MY heart leaps up…

John Starr, Professor of Health & Ageing, Director of the Alzheimer Scotland Dementia Research Centre, University of Edinburgh.

I have been a consultant geriatrician in Edinburgh for over twenty years. I studied in Cambridge and London, and worked in Kent, the West Midlands and London before moving to Scotland.

Recently, one of my PhD students had just got a post-doc post. He’s a mathematician by training and we’ve been working on applying graph theory to EEGs to understand changing connections in the brain before the onset of dementia. He’s shortly going on to work with the Dementia Research Institute, including the vast genomic data of UK BioBank. He has no background in biology so I was explaining to him how all our cells have the same DNA, but not all the genes are expressed by all cells. I illustrated this by saying that the eye doesn’t start growing a kidney. It was a bizarre image, but he’d never thought about its implications before. Why, given that eye cells have the same genes as kidney cells, doesn’t it grow into a kidney? It was a moment of wonder – a moment of wonder that we both shared, for every time I think about growth and differentiation I am inspired with a sense of wonder. And that’s, fundamentally, why I do research.

Having sat on various national and international research funding boards, I am aware that ‘a sense of wonder’ doesn’t rank highly on the list of potential impacts to be scored. Clinical colleagues who like to ask the “so what?” question about research would surely be unimpressed by it as a response. I’ve been in research for nearly thirty years, direct and co-direct research centres, held tens of millions of pounds in grants, published more than 400 original papers including in all those favourite journals Nature, Science, NEJM, Lancet, BMJ, PNAS etc etc, have a Google Scholar h-index of 85, sit on and contribute evidence to NICE and the WHO, but when all this is considered, the impact I feel best about is inspiring a sense of wonder.

Every time I look at data, quantitative or qualitative, and something jumps out and I suddenly see completely afresh, as if someone had switched on a light in a dark room full of treasures, I am inspired by a sense of wonder. The same now as when I first experienced it. And I hope that I can communicate that sense of wonder that comes from research to others. I remember doing some practical workshops in schools when one station was looking at functional asymmetry using a scanner to scan both hands and then measuring the difference in the length of digits between left and right. There was always hardly any difference at all. How could that be? The left index finger is millions of cells away from the right index finger and, for those us who are right handed, surely gets used far less. But there it is, almost exactly the same length. The school pupils had never thought about it, but once they did they, too, were inspired with a sense of wonder.

Perhaps you know Wordsworth’s poem about a rainbow:

MY heart leaps up when I behold
A rainbow in the sky:
So was it when my life began;
So is it now I am a man;
So be it when I shall grow old,
Or let me die!
The Child is father of the Man;
I could wish my days to be
Bound each to each by natural piety.

I must be an old Romantic at heart, but for me living isn’t about accumulating a list of achievements, or “impacts” as they might be termed, to be read out as a eulogy at my funeral. No, living is about being alive, that sequence of moments strung together from cradle to grave; and moments which inspire me with a sense of wonder, however ephemeral, are when I feel really alive. Research, suddenly seeing things revealed, just like moments when relationships deepen and transform, is able to bring such wonder into our lives. How many people’s research will make any great impact? I’m certainly under no illusion about what I have done. Most of us researchers contribute just a little to the great enterprise of improving people’s lives. But I hope I’ve helped to inspire a sense of wonder in a few folks along the way and, more importantly, that they have learnt the research skills to be able to inspire a sense of wonder in others. Whether this is about what they’ve found or, sometimes, what they haven’t found when they’d been expecting it – not just a rainbow in the sky, but also no kidney in the eye.