Harvard Medical Labcast

As a teenager, Joan Brugge expected to become a math teacher. Then her sister developed a fatal brain tumor, and Brugge shifted to devote her career to uncovering the fundamental workings of cancer.Now a world-renowned cell biologist, Brugge investigates how cancers form, spread and become resistant to therapy. Whether she's probing the startling variety of cells within tumors or building 3D models to study cancer development in structures that more closely resemble the human body, Brugge continues to illuminate cancers of the breast, ovaries, lungs and more.In this episode, Brugge tells the story of her path into cancer biology and discusses her latest endeavors. She also shares her thoughts on the challenges and opportunities facing the field today and the skills she believes will best serve the next generation of cancer researchers.Brugge is the Louise Foote Pfeiffer Professor of Cell Biology in the Blavatnik Institute at HMS and co-director of the Ludwig Center at Harvard Medical School, which brings together researchers across disciplines to overcome barriers that prevent the development effective cancer therapies.Note: This interview was recorded before the emergence of the COVID-19 pandemic.Download the full transcript [PDF].Episode guide:0:03 Introduction1:20 Diverted from math by sister's illness3:55 Major discovery as a postdoctoral researcher6:05 Finding a balance between work and family7:25 Sojourn into biotechnology and back to the lab10:35 Building 3D models to study tumors13:10 Current investigations in ovarian and breast cancers18:40 Lung cancer research and the paradox of antioxidants21:35 Interdisciplinary collaboration and skills for future researchers25:50 Hopes for new discovery28:35 ConclusionProducer: Rick GroleauMusic: "Fairy Dust" by Velvet Ears 3 via Extreme MusicSubscribe to the Harvard Medical Labcast on SimpleCast or iTunes.

Note: This interview was recorded in 2019. For updates on Sequist's work during the COVID-19 pandemic, read our new Q&A.Traveling between New York, Albuquerque and Taos Pueblo while growing up and transitioning from computer chip engineering at Intel to enrolling in medical school, Thomas Sequist has never quite followed a straightforward path.After training in primary care and health care policy, Sequist found his way toward pursuing a great passion: improving health care quality and equity for all patients, with a special focus on American Indian communities.Now, Sequist helps new generations of American Indian students find their own paths into medicine, biomedical research and health care policy. For his part, he's not sure where he's going next.Sequist is professor of health care policy in the Blavatnik Institute at Harvard Medical School and professor of medicine at Brigham and Women’s Hospital. He is also chief patient experience and equity officer at Partners HealthCare. Download the full transcript [PDF]. Episode guide:0:02 Introduction1:05 Growing up in New York, Albuquerque and Taos Pueblo3:15 A winding path from Intel to medical school8:50 Seeking impact in primary care and health care policy11:00 Research into practice: health care quality and equity17:20 Addressing health disparities in American Indian communities19:25 Helping American Indian college students find their paths into medicine24:45 Clinician partnerships with the Indian Health Service and Navajo Nation30:15 Looking back at 25 years of service32:05 Conclusion Related links:Co-author, Investing in the Health of American Indians and Alaska Natives (JAMA, March 2020)Director, Four Directions Summer Research ProgramMedical director, Brigham and Women's Physician Outreach Program with Indian Health Service Producer: Rick Groleau Music: "Get Up While We Can" by Epic Country via Extreme Music Subscribe to the Harvard Medical Labcast on SimpleCast or iTunes.

