Madison Spach (1926–2025)

Madison Stockton Spach died recently. An Instagram post by the account for the Duke Pediatric Cardiology Fellowship stated

Very sad to report the passing of Dr. Madison Spach. Dr. Spach was the first Division Chief of Pediatric Cardiology at Duke and the founder of our program. He was a legend in the field and mentored others who also went on to become preeminent in the field. His impact through innovations, the patients he cared for, those he mentored, and the program he built is immeasurable.

I have not been able to find an obituary about Spach (I hope one is published eventually). However, here’s a picture and bio published in the IEEE Transactions of Biomedical Engineering in 1971. 

His wife Cecilia passed away seven years ago. Her obituary said

Cecilia Goodson Spach, 92, died peacefully in her sleep on Oct 20, 2018, after a short illness. Madison Spach, her loving husband of nearly 70 years, was with her when she passed away…

Cecilia Goodson was born and raised in Winston-Salem. She was a star athlete at Reynolds High School, where she met her perfect match in Madison Spach. Cecilia earned a nursing degree from Presbyterian Hospital School of Nursing in Charlotte. When Madison returned from the service, they married and moved to Durham, where Madison attended Duke University.

Madison Spach was born in 1926. This would mean if he entered the service right out of high school, he may have fought in the last year of World War II. He was 98 when he died this year. It’s sad that we are losing so many of our veterans of the greatest generation these days, when we need them most. 

Russ Hobbie and I didn’t mention Spach in Intermediate Physics for Medicine and Biology, although we do discuss his field: cardiac electrophysiology. However, I described his contributions briefly in my unpublished review and history of the bidomain model of cardiac tissue. I wrote

In the 1980s, Duke was the center for research about the electrical behavior of the heart. Not only was Plonsey there, along with his collaborator Barr and his student Henriquez, but also it hosted several other leading scientists. Barr was a long-time collaborator with Madison Spach, a Duke medical doctor known for his electrophysiological experiments on cardiac tissue. Some of their analyses foreshadowed key features of the bidomain model (Spach et al. 1978).

The citation was to Spach’s paper with long-time collaborator Roger Barr and others published in the journal Circulation Research.

Spach MS, Miller WT III, Miller-Jones E, Warren RB, Barr RC (1978) Extracellular potentials related to intracellular action potentials during impulse conduction in anisotropic canine cardiac muscle. Circ Res 45:188–204.

In addition, when reviewing Craig Henriquez and Robert Plonsey’s work on cardiac wave fronts propagating through cardiac tissue surrounded by a perfusing bath, I wrote

The bidomain model represents cardiac tissue as a continuous syncytium, so Henriquez and Plonsey’s mathematical simulations provided a new interpretation of earlier experimental data that had been used to argue that cardiac tissue acted like a discrete collection of cells (Spach et al. 1981).

This citation was to Spach’s hugely influential article 

Spach MS, Miller WT, Geselowitz DB, Barr RC, Kootsey JM, Johnson EA (1981) The discontinuous nature of propagation in normal cardiac muscle. Evidence for recurrent discontinuities of intracellular resistance that affect the membrane currents. Circ Res 48:39–54.

It’s no secret that, like Henriquez and Plonsey, I disagreed with Spach’s interpretation of his data as implying discontinuous propagation in cardiac tissue. But I’ve told that story before and this isn’t the time or place to rehash it. Suffice to say, according to Google Scholar Spach’s paper has been cited about 950 times. Another paper on the same topic (Spach’s most highly cited article) with Paul Dolber has over a thousand citations.

Spach MS, Dolber PC (1986) Relating extracellular potentials and their derivatives to anisotropic propagation at a microscopic level in human cardiac muscle. Evidence for electrical uncoupling of side-to-side fiber connections with increasing age. Circ Res 58:356–371.

Duke now has a scholarship named jointly for Roger Barr and Madison Spach. Here’s what the Duke scholarship website says about Spach’s contributions.

Madison S. Spach is a James B. Duke Professor Emeritus of medicine and Professor Emeritus of pediatrics in the School of Medicine. A renowned pediatric cardiologist and scientist, his research examined electrophysiology and the mechanisms behind cardiac dysrhythmias. On the faculty from 1960–1996, Spach developed Duke's training program in pediatric cardiology.

As I said in last week’s post, one goal I have for this blog is to support scientists, and that includes  retired ones who’ve made important contributions. Madison Spach helped us advance our knowledge of cardiac electrophysiology. His was a life worth living.