What was the subject of your research?
“New forms of technology that are useful for neurosurgery. The brain stimulation method we currently use is almost exactly the same as the one used in 1936, when the first ‘awake’ brain surgeries were carried out. There is actually still considerable scope for technical advancements within this field, especially since there are potential technical solutions to so many questions in neurosurgery. I wanted to do something about this. One of the techniques that I looked into is functional ultrasound imaging. This allows us to quickly and accurately generate images of very small blood flows in the brain and allows surgeons a better view of the boundary between a tumour and healthy tissue. So, hopefully, operations will be safer and more effective.”
What are your main findings?
“I have demonstrated that we can successfully use functional ultrasound imaging to generate images of brain activity, both in operating theatres and beyond. I haven’t actually discovered anything new about the brain. I hope I will at some point, though, and now that we have this technology, the likelihood of obtaining new neuroscientific insights is far greater. We could learn more about how language works in the human brain, for example. None of the other technologies that we can use at the moment, such as fMRI and EEG, are really close to finding answers, because they are not precise enough.”
How groundbreaking is this?
“We are the first and currently the only lab that tests functional ultrasound imaging so extensively on humans. Other researchers have only tested it on mice. The device that you can use to take the measurements and apply the technology is not for sale yet. We built and manufactured the software and algorithms of the device that we use in our lab ourselves. Our work was extremely well received at international conferences. That was a great feeling. It always gave me a boost whenever I faced problems in my research or when I was being really tough on myself over things that weren’t going well.”
How did you manage to test this technology on humans?
“The neurosurgeons at Erasmus MC were enthusiastic about it and agreed that we could take our measurements during operations in the operating theatre over a 30-minute period. The operating theatre was our test chamber – that really is a unique situation. The brain of an awake person is open during that time. You can stimulate it with electricity, and you see straight away what it does to the patient. Without that half an hour in the operating theatre, we wouldn’t have been able to do these experiments, and we would never have obtained these data.”
How did patients react when you asked them for permission to take these measurements?
“An astonishing number of people agreed. I thought that was amazing. These are people whose lives have been turned upside down. They have a brain tumour, and their brains have to be open while they are awake. And we ask them to keep it open for half an hour longer than is actually necessary for their operation. But almost everyone was keen to contribute to our research. They hoped that, by doing so, they could help others who get ill.”
Why did you want to study for a PhD in neuroscience?
“I wanted to see and learn more before I started my Master’s in Medicine. During my Bachelor’s degree, I switched to studying Philosophy. I’m interested in the big questions: what is consciousness, what makes us human and what does it mean to be sick? Those questions are partly about the brain, which determine to a large extent who someone is; it’s really about the personality of your patient. That makes operating on the brain different to operating on the gallbladder, for example. To learn more about this, I studied for a research Master’s in Neuroscience, and that confirmed to me that I find research really cool. At the end of the Master’s, I helped set up this lab. I suppose I sort of drifted into the PhD programme.”
Was it hard to start studying for a PhD before you had obtained your degree in medicine?
“Yes, but I think it was good for me. You learn a lot about yourself during a PhD programme. I have a better understanding of who I am, what I believe in, how I cope with disappointments and what my weaknesses are. That meant I was way more confident when I started my medical internships. I wasn’t worried about the internships, and I could really focus on learning how to be a doctor.”
You also published a children’s book while you were studying for your PhD. What was that like?
“Children ask incredibly cool questions about the brain. Things that I basically don’t think about any more, such as ‘why do we see colour?’ By writing a book about these kinds of questions, I challenged myself to explain these things clearly. It was really good training on how to write properly, and I learnt a lot about children’s brains. Children take analogy or abstraction completely literally. I said in the book, for example, that everyone has a seahorse in their head. I was describing the hippocampus, because it looks like the tail of a seahorse. But if you’re not careful, children might just believe there really is a seahorse in their head!”
What do you plan to do now that you have finished your PhD?
“Ultimately, I hope to become a neurosurgeon. And I also want to continue to work as a scientist. I want to resolve brain diseases in a broad sense by finding and applying new technologies to understand and treat diseases. Ultimately, I dream of connecting clinic with science, as we are already doing in our lab. Patient care and science stimulate each other but, in terms of time and logistics, it’s a challenge. Still, I believe that, if it can be done anywhere, it can be done here at Erasmus MC, because we already work so closely together and the people really have that Rotterdam go-getter mentality.”
