Zebrafish make it to Hollywood!

The zebrafish is not just your average minnow, it is a model organism commonly studied because of its rapid development, see through embryo and easily maniputable genome.  Dr. Schroeder’s lab at Loyola University Chicago, is researching the development of this organism.  Specifically, Dr. Schroeder is studying the development of neurons, mostly retinal cells, which include the bipolar cells and ganglion cells. These cells are neurons responsible for vision in the fish (similarly in humans).  Dr. Schroeder uses gateway cloning in order to extract, clone and tag a specific gene in the zebrafish. Then, using a fluorescent protein, the development of the zebrafish can be studied. But why would one study the development of the zebrafish? I mean, come on, even if it is a model organism, how cool can this fish really be?

                                          Zebrafish transparent embryo in laval development

Well, like I said before, zebrafish are not your average minnow, because of their unique developmental and genomic characteristics, the zebrafish has been studied in various areas in biology. Which is why zebrafish have made it to Hollywood, or at least have been a forerunner in modern biomedical research. For example there are genetically modified zebrafish able to detect oestrogen, a pollutant in lakes and rivers.  Zebrafish have also been used to study cancer, drug treatments, and regeneration. Yes, you read that correctly, zebrafish have regenerative capabilities of various parts of the body such as limbs, cardiac muscle, and neural cells.  Cut the zebrafish’s heart, injure its retina or spine… and it will heal itself- it will regenerate. Stem cells can be generated from zebrafish to help heal with diseases and trauma in humans.

                                          Fibroblast growth factor expressed in Zebrafish

Humans most likely do not regenerate due to an evolutionary trade off (suppressing cell growth in order to reduce cancer). After a spinal or retinal injury, the glial cells scar to prevent bleeding and further injury. This also prevents axons from getting access to the injured area, and does not allow regeneration. In zebrafish, the glial cells form a bridge that spans across the injured site. However, the glial cells allow for axon access. The injured site can, therefore, be regenerated.  Scientists at Monash University discovered a protein called the fibroblast growth factor, which accounts for the shape of glial cells and how they react to injury. This accounted for the differences between humans and zebrafish. This discovery can eventually lead to human neural repair. Other genes can lead to cardiac and limb repair. So if you thought nothing of zebrafish in the past, think again- this little organism could be the regenerative hero for humans in the near future.

Sources

http://www.futurity.org/health-medicine/zebrafish-protein-bridges-spinal-cord-injury/

http://www.sciencedaily.com/releases/2012/07/120706184353.htm

Schroeder, Eric et. al.,  In Vivo Development of retinal ON-bipolar cell axonal terminals visualized in transgenic zebrafish. Feb 2006.

How much Empathy is Needed?: A Deeper look at “Care” in the Medical Field

According to Dr. Jean Decety of the University of Chicago’s Department of Psychology, and Department of Psychiatry and Behavioral Neuroscience, when many medical students start their schooling, they show high empathy and then gradually it seems that that level declines. This has been associated with burned out personal distress and an emphasis on more care for one’s self. A medical student has his or her own “troubles” and therefore is more occupied or detached on a psychological level.  By the time that these individuals are doctors, a great number of them appear to have little or even no empathy when they practice. However, a detached perspective as a physician from a patient may not be as good as it had been perceived in the past.  

In Dr. Decety’s lecture, he explained how the concept of empathy has recently achieved an enormous amount of attention in medicine, psychopathy, justice, and the media. Empathy has deep evolutionary, biochemical, and neurological underpinnings. Empathy is mediated and moderated by multiple physiological and brain systems as well as social context. Furthermore, even the most advanced forms of empathy in humans remains connected to core mechanisms associated with communication, social attachments, and parental care. When a doctor clinically practices in the medical field, though they require mechanisms for communication and some social attachment, it can be challenging because they deal with the most emotionally distressing situations such as suffering in many forms, illness, and even death. Therefore, it has always been stigmatized  that a doctor must not be too attached to their patients, because this can be greatly detrimental for the physician. However, recent findings, such as in Can Doctors Learn Empathy? by Dr. Pauline W. Chen, shows that too little empathy when dealing with patient’s can also be detrimental for both the patient as well as the doctor.

The benefits of being apathetic during practice is that the medical practitioner feels no sense or alarm or fear while working. This also frees up processing capacities so that they can be used, and the doctor will not consistently suffer from compassion fatigue with each patient. On the other hand, the costs of lacking empathy when practicing is that the doctor underestimates the pain of others leading to poor rapport with patients. Another crucial point is that the doctor may filter out emotional information when speaking to patient that may be essential to interpretation and understanding of treatment. In agreement with Dr. Decety, Dr. Chen’s article states that “Empathy has always been considered an essential component of compassionate care, and recent research has shown that its benefits go far beyond the exam room. Greater physician empathy has been associated with fewer medical errors, better patient outcomes and more satisfied patients. It also results in fewer malpractice claims and happier doctors” (Chen).

For this reason and by the new revelations of studies and research in the last decade, a “Dr. Helen Riess has been able to create a series of empathy “training modules” for doctors. The tools are designed to teach methods for recognizing key nonverbal cues and facial expressions in patients as well as strategies for dealing with one’s own physiologic responses to highly emotional encounters” (Chen). Though empathy seemed to be rooted in much deeper things, it seems that it can also be learned like much anything else. The results of these empathy classes according to research have greatly improved doctors’ “empathetic behavior” with their patients making patients feel much more comfortable while renewing a doctor’s enthusiasm and enjoyment of his or her profession.

Knowing all the following about empathy and its correlation with the medical profession, it is evident that it must be taken into higher regard with respect to treatment of not only the illnesses that patients suffer from but also general treatment and communication with them. Maybe this could be basis for possibly creating classes during medical school so that this concept is incorporated during their formal education before they become doctors. 

Sources: http://well.blogs.nytimes.com/2012/06/21/can-doctors-learn-empathy/

Dr. Jean Decety's Lecture, "Empathy", Loyola University Chicago, Oct 30 2012