Introduction: After a varied start to his career Prof. Reynolds qualified in medicine, practised for two years then began a distinguished research career (which includes award of a Rutherford Discovery Fellowship, as well as a National teaching award), and here offers some valuable advice to first years.
Prof. Reynolds began by showing a small number of slides, and as he showed the first of these, told us his name is John, currently a lecturer in third year medicine, and also in second and third year neuroscience. He noted that anyone for any reason not going into one of the professional Health Science courses might well end up doing neuroscience or anatomy, and would see him again in those papers.
That first slide shown was Te Mata peak, south of Hastings, with a dawn sky behind it. “This is a pretty important mountain to me, as a boy growing up.” Nearby also is the Ngaruroro River, “which I nearly died at when I was 17. So it's also very special to me!” The next shot was of John when he worked in electronics, sporting a fine moustache, which was common in the ‘80s, “people wearing moustaches looking like they were in the Mafia.”
As a schoolboy, he was interested in a career in Engineering. “What I did was somewhat unconventional, and that’s the message at the end of this talk.” Along with the rest of his class he had some advice on University study, and his aim was to take Engineering at the University of Canterbury. After noting that he was “really good at languages, Russian and French”, to stick with those and Physics and drop everything else, including Chemistry “because that’s what you need for Electronic Engineering.”
Two years later, seeing the same advisor, “sweat dripping off his brow”, John was told he could not do Engineering at Canterbury, because he did not have Chemistry!
The advisor recommended that he worked in electronics, and study afterwards towards a New Zealand Certificate in engineering which he could cross-credit towards entering an engineering degree.
Wellington and Electronics
Things didn't quite work out that way. John worked for three years in a hospital, on electronics service and design, and quite liked it. “And then I had a bit of turmoil in my life. My mother died suddenly, and I wanted a change in my life. So I took off to Wellington.” There John worked in medical companies, again in electronics, rising to the position of manager over a period of 8 or 9 years, but came to realise it was not really what he wanted from life.
“And I knew this wonderful nurse who said, ’you would make a good doctor, you’re a nice person!' and I said, ‘I’d like to do it but I haven’t done biology and chemistry’, to which she responded, ‘If you work hard, you can achieve it.’ So I did it.”
The equivalent of health science back then was called Med Intermediate, which John sat. “Luckily, I got the grades”, and so he entered medical school.
In his first post-qualification post, at Whangarei Hospital, he was unlucky to strike a very difficult time. “That was a very trying time in Whangarei, because we were very short staffed, and it was very dangerous.” He could be called for anything, from an infant in distress to Intensive Care. “It was a scary place.” John told us that he had given a similar presentation recently and the parents of one of the students were in the audience. They had been working at that same hospital at the same time John was there, and and she confirmed that, ‘Oh, yes, they talk about what a terrible time it was.’ The situation is obviously vastly improved since those days.[More on that later in Questions].
After two stressful years there, he decided to do research for a while, with the aim of then going back to practising medicine.
The Silver Lining - and the Value of a Summer Studentship
One thing that made him think of Otago was a summer studentship:”I'd actually done a summer studentship in Neuroscience with a guy who's retired now, Brian Hyland.” As John was interested in electronics, this studentship had fitted in well with Dr. Hyland’s work which involved recording nerve activity. “I do highly recommend, if you're even slightly interested in thinking about research, to consider a summer studentship. They're really good value. And they're good opportunities to dip your toes in and think, ’I might want to do some research in that.’”
John also explained his motivation for working on the brain. During his two years at Whangarei Hospital, he spent some time in the Rehabilitation Unit, where patients who had suffered some kind of brain damage were retrained so their brains could perform as they had before the ‘incident’. That incident might have been a stroke, a head injury, Parkinson’s disease or other chronic neurological disorder. One of the most frustrating things was the great difficulty of getting drugs past the blood-brain barrier. “Only less than half a percent of amazing new drugs that are discovered in the labs ever get to come into practice for lots of reasons. One would be the blood-brain barrier and also, we don't understand the brain very well to know how to make it any better.”
Although it had not been his original intention, he registered for a Ph.D. After gaining that qualification, Dr. Reynolds set up his own lab. in 2005 and was made Professor of Neuroscience in 2017.
First Year Health Science Directorship
As inaugural Director of HealthSci First Year from 2016 to 2019, Prof. Reynolds lead a team that introduced substantial changes to the course. Between the years 2002 and 2016, there had been a tendency for the course to overexpand by teaching staff slipping things in they thought were interesting, but were not necessarily relevant to Health Science students at that stage. The year is undoubtedly still tough, but prior to that, “Students were being pushed too far.”
