What is your Passion?!?!

I was confronted with a very important question by my mentor, which has haunted me for the past few days.

What is your passion?

When I got home from my lab I started to discuss the origins of passion with my best friend and SFSU philosophy grad student Saja Parvizian. We explored how one discovers what their soul has an affinity to especially in relation to choosing a profession. I became interested in discovering what my passion was for the first time when my P.I. Piotr asked me, "What drives me in life, and more specifically, what has led you to working in this lab and what are you passionate about?" These series of questions both haunted and disturbed me because I told him in all honestly that I don't have a passion for anything. In this whole process of work, I never stopped to ask my heart what it inherently liked or what it had an affinity to. It bothered me that I came this far to end up with this sort of answer. How could I continue research and medicine if I didn't have a passion in it? How do you know when you have a passion? more importantly, DO I have a passion in medicine? My P.I. in his wisdom of age and experience told me that it was something he commonly sees in people my age. We tend to go through life doing something without fully understanding why we do what we do. Many of us never stop and ask ourselves if what we're doing is something we have a passion or affinity for. In the subconscious realm, it may be that we're driven or putting ourselves through a field of work to impress others, our parents, or economics but all of these things are hardly passion, and are more detrimental to a pursuit that any genuine interest. I proceeded to explain to my P.I. that it wasn't passion of any sort that led me to working in this lab. It was just that I found neurosurgery interesting and so I gave it a shot. I guess I imaged that it had the opportunity to facilitate my development as a physician and a human being; so far that turned out to be true, but what bothered me was my lack of "passion" or thirst in what I was doing. In the back of my mind, I thought maybe I should've told him that as it may have repercussions on my recommendation, but I decided that being honest and open is why me and my boss have a mentor-student relationship, and it's also why he cares about how I'm developing as an individual. And if I am to be a successful human being, and possibly a doctor, I want to be honest and open with those around me in order to develop meaningful relationships with my peers and mentors. I ended up at a point where I ultimately had to confront the possibility of my interest in neurosurgery and medicine not being a passion, rather a culmination of other external factors which would not make the pursuit worthwhile as a lifetime commitment. My P.I.'s advice was to reflect on it for hours or days, and search your soul with true honesty in whether you love medicine or maybe something else.

The very first day I was posed that question, I went home and finished studying for my MCATs. After my studying, I sat for four hours in self-reflection thinking of all the experiences I've had, and whether I truly enjoyed them or not. Experience both related and unrelated to medicine. This self-reflection was priceless because I was able to discover a lot about myself in the process, and identify the motivations that led me to where I was. It also helped me identify, to an extent, the barriers and obstacles standing in the way of further developing my current interests into real passion. After talking, to a few Ph.D's about how they discovered their love for neuroscience and molecular biology I understood what it means to be passionate and how passion can come about. For some people they just know after one key experience that they were meant to be a certain profession. In fact, a researcher in my lab named John Forsayeth told me about how he knew a gravedigger who knew since he was 4 years old that he wanted to be a gravedigger. Ever since he watched his first funeral he knew that is what he wanted to do. As weird as that story was, it demonstrated that passion just strikes from a life experience completely out of your control. Then I talked to my cousin, who's a medical student at Irvine and asked the same question. "What is passion and how do you get it?" She said something that also made a lot of sense. For some people, passion develops from interest and that to develop a passion you should be in a mindset where it can be discovered. She said that for some people, such as herself, passion takes work and development, until you reach a point where you have it. The next day I talked to John again and he said that for a lot of people passion can strike when their older or at any point in life, and it's different for different people. Talking to Saja about his experience in philosophy was also enriching. He took a philosophy class at Davis and his passion struck him. He was stimulated because the field answered a lot of questions that he had; as a result he ended up leaving his pursuit of law school to become a professor in philosophy. What all of these people had in common was that they were in tune with themselves and they knew who they were as people, and more importantly they were honest with themselves. As for myself, I'm still in the process of discovery and finding out who I am. Self-reflection has helped me further identify certain characteristics about myself. I realized that reflection is important in allowing one to take oneself to new places in life, let alone their career.

