3 doctors awarded $500,000 MacArthur Foundation grants

One rainy night in August, 17 years ago, D. Holmes Morton II, MD, pulled his car off the highway to think about where his life was headed. Former teachers at Harvard Medical School told the pediatrician that moving to Lancaster County, Pa., would end a bright career in academic medicine. Some Amish and Mennonite families were skeptical about his plan to open a clinic in their community, and Dr. Morton had his own reservations.

With perseverance, his Clinic for Special Children opened a few months later and found a home in a farming community in Strasburg, Pa., treating Amish and Mennonite children afflicted with genetic diseases. During a benefit auction last month for the clinic, he remembered that dreary day of doubt and how far he and his practice had come.

The clinic has reduced child mortality from genetic diseases, and Dr. Morton's research has influenced how physicians around the world diagnose and treat patients with such diseases. Part country doctor with a bushy moustache and part researcher with a passion for discovery, Dr. Morton has been honored numerous times, including the Albert Schweitzer Prize for Humanitarianism in 1993.

He's not sure how he will spend the $500,000 he's getting from the MacArthur Foundation for being one of 25 fellows honored last month for innovative work in medicine, science and other areas. He is one of three physicians -- along with John A. Rich, MD, MPH, and Atul Gawande, MD, MPH -- who will receive the award money, no strings attached, over the next five years.

"I really take it pretty seriously as a challenge to do something that I couldn't have otherwise done," Dr. Morton said.

He doesn't consider the fellowship a reward for past work but an opportunity for future endeavors. He plans to continue treating patients and searching for new insights into rare diseases. And he wants to establish a continuing medical education course for pediatricians to learn about genetics and see the clinic in action.

"That's one thing that will happen from this [fellowship]," he said.

Improving black men's health

Dr. Rich was surprised when he got the call from the foundation about his fellowship. He said he likely would use the money to continue his work addressing the health needs of African-American men in urban settings.

"It's quite a gift. It's a blessing," said Dr. Rich, professor and chair of the department of health management and policy at the Drexel University School of Public Health in Philadelphia. "It's part of my responsibility to take time and figure out what to do with it."

The foundation said Dr. Rich's work with African-American men has influenced policy discussions and health practice in the United States. In 1993, he created the Young Men's Health Clinic at what is now Boston Medical Center. The clinic provides primary care to young men in the inner city.

In 1995, he developed the Boston HealthCREW, a program that trains young African-American men to serve as community outreach educators on health issues.

"After adolescent care, men tend to fall out of [the health care system]," Dr. Rich said. "Our goal was to get those people back into [health] care."

Innovations inside, and outside, the OR

In selecting Dr. Gawande as a MacArthur Fellow for 2006, the foundation cited innovations such as the surgeon's work in designing bar codes on sponges so they can be counted accurately to reduce the risk of being left in patients. Dr. Gawande said the fellowship will mean changes in his life, allowing him to place new emphasis on his efforts as surgeon, researcher and writer.

He said he may trim his surgical caseload and devote more time to writing, which he now squeezes in nights and weekends. He writes for The New Yorker and the New England Journal of Medicine.

"It's having the financial support and sort of the moral support that what I'm doing outside of surgery is as worthwhile as what I'm doing inside of surgery," said Dr. Gawande, a surgeon at Brigham and Women's Hospital in Boston and assistant professor at Harvard Medical School and the Harvard School of Public Health.