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!