A Comprehensive Legacy, Early Life and Education, in Memoriam 

Mitchell Goldstein, MD, MBA, CML, Joy V. Browne, Ph.D. PCNS, IMH-E 

Stanley Norman Graven, MD, was born in the United States on May 20, 1932. His early academic journey began at Wartburg College in Waverly, Iowa, where he earned his Bachelor of Science degree in 1955. His pursuit of medical knowledge continued at the University of Iowa College of Medicine, where he graduated with his M.D. in 1956. His formative years in medicine were marked by an internship at Madigan Army Hospital, Tacoma, Washington, from 1956 to 1957. Dr. Graven furthered his training with pediatric residencies at The Children’s Hospital in Cincinnati, Ohio, and the State University of Iowa in Iowa City, where he received extensive training in pediatric care. 

Military Service and Early Research Contributions 

Dr. Graven’s service in the U.S. Air Force from 1960 to 1964 gave him significant opportunities to advance pediatric care. As Chief of Pediatric Services at USAF Hospital-Fairchild AFB, Washington, he established a new pediatric ward that became a model for future pediatric care facilities. His research during this period included pioneering studies on the relationship between cholesterol, lysolecithin, and bilirubin in breast-fed versus bottle-fed infants, contributing to a better understanding of neonatal nutrition and metabolism. 

At Wilford Hall USAF Hospital in San Antonio, Texas, he led the newborn service and made groundbreaking advancements, including creating the first special care nursery for newborns in the military. Dr. Graven’s work here involved the innovative use of ventilators and intravenous therapy in preterm infants with Respiratory Distress Syndrome (RDS). His research on fibrinolysin therapy for RDS and the genetic basis for RDS in preterm infants was instrumental in improving treatment outcomes. Additionally, he studied the effects of television viewing on children’s fatigue and somatic symptoms, providing insights into the impact of environmental factors on child health. 

Academic and Research Career 

In 1964, Dr. Graven began his academic career at the University of Wisconsin-Madison as a Research Associate in the Department of Pediatrics and the Institute for Enzyme Research. Under the mentorship of Professor Lardy, he focused on the biochemistry of mitochondrial function, which contributed significantly to the field of enzymology and mitochondrial research. His work during this period included crucial findings on the role of mitochondria in cellular metabolism. 

Dr. Graven’s academic ascent continued as he became an Assistant Professor in 1966 and later an Associate Professor and Professor. During his tenure, he was a driving force behind the establishment of Wisconsin’s first neonatal intensive care unit (NICU) and the Wisconsin Perinatal Program. This regionalized perinatal care system was pioneering, offering data on its impact on fetal and infant mortality and setting a precedent for similar programs across the U.S. His research on lecithin and sphingomyelin levels in amniotic fluid provided critical insights into prenatal development and neonatal health markers. 

As Chairman of the Committee for Sub-specialty Certification in Neonatology, American Board of Pediatrics, and later Chair of the Sub-Board of Neonatal-Perinatal Medicine, Dr. Graven played a critical role in defining the standards and scope of neonatal care and certification. His efforts to establish the first neonatal nurse clinician program in the United States and publish groundbreaking research on lecithin/sphingomyelin ratios in amniotic fluid were seminal in advancing neonatal care practices. 

Leadership and Contributions to Public Health 

Dr. Graven’s transition to Medical Director for Maternal-Child Health at the South Dakota Department of Health in 1976 marked a new phase in his career. His leadership led to the creation of a statewide perinatal program, a comprehensive prenatal and parenting education system, and the establishment of the National Perinatal Association. He also established a neonatal nurse clinician program and developed the Children’s Comprehensive Health Care System, which aimed to improve pediatric care infrastructure across South Dakota. 

