Art & Science

Art & Science

Usha Raj’s need to know ‘why’ led to a rewarding career studying the pulmonary circulation.
By Melanie Padgett Powers

When Usha Raj, MD, MHA, FAPS, was a little girl growing up in India, there were two acceptable career paths: engineering and medicine. Boys could choose either, but girls were steered into medicine.

However, young Usha wanted to be an artist. “When I was 15 I used to hang out with artists in their studios and do a lot of painting,” she says. But when she read about famous artists such as Vincent van Gogh, they all seemed to be poor and willing to give up everything for their art.

“I really questioned myself: I mean, would I be willing to be barefoot and hungry on the street because that’s all I wanted to do? And I decided I didn’t really have that fire in the belly.”

So, what path should she choose? “I was raised in a Christian family, and my mother was really a very devout Christian, and she used to tell us, ‘to whom much has been given much is expected.’ She would tell me that we have to give back.”

When Raj realized giving back is inherent to being a doctor, she chose medicine. Fortunately, she was naturally good in the sciences, and as she began studying medicine, she became fascinated by how the body works.

Raj, who is the Anjuli S. Nayak Professor of Pediatrics at the University of Illinois Chicago (UIC) College of Medicine, has spent the past four decades studying the pulmonary circulation. She is determined to figure out how to cure pulmonary hypertension, a rare disease associated with high blood pressure in the arteries that go from the heart into the lungs.

Finding her way to physiology

As a medical student in India, Raj knew she wanted to become a neonatologist because treating the sickest babies could teach her a lot about physiology. “I was one of those residents who always asked, ‘why, why, why?’ I did not like just getting an answer from a textbook.”

Neonatology allowed her to observe how a newborn’s lungs and heart were functioning. Once a baby was born, a neonatologist monitors every aspect of the baby. “To me, it was absolutely fascinating.” But her ultimate goal was to become a researcher.

India didn’t have a neonatology subspecialty at the time, so after residency, Raj moved to the U.S. for a two-year neonatology clinical fellowship at Tulane University in New Orleans. Next, she spent four years at the Cardiovascular Research Institute at the University of California, San Francisco, to train as a researcher before being recruited by UCLA. She spent 24 years at Harbor-UCLA and its research institute, doing research about 75% of the time.

In 2008, UIC offered her the opportunity to completely rebuild its department of pediatrics and establish the children’s hospital. She led the overhaul of the UIC department; established all the subspecialty programs that were missing; rebuilt the training programs for medical students, residents and fellows; and recruited close to 50 new faculty, many with their own research programs funded by the National Institutes of Health. “It was just an enormous lift,” Raj says. Soon, it was ranked first among the pediatric programs in Chicago for its academic excellence.

In 2015, she stepped down as pediatrics department head and gave up her clinical and administrative work to focus entirely on research. “I think I worked hard to create a great department and children’s hospital, and now that the job was done, I could hand it over safely to someone who I had recruited.”

Breakthrough findings

When Raj first set up her own laboratory at UCLA, she focused on the pulmonary circulation, eventually zeroing in on one type of cell: the pulmonary vascular smooth muscle cell. Her breakthrough finding in the field was her discovery that both arteries and veins in the lungs regulate flow. In the rest of the body, the veins only take blood back to the heart. But Raj discovered that veins in the lungs “are very active. They contract, relax. They can also remodel and lead to this problem of pulmonary hypertension.”

There were skeptics when she first published her findings, and she received a lot of pushback. “But after many, many publications, now everybody accepts it,” she says, “and in every patient with pulmonary hypertension, they look very carefully at both the arteries and the veins. … That discovery is going to last the test of time.”

Her research has been funded by the National Heart, Lung and Blood Institute for over 38 years, and she has over 203 peer-reviewed manuscripts and book chapters published. Over the years, she has discovered different signaling molecules that regulate the smooth muscle cell, which eventually led to drug companies developing medications to treat pulmonary hypertension.

For her research, she was awarded the Julius H. Comroe Distinguished Lectureship of the APS Respiration Section and was elected an APS Fellow. She has received several top research awards from the American Thoracic Society, including the Recognition Award for Scientific Accomplishment, the Elizabeth Rich Award and the Distinguished Achievement Award. She received an honorary doctorate from the University of Lausanne in Switzerland in 2016.

More recently, her laboratory has been studying the microRNAs that are involved in regulating the growth of pulmonary vascular smooth muscle cells. Her team identified a novel microRNA that regulates its growth, one that was previously not known. “It turns out this microRNA tries to inhibit the growth of the smooth muscle cells when all the other stimuli are making it overgrow,” she explains. “So, we have developed a new way of delivering more of this microRNA to try to inhibit the growth of the smooth muscle cell.”

Raj’s laboratory is also studying extracellular vesicles, recently engineering them with the newly discovered microRNA to give to animal models with pulmonary hypertension.

“We found that it works very, very well and gets them to almost 100% recovery from the pulmonary hypertension,” she says. She has established a small startup company and is preparing to pitch venture capitalists to fund drug development based on this research, which would lead to better treatment for pulmonary hypertension.

Embracing creativity

Raj’s mother’s instruction to always give back has stayed with Raj her entire career. Since stepping down from her UIC administrative and clinical responsibilities, she’s found more time to focus on her passion of global health. She organized a medical mission trip to Cuba, where she delivered a truckload of needed medical supplies. She plans to return to Cuba next year and hopes to take a few residents with her.

She also has an appointment, and is working with faculty, at the Robert J. Havey, MD Institute for Global Health at Northwestern University Feinberg School of Medicine.

When she finds time after all that, she returns to the art she loved as a child. Pastels, watercolor, oils. Her own artwork covers the walls of her Chicago home, including a few of her son and of her cat. She gave her sister an oil painting of her dog for Christmas.

Both of Raj’s sons developed her love and talent for painting. She says her oldest son was a “brilliant” artist who had an artistic “fire in the belly.” Sadly, he died at age 18 from leukemia. Her younger son also loves art but decided to combine it with a love of the environment, becoming a landscape artist. “He does beautiful designs in all his work,” she says. And he encourages his mom to lean into her art: “He always tells me, ‘Mom, why aren’t you painting?’ so I do a little bit and I should do more.”

Raj also started writing memoir-style essays that she plans to eventually turn into a book. She was delighted when two of her essays were selected for publication in the Smart Set, a journal of arts and culture published by Drexel University’s Pennoni Honors College (www.thesmartset.com/belonging).

There’s a piece of advice when people are looking to reduce stress or invite more joy into their life: Return to the hobbies you loved when you were 12 years old. In addition to building a successful, rewarding research career, Raj has embraced her childhood self, nurturing the joy she finds in art and self-expression.

This article was originally published in the July 2023 issue of The Physiologist Magazine.