After reflecting that first day, and a few more interactions over e-mail with Piotr (my P.I.), I started to articulate an answer that made sense. I thought about experiences stimulated me. I remembered my first true neurobiology class at Davis. I remembered how addicted I was so nervous system physiology, in addition to other systems of the body such as the circulatory system. However, neuroscience interested me the most. I remembered I enjoyed it to the point where I would start teaching my study group all of the concepts in the lectures. A lot of the other kids found the class hard, and hated it, however I was stimulated and absolutely loved every aspect of human body function. My professor, Dr. Ishida, in the class was thrilled to write me a letter of recommendation because most of our office hours ended in me teaching everyone else the concepts, while the professor watched. I used my newly developed interest in human sciences to explore laboratory research. At first, I asked Dr. Ishida being that his research was directly relevant to my interest, however his lab was full, so I searched some more. I came across a pulmonary cancer-signal transduction lab focused on characterizing EGFR signaling abnormalities (which is common in cancer research). I loved my experience in research as it really introduced me to the challenge of building knowledge to a level that it can be used as a tool to find something new and undiscovered. It was extremely hard and intimidating. Due to the difficult personality of my P.I. and the eventual quitting of all of her post-docs (6 in all!), I knew I would have a shaky relationship with the lab. Even though there were many complications in lab bureaucracy, I was able to take tons of positive experiences from it. Due to the fact that all of the post-docs had quit, I took on many experiments on my own. My P.I. entrusted me with procedures and experiments that were way above my level of training and understanding, thus forcing me to familiarize myself with literature and learn tests and procedures on my own. Though this experience, I became acquainted with planning experiments and reading journals. I can't say that I produced any meaningful data or work, and on top of that a lot of my experiments failed, but that's how the learning process goes and as far as I was concerned it was my failure that I benefitted from it. I learned how it felt to fail, and I learned how research is a field in which failure is common and success is rare. It's a very unforgiving and disheartening field, but rewards of knowledge and personal advancement make it worth it. In my first experience, I was in a living hell and came to hate research, but when I thought about it in retrospect, it was also the experience that taught me the most about myself. I learned that I had trouble committing to hard work. I want everything spoon-fed, thus taking away from my ability to show initiative and go after what I want...problems I'm still trying to overcome today. Luckily, after talking to a few other students and mentors, I realized that my lab experience was atypical, and I'm glad it was. My PI's unrealistically high expectations forced me to work harder than I ever have. It forced me to realize the limits of myself, and the problems that I needed to overcome.

As much as I thought I learned from my previous lab experience, I was lucky enough to meet people who cared about my personal development, in my current lab experience (such as Piotr, John, and Krys). I really started to realize how much patience you need to achieve a certain level of understanding and contribution to a particular field. Accumulating knowledge is a slow and hard process. My P.I. told me it takes years to accumulate enough to gain a functional understanding of science that can be used to conduct to experiments, analyze data, and research. I've been finding out that the hardest part is staying committed to this field, and many times I just feeling giving up, or I'm burned out. I have a tendency to run away from difficulties, but now I'm trying to deal with them head-on. Also, being around the masters of this field is quite intimidating and it makes you feel extremely stupid and unconfident. I make tons of mistakes in lab procedures, many times leaving things out or forgetting about things, and it becomes this disheartening cycle or failure. One might ask, why am I still in lab then? I think slowly, with time and commitment I'll be able to develop skills and expertise, which will benefit me for the rest of my life; it's an extremely humbling experience. I just hope I don't get fired!

Anyways, I had to leave my first lab experience because I was spending 20 hours a week trying to do all the work left by the previous post-docs and I came to point where I had to make the decision to either recovering my declining grades or continue my research, and so I chose grades. I fells so behind that I had to drop a class in order to recover the others, and I did the best I could with what I had. In the short term, my decline in grades also made me hate the previous experience and temporarily disincline me from research, as I assumed all labs were an insane time commitment and incompassionate PIs. As I continued my neuroscience classes, I found that it was easy to study hard and learn human physiology. I simply would not accept not knowing how some bodily function worked. It really allowed me to excel in my classes. Unfortunately, this same hunger wasn't present in math, english or some other subjects ( I also think UC Davis suffers from a lot of unenthusiastic professors, which makes a big difference in my ability to learn the material), which I don't regret too much because it was easy to identify what I had an affinity to. I do realize however, that I have to work develop skills that will allow me to work hard in things that I don't inherently like as well, otherwise I won't be successful in any of my pursuits. Hopefully, my PI and mentors can help overcome that issue because it's posing a big problem for me.