At the University of South Dakota, where he served as a Professor in the Departments of Pediatrics and Obstetrics/Gynecology, Dr. Graven spearheaded the creation of a new NICU with full-time neonatologists and neonatal nurse clinicians. He also initiated a series of pediatric subspecialty clinics, including those for cardiology, neurology, gastroenterology, and child development. His role as Program Director and Senior Program Consultant for the Rural Infant Care Program and the Egyptian Newborn Care Program highlighted his commitment to improving neonatal care globally. The latter program was instrumental in reducing neonatal mortality related to tetanus in Egypt by legalizing and training traditional midwives. 

Impact at the University of Missouri and University of South Florida 

Dr. Graven’s tenure at the University of South Florida, starting in 1984, was marked by significant achievements. As a Professor and later Chair of the Department of Community and Family Health, he built the department from two faculty members to a robust team of eleven academic and thirty-two total staff members. He developed and expanded academic programs, including MPH, MsPH, and PhD programs, and led the creation of the Healthy Beginnings Program. This program aimed to improve public health practices and optimize Medicaid spending for maternal and child health. The Gravens Conference was established to inform and educate about the importance of environmental factors on infant development. Dr. Graven also served as a principal investigator for over fifty grants and contracts, securing over $4.5 million in funding. 

As director of The Lawton and Rhea Chiles Center for Healthy Mothers and Babies from 2000 to 2003, he oversaw initiatives to improve maternal and child health outcomes. As Interim Dean of the College of Public Health from 2003 to 2004, he managed the college’s academic and research functions, further cementing his leadership in public health. 

Recognition and Awards 

Dr. Graven’s contributions to pediatric medicine and public health have been recognized with numerous awards. He received the Bordon Undergraduate Medical Research Award in 1956 and was honored as a John and Mary Markle Scholar in 1968. The Stanley N. Graven Award, established by the National Perinatal Association, and the Virginia Apgar Award from the American Academy of Pediatrics (2005) are among the many accolades that reflect his significant impact on the field. In 2005, he was awarded the Distinguished Service Award from the University of Missouri-Columbia, and in 2006, the Stanley & Mavis Graven Award was named in his honor. 

Professional Affiliations and Activities 

Dr. Graven’s professional affiliations include membership in Sigma XI, the American Academy of Pediatrics, the Society for Pediatric Research, and the American Public Health Association. His leadership roles have encompassed chairing and participating in various committees and task forces on perinatal care, including serving as President of the Wisconsin Association for Perinatal Health Care and consulting for international health programs. 

Community and Church Involvement 

Beyond his professional achievements, Dr. Graven has been actively involved in community and church activities. His service on the Board of Missions for the American Lutheran Church, the Board of Regents for Wartburg College, and various other church-related organizations highlights his commitment to community service and faith-based initiatives. 

Courses and Teaching 

At the University of South Florida, Dr. Graven taught a wide range of courses in the College of Public Health, including Introduction to Maternal Child Health, Program Development and Change Process, and Child Development and Public Health. His dedication to education and mentoring has shaped the careers of many future pediatric and public health professionals. 

Personal Life and Legacy 

Dr. Graven was married to Mavis Graven for over 70 years. They had four children together. His dedication to pediatric medicine and maternal-child health has been evident throughout his career, marked by significant advancements in neonatal care and public health initiatives. Today, Dr. Graven continues to be a respected figure in his field, influencing the next generation of healthcare professionals and contributing to the ongoing evolution of pediatric care. 

Dr. Stanley Norman Graven’s career is a testament to his enduring commitment to advancing pediatric medicine and public health. His pioneering work in neonatal care, leadership in public health programs, and dedication to education have profoundly impacted the field. His legacy continues through the institutions he helped build, the policies he influenced, and the lives he has improved through his work. 

Stanley Norman Graven, MD passed away on July 8, 2024, in Dallas, Oregon. He was 92. 

References:

1. Markle Scholars in Academic Medicine, 1948-69.; John and Mary R. Markle Foundation; 1970; p.7
2. SONPM Awards and History: The Virginia Apgar Award in Neonatal Medicine, https://www.aap.org/en/community/aap-sections/sonpm/neonatologists/awards–history/

Disclosure: The authors have no conflicts of interests to disclose.