Clear objectives — Barney Graham leaves Vanderbilt for NIH, but his feet stay planted

Clear objectives —
Barney Graham leaves Vanderbilt for NIH, but his feet stay planted

Barney Graham. It’s an unassuming name, like one you’d read in a Mark Twain story, or one you’d associate with the guy quietly stocking lettuce at the grocery. The name itself doesn’t carry much fanfare, but then neither did the name Jonas Salk before he tested his polio vaccine in 1952.

In his fourth-floor Medical Center North office, Dr. Barney S. Graham, professor of medicine in Infectious Diseases, rises from a leather chair behind a desk – and rises and rises. Finally unfolded, Graham, a head over 6-feet, extends a big paw for a handshake. There’s an easy, studious expression on his face, as if he’s trying to remember the last detail of what he was working on when you walked in, while impressing upon his mind your face and name and for future reference. A quiet “hello” escapes his mouth and a smile emerges. His hair is graying, speaking to his 47 years. He’s wearing a casual short-sleeve shirt and khakis, and you wonder: is this the man to whom the government turned to find an AIDS vaccine as director of clinical trials at the new Vaccine Research Center at the National Institutes of Health?

Unassuming. That’s Barney Graham. Dr. David T. Karzon, professor of Pediatrics, emeritus, says “you’d think he’d be a bombastic man, with all of his skill. But he’s a quiet man. A prince of a man.”

A man comfortable in the midst of the files and journals that tend to pile up on his desk, file cabinets, shelves, and the leather chair and sofa from which he once gave reports in a conference room as a resident and nostalgically rescued from storage when he moved to his current digs. Comfortable in a lab. But perhaps most comfortable at home, where he and his wife, Dr. Cynthia Turner-Graham, just graduated the last of their three children from high school.

He spends an hour and a half with this reporter, talking passionately about his work, brightly about his family, shyly about himself. “I just feel like a very fortunate person who puts one foot in front of the other,” Graham says. “I’m fortunate to work with so many good people. I’ve spent my life asking questions about God’s creation and trying to understand how it works.”

He’s mild-mannered, yet on the national virology stage, as well as throughout Vanderbilt labs, he’s a super scientist.

“We have come to use the term ‘clinical scholar’ rather loosely, but (Graham) is the genuine article,” says Dr. William Schaffner, professor and chair of Preventive Medicine.

Schaffner points to two papers Graham worked on as a resident as “minor classics.” One was about a correlation of different opportunistic infections with varying concentrations of cortisol in patients with Cushing’s disease, the other the evaluation and management of heat stroke. “Just recently I saw the heat stroke article cited again as an exemplar of the best management of this emergency,” Schaffner says.

Dr. John A. Oates, Thomas F. Frist Sr. Professor and former chair of Medicine, says that, on a recent consultation, Graham “didn’t just answer questions or summarize the present knowledge. He went out and got new data. It was an investigator at work.”

Graham showed quiet leadership as a resident, Oates says. He was chosen chief resident at Metro General in 1982, which he calls the best year of his life. The next year Dr. Grant W. Liddle, former chair of the Department of Medicine, tapped him to fulfill a rare second chief residency at Vanderbilt.

After his residency, Graham undertook a fellowship in infectious disease. Karzon set him onto RSV, respiratory syncytial virus. “It’s an important virus. We didn’t know how to work with it or even consider making a vaccine. It’s in a class of its own,” Karzon says. But Graham developed a new mouse model to study the pathogenesis of the virus and the mechanism of viral injury, as well as the host immune response to the virus. The work, Oates says, “provided the basic vaccine strategies.” Graham was simultaneously a faculty member and earning a Ph.D. in microbiology.

From the office in his own lab, Oates sums up his confidence in Graham. “I’ll go out on a limb and say he will be successful with a preventive AIDS vaccine by the end of the decade. He will be in a leadership position worldwide in terms of developing vaccines to prevent HIV, and even possibly using them adjunctively as treatment.”

His arrival

Graham’s career as a physician began at Vanderbilt almost by accident, but his career was shaped as a Kansas farm boy. When he was entering high school, Graham’s father, a dentist, moved the family to a farm in Paola, Kansas, a wide spot in the road about 40 miles south of Kansas City, near the Missouri line. They raised quarter horses, cattle and at one time as many as 2,500 hogs.

“We farmed about 800 acres to grow crops to feed the animals,” he says, and that image of Graham as a produce handler seems not so far-fetched. With his brother and a few hired hands, Barney worked the farm, tended the animals, built and repaired the outbuildings. “I loved the farm, “ he says. “It was one of the best experiences of my life. It taught me ingenuity, independence – we spent half the day fixing something before we could do any work. There was a lot of freedom to build and do things and figure out how to get things done on my own.”

He flourished in sports at Paola High, lettering in football, basketball and golf. He was in the Spanish club, on the yearbook staff, jazz band, National Honor Society , and graduated valedictorian. He was good at math, and interested in it, so he “looked for a small school in a warm climate” and headed to Rice in Houston and graduated Phi Beta Kappa.

While at Rice an interest in biology bloomed. Graham decided on medical school and returned to Kansas. In 1978, he met another medical student, Cynthia Turner, whose father also was a Kansas dentist. The two performed their first medical history and physical examination together as medical students.