Note: This interview was recorded in 2019. For updates on Inouye's work during the coronavirus pandemic and the link between COVID-19 and delirium, read our new Q&A.Each year, more than 7 million hospitalized people in the U.S. slide into delirium: an acute state of confusion that raises risk of serious health complications and death.Only a few decades ago, medical professionals believed they couldn't do anything to prevent delirium. Then Sharon Inouye proved otherwise. Her programs, adopted by hundreds of hospitals, have helped reduce cases of the condition by an estimated 40 percent. Inouye is a professor of medicine at Harvard Medical School and director of the Aging Brain Center in the Marcus Institute for Aging Research at Hebrew SeniorLife.In this episode, Inouye shares the story of how she became interested in delirium, describes how caregivers and clinicians can identify and prevent it, and explores the connection between delirium and dementia. She also talks about the family roots of her interest in medicine, her forays into English literature and harpsichord in college, dipping her toe into health policy—and how she struggled to stop her own father, a physician who treated survivors of atomic bombings, from developing delirium.Download the full transcript [PDF].Episode guide:0:05 Introduction2:25 Father as role model6:45 Family roots of humanism in medicine9:15 Turned to English and harpsichord in college12:05 Early application to medical school on a dare15:20 What is delirium and why is it an important issue17:40 Discovery that delirium doesn't "just happen"23:00 Risks for delirium and what family members, clinicians and researchers can do to mitigate them26:55 Delirium prevention in health care settings29:35 Father's delirium and the importance of teams33:00 Turn to health policy35:00 Connection between delirium and dementia38:25 ConclusionRelated links:Principal investigator of SAGES, Successful AGing after Elective SurgeryHospital Elder Life Program (HELP) for delirium preventionConfusion Assessment Method, the most widely used checklist for delirium identification [PDF]Producer: Rick GroleauMusic: Bach, "English Suite No. 1 in A Major, BWV 806," via Pond5

Neal Baer is an award-winning television writer and producer—and a Harvard Medical School-trained pediatrician (MD ’96). Through his pioneering work on hit shows such as ER and Law and Order: Special Victims Unit, as well as his leadership in connecting media producers with doctors and scientists, Baer has helped shape public perceptions of medicine, illness and health disparities, with a special focus on issues that disproportionately affect LGBTQ communities. In this month’s podcast, Baer recounts his unconventional journey and explains how storytelling is central to being both a writer and a doctor. Along the way, he reveals how medical school inadvertently prepared him to be an executive producer. Baer is an adjunct professor at the UCLA Fielding School of Public Health and a part-time lecturer on global health and social medicine at HMS.

Dentists take care of our mouths, and doctors take care of the rest of us—but it’s becoming increasingly clear that oral health and overall health are inextricably linked. In this month’s podcast, dentist and future physician Lisa Simon talks about the potential benefits and challenges of bringing dentistry and medicine back together after a 150-year separation. A graduate of the Harvard School of Dental Medicine, Simon is currently the HSDM Fellow in Oral Health and Medicine Integration and a medical student at Harvard Medical School.

Staci Gruber, HMS associate professor of psychiatry and director of the Cognitive and Clinical Neuroimaging Core at McLean Hospital, describes what she and other researchers are learning about the effects of recreational and medical marijuana on brain structure, brain function and quality of life in teens and adults. Along the way, Gruber counters common misconceptions about marijuana research and shares many of the puns that are inevitable in her line of work.

Economist and physician Anupam “Bapu” Jena, the Ruth L. Newhouse Associate Professor of Health Care Policy at HMS, analyzes compelling health care issues ranging from physician behavior to prescription drug abuse to the economics of medical innovation. Here, he talks about finding research questions in unusual places, what happens when a result contradicts “common knowledge,” what’s fun and challenging about his work, and learning when to let a project go. And in this month’s abstract, researchers in the lab of Timothy Mitchison uncover potential clues about how immature egg cells remain dormant in the body for years. Read the full story.

Jessica Halem, program manager of the LGBT Office within the Office for Diversity Inclusion and Community Partnership at HMS, shares some of the ways the Harvard Medical School community is working to reduce health care disparities for transgender patients. Efforts range from medical education and faculty training to research programs to environmental modifications, such as on doctor’s office intake forms and bathroom signs.

Joseph Betancourt, HMS associate professor of medicine, shares stories about the challenges of cross-cultural communication in health care, both as a doctor today and as a child from a bilingual, bicultural household who accompanied his grandmother to the doctor’s office. He also describes the progress he has seen in reducing racial and ethnic health care disparities as director of the Disparities Solution Center at Massachusetts General Hospital. And in this episode's abstract, research from HMS and Brigham and Women’s Hospital shows how understanding the personal, political, ecological and economic factors behind the Ebola pandemic is critical for preventing future disease outbreaks.

