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A research practice

Doing research can sometimes be a full-time job, even for Beckman Institute faculty members who already have teaching and other duties. So how does a doctor who sees patients and performs surgery sometimes on a daily basis decide to add research to his list of duties? For Dr. Huan (John) Wang, there was no other choice. Major life decisions for this neurosurgeon come not from his head but from his heart.

Published on Sept. 27, 2011

Doing research can sometimes be a full-time job, even for Beckman Institute faculty members who already have teaching and other duties. So how does a doctor who sees patients and performs surgery sometimes on a daily basis decide to add research to his list of duties?

For Dr. Huan (John) Wang, there was no other choice. Major life decisions for this neurosurgeon come not from his head but from his heart. They guided his switch from cardiology to neurosurgery in medical school, his choice of a spouse, and his decision to build a research line that is integrated with his practice.

“It’s not a decision,” Wang says with passion. “I did not have a choice. Sometimes you do certain things because it’s a logical decision. This has nothing to do with logic. This is something that I want to do, period. I don’t think whether this is practical, whether or not it’s logical, this is what I want to do.”

The decision in medical school came as two separate, unexpected realizations in the operating room.

“I started out wanting to be a cardiothoracic surgeon. The first time I tagged along with the cardiovascular team they opened the chest, and they encouraged me to hold the heart,” Wang said. “It did nothing for me. I felt nothing. I said ‘you know what? This is not for me.’ So then I was lost. I didn’t know what to do.”

Wang’s voice softens as he describes the epiphany he experienced during brain surgery. 

“I was under the microscope looking at the brain and that moment did it,” he said. “That moment defined what my career choice was going to be because that mesmerized my entire being. Everything became so clear: this is it.”

The same was true with his choice of a spouse.

“I met my wife the same way. The moment I saw her, I knew she was going to be my wife,” Wang said.

“She never said she agrees with that,” he added with a laugh, “but she has been my wife for 18 years. You just happen to meet the right woman and you know it and there you go, 18 years already.

“For my career, it was the same thing. I was just fortunate enough to have that moment and that moment was right for me. That just defined my entire future career.”

Wang’s decision to pursue research in the new field of thermal neuroscience is also informed by his passion – one for making the most out of his role as a physician.

“Through the clinical care of patients, that gives me research perspectives and insights and also provides me with motivation and inspiration,” he said.

Wang’s choices have led him to a place that few inhabit: a neurosurgeon at Carle Foundation Hospital and a Beckman Institute researcher who is mapping out new territory in a field he terms thermal neuroscience. In addition to his appointment in Neurosurgery, Neurosciences at Carle, Wang is on the faculty at the College of Medicine at the University of Illinois, a member of Beckman’s Bioimaging Science and Technology group, and directs the Thermal Neuroscience Laboratory at the Institute. 

“Through the clinical care of patients, that gives me research perspectives and insights and also provides me with motivation and inspiration.”            – John Wang

As all those titles indicate, Wang’s day is full. He sees patients, performs brain and spinal surgeries – both scheduled and sometimes in the middle of the night following a gunfight – and has ongoing and planned research projects that would test someone whose days were built simply around research. Wang might seem to be a hybrid, both doctor and researcher, but for him, it is all one thing.

“It’s altogether in the sense that when I’m taking care of patients, that helps my research,” he said. “Now, one day a week, I’m sort of having an academic day; like today is my academic day but I did two procedures. It’s not like I clock in and today is my academic day and I don’t see patients. Patients, if they have needs, they can’t wait. You take care of them.

“It’s the sort of lifestyle that we’ve chosen for ourselves. So that by itself does not diminish my quality of life; it’s something that I knew I was about to get into.”

Wang’s wife likely understands, since she just graduated from the University of Illinois Medical School, and is a first-year internal medicine resident here. They have an 11-year-old boy and 9-year-old girl.

“In terms of do I need and have family time? Yes, I do,” he said. “Would I would like to have more family time? Yes, I would. But it’s all about quality and I’m hoping that’s true and I am not delusional in thinking that.”

Again, Wang returns to his calling.

“Yesterday morning, I got woken up way before dawn; a young man put a bullet in his neck,” he said. “I don’t think ‘ok, I need to arrange for my kids to go do this and eat breakfast’. I just dropped everything and here I am, let’s get that taken care of. It’s just that a certain breed of people have chosen that kind of lifestyle for a reason.”

Yet Wang has chosen to make research an integral part of his practice. He says that’s because his work as a physician underlies the research endeavors.

 “Seeing the head traumas, taking care of them, seeing them back in the office, you realize they have a lot of problems after the head trauma is treated,” he said. “What about their quality of life afterward?

