under the sun -=*=- B
INSIDE THIS SECTION:
? Sporfs, Pages 8-10
K Fishing Report , 1 1
Dwham.IOL?GIST UZZIE J HARRELL> a Shallotte native, is on sabbatical this year from Duke University Medical Center, learning the latest lab techniques for molecular biology at aether lab
CONTHIBUTED
in
SHALLOTTE NATIVE CONSIDERED AN EXPERT IN HER FIELD
Lizzie Harrell:
Waging Quiet
War In The
Laboratory
Editor's Note: This story is a slightly edited version of a
story that appeared in the January 1993 issue of NCSU
Alumni Magazine. Reprinted with permission. News
Editor Susan Usher contributed to this story.
BY DEE SHORE
In Ociobcr 1957 all attention turned skyward as the
Soviet Union launched the Earth's first artificial
satellite. Half a world away, young Lizzie Johnson
hallotte launched a dream of some day being a sci
entist, of helping others by exploring a world impossible
to find or measure with the unaided eye.
Today the young dreamer is known as Dr. Lizzie J.
Harrell, and the world she explores is not the vast uni
verse of stars and planets. Rather, it is the tiny but just as
complex universe of bacteria, fungi and parasites she
sees through the microscopes in Duke University Med
ical Center's microbiology laboratory in Durham.
Harrell, an associate medical research professor of
microbiology, teaches in Duke's medical school and
leads the laboratory's bacteriology section. A diplomate
of the American Board of Medical Microbiology, she is
recognized as being an expert in her field.
Harrell's job requires the inquisitiveness of a detec
tive and the tenacity of a warrior. With little more than a
blood sample, a swab from a wound or a piece of tissue
obtained in an operating room, Harrell must figure out if
a microorganism is causing a patient's illness, and, if so,
which of thousands of microorganisms it is. Then it's
her job to suggest antibiotics to destroy it before it has a
chance to destroy the patient.
With Duke's reputation as one of the nation's leading
research and teaching hospitals, patients come there
?".om hundreds of miles around. Oftentimes they are the
sickest of the sick, suffering from the most puzzling ail
ments.
"We have patients who are referred here after they've
been to their family physicians or community hospitals,
and they still aren't getting well," Harrell says.
"They come from as far away as New York or
Florida. And if they come here and an infectious process
is found, then our laboratory is the one that is called up
on to try to identify the microorganisms causing the in
fections.
"I would venture to say that there are very few places
in the world where one would see a larger variety of dif
ferent microorganisms than we see here."
For that reason, the work of Duke's microbiology lab
is all the more important. An unusual microorganism
that is found there will likely be found later in other hos
pitals, she says, and any information she can share about
her lab's findings can save other labs time and money
and, most important, can save lives.
Harrell's lab is tuckcd off Duke Medical Center's
beaten path. It is a gleaming, busy place filled with the
increasingly complex instrumentation that is transform
ing the field of clinical microbiology. Under the direc
tion of Harrell and three other section heads, 30 or so
technicians work amid anaerobic chambers, computer
screens and high-powered microscopes.
Harrell is at home here. She moves easily from one
workbench to another, chauing with the technologist,
offering them guidance based on more than 20 year.; of
experience in microbiology labs.
She points to a plate speckled with salmon-colorcd
lumps. These, she explains, are bacterial colonies grown
from a sample taken from an AIDS patient with pneu
monia.
In 1984, when her lab found the bacterium, technolo
gists had difTicully identifying it. By testing it, they de
termined it was Rhodococcus equi, a bacterium com
monly found in horses. Up to that point, the microorgan
ism had been reported in only 12 people.
With the spread of AIDS, the number of patients in
fected by the bacterium has increased. Harrell published
her findings in a clinical microbiology journal, and she
has traveled halfway across the country to discuss tne
findings with her peers.
Such information exchange is crucial to helping cure
disease and stem its spread. And, at a time, when bacte
ria seem to be transforming faster than ever, it is becom
ing even more crucial.
One of the major challenges facing Harrell and other
clinical microbiologists is an onslaught o? new drug-re
sistant bacteria dial cause infections. Such resistance
poses particular problems for hospitals, where up to a
third of die patients are taking antiobiotics.
The development of agents to kill harmful bacteria
croorganism to the hospital's infection-control team so
that they might act to avoid spreading a resistant bacteri
um from one patient to the next.
Also, Harrell and other faculty members meet daily
with the hospital's infectious diseases physicians, dis
cussing their lab's findings and encouraging them to pre
scribe antimicrobials selectively so that antibiotic resis
tance doesn't develop.
More recently, Harrell has taken up the topic of an
timicrobial resistance as a special area of her research.
By publishing findings early, microbiologists believe
that they might be able to head off the spread of resis
tance genes.
Part of her research involves testing new drugs. "As
resistant bactcria emerge, I like being able to analyze
new antibiotics to see what is still available for treat
ment," Harrell says.
The high-tech lab from which these significant find
ings emerge at Duke seem light years from her first
home, where her interest in science was sparked.
"I like things that give me a challenge
where I can see something happen and I can
ask the questions, 'Why did this occur? How
can I investigate?'" _
? Lizzie J. Harrell
transformed medicine in this century, allowing doctors
to prevent some infections, to cure others and to slow
the spread of some diseases.
