance of the host defense system in infectious diseases. He correctly predicted that the future in this area would be in learning to understand, and then control, the host defense components. He earmarked several areas in the field which should be developed. One was phagocytic cells; one was complement systems; one was cellular immunity, which subsequently became Tony Fauci's area; and then there were several other interrelated areas.

So Shelly Wolff collected young people interested in these areas. My own group of clinical associates was quite amazing. There were seven of us. One was [Dr.] John Atkinson, who is now chairman of medicine at Washington University, St. Louis, and quite an accomplished investigator in complement; there was myself; there was [Dr.] Peter E. Lipsky, the current editor of the Journal of Immunology, who has done very well; there was [Dr.] Charles Dinarello, who basically discovered interleukin-1 and all of its ramifications; and then there was a fellow named [Dr.] Jim [James] Pennington, who is now a senior executive at one of the pharmaceutical companies. Two of the members of our group went into private practice. It was a very exciting group. There was a lot of interaction and a lot of fun.

I pursued my interests in phagocytic cells and then the research was interrupted when I went back to Bellevue to complete my clinical training as a chief resident. I came back to NIH and continued to work on phagocytic cells. I was made a section chief in 1978. I worked on the population of patients with chronic granulomatous disease of childhood. These patients' phagocytes are not capable of producing hydrogen peroxide.

When [Dr.] Robert Good described these patients in the late 1960s, he thought there was one enzyme linked to the disease and that it would be a very simple thing to understand. He believed that in a few years we would have treatment for it. What we have learned over a span of twenty years is that it is not so simple. It is a spectrum of diseases with disorders of oxidation metabolism, and we have now defined four genes that can lead to this disease. It is an abnormality of any one of the four genes. We are in the midst of trying to correct the disease through gene therapy right now. It has been an exciting story, but it is a whole other story than AIDS.

Harden: It would be fascinating to discuss that other research.

Gallin: I can tell you a little more about my appointment as Director of the Intramural Research Program for NIAID.

Harden: Please do.

Gallin: That occurred in 1985, following Dr. Kenneth Sell's departure. Dr. Fauci first selected Bill [Dr. William E.] Paul to be the Intramural Director of the Institute, and he agreed to do it. He did it for about seven days and then he quit. He decided he did not want to do it. You can ask him why, but he had a very short tenure as the Scientific Director. Then Tony Fauci conducted another search and asked me if I was interested. I said yes. We had a long discussion about whether it was the best thing for me and my career. One day in August we were eating fish with our wives on Tilghman Island and Tony asked me whether I wanted to take the job. I said yes.

Harden: Have you ever regretted it?

Gallin: No, I have never regretted it. It has been a lot of fun.

Harden: Let us go back now to the early 1980s, and talk about AIDS, when it first emerged into people's consciousnesses, before you became an administrator and before you were actually working on it. Can you remember when you first heard about the disease and describe your initial thoughts?

Gallin: I think I first read about it in the CDC [Centers for Disease Control and Prevention] Morbidity and Mortality Weekly Report, or maybe I actually heard about it earlier. There were stories in the New York Times or the Washington Post about some unusual patients. But the first serious discussion was on one of those Saturday or Sunday mornings when I came in and was talking to Tony Fauci. I can still remember him saying that this was going to be a disaster. He picked it up right from the very beginning. He immediately recognized that this ailment was in his area of research because it was clear that all the things in the immune system that he had been studying were defective in the patients. You could tell by the kinds of infections the patients were having. Very early on, Tony Fauci said that it was going to be horrible and that he was going to study the problem. There was no hesitation on his part. I was astonished at how quickly he recognized the seriousness of the potential of this infection.

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