Interview with Julian L Seifter, MD, David E Sloane, MD, EdM, and Elisa Walsh
Why did you feel that it was important to write Integrated Physiology and Pathophysiology? What does your publication add to the field?
We felt that a book dedicated to physiology and pathophysiology would be helpful for medical and dental students, as this text has significant contributions from students who recently completed their pre-clinical training and thus are uniquely poised to delineate the material appropriate for early medical and dental students. This text should be useful not only for basic science courses, but throughout medical and dental school and beyond, especially as a refresher for those doing clinical work. This text addresses a need for integration of pathophysiology with physiology. There was a need for a book that was focused mainly on physiology but brought in clinically relevant pathophysiology. Educational materials and educational methodologies have evolved, with clinical experiences starting earlier in medical and dental school. This text streamlines important information into a concise format to deliver relevant information. It goes beyond a typical boards prep book – we are adding first principles knowledge and integrating descriptions of health and disease so that students develop a deep and flexible mechanistic understanding of how the body works. This text is comprehensive on human physiology, and highlights selected clinically relevant pathophysiology in the appropriate context with case studies and boxes.
What is the most exciting aspect of Integrated Physiology and Pathophysiology? What chapter or topic covered in this title are you most excited about?
The coverage of the central nervous system is especially exciting to us. We pay special attention to basic neurophysiology but are not limited to that – important sections cover the autonomic nervous system and the central and peripheral nervous systems, making this text one that could uniquely fit in well with neurophysiology and neurology courses. The general treatment the action potentials was readily applicable to the muscle chapters (skeletal, smooth, and cardiac). More broadly, we are excited about the integration of descriptions of various diseases at the right places where the relevant basic physiology is being described.
Who will find the greatest value from Integrated Physiology and Pathophysiology and why?
This book will be most valuable to early stage medical and dental students, but it will also be very helpful for those coming back to basic physiology when they prepare for standardized exams and whenever they need a refresher while in clinical work such as rotations.
What new ideas, practices, or procedures do you hope your readers take away from Integrated Physiology and Pathophysiology?
The chapters include anatomical or embryological information, allowing students to make connections to other courses they will take early in medical and dental school. The text focuses on structure-function relationships, and while it is not specifically a procedure textbook, it introduces the basis for practices and procedures like spirometry, electrophysiology studies (EEG, ECG), and selected endocrine studies.
What problem do you hope the future generation of your specialty will be able to solve?
Medicine is in great change right now. Medical specialties started with the development and mastery of organ specific techniques like electrophysiology in cardiology. But now we are in an age of sub-specialties, and it is harder to be a generalist.
At the same time, there has been a melding of subspecialties, with the arrival of new technologies, molecular detail that crosses along specialties. For example, there are now deep connections appreciated between cardiovascular disease and inflammation.
We hope the next generation of physicians and dentists will be able to knit together specialties that share molecular (for example, genetic) and engineering technologies based on a deep understanding of basic science principles that will lead to new innovations.
Is there anything else about Integrated Physiology and Pathophysiology you’d like to say?
We think that this text has many novel ideas in the composition and organization of the information that addresses the merging of many previously disparate areas of basic science. Appreciating these connections will be critical for future caregivers and biotech innovators seeking to improve healthcare. For example, potassium is critical for cells growth through stimulation via epidermal growth factor (EGF) and precipitous decreases in the intracellular potassium concentration can active the innate immune system complex called the inflammasome. Information like this that connects superficially disparate subsystems in human physiology and pathophysiology can inspire the asking of new questions, the posing of new hypotheses, and the reaching for new approaches.
Julian L. Seifter, MD is Distinguished Chair in Medicine at Brigham & Women’s Hospital in Boston MA. He is a Master Clinician Educator at the Brigham and the author of numerous textbook chapters and original research articles on renal disease and electrolyte physiology. He has trained generations of house staff and fellows in the Harvard hospitals as well as students at Harvard Medical School, and he has been the recipient of many teaching and mentoring awards. He is nationally recognized as a leading scholar in renal physiology and disease.
Elisa Walsh is a staff anesthesiologist who specializes in intensive care medicine, vascular anesthesia, and thoracic anesthesia. She is a Chief Resident of the Massachusetts General Hospital Anesthesia Residency Program and serves on the Education Committee and the Combined Base Year Committee. In addition to her work in the intensive care fellowship, anesthesia residency, and internship curricula, she became interested in the topic of preventing line complications during her residency. She had given several departmental lectures and produced local educational materials related to this topic.
David Sloane is an allergist-immunologist at the Brigham and Women’s Hospital, the Dana Farber Cancer Institute, and the West Roxbury VA. He is interested in complex systems, and human physiology is replete with them on multiple scales. Examples dear to his heart are the immune system, the nervous system, and signal transduction networks, but such systems scale up to human populations as we have seen in with the spread of infectious diseases like the SASR CoV-2 pandemic. He clings to an optimism that we will be able to understand the dynamics of complex systems deeply by modeling them mathematically.
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