Looking Back: A Retirement Interview with Dr. Stephan van Eeden

Throughout their diverse and storied careers, UBC Department of Medicine faculty members acquire a wealth of clinical, educational, and leadership knowledge and skills. We value the experience of our retiring faculty and seek to capture some of their valuable insight and wisdom to share with the UBC Department of Medicine community. We hope that our current faculty will find these perspectives useful as they consider their own career paths.

Dr. Stephan van Eeden (He/Him/His)

Professor Emeritus

Department of Medicine/Division of Respiratory Medicine & General Internal Medicine

Vancouver, BC

Dr. Stephan van Eeden was born and raised in Johannesburg, South Africa. He completed his medical training at the University of Stellenbosch in Cape Town, South Africa, and received his PhD from the University of British Columbia.

Dr. van Eeden’s research focuses on the mechanisms of lung inflammation caused by infection and inhalation exposures, particularly cigarette smoking and air pollution. A landmark finding of his group’s research efforts is that exposure to ambient air pollutants, in particular the small particles component, generated inflammation in lung tissues, and mediators of this inflammation spill over into the bloodstream, and these are responsible for the downstream adverse cardiovascular health effects of exposure to air pollution, well documented in epidemiological studies.

Dr. van Eeden retired on December 31, 2022, from the Department of Medicine in the Division of Respiratory Medicine. He intends to travel with his family and pursue his love of photography while continuing to teach at UBC.

Where did you grow up, and what brought you to Medicine?

I grew up in South Africa and attended Medical school directly after school. In those years, Medical school was six years of training, with the first three being basic science training and the last three being clinical training. After that, you had to complete a one-year internship training, usually in a teaching hospital, to gain clinical experience and skills.

Table Mountain, Cape Town, South Africa

After that, I returned to Stellenbosch University to train in Internal Medicine. Following my specialist training, the lure of private practice was there, but due to my interest in medical research, I decided to stay in academic medicine and did further training in lung medicine for five more years.

We were still required to do two years of compulsory military service at that time. It was a very interesting time in my life. My post was in a peripheral state hospital located in the operational area in the northern part of Namibia. It was a large 5-600 bed hospital, and some of my best friends and colleagues were also stationed there. Although we were fairly isolated, I could not have asked for a better placement. I worked with a lovely group of colleagues managing challenging and interesting cases in a rural hospital setting with limited resources.

Did you have any life-changing experiences in Medicine?

One of the most interesting times in my career was in the military service. We were stationed in northern Namibia because of terrorist activity on the Angola-Namibia border, which is why the military was there. Angola (previously a Portuguese colony) was supported by East Germany and Cuba, both communist countries at that stage, whereas South Africa was more pro-western.

Most of the medical services in northern Namibia were in small hospitals that the Finnish mission organizations ran. When the terrorist activities started, all the Finnish doctors left, leaving the mission hospitals without physicians and only the nursing staff to run medical services. We did outreach clinics at these small mission hospitals using army vehicles. These landmine-proof vehicles – a pick-up truck with a v-shape bottom deflect landmines. If you were unlucky and hit a landmine, it may blow off one of the wheels but (hopefully) protect the people inside the vehicle. These small hospitals/clinics were run by experienced nurses who would manage most of the cases and keep the more complex cases for us to see when we visited once a week. The most common cases were malaria and infectious diseases. The nurses became very good at diagnosing and managing these diseases. We got to know all of the nurses who ran these clinics very well, and it was a very fulfilling time in my career.

Our time in Namibia also allowed us to explore this sparsely populated, beautiful country with several game reserves, nature parks, and miles of white sandy beaches of outstanding natural beauty.

Elephants crossing the river, Etosha Game Reserve, Namibia

What brought you to UBC?

A critical turning point in my career was deciding between academic medicine and opening a private practice in South Africa. I’m inquisitive, and I liked the academic atmosphere, the students, and the research environment. Once the decision was made, I had to explore opportunities to ensure a successful academic career—that involved extra training in a research environment to carve a path for myself. Looking for a research fellowship, I talked with one of my friends, a pediatric respirologist that had just returned from Vancouver and worked with Dr. Jim Hogg at St. Paul’s Hospital as a research fellow. Dr. Hogg’s research at the Pulmonary Research Laboratories (now the Centre for Heart & Lung Innovation or HLI) was similar to what I was interested in: the mechanisms of lung inflammation. Seeing the long-standing collaborative relationship between Dr. James Joubert, my department head in Cape Town, and Dr. Jim Hogg, who were fellows and colleagues in Montreal many years earlier, my application for fellowship in Vancouver with Dr. Jim Hogg was successful.

My original plan was to do a two-year fellowship in Vancouver and then return to South Africa to establish my own research program, but Dr. Hogg convinced me to do my PhD at UBC, which I obtained in 1995. I considered returning to South Africa after my PhD, but the research opportunities weren’t promising. At that stage, South Africa was more involved in public health research, whereas my research was basic science orientated.

In Vancouver, Drs. Hogg and Pare were gracious to secure an Assistant Professor position in internal medicine for me so that I could continue my research at St. Paul’s Hospital in the Pulmonary Research Lab. Doing research and working in the Pulmonary Research Lab (now HLI) was being part of a big family that does not just involved research but also social activities such as participating in our annual Sun Run team and yearly summer barbeque on the beach and Christmas potlucks. My clinical duties initially were predominantly in internal medicine, which allowed me dedicated time to establish my research career. I was recruited in 2000 to join the respiratory group at St. Paul’s Hospital, and the 25 years at UBC have just flown by – especially when you’re busy.

