Since 1936, this charitable organization has followed in the caring footsteps of its famous namesake.
When most people think of Will Rogers, they most likely picture the vaudeville entertainer who went on to star in numerous motion pictures during the 1920s and early 1930s. Yet one of the most important roles Rogers played never made it to the silver screen: that of goodwill ambassador and philanthropist for numerous causes.
Pulmonary research is just one area that has benefited because of Will Rogers’ commitment to helping improve the lives of others. His example was the inspiration for the Los Angeles-based Will Rogers Institute, a national charitable organization dedicated to understanding pulmonary diseases and disorders.
A Legacy Of Caring
Rogers’ legacy began in 1936 when the Will Rogers Hospital was established in a small town in upstate New York a year after Rogers died in a plane crash. The hospital was designed to help entertainers suffering from tuberculosis (TB) and promote pulmonary research on TB and other lung diseases. The hospital grew into a leading treatment center for TB and was instrumental in helping find a cure for the disease. The hospital was eventually closed in 1975 and the research projects that had taken place there were continued at Burke Rehabilitation Hospital in White Plains, NY.
The Burke Rehabilitation Hospital research center is now just one of four research laboratories funded by the Will Rogers Institute. The others are located at the University of California Los Angeles School of Medicine; the New York Hospital Cornell Medical Center, in New York City; and the University of Southern California School of Medicine, in Los Angeles.
“Each of these state-of-the-art laboratories focuses on a different aspect of pulmonary research and the treatment of debilitating lung diseases,” says Todd Vradenburg, executive director of the Will Rogers Institute. According to Vradenburg, all of the funds needed to support these laboratories are raised through the Will Rogers Institute’s annual audience collection campaign in movie theaters across the nation. This time-honored tradition began in 1936 when movie stars Jimmy Cagney, Humphrey Bogart, and Bette Davis urged audiences to contribute to the fund in a movie trailer. Throughout the decades, a number of celebrities, including Cary Grant, Henry Fonda, John Wayne, Frank Sinatra, and, most recently, Mel Gibson, have participated in the campaign, which raises approximately $2 million annually for pulmonary research and treatment programs.
The University of Southern California
The research laboratory at the University of Southern California, under the direction of Edward Crandall, PhD, MD, Hastings Professor and chairman of the Department of Medicine, has focused on the molecular biology and cellular physiology of pulmonary disorders. Specifically, Crandall, who serves as medical advisor of the Will Rogers Institute, and his research team have studied pulmonary edema and lung injury. “In terms of pulmonary edema, we have discovered that the sodium pump can help save lives by removing water and dissolved substances from the air spaces, thereby restoring the normal function of the lung,” Crandall says.
Crandall’s research team has also studied the growth, differentiation, and transformation of type 2 alveolar epithelial cells into type 1 alveolar epithelial cells. “We have discovered one of the regulating factors that controls the process of growth differentiation,” Crandall says. “Our objective is to learn enough to guide the impaired lung toward normal healing and prevent undesired injuries.”
Approximately 15%200of Crandall’s research is funded by the Will Rogers Institute; the remainder is supported by the National Institutes of Health (NIH), the American Heart Association, the American Lung Association, and several private
According to Crandall, RCPs who treat patients in the hospitals associated with each of the four Will Rogers Institute research laboratories occasionally participate in the research activities. “Respiratory therapists typically plug into the research process in a clinical way,” Crandall says. “For instance, in gene therapy experiments with cystic fibrosis [CF] patients, respiratory therapists are generally involved in the care of the patients.” He adds that in some rare instances, RCPs are actually involved in specific research projects as a part of their training or career. “In either case, working in such an environment provides a considerable amount of interest and excitement,” Crandall says.
Burke Rehabilitation Hospital
Under the leadership of principal investigator Henry M. Thomas, MD, director of the Pulmonary Research Laboratory at Burke, a research team has been studying the vascular properties of the lung, particularly hypoxic vasoconstriction and its regulation. “My interest has been in how to improve oxygenation by improving blood flow through the lungs,” Thomas says. “Our long-term goal is to get patients off portable oxygen earlier.”
In addition to helping support Thomas’ research activities, the Will Rogers Institute has also helped fund Burke’s inpatient respiratory unit. Funds were initially provided to help the hospital acquire pulmonary equipment, and an ongoing commitment from the Will Rogers Institute provides financial support for a part-time outpatient rehabilitation coordinator in the pulmonary unit.
Burke Hospital’s inpatient pulmonary unit is extremely busy with only six RCPs caring for about 10 to 15 patients for 3- to
4-week periods. Patients are primarily treated for chronic obstructive pulmonary disease, and are usually transferred from acute care hospitals where they received care for serious intrinsic lung diseases or other diseases that resulted in respiratory complications.
the inpatient pulmonary unit at Burke.
Novitch points out one thing that differentiates pulmonary rehabilitation from other forms of rehabilitation: the strong emphasis on education. “Much of our effort is placed on training our staff and then getting our staff to train our patients and their families,” Novitch says. The Will Rogers Institute has always focused heavily on patient education and research, which is why it has helped support Burke Hospital’s pulmonary program over the years.
