We talk with Professor Stefan Marciniak, Professor of Respiratory Science at the University of Cambridge
Professor Stefan Marciniak, respiratory consultant, professor and researcher, talks to us about the challenges of science, research and medical practices, his speciality, what inspires him and much more. Read below some of the main takeaways from our chat and, of course, watch the full interview if you don’t want to miss anything.
On research
“I love the research because it’s very creative. It lets my creative side out. Research is creative because you have to imagine lots of things that nobody knows, design experiments and most of the time it turns out you’re wrong. so you have to come up with new ideas. And you’re literally making it up as you go along. But it’s really fun discovering new things.”
“The best research is done when it’s interdisciplinary. and when I’ve got my research hat on and we’re doing basic cell biology, we have lots of collaboration with physicists and engineers to develop new treatments or new ways of doing things”.
On medicine
“Medicine is fantastic biological training. You learn a lot about many different things. Whereas people who do basic science tend to learn one thing very very well”.
On collaboration
“[On RDCNs] my collaborator is a chap called Kevin Blyth. He’s a professor in Glasgow and so we set up the rare diseases collaborative network in familiar pneumothorax […]. What that means is that every month we meet virtually […] via a secure web link, we discuss the difficult cases we’ve had in our clinics in the last month but, increasingly, doctors in other hospitals around the country […] will dial in and present their unusual case and we’re finding we’re increasing the likelihood of making a diagnosis by working together”.
“Most patients with any respiratory problems will see any respiratory doctor in any NHS hospital and get fantastic care. But if you look across the UK there will be a large number of people with rare diseases and it is inefficient and unrealistic that every single respiratory doctor is going to know about the incredibly rare disorder that I look after, for example […]. So, concentrating a lot of expertise on a small number of people is good, it’s efficient. But then, making it accessible to everybody else needs to be done. And that’s the idea of these NHS England rare disease collaborative networks or RDCNs. There are 8 now and the plan is to create more.”
On pneumothorax
“A couple of years ago a couple of trainees contacted me during the first wave of the pandemic independently to say they’d seen a patient of Covid-19 and pneumothorax. They were asking me ‘Is this a thing?’. And I said, well, pneumothorax can happen during a chest infection, but is relatively uncommon after a viral infection. But being an avid Twitter user, I asked my community if they’d seen it. And there was this wave from all over Europe saying, ‘yes, we’ve seen it’. We did some research based on that. Estimated how prevalent it was. And then one year later we found out how correct we were.“
On Pneumothorax Day
“Some charities got interested and thought it was a good opportunity to make doctors think about a rare disorder, and make it fun. They created lots of web art. They had interviews with patients and experts. It generated a lot of engagement. So, in a way, this thing that we created became a real thing. And we’re doing it again this year too. It’s hopefully going to be an annual thing and it-s a good excuse to talk about this condition and rare diseases most people may not be aware of”.
On Technology and misinformation
“Social media gives everybody a soap box. Experts can stand up on it and tell people about what they know. And patients can talk about their experiences. But also people who’ve got no idea what they are talking about can talk about that. And in social media, sometimes followers can be mistaken for gravitas. Even more sinister than that, some people on social media have their own agenda. And they can then become active on social media and it’s very difficult to counteractive them. They believe they know something secret, and of course, that’s not true… But it’s really difficult to convince them otherwise. The spread of misinformation is a real problem”.
“It’s very difficult for scientists or medics to get evidence that they are real accounts”
“And that’s why the snake oil salespeople who have a wonder type of diet are able to make so much money. Because they are able to feed people some nice simple untruths. the truth is the link between biology and medicine are incompletely understood. And that can be uncomfortable. But we have to be realistic. We have to help people by teaching them very early in life about uncertainty.“
“It’s important that patients understand their disorders as well as they possibly can but also appreciate that there are gaps in our knowledge and that disagreement between specialists doesn’t mean an absence of truth.”
On genomics
“I am sure that in 5 to 10 years we will have wonderful computational methods of linking a new mutation that we find in one of our patients to the structure of the protein and maybe the effects of the protein. But right now we can’t really do that.”
“It was this sharing of data, and being able to sequence a virus like that, and then sharing it around the world that meant that we now are starting to head to something resembling to normality.”
On the impact of Covid-19 sharing of information on the science community
“The traditional peer review system, whilst not broken, is slow. We shouldn’t throw it out. But there’s a lot to be gained from sharing information and data before papers haven’t been peer-reviewed. There will be some stuff that’s not high quality, but it needs to be discussed. and people need more tools to understand science.”
On sharing information
“We need people to understand the benefits of sharing information and being involved in clinical trials, the benefits for the community. And we need them trust. And the way we trust with them is we explain to them how important it is that they are involved and that we need leaders that we can trust.”
“In medical research there’s always an abstract, a summary for the scientist. But there’s also a lay summary. And if your grammar can’t understand it, then it’s not going to fly. It’s very important these days whenn people are applying for medical research funding, the grant bodies, absolutely expect that any paper will have had the involvement of patients. […] Because it’s as important what the patients think because what I may thing it’s important to do research on may not necessarily be what a patient thinks is important.”
“We need to ask patients if research makes sense. They will look at the consent forms or documentation and give you very valuable information in science”.
