The Shwachman Award of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition 2002: Presentation (2003)

I am deeply honored and privileged to present Buford L. Nichols, Jr. as the 2002 winner of the Shwachman Award given by the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition. Buford is my mentor and my friend. Buford Lee Nichols, Jr. was born on December 21, 1931. His father was a Baptist minister, and the family lived in Junction, Texas for the first few years of his life. Growing up in a small town in central Texas was difficult for Buford since his mother did not dress him in cowboy clothes like the rest of the children. Buford tells me that he frequently had to fight his way down the street. Undoubtedly it was here that he learned the tenacity and persistence that has characterized his career (Fig. 1).FIG. 1.: Buford Lee Nichols, Jr., M.D. Photo credit: Adam Gillum.In 1936, at the age of five, Buford moved with his family to China, where his father accepted a post as a missionary. They lived for two years in Peking and then moved to Kaifeng on the Yellow River. World War II interrupted the family's stay in China, and they returned to Texas in 1940. In 1946, after the war, Buford and his family returned to China. It was here that he finished high school. Buford made the high school football team. He told me, however, that he did not consider this a tribute to his athleticism, since only 11 students understood the game well enough to try out, and all made the team. In 1949, the communist Chinese expelled the Buford family from China as Mao Tse Tung overran Mainland China. Upon returning to the United States, Buford enrolled at Baylor University in Waco, Texas. There he majored in Sociology and Religion intending to become a minister. During his senior year he was given an assignment as a student pastor at a small Baptist church near the town of Cameron, Texas. As Buford puts it, the congregation fired him. Buford was devastated. His dream of being a minister like his father was destroyed, and he was not sure what to do with his life. While in college, he met Veda, his future wife, who was in nursing school. She was training in Galveston, so Buford followed. With time on his hands, he attended medical school classes with friends from Baylor who had entered the University of Texas Medical Branch in Galveston. He found that he liked medicine and applied to Baylor University College of Medicine in Houston, Texas. To his surprise, he was accepted. It was there that his research career began. During his first two years of medical school, Buford took a year off to get a Masters degree in Physiology and Biochemistry under Roger Guilleman, who became his scientific mentor. Roger Guilleman ultimately received the Nobel Prize in 1978 for his work on hypothalamic hormones. Throughout his career, Buford has worked with outstanding mentors and colleagues. It was Roger Guilleman who convinced Buford to finish his medical education in the east. Thus, in 1958, he transferred to Yale University for his last two years of medical school. He wrote his thesis on ACTH, working under C.N.H. Long, who is well known for his work on glycogen metabolism. After an internship at Yale, he did a two-year residency in Pediatrics at Johns Hopkins. There, after blowing up an endocrine laboratory during an experiment—which embarrassed him immensely and forced him to look for another mentor—he joined the laboratory of Dr. Harold Harrison and worked on magnesium metabolism. After his residency, he returned to Yale, where he became chief resident in pediatrics under Nelson Ordway. His interest in diarrheal diseases undoubtedly was influenced by both Doctors Harrison and Ordway. Buford's research career began in earnest when he was recruited to Baylor College of Medicine in 1964 to become the Associate Director of the General Clinical Research Center and House Staff Director of Texas Children's Hospital. To date he has published 256 manuscripts—166 original papers, 255 abstracts, and 11 books. Buford has made a significant impact on both Pediatrics and Pediatric Gastroenterology. I would like to share just a few of his accomplishments with you. Perhaps because of his early work in adrenal physiology, Buford has always maintained an interest in mineral metabolism. He wrote two seminal papers on potassium. The first defined intracellular potassium in the normal child, and the second described the importance of potassium in the recovery from malnutrition. I remember the second paper well. I believe that it went through at least ten drafts before anyone but Buford could understand it. It, however, was the first paper that showed how important potassium is during the refeeding of malnutrition, a concept that is considered routine at the present time. Because of his love of minerals in the body, Buford became an avid mineral collector. He is happiest chipping away on some godforsaken rock in some godforsaken part of the world to expand his collection. Buford's interest in potassium led to an interest in body water. An early paper in Nature, written by Buford and Carlton Hazelwood, described the physical state of water inside the cell as seen by nuclear magnetic resonance. This research became extremely controversial because it led to a theory called the