Washington People: Leonard Bacharier

Looking for answers in childhood asthma

Leonard Bacharier, MD (left), professor of pediatrics and clinical director of the Division of Allergy, Immunology and Pulmonary Medicine in the Department of Pediatrics, talks with patient Amoré Jones during a checkup. “Len is a rare combination of an excellent teacher, a superb clinician and an accomplished clinical researcher,” says Robert C. Strunk, MD, the Donald Strominger Professor of Pediatrics at the School of Medicine. “One of his best talents is giving thoughtful input into ideas that others are developing, always leading to improvement in grant proposals, manuscripts and presentations for national meetings.” (Credit: Robert Boston)

When Leonard Bacharier came to Washington University in 1988 to interview for admission to the School of Medicine, the native New Yorker knew he was in the right place.

“It had a different feel from anywhere else I had been,” says Bacharier, MD, now professor of pediatrics and clinical director of the Division of Allergy, Immunology and Pulmonary Medicine in the Department of Pediatrics. “I was certain at the end of the day that this was where I was supposed to be.”

Not only did he earn a medical degree from Washington University, he completed an internship and residency at St. Louis Children’s Hospital and has been on the faculty since 1998 treating children with allergies and asthma.

At the start of his medical training, Bacharier envisioned his future as an immunologist in a laboratory. During a fellowship at Children’s Hospital in Boston, he discovered a new passion.

“I wanted to be in academic medicine studying allergy and asthma in children, and it became very clear where I was supposed to go and whom I was supposed to call,” he says.

And that person was Robert C. Strunk, MD, the Donald Strominger Professor of Pediatrics at the School of Medicine and preeminent pediatric asthma researcher.

The pair has formed a formidable team seeking clues into childhood asthma. In fact, Bacharier’s first task after joining the School of Medicine faculty was to jump right into the research under way by the Childhood Asthma Management Program, as well as to collaborate with Strunk in applying for a new National Institutes of Health (NIH)-funded network, the Childhood Asthma Research Network, an opportunity Bacharier says most junior faculty don’t get.

“Bob handed this to me and said, ‘Make everything out of this that you can,’” so I ran with it and had a great experience learning from that process and the other researchers in the network,” Bacharier says.

“Len is a rare combination of an excellent teacher, a superb clinician and an accomplished clinical researcher,” Strunk says. “One of his best talents is giving thoughtful input into ideas that others are developing, always leading to improvement in grant proposals, manuscripts and presentations for national meetings.”

Strunk also introduced Bacharier to Mario Castro, MD, professor of medicine and a renowned adult asthma researcher. Since that time, Bacharier and Castro have teamed up on a variety of research projects, looking at both pediatric and adult asthma, including research funded by the NIH and American Lung Association.

“Mario and I have a remarkably synergistic relationship and have found a lot of opportunities to work together,” Bacharier says.

“He thinks differently, and he pushes me to think differently, and we teach each other how to get to the right place, starting from two different places.”

Following his interests

Since an undergraduate earning a degree in biophysics at Johns Hopkins University, Bacharier has been interested in the immune system, which led to his interest in allergy.

“I wanted to spend my time on something that has a major impact on children and society,” he says. “Allergies and asthma fit the bill.”

Asthma is a chronic respiratory disorder that obstructs airflow in and out of the lungs. Nearly 14 percent of children under age 18 in the United States suffer from asthma, and about 75 percent of all people with asthma first develop the disease in childhood, making it the most common chronic childhood illness.

“It can be a really big problem for children, but what’s remarkable is that when asthma is dealt with appropriately, it’s not a problem,” Bacharier says.

“You can make marked improvements in the quality of a child’s life and in a family’s life with appropriate treatment,” Bacharier says. “I love having patients come back and say they are running track now when they never thought they could because they had asthma.”

Bacharier is the clinical director of the Division of Allergy, Immunology and Pulmonary Medicine, the busiest division in the Department of Pediatrics, with more than 11,000 outpatient visits a year.

That’s accompanied explosive growth in the division, which now has 14 faculty, up from four when Bacharier arrived.

“It has been an honor for me to observe — and perhaps encourage a bit — the exceptional growth and maturation of Len from a Washington University medical student to a major national figure in asthma clinical care and research,” says Alan L. Schwartz, PhD, MD, the Harriet B. Spoehrer Professor and head of the Department of Pediatrics.

Looking for answers

While there are treatments for childhood asthma, Bacharier says researchers and clinicians have a lot to learn about the disease, especially in children.

“Children’s asthma is not adult asthma on a smaller scale — it’s a different disease,” Bacharier says. “We can’t assume what we learn in a group of young adults is going to work in a 4-year-old.”

Bacharier is conducting several studies on childhood asthma. He also is a principal investigator for AsthmaNet, a nationwide clinical research network created by the National Heart, Lung, and Blood Institute to develop and conduct clinical trials that explore new approaches in treating asthma in children and adults.

As part of this network, he’s the national principal investigator for two trials looking at whether medication can prevent respiratory infections in young children from becoming more serious.

Bacharier also spends time doing what Strunk did for him: mentoring junior faculty in the division and directing the pediatric allergy and immunology fellowship program.

Remembering priorities

Balancing research, patient care, administration and mentoring could be overwhelming to some, but Bacharier says it’s all about remembering one’s priorities.

“I make it work by being efficient, getting to places on time, paying attention to deadlines and realizing where my priorities lie,” he says. “My priorities to my family are at the same level as everything I do here.”

From left: Daughter Tess; wife, Kristen; daughter Ella Rose; Len; and son, Galen, at the 2011 North American Irish Dance Championships in Nashville, Tenn. (Credit: Courtesy photo)

These priorities also include quality family time with his wife, Kristen, a former nurse, whom he met while an intern at St. Louis Children’s Hospital, and three children: Galen, 13, Ella Rose, 9, and Tess, 7.

All three children are competitive Irish dancers, an activity that keeps the family busy with rehearsals and travel to competitions.

“I spend a lot of time paying attention to dance because it’s what my kids do, and I want to be able to talk to them about what they do,” he says. “So I better understand the difference between a reel and a hornpipe.”

And just as Washington University was the right place for Bacharier as a medical student, St. Louis is the right place for his family.

“Although I don’t like being away from my family in New York, I do like the completely different life St. Louis has offered us,” he says.

“It has allowed me to see that this is a much gentler, kinder way to spend one’s life.”

Fast facts about Leonard Bacharier

Grew up in: Long Island, N.Y.
Book on the nightstand: What the Dog Saw by Malcolm Gladwell
Favorite family getaway: The beach
Favorite solo getaway: Playing golf most Sundays