Before Dr. Stanley Horner, D.O., began his service at Wayne County Hospital, he may have already provided a clue to solving the mystery of the high rate of autoimmune disorders in the area.
Just a normal day for the Yale graduate who once worked with late musician John Denver.
Horner was born and raised in Canaan, Vermont, a small town of around 1,000 on the New Hampshire and Canadian border. It sits in the corner of where Maine begins its rise to the north. The closest town on the Canadian side is Magog.
“It’s called the Northeast Kingdom,” Horner said. “Very rural. There are more deer and moose than there are people. If you wanted to go to McDonald’s, it was a 150-mile roundtrip.”
His father worked in the Ethan Allen furniture plant. The family lived on a dairy farm with 50 head of cattle and a five-acre garden.
“I spent most of my time taking care of animals and plants,” Horner said. “When I was 12 years old, I had an epiphany that I wanted to help take care of people.
“My grade school was four rooms. The high school was 50 feet away, and there were another four rooms for each one of the classes there. I came from an environment where the common language was French.”
In 1971, he graduated from Canaan High School. Out of a class of 36, three students became physicians, one became a judge, while another is a Julliard-trained pianist.
“We were fairly motivated. Life was either going to be something else, or we would be logging trees or making furniture.”
In 1972, Horner received his draft notice near the end of the United States’ involvement in the Vietnam War. He had to drop out of school that spring to join the National Guard, where he was trained as a chopper rescue medic, though he still graduated from the University of Vermont in 1976.
After finishing his military obligations, Horner arrived in the Ivy League, but had to work his way from the basement up.
While still at Vermont, he had read a manuscript that fascinated him about Lassa Fever.
When he arrived at Yale, he met the characters from the book.
“I actually got started at Yale because my car broke down,” Horner explained of his humble beginning at one of the most prestigious institutions in the country.
One day, he turned the ignition in his car to begin the long drive back to Colorado to work for John Denver, whom he had gotten to know personally the year before.
However, as fate would have it, his vehicle was deceased.
“They were both very nice people,” Horner said of Denver and his wife. “But because my car didn’t run, I had to find a job. I started work at Yale. I got into their master’s program after I was there about a year or so.”
The transition was not a stretch, since instead of bussing tables, Horner began researching equine encephalitis in a virology lab.
While he was there, doctors at Yale are credited with discovering Lyme disease.
“In 1978, I watched Ebola being walked down the hall,” Horner said, “as it was being carried in by the Navy—they had a research center there.”
With all he had already seen, Horner was honored when he got accepted into Yale after that first year. It more than made up for the disabled automobile and no longer being able to work in John Denver’s restaurant beside a bartender who is now a magician.
“It was quite amazing,” Horner said. “Your graduate instructors, professors and advisors are Nobel Laureates.”
The husband of one of his advisors was a Nobel Prize winner who discovered mitochondria.
“She was a super nice lady,” Horner said. “She was an immunopathologist, and she wanted me to go down that path, but I told her I’d killed enough mice and rabbits—I’d start working on people next.”
Despite a trail of dead mammals, this research has led to saving lives and alleviating the suffering of many children.
“My area of expertise is actually immunopharmacology,” Horner explained. “Back in the 1980s, I did research on many of the products you see advertised on TV today, which are these monoclonal antibodies for various disease states.”
Monoclonal antibodies are designed as substitutes for what the body manufactures, either to strengthen, restore or imitate the immune system’s defense against cancer.
After his time at Yale, Kansas City accepted Horner into its osteopathic medical school, and his adventure in the Midwest began. He performed residencies and fellowships in that region, and graduated in 1988.
“I’m a D.O., but I did all my training in the M.D. world.”
Horner’s family has a farm in Fulton, Mo., and he also maintains a residence in Oskaloosa.
Horner’s primary function at Wayne County Hospital will be diagnosing allergies. While many people will pass through his door, Horner maintains that only 20 percent of adults and 30 percent of children actually have allergies.
“Most people have allergic antibodies, but that doesn’t make you truly allergic,” Horner said. “I’m an evidence-based physician who is attempting to find out why you have your symptoms. You must entertain conversations. Many times, I’ll learn something from a patient because they’ve researched it.”
Before he has seen his first patient in Corydon, Horner may have been able to provide an answer to one of the region’s major health concerns.
In a recent article in The Wayne County Independent, elementary school teacher Patty Hackney described her battle with the autoimmune disorder Crohn’s, and how she is helping a young woman, Maddy Willey, just diagnosed with the disease.
With five cases in Lineville, Hackney’s research shows a person living in that area is 250 times more likely to develop Crohn’s.
“If you go to the Mayo website, the incidents of immune deficiency on the national level is maybe one in 10,000,” Horner explained. “In Oskaloosa and Mahaska County, the incidents of immune deficiency are one in 300.
“In the Iowa area, there is a strong propensity for people to have Dutch-German heritage. There is a significant number of people who end up with recurring infections because they have genetics that make them at risk for immune deficiency.”
And indeed, Hackney is of German descent.
“The expression of inherited genetic problems is multifactorial,” Horner continued. “If you’re not exposed to the other cofactors, you may never have it.”
In layman’s terms, though a person is predisposed to a disease, if there is no trigger, there may never be a problem.
“It may be chemical exposure, radiation, viral infections,” Horner said. “For example, Crohn’s has a relationship to the bacteria colonizing in your gut. If you happen to be colonized with a certain organism, and you make an immune response and carry the genetic risk for Crohn’s, you’ll end up with bowel inflammation.
“And so, there’s a big push in the immune world, both in Europe and in the United States, in looking at what is in your skin, gut, and respiratory system, and discovering if they can be manipulated to reduce or improve immune disfunctions.
“There are a lot of variables, and of course environmental factors play a role, and we’re still learning.”
It all began in the 1970s, when his undergraduate degree was microbiochemistry, a subject that still fascinates him. For good measure he minored in botany at Vermont.
One of the reasons Horner entered immunology is the fast pace at which knowledge in the field changes, and the willingness he must possess to question or dispose of past beliefs and accept the possibility of new ideas.
In other areas of science, there are gatekeepers who attempt to keep the truth rigid.
“It’s a fascinating world. Stuff I learned in the past isn’t true, and I’m going to learn stuff this year that will be considered true, and maybe in a decade I’ll have to forget it. You must be openminded.
“For example, I was talking to a respiratory therapist who works at the University of Iowa. He was doing a research project with a physician on a condition called sarcoidosis, which when I went through my training, there is a tradition of it being dominant in African-Americans, specifically in females.
“And so, when they had these Caucasian, blue-eyed people coming through with biopsies positive for sarcoid, they still rejected them from the clinical trial.
“I had practiced on the Missouri River, where there’s a large German population, and had diagnosed all these people with sarcoid. I asked myself, ‘Where is this coming from? Is this something in the environment?’
“Well, about four or five years ago when the human genome project was completed, they identified that Germans have a separate gene mutation for the development of sarcoidosis. People had been saying, ‘They can’t have sarcoid—they’re not black.’ I said, ‘I’m sorry—apparently you haven’t been reading the most recent literature.’
“You have to be flexible in your mind. Unfortunately, that’s not true of medicine in general. A lot of people like to learn pieces of information and then it becomes rigid. I refer to the individual as glacial. The ice calved off, it melted and fizzed, and that’s all they know.”