I continued to take classes, and erratically involve myself in my previous lab mostly because I still had an undying interest that kept telling me to try to balance school and research somehow. I should've listened to my logic rather than my heart because the relationship was somewhat detrimental to me statistically. As I went through my major, there were classes I loved and classes I hated, but life went on. One day, I stumbled upon UC Abroad's Oaxaca's medical internship program. It was a program designed to expose U.C. DAvis students to medical practice, specifically in the third world. My reasoning for joining the program was simple enough... I thought it was a great thing to put on my resume for medical school! It wasn't a good reason, but I think the program was made for premed like me because it forced me to redefine my approach in wanting to be a doctor. I suppose there have been a lot of experiences of mine with medical school resume building in mind, including my first research experience. In all honesty, I never gave medical school much thought before other than it was something that was noble, my parents loved it, and I loved the human sciences. Logical enough right? Well, as logical as it was to approach, I realized NOW that I never took the time to ask myself whether I was passionate about it, and whether I had any experiences that reflected any possible passion I had. So I'm not saying I'm not passionate about medicine, it's more so that I never looked into whether I was passionate or not, rather it was choice of logic based on external factors and my intelligence. I liked human sciences a lot because I was good at it and that's that right? Wrong, I need to see if I had any experiences that allowed me to fall in love with it, and carry the potential to establish a drive/hunger/motivation (w/e you want to call it) that would allow me to flourish within this field. I remembered a few things from undergrad. Luckily I explored other fields such as business ,engineering, and plant science. What I remember from those fields is that I was bored literally to death. I didn't have the love for those classes which the grad students TA'ing obviously did (can't say the professors loved what they did, except the plant bio lady she was insanely in love with trees).

Mexico truly revealed to me how fascinating medicine was. Specifically in two fields. One was othropaedic surgery and the other pediatrics. I was lucky enough to shadow a the head of pediatrics at Hospital Civil, the general hospital in Oaxaca. He treated me just like a medical student, and forced me to look at children with him and try to diagnose their problems. I was having the time of my LIFE. The pinnacle of this rotation/shadow was when the Dr. asked showed me a kid with bruising all over her body, and asked me what I thought it was. Everyone else in the group was stumped, but it suddenly came to me (I don't know how), and I yelled AUTO IMMUNE DISORDER. BOOM, CORRECT; it turned out to be thrombocytopenia. The doctor turned around with the MOST impressed look on his face, and he said, "I see there's a future doctor here!" and those words were the most kind/amazing/meaningful/beautiful words that anyone has ever said to me. I realized that it was this experience that revealed to me, my affinity towards medicine. It's about solving complex problems, in which the solution will save lives. I was led to many other patients with a variety of problems, such as kidney failure, meningitis, brain tumors etc. and each disease fascinating (in etiological terms of course). That day I also learned that passionate people are the greatest of teachers because they care about the field and they care about propagating that field through individuals who carry the same affinities they do. My rotations/shadows through orthotrauma were equally fascinating. I was lucky enough to shadow Dr. Rene Vasquez De La Rosa, and a very enthusiastic and impassioned surgeon who loved his patients and loved improving their lives. Orthopedics interested me because you work with a variety of tools, calculated angles, and implants to essentially restructure bone to restore function. It's fascinating the way bone can be treated similar to wood, yet unlike wood can heal over holes and breaks. I honestly can't even count how many surgeries I've watched, and I was lucky enough to scrub-in and get a closer look while the surgery was going on. During my trip to Mexico, I can confidently say that I developed a passion for medicine because I was never so excited over anything before. It was one of those experiences in which I would love to get up early in the morning to go to the hospital earlier to catch the morning surgeries. I would also skip night-time hang-outs with my peers so that I could watch procedures at private hospital close to where I lived. Thus, Mexico was the most relevant experience in helping me identify my passions or interests.

