“What I breathe now is sweet air,” said Len Geiger, delivering his address at the Plenary Session of the ATS 2025 International Conference on Tuesday.

Mr. Geiger asserted that 31 years after he was diagnosed with Alpha-1 antitrypsin deficiency (Alpha-1), and nearly 23 years to the day after a life-transforming double-lung transplant operation, he would “never take breathing for granted.”

This gratitude was the product of a transformative life experience, with lessons for patients and doctors, that Mr. Geiger shared with ATS 2025 San Francisco attendees.  

The (Mis)Diagnosis

In 1994, after recently turning 35 years old, Mr. Geiger collapsed and realized he was facing troubles beyond his recent diagnosis of “some sort of asthma” that he had received after numerous doctor visits.

During an emergency visit, he pleaded with his doctor to run every possible test, and was told by a nurse that perhaps he might have this “rare genetic thing” she had just learned about.

The nurse turned out to be correct. Test results confirmed that Mr. Geiger had Alpha-1. The disease is relatively rare but serious.

According to the not-for-profit Alpha-1 Foundation, 100,000 people in the United States live with Alpha-1. It can cause severe lung damage, including emphysema, and lead to skin conditions and liver damage.

At first, the details of the disease “went over my head,” said Mr. Geiger. What he was able to absorb was that he was “not expected to live a normal life and not expected to live for long.”

As his breathing capacity diminished and his spirit weakened, Mr. Geiger was unable to work or to pay for his home or car. Despite moments where it seemed his health was improving, complications from Alpha-1 kept returning before he could truly get well. This period in his life reached a nadir when his marriage also ended.

“In just over two years, I went from having everything I thought I would want or need from my life to having nothing,” Mr. Geiger said. “I had lost my identity.”

A Purpose in Life

Eventually, Mr. Geiger said he realized that his biggest problem wasn’t that he was sick, but that he wasn’t doing anything about it.

He began to volunteer, form new friendships, and take his oxygen tank with him to the treadmill.

He also had an epiphany during a pulmonary function test (PFT): It made no sense to think about his lung capacity in terms of how it compared to a normal lung rate.

From then on, he would think about how he could “use my limited lung function to rehabilitate myself to the best of my abilities.”

At that time, Mr. Geiger realized, “I had a true purpose in life. Despite everything, I was happy.”

The Hips and the Lungs

Recovery is rarely complete or linear.

Just as Mr. Geiger had seemingly found peace in his life, he had to have his hip bones fully replaced. The operation left him with limited mobility, along with a tremendous loss of muscle mass and function.

For two years, Mr. Geiger said, “everything tumbled downhill.”

Until he got a call that his name had come up on the list for lung donations on Memorial Day weekend, 2002.

Less than two weeks after that surgery, Mr. Geiger could perform physical activities that he hadn’t for years, including mountain biking. Unfortunately, one of his rides resulted in a crash that led to a pulmonary embolism, following the operation to restore his shattered left femur.

Again, Mr. Geiger found himself weakened and depressed.

In Honor of Korinne

This time, he decided he would return to running, even if it meant doing so with a newly awkward gait.

Then, he had a transformative meeting with his lung donor’s family.

The donor, Korinne Ashley Shroyer, had a father, Kevin Shroyer, who shared Mr. Geiger’s passion for running.

Soon, the two of them began running races together to honor Korinne.

Eventually, the two garnered attention from national media outlets and used this publicity to speak about organ donations and preventive screening, a mission Mr. Geiger continues to advance today.

True to this work, he called on the members of the ATS to use their expertise to screen for Alpha-1 and to raise awareness about the disease.

After all, Mr. Geiger noted, a screening could save a life, which is something he thinks about as he lives in Florida with his new wife and their daughter, and the memory of Korinne Ashley Shroyer, whose lungs live within him.

“When we see this little girl,” Mr. Geiger said of his daughter, “we can’t help but think of the young woman who died and saved my life.”

A New ATS President

As part of the plenary session, the ATS marked the formal “gavel-passing” of the Society’s presidency, from Irina Petrache, MD, ATSF, to Raed Dweik, MD, MBA, ATSF.

Reviewing her term as president, Dr. Petrache singled out the past year’s “active and impactful” advocacy efforts to stand together behind the Society’s values, and to respond to all the threats against innovation, science, and funding for the future generation of scientists.

Stepping into the role of ATS President, Dr. Dweik challenged ATS members to become involved in the Society’s committees, events, and leadership to ensure it continues as a premier respiratory society.

“If the ATS thrives, then we thrive,” he said.

The ATS thanks GSK for their generous support of the ATS 2025 Plenary Session.