Challenging Common Knowledge

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.