In fact, the quarter after Mexico I was so intent on going to medical school that I worked ridiculously hard in all of my classes, and got the best grades that I've ever gotten over my whole career at U.C. Davis. Everything was so fresh in my head; the motivation from mexico and dream of being a doctor filled my veins, and I could study for hours and hours. I noticed over-time that my motivation was declining and was becoming more apathetic to school and everything else. I couldn't figure out why. By spring quarter I could barely lift a book to study, and I was exhibiting symptoms of depression. I talked to a councelor, and we discussed how certain pressures, and external factors (I'm not comfortable discussing here) that were destroying my motivation. I was going through an extremely hard part of my life, none of which was under my control. Even after my trips to the councilor, I was unable to fully manage my depression and it consumed me. There were morning in which I couldn't get out of bed, and I got sick often. I caught an infection every 2 weeks, and I was sick 4-5x that quarter. I couldn't explain it. Why was I so motivated one quarter, and the next I could barely get out of bed? Reflecting now, I think that over the quarter it's easy to lose the amazing realizations that one has earlier on, and once you are caught up in the process of studying and academics you lose sight of WHY you're studying so hard. It came to point where I hated all of my subjects, and I had to drop a class because of the depression and illnesses. It's something I still think about to this day, and it's a problem that I know I need to solve. My guess is to keep oneself motivated they need to be in contact with experiences outside of school, which will remind them of their goal and why they need to study. I should've continued my shadowing throughout the year, so that I could observe cases and remember the exhilaration and excitement that lies in medicine. In retrospect, it was a great learning experience as well. I learned how easy it is to be disillusioned, and how important it is to keep an outside experience or interest as a reminder of your ultimate passion or goal. School can be rough, and it's easy to lose sight of why you're studying so hard; even if you consciously know of your goal, the reality of the goal has to fill your heart and veins for you to work hard and stay on track.

One thing about me is that I'm easily jaded, and it's easy for me to forget why I'm doing something unless it's directly related to medicine. Within medicine, I figured out that surgery interests me most. Even in my current lab, my favorite past of the week is doing operations on rats, and injecting chemotherapeutics or vectors into different regions of the brain. While shadowing Dr. Kunwar, I was never bored because I loved every moment of a meningioma removal or disc fusion. Like academics, research can make one forget the end-point. I think I'm jaded by the pressure of the MCAT and intimidation of the vast amount of knowledge I need to acquire in order to truly understand what I'm doing in lab. When my mentor asked me the question What is you're passion?, it was at a point where I was overwhelmed and disillusioned. I forgot why I was doing what I was doing, and by forcing me to reflect I have rediscovered why I like research and medicine in the first place. I do have a passion, I love solving problems and applying science to save lives. I love surgery, and I know that in order to maintain that motivation I need to be around it and immerse myself in it. I need to find a way in which it will constantly be in my heart and veins as it has been in Mexico and my Shadowing with Dr. Kunwar. I want to overcome the intimidation of knowledge and hard work so that I can reach the point that I want to reach. It's going to be a long journey, but I look foreword to it. I now have mentors in the lab who can guide me in the right direction, so I no longer have to go it alone. I'm greatfull, and I plan to stay committed to the very end.

Some Exprience

Hello All,

I know my posts have been far and in between but that's a good thing because it reflects how busy I have been! As for this post, I don't even know where to begin...Wayyyyy too many things to talk about. UCSF is most probably the greatest resource for medical exposure that I've ever had; I cannot tell you about how many seminars, conferences, and presentations that I have seen or done. Not to mention that I am spending enormous amounts of time with world renowned faculty in the field or neurosurgery and neurosurgical research. The best part is that I'm not just a student who is just observing everything, I have a level of active involvement in everything I do, which is what makes this experience so profound and enriching.

In terms of my lab work, I have gained exponentially on an intellectual, social, and professional level. I have carved out a niche in the lab based on my primary interests in research. Carving out an area of interest has really helped me focus on improving my understanding and participation in the projects of this lab. I focus on the brain tumor research projects specifically in chemotherapeutic drug delivery via CED. Focusing has allowed me to learn a tremendous amount about brain tumor biology, etiology, and pathophysiology. One thing I've learned in research is that there is a tremendous amount of knowledge out there and it's simply not possible to learn it all, and a successful physician-scientist specializes on an area of research in which he/she can focus their expertise to produce results. So far, this approach has allowed our lab to produce over 20 publication per year, which is RIDICULOUS! The pace of our progress also allows us to get our newer techniques translated at a faster pace. Thus, if we find a superior Topo I or II (or combination) inhibitor that works well to destroy brain tumors, you can bet that clinical trials will begin within that year or early next year. Our Parkinsonian research has made the most progress, as we have seen real regeneration of dopaminergic neurons, which is revolutionary; maybe, after exploring brain tumors I'll venture into that field as well.

