RM: Why is it important to be a surgeon-scientist?
Wilson: Anyone who has been a patient, a loved one, a support person, or even a health care worker knows that medicine isn’t perfect. Too often we are asked to treat a condition using imperfect or incomplete information. Your doctor cannot tell you exactly what is going to happen. Instead we work in likelihoods and probabilities. We hedge our bets.
Uncertainty in medicine arises from an incomplete understanding of the complex human machine and all of the external forces that act on and interact with that machine. While clinical surgical training teaches you to operate and even to develop a degree of comfort making decisions under uncertain circumstances, surgeon-scientists go a step further. We want to know the “why?” What makes one treatment work and another fail? What if we tried something else for this patient? In short, we play a critical role in investigating the mysteries of medicine.
Canonically, a surgeon-scientist is uniquely able to address clinical needs, identify gaps in knowledge, take those ideas to the lab to design and execute experiments, and bring it back to the clinic to translate discoveries from bench to bedside. We are important contributors to the overall mission of academic medical centers, we are skilled at multidisciplinary collaboration, and we help train the next generation of surgeons interested in academic investigation. However, for me, the importance of being a surgeon-scientist is much more personal. As a surgeon-scientist, I am uniquely able to serve as a bridge between the uncertainty found in the clinical environment and the laboratory where I can ask questions and build experiments that try to push that edge of uncertainty just a little further back.
As a pediatric surgeon, I am inspired by the complex and ever-changing nature of the clinical experience, where I am faced with new challenges daily and offered the chance to take those challenges back to the lab to help create better solutions. Pediatric Surgery provides the fuel for the inception of an idea and the proving ground once conclusions are drawn and solutions are developed. As a Pediatric Surgeon, I look forward to the chance to intervene in the course of a child’s illness and, perhaps, to see them turn the corner more quickly. My goal for today and for tomorrow is to combine my experience in engineering and surgery with the goal of developing and implementing treatments that will improve the health and wellness of infants, children, and adolescents.
RM: Tell us about your current research-related activity
Wilson: In addition to being a pediatric surgeon, I am also a biomedical engineer and I direct the NIH-funded, ECLIPSe (Engineering & Clinical Laboratory for Innovation in Pediatric Surgery) Laboratory at the University of Rochester. Our mission is to create an environment aimed at developing innovative, novel tools that will improve the practice of pediatric surgery with a focus on computational imaging and machine learning technology. For example, we are currently developing a noninvasive, comprehensive digital tool for modeling the structure and function of the small intestine.
Small intestine diseases affect an enormous number of patients. Intestinal failure, or the inability of the gastrointestinal tract to sustain life without supplemental nutrition, affects patients throughout their lifespan, carries a 23-53 percent mortality rate, and is a substantial financial burden to patients and the health care system. While the clinical burden of small intestinal disease is astonishingly high, there are currently no methods to directly, noninvasively quantify small intestine function. Our research challenges standard assessment methods by shifting focus to developing a dedicated tool for direct quantification of small intestine physical properties. We have begun developing a validated digital tool that enables non-invasive, subject-specific measurements of the physical properties of the small intestine. In patients with intestinal failure, inflammatory bowel disease (e.g., Crohn’s disease and ulcerative colitis), this tool will allow us to predict patients’ ability to grow and thrive without supplemental nutrition and to predict whether surgical intervention is likely to be successful.
This research combines our expertise in the fields of tissue biomechanics, computational imaging, and clinical evaluation of individuals with intestinal disorders. Understanding the interplay between intestinal structure and function will be influential across the continuum of research and clinical care, inspiring and enabling further research towards defining pathophysiology, providing and improving diagnostic tools, and culminating in the defined targeting of disease-modifying interventions.