Welsh receives Kober Medal

Michael Welsh, MD, professor of Pulmonary, Critical Care and Occupational Medicine, received the 2020 Association of American Physicians (AAP) George M. Kober Medal. Joseph Zabner, MD, Director of the Division of Pulmonary, Critical Care and Occupational Medicine, presented the honor to Welsh during the AAP, American Society for Clinical Investigation (ASCI) and American Physician Scientist Association (APSA) Joint Meeting.

To commemorate George M. Kober, MD, the AAP awards the Kober Medal and Lecture every three years to a member of high honor whose research has significantly improved the lives of patients. Kober was the dean of the Georgetown University School of Medicine from 1901 to 1928. Committed to improving public health and disease prevention, Kober also served as the leader of the AAP as well as several other national health organizations.

In his introduction, pre-recorded for broadcast on April 7, Zabner detailed Welsh’s contributions to cystic fibrosis research and patient care. He began by noting that the specialty care unit where most people with CF are treated at University of Iowa Hospitals & Clinics has seen a significant decrease in RVUs (the “relative value unit” measuring a physician’s billable activity) in the last few years. What had happened, Zabner asked, to produce such a precipitous drop in CF RVUs?

Nothing had been seen like that at University of Iowa Health Care since the days of the university-run tuberculosis wards at the Oakdale campus. Effective treatments rendered TB no longer a chronic disease. Zabner noted the coincidence that in 1981, the same year that Welsh joined the University of Iowa, those TB wards were finally closed.

Zabner’s point became clear as he moved into the history of CF and the challenges that existed in treating it. “The only option,” he said, “was lung transplant.” But then, Zabner continued, Welsh was recruited to Iowa by François Abboud, MD, then-Chair of the Department of Internal Medicine. Zabner’s slide quotes the Mishna, which can be interpreted to mean that choosing a mentor well also earns one a valuable and lifelong friend. (And, he noted, Abboud himself won the Kober Medal in 2009. The man who introduced him? Michael Welsh.)

It was Abboud’s support, Zabner explained, that helped clear the path for Welsh to follow a hunch and the science, both of which led him to find the mutations behind cystic fibrosis in the recently identified CFTR gene.

Zabner then detailed Welsh’s discoveries, how the answer to one question led to the next question, from mice to the pig model and then to therapeutics and then, as Zabner had begun his presentation, to that dramatic drop in the numbers of patients coming to the respiratory care unit only just in the last couple years.

“Dayenu,” Zabner explained, is a word used during Passover to detail the many things celebrants are thankful for. “It would have been enough.” And, as Zabner listed Welsh’s many accomplishments that have earned him the Kober Medal, at each bullet, he said, “dayenu,” even just that would have been enough.

Zabner closed by noting his gratitude for Welsh’s mentorship, friendship, and inspiration, noting that he was far from the only one who had come to Iowa because of what Michael Welsh had built.