Recently, I attended a very cool Neurosurgical grand rounds at Parnassus. It was cool to see how attendings would review cases with residents in order to instill a certain mindset or train of logic within these future neurosurgeons. I can already see that being a neurosurgeon requires a lot of critical thinking in how to approach a specific neurological problem, as there are many approaches and a surgeon must choose the best on for their respective patient. The best procedure depends on the context of which the patient's pathology presents itself, which is why I suppose Transphenoidal Pituitary Adenomas require a high level of skill and analysis. I wish I could go into more specifics, but I understood very little of what was going on. The field of neurosurgery, especially on the clinical level, requires a lot of specialized and in-depth knowledge of brain anatomy and pathophysiology. However, this high level of knowledge and stimulation is why I love the field so much!! It's something I can see myself doing everyday for the next 30-50 years of my life. Hopefully, with a few more conferences I'll be able to understand cases in more detail.

I suppose the most intellectually stimulating part of my internship/job is reviewing papers and attending the weekly journal club. My P.I. makes me read a few papers every week so i can progressively increase my understanding of the research being done at the lab. After I read papers that our lab has published, he would sit with me for an hour or more to review my understanding and fill in any gaps that I have; the value of this process is something I cannot even describe. Having someone of great knowledge sit with you and help you develop your understanding and comprehension of science is indescribable. My analytical thinking and comprehension of what is occurring around me has increased exponentially. I can recognize concepts, and understand the significance of data and results. Also, I participate in journal club which further increases my understanding and involvement within the lab.

In journal club, each week a post-doc must read and paper and complete a presentation on that paper. This forces the person making the presentation to be familiar with everything within that paper and understand it so they can explain it to the rest of the lab. This process is invaluable because it forces you to master the knowledge presented within that paper. You're understanding must be so great that you should be able to answer questions related to that paper from post-docs or P.I.s. This paper review process has allowed me to make papers and lab research a part my persona, which I can use to further my development as an academic neurosurgeon.

In the upcoming weeks, I'll be shadowing one of the only UCSF neurointerventional radiologists so I'll keep you posted on that. Also, I'll be able to observe our monkey infusions which is very interesting because it's the closest model to a human that we have. We use monkeys mainly to develop the next generation of CED technology that can be transferred to the clinic in the near future.

Salaaam!!

Update

Hellooo,

I haven't posted in a while because my time has been saturated with some amazing research projects. As a quick overview, I've been performing neurosurgeries on rats for the brain tumor projects. We've been testing liposomal Topo Isomerase I and II inhibitors which target gene expression of both topoisomerases. So far we've done the cytotoxicity tests for these drugs to see how damaging they are to cancer calls and normal tissue, and have come up with the proper dosages to use in our tumor implantation rats. This week, I'm delivering these drugs (I and II) via CED into rats for drug half-life testing in which we harvest the tissue at different time points to see what the drug half-life is within the target tissues. It should be pretty long due to the fact that liposomes are inert until endocytosis occurs within the cells. In previous papers, we've detected liposomes to be present at 0, 30min, 24 hours, and 72 hours. Also, I've been two a few amazing research conferences at Mission Bay, which I intend to talk about briefly in this post.

I'm quite lucky at this job because the people here are amazing. They are easy to get along with and facilitate intellectual development by providing answers to any questions that I have. They all carry a positive attitude and are willing to help anytime, especially my co-worker Yuying who was a nurse in china but moved with her Neurosurgeon husband Dali to work at UCSF on brain tumors. Yuying taught me pretty mcuh every lab technique I know, and she did with an amazing level of patience. I can't tell you how many things I've probably messed up in the learning process, however Yuying never reprimands me and gives me tips to improve my technique. Everyone's support really reflects their willingness and passion to develop the next generation of researchers and physicians who will continue their research in the future. I'm lucky to be here because these people are just so giving, and maintain that attitude in every part of their career. I plan to be like that as a physician, and to carry on this philosophy of teaching for the development of the future of research; which is what compels me to practice in academics.