Dr. van Eeden and the Pulmonary Research Lab Sun Run

What led you to your research focus?

Your experience in clinical practice always drives the ideas you explore in research. In South Africa, after finishing my lung medicine training, I was assigned to take over the 12-bed medical ICU in our teaching hospital after the unexpected resignment of the director of the ICU. Through this position, I became very interested in lung inflammation and the impact of systemic inflammation induced by lung disease. We admitted many with pneumonia, a focal inflammatory condition in the lung, but these patients can become very sick and develop multi-system organ failure. This suggests that a systemic inflammatory response induced by the pneumonia impacts other organs, such as the kidney, liver, brain, etc., not just the lungs. I became interested in further exploring this concept, and in retrospect, I think it is the area of research where I’ve made most of my contributions.

Early years in the van Eeden lab

At the time, Dr. Hogg’s laboratory worked on different forms of lung inflammation. I was assigned to study pneumonia as a model of lung inflammation. Using a rabbit model, we instilled pneumonia bacteria into one of the rabbit’s lungs. To study the inflammation pneumonia causes, we instill just the solution we use to carry the bacteria in the opposite lung as a control. To ensure we sample the correct spot in the lung where we instill the bacteria and carrying vehicle, we added a small amount of black colloidal carbon to the vehicle (to mark the area to sample). Interestingly, we found that there was also inflammation in the control group induced by the colloidal carbon particles. This finding led us to further study carbon particles to determine how they cause inflammation in the lungs. That’s where our air pollution research started. This finding was, by pure serendipity, the background story of many landmark discoveries.

This finding propelled our studies on the systemic response induced by inhalation of air pollutants. Epidemiological studies have established the adverse effect of air pollution on the lungs aggravating lung conditions such as asthma and COPD. However, when you look at the mortality data, the majority of people die of cardiovascular disease exposed to air pollutants. So how do you get vascular disease from inhaling things into your lungs? Again, we used rabbits that naturally develop atherosclerosis early in life due to a genetic defect, instilled air pollution particles in their lungs, and we could show that the exposures cause rapid atherosclerosis development and also destabilize the atherosclerotic plaques, a process that precedes heart attacks and stroke development.

Who was your most important mentor?

My most significant research mentor was Dr. Jim Hogg, my PhD supervisor, and we worked on multiple research projects together.

At Stellenbosch University, I worked under a professor named Attie De Kock. Attie was the head of medicine and influenced my interest in respiratory and academic medicine. He was a very colorful person with interesting and entertaining stories up his sleeve. He would tell the story about when he returned from his fellowship in San Francisco and decided to bring a “Bird mechanical ventilator” with him, which he had used for his research work in San Francisco. At that time, there were no mechanical ventilators in South Africa, and he was planning to start an ICU back home. Landing in Cape Town, he had to explain to the customs officer what this contraption was because they were ready to confiscate it, thinking it was some secret weapon. Apparently, it took him a couple of hours to get thru customs, and with that ventilator, he started the first ICU in Cape Town in South Africa.

What advice would you have for a junior faculty member in your field?

To be always inquisitive and curious about other researchers’ work. It doesn’t matter if they’re doing something completely different because, frequently, it may generate novel ideas for your own research. Working with students of all levels is the most rewarding thing in research. So often you get many ideas talking with these young people. I was always eager to get summer students because they have different ways of thinking. Working with students is an essential component of a successful research career.

What advice might you give a senior faculty member approaching retirement?

You have to realize it is a process. It’s not a point-in-time event. You have to prepare and plan for it. I retired at 70 but started thinking about it at 65. I attended UBC workshops for retiring faculty and discovered that the most common reason for retiring is actually medical. It can be unpredictable. You need to think about how to wind down research and clinical practice in a manageable way. I’m no longer the primary person running research projects, but I enjoy collaborating and sharing my experiences. In that respect, teaching is also very fulfilling. You must also do some succession planning if you hold leadership positions- you can’t leave leadership roles like that in mid-air.

I’ve officially retired from the University of British Columbia, but still part of the Pacific Lung Center and do clinics there. It’s been a gradual process which I think is the best way to do it.

How do you plan to spend your retirement?

I’m slowly figuring it out. As a student, I was part of the university photography club. In those days, it was primarily black-and-white film. I’ve been taking photos since then, but I was so busy with other things that I could not focus on my skills. I wanted to take up photography again, so I joined the Delta Photography Club. We have meetings and outings and learn how to take and manipulate photos. Applying the same principles as a researcher, I’d like to have a stronger foundation, so I would also like to explore more formal photography training.

I have two sons and three grandkids that live just a few blocks away. They come over for sleepovers every Friday night, and we love this. My wife and I also like to travel; my wife, my sons, and our grandchildren are all returning to South Africa this year to visit family and friends after the pandemic. I like to play golf and will spend some time training my pandemic dog, an Australian labradoodle named Nellie (after my mom, Neeltje). I love dogs; they have no pretenses, are always glad to see you, and like pushing your boundaries (just like kids), which can be fun.

Dr. van Eeden, photographer, Namibia

The Department of Medicine is incredibly grateful to Dr. van Eeden for agreeing to be interviewed and being so generous with his time and insight.

All photos courtesy of Dr. Stephan van Eeden