2014 Science, Technology and Environment

William A. Bauman and Ann M. Spungen

Greatly improved the health care and the quality of life of paralyzed veterans by developing new ways to treat long-overlooked medical problems.

It was chance that brought them together, but what sealed the deal was their burning desire to build a program to help paralyzed veterans.

Dr. William A. Bauman was a medical researcher and internist specializing in endocrinology at the Department of Veterans Affairs (VA) hospital in the Bronx. Ann. M. Spungen, an applied physiologist, worked with Bauman on a respiratory function study using sophisticated equipment in veterans with spinal cord injury, a disabled population with numerous medically incapacitating conditions. When Bauman explained his dream of learning how spinal cord injuries caused many parts of the body to work poorly, Spungen quit her job and joined him.

During their nearly 25-year-long collaboration, Bauman and Spungen have paired science and clinical practice, studying every organ system in affected patients. Along the way they produced novel medical advances and drug therapies to improve the lives of those with spinal cord injury.

“William Bauman and Ann Spungen have led a team of talented doctors in internal medicine, neurology, rehabilitation medicine, physiology and molecular biology to address many of the largely neglected but highly relevant issues that have faced those with spinal cord injury,” said Dr. Erik Langhoff, director of the James J. Peters VA Medical Center.

“They have been focused on investigating what goes wrong with the body after spinal cord injury and have developed innovative approaches and effective interventions to improve the health and quality of life for persons who are paralyzed,” he said.

In 2001, Bauman and Spungen established the VA’s Rehabilitation Research & Development National Center of Excellence for the Medical Consequences of Spinal Cord Injury, where Spungen most recently tested a new bionic walking assistance system that enables individuals with paralysis to stand, walk and climb stairs.

As part of their collaboration, Bauman and Spungen have made great strides in our understanding of the effects of spinal cord injury on the body.

Their work led to the realization that persons with spinal cord injury are at a markedly increased risk for heart disease. These investigators were the first to describe and then treat an asthma-like lung condition common in those with higher levels of paralysis. They have developed approaches to make it easier for paralyzed patients to undergo successful colonoscopies.

With other researchers in their unit, they have formulated novel drug combinations to raise low blood pressure, and they have overseen the development of animal and clinical treatments to reduce bone loss shortly after spinal cord injury. Their work has advanced our understanding and treatment of chronic, non-healing pressure ulcers. Investigators under their direction also are making strides toward improving our understanding of body temperature regulation and the effect of swings in body temperature on one’s ability to think.

“Not long ago, a spinal cord injury was tantamount to an early death sentence, not because of the immediate effects of a paralyzing injury, but because of the many medical complications that followed,” said Dr. Michael E. Selzer, director of the Center for Neural Repair and Rehabilitation at Shriners Hospitals in Philadelphia. “Now these patients have an almost normal life span and a greatly improved quality of life.”

Selzer described Bauman as “the single most important scientist and physician leading the way to improved medical management of persons with spinal cord injury,” while Langhoff said Spungen has “made seminal contributions to spinal cord injury medicine.”

Bauman has worked at the Bronx VA hospital for 35 years, starting in the laboratory of the late Rosalyn Sussman Yalow, a physicist and Nobel Prize winner. Bauman made up his mind from the start to devote himself to patients with spinal cord injury, who at the time were largely marginalized and overlooked by physicians with training in general medicine.

“I would say our center’s greatest accomplishment has been to identify problems in persons with spinal cord injury that no one had appreciated prior to our work, and then to develop successful approaches to solve them. Prior to our work, many of these problems were not realized to be important, or were ignored because it seemed that nothing could be done to improve them,” Bauman said.

Spungen said she can recall being captivated by the sense of civic duty pervading Bauman’s energetic sphere of medical research activity at the hospital.

“I got to the VA and met these incredible scientists and investigators who were here working for the veterans and who so intelligent, open were and kind. I just became enamored with the entire atmosphere and dug in, and have been here ever since,” she said.

Robert Ruff, national director for neurology at the Department of Veterans Affairs, said the work of Bauman and Spungen has had a wide-ranging impact.

“The research is relevant not only to people with spinal cord injury, but to a larger population who are immobilized, from those with ALS to cancers, muscular dystrophy, multiple sclerosis, dementia or Parkinson’s disease,” he said.