© 2004 American Thoracic Society
E. J. Moran Campbell, 1925–2004Department of Medicine, McMaster University, Hamilton, Ontario, Canada Correspondence and requests for reprints should be addressed to Norman L. Jones, M.D., Department of Medicine, McMaster University, Hamilton 3U1, 1200 Main St. West, Hamilton, Ontario, L8N 3Z5 Canada. E-mail: jonesn{at}mcmaster.ca Dr. Moran Campbell, Founding Chairman of Medicine at McMaster University, 1968–1975, died on April 12, 2004, after a long battle with colon cancer. He was an outstanding scientist, physician, and educator, achieving a worldwide reputation as the foremost clinical respiratory physiologist of his generation. He changed how respiratory medicine was taught and practiced. Moran was born in 1925, the son of a Yorkshire general practitioner. In 1950 he obtained his medical degree at the Middlesex Hospital Medical School in London, and shortly after began research in the Department of Physiology at the same institution. He used the new technique of electromyography, together with pressure and volume measurements to provide the first comprehensive description of the mechanical events during breathing and the neural mechanisms that control the respiratory muscles. His book The Respiratory Muscles and the Mechanics of Breathing (1958) remains the seminal work on these topics. In it Moran developed a diagram (universally known as the Campbell diagram) that remains the standard tool for partitioning work of breathing. After a year at the Johns Hopkins University with Dr. Richard Riley, the foremost researcher in pulmonary gas exchange, Moran returned to London in the late 1950s. He applied the new techniques for measurement of blood oxygen and carbon dioxide pressures to patients with respiratory failure. He documented their blood gas derangements and formulated a new approach to treatment. Central to this approach was the careful control of inspired oxygen concentration to avoid carbon dioxide retention. Both the measurement of carbon dioxide pressure and the administration of small but precise increases in oxygen concentration presented obstacles, but Moran developed novel techniques to overcome them. To achieve precise increases in inspired oxygen concentration, he developed a mask into which a jet of pure oxygen was delivered using a precisely machined nozzle; this led to a reduction in pressure surrounding the jet (the Venturi effect), which thereby drew in room air through holes in the neck of the mask, precisely diluting the oxygen to achieve a small increase in concentration. The "Ventimask" has remained the standard of care ever since, and the approach received worldwide acceptance, and doubtless profited the manufacturer to an incomparably greater extent than the inventor (the only remuneration he ever received from the manufacturer was a free briefcase). He summarized his new ideas when he delivered the Burns Amberson Lecture at the Annual Meeting of the American Thoracic Society in 1967. The principles enunciated in this published lecture (Am Rev Respir Dis 1967;96:626–639) remain the cornerstones of care in respiratory failure. During the late 1950s, Moran became intrigued by breathlessness. He began with a series of studies in which breathing was impeded in healthy subjects by elastic and resistive loads. With Dr. Jack Howell he developed a theory of length/tension inappropriateness, which was based on a complex understanding of muscle and neurophysiology. This work paved the way for investigators right up to the present time, notably, his pupil Dr. Kieran Killian. Moran's achievements were celebrated in an international symposium, held at McMaster in 1991 (Breathlessness 1991; the Campbell Symposium). More than 50 trainees and fellows from around the world worked under Moran's supervision, leading to many advances in our knowledge of various aspects of basic and clinically applied pulmonary physiology, including mechanisms controlling breathing in health and disease, the control of acid–base homeostasis, body carbon dioxide storage capacity, the indirect, noninvasive measurement of cardiac output during exercise, and clinical application of exercise testing. His preeminence in the field was recognized by his appointment as Editor-in-Chief of Clinical Science in the early 1960s; he guided this journal (the equivalent of the Journal of Clinical Investigation in Great Britain) through many changes in format and process, thus modernizing the journal into a form that it retains to this day. Moran was an outstanding educator, being especially effective in Socratic teaching. Although best remembered for his teaching at the postgraduate level, and for the weekly Grand Rounds at the Department of Medicine, he was deeply interested in undergraduate education and provided much guidance as the curriculum of the McMaster program was developed. Education, not training, was his credo. In the early 1960s, he authored Clinical Physiology, the standard undergraduate textbook that has remained current through many editions. Moran was a man of great intellect. He was the master of the telling phrase and could be very critical: for example, of research that he considered more technological than thoughtful ("if a project's not worth doing, it's not worth doing well"), or of medical practice ("Doctors in intensive care units would do better if they were less intense and more careful"). He employed humor to great effect, as seen in the titles of some of his papers ("Is pK OK?" and "RIpH"), and he was not above humorous—but well designed—studies ("On the probability of a committee meeting," "Ability to detect whisky (uisge beatha) from brandy [cognac]"). Moran courageously described his struggles with manic–depressive illness in the book Not Always on the Level; first recognized by a fellow medical student, the bipolar nature of his personality was an advantage in his early career, but later became a great burden. He could destroy a committee meeting or seminar, and eventually his manic behavior led to his being hospitalized. In his book, Moran analyzed these features of his illness with his customary insight and humor. His favorite author was James Joyce; several chapters contain Joycean passages written in mania, with a more sober subsequent commentary. Outside of medicine, Moran's interests were wide and varied. He loved literature and music, sports, and cottage vacations. A lifelong cyclist, he lobbied hard and successfully for cycle paths in and around Hamilton. He could not have achieved or accomplished what he did without the dedicated and loving support of Diana, his wife of 49 years, and their four children, Fiona, Susie, Robert, and Jessica. His colleagues have established a fund in his honor, to provide for The Moran Campbell Senior International Fellowship in Medicine (McMaster University Downtown Centre, Room 125, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada). FOOTNOTES Conflict of Interest Statement: R.N. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. Received in original form May 29, 2004; accepted in final form June 1, 2004
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