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Bruce Levy at the Brigham: New Ways to Look at Medical Problems and Medical Education

The building Bruce Levy, MD, works in at the Brigham and Women’s Hospital (“the Brigham”) in Boston has a particularly apt name: the Hale Building for Transformative Medicine.

As a researcher, Dr. Levy has helped to create a new paradigm for understanding inflammation in respiratory disease and has patented small molecule therapeutics and smart inhaler technologies. As a medical educator, he created a mentorship program for interns and residents that became a model for other teaching hospitals. And as an associate editor at the New England Journal of Medicine, he helped create the popular Interactive Medical Case Series.

“One of the most exciting aspects of working in academic medicine today is thinking about the science and art of medicine,” says Dr. Levy, who is chief of pulmonary and critical care medicine at the Brigham. “I am surrounded by colleagues passionate about improving access to care, understanding disease better, and developing transformative treatments.

His own research in severe asthma is a testament to the passion he finds at the Brigham and the power of challenging scientific dogma.

Discovering How Inflammation Resolves

Instead of focusing on the pathways that are the engines of inflammation, Dr. Levy’s research has focused on the molecular and cellular brakes on inflammation. In the process, his laboratory provided the first definitive evidence that inflammation is resolved not when the engine runs out of gas, but when other mediators, signals, and pathways bring run-away inflammation to a halt.

“Bruce’s research was seminal,” says Raja-Elie E. Abdulnour, MD, assistant professor of medicine at Harvard and a pulmonary and critical care physician at the Brigham. “When I joined the lab as a fellow, it was an oddity to go to a conference and hear researchers talking about treating inflammation by promoting resolution. Now a huge number of people are studying resolution.”

The first “braking” mediators Dr. Levy worked on with his research mentor, Charles N. Serhan, PhD, were lipoxins. Dr. Serhan’s lab was the first to identify lipoxins and the pro-resolving mediators resolvins, protectins, and maresins, along with their receptors.  Dr. Levy has focused on the production of these specialized pro-resolving mediators in the lung and their signaling mechanisms in the context of lung health and catabasis. His lab is now looking at the cellular targets and effectors for these resolution mediators, including natural killer cells, innate lymphoid cells, regulatory T cells, and macrophages, that play a role in restraining lung inflammation.

Translating Discoveries to Help Patients

From the beginning, Dr. Levy has wanted to take his basic science discoveries and translate them into patient care. His laboratory has created in vivo and in vitro models that allow researchers to study the post-inflammatory response in health and disease, including asthma, COPD, bacterial pneumonia, viral infections, and acute lung injury.

“All the projects in Bruce’s lab address questions important to patients,” says Melody Duvall, MD, PhD, instructor of pediatric critical care and anesthesia at Harvard and a critical care physician at Boston Children's Hospital who joined Dr. Levy’s lab four years ago.  Bruce is a model for how to conduct research that will help the patients we care for.”

In addition to his leading work on specialized pro-resolving mediators and their potential as new therapeutics in asthma and other respiratory diseases, Dr. Levy worked with a trainee to create a prototype of a smart inhaler that monitors patient use wirelessly. The technology, which he licensed to a company to develop further, detects patterns of usage that indicate patients are headed for an exacerbation so that a provider can “intervene early and reduce adverse outcomes.”

Mentors, Interactivity in Medical Education

Dr. Levy has also worked to advance medical education. He created a mentoring program for all internal medicine interns and residents at the Brigham and Women’s Hospital that addresses the diverse needs of trainees who come from medical schools around the country and, in some cases, the world. The non-evaluative program, which has been widely emulated, is “highly structured but flexible,” with a focus that evolves as the trainees progress through their program.

Another program at the Brigham that Dr. Levy started provides educational grants to faculty, fellows, and residents to improve training programs at the hospital or conduct research on teaching and learning.  
For many years, Dr. Levy taught a course for Harvard medical students on caring for homeless veterans. The course grew out of his own experience beginning as a fellow at the Brigham of providing volunteer care to homeless veterans and the knowledge that about a third of the nation’s homeless are veterans.

Dr. Levy says he wanted students to understand the importance of caring for our veterans, especially those having difficulty reintegrating into civilian society.  “The students would immediately appreciate that these sheltered homeless patients were like so many of the veterans they meet at the VA medical center or at their teaching hospital,” Dr. Levy explains, adding that homeless patients often neglect medical problems in the search for the basic necessities of shelter, food, and clothing.  “In caring for their patients, I wanted students to  learn how important it is to ask whether a patient has a safe place to live.”

Dr. Levy is also the co-founder of the New England Journal of Medicine’s Interactive Medical Case Series. Each case draws tens of thousands of students and clinicians worldwide who go online to solve an actual case at the Brigham. The participants receive information about the patient at a pace that mirrors a real clinical experience. Many of these cases are then solved by a master clinician and published in the Clinical Problem Solving section of the printed journal. Dr. Levy created an in-person version of the series at Harvard to help MD/PhD students maintain and further develop their clinical skills during their research training.

Beyond the Brigham

Dr. Levy’s work extends beyond Harvard and the Brigham. He is an ad hoc reviewer for more than 20 journals, a frequent grant reviewer for the NIH and co-chair of the NHLBI’s 2015 Asthma Strategic Plan, and a member of a dozen medical and scientific societies. Away from the Brigham, he considers the ATS his professional home and is grateful for the mentoring and leadership opportunities the Society offered him. He is currently serving as chair of the Society’s Publications Policy Committee.

Despite his many responsibilities and the many honors he has received, those who work with him say, Dr. Levy is very approachable and takes a personal interest in others.

“People who reach Bruce’s level of success and leadership tend to be battle hardened, but Bruce is a tremendously thoughtful, respectful, and considerate guy,” Dr. Abdulnour says, adding that Dr. Levy is “extremely empathetic” about the demands of family life. “He has allowed me to be very productive professionally while prioritizing my family.”

Dr. Levy, himself, is married, and he and his wife, Sally, have two children, Shoshana and Jacob, whose love and support, he says, “enable my efforts for my patients, trainees, faculty, and colleagues at the Brigham and the ATS.”