Stuart Bondurant, a member of the Climatological since 1968, died on May 16, 2018, after a long career marked by multifaceted accomplishment and visionary engagement in the opportunities and responsibilities of academic medicine.
Born and raised in North Carolina, Stuart was educated at the University of North Carolina at Chapel Hill and Duke University School of Medicine, where his lifelong interest in cardiovascular physiology emerged. His clinical training started at Duke Hospital on Eugene Stead's medical service, and the impact of Gene Stead's keen analytic approach to clinical problems, educational style, and broader philosophical perspectives were still evident in Stuart's appreciative and sometimes bemused recollections years later.
After 2 years on the house staff, he spent a year as a postdoc in studies of cardiopulmonary physiology with John Hickam at Duke, followed by 2 years in the Air Force as Chief Medical Officer of the Acceleration Section of the Aeromedical Laboratory at Wright Patterson Air Force Base. Extensive physiologic studies were under way there in anticipation of the exposure of pilots to the demands of ultra–high performance aircraft and of space flight. Studies focused especially on the physiologic effects of G forces on cardiovascular and pulmonary function and on human tolerances of the stresses of rapid sustained acceleration. Stuart took advantage of the opportunity to take a ride in the human centrifuge, thus becoming simultaneously experimental subject and investigator, dual roles some might have viewed as ethically and intellectually appropriate, others as something less, adventurous perhaps, but unnecessary, even foolhardy. These studies resulted in seven papers and three book chapters by Stuart on topics ranging from human tolerances in prolonged positive acceleration to the effect of the Valsalva maneuver in protecting against the physiologic impact of positive acceleration, to the effects of acceleration on the spatial vectorcardiogram and to optimal design characteristics of ejection seat cushions.
After his Air Force tour, inclined to an academic career, he had a third year of residency training at the then Peter Bent Brigham Hospital, following which he joined the faculty of the Indiana University School of Medicine as an assistant professor in the Department of Medicine, now chaired by John Hickam. He was also named Associate Director of the Cardiovascular Research Center and rose to full professorial rank in 8 years. His publications in those years reflected his continuing interest in cardiovascular and respiratory physiology, and included studies of adjustments to the effects on respiratory function of breathing pure oxygen or of abdominal compression or smoking. Another line of studies focused on the surface characteristics of lung extracts, including pulmonary surfactant. I once told Stuart that I thought the breath of patients with acute pulmonary edema had a characteristic odor, which he said must be due to surfactant. Accordingly, he sent me a small vial labelled “Pulmonary Surfactant” containing a white powder, which had no detectable (by me) smell. Stuart, charitably protective of the possibility that I had made a (small) original observation of some clinical interest, and probably a little crestfallen, said it must have been a bad batch.
In 1966, on leave from Indiana, he was appointed Chief of the Artificial Heart–Myocardial Infarction Program at the National Heart Institute at the NIH, the first national research program on myocardial infarction. A year later he was appointed Chairman of the Department of Medicine and later President and Dean, at Albany Medical College, where he built on a strong clinical tradition and bolstered the research base of the school. His publications in that period reflected broadening of the issues of concern to him, including the role of government in the provision of health care and the organization of research programs in cardiovascular disease.
In 1979 he returned to Chapel Hill as Dean of the medical school and professor of medicine. During the 15 years of his deanship, the UNC medical center flourished as the scope of its activities increased substantially and its national profile expanded. Five new departments were added (Biomedical Engineering, Emergency Medicine, Nutrition, Physical Medicine and Rehabilitation, and Radiation Oncology) and new Centers were created in Ambulatory Care, Cystic Fibrosis/Pulmonary Research and Treatment, Health Promotion and Disease Prevention, and Environmental Medicine and Lung Biology. A number of these represented innovative partnerships inside the University as well as extramurally, the latter an effort to tie the University and the School more closely to complex issues at the interfaces of medicine, clinical care, and the multiple social forces bearing on health. Further to those needs, Stuart became a force for expanding the medical center's impact on the health of North Carolinians: he was a co-founder of the North Carolina Institute of Medicine, Chair of the Governor's Commission on the Reduction of Infant Mortality, Vice-Chair of the North Carolina Healthy Start Foundation, and Chair of the North Carolina Biotechnology Center.
After stepping down from the deanship at UNC in 1994, he accepted appointment as Director of the Center for Urban Epidemiologic Studies at the New York Academy of Medicine, a reflection of his interests in health issues at the population level. During his time at the Academy he published a number of thoughtful papers on issues in urban health, an Academy priority, and made the health exposures of urban environments the topic of his Metzger Lecture at the Climatological meeting in 1995. In addition, he continued to publish on his longstanding concerns over the gap between the clinical and public health communities and the need for them to move closer together, to find the large-scale conceptual and operational synergies needed to engage more effectively the major health challenges of our time.
After returning to UNC in 1996, he was asked to again take on the responsibilities of the Deanship on an interim basis, which he did until 1998, when he was named professor of medicine and Dean Emeritus. Following that he served from 2004 to 2008 as Executive Vice President for Medicine and Executive Dean at Georgetown, helping the medical school through a period of reorganization. Returning to UNC, he was an active presence in the medical school community, faithfully attending Department of Medicine Grand Rounds and interviewing candidates for residency appointments.
At the national level, he served at various times as an advisor to federal agencies, including the Department of Health and Human Services, the Department of Defense, the Veterans Administration, the NIH, the Air Force, NASA, and the FDA. He was President and later President Emeritus of the American College of Physicians, president of the Climatological and of the Association of American Physicians, Chairman of the Association of American Medical Colleges, and acting President of the Institute of Medicine. In all these roles his tenures were characterized by intelligence, fairness, probity, and good humor.
Unsurprisingly, Stuart's honors were many. They included election to Phi Beta Kappa and Alpha Omega Alpha and multiple honorary degrees, the Meritorious Civilian Service Medal of the US Air Force, a Citation for Distinguished Service to Research from the American Heart Association, the David P. Rall Award of the IOM, Mastership in the American College of Physicians, and Honorary Fellowship of the Royal Colleges of Physicians of London and Edinburgh. He was named Dean Emeritus at UNC after his retirement, and in 2006 the central administrative building on the medical campus was named for him, a gesture of respect and affection he called “a surpassing honor.”
Personally, Stuart was a quintessential gentleman, quiet, unassuming, affirming of others. David Nathan, a member of this Association and longtime friend who first knew Stuart as a fellow house officer at the Brigham, remembers him as wise, humorous, self-deprecating, even then a physician's physician, who exuded patience, kindness, tolerance, and intellect. Ronald Falk, Chair of the Department of Medicine at UNC, describes him as the consummate lifelong learner, and Joanne Jordan, Vice Dean for Faculty Affairs, as wise, thoughtful, and deliberate.
Stuart treasured his membership in the Climatological. He valued its particular mix of high-quality exchange and social warmth and especially the range of inquiry and discussion at the meetings, the persistence of its original intent as a venue where the value of intellectual generalism in medicine was made plain.
He is survived by a son, two daughters, five grandchildren, and by his wife, Susan Ehringhaus, an academic lawyer with special expertise in the legal and ethical complexities confronting universities and particularly academic medical centers. She brought new perspectives to his thinking and she brought him joy — and she improved his neckties by an order of magnitude.
Jeremiah A. Barondess, MD
