John H. Eisenach, M.D., recipient of the 2008 Presidential Scholar Award.

IN 1995, the National Institutes of Health (NIH) Director’s Panel on Clinical Research met to review the status of clinical research in the United States and to make recommendations about how to ensure effective continuance. In the same year, John H. Eisenach, M.D., finished his first year of medical school at the University of Colorado (Denver, Colorado), expanding the scope of his premed research experience in microbiology to investigate physiologic disease states. John accepted the challenge of developing a rat model of acute lung injury after mesenteric ischemia–reperfusion. Before starting his second year, John had proven that inhaled nitric oxide during gut ischemia improved endothelium-dependent pulmonary artery vasodilation and reduced lung neutrophil accumulation. From there, a fondness for integrative physiology and a natural interest in anesthesiology was born. Dr. Eisenach graduated from Colorado in 1998, at which time the formative recommendations by the NIH Director’s Panel were instituted under the initial program announcement “K23: Mentored Career Development Award in Patient-Oriented Research. ” This award formed an important part of the NIH initiative to attract and retain talented individuals to the challenges of patient-oriented research. For residency, Dr. Eisenach selected the Mayo Clinic in Rochester, Minnesota, because of the long-standing tradition of human and integrative physiology research, and also because of the small-town lifestyle reminiscent of his upbringing on a farm in Fort Morgan, Colorado. He immediately planned a research rotation under the mentorship of anesthesiologist Michael J. Joyner, M.D., an internationally recognized expert in the autonomic control of the circulation and the responses of humans to mental and physical stresses. Dr. Joyner is a direct “academic descendent” of John T. Shepherd, M.D., M.Ch., D.Sc., Mayo Emeritus Professor, former president of the American Heart Association, and cofounder of the Mayo Medical School. Dr. Shepherd “descended” from Henry Barcroft, M.D. (1904–1998), who initially characterized nervous control of muscle blood flow by showing that patients undergoing sympathectomy for hyperhidrosis had an initial marked increase in limb blood flow but that the flow returned to normal over several weeks’ time, a phenomenon that is still unexplained today. Barcroft’s famous father (Sir Joseph) described the oxygen hemoglobin dissociation curve a century ago. Why is this relevant? Because under the watchful eyes of Dr. Joyner and Dr. Shepherd, Dr. Eisenach’s first investigation during residency demonstrated that in patients who had previously undergone sympathectomy for hyperhidrosis, endothelium-dependent and -independent forearm vasodilation was similar to controls, although the sympathetically mediated forearm vasoconstrictor response to lower body negative pressure was essentially abolished in the patients. This also highlights the generational continuity in human physiology research at the Mayo Clinic for more than 50 yr. During the same residency research rotation, Dr. Eisenach assisted in the first human study to report that after 5 days of a controlled normal sodium diet, single nucleotide polymorphisms in the 2-adrenergic receptor ( 2-AR) gene influenced the forearm vasodilator response to intraarterial administration of a -adrenergic receptor agonist, and the effect was dependent on the generation of endothelial nitric oxide. Combined with the work in the sympathectomy patients, this formed the scientific foundation for a career development research application, and soon after the NIH implementation of * Associate Professor and Chair, Department of Anesthesiology, College of Medicine, Mayo Clinic, Rochester, Minnesota. narr.bradly@mayo.edu