Working life: Surgeon and researcher Damian Mole
Damian Mole combines surgery with research. He has just been awarded a prestigious MRC Senior Clinical Fellowship to find out why people who’ve had acute pancreatitis have a shortened lifespan, even after they seem to have fully recovered. Here he tells us about the buzz of surgery, the importance of mentors and relaxing with his jazz band.
Career in brief:
- BMedSc in Cell and Molecular Pathology, University of Birmingham
- Medicine degree, University of Birmingham
- PhD on pancreatitis-associated organ failure, Queen’s University of Belfast
- Clinical Lecturer, Clinician Scientist Fellow, then Senior Lecturer and Consultant Surgeon, MRC Centre for Inflammation Research, University of Edinburgh
- MRC Senior Clinical Fellowship
I like to pretend that I can trace my interest in surgery back to my childhood living in Greece. I used to love watching fishermen darning their nets on the beach – I’d sit there for hours. You learn the same way with surgery; you spend a lot of time in the operating theatre watching people make very delicate, skilled movements with their hands.
The first time I saw an operation was a Road to Damascus moment for me. Surgery is the only branch of medicine where you actually see physiology, anatomy, biology in action before your eyes. It’s such a privilege. It’s a great team environment and there’s such a buzz about it. I still get that feeling every time I walk into an operating theatre.
I’ve never been entirely comfortable taking anybody’s word for anything. It must be very annoying for people. It’s not that I disbelieve people, but I like to understand why things are the way they are, rather than just taking the dogma or the status quo as a done deal. That’s why I love research, you really get to see what’s ‘under the bonnet’. The excitement when you realise you’ve found out something about the natural world that only you know is unsurpassable.
I’ve been researching a disease called acute pancreatitis for nearly 20 years, since before my PhD. It’s quite common, and caused by excessive drinking, gall stones or trauma. It causes the worst abdominal pain you can possibly imagine, which is often resistant to all painkillers. On average it kills one in 20 people who get it. Around a quarter of patients get dysfunction of organs separate from the pancreas – usually the lungs or kidneys – and go into intensive care; for them the likelihood of dying is one in five.
I want to find out why people who have had acute pancreatitis tend to die younger than those who haven’t, even after they have completely recovered. By looking at national death certificate data my research team found that those who’ve recovered from acute pancreatitis die, on average, three years sooner than those who’ve had less severe pancreatitis. We want to know what is damaged or changed in the body that has this lasting effect.
My MRC senior fellowship funding, which starts this year, will allow us to recruit and study a large group of people with pancreatitis and measure lots of things about them: their anatomy, physiology and genetics. We’ll do that at the time of their pancreatitis, three months after – when they’ve recovered – and then again two years later to see what parts of their organ systems or cell types have changed.
We’re particularly looking at a process called senescence, where cells lose their ability to divide and grow, but are still alive. If the cells in an organ are senescent then it’s likely that the organ itself will become senescent and ultimately fail. If we can unpick the molecular processes behind all of this, we can develop new drugs for pancreatitis patients to prevent an early death.
People who’ve had acute pancreatitis are more likely to get other diseases such as diabetes, so we might also be able to screen for those at greatest risk and intervene before it happens. The potential savings to healthcare worldwide could run into billions of pounds.
There’s no typical day in this career. I’ve spent today in front of the computer writing ethics applications, a business plan and a press release for an advanced liver MRI scan we’re planning to develop. This Friday I’m in theatre, doing the first stage of a two-stage liver resection.
I attend multidisciplinary meetings where we discuss treatment of cancer patients, and I run a weekly clinic. I try to get into the lab most days, but it seems to get increasingly difficult as my career progresses. With the explosion in ‘omics’ data it seems that even more of my time is spent at a screen than with a lab coat on!
Combining research and clinical work can be a tough balance to achieve. My MRC fellowship is critical, it makes everything happen – it pays salaries, runs labs. Most of all it gives me a solid platform to deliver this research project, so that I’m free of the perpetual cycle of applying for funding and able to fully immerse myself in the science. The fact that taxpayers’ money is invested in my research gives me a great boost.
I’m quite firm with myself about maintaining a healthy work-life balance. In the long-term your work can suffer if you don’t have outside interests. I still want to love what I do when I’m age 65 or 70. I have four daughters, two of them identical twins, and they keep us very busy. One night each week I play trumpet in a jazz band. The others are much better musicians than me, so I have to concentrate hard to keep up. When I stop, the work stress floods back in, but for those two hours I have been totally absorbed, and it feels great to know that.
If I were to offer one piece of advice to a prospective MRC fellow it would be to find a good mentor. Seek them out and take their advice on what’s best for you. I was lucky enough to benefit from the mentorship of some incredible people here at Edinburgh University and that was key to getting my Senior Clinical Fellowship.
If I could choose my legacy, it would be that the people I’ve trained over the years will come to love academic research as much as I do. And it would be brilliant if my research could help pancreatitis patients to live longer and healthier lives than they do now.
As told to Sarah Harrop