One of Prof. Reynold’s teams early steps was to cut literally 20% out of the course, including reducing lectures per subject from 4 to 3, and ensuring each student had at least one 3 hour period every week with no classes.
Research
“I’m very interested in how the brain changes, how chemicals like dopamine can change the circuits in the brain. So presumably you're listening to me and there's brain circuits in your brain that are changing - a thing called plasticity.” He went on to explain that Parkinson’s disease, which affects around 1% of the over-60s, is due to a decrease in dopamine level, and all that can be done is to “try and replace the dopamine in a certain way, which causes in a few years these terrible abnormal movements called dyskinesias.”
Dopamine is not only involved in movement, another of its many functions is in reward. John gave the example of teaching a dog to sit, in which one starts by saying the word ‘Sit!’ and encouraging the dog to lower its bottom to the ground, then rewarding them with a biscuit. “And what that does is stamp in that activity to go into the brain and what it stamps in is the association between the word sit and them actually sitting and getting the reward.” - After a while, the biscuit becomes unnecessary, a phrase such as ‘Good boy!” being sufficient reward.
“What have they learned? What their brain is doing, and we've actually contributed to the literature in the last couple of years because it's not been well understood . . . it works backwards in time. The brain is looking a couple of seconds before what's just happened to see what happened and then reinforcing that.”
In other words, the dog has learnt to associate hearing the word ‘sit’ then actually sitting and getting the reward, so dopamine is released upon the word ’sit’, and exerts its reward action on the brain.
How is this working at the cellular level?
This and other discoveries have been made using microelectrodes in the brain of anaesthetised rats. Microelectrodes are extremely fine glass probes that can - in expert hands - be inserted into individual neurons. The big question is, what will cause that cell to fire and so initiate a response? Nerve cells have tens of thousands of inputs called ‘spines’ all feeding into the cell. When these combine to reach a certain threshold, the cell fires. Using microelectrodes it is possible to measure the input strength into the cell. Furthermore, it is possible to influence the strength of the inputs, so the experimenter can make them larger or smaller “We found that it depends on when you apply dopamine onto the cell to see if it will get stronger or weaker.” So you do an action, you get an input in here, you get a dopamine pulse afterwards, you strengthen the synapses. - It’s intuitive, but we've only just proven that.”
Can This Information Be Used in the Treatment of Parkinsonism, etc?
Dyskinesia, mentioned earlier, is a truly horrible side effect of using the current treatment which floods the body with dopamine. After a few years of treatment, the patient develops involuntary movements. ”If you look at Michael J. Fox on Youtube you’ll see him with dyskinesia. You don't see people down the street usually with dyskinesia because it's very debilitating and somewhat embarrassing . . . we are trying to deliver drugs to the brain in small controlled pulses by using liposomes a couple of hundred nanometers across. We can put drugs inside them and . . . use ultrasound to blast into the brain to make these liposomes release their material into where you want them at the right time.” His group is currently working on a non-invasive device for the treatment of intractable epilepsy. Potentially, a similar approach might be used for Parkinsonism, brain cancer, and other neurological conditions.
What Does the Future Hold for You? - Make a Plan!
Most of the members present were Health Science students, and most Health Science students are aiming at Medicine, Dentistry or Physiotherapy. “And I hope you do it - [They] really are fantastic interest careers . . . The reality is that many of you will not get into a health sciences professional course.” One can go for a degree, then go for Graduate entry, “ but don't see it as a failure, see it as a new challenge.”
You are in a situation where a couple of marks makes the difference. “It's not the way it should be. It's something I tried to make less important here, but it never got to that point . . ."
"It's not a good situation to be in. And in reality, some people don't get there. So have an alternative pathway mapped out."
" . . . I still have mine. I’ve still got the calendar marked with the physiology degree I was going to do . . . Think of it as an alternative. But you really should make a plan. Be deadly serious."
"Do it at a winter semester break . . . your brain is a prediction device. It relies on things that can be quite aware are going to happen. It's better to be prepared for it than to have a big shock that things don't work out. Still, I hope you'll get to where you're aiming.”
Prof. Reynolds told us that sometimes one goes down the wrong path and that he personally has changed paths twice, once at 25 and again at 32, “and now I'm the happiest I've been in terms of my career.”
[Also check the report of the previous speaker, Prof. Houghton in regard to the many ways of helping people].
Question Time: Members questions were of the usual high standard, eliciting some very useful information, and will be published over the next couple of days.