Ting Wu, HMS professor of genetics, talks about ways scientists are striving to optimize astronauts' physical and mental health—and anticipating the biomedical challenges ahead as humankind considers long-term space travel. And in this episode's abstract, a study led by Brittany Charlton at HMS and the Harvard T.H. Chan School of Public Health offers reassurance for women and their health care providers about the safety of taking oral contraceptives during or just before pregnancy.

Reisa Sperling, HMS professor of neurology at Brigham and Women's Hospital, shares her family's personal connection with Alzheimer's disease and describes ongoing research into early diagnosis and intervention. And in this episode's abstract, researchers in the lab of George Church use the gene-editing tool CRISPR to inactivate retroviruses in the pig genome with the hope of one day making organs safer for transplant into humans.

Dragana Rogulja, assistant professor of neurobiology at HMS, runs a sleep lab in which hundreds of thousands of fruit flies are studied as they snooze. Rogulja’s goal is to identify genes involved in sleep that are also conserved in human beings. And in this episode’s abstract, researchers in the HMS Department of Health Care Policy have found that hospitals can be penalized for serving vulnerable populations.

Dominic Hall, curator of the Warren Anatomical Museum in the Center for the History of Medicine at the Francis A. Countway Library of Medicine, talks about how individual medical artifacts can bring to life multiple narratives and inform today’s doctors and researchers. Along the way, he explores just a few of the 15,000 objects in the 160-year-old collection, including a giant skull and a tray of model eyes. And in this episode’s abstract, researchers at HMS and Mass Eye and Ear recreate ancient viruses to deliver modern gene therapies in mice.

Physician and poet Rafael Campo describes how medicine and poetry are interconnected at the most basic levels. According to this HMS associate professor of medicine at Beth Israel Deaconess Medical Center, language and metaphor reveal medical and humanistic insights into the body in ways that go far beyond data and checklists. And in this episode’s abstract, researchers in the lab of HMS professor and Wyss Institute core faculty member Pamela Silver transplant a circadian clock into a non-circadian species.

Robert Truog, a Harvard Medical School professor at Boston Children’s Hospital and director of the HMS Center for Bioethics, teaches doctors and nurses to become more aware of the ethical decisions they make every day—including the conscious and unconscious biases that shape the words they use and the way they frame conversations with patients and families. This kind of “microethics” education aims to help doctors and patients alike achieve more compassionate care. And in this week’s abstract, a new research tool from the lab of HMS geneticist Stephen Elledge can reveal a person’s entire viral history from a single drop of blood.

John Brownstein, HMS associate professor of pediatrics at Boston Children’s Hospital, explains why your most important Facebook friend might be your doctor. Brownstein, a computational epidemiologist, also describes how our online behavior forms a “digital phenotype” that says more about our health than we might think. And in this week’s abstract, HMS neurobiologists discover a new pathway in the brain that might help explain how antipsychotic drugs work. Read more about this finding from the lab of HMS neurobiologist Bernardo Sabatini.

David Reich, professor of genetics at HMS, studies modern and ancient DNA to probe human history and learn about health and disease. In this podcast, he shares his excitement about new genetic technologies and tells the story of his winding path from social studies and physics to becoming one of the world's foremost population geneticists. And in this month's abstract, HMS geneticist Connie Cepko is investigating a new antioxidant gene therapy in mouse models of inherited blindness. Read more about her work: Seeing the Light.

For many students and young researchers today, pursuing a career in science can seem more frightening than energizing. A wealth of qualified postdocs seeking a limited number of academic positions, ever-shrinking funding, and pressure to publish all fuel a hypercompetitive atmosphere in which the quality of science can suffer. In this month's conversation, postdocs Kristin Krukenberg and Jessica Polka, lead organizers of Future of Research and authors of the Science article Making Science a Desirable Career, discuss ways the scientific enterprise can be changed to alleviate some of these challenges and make room for the next generation. And in this month's abstract, a study by genetics professor Susan Dymecki finds a new twist to serotonin neurons in the brain. Read more about the work here.

Amy Wagers, professor of stem cell and regenerative biology at Harvard and Joslin Diabetes Center, is motivated by both the prospect of treating disease and the thrill of discovery. Watch for the Winter 2013 issue of Harvard Medicine magazine for a Q&A with her.

