Take a Deep Breath

Tony Babb is easy to talk to. There is a pleasant, subtle upward lilt in his voice, perhaps an artefact from a Kentucky upbringing, although you might be able to lay some of it at the feet of his having worked at University of Texas Southwestern Medical Center for the last 30 years. This vocal adornment has not yet become a twang, but there are definite hints from time to time. It lends a comforting authority to his words, a subtext of profound experience distilled into approachable simplicity. 

Babb — Ph.D., FACSM — is an expert in exercise pulmonology, and though his research interests are diverse, they all orbit the lungs and related systems. He’s studied pathology, obesity. He’s analyzed the breathing of athletes, of children, of older adults. He’s worked in hospitals and in labs. Naturally, he runs and lifts weights. He plays tennis when he can. 

“Really, my career has been sort of different populations but always looking at the same question of what are the limitations to breathing during exercise,” he says. 

First steps 

I ask him how exactly he got into the field. 

The story begins when he is an undergrad at Western Kentucky University. He took a course with David Cundiff covering the preventative aspects of exercise — i.e., how staying fit keeps you healthy. Babb enjoyed the class, and Cundiff suggested he a declare a major in biology with a minor in phys ed — such a combination being, at the time, how one would pursue exercise science as an undergraduate. Babb had a degree in hand by 1976. 

The next step was a master’s program in exercise physiology at the University of Illinois. Here, a bit of foreshadowing: 

“A lot of people were talking about the American College of Sports Medicine,” he says. 

But his affiliation with the college would come later, though not much later — while completing his M.S. thesis, Babb concurrently served as an assistant pulmonologist at the University of Texas Health Center at Tyler. It was through said work and connections that he decided to become a member of ACSM, attending his first annual meeting in Miami in 1981, the same year he completed his master’s program. 

Of this introductory meeting he recalls: “Everybody would go out to the beach and get some sun and then come back in and go to different sessions and then go back out to the beach and come back in.” Of the college’s meetings during this period generally: “You used to go to an ACSM meeting and they were out running in the morning, they were out running in the afternoon. They were just everywhere in their running gear.” 

Back home, Babb stayed on at Tyler for a few more years, eventually becoming assistant director of the Department of Exercise Physiology and Rehabilitation. 

“It was a real introduction to take textbook physiology and some of the research I’d done and actually work with — this hospital specialized in pulmonary patients — people with emphysema, chronic bronchitis, some lung cancers, TB,” he says. “But it was my first time being involved in invasive measurements in patients. And while I was there, I just had this hunger to learn more.” 

Ph.D. and early research 

The hunger led him to apply to Ph.D. programs, eventually landing at Penn State. 

“Ellsworth Buskirk was my mentor,” Babb says of the famed ACSM researcher and past president. “And I may have been the last graduate student he had before he retired.” 

Studying at Penn State required a slight pivot. The university’s medical center wasn’t treating many patients with lung pathologies, so Buskirk suggested Babb study the pulmonology of obese patients instead. Babb assented and got to work setting up a lab — part of which included borrowing a memory board from the biomed department “so that I could have a little more memory on the old computers we had at that point in time.” He decided to focus on where, specifically, obese people were breathing while they exercised — as in how deeply they were breathing, and with what part of their chest. 

“I had seen this in the clinical setting where patients with emphysema and chronic bronchitis, they have limited flows, so they can’t get all of the air out that they take in.” He’d noticed what he suspected were similarities in obese patients: “Obese individuals, they breath at very low lung volumes, so the diaphragm is very high.” 

In fact, back at Tyler Babb had encountered an obese patient whose lung function had changed so significantly that their oxygen level was low. 

“Their fingertips were blue and their lips were blue,” Babb says. 

A more seasoned coworker took Babb to the patient’s bedside and asked them to take in a deeper breath. Babb was amazed to see the patient regain some color just from changing where he was breathing. 

Babb spent a year getting his system up and running at Penn State, then another twelve months collecting data. To streamline the process of recruiting research participants, he partnered with fellow grad students studying the same population; he shared his subjects with, among others, a researcher who was using dance as a training intervention for obese women and another studying early signs of diabetes and insulin resistance. 

A varied and productive career 

After earning his Ph.D. in 1986, Babb stayed on at Penn State as a postdoctoral fellow in the graduate program, then went on to complete a second postdoc, this time at the Mayo Clinic’s Thoracic Disease Research Unit. Eventually, after a roughly yearlong stint as a research assistant professor at Baylor College, he made his way to UT Southwestern, rising through the ranks from assistant professor (1992) to associate professor (2005) to professor (2012). 

During his long career, Babb has published more than 100 academic articles as well as 15 book chapters and research reviews — two of the chapters, “Exercise Assessment of the Pulmonary Patient” and “Pulmonary Assessment” he was tapped to write for ACSM’s Resource Manual for Guidelines for Exercise Testing and Prescription. In the same period, Babb earned an NIH Institutional National Research Service Award, a First Independent Research Support and Transition Award and an American Lung Association Career Investigator award, and he was named the Effie and Wofford Cain Chair in Cardiopulmonary Research, among other honors. 

Of his work, Babb reiterates, “Most of my career has been devoted to trying to find limitations to breathing that might affect people in health and in disease. I have done work in other areas, but that has been my main goal: to see how these limitations show up, how people complain about them, what we can do about them.” 

In conversing with him, though, one gets the sense that Babb is ultimately driven by an interest in people — not as abstracted systems or research subjects but as, well, people. When discussing his extensive career at UT Southwestern he says “I’ve been lucky to come to a place where I can stay 30 years and have people that are more like family maybe than coworkers.” 

Of the ACSM meetings: “Every time you go to a meeting, you’re going to meet someone — you’re going to talk about their science, they’re gonna give you some input.” He continues: “ACSM has been a reunion every year to meet up with all the people I studied with at Illinois and Penn State and Mayo, and saying ‘What are you doing now?’ Also seeing what people are working on – like, ‘Oh geez, I thought you were working on pulmonary and now you’re doing cardiovascular stuff. What happened? You went to the dark side!’” 

Likewise, he remembers fondly a young man with cystic fibrosis with whom he worked at Tyler. So too he readily recalls working with World War Two veterans and being captivated by their stories. 

Thus: 

“My career has been blessed by the places I’ve gone, the people I’ve met of high character, good character.” 

And: 

“Working in a small hospital in Texas certainly has an impact on you — if you’ve ever been to East Texas.” 

You even find this throughline when he discusses the mainspring propelling his research: “For me, the fun has been always coming up with the questions, and I think probably the one thing I’ve found that I’m pretty good about is looking at A and B and coming up with question C. Trying to use some of that creativity in looking at a question." 

“I’m not always prepared to answer that, and I may have to reach out to people with different backgrounds to say, ‘Have you thought about this? Is this a way to test that?’ And I think that’s the part that I’ve enjoyed.” 

Wrapping up 

As for current and upcoming research, Babb has some concurrent projects. One is a grant studying the effects of obesity on older people. Another applies the same principles to individuals with heart failure. 

“It’s been a very interesting project. We’re about four years into that now.” 

Presently I ask — selfishly — what someone in his early thirties can do to protect his lungs into older age. He stresses prevention, especially from environmental exposures. Also, “Keeping weight under control, being active are all good.” 

Then a friendly chuckle — I mentioned earlier that I live in Northern California — “Be cognizant, when forest fires are blazing, don’t go outside for a run.”