Paul Lauterbur and the Invention of MRI

by M. Joan Dawson

  The 10 T project bumped into the controversy of “Big Science versus Little Science” that was raging at the time and that underlined the growing rift among scientists as competition for federal funds became more intense. There was a clamor that big projects such as the SCC, later killed by Congress, were taking away resources from individual investigators. SSC supporters retorted that among other useful things, MRI was a spin-off of their very expensive project, and that MRI stood to benefit from continued work on the SSC. A medical spin-off—great, just what they needed! And there would be other spin-offs as well, all to the good. Nicolaas Bloembergen, then president of the American Physical Society and a Nobel laureate researcher in NMR, blasted this idea. It would all have been a tempest of big egos in a teacup if such large amounts of money were not involved. Paul stayed out of the fray except for posting a Sidney Harris cartoon in the lab. The first panel was the scene of a large industrial laboratory spewing smoke into the sky; it was captioned “little science.” The second panel showed Einstein sitting in a chair with a book and was captioned “big science.”

  April Fool’s!

  Amid all these scientific breakthroughs and rivalries, a transatlantic courtship resulted in our wedding. Paul’s long-contemplated professional move became urgent in 1984 when he and I were married and had a baby on the way. I didn’t dare leave my tenured lectureship in London and come to the United States until I had a job. And we needed to find employment in the same city. The University of Illinois at Urbana-Champaign (UIUC) had been on Paul’s short list even before I met him, and I had visited there shortly before we were married. At the beginning of my job talk, attended by members of my future department, Physiology, I said how glad I was to be at interesting Illinois. The room roared with laughter; people came to Illinois to work, not because it was interesting.

  Paul was well aware that limits in computational technology were stymieing the progress and usefulness of MRI. If you wanted strong computational technology, the University of Illinois was a good place to go. (It is no accident that in Arthur C. Clarke’s novel 2001: A Space Odyssey the intelligent computer HAL introduces himself with the note, “I was born in Urbana in 1997.”) A national center for supercomputer applications (NCSA) was established at the University of Illinois in February of 1985 and Paul was excited about having available what was at the time perhaps the best computing power in the world. And the NCSA, led by Larry Smarr, was eager to collaborate with Paul on real-world applications for the powerful technology NCSA was developing.

  Ben Williams, head of the Pathology Department at the Urbana-Champaign branch of the UI College of Medicine, had spent seven years luring Paul out there. He, like many other nonradiologists, called NMR “no more radiation.” Paul was interested in belonging to a medical school because he needed medical equipment and collaborators, and a small medical school seemed ideal because he wouldn’t be bossed around. He would be the big fish in a little pond. The medical school was interested in Paul largely because of the prestige of such an illustrious appointment. There was the possibility of a Nobel Prize for the invention of MRI, which would certainly bring home some sparkle. (Interestingly, the other person whom Ben also tried to lure to Illinois was Peter Mansfield, Paul’s co-recipient of the Nobel Prize.)

  UIUC was an outstanding campus for scientific research. Important to Paul, the School of Chemical Sciences and the Department of Chemistry were rated perhaps top in the country, as was the Computer Science Department. Chemistry, of course, was his home discipline, and it was unthinkable to go forward without a joint appointment in that department. Ben and Chris O’Morchoe (dean of the College of Medicine) believed that the Chemistry Department would be more than happy to accept Paul as a member. But the head of the department at the time, Jiri Jonas, was angry that he had not been properly consulted, and the appointment did not happen until after Jiri left that post.

  When it was finally made, the offer seemed approximately perfect, and we accepted it on April 1, 1985. An appropriate date, as we turned out to be fools. As the story unfolded, it became clear that the offer was full of holes and Paul’s plans were full of his innate optimism that everything could always be worked out, and not hardheaded reality.

