The Hower Award honors a member of the Child Neurology Society who is highly regarded as a teacher and scholar, who has made substantial contributions to the Child Neurology Society, and who is recognized for contributions to child neurology at other national and international venues and organizations. In other words, the Hower Award winner is a consummate role model whose career and accomplishments the rest of us aspire toward. This year, the Child Neurology Society’s choice for this prestigious award is Dr. James (Jim) Bale, whose work and impact as a scholar, administrator, doctor, and educator in the field of child neurology have been awe-inspiring.
James Franklin Bale was born in Kalamazoo, Michigan to a family that revered education, many of whom practiced it as their profession. His paternal grandmother, father, and uncles on both sides of his family were educators and instilled in young Jim the importance and excitement of learning. This familial passion for teaching likely formed the nucleus of Jim’s enthusiasm for teaching and the awards that he would win for it.
While his family background pushed Jim toward a career in education, his mother pushed him toward medicine. A registered nurse, his mother revered physicians and encouraged her young son to make her proud by becoming a doctor. Valedictorian of his high school class, Jim had the academic skills to enter whatever field he chose. Eager to please his parents, he chose medicine and has never regretted his mother’s advice or the choices he made.
After graduating from Residential College and Medical School at the University of Michigan, Dr. Bale entered a pediatrics residency at the University of Utah. While still in the first few months of his intern year, he encountered Dr. Pat Bray, the director of Utah’s child neurology program. Despite being in the earliest stages of his training, Jim must have impressed Dr. Bray, who offered him a fellowship position in child neurology, to begin after his second year of pediatrics training. Fascinated by the developing brain and the diseases that can afflict it, Dr. Bale leapt at the opportunity.
During his training, Dr. Bale encountered Dr. Lowell Glasgow, Utah’s pediatric chairman in the 1970’s, and he became Dr. Bale’s first research mentor. Dr. Glasgow nurtured Dr. Bale’s interest in viral infections, the subject that would constitute the basis of Dr. Bale’s research for the rest of his career and toward which he would make important contributions. He would later learn neurovirology from Dr. J. Richard Baringer, University of California, San Francisco.
During his early career in child neurology, Dr. Bale had many mentors who left their marks on his practice of child neurology. Dr. Bray would teach Dr. Bale the science of child neurology, and Dr. William Bell, division director at the University of Iowa, where Dr. Bale took his first academic appointment, would teach him the art of child neurology. (It is worth noting that both Dr. Bray and Dr. Bell were previous Hower Award winners.) With the science and the art of child neurology bestowed by these two eminent figures in the field, it is little wonder that Dr. Bale became a highly successful child neurologist.
As a scientist, Dr. Bale has made major contributions to the field of virology. Focusing principally on cytomegalovirus (CMV), he explored virus transmission among humans, risk factors for infection, and the effects of CMV on the developing brain. Dr. Bale’s contributions to knowledge regarding CMV infections in children have been so great that it is difficult to find a textbook or article on this subject, published within the last 30 years, that does not include him as an author or cite his work.
In his research on CMV, Dr. Bale formed a productive and long-lasting collaboration with Dr. Jody Murph, a pediatric colleague at the University of Iowa. Together, Drs. Bale and Murph investigated the epidemiology of CMV in young children and in child care personnel. While Dr. Murph directed the clinical program, Dr. Bale’s laboratory used PCR- based methods to characterize CMV strains. Using this division of labor, they made several impactful discoveries. Among the most important, they found that several different CMV strains could circulate in a child care center simultaneously, that children in these centers could be re-infected with new CMV strains, and that the risk of seroconversion among child care providers parallels rates of CMV excretion and acquisition among children at each center.
As a teacher, Dr. Bale has positively impacted the educations of countless learners at all levels. He has lectured to medical students on many subjects, demonstrated the technique of the history and physical exam to residents, served as a trusted mentor to junior faculty and provided continuing medical education to practitioners. Dr. Bale’s greatest joy as an educator was the privilege of serving as Director of Utah’s Categorical Pediatrics Residency Program for ten years. Under his direction, the Utah program grew into one of the premier pediatric residencies in the US.
Following his term as residency program director, he led Utah’s initial participation in Education in Pediatrics Across the Continuum (EPAC), an innovative medical student pathway that uses competency, rather than time, to determine medical student readiness to enter residency. Should the EPAC experiment succeed, it will revolutionize medical education in the US. To those who know him, it comes as no surprise that Dr. Bale was involved in this revolution.
Dr. Bale has contributed mightily to the Child Neurology Society. He has chaired symposia, served on the board, chaired committees, and served as President from 2003-2005. As President, he encouraged work force studies and supported the efforts of Dr. Harvey Singer and colleagues in establishing the residency match in child neurology. He has represented the discipline of child neurology on committees or work groups of the American Board of Pediatrics, the National Institutes of Health and the Centers for Disease Control and Prevention and chaired the Council of Pediatrics Subspecialties (COPS).
For 45 years, Dr. Bale has been married to his wife, Martha, who has been a great success in her own right, serving as Director of Technical Operations at ARUP Laboratories, Salt Lake City, prior to her retirement. Together, they raised three children, in whom they instilled a commitment to service, as demonstrated by the remarkable fact that all three served overseas in the Peace Corps.
Dr. Bale has been a great success in academics. But the place in which he has touched lives most profoundly is at the bedside. A virtuoso child neurologist, Dr. Bale could be counted on to deliver the best of care and to reassure the most anxious of parents. Dr. Bale’s patients and their families loved him – for his knowledge, skills, and compassion. Dr. Bale’s greatest impact as a teacher likewise occurred at the bedside. For those of us privileged to study under him, it was a joy to observe him obtain subtle, but crucial, aspects of the history and physical examination of a sick child. His greatest skill was listening, and he taught, by example, the value of careful listening to everyone he met – patients, families, students, and colleagues. Dr. Bale, an inspiration for all who have met him, personifies excellence in child neurology.