Rochester Medicine

Alumni News: Answers on Ice

Jul. 8, 2013

Warren Zapol conducts groundbreaking research in Antarctica

Warren Zapol Last November, when Warren M. Zapol (M '66) appeared as a witness before a U.S. House Congressional Science committee hearing on the country's Antarctic Research Program, he didn't wait for lawmakers to pose the first question. "Why is an anesthesiologist talking to you about research in Antarctica?" Zapol began his testimony.

The answer lies swaddled in newborn nurseries throughout the nation. Every year, about 15,000 hypoxic newborn babies are saved by a technique inspired, in part, by Zapol's work with seals 800 miles from the South Pole.

"Allowing scientists to explore in Antarctica leads to unanticipated discoveries," Zapol continued, urging lawmakers to solidify America's leadership in scientific exploration of the Earth's southernmost continent.

As an undergraduate student at Massachusetts Institute of Technology in the early 1960's, Zapol did not envision a future that would include at least nine Antarctic expeditions, repeated Presidential appointments to the US Arctic Research Commission, and an Antarctic glacier named in his honor. Instead, he planned on being an engineer. While taking an advanced biology course, however, he developed a passion for physiology. A short time later, the New York City native obtained a scholarship to attend the School of Medicine and Dentistry.

"Rochester was quiet as a social town," he recalls, "but what a fabulous place to focus on learning medicine."

Zapol buckled down and studied, taking occasional breaks to enjoy Rochester Philharmonic Orchestra concerts. As he was preparing to graduate, many of his peers were being drafted to serve in the Vietnam War. When he failed to get a deferment to complete his residency, Zapol sought a position with the U.S. Public Health Service at National Institutes of Health (NIH). It was a peaceful alternative to military service, but the competition for fellowships was fierce.

"They had their pick of us," Zapol says. "Stanley Prusiner, Joseph Goldstein, and others who went on to win the Nobel Prize were there. It was a hotbed of aggressive, young researchers."

Zapol landed in the Laboratory for Technical Development of the National Heart Institute at the NIH Clinical Center, where he worked in a prestigious, multi- disciplinary team addressing respiratory distress in adults and newborns. He went on to receive his anesthesiology training and join the staff at Massachusetts General Hospital (MGH), where he remains today. During the course of his fledgling career, he watched hypoxic babies die in the hands of doctors who didn't yet have the tools or techniques to put adequate oxygen into their tiny bodies. He saw mechanical ventilation fail to improve their hypoxia. These are the kind of experiences that led him to the bottom of the planet.

"I was at an American Association for the Advancement of Science meeting, and there was a report about research in Antarctica. There was a presentation on Weddell seals, and how they could hold their breath for an hour during deep dives in cold seawater. I was so focused on lungs, and collapsing lungs, and making lungs effectively breathe that I just had to gravitate there."

Fortunately, Zapol's chief at MGH, Richard J. Kitz, M.D., responded with enthusiasm. In 1975, Zapol found himself on a U.S. Navy aircraft on his way to "The Ice." It would be the first of nine expeditions. Each year, Zapol gathered a multi-disciplinary team of hearty scientists who could withstand the frigid temperatures and isolation. Their research has involved the invention of underwater microchip computers to record the vital signs of diving seals and capture arterial blood samples, staring down an occasional Weddell bull who adamantly refused to dive, and performing pelvic exams to document pregnancy in Weddell females. "Several times, those of us holding the rear flippers to steady the seal feared that obstetrician Mont (Sir Graham C. "Mont" Liggins, M.D., Ph.D.) would experience a traumatic arm amputation when the seal realized what this human was attempting..." he wrote in Anesthesiology.

In the midst of all this adventure, the Zapol teams gained extensive insight into pulmonary circulation. He says his Antarctic research helped lay the groundwork for what he considers his most significant achievement to date: employing inhaled nitric oxide to treat newborns with respiratory failure. A team at MGH, assembled by Zapol, was instrumental in early studies leading to widespread use of this therapy for persistent pulmonary hypertension.

"We first tried it in newborn lambs, and one day we tried it in our first baby. I remember turning that blue baby pink within seconds, and it knocked everybody's socks off," he recalls. "Now it's not an experiment. You will get sued if you don't treat a hypoxic newborn with nitric oxide."

Zapol's work with Weddell seals also caught the attention of the U.S. Board of Geographic Names. In 2006, the board named an Antarctic glacier after him, in honor of his accomplishments studying the seals and newborn babies.

More recently, President Barack Obama reappointed Zapol to the US Arctic Research Commission, a post he was first selected for by President George W. Bush. In this role, Zapol works with natives in remote villages throughout Alaska. He focuses on their mental health and other medical issues such as water and sanitation problems. He says his Antarctic training helped prepare him for this endeavor as well.