  It is typical that when a university wishes to attract a scientist, an offer is made that specifies salary as well as help in setting up a new laboratory, the “start-up package.” For scientists and engineers who work in areas that require expensive equipment and much laboratory space, the start-up package is much the more important element of the offer. The depth of the university’s commitment to the scientist helps to determine the success of future research proposals both to government and to private research funding agencies. So, negotiation of the start-up package is absolutely critical. The one put together for Paul and me was given major publicity, but it was largely smoke and mirrors.

  Paul needed to be able to do preliminary testing of new ideas, which is often done in model solutions in which the chemistry is known and carefully controlled, followed by investigation of the more promising ideas in animal models and, if all goes well, in human subjects and patients. So he needed three magnets, one for each stage of development. This suite of instruments was also to be the biological NMR facility for the campus and, we were told, would receive campus funding for this purpose. That funding never materialized. Very important was an agreement between Mercy Hospital (now Covenant Medical Center) and the University of Illinois that was to give Paul access to an up-to-date clinical MRI system, which he and his students could use on a liberal basis.

  There was also an agreement that Paul and I would be members of the Department of Radiology at the university’s Chicago campus and would have access to instruments on that campus. This arrangement was based on the fact that its Radiology Department wanted new instrumentation, which could best be negotiated in conjunction with Paul’s recruitment. In fact, purchase of instruments for the Chicago campus was a nonnegotiable part of the start-up agreement. All of these things were promised and noted in the press, but did not materialize. Paul, a man of optimism and trust, did not think to ask for them in writing.

  A New Society

  Edgar Haber, chief of cardiology at Mass General Hospital, donated the idea of founding the International Society of Magnetic Resonance in Medicine. And this is how he did it. In the early 1970s Jerry Pohost, then a cardiologist in Dr. Haber’s department, working with Joanne Ingwall and Eric Fossel of Harvard, became very excited about the electrifying possibilities of NMR spectroscopy to monitor cardiac health—and even more excited once they learned that Paul Lauterbur had just published a paper showing NMR could be used to do cardiac imaging. It would be a good idea, they thought, to look at the literature and invite Paul to cardiology grand rounds. Paul gave a good technical talk on imaging, and those cardiologists with the background to understand were most impressed. Edgar Haber was a very smart man, also very capable of falling asleep during a talk and then waking up to ask relevant questions. After the question period following Paul’s talk, Dr. Haber invited Joanne, Jerry, Eric, Mark Goldman (another cardiologist), and Paul to his office for further discussion over sherry. He sat at his desk. The first question he asked Paul was, “This is all very interesting; where do you think it is all going? “ Paul said, “Well, Dr. Haber, if you had been listening to my talk and not sleeping, you would now know the answer to that question.” The junior people ducked and slid down in their seats. Dr. Haber was soon immersed in MRI.

  Joanne and Jerry kept talking with Dr. Haber as they developed their NMR studies of cardiac function. Professional rivalries were developing quickly in this new field, and the young cardiologists were afraid that radiologists would take over what, in their opinion, should be the realm of cardiologists, physiologists, and multidisciplinary teams. Jerry asked Dr. Haber what they should do. “Do what I always do,” said Haber. “Start a society.” So Jerry and Joanne called Paul for a dinner at the Ritz to talk about it. “How would you like to form a society, P
aul?” they asked him. “I don’t want to start a society unless you help me,” he responded. Of course they could help. A more narrowly focused society was then forming in Houston, and Paul’s concern, like Jerry’s and Joanne’s, was that it could be taken over by clinical practitioners, who would set the agenda. It might become a society for a medical specialty, whereas the people seated at this dinner wanted a society that would embrace scientists of all fields who were developing the technology or applying it for scientific research. So Paul agreed to be its first president, and they started naming people they would like to have on an executive committee. And, oh—they would need money to start a society.