Illumination

Heyyy,

I had lunch with a good friend of mine attending UCSF med, and talking to him really allowed me to obtain perspective in how I would like to approach a career in medicine. His wisdom from going through the application process was invaluable and allowed me to reflect on what I wanted to take from my current and past experiences. After exploring health policy and planning, underserved medicine, and research, I feel that I know where my passion lies. The process of exploration was an amazing growing experience as it really allowed me to learn more about myself; in addition, It has also given me an idea of what direction my career in medicine may take.

As of now, research has been the most invigorating experience that I have ever had. Because I have always been the creative/spatial learner, research seems to fit in extremely well with my persona. It's intellectually stimulating, extremely challenging, and really allows me to exercise my creative intelligence through the extensive problem solving and conceptual learning involved on a daily basis. Also, the challenge of making experiments work and solving complex problems that impede experimental progress, really makes produced results rewarding. I like translational research because it's easy to see the potential application of experiments in solving human diseases (hopefully benefitting my future patients!). I was able to see the translation while working in the lab because by treating human gliomas implanted rats with CED therapeutic, we can gauge how it may benefit patients suffering from GBM (or other malignant tumors), due to the similarity of mammalian physiology. If tested chemotherapeutics are fully translated, neurosurgeons around the world will have a new tool in their fight against brain cancer!

So...one might wonder why I don't pursue a Ph.D? Well, as interesting as research is, its main appeal to me is that it can be used clinically to benefit people suffering from fatal diseases. I would like to be the liaison between the lab bench and clinical treatment. I want to offer the newest, most cutting-edge treatments for my patients in order to give them hope through their difficult conditions. My year-long shadowing experience with Dr.--- has shown me the true advantage of being an academic physician involved in translational research. As a faculty neurosurgeon at UCSF, Dr.---- takes what basic and translational researchers produce from UCSF labs and apply it to his own patients by enrolling them into clinical trials. For example, many people with GBM have no change for survival within 1 year of diagnosis, only 20% survive up until two years, and there is no effective treatment thus far. Any development from translational labs carries the potential of a cure or at the very least superior management of the disease; the only people able to offer these new promises are physicians who involved in these studies, which is what makes academic/research medicine so intriguing to me. Also, translational/clinical research physician expand the field of medicine by generating data from clinical trials that could benefit patients at other medical centers, and incorporate new therapies into universally accepted medical practice. It's just mind-boggling how much of a contribution a physician can make to their own patients when he/she is involved in research and academics.

Also, academic medicine is extremely rewarding not only because of the research, but also because of the teaching aspect. It contributes to medicine by training the next generation of neurosurgeons who will further carry the field to new limits. From my limited teaching experiences in halaqas and training other lab assistants, it's extremely rewarding to see someone learn and apply knowledge due to your own efforts. When shadowing Dr.----, and discussing lab publications with Piotr (my P.I.) I can see how much they enjoy teaching their respective fields to students. It seems as though they also had amazing mentors, which inspired them to teach with kindness and compassion to create another generation of compassionate contributors to medicine. I would like to be part of this extremely spiritual process of teaching and mentorship in which you guide individuals into doing their best for humanity. I'm sure it's an amazing feeling to know that you helped create physicians who are improving the quality of life for hundreds of others.

First post

This is my first post of Fall Quarter, and I wanted to keep everyone updated on what I was doing. I've been ridiculously busy, and haven't had time to write in a while; fortunately for me, it means have tons to write about!! To get everyone up to speed, I began my research associate position at UCSF's Krystof Bankiewicz Laboratory for Convection Enhanced Delivery (CED) of Gene Therapy and Chemotherapeutics two weeks ago. The lab is a translational lab focused on bringing CED to clinical applications in the field of neurosurgery (and maybe even neurointerventional radiology). The technology is extremely promising as the results have been great in our animal models.

In addition my research, I'm continuing my volunteer position at Bayanihan Clinic in Sacramento. Over the course of the summer I've accumulated a ton of experience as an intake, which has really helped me develop some effective interaction skills with patients. The most enriching part of clinic is watching medical students interact with patients because you can watch the learning methodology that is being taught at UC Davis medical school in action, and it has continued to fortify my decision to pursue medical school. Medical students are invaluable to watch as they are in an essential part of the training process in professional medicine; they represent a key transition phase from undergraduate education to medical practice. I'm glad I have a chance to observe this transition phase and get used to what is in a sense the medical student "culture". In the near future, I'll make a separate post elaborating on what I was able see and learn from the medical students that I've worked with.

