Giants in Chest Medicine |

Giants in Chest Medicine: Professor James C. Hogg FREE TO VIEW

Manuel G. Cosio, MD
Author and Funding Information


ADDITIONAL INFORMATION: See video interview of Professor Hogg online at journal.publications.chestnet.org.

McGill University, Montreal, QC, Canada and Univerity of Padova, Italy

CORRESPONDENCE TO: Manuel G. Cosio, MD, Department of Cardic, Thoracic and Vascular Sciences, University of Padova, via Giustiniani 3, 35100, Padova, Italy

Copyright 2017, American College of Chest Physicians. All Rights Reserved.

Chest. 2017;151(4):746-748. doi:10.1016/j.chest.2016.11.061
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Sioux Lookout, where Jim Hogg grew up, is a very small place in Ontario, Canada. It is cold there, very cold, but that did not deter young Jim Hogg from his ice hockey daily practice. He was persevering at it to become a legendary hockey player, his dream and the dream of every young kid in Canada. However, one day the coach killed his dream “…you are not going to make it Jim…you are not good enough.” Bad for Jim, good for the rest of us because with steely resolve and mama’s helpful “advise” he placed his energies into studying. Study he did and eventually joined the Canadian Air Force in order to finance his medical studies, with the idea of becoming a general practitioner. His tutors and “coaches,” Joe Doupe and Rubin Cherniack in Manitoba and then Charlie Brian in Toronto, with whom he started doing some research, had a different feeling about him: “You are good Jim, you are going to make it and big. Go to Montreal and work with the best, Peter Macklem and William Thurlbeck, the leading authorities in lung physiology and lung pathology.”

Arriving in Montreal, he promptly started working in COPD, an entity that was barely understood when Jim, along with Macklem and Thurlbeck, began working out its underlying mechanisms in the mid-1960s. Using his newly acquired special combination of expertise in lung physiology and pathology, along with curiosity, hard work, and perseverance, he tackled the obscured pathophysiology of COPD in an attempt to define the basis for the reduction of flow in the disease. Jim used the sophisticated retrograde catheter technique to measure the small airways resistance of excised human lungs to elegantly demonstrate how in normal lungs the small airways contributed minimally to the total flow resistance, whereas they contributed to most of the resistance in lungs with COPD. These findings meant that the site of the reduction in flow in COPD was not in the large airways, as was believed, but in the small airways, the lung silent zone, which was a revolutionary finding and a change of paradigm that guided Jim’s research for the rest of his life.

His studies on the resistance of the small airways in early childhood, along with the importance of this finding in pediatric lung disease and how airway conductance increases after 5 years of age were also fundamental.

During his time in Montreal, he excelled not only in his academic endeavors, promptly becoming a full professor, but also in his personal strengths, his inspirational character, his leadership and team-building abilities, his contagious enthusiasm and adventurous spirit—all tamed down, and because of it enhanced—by his great humility, and by being a “very nice guy,” which makes him a great role model. I, along with many of the fellows he trained, can surely attest to that.

The time came to prove his adventurous spirit along with his leadership and team-building abilities. Recruited to the University of British Columbia in Vancouver in the late 1970s, where there was no pulmonary research or space for it for that matter, he was able in a few years to build the so called “The James Hogg iCapture Center for Cardiovascular and Pulmonary Research.” The center now has 33 principal investigators who in the past 5 years have trained 597 research fellows from 31 different countries.

His work trying to understand the underlying mechanisms of lung diseases, and COPD in particular, has continued all along using progressively more sophisticated and accurate technologies in morphometry, molecular biology, and, lately, cutting-edge genetic and computational techniques. Jim is always prepared to change with the times in the most productive way—highly unique and unusual.

His latest publication using micro-CT scanning in human lungs has probably finally answered the question of why airway resistance is so increased in COPD by showing how in this disease, a high proportion of the small airways, up to 90%, are narrowed and eventually obliterated, which would account for an important reduction of the cross-sectional area of the small airways increasing the resistance to flow and the consequent clinical symptoms these patients exhibit. With his contributions, Jim Hogg has arguably had a greater influence on the medical community’s knowledge of COPD and asthma than any other individual worldwide. However, probably his most important legacy is the number of other scientists he has drawn into the field over the years and the way he has helped to maintain enthusiasm for work on a disease that defies easy solutions.

Of course he has had a few prizes and honors—24 since 1974: Officer of the Order of Canada, Chugai Award for Excellence, The Canadian Hall of Fame Inductee, Canada Gairdner Wightman Award, among many others. His reaction to those prizes is always the same: “I never expected to get it. I never expect to get any of the awards I’ve won. Actually always comes as a bit of a surprise.”

He recently told me “I never planned to keep working till I was 80, but here I am and I am quite enjoying it.” He had 11 papers published in 2015 and eight in 2016.

Thank you Jim. Please keep on going.

I encourage all to view the interview to hear Jim’s words of wisdom (Video 1).

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