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 19 October 2017

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GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

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SteveBown

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Stephen Bown is Professor of Laser Medicine and Surgery and Director of the National Medical Laser Centre at the Royal Free and University College Medical School, London, England, and Honorary Consultant Gastroenterologist at the University College London Hospitals.

He was born just before Christmas in 1944 and grew up in the South London commuter belt. He found this suburban environment a bit restrictive, which stimulated a life-long urge to see how the rest of the world lived and worked.

After his first degree (BA physics), he went to Harvard - ostensibly to do a PhD in physics, but in reality to get away from all local influences and decide what he really wanted to do. Volunteer work at the Boston City Hospital convinced him medicine was the answer, so he signed off with an AM (which included an elementary biology course) and went back to his tutor in Cambridge. After a little negotiation, and with one week's notice, in January 1967, he started as a medical student, being allowed to catch up on the course that had started the previous October. With clinical studies at University College Hospital London, Professor Bown qualified in 1971, despite a couple of little hiccups with examiners (life as a medical student was somewhat more relaxed than as a physics student)!

In 1975, with an MRCP behind him and a general feeling that the Health Service was falling apart (what's changed?), he went to one of his recent bosses, Professor Jack Shillingford at the Hammersmith Hospital. He asked him, "Do you think I would be mad to take two years off and go round the world?" The answer was 'No', so off he went. Four months as doctor to 80 people driving overland to India in 4 buses, followed by a year as a clinical lecturer at Singapore University Medical School (where he and a pal taught themselves endoscopy in a ward side room). He then spent a few months as a flying doctor in outback Australia. Wonderful - highly recommended to everyone!

While in Singapore, he wrote to Professor Alan Read in Bristol (enclosing his CV with lots of physics on it), asking if he could do a research project on therapeutic endoscopy. He got a rather surprised letter back from Dr Paul Salmon saying, "We've just had this project funded on using lasers to stop gastrointestinal hemorrhage - you'd better come and do it!". After this, getting accreditation in gastroenterology was a bit of a sideline - his life was lasers, lasers, and more lasers.

Feeling that a conventional consultant position was not for him, Professor Bown next persuaded the Imperial Cancer Research Fund to support him as a senior lecturer at University College London. They did this for 11 years (the latter 5 years with a personal chair), until the University took over his ongoing support in 1995.

In 1986, the Department of Health and Social Security (as it then was) stepped in with a "Special Medical Development" on lasers and the National Medical Laser Center was born. It has now evolved to the present group of about 20 full-time scientists and clinicians. The philosophy is to understand what effects laser light can have on living tissue, and identify how these effects can best be used in the treatment of human disease. The major strength of the center is to cross the barrier between the very different worlds of the laboratory and the hospital (Photodynamic therapy to scientists and clinicians - one world or two? J Photochem Photobiol 1990; 6: 1-12).

In the early days, the laser research was predominantly related to gastroenterology, but individuals from other specialties kept coming along saying, "You know about lasers, we know about . . . lungs, bladder, arteries, skin, etc. How about a joint project?" The result was the multi-specialty laser center of today, with its many collaborative programs within the University College London Hospitals, elsewhere in the UK and overseas. These are mostly supported by research grants from charities, industry, and various government agencies (New techniques in laser therapy BMJ 1998; 316: 754-7).

Professor Bown has authored over 200 publications on all aspects of the medical applications of lasers, and has given invited lectures in 40 countries. He was, in addition, co-founder of the British Medical Laser Association and the first Editor of Lasers in Medical Science.

What made you decide to become a gastroenterologist?
Endoscopes. With a background in physics, I was looking to be a cardiologist with an interest in electrophysiology; but my first boss as a registrar, Dr Gerry Bevan, was experimenting with a short, flexible gastroscope and I was soon hooked.
Who was the teacher you admired the most?
Professor John Lennard Jones. My first firm as a clinical student was with him. Not only did he teach me clinical medicine, but also, by example, taught me how to listen to and communicate with patients and to understand their needs and worries.
Which research paper influenced you the most?
My main research interest is photodynamic therapy (PDT). In the early days, many wild claims were made about selective destruction of cancers with PDT. Bugelski et al. (Cancer Res 1981; 41: 4606) showed that the photosensitizer of the day, hematoporphyrin derivative (HpD) was localized in blood vessels, not tumor or normal cells, and that tumor selectivity was a minor effect. This started me on a 20-year crusade (still going strong, but without as much progress as I would like) to convince the world that the real value of PDT is the nature of the biological effect, not tumor selectivity.
What is the most important fact that you have discovered?
If you are developing a new therapeutic modality (like thermal or photochemical (PDT) laser effects), the best way to start is by understanding the biology of the therapy on normal tissue. Destroying a lump of cancer is easy. Doing it in such a way that all the cancer is destroyed and that the surrounding normal tissues don't fall apart is much more difficult. PDT experiments on normal tissues have opened the way for studies on PDT for lesions such as dysplastic Barrett's esophagus and localized pancreatic cancers.
What is your unfulfilled ambition?
The human race is destroying itself through over-population and over-consumption. I wish I could do something to convince those with the power to change things that a better balance between the selfish demands of Homo sapiens and the needs of all other forms of life would be in everyone's long term interest - perhaps I should have been a gynecologist! Nevertheless, there are ways in which lasers might be used in simple sterilization techniques, so perhaps I can help a little.
What is your greatest regret?
To be born a few years too early, so molecular biology and computers do not come as naturally to me as they do to more recent graduates.
How do you relax?
With my family. With daughters aged 9 and 11, holidays, sports, and music fill many delightful hours.
What is your favorite sport?
Anything with a racket - particularly squash and tennis.
What is your best place in the world?
Bexhill-on-Sea railway station (the westbound platform). That's where I met my wife.
What is your favorite film?
"Shakespeare in Love" - it's nice to spend a while in another, simpler world.
What car do you drive?
A Tigra, but my all time favorites were my MGB's.
What is your best electronic 'toy'?
Palm Vx. Small, light, easy to use and to synchronize with the backup.
What book are you reading at the moment?
"Cider with Rosie" by Laurie Lee - more escapism!
Why did you get in involved in GastroHep.com?
Gastroenterology is a friendly specialty, and I'm beginning to get a taste for cyber communication. GastroHep is a nice way to do it.

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