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A Scholar and a Gentleman

Richard Johnston Jr., M.D., MD ‘61, dedicates life’s work to improving the health of children


By Jessica Ennis
February 2012

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When women of childbearing age wake up in the morning and pour their favorite cereal into a bowl, they can thank the efforts of Richard B. “Dick” Johnston Jr., M.D., for helping them have a better chance at delivering a healthy baby.

Research found that consuming folic acid prior to and during the early stages of pregnancy reduced the occurrence of neural tube defects. What better way to do so than by putting it into staple foods like bread and cereal? “It was during Dr. Johnston’s tenure as our medical director that the March of Dimes began its national folic acid awareness campaign. His leadership was crucial to bringing the nation’s obstetrician-gynecologists, pediatricians and women’s nurses together with the March of Dimes to urge all women of childbearing age to [take] folic acid every day beginning before pregnancy,” said Jennifer Howse, M.D., president of the March of Dimes.

Johnston went directly to David Kessler, M.D., who served as U.S. Food & Drug Administration (FDA) commissioner from 1990 to 1997, to urge that folic acid be added to the nation’s grain supply. Kessler, a pediatrician and lawyer, was best known for taking on “big tobacco” in FDA v. Brown & Williamson Tobacco Corp.

“I remember going to Dr. Kessler’s office with letters from the pediatric, obstetrical, and genetic academic and professional societies and the March of Dimes to urge that folic acid be added to fortified grains,” Johnston said. “When I rose to give Dr. Kessler the letters, two lawyers jumped in front of me. He waved them aside and said, ‘It’s OK, I know these people.’ After consulting his nutrition experts in the room, he turned back to me and said, ‘We’ll have this out by December.’ He’s a hero for me.”

Despite much opposition outside the medical community, the FDA ruling was enacted in 1998, since resulting in a one-third reduction of neural tube defects such as spina bifida in the United States. “We consider this a significant victory for America’s mothers and babies because it’s so rare to get the chance to prevent a major birth defect with such a simple, low-tech solution as food fortification,” Howse said. Johnston first encountered the devastation of neural tube defects during his residency at Vanderbilt. “There was an entire ward occupied with children suffering from spina bifida,” he said. “The opportunity to try to prevent these defects was spectacular.”

Driven from an early age

A deep desire to make the world better has been a driving force in Johnston’s life since he was a child.

Born in Atlanta in 1935, he lived there with his three younger brothers, reared by “outstanding parents” in a household filled equally with a love for athletics and literature. “Our father was an athlete. He had a personable, wonderful way about him,” Johnston said. “We were fed on athletics. We set out to be the best, particularly in football and track. Our mother was extremely bright and had a particular sense for words. She raised us on Robert Frost and encouraged our reading of poetry.”

Johnston came to Vanderbilt University in 1953 as a pre-med student, but instead of immersing himself in his studies, he was drawn to participate in extracurricular activities. “When I got to Vanderbilt, I was not a committed student nor was I an effective student,” he said. He played halfback on the freshman football team until he had a career-ending anterior cruciate ligament tear midway through the season. Former teammate and longtime friend, Garrett Adams, M.D., MPH, president of Physicians for a National Health Program, remembers that Johnston became focused on academics after he was unable to play football.
“I remember visiting him in his dorm room,” Adams recalled. “It was so neat. His desk was perfect. His books were in a small neat pile. It was the picture of neat academic pursuit and that’s the way he’s continued.” As Johnston ramped up his studies, he also became more involved on campus, eventually being named Bachelor of Ugliness, which recognized the outstanding male undergraduate from his graduating class. “Somehow I accepted leadership roles, and a part of me has always wanted to be in those roles,” he said. Johnston met his wife, Mary Anne Claiborne, Ph.D., at Vanderbilt in 1958, and they married in 1960.
“My grades improved dramatically after marriage, a reflection of the irreplaceable support Mary Anne has given me over the past 51 years,” he said.

Johnston, Mary Anne and his brothers, Dillon and Chuck, were all philosophy majors at Vanderbilt.

Johnston paid for college and medical school by working summers at a YMCA camp in Atlanta.

“When the camp ended at 3, I went to the pool and taught private lessons to kids,” he recalled. “It taught me two things: I really loved interacting with kids – it was great fun for me – and it taught me how rewarding teaching is.”