Plastic surgeon Sumner Slavin has pioneered methods of tissue reconstruction for patients—including women with breast cancer—to restore body parts to a more usual appearance. After spending time in the Middle East, he also started a fellowship program to teach plastic surgeons from the region advanced techniques and procedures. Slavin is an HMS associate clinical professor of surgery at Beth Israel Deaconess Medical Center and serves in a number of leadership roles.

Jonathan and Christine Seidman —both professors at Harvard Medical School—run a household and a lab together. They’ve been collaborating for decades to explore the causes of hereditary heart disease, especially hypertrophic cardiomyopathy, and their skills in this area complement each other perfectly. Jonathan Seidman is a PhD and geneticist while Christine Seidman—who also has an appointment at Brigham and Women’s Hospital—is an MD and cardiologist.

Medical innovations build upon basic, curiosity-driven research—that is, research done in yeast and flies and other organisms without a specific application in mind. In this podcast, four scientists argue that it is essential for labs to continue exploring how life works. After listening to the podcast, read the related feature story.

Robert Truog—an HMS professor and a senior associate in critical care medicine at Children’s Hospital Boston—reflects on the evolving patient-doctor relationship. He recently authored a perspective piece on the topic in the New England Journal of Medicine. In addition to being a practicing physician, Truog has a master’s degree in philosophy, and he holds a leadership role in the HMS Division of Medical Ethics.

Last month, the Supreme Court heard oral arguments in a case with sweeping implications for U.S. health care. Gregory Curfman, an HMS assistant professor and executive editor of the New England Journal of Medicine, scored a coveted ticket to the proceedings. He shared insight and analysis with faculty and students during a recent Medical Education Grand Rounds presentation on campus. At issue is the constitutionality of the Affordable Care Act, which was passed by Congress in 2010. The court’s decision—expected in June—could influence the race for the White House and shape health care policy for years to come. Extended audio is available from this HMS event.

Jack Szostak, an HMS professor of genetics at Massachusetts General Hospital, shared the 2009 Nobel Prize in Physiology or Medicine for work he completed in the 1980s on telomeres, the protective caps at the ends of chromosomes. But he hasn’t worked on telomeres in years. In fact, he completely shifted fields in the early 1990s. Now he’s working to build primitive cells in the laboratory. Learn more about Szostak in the Spring 2012 issue of Harvard Medicine magazine.

HMS Instructor of Radiology Phoebe Freer explains the benefits of tomosynthesis, an imaging tool developed at Massachusetts General Hospital to enhance breast cancer screening. During a tomosynthesis exam, a camera moves in an arc over the patient, taking a series of low-dose images, which get stitched together by software. Radiologists use the resulting 3D compilation to find tumors that might be hiding and scrutinize potential problem areas before worrying patients. This podcast also explores 3D tissue models developed in the Brugge laboratory to study cancer. Plus, Professor of Radiology Tina Young Poussaint at Children's Hospital Boston shares her perspective.

Everything changes during the third year of medical school. Leaving classrooms for the clinic, students begin to apply lessons learned from textbooks, lectures and labs to real patients. And for the first time, future MDs begin to feel like doctors. Learn about this intense—and rewarding—year, known at Harvard Medical School as the Principal Clinical Experience, or PCE. Listen as students and faculty members share, based on personal experiences, how the approach fosters mentoring, communication and empathy. Interviewees include HMS student Kat Wakeham and her mentor David Hirsh, an HMS assistant professor of medicine at Cambridge Health Alliance.

Marc Kirschner, head of the Harvard Medical School Department of Systems Biology, describes a new initiative that takes aim at the alarming slowdown in the development of new and lifesaving drugs. Plus, Professor of Genetics David Reich is studying DNA from an ancient finger bone to shed light on the dawn of humanity. Image by Martin Sorger.

Elsie Taveras, an assistant professor of population medicine and of pediatrics at HMS, discusses a new Institute of Medicine report on early childhood obesity. Plus, Assistant Professor of Cell Biology Stephen Liberles explores how mice and rats sense predators. Image by Nazdravie/iSockphoto.