“So you start to see deficiencies, you start to see areas of disappointments for the patients, how they’re not going on with their life, despite the fact that they are alive. You start to have a real feeling of what they are going through and that motivates you.”

Wang’s motivation is simply better health outcomes for his patients and for those who someday may benefit from his research, which is mutlifaceted and innovative. A prototype of a cooling helmet for the brain will soon be tested in Beckman’s Biomedical Imaging Center (BIC) and in the field in ambulances.

Wang also hopes to someday create injury centers that could address some of those deficiencies he talked about arising from brain trauma, such as subsequent loss of memory. He says the research is about improving the healthcare model for people suffering from brain injuries and disorders, not toward making him a better surgeon.

“I’ve been using chopsticks since I was a child, but I’m not a better chopstick user than when I was 11 because repetition by itself doesn’t make it any better,” he said. “It maintains the skill but it doesn’t take you to a different level. The research perspective takes you to a different level because it takes on a different perspective; it’s a different, inquisitive pathway in order to further the clinical outcome, and you may dramatically improve the outcome for your patients.”

At his Thermal Neuroscience Laboratory the focus is on the study of brain temperature, its physiological understanding, and its therapeutic implications. Wang said research into the potential therapeutic benefits of taking thermal properties into account when treating brain injuries is something that’s been needed for a long time but has been lacking because of the lack of easy access to the brain.

In order to address these issues Wang is involved in or starting several research projects. His current research focus on developing a cooling helmet – in essence a head cover that will be placed on patients who have suffered a brain injury or stroke, and could be used in the future for diverse treatments such as for people with brain disorders like schizophrenia – that is ready for the testing phase. The helmet will be evaluated this fall at Beckman’s Biomedical Imaging Center and tested with brain injury patients who are being taken by ambulance or by air to Carle’s Emergency Department.

The cooling helmet was developed at WElkins – a company headed by former NASA scientist William Elkins that uses spin-off technology from the space agency – with modifications done for Wang’s project. The concept for the helmet lies in benefits such as reducing swelling that can come from safely lowering the temperature of the brain. It is the same theory behind icing down injuries such as muscle pulls, but without lowering overall body temperature and causing potential problems elsewhere, such as in the heart.

The project is funded by the Department of Defense, with evaluations on the helmet’s performance beginning in the magnetic resonance imaging facilities at BIC. 

“The starting point is having a non-invasive MRI protocol to evaluate brain temperature,” Wang said. “And the project’s first goal using MRI – chosen for its non-invasive and high resolution qualities – will be to understand thermal properties in normal states of the brain, then move on to pathological states. So we are actually coming up with a MRI compatible cooling helmet that we are going to study inside the scanner.”

The helmets will also be included in ground and air ambulances and employed by emergency responders who have been trained in their use for head trauma and stroke patients. Wang foresees it also being used in the hospital for surgeries and eventually for treating brain disorders and follow-up treatment for brain injury.

“I also want to explore the cooling therapy in an ambulatory setting, in that a patient would be able to wear it at home for a given frequency and time and would it improve their cognitive ability,” Wang said. “In a patient with coronary artery bypass, we’ll use this to protect the brain when the heart is stopped for the surgery. We will also use it for people who have a lot of post-concussion, post-traumatic stress disorder to see if chronic application of this will sort of alleviate some of the long term consequences.”

Some of those long-term consequences Wang hopes to deal with through the creation of injury centers that would address specific aspects of brain injury, such as stroke, concussion, or memory-related issues. This project is currently in the proposal stage and would include collaboration between the University of Illinois and Carle Hospital.

Wang also helped lead an effort at Carle to create a Primary Stroke Center that was certified in 2010 for cerebrovascular and stroke interventions. He works at Carle with Dr. William Olivero, a fellow neurosurgeon and Beckman faculty member who Wang says has served as his mentor, and who recruited him to Illinois.

“He was heavily influential in my growth,” Wang said. “He’s been mentoring me, encouraging me, inspiring me, and he’s always been there for me.”

As if all the research and physician’s work weren’t enough, Wang also teaches. Wang, who earned his M.D. at the University of Kentucky and served his internship at the University of Illinois College of Medicine in Peoria, is an Assistant Professor here in the College of Medicine.

The myriad of endeavors are geared toward one goal, Wang said.    

“What happens is that if we simply help individual patients, it makes a huge difference for that given individual, but we are not making any difference in public health,” Wang said. “But if you ever come up with an effective treatment protocol, a structure, even an infrastructure that’s meaningful for head trauma patients, then that can be replicated elsewhere, as long as you have proven efficacy for that given population. That will change public health.”

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