  The Cardiology Department at Mass General had a working relationship with the medical supply company Johnson & Johnson. Jerry went to his friend who was head of new ventures at J&J, and he in turn broached the subject with executives of his company. He later came back to Jerry and said that J&J was prepared to provide the start-up funds. “He gave the numbers and they were pretty good. Enough,” thought Jerry. There was some early, and perhaps mild, effort by J&J to plan the direction of their new society; for example, they wanted Jerry, with whom they were working on NMR research projects, to be the first president. But when Jerry pointed out that Paul was the best-known person in the field, they settled for Jerry’s being a member of the executive committee. J&J hired a lawyer, who wrote the bylaws. Jerry remarked of his meetings at J&J, “I went to the bathroom and everything was mahogany; the walls and everything were mahogany. So I said, this is what executive bathrooms are like.” They certainly had the money he needed. Always frightened of a radiology takeover, the cardiologists insisted on a rule restricting the number of members from any given discipline to no more than one-third of the organization. And thus it began: part idealistic and forward-looking, part professional rivalry.

  When it came to naming the new society, there had been some in favor of “Society of Magnetic Resonance.” Paul had to explain to his colleagues that the field of magnetic resonance was vast and various, and they were a tiny subcategory. It would be like naming your child for a grandiosity he could never live up to.

  Paul preferred the name “SMRI,” but not to please radiologists or out of distaste for his baby being adopted by nuclear medicine. Hal Swartz, an electron spin (or paramagnetic) resonance man, said,

  Although there is a general consensus that the title of the field ‘magnetic resonance in medicine’ was chosen to avoid the word nuclear, Paul has said to me on more than one occasion that his motivation for choosing the name was to make sure that electron paramagnetic resonance was included. Indeed, when the society was formed, there were representatives from both NMR and EPR. There was a proportional representation in terms of the status of the two fields as potential medical applications; that is, there were 17 people from NMR and one from EPR.17

  EPR people sometimes feel unappreciated.

  From this germ, the society prospered as interest in MRI exploded. That interest spanned a wide range of disciplines. Physicists were now working in the area, as were chemists, biologists, biophysicists, computer scientists, engineers, physiologists, radiologists, and other medical professionals. Many scientists were interested in applications of ESR to medical problems, particularly cancer. None of the scientific societies serving these specific fields could become a locus for bringing together all of these people with all of these different backgrounds. They needed the new society devoted to their common interest. The first meeting was planned for August 16–18, 1982, in Boston, for about two hundred participants. The registration line snaked around the block! The hotel had to expand the room three times to accommodate all the people who came. The second meeting was held in San Francisco, and the third in London. The society had eighteen founding members and now has 15,000 members.

  About founding the society, Jerry Pohost reminisced,

  I think that committee, the executive committee was really good. Everybody had a role and worked hard; each one of us became president in turn and was responsible for organizing an annual meeting. But they were all wild-mannered people and there could be real dust ups. I was a little afraid to go the executive committee meetings because I was secretary. Oh, it was so bad; everyone would blame me if the minutes didn’t reflect his own points of view.18

  One of the early decisions of the board was that findings submitted to the annual meeting had to be accompanied by abstracts, which would be peer-reviewed for appropriateness and the most interesting ones chosen. But suspicious lot that we scientists are, some were sure that reviewers, who were also their competitors, were downgrading their abstracts for their own advantage. So a new rule was made: reviewers would not be told who submitted the abstract; names were obliterated with White-Out. But that didn’t make much difference in the early days because we were so familiar with each other’s work we always knew who had submitted a particular abstract. But as the society grew bigger, the White-Out policy tended to have hilarious effects. There was a great deal of respect for Paul within the SMRM, and everyone wanted to hear about his latest work. But the abstracts he submitted anonymously were often rejected. His work continued to be so cutting edge that reviewers sometimes didn’t take it seriously!

