September 2008 Mentor of the Month Interview: Michael Bennett
- What is your job title and affiliation?
I’m Director of the Metabolic Disease Laboratory at the Children’s Hospital of Philadelphia (CHOP). This is a section of the Department of Pathology & Laboratory Medicine. I am also a Professor of Pathology & Laboratory Medicine at The University of Pennsylvania.
- Briefly tell us about your educational and career background.
I received my BSc degree in physiology and biochemistry from Reading University (UK) in 1972 and my PhD in clinical enzymology from Sheffield University (UK) in 1976. In 1976 Walter Timperley MD, my PhD mentor, convinced me that a career in clinical chemistry was the way to go. By 1978 I was a senior grade clinical biochemist at Sheffield Children’s Hospital where I first developed an interest in inherited metabolic diseases. This has been my professional passion ever since. I was recruited to CHOP in 1988 and worked as an Assistant Professor in the research track. I then moved to Dallas in 1991 where, following 13 years of very productive research and clinical service returned to CHOP and Penn in 2004 for my final career move.
- What are your Board certifications?
I am a Fellow of the Royal College of Pathologists (London) and a Diplomat of the American Board of Clinical Chemistry.
- With which professional societies/organizations (e.g. AACC) are you involved?
Since arriving in the USA I have been active in AACC. At first I was active in the Pediatric and Maternal-Fetal division with which I retain strong ties. I am currently on the Board of Directors of AACC and I am also on the ABCC Board of Directors. I have served on the NACB Board recently.
Previously, I was active with the Association of Clinical Biochemists and served in a number of capacities at the regional level. In particular I was the regional representative for the junior members on the National Committee. This committee was very much similar to SYCL with primary responsibility for training and career enhancement of the junior members.
I am also a long-time member of the Society for the Study of Inborn Errors of Metabolism (SSIEM) and the Society for Inherited Metabolic Disease (SIMD) and the Society for Pediatric Research (SPR) reflecting my interest in pediatric metabolic diseases.
- Just for fun, tell us a few interesting facts about yourself:
Jackie, my wife of 37 years and I have two daughters. One is a pediatrician in a local (PA) practice and the second is a 4th-6th grade science teacher. Honestly, they chose and were not coerced into their respective professions! We also have 3 grandsons aged 6 years, 2 years and 9 months.
- Favorite activities/hobbies
I totally enjoy gardening and growing vegetables despite that we live in a deer haven. This year I plan to make it impossible for our woodland creatures to use my plot as a salad bar. I used to enjoy reading complicated Russian historical novels (Tolstoy etc) but recently with an increasing volume of editorial work for the 4 journals that I am on the boards of, I’m lucky to read a volume of short stories.
- Favorite places you have traveled
I enjoy travel better when Jackie travels with me so although I have been privileged to go to some very cool places professionally, the trips that stand out mostly include camping vacations in the South of France with the children.
- Favorite book/movie
My favorite easy read author is Dave Barry. He appears to be aging (maturing) at pretty much the same rate that I am and I see a lot of similarities in his humorous observations of life. Movies: Top of my list is “The Lord of the Rings” best movie ever! My list also includes a number of fairly recent releases from the UK including “Brassed Off” which was filmed close to where I grew up in the coal-mining region of South Yorkshire, and “The Full Monty” which was filmed in Sheffield.
- What area(s) do you specialize in?
I specialize in pediatric clinical chemistry with a particular interest in inborn errors of metabolism. In the field of inborn errors my expertise is in the study of mitochondrial fatty acid oxidation defects and also a rare group of untreatable inherited neurodegenerative diseases known collectively as Batten disease.
- What initiated your interest in this (these) area(s) and how did you eventually choose this (these) area(s) for your career?
In Sheffield during my formative years, Trainee clinical biochemists were allotted different clinical rounds for training and participation. My rounds included Hem/Onc and metabolism, where I encountered many children with incurable cancers and metabolic diseases, and where I saw my first patient with methylmalonic acidemia. I have been very fortunate in being able to spend most of my career in tertiary care pediatric settings despite the need for significant relocations.
- What are your clinical and research interests?
My clinical interests now revolve around directing the activities of a pre-eminent metabolic disease laboratory. This laboratory not only confirms diagnoses of these conditions but also serves a very busy clinical practice that monitors therapy in these patients.
