Tuesday I ventured to a part of England I have never been before... google "croyden face-lift" for some lovely derogatory remarks about the surrounding environs. The Royal Marsden Hospital has a site in Sutton, about 40 minutes out of Victoria station, which is far enough away from metropolitan London to have unmanned train stations where nothing checks that you have a ticket. (I obviously had proper tickets, my time in Berlin has me very paranoid about traveling "schwartz.") The hospital looks like a miserable construction of greenish corrugated metal, but is apparently immensely respected for its cancer research and treatments. Inside is chaotic, and as someone told me "they try to keep the atmosphere very upbeat seeing as it is a cancer hospital." It succeeds at the bubbly optimism, but it still feels structurally like an old elementary school.
I was making the journey to meet with a highly established researcher that I spoke with just prior to leaving Oxford in December. She is referred to as the "Queen of HIFU." Awesome. My college tutor had arranged a coffee meeting for us all, thinking that we might get along and I might do well to move into this area of research. Yes, despite not being the typical "old boy" in the Oxford world, the old boys club has been taking care of me of late.
At that meeting, we talked in very vague generalities... "I think I might want to do X" and "Y is very interesting to me" and "I like how P and Q would utilize good parts of the research I do now." I liked
her, and the way she was very straightforward and open to my opinions and interests. It was a no-brainer to ask to meet her again on this visit, and after sending a very over-thought three-paragraph email I had a nearly instant two sentence reply: "OK, great! The 9th or 10th would be best for me." Life lesson: don't fret too much about subtle wording in letters to busy academics.
This meeting was different, as I came in with slightly more knowledge and soul-searching under my belt. I had read several review papers from the last few years describing the broad field of research as it currently stands as well as the promising directions for the future. The area I am very strongly leaning towards throwing myself at would incorporate focused ultrasound (her domain) and neuro-MRI (apparently where my skills come into play). A big problem of delivering drugs is that the blood vessels are kept very well encased, preventing most molecules you pump into the bloodstream from ever being absorbed by the tissue cells that you want to be treated. Focused ultrasound is normally used with enough power to heat up cells in the focal point, usually bad cells in tumors etc, until they die. BUT, if you use slightly lower power, you don't cause any damage to the cells but instead can disrupt the "blood brain barrier" for a little while. So, a little bit of ultrasound can reversibly open up little pockets in the blood vessel walls in a very localized and controlled bit of tissue... if you inject some drugs at this point, the drugs will be kept nice and tidy in the blood vessels everywhere but the disrupted area. You can deliver toxic drugs in much lower doses than currently being used, and actually get MORE drugs at the place you want them. Yay!
So where does MRI come in? Well, MRI is exceptionally good at making pretty anatomical pictures, which would be immensely helpful in figuring out where we want to direct the focused ultrasound. Plus, if you mix in some MRI contrast agent with the drug you want to deliver, you can observe where the mixture is "leaking" into the cells successfully. Of course, I really want to do all this in the brain, and there is a small problem... the skull causes massive distortions in the ultrasound waves, and requires really clever arrays of many ultrasound transducers all working together in an intelligent way to overcome this itty bitty gigantic problem.
This stuff has all been done by a few groups around the world. It appears to work AND be safe in small animals. I love the idea that with this method I could have a career working on hundreds of different medical conditions and problems. And I would be doing a bit more physics, while still dragging in the work I already have done. I would probably have to do animal research now, which I *think I am okay with but will need to think about.
So, I very carefully told the HIFU (high intensity focused ultrasound) guru that I "know she isn't working in this area but this is where my interest is." And she replied that she has been wanting to get into this kind of work for a long time now. Let's apply for a four year project grant, with me as one of the named post-docs (whoa), in a joint venture with Oxford and the Royal Marsden. I wouldn't reinvent the wheel, but rather go to Paris, or Zurich, to learn about the magical arrays of ultrasound transducers needed to get around the skull problem, and then I would come back to the UK and implement it.
Right, so we talked a lot more, and all the details will likely bore those of you who have actually read this far down (sorry! Is it obvious that I'm thinking about this all the time?!). Ultimately, it is an amazing offer. I would be in something from the baby stages, which is hard work but would make me a total expert in a field that I expect to be getting huge in the next 10 years. It's a little overwhelming, knowing I have to write a big giant grant whilst writing a thesis, even if she says she'll helps lots. And what if the money isn't there, just due to the way money is these days...
So I need backup plans. But, in general, I really like this area of research. For the first time in a long time I am very enthusiastic about science. We shall see how this plays out...
(!)