TIBURON, CA — Dr. John A. Clements, a distinguished figure in pulmonary research, passed away on September 3 at the age of 101 at his home in Tiburon, California. His groundbreaking work in the 1950s transformed the understanding of lung function and directly contributed to the development of life-saving treatments for premature infants suffering from lung failure.
The news of Dr. Clements’ death was confirmed by his daughter, Carol Clements.
A Trailblazer in Pulmonary Research
In 1949, shortly after graduating from Cornell University Medical College (now Weill Cornell Medical College), Dr. Clements joined the Army as a physiologist. It was during this time that he became fascinated by the mechanics of human breathing. He pondered a crucial question: how do the millions of tiny air sacs in the lungs deflate without collapsing, similar to a balloon?
Dr. Clements hypothesized that a chemical substance must be present to reduce the surface tension within these air sacs. His research led to the identification of this crucial substance, known as surfactant, which acts similarly to household detergents in its ability to reduce surface tension.
In a landmark 1956 paper, Dr. Clements used a rudimentary instrument of his own design to demonstrate the presence of surfactant in human lungs. His findings laid the groundwork for further research into its role in neonatal respiratory health.
The Link to Premature Infants
In 1959, Dr. Clements’ advisory role proved pivotal when two Harvard researchers identified a significant link between surfactant and neonatal respiratory distress syndrome (RDS). They discovered that premature infants, who were particularly vulnerable to RDS, often lacked sufficient levels of this vital substance in their undeveloped lungs. RDS was the leading cause of neonatal mortality in the United States during the 1960s, accounting for approximately 10,000 deaths annually.
One of the most notable cases was that of Patrick Bouvier Kennedy, the infant son of President John F. Kennedy and Jacqueline Kennedy, who died shortly after birth due to RDS. The urgency of the situation drove a global effort to find effective treatments.
Development of Synthetic Surfactants
Following the revelation that premature infants were often deprived of surfactant, researchers began a worldwide search for viable treatments. Some experimented with surfactants derived from animal sources, such as sheep and cow lungs. However, Dr. Clements expressed concerns about the safety of using animal-based surfactants in fragile infants.
In response to a request from the neonatal unit at the University of California, San Francisco, where he served as a professor of pulmonary biology and pediatrics, Dr. Clements embarked on the ambitious task of developing a synthetic surfactant.
“It sounds incredibly naïve, or maybe really arrogant,” Dr. Clements reflected in a 2017 interview. “But I said, ‘Well, I’ll make one for you’—trying to accomplish in a few weeks or months what had taken millions of years if you believe in evolution.”
His efforts culminated in the creation of the first synthetic lung surfactant. This breakthrough was licensed to the drug manufacturer Burroughs Wellcome and Company, leading to the development of Exosurf, the first replacement surfactant approved for clinical use by the FDA in 1990.
Although subsequent research showed that animal-derived surfactants were more effective, the impact of Dr. Clements’ work was profound. Today, infant deaths from RDS in the United States have dropped to fewer than 500 annually, a remarkable reduction that can be traced back to his contributions.
Recognizing His Legacy
In recognition of his groundbreaking work, Dr. Clements received the prestigious Albert Lasker Clinical Medical Research Award in 1994. The citation noted his discovery as “widely regarded as the most important discovery in pulmonary physiology in the last 50 years.”
Dr. Jordan U. Gutterman, who oversaw the awards, praised Dr. Clements for bridging the gap between basic research and practical application. “It’s an incredible story of one man who looked at a problem, studied the physiology, and then solved it,” he stated in a New York Times interview.
True to his philanthropic nature, Dr. Clements donated the $25,000 prize money from the award to UNICEF, further emphasizing his commitment to improving child health worldwide.
Early Life and Education
John Allen Clements was born on March 16, 1923, in Auburn, New York, the youngest of four children. His parents, Harry and May Victoria (Porter) Clements, encouraged his early interest in science. As a child, he conducted various experiments, including constructing a Tesla coil, which attracted the attention of local authorities for interfering with neighborhood radios.
Dr. Clements took advantage of an Army-funded accelerated program to complete his undergraduate degree and earn his M.D. from Cornell in just five and a half years. After graduating in 1947, he began working at the Army Chemical Center in Maryland.
In 1949, he married Margot S. Power, a talented classical singer who performed with prestigious orchestras. She passed away in 2022. In addition to their daughter Carol, Dr. Clements is survived by another daughter, Christine Clements.
A Lasting Influence
In 1959, Dr. Clements joined the faculty at the University of California, San Francisco, where he trained generations of physicians and researchers in his pulmonology lab. His mentorship and guidance significantly shaped the field of pulmonary medicine.
Even after retiring in 2004, Dr. Clements continued to work at the university, driving to his office two or three days a week. Well into his 90s, he remained active in research and mentoring. He maintained a unique routine, parking in the same spot for 50 years—a testament to his focused dedication to his work.
Carol Clements remarked on her father’s unwavering commitment to his research, noting that his steadfast parking spot exemplified his deep focus and dedication.
Conclusion
Dr. John A. Clements leaves behind a remarkable legacy that has saved countless lives and transformed neonatal care. His pioneering research not only solved critical mysteries of pulmonary function but also paved the way for innovative treatments that continue to benefit premature infants today.
As the medical community reflects on his extraordinary contributions, Dr. Clements will be remembered not only as a scientist but also as a compassionate advocate for child health. His work serves as an enduring reminder of the profound impact that one individual can have on the lives of many.