“On our first date we were together 14 hours,” Cynthia Turner-Graham remembers. “We went to an outdoor jazz concert, then to dinner, a movie, another jazz club and then to breakfast. We didn’t get bored. We just talked. He was very gentle, with a kind spirit. He was just real. “

Graham says her husband “saw me as an equal. He wasn’t patronizing, but he didn’t cut me any slack, either. Most men had a deference to women. Barney was not that way and still isn’t.”

After three months, the two were engaged. In another six months, in March of their senior year, they were wed. In the meantime they had no luck matching residency programs together. Cynthia wanted to match in pediatrics (she would later become a psychiatrist); Barney in internal medicine. On Christmas Eve, Barney was driving home to Kansas from a rheumatology rotation at the University of North Carolina. He called Cynthia, who had a plan: she could go to Meharry, where her parents both went to school, and Barney could go to Vanderbilt.

“I didn’t know anything about Vanderbilt,” Barney says. But the plan had potential, so he phoned the Department of Medicine for an interview. On Christmas Eve, the department assistant, Debbie Lennon, scheduled interviews with Dr. Grant W. Liddle, the department chair, Dr. Thomas E. Brittingham, who was in charge of residents, and chief resident Dr. Mike Brennan.

“Dr. Liddle wasn’t sure if I would be able to manage the workload at Vanderbilt. They were on call every other night. With Dr. Brittingham, things had gone reasonably OK. As I was leaving, he had asked me about my wife (his fiancée at the time). I turned around and told him, ‘My wife is black. If that makes a difference at Vanderbilt or in Nashville, you need to know that.’”

Brittingham called Graham back into his office. “Later that day, we agreed that if I listed Vanderbilt high on my list, they would take me. I had just stopped by that morning, and by the end of the day I had a deal,” Graham says.

Cynthia had made a similar arrangement with Meharry. The following year, they were two residents with one daughter, Ebone’, from Cynthia’s previous marriage, home together only every sixth night and both gone together every sixth night. But as his career grew, Barney Graham the scientist didn’t abandon his role as father. He and Cynthia have a son, Daniel, a junior at Morehouse, and a daughter, Anne Margaret, beginning her freshman year at Tulane in the fall. Graham coached baseball and went with the family to church. “Barney was there,” Cynthia says. “He was present.”

Coming of age

In 1987 the federal government established a network of research sites to test HIV vaccines. At the time, Graham was working with Dr. Peter Wright, professor of Pediatrics who also works in the Infectious Disease division, mostly on RSV. Wright was tapped as principal investigator at Vanderbilt’s AIDS Vaccine Prevention Unit. Wright asked Graham to help out.

“He told me it would take about 15 percent of my time,” Graham recalls, raising an eyebrow and smiling wryly. “It really has taken more than 15 percent of my time.”

But, he says, “It was an opportunity Dr. Wright provided for me that changed my whole career.”

Coincidentally, Graham had diagnosed one of the first two cases of AIDS in Tennessee as a chief resident at Metro General in 1982.

He’s fascinated by biology and its impact on human health. He’s motivated, he says, by discovery. “It’s a very addictive process.”

Now, he says, “HIV is a virus that, in my mind, is the greatest biomedical challenge in the past century, if not ever.” He rattles off worldwide AIDS statistics as if rehashing the facts of an unsolved case: More than 40 million people are infected with HIV; 21 million AIDS-related deaths; 16,000 new infections daily; 13 million AIDS orphans by 2010.

“If you’re a viral immunologist, you are compelled to try to make a contribution to solve that problem.”

“Barney has already played a very important role,” in AIDS vaccine research, says Wright, who became Graham’s closest colleague and another mentor. It seems fitting that he step up to the next level, compelled by the complexity of the virus and motivated by altruism to help the tens of thousands of people infected by HIV each year.

In the worlds of people affected by HIV and AIDS, one moment is often recalled as their “Remember the Alamo!” In a June 1997 commencement address to Morgan State University, President Bill Clinton asked the nation to commit to developing a vaccine against AIDS. The speech sparked the beginning of the Vaccine Research Center, Graham’s new home, where he will lead HIV vaccine clinical evaluations and continue his work on RSV.

Wright and Dr. Paul Spearman, assistant professor of Pediatrics (Infectious Disease), will carry on HIV vaccine research at Vanderbilt.

One measure of Graham’s success, Karzon says, is his ability to attract talent. Just as Graham admires and appreciates his mentors, he has in turn cultivated another generation of scientists. In fact, he’s taking a clutch of young researchers with him to NIH – Teresa Johnson, Manoj Pastey and Tiffany Alley, all postdocs with Graham; Dr. Lewis McCurdy, an infectious disease fellow; and John Rutigliano and Philip Budge, two graduate students who will complete their dissertations at NIH but receive Vanderbilt degrees. “They’re following him like a Pied Piper,” Karzon says.

Staying the same

Cynthia Graham says her husband probably is surprised by his appointment to NIH. “Somewhere deep inside he might have some idea (of his success). But it’s not important to him,” she says. “He doesn’t take himself too seriously. He wants to do well and represent his program well.

The parallel between Graham and Salk is strong – two scientists working to heal the world from a devastating virus. But Graham is part of a larger team and there are international as well as national aspects to the vaccine search. And, Wright suggests, the discovery of an HIV vaccine will be a collaborative effort, not Barney’s alone, although this will not diminish his contribution to forward the effort.

There’s probably another difference. It’s doubtful that Salk had as many people cheering him on as Barney Graham does. No amount of NIH status can change the fact that Barney Graham is more than a scientist – he’s unassuming, a nice guy, like the one at the grocery.

“We’re going to miss the hell out of him,” Oates says.