Harvard Medical School Professor of Systems Biology Pam Silver is engineering organisms that produce fuel and even food. Find out how she’s working to build a sustainable future through synthetic biology. Plus, Nancy Keating, an HMS associate professor of health care policy, sheds light on one aspect of the debate over the rising costs of health care.

According to research by Elizabeth Klerman, an associate professor of medicine at Harvard Medical School and Brigham and Women’s Hospital, most adults should be getting 8.5 to 9 hours of sleep each night. Learn about her study and about the benefits of a good night’s sleep. Plus, HMS Associate Professor of Medicine Julia Wang explores what causes the immune system to attack healthy cells and tissues by mistake. Photo by Jojomarie/stock.xchng.

A draft sequence of the human genome was first published in 2001. Ten years later, David Altshuler, Harvard Medical School professor of genetics, discusses how the Human Genome Project has changed the landscape of biomedical research. Plus, a study by HMS Professor of Neurobiology Qiufu Ma sheds light on the relationship between itch and pain. Image by Clix/stock.xchng.

HMS Associate Professor of Medicine Ted Kaptchuk defines placebo effects as the self-healing capabilities embedded in the ritual of medicine. Find out why he’s trying to understand the magnitude, duration and boundaries of these effects. Plus, in the process of studying the genetic roots of a horrific disease, HMS Professor of Cell Biology Bjorn Olsen and colleagues discover a new way to create adult stem cells. Photo by Christopher Bernard/iStock.

We ask some Bostonians to envision a doctor of the future and bring their questions about medical training to HMS Dean for Education Thomas Michel. We also speak with medical students who are learning that research isn’t easy. Plus, a new topical cream disables herpesvirus in a molecular two-punch knockout. Photo by Jan Reiss.

HMS professor Peter Sorger shares his perspectives on the emerging field of systems biology, and we visit the lab of Roy Kishony, where researchers are using mathematical models to probe the evolution of drug resistant bacteria. Plus, the best-laid plans of mice and men have gone awry again; scientists tell us how differences in the mouse and human brain are complicating Alzheimer’s research. For supplemental information, listen to an extended interview (mp3) with Peter Sorger.

Adrian Ivinson, director of the Harvard NeuroDiscovery Center, explains why researchers need to collaborate to tackle neurodegenerative diseases, and reporter Yvonna Reekie brings us the latest on autism spectrum disorders. Plus, a team has discovered how beetles and bacteria form a symbiotic relationship—one that ultimately results in the destruction of pine forests.

HMS professor David Altshuler discusses the relationship between human genetic variation and disease, and HMS professor George Church explains the complexities of the Personal Genome Project. Plus, we learn whether drug sales are influenced by direct-to-consumer advertising. For supplemental information, listen to an extended interview (mp3) with David Altshuler.

Nobel Laureate Eric Chivian discusses the connection between biodiversity and human disease, and Yvonna Reekie examines the emerging problem of drug-resistant tuberculosis, which is plaguing countries worldwide. Plus, using an innovative approach, researchers halt the spread of HIV in an animal model. For supplemental information, listen to an extended interview (mp3) with Eric Chivian.

HMS associate professor of medicine Stephanie Woolhandler shares her views on universal healthcare, and Yvonna Reekie takes you for a ride on the Family Van, which provides free education, counseling, support and healthcare to Boston’s economically disadvantaged neighborhoods. Plus, biology enters “The Matrix” through a new computer language.

HMS professor of neurobiology Margaret Livingstone uses art to understand how we perceive and process visual stimuli, and HMS professor of pediatrics Charles Nelson employs noninvasive techniques to measure the brain activity of children while they look at faces. Plus, you’re more microbe than mammal—at least according to your latest cell count. For supplemental information, listen to an extended interview (mp3) with Margaret Livingstone as well as an extended interview (mp3) with Charles Nelson.

HMS associate professor of pathology David Sinclair is getting under the hood of the molecular machinery that drives longevity, and HMS assistant professor of medicine Anne Fabiny is preparing students for an aging population. In addition, an HMS lab discovers a new cell death process with links to cancer.

HMS professor of medical sociology Nicholas Christakis examines how social networks affect our health, and an HMS student relies on social networking websites to rally the Kenyan diaspora. Plus, an HMS lab makes a startling discovery with implications for an emerging field called personalized medicine.