55 Years and Counting: The Remarkable Career of Pathologist Kevin Bove, MD
While being in the workforce for 55 years is an accomplishment in itself, working for the same organization for that amount of time is extraordinary.
“My mother always said that I was persistent,” jokes Kevin Bove, MD. After graduating from medical school at the State University of New York in Buffalo in 1961, Kevin, staff pathologist in the Division of Pathology, and professor in the UC Department of Pediatrics, Pathology & Laboratory Medicine, traveled to Cincinnati to join Cincinnati General Hospital (as it was known at the time) as part of a national intern matching program. After completing his training in pathology here, he spent two years serving in the military at Walter Reed Army Medical Center in Washington, DC, as part of the Berry Plan (a Vietnam War-era program that allowed physicians to defer obligatory military service until they had finished medical school and residency training). But Cincinnati was calling him back.
(L) Kevin Bove, MD, professor, Pathology (35 years), and Irwin Light, MD, chair, Institutional Review Board, at a long-term service award celebration in 2004. Kevin was celebrating 35 years at Cincinnati Children's then.
During his rotation as a resident from UC pathology, Kevin met A. J. McAdams, MD, chief of pathology at Cincinnati Children’s Hospital from 1961 to 1995, who offered him a job here in 1968. “I was very enamored of this place,” says Kevin. “It was very special in the ’60s—the faculty was small, and we all knew each other and worked on projects together. And, because of the quality of the faculty, we generated hundreds and hundreds of publications. And pathology was a key player in the development of all the newly emerging pediatric subspecialties—we collaborated with all of them. I also think Cincinnati is a marvelous community, not widely appreciated outside of this area. Of course, it helped that I had married Nancy Eckert, a Cincinnati girl,” he says with a smile. “Her family was here, so it was a simple decision to come back.”
In his early years here, Kevin worked and collaborated with some of the most well-known physicians and researchers in Cincinnati Children’s history. “I rotated over here in 1965 in pediatric pathology, and I met all the people who were developing these specialties. There were so many really great people—Joe Warkany (Teratology), Fred Silverman (Radiology), Sam Kaplan (Cardiology), Clark West (Nephrology), and Bill Schubert in what became Gastroenterology and Nutrition. These people helped make this place what it is.”
During his career, Kevin has focused on the pathogenesis of childhood cancers, metabolic disease, liver disease and skeletal muscle disease. His major clinical collaborators included Bill Balistreri, MD, in Gastroenterology, Hepatology & Nutrition, Jim Heubi, MD, in Gastroenterology, Bill Crowe, MD, in Rheumatology, and Susan Iannaccone, MD, in Neurology, and his research has resulted in more than 220 peer-reviewed publications, many published in prestigious pathology and clinical journals. He continues to work on projects, nurture them along, and eventually submit papers for publication, adding to the vast body of knowledge he has shared over the decades.
One of the people Kevin has worked with the longest at Cincinnati Children’s is Dan Lovell, MD, MPH, who observed that “the Cincinnati Children’s mission has changed and evolved over the years, and for each iteration, Dr. Bove could have been the poster ‘child/adult/senior citizen’ as he represents our highest standards. He loves what he does at Cincinnati Children’s and in medicine to his very core—for him, serving children is a mission. He still has a passion for answering questions, some of which we have been struggling with for decades, as well as embracing with enthusiasm the newest questions and approaches.”
As Kevin enters his 56th year at Cincinnati Children’s, he still has goals he wants to achieve. “I'm trying to stay busy and finish my work. And most of all, I fully intend to clean up my office by the end of this calendar year,” he says with a laugh. Dan added, “[Kevin] has had several different offices during his time at Cincinnati Children’s—but they all looked the same, and his current one should be placed on the National Registry of Historic Sites!”
“But seriously, I'm really pleased to be connected with this place,” says Kevin. “To have—as an observer and a participant—witnessed the growth and flourishing of our national and international reputation. I've always had this feeling that we knew we were good. I think the leadership made a decision in the late ’80s or early ’90s of where we wanted to be. And it seems like we've arrived. So now the challenge is to keep it going, to continue to recruit outstanding talent and fulfill our mission.”
Kevin Bove’s 15-Year Focus on Biliary Atresia
For the last 15 years, I've been involved in a multi-institutional collaboration with about 15 organizations around the U.S. and Toronto. We're studying cholestatic diseases of infancy, and the one that really grabbed my attention is a disease that everybody knows about, but nobody fully understands. It's called biliary atresia—when bile flow from the liver to the gallbladder or intestine is blocked.
Through this collaboration, we get tissue specimens from a palliative procedure (Kasai procedure) that is fairly successful. And we get these specimens from the exact area where the lesion is. Having studied it, I believe that if you get the samples early enough, you might be able to figure out what is the fundamental abnormality of biliary atresia.
Right now, I’m focused on hundreds of these specimens, which I've had access to through the consortium. So I've been able to study hundreds and hundreds of these, as well as focusing my investigative efforts on the three or four specimens a year that we get here at Cincinnati Children’s.
Theoretically, biliary atresia can be diagnosed in the first few weeks of life, but it rarely is. Usually, the babies are a month or two, sometimes even three months old, before it’s detected. It has to be identified out in the community because the babies typically look fine when they're born. So, everything really depends on awareness in the community—of physicians, generalists, pediatricians. This is an ongoing challenge to promote early diagnosis. And [the Kasai procedure] actually works better the younger the patients are. So there's every incentive to identify babies who have early jaundice, and figure out if they have biliary atresia or not. And if they do—do something about it.
An exciting development happened in Houston, Texas—there was a community-wide practice of measuring the serum bilirubin level via a blood test on all newborn babies before they were discharged from the newborn nursery. For years, the investigators at Texas Children's collected and analyzed this data, and they were able to show that you could detect the first signs of biliary atresia in the first two days of life.
But that's not the standard of care, and there’s a big argument going on about whether the cost of doing inexpensive bilirubin tests on every newborn baby is worth the benefit. It's a discussion worth having because if you know enough about the natural history of biliary atresia, it's a lethal disease. With the palliative operation, there are a lot of good results—maybe half of the patients establish drainage. But many of them eventually require a liver transplant. That is the most common cause of the need for a liver transplant in the pediatric age group.
So, I'm not going to quit until I drop. And I hope before that happens, I will have learned something new about biliary atresia that might be useful. Because if we get to the point where we diagnose it early, we may be able to interrupt the process.