According to Karen Jordan, RRT, director of respiratory care, the RCPs work 7 am to
5 pm shifts, and an on-call system is in place evenings and weekends. “Each therapist is assigned to a specific patient from the time they’re admitted to the time they’re discharged,” Jordan says. “The therapists primary responsibilities include taking blood gas measurements, monitoring pulmonary function tests, and then following through on the educational needs of patients and their families,” she says. The outpatient rehabilitation coordinator position, which is supported by the Will Rogers Institute, is responsible for providing therapy to four or five higher-functioning patients 3 days a week. Patients who have completed their inpatient or outpatient pulmonary rehabilitation are also enrolled in the hospital’s Pulmonary After Care Exercise (PACE) program, which is offered twice a week with minimal supervision.
RCPs at Burke are integral members of the patient rehabilitation team, which consists of the physician, physical therapist, occupational therapist, nurse, recreational therapist, and social worker. Team meetings are held each week to discuss the patient’s progress and goals.
Jordan explains that each of the RCPs currently working at Burke has worked in acute care hospitals. “The opportunity to work with patients in a very personal way and to help them achieve independence with their self-care is something that appeals to many therapists who have formerly worked in acute care settings,” Jordan says.
One thing that sets Burke Hospital apart from other institutions, Novitch says, is that pulmonary rehabilitation is provided in an inpatient setting. In most areas of the country, pulmonary rehabilitation is conducted primarily in an outpatient setting, and the patient’s physiological impairments are less severe. “What’s interesting here is that we take people with the most severe physical impairments and we help them get back into their communities,” Novitch says. “That’s our primary challenge, and it’s extremely rewarding for our rehab team when we succeed.”
Over the years, the Will Rogers Institute has recognized Burke Hospital’s track record in helping improve the quality of life for its patients, and the Institute continues to provide funding to help support the pulmonary rehabilitation program. “We have always enjoyed working with the Will Rogers Institute since it’s not only interested in the future in terms of research, but is also concerned with what we can do now to help people afflicted with lung diseases,” Novitch says. “Traditionally, pulmonary rehab has been underfunded, so philanthropy plays a huge role in helping enhance our services.”
Cornell Medical Center and UCLA
The Will Rogers Institute began supporting the research work of Ronald Crystal, MD, chief of the division of Pulmonary and Critical Care Medicine at New York Hospital Cornell Medical Center, in the early 1990s. Initially the funding was channeled to support gene therapy research in CF. Crystal’s research team led the first clinical trials involving CF patients, and although the research resulted in interesting findings, it also revealed additional research was needed before future clinical trials could succeed.
In addition to CF research, Crystal’s laboratory is carrying out research on the following projects: gene therapy for solid tumors, cardiovascular disease, and hematological disorders; adaptive and innate immunity against adenovirus; promoters to control gene expression following in vitro gene therapy; and new vaso vectors for gene therapy.
Under the direction of Tomas Ganz, PhD, MD, professor of medicine and pathology at the University of California Los Angeles School of Medicine, the Will Rogers UCLA Pulmonary Research Laboratory is studying natural defense mechanisms against respiratory infection. When the ability of the respiratory system to resist infections is impaired, as with CF, chronic bronchitis, and AIDS, respiratory infections are the major cause of decline in lung function. Ganz’s research team has been studying resistance to infection by the production of natural peptide antibiotics, called defensins. Specifically, Ganz and his team have found some evidence that the defensins in CF patients may be inactive or damaged, which is part of the reason they have so many destructive lung infections at such a young age.
In addition to supporting the four research laboratories, the Will Rogers Institute has also funded pulmonary research fellowships at many major medical institutions, including the University of California, San Francisco, the University of California, San Diego, Harvard University, the University of Toronto, Northwestern University, the University of Texas, and the University of Pennsylvania. The fellowship program was suspended last year, however, because of financial constraints. “These fellowships were very important in advancing pulmonary research and helping train the new leaders of pulmonary research,” Crandall says. “We hope the Will Rogers Institute can fund these again in the near future.”
A Vital Research Resource
Although each of the pulmonary research laboratories receives funding from a variety of sources including the Will Rogers Institute, the scientific investigators concur that the Will Rogers’ funding plays an especially vital role in their endeavors. “It represents the kind of funding that allows the laboratories to take risks in their research,” Crandall says. “It allows us to explore ideas that may be considered premature or unrealistic for NIH funding.” In other words, NIH funding today requires grant proposals for projects that are almost certain to achieve success. To accomplish this, Crandall points out that a researcher needs to have ideas completely developed and supported by preliminary data, which sometimes tends to suppress creativity.
“The Will Rogers Institute funding, as well as other types of funding from private foundations, is really valuable in allowing investigators to pursue the kernels of ideas –findings that might lead to spectacular results or may lead us down a blind alley,” Crandall says. “It’s the type of work that, without which, the NIH type of proposal could never be written.”
Carol Daus is a contributing writer for RT. r