  The competing radiological society in Houston, the Society of Magnetic Resonance Imaging (SMRI), was all the while growing in influence. The struggle between the two societies was pretty tough for a while. The SMRI was trying hard to get all of the commercial and industrial sponsorship. After all, while the SMRM had a larger membership, the Houston-based SMRI had the people who would be making the choices to buy MRI equipment. For a few years the two rival societies had separate memberships, separate journals, and separate meetings. Paul explained, “Vendors of magnetic resonance imaging equipment got fed up; they were paying for large chunks of both meetings, and they were traipsing around the world setting up demonstration equipment twice a year. It was all very expensive and they gave an ultimatum: merge or die.” The SMRM absorbed the SMRI, with another membership jump and a name change to International Society of Magnetic Resonance in Medicine, or ISMRM. Jerry Pohost was disappointed. “In my opinion, the Society ended at the time it merged with the other society.”

  Paul continued as a guiding figure for the ISMRM for years to come.

  9

  Among the Corn Fields

  Most of the worst things in my life never happened.

  —Mark Twain

  Let me backtrack a bit to fill in the picture at home. We were married on July 3, 1984, on Long Island Sound, in a garden ceremony on a cliff overlooking the water. Nothing could have been more propitious, except perhaps the date of July 4, which Paul had wanted, so that the whole country would forever celebrate our anniversary. Along with our public vows, Paul promised never to be right when we had arguments.

  Our daughter was born the following year at Stony Brook. You would think that a system as big as SUNY could negotiate a good price on elevators from some major manufacturer such as Otis. But no, the elevators for each of the separate buildings at Stony Brook had to be negotiated separately. And they generally came from small, unknown firms, and generally didn’t work. I went through a difficult labor, and because the elevators at Stony Brook Hospital were not working, as usual, I had to climb several flights of stairs to reach the delivery room! Things got better from there, and we welcomed Elise into our lives. I had expected to furnish a nursery from used furniture shops and garage sales, but Paul had won the Lasker Prize (considered a stepping-stone to the Nobel), and the honorarium provided funds for a lovely little nursery.

  What was life like? Well, busy. A journalist noted that Paul’s desk was piled high with journals and correspondence to review; the telephone rang unrelentingly, and queries from graduate students and the media were all facets of his hectic day. Paul thrived on this life. He enjoyed running his laboratory and serving on committees, local, national, and international. He liked jetting around the world to give talks, and he loved taking part in symposia
. All of these things fed his creativity. But to get done the quiet contemplation that he liked to call “big science,” he worked in the lab at night. I never knew what to do about dinner since he never knew when he would find a stopping point and come home.

  I took care of all matters relating to our home life, because Paul did not do ordinary things well. For example, when I learned that he had left a certificate of deposit in the bank for months after it had matured, sitting there gaining no interest, well, I took charge of our investments. When I found that Paul was paying taxes on reimbursed travel expenses, I took over the taxes. When he called me from halfway between Urbana and Peoria to say that his car had stopped running, and it was because the engine had burned out for lack of oil, I took over car maintenance. What sane person goes for two years without putting oil in the car? It got so bad a friend could say, “She did everything for him and he didn’t notice anything. She would literally have to snatch worn or soiled clothes off him. He could care less.”

  When Paul was courting me he talked about the first-rate laboratory he wanted to build for NMR spectroscopy and imaging. When I said my marriage vows, one was unspoken—to help Paul with this dream. I continued my work on muscle physiology and worked hard to attract collaborators on projects involving NMR spectroscopy of living tissues, and to deliver on my promises. So I did studies of the effect of light on retinal energetics with Tom Ebrey, of temperature on phosphorus metabolites in red cells with John Willis, and of heat shock proteins with Howard Ducoff and uterine smooth muscle with Suzanne Trupin. I thought I could do all of these on the side, and help run the Biomedical Magnetic Resonance Laboratory, too, while really investing myself in muscle energetics. It didn’t work. The output was too low and didn’t have a consistent theme anyone could see. I tried telling people, especially promotion committees, that I was doing comparative tissue metabolism analogous to comparative physiology, but no one would buy it. I was never promoted to full professor. I am wiser now then I was when making those fateful decisions, but I would make most of the same ones anyway.