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Neurosurgery advances rely on interdisciplinary focus, scientist says
In the middle of the 17th century, as the king and Parliament fought a civil war and a typhus plague raged, a group of scholars gathered in Oxford, England.
"This Oxford Circle was a group of men with very different talents -- mechanical, biological, artistic, mathematical -- who focused, if you will, as the first multidisciplinary group to study the human brain," said Dr. Dennis D. Spencer, the chair and the Harvey and Kate Cushing Professor of Neurosurgery, who delivered the first Franklin Robinson Memorial History of Neuroscience Lecture on Nov. 17.
The lecture commemorates the late Dr. Franklin Robinson, a community neurosurgeon on the clinical faculty at Yale. Robinson had a strong interest in the history of neurosurgery, and before his death last year had organized a lecture series for neurosurgical residents. Robinson was the father of General Counsel and Vice President Dorothy K. Robinson.
At the center of the Oxford Circle was the physician Thomas Willis, who studied the structure and workings of the human brain. (Among his colleagues at Oxford was Christopher Wren, who sketched the regions of the brain that Willis explored.)
In his talk, "The Future of Neurosurgery; the Yale Circle," Spencer noted that today, as medicine and science become increasingly specialized and new tools and technologies present new opportunities and challenges, an increasingly multidisciplinary approach is needed.
Just as members of the Oxford Circle drew inspiration from one another, said Spencer, the "Yale Circle" reaches out to include scientists in other fields, including engineering, physics, molecular biology, medicine and bioinformatics. "The basic science of molecular and cellular therapy is tied to the physics and engineering technology of how it must be delivered," the neurosurgeon noted.
As he described some of the newest tools and technology -- interoperative MRI, telerobotics, magnetic assisted intervention -- Spencer provoked laughter from the audience in the Brady Auditorium by showing how beliefs and myths about the brain were depicted in movies such as "Young Frankenstein," "Donovan's Brain" and "The Man with Two Brains."
But reality and fantasy are becoming blurred, he said, pointing to the advances in neuroscience.
"We will be able to efficiently record real-time neurotransmitter and biochemical changes, the electrophysiological consequences of those changes, the oxygen and PH variability within the brain -- and will be able to deliver molecules or stimulate safely any place within the central nervous system," Spencer said.
These advances, however, are not yet the solution to disease, he said, noting that many neurological disorders -- malignant brain tumors, Alzheimer's disease, Parkinson's disease and multiple sclerosis, among others -- are still incurable.
With new technologies come ethical questions, Spencer added. "Have we evolved the social responsibility to control where science and technology are leading?" he asked. "Are we providing the proper ethical oversight, or will we let our hunger for new therapies, fame and fortune drive our research?"
In concluding, Spencer pointed out that the model of the Oxford Circle is being replicated around the world and, in looking forward, it is necessary to look back at history.
"The Yale Circle, and similar circles in our other outstanding educational institutions in the United States, are becoming as isolated as the Oxford Circle was in the mid-1600s, with similar political and religious pressures," he said. The difference, he added, is that today scientists are connected by a vast, worldwide communication network that cannot be taken apart.
"At home, here at Yale, we must continue to tear down our own partitions of the individual disciplines. We must search for the most creative additions to our faculty in fields that would seem to have no specific contribution to our own immediate needs. We must recognize that departments are for nurturing programs, and that multidisciplinary programs within the academy should provide the fertile soil for sharing information and ideas, and ultimately shifting paradigms and not be about strengthening a tribe or building a nation," Spencer said.
-- John Curtis
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