“Where my soul is”

When it was time for Johnston to settle on a career, he chose pediatrics and immunology. “Child health is where my soul is,” Johnston said. “My professional goals are centered on doing something to improve the lives and health of children.” Medical school was a challenging but satisfying time for Johnston. “I felt like I was tolerated and nurtured until I reached a higher level,” he said. “I valued so much the sense of community that we had with the faculty, and the way they were devoted to teaching us was remarkable.” Johnston appreciated the high expectations he felt throughout medical school and into his two-year pediatric residency.

“I was taught to never fall short of doing what was absolutely optimal for every patient,” he said. “Whatever it took, that is what we were taught; anything short of the best possible was unacceptable.”

During an immunology fellowship at Children’s Hospital, Harvard Medical School, Johnston did immunology studies for the early development of the Haemophilus influenze type B vaccine. Later at the University of Alabama-Birmingham he investigated why sickle cell patients were so susceptible to pneumococcal infection and found an abnormality in the phagocytosis-promoting complement system. These results were published in the New England Journal of Medicine in 1973. He has since published 285 scholarly papers. Johnston first came to Colorado, where he and his wife live and work now, in 1977. He served as professor of Pediatrics at National Jewish Hospital and University of Colorado School of Medicine for nine years. He was recruited in 1986 to join the University of Pennsylvania as chair of the Department of Pediatrics and physician-in-chief at Children’s Hospital of Philadelphia. He later joined the Yale School of Medicine, then found his way back to University of Colorado School of Medicine and National Jewish Health, where he has remained for the last 12 years. As the associate dean for Research Development, Johnston created and oversees four committees that the school uses to support research and determine its research priorities.
“He’s indispensable,” said E. Chester “Chip” Ridgway, M.D., executive vice chair of Medicine, Frederic Hamilton Professor of Medicine and senior associate dean for Academic Affairs at University of Colorado School of Medicine. “He approaches everything with grace and never comes to a problem with an agenda. Quite simply, he wants people to give ideas an honest evaluation. His passion is to push process forward and he has done that in spades on this campus.”

Johnston has written and given talks on the subject of ethical decision-making in medical policy and practice and has urged other physicians to question authority and focus on evidence. “This belief is essential to the way I function,” Johnston said. “I really resist being told that ‘this is the truth.’”

Accomplished yet humble

It’s that principle that has made his expertise and opinion a sought-after resource at many of the most respected medical organizations in the nation. He has been president of the Society for Pediatric Research, American Pediatric Society, and International Pediatric Research Foundation and is a member of the Institute of Medicine (IOM) of the National Academies of Science. He has chaired vaccine advisory committees for the FDA and the Centers for Disease Control and Prevention and has chaired seven IOM committees. He received the highest award in academic pediatrics, the Howland Medal, in 2008, in the footsteps of his Vanderbilt teachers and earlier Howland awardees, Amos Christie, M.D., and Mildred Stahlman, M.D.

Throughout his career, Johnston has remained a loyal supporter of Vanderbilt. In 2008, he was honored with the Distinguished Alumnus award, nominated by Adams. Johnston recently joined the Medical Center Advisory Committee for the Vanderbilt University Board of Trust. For his many accomplishments, Adams says Johnston has remained the same warm, unassuming, genuine person he met during their freshman year.

“The gift he brings is the unusual depth of academic research experience at the very highest levels,” he said.

Far more important than his career, Johnston said, is being a father to three and a grandfather to seven. His elder son, Richard, a 1989 graduate of VUSM, is an orthopaedic surgeon and has been a physician for the Atlanta Falcons. His younger son, Claiborne, is a professor of Neurology and research leader at University of California-San Francisco.

His daughter, Kristin, is a pediatric clinical psychologist in Boulder, Colo. Johnston may be inspiring a third generation to pursue medicine. When meeting Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs, during Vanderbilt’s 2010 reunion, two of Johnston’s young grandchildren told Balser they wanted to go to medical school at Vanderbilt.

“If I’ve contributed anything to the world, it’s being half of the parents of three spectacular children and now grandfather to their children,” Johnston said. “That’s the most fulfilling part of my life.”
 

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