But as each potential lifesaving drug was introduced,
bacteria caught on, throwing up a barrier to the drug.
Today, such antimicrobial resistance has reached a level
that one National Institutes of Health adviser has callcd
epidemic. And the epidemic is a costly one in terms of
both lives lost and money spent.
Tests to determine whether a microorganism is sus
ceptible to the usually prescribed therapy may take
hours or days after the isolation of a specific bacterial
agent, so the possibility of complications ? or death ?
arises. Also, the substitution of newer and more expen
sive antimicrobial agents for drugs to which organisms
have become resistant increases the cost of medical care,
as docs the increase in morbidity associated with such
infections.
According to Science magazine, "having to cycle
through drug after drug to find one that will kill a pa
tient's resistant bug adds between $100 million and $200
million a year to the nation's medical bill."
Experts have warned that neither drug companies nor
the federal government has mobilized to the extent need
ed to combat the drug-resistant bugs. So the job of deal
ing with antimicrobial resistance falls in large part on
clinical microbiologists such as Harrcll.
At Duke, Harrell discourages the development and
spread of drug-resistant bacteria in several ways. She
and the technologists in her lab strive to make rapid di
agnoses so that the correct antimicrobial agents are pre
scribed, and they pass along findings about resistant mi
Bom in Shallottc, it was here that she first earned a
reputation as a scholar, her desire to please her teachers
at the former Union High School drawing her further
and further into academic pursuits. And it was here that
learning about Sputnik 1 made her determined to focus
those pursuits on science.
"I think my interest in science was sparked when
Russia sent up the first sputnik Everywhere on the news
the emphasis was o? science, science.
"And I remember as a high school student, my cousin
Allene Johnson taught me chemistry. Her being my
cousin made a greater impression, though all of my sci
ence teachers were excellent. Overall 1 had excellent
teachers in all areas."
"I was just fascinated watching her go through all the
chemical reactions. There was never any doubt in my
mind that some area of science was where I wanted to
be," Harrell recalls.
"I like things that give me a challenge ?where I can
see something happen and I can ask the questions, 'Why
did this occur? How can 1 investigate? Let me apply the
scientific method."'
Though Lizzie's parents, Etta Gore Johnson of Supply
and the late James Henderson Johnson, lived modest
lives and weren't college educated, they wanted some
thing better for their children.
"When I was working on the farm, I always knew,
and my parents knew, that 1 would go to college,"
Harrell recalls.
In 1961 she left Shallottc for N.C. Central University
in Durham, to study biology.
"It wouldn't have been possible for me without the
federal student loan program ? that's why I urge stu
dents to pay those loans back, so that opportunity will
continue to exist for others."
After graduating with honors she went to Newark,
Del., to work in pharmaceutical research for DuPont, an
alyzing specimens from animals that had been given ex
perimental drugs.
After three years there she decided she wanted to con
tinue her education. Her experience at DuPont had
piqued her interest in microbiology, and, with her hus
band, Sampson, studying mcdicinc at the University of
North Carolina at Chapel Hill (UNC-CH), she knew her
life would be spent around hospitals. So the clinical side
of microbiology seemed a natural career choice.
After earning a master's degree in bacteriology and
immunology at UNC-CH and working in the infectious
diseases lab at a Veterans Administration hospital in
Washington, D.C., for 2 1/2 years, Harrell came to N.C.
State University in Raleigh in 1975, receiving her doc
torate in microbiology in 1978.
Her subsequent career has resulted in a 13-page vitae
that is sprinkled with evidence of he desire to help oth
ers. That desire extends beyond her job. Sandwiched be
tween listings of the hospital committees she's served on
are mentions of her work as a mentor for minority stu
dents interested in scicncc and her work as a youth
leader at her church.
Between listings of professional lectures with tides
such as "Characterization of four beta laclamase-posi
live ampicillin-resistant enterorocci isolated from blood
cultures" are speeches titled "Preparation for Careers in
the Sciences" and "Clinical Microbiology ? What is
It?" ? lectures geared to junior and senior high school
students.
On top of all this, she spends time with her son,
Kendal, a 1992 N.C. State computer science graduate
now employed as an assistant systems analyst in com
puter graphics at SAS Institute in Research Triangle
Park.
"1 love children," says Harrell. "1 think that stems
from my childhood, being from a large family and trying
to be a mentor for younger members of my family, says
Harrell, the oldest of 13 children.
Often Harrell is asked why, with her scientific
prowess and her love of people, she didn't choose med
ical school.
'The laboratory was more to my liking than was
working directly with patients," she answers. "1 know
that I am doing something to help someone, even though
I do not deal onc-on one with the patient.
"I feel more comfortable being behind the scenes."
Presently Harrell in on a year-long sabbatical from
Duke, working at a laboratory in Durham which is affili
ated with both Duke University Medical Center and the
Veteran's Administration Hospital.
'This is very convenient for me not to have to move,
to be able to stay here with my family." she said.
"Everything I need to learn is available right here."
The arrangement allows her to learn the latest labora
tory techniques related to molecular biology, while
keeping up with and publishing results of her ongoing
research at the Duke lab.
The pace of her life is fast, but it's one on which
Harrell appears to thrive. "It docs keep me busy, but I'm
loving every minute," she said. "There's never a dull
moment!"