At the epicenter of cancer research

Dr Andy Wood from Auckland received a 2007 Fulbright-Ministry of Research, Science and Technology Graduate Award to research new treatments for neuroblastoma at the Children's Hospital of Philadelphia.

Andy Wood

When we arrive in Philly it is night time. When I awake the next morning, I rush to the window and open the blinds. The sun is shining, across the street children are playing and yelling with delight in the shadows of a church, squirrels are running up beautiful old trees. I breathe out a long sigh of relief... Phew! I like it here. More importantly, my wife likes it here. That is fortunate because we're going to be spending the next five to seven years here while I complete my clinical and research training to become a paediatric oncologist.

I wander down to the local shops and buy a newspaper. There is an article describing an infamous incident in 1968 when Philadelphia fans pelted Santa Claus providing half time entertainment at a football game. The article was angry that Philadelphia continued to be misrepresented by the press about the infamous incident from long ago. Angrily the author defended Philly - Santa deserved it, and he was lucky he was only pelted with snow balls.

I glance up from the newspaper, and abruptly stop strolling. Just 150 yards from where we're staying the beautiful row homes, trees and squirrels are replaced by groups of bored men staring at me, sitting on porches of dilapidated row homes with broken windows. Grass and knee high weeds are growing up from cracks in the pavement, and rubbish is strewn everywhere. It was clearly going to be a tough town.

It has now been ten months since I started work at the Children's Hospital of Philadelphia (CHOP), an international Mecca for research and treatment of childhood cancers. The star struck intimidation I used to experience at the hospital conferences has faded... having an international expert at every teaching session and case conference is normal now. The academic atmosphere is rarified, but there are no ivory towers here. Nothing is quite so grounding as walking through a ward of children with cancer.

My primary goal here is to improve outcomes in childhood cancer and that means becoming a physician-scientist. A physician-scientist is both doctor and scientist, trained in both fields, and ideally situated to translate discoveries from the lab to patients. When I left New Zealand I was enjoying the fruits of increasing clinical competence and autonomy as an advanced trainee. Transitioning from the wards to the lab to carry out basic science research was like starting a new career. I was at the bottom of a hierarchy again. Any traces of competence disappeared in this new realm. I was starting from zero.

Seven months into my lab experience my boss dropped a minor bomb shell on me. My main project is working in a consortium with a pharmaceutical company using cancer genetics to guide the development of new therapies. The collaborators group was having a meeting where eminent scientists from top labs were gathering to discuss their progress and present their findings for critique. My boss couldn't make it so I was going to have to give the presentation on behalf of our lab.

I scanned the day's itinerary. Speaking before me was Sir Walter Bodmer from Oxford, knighted for services to science, and speaking after me was a professor from arguably the top adult cancer center in the US. On the day my mouth was dry. As I spoke I could see one guy typing. Phew, I thought, he's ignoring me. Then three slides later he pipes up - "How does that fit with what you showed us just before?" He refers to his laptop, and his finger scrolls down his screen and he reads off it - "Three slides ago you showed copy number variation data showing no variation with risk group, so how do you explain the expression data?" To my surprise out came a sensible answer. That is the power of this place... this learning environment is just so enabling.

Ten months in I have already experienced being on the cusp of a genuine breakthrough in the cancer I have come to study. This environment is why seven months into my lab experience I had the opportunity to present to world class scientists, and produce sensible answers to their questions. That is the power of being at the epicenter.

Walking over South St Bridge I look at large panels of rust peeling off this bridge thirty years overdue for repairs, and a chain of homeless men shuffle by. I look back at CHOP, tall gleaming glass buildings and cranes building even more tall gleaming glass buildings. The juxtaposition is striking. Why is this environment so enabling for some, and disabling for others?

Spring has arrived. The new leaves add brightness everywhere and cover some tired corners of the city bringing scenic relief. As the end of our first year in Philly approaches, I laugh when I realize that to celebrate our one year anniversary in the US we're going to get given our own American citizen when our first baby is due. I wonder if that will be the sort of cultural exchange the good Senator had in mind? A part of America with us forever.