I have 2 major and long-standing research interests:
1. In 1978, I developed one of the first clinical services for the measurement of urinary organic acids which at that time was not a recognized clinical test and was only available in a few places world wide. Very quickly, in our Sheffield population, we identified a number of patients, some who died at presentation, with non-ketotic medium-chain dicarboxylic aciduria. We could only explain this phenomenon by a defect of an enzyme that was not proven to exist at that time. We developed an assay based on the likelihood that the enzyme existed as this turned out to be MCAD deficiency. This is the most commonly seen fatty acid oxidation defect, which we now know we can treat and most babies born in the US are screened for as part of the expanded newborn screen. After studying MCAD, we worked on gaining a better understanding of the other enzymes in the pathway. These studies continue to this day.
2. Batten disease was different; I gave a journal club as a junior clinical chemist in the early 1980’s on the subject. I thought that it would be a good thing to set up an assay for the early diagnosis of this horrible progressive, untreatable neurodegenerative disease. In order to get samples to test the assay, my neurology colleague invited myself and his 12 patients of various ages to the clinic. I saw the full spectrum of the disease and it’s devastating impact. I’ve never forgotten that day and continue my research trying to find a cure. As a postscript, the diagnostic test did not work and 25 years later, I’m still trying to develop that test.
- What, in your opinion, has been the most important contribution you have made to the field of laboratory medicine?
I have participated not only in the recognition of a whole family of metabolic disorders but also in the development of methods to make early presymptomatic diagnosis of what were initially seen to be fatal conditions. I have also trained a number of individuals to follow in my footsteps (Not that retirement is an option for me.
- Are there specific aspects of practicing laboratory medicine that you find unappealing?
It would be very easy to say that the increasing burden of legislation and administration is a burden. However, the majority of these administrative issues help to maintain better quality of the service, which I now view to be as important as the use of clinical methods themselves.
Taking call for mislabeled or inappropriate pediatric samples at 2.00am is not overly appealing but has been a necessary part of my job. I found that it is much harder to tell a physician to redraw from a very small, sick neonate than it is for an adult.
- How would you recommend achieving an optimal work/life balance?
I would never recommend throwing all of your efforts into just the working environment. It is important early on in a career to put in that extra effort at the workplace in order to get established and move on up the career ladder but never do that to the extent that your other life suffers. Always find the time to enjoy doing the activities that also give you great pleasure outside of the workplace.
- What excites you about practicing laboratory medicine everyday?
The unknown. In my own specialist field, hardly a day goes by when there isn’t at least one patient or patient sample that requires further in depth detective work. For instance no two chromatograms from urine organic acid analysis are identical and there remains a huge thrill when after 30 years I see something that I haven’t seen before. I continuously remind the fellows as I train them that there are still novel disorders out there waiting to be identified.
- What are your predictions for advances in laboratory medicine and/or your area over the next ten years?
In my own area, I see that advances in mass spectrometry are going to continue to revolutionize the fields of metabolomics and proteomics. Thus increasing the quantity and quality of disease-related biomarkers that we will have in our clinical service. We are still remarkably limited in many areas to be able to diagnose and predict outcomes for disease. In all of laboratory medicine, advances will be made as we develop a greater insight into the interpretation and use of the wealth of data that is being derived from microchip technology.
- What do you see as the challenges facing young scientists in laboratory medicine?
Over the short term, it is going to be difficult to generate an academic career in laboratory medicine due to the low levels of federal funding for new scientist development. I sincerely hope that funding levels return to previous levels otherwise we will lose a generation of gifted scientists. In clinical laboratory medicine, it is going to become increasingly important that young scientists become involved with emerging technologies. These are the tools that are going to be used as their careers evolve and now is the time to become an expert in this technology.
- What specific goals would you recommend that young scientists in your discipline set for themselves? Any suggestions on how to achieve them?
Early in your career, identify a very specific area that you are interested in and make it a major focus of interest. An interest that you would like to be known as an expert of in later years. Use this focus to initially present teaching rounds and local seminars so that you can get in tune with the topic. Then identify an individual within the profession who is already acknowledged as an expert in that particular field and ask that person for advice as to which areas in the field need addressing. Don’t ever be afraid to approach these established experts. All of them are human and most of them will be very flattered to be asked for their advice. Try also to visit the experts or get them invited to give rounds or seminars at your institution, as one on one meetings can be much more productive. It is easier to communicate and develop collaborations with someone who you know personally.
- Do you have any other specific comments or advice that you like to provide to the members of SYCL?
Get out there and make yourself known to the clinical laboratory community. Do good science and present it at scientific meetings. Be active within your professional body.