I've joined the Bankiewicz lab for the year 2010 as a research associate. For the past two weeks, I was being trained for the various projects that I would have to take part in. My training incorporated skills and techniques for rat neurosurgery, tissue histology and extraction, cell culture and tumor-cell implantation. This lab is fascinating because each investigator has come from a different field of expertise. We have two histologists, a biochemist, three neurosurgeons, and a molecular biologist...and pretty soon a bioengineer (for our fluid-dynamics experiments). This multidisciplinary approach has allowed us to design extremely complex experiments, which normally could not be formulated by any one discipline alone. Experiments need perspectives from physics for the liposomal distribution component and from molecular-biology for liposome receptor interactions etc... The learning experience is unlike any other experience that I have ever had. The level of intellectual stimulation that this research facilitates is indescribable. My ability to think analytically and learn complex concepts has increased exponentially. I don't think I've been able to exercise my mind like this even in undergrad. Through this experience, I've realized that most learning in undergrad is memorization-based and isn't directly useable to produce outcomes or results. Memorization-based learning is only the first step in the process of learning, and isn't useful unless one takes the essential step of making it functional, so that it can be applied to something real (i.e. experiments). I've learned that research at it's very core is the act of turning the knowledge that you've learned from books or papers into knowledge that can be used and applied, which is also what makes it so essential for any future physician-scientist. As I went through the process, it surprised how little of what you memorize can be applied; the functional transition is completely intuitive and many times you're mind has to fill in the gaps by developing logic. When knowledge becomes functional its the most rewarding thing in the world because you now have a new tool that illuminates your intellect; it gives you the ability to address a particular issue with new angles and perspectives. In fact, only through functional knowledge can one even propose new hypothesis and predictions for further experimentation, which is the very foundation of new ideas and experiments. Within just two weeks, I can already tell that research will be inseparable part of my life and future career as a physician. As a physician, It's unthinkable for me to not participate in some form of translational or clinical research because I feel that it is the most effective way to advance the medical field and bring the most cutting-edge care to my patients.

The overall focus of the lab has been to develop and apply Convection-Enhanced Delivery (CED) as a treatment modality for degenerative neurological diseases (i.e. Parkinson's) and Brain Tumors. CED works by using a catheter to deliver various therapeutic chemicals directly to the target neural tissue through the bulk flow of molecules. It relies on a pressure gradient to drive the distribution of therapeutic molecules to the region of interest in the brain. It's better than simple neural injection because of the superior distribution achievable within a tissue-mass (due to the constant pressure gradient/stable rate of infusion). This technology is first applied to rats and if promising, then to monkeys, and then to humans, which is pretty much how all translational research works.

The lab specializes in treatments for two areas of diseases neurodegenerative disorders (Parkinson's etc..) and Brain Tumors (mostly gliomas). I chose brain tumors, as neuro-oncology is what interests me most as of now...however, I'm learning more about CED gene therapy and it's fascinating as well. The basic layout of what I do, or rather what I'm being trained to do, is to grow various human tumor cell lines in-vitro for implantation into immunocompromised rat models, specifically the striatum. We wait for the tumor cells to form a large tumoral mass that mimics the human pathological condition. The tumoral mass is then treated via CED infusion of liposome encapsulated chemotherapeutic drugs in order to test drug efficacy and potential for translation to clinical trials.

The lab is an the ideal training ground for a future neurosurgeon. The neurosurgeries and euthanasia operations on rats (and monkeys in the future!) allows me to gain an early understanding of the intuitive and functional aspects of the field. So of far I've conducted 5 or more CED infusion and tumor cell implantation surgeries on rats....and I must say that the experience is unreal. It's hard for me to believe the work that I'm doing is on the cutting-edge of neuroscience. I'm so lucky to be in this position because it has situated me in a place where I can prepare and plan for my future career. My involvement in the development of CED treatments and technologies will be the gold-standard of minimally-invasive treatment for neuro-oncological and regenerative medicine when I become a physician. I plan to make the most of this experience and stay with it from medical school and hopefully residency!