Patients: The motivation behind clinical research

Three MCH clinical researchers share their experiences
By Christine Zeindler
For Drs. Bruce Mazer, Pia Wintermark and Indra Gupta, their days begin much the same as other physicians. After waking up, they eat, check their pagers and review the list of patients they will be seeing. Then they turn their minds to a different kind of medicine – how their laboratory experiments are doing. For these physicians at the Montreal Children’s Hospital (MCH) of the McGill University Health Centre (MUHC) patient care is tied inextricablyto their research. This makes for a busy life, but they can’t imagine doing one job and not the other.
“It can make me a little schizophrenic,” says Dr. Mazer, Head of the MCH Allergy and Immunology Department, commenting on dividing his time between seeing patients and working in the lab. “Because we are always multitasking we feel pulled in one direction or another. We work long hours. If it wasn’t so much fun, I probably wouldn’t do it. But it’s extremely enjoyable, tremendously rewarding and I know I’m doing this to help people.”
Research focus: Antibodies to treat inflammatory disease
In addition to running numerous immunology clinics, to treat children with asthma, allergies, severe skin diseases and immune deficiency, Dr. Mazer conducts research at the McGill Meakins-Christie Laboratory. His work is focused on looking at how antibodies, the molecules that fight infection, can also control the immune system. “We believe antibodies are not just in the body to fight infections. We are looking at how the administration of high levels of antibodies can decrease over-stimulated immune systems, such as the immune systems of patients with asthma. It is like these molecules go into the body and calm down the immune response. We have seen this result in both animal models and in humans.”
“My research gives me interesting approaches for parents and patients. Having an understanding how the cells work and how they interact allows me to give a bit more perspective and information to families. I think they really appreciate this.”
Research focus: Cooling the body to combat brain injury
Dr. Wintermark, a neonatologist, says there is a need for research in her area of clinical expertise, the care of sick newborns. She is examining ways to stop the brain injury that occurs when a newborn is deprived of oxygen at birth, something that can happen during a particularly difficult labour. “Physicians can repair damage to the heart and most other organs, but for the moment, we have no solutions for repairing damage to the brain. Telling parents their child has this type of injury and that there is nothing we can do is unacceptable.”
Dr. Wintermark’s research focuses on cooling babies several degrees below normal to decrease brain injury. “This technique works well for some babies. Others however still develop injury, despite the treatment. Our goal is to figure out why there is a difference and how we can improve the current treatment.”
Molecular biology to understand kidney disease
Patients are also the motivator for Dr. Gupta’s research. “When I see children with kidney disease and how they struggle, it motivates me to go back to the lab and re-examine the biology behind the disease.” Dr. Gupta, a pediatric nephrologist is using molecular biology to understand how inherited kidney and urinary tract abnormalities occur. Although she is optimistic about future prospects, she cautions about expectations. “I think we should remain humble about what we can do in the lab because there are many small steps, over years, that will contribute to a significant finding down the road. I am attracted by the process of taking what we know about patients and bringing this to the lab and then back to the patient. It takes a lot of stamina, but is well worth it.”
“Patients ask why I’m always in such an upbeat mood and I say it’s because I don’t just do one thing. I think treating patients and conducting research improves the quality of care I deliver,” adds Dr. Mazer.