association induction hypothesis that challenged the role of the ATP-dependent sodium pump. The pumpers and nonpumpers fought so much within the peer review system that the fight made its way into both the United States Congress and Time magazine. The pumpers won the fight, but a man by the name of Ray Damadian took this research in a slightly different direction and won the Nobel Prize for his role in developing an imaging technology that we now know as MRI. Malnutrition in children has always influenced Buford's research, perhaps because of his missionary roots. To learn more about this problem, Buford spent some time at the University of the West Indies in Jamaica, working with John Waterlow and other major players in the field of nutrition such as Champ Alleyne, Ann Ashworth, and Fernando Viteri. Many papers on malnutrition resulted, several of which were published in Nature. He also developed a lifetime friendship with John Waterlow. His interest in malnutrition took Buford to Mexico, where he developed a long-term collaboration and friendship with Al Parra. I came into the picture at this time, for it was then that I started my fellowship under Buford. The only reason I did a fellowship with Buford was that he promised that I could spend my first four months of fellowship in Mexico. Again, a series of definitive papers resulted from this collaboration, this time on energy metabolism and the endocrine effects of malnutrition. Buford brought his interest in malnutrition back home and began to study intractable diarrhea of infancy or what we called acquired monosaccharide intolerance or the slick gut syndrome. This was a very common disease in Houston at the time and as the understanding of the etiology and treatment of this condition developed due to Buford's research, the mortality rate of pediatric patients at the city/county hospital in Houston was cut in half, and the disease has virtually disappeared. Buford's interest in diarrhea led him to examine the effect of chronic diarrhea on the digestive capacity of the disaccharidase enzymes in the intestinal tract. Knowing that he could follow this line of research only through a better understanding of molecular biology, Buford did an amazing thing. At the age of 63, he took it upon himself to learn the entirely new discipline of molecular genetics. As part of this training, he spent time in the laboratories of Erwin Sterchi in Switzerland. This resulted in a paper describing his successful cloning of the ma1tase glucoamylase gene, which was published when Buford was 67. Don't you hope you will have that kind of staying power? And you haven't seen anything yet. The recent papers he published in the October issue of JPGN concern the relationship of this gene to chronic recurrent abdominal pain in children. There is another part of Buford's career that will have an impact for many years to come. In 1972, he became convinced that the Agriculture Research Service of the United States Department of Agriculture should increase its presence in studies of human nutrition. He envisioned U.S.D.A.-funded human nutrition research units strategically placed throughout the U.S. to complement those in Beltsville, Maryland and Grand Forks, North Dakota. To do this, he became a lobbyist and began talking to people such as Jack Hightower, then chairman of the House Appropriations Committee, and Senator Lloyd Benson. His low-key Texas lobbying style served him well, and he was able to unite the Texas delegation and have legislation written into the federal appropriations as a line item that funded this venture. Even though the first research building to be built went to Boston thanks to the skill in pork barrel politics of Tip O'Neill, the second building went to Houston and to Buford. After formally opening the Children's Nutrition Research Center building in 1985, Buford began to fill it with premier nutrition scientists from all over the world. Two of those scientists, Peter Klein and Peter Reeds, sadly have passed away. Buford became Director Emeritus of the CNRC in 1993, but his impact on the world of nutrition research will continue for generations through the continuation of this institution that he founded. Buford has been very active in the training of others, and has trained 27 fellows and numerous visiting scholars over the years as either a part of his fellowship training program or more recently in his laboratory. I cannot speak about Buford without speaking about his family. He married his wife Veda in 1953. Veda is Buford's anchor, his rock. She is with him always and has been his support in both bad times and good times. Buford has three lovely daughters, Beth, Susan, and Carol, of whom he is very proud. All three are happily married and have presented Veda and him with seven grandchildren to dote over. Summers now are spent at his cottage in Colorado and since it has been recently winterized he tells me he will now be sneaking off for winter vacations as well. It is here that I am sure Buford does his best thinking. I could go on for hours about Buford. I have anecdotes and stories that could probably fill a book. However, it is far more important that you meet the man himself. Ladies and gentlemen, let me present to you the 2002 Shwachman award winner, Buford Lee Nichols, Jr., M.D.