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Meet the KI Editor: an Interview with Qais Al- Awqati
The following is the full transcript of an interview which appears in edited form in the May 2005 edition of the ISN newsletter.
ISN news : You left your country to study in the United States early in your career. How did you get to Johns Hopkins from Baghdad?
Qais Al-Awqati: When I was a resident in a hospital in Baghdad I applied for several positions abroad and was awarded a fellowship at a chronic disease hospital that was affiliated with Johns Hopkins in Baltimore. In Baghdad we experienced a cholera epidemic in 1966 and I helped to set up a hospital for the treatment of victims. Almost all of our patients survived and we became well known for our success. Representatives from the World Health Organization (WHO) were impressed that people from the Third World were able to do something without much foreign advice or assistance. At the time, Johns Hopkins was one of the major centers for the study of cholera and its treatment. It was a very lucky coincidence in a way since shortly afterwards, William B Greenough, one of the major figures in the cholera field returned to Johns Hopkins to become the Chief of Infectious Diseases and I started working with him on the pathophysiology of cholera.
ISN news : Did you know from the beginning that you wanted to specialize in the kidney?
QA: Though I always liked the kidney, I?m not sure that I knew that I wanted to specialize in it. When I was a student, the person who had the greatest effect on me was my professor of physiology, who was a renal physiologist. As a result of his influence, I was interested in electrolytes and acid-based problems from early on. It was only natural that the kidney was in the back of my mind. In fact, I was pretty open to several directions early on. If I had enjoyed the clinical work of infectious diseases I think I would have specialized in that field. My work in cholera dealt with something that many nephrologists identify with: ion transport across epithelial cells. I was part of a team that discovered how cholera toxin works and produces secretion. The GI tract, which is the target of the cholera toxin, functions like one giant nephron, actually.
ISN news : Have you maintained a side interest in infectious diseases?
QA: I still find infectious diseases one of the most wonderful areas to work in, especially now. In the old days, the clinical aspects were not as interesting ? we mainly searched for the correct antibiotic to use. Because of progress in molecular biology, the interaction between the host and the parasite, between the person and the bug, is now tractable. It?s a good time to become an infectious disease specialist. I retain an interest not in infectious diseases per se but in diarrhea and intestinal transport and the ?nephron? role of the intestine .
ISN news : How do you balance clinical medicine with research into renal developments?
QA : It?s difficult to become really proficient in both. In my own work I attend on the wards for two months of the year, which keeps me in contact with the residents. Our group is first rate, and they help to keep me up-to-date. We hold weekly meetings that I attend – at least two per week, both of which are dominated by interest in kidney diseases. That?s essentially how I keep up – as an integral part of a division mostly comprised of full time clinical researchers. I always hear about interesting patients, about what is happening with certain diseases. Would I call that proficient? Depends on how I think of myself on any given morning. Let?s say that when I have a question, I know who to ask.
ISN news : What are some of the most important insights you?ve gained as deputy editor of the Journal of Clinical Investigation ?
QA: I?ve learned how to work with and, as much as possible, meet the needs of authors. Aside from working together on a paper, one ought to provide authors with a very quick reply. Within a few days, you should let someone know if his/her submission would best be published elsewhere. People appreciate it if you don?t waste their time. I?m extremely impressed by the time and care that reviewers spend on papers. These are duties of citizenship that are often taken for granted, but which are actually an incredible effort. We don?t pay people to review papers; it?s simply part of being an active member of a community. Reviewers are unsung heroes. When someone receives a review of a paper that is critical, the tendency is to silently curse the reviewer. Yet when the review is positive, the writer often thinks it?s his/her proper due for brilliant work. Reviewers are never appreciated enough. I wish there was some way to tell them that they?re performing a great service. We can?t do that officially because they?re supposed to be anonymous.
ISN news : How is your current research translating back into the clinical realm?
QA: That?s hard to say. My colleagues and I have been investigating whether or not the mature kidney actually has stem cells. Our initial results are very positive – it looks like, as a matter of fact, the kidney contains stem cells and that these stem cells are useful in repairing damage. Perhaps this will help provide an explanation of why the kidney sometimes recovers and sometimes doesn?t. Of all of the projects that I have worked on, this looks like the one with the most promise for translation into some sort of treatment or wider understanding of how a disease actually progresses. I think that many people under appreciate the promise that stem cells hold. There is no other area in modern science – within the past fifty years, let?s say – that combines the potential for an incredible insight into the basic mechanisms behind the production of an organ or the production of a human being. On the one hand, there?s potential for gaining very deep knowledge into the basic workings of biology. On the other, we have this extremely interesting idea that stem cells could actually be used therapeutically. It?s rare that the same subject combines these two facets. Added to these is a third concern: the ethical problem posed by both the research and the basic science. In my view, the only other similar area was nuclear physics in the 1940s. The physicists working in this area were only interested in the structure of matter, but the consequences of their interest produced the fields of radiation, nuclear fission, and now nuclear fusion. These are all areas of application – whether for the benefit of mankind or its destruction. Radiation is used for the treatment of cancer of course, but we have the atomic bomb as well.
ISN news : What would you say is your strategy for building on the success of the scientific quality of KI under Dr. Klahr?
QA : Fundamental to KI ?s success is the quality of the research it publishes. We want to encourage submissions describing the best research in nephrology, in line with the high standards that Saulo established during his time as editor. In terms of changes, I would like to make the journal a little more portable and readable. Scientific journals tend to publish articles that require you to be in a certain frame of mind when you pick them up. You need to be in the mood to read in a focused manner a somewhat dense article that says one very little thing but offers mountains of proof to back it up. Most of the time, we lack the time or the inclination to do this for anything beyond one or two articles per issue. In my opinion, this limits the readability of a journal. I would like to add more features that require less concentration. This is certainly not meant to dilute the journal in any way; I simply think that people might read more articles if the journal included lighter pieces in addition to the standard ones.
ISN news : Which goes hand in hand with plans for a more frequent production cycle…?
QA: Certainly. If we make the journal portable one might be able to carry it along and read it while sitting on the plane or train. We would like to offer scientific news articles covering recent discoveries or significant developments that do not necessarily require you to examine original supporting data. A reader might even be tempted to find out more about a topic outside of his/her primary area of interest. I would also like to increase the amount of offerings that are of educational value to trainees or clinicians, something that Saulo had already begun.
ISN news
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Any major design changes planned ?
QA: We are contemplating a very big change in the look of the journal. We?re interested in making the page more legible and reader-friendly, overall. Thanks to our new collaboration with Nature, our design resources are greater than ever before. We haven?t yet decided on the definitive look and feel, but are currently working on it together.
ISN news : How do you see KI interrelating with the other two ISN/Nature collaborations, the online Nephrology Gateway and NCP Nephrology ?
QA: I see them as complementary. Perhaps we could develop joint projects. The clinical nephrology journal could include summaries of articles that appear in KI , for example. For the web-based knowledge environment, we?ve discussed making KI ?s educational material available for online reading or download. We haven?t really met yet to discuss any of these options, but these are the kinds of initiatives I hope to pursue.
ISN news : What was your reaction to the announcement that Nature would be ISN?s new publishing partner?
QA : I was intrigued when I heard the news. Nature is a distinguished publisher. Not only because it publishes top tier scientific journals, but also because its production values are incredibly high. Nature is the leader in the field, essentially. Its ability to produce interesting material is phenomenal. For instance, Nature includes a fairly significant news department. Each issue of its flagship journal includes some twenty pages of news articles. Nature has offered to share some of these resources with us, which I see as an incredible dividend resulting from the partnership. |