International Journal of Chronic Obstructive Pulmonary Disease

Interview: Dr Russell

Listen to the interview with the Editor-in-Chief of the International Journal of COPD, Dr Richard Russell, by clicking the Play button (the full interview is 12 minutes). A transcript of the interview is also provided below.

Q: Tell me a bit about yourself. What’s your degree in and where/when did you study?
Dr Russell: I actually started life as a doctor: a medical doctor. During my training I was kind of lucky: I did a degree in health politics and sociology, but then moved into medicine and did a degree at Guy’s Hospital which is an old hospital in London.
I then trained as a respiratory doctor and was lucky enough to then do a PhD and whilst based at the Royal Brompton Hospital at the National Heart and Lung Institute which is all part of Imperial College.
Now I’m still a senior lecturer at Imperial Collage but also I’m a full-time respiratory physician working with patients at Wexham Park Hospital which is north of Slough near Windsor outside West London.

Q: What led you to decide on this particular course of study?
Dr Russell: It’s funny how things sometimes go. I always wanted to do medicine and you kind of get influenced by people. And I fell in love with respiratory disease, mainly because of people who I thought were extremely admirable in this specialty. Then you find you’re good at it and you kind of go on from there.

Q: What are your main research interests now?
Dr Russell: At the moment I’m quite active in two areas: one of which is kind of national research and policy-making which is based on structures of care, so talking about how primary and secondary care – GPs (general practitioners) and specialists interact and work together.
I’m also interested in cellular work to do with COPD itself which is how cigarette smoke particularly influences the lungs to cause this very difficult to treat disease.

Q: How well do you think the current education system and educators serve students today?
Dr Russell: I think it serves students extremely well. I think students get a very good deal. I think there is a challenge at the moment because of pressure on them to learn more and achieve and commit to what they are doing very early when in many ways they don’t know what they want to do. That’s a big challenge for the system.
The only point I would criticize is there’s sometimes lack of original thought in that students today often don’t have a very good basic grounding of, in medicine, anatomy, physiology, pharmacology and biochemistry which you really have to have to understand health and illness and then understand what actually happens when you get disease.

Q: How can specialists in the field help patients better understand their work? For example, do you support the idea that academic/scholarly papers should all carry a “plain text explanation” of main findings/conclusions?
Dr Russell: This is a really important question. It’s a really important idea. I do think it’s slightly aimed the wrong way, though, in that, really, what we need to be doing as specialists is actually helping the press and people who then communicate with patients understand what’s going on.
To be able to write things so that the press can get excited about something and interested in something really is going three quarters of the way then to getting patients to understand. But clear English is essential: avoiding jargon and not using long words without explanation is really, really important. But it’s not just for patients. It’s also for other scientists and other medical doctors as well. So we need to excite the press, get people interested in medical research, show them what we can do and what we have done and then communicate with patients.

Q: Who, in your opinion, is doing the most interesting/exciting work in your field of medicine at the moment?
Dr Russell: There are many people all over the world in my area of COPD which is very exciting.
There are very strong groups in Italy run by a chap called Leo Fabbri.
There’s an extremely strong group in Spain particularly as well with a chap called Marc Miravitlles who is extremely good at what he does.
And then in main centers in America there is some extremely exciting work being done in Los Angeles, also in Vancouver in Canada: all of which add to the great body of knowledge that we have.
We are very lucky in the UK to have world-class both primary investigators in how the disease is formed – such as in Edinburgh and Leicester - as well as in people who are great at pharmacology such as Peter Barnes at Imperial College.

Q: Who’s had the biggest influence on your career? What have they done that has been influential on you? 
Dr Russell: That’s a very difficult question because there are so many people. Peter Barnes, who was my PhD supervisor who is one of the top scientists in the world as well as a great physician, has influenced me in many, many ways. His energy is unbounded and how he manages to produce what he does….  secondly, he’s also a genius and that really helps. It’s great, inspiring, working with him but also a little bit depressing because you know you can’t actually be as good as him. But it is inspiring more than depressing.

Q: What’s the most far-reaching change that you’ve experienced during your career?
Dr Russell: I think that’s happening right now. We’re in a really challenging time at the moment in the UK and, in fact, worldwide with healthcare systems. We’re under massive budgetary constraints because of increasing costs all of the time and obviously the slight recession that is on at the moment.
The other thing that is going on is a major limitation of junior doctor working hours and assessment and changes in their working practices all of which, to some degree, is leading to a de-professionalization such that doctors who always have prided themselves as a profession that patients like to trust, are particularly becoming, in some places, salaried workers for a hospital organization which is less professional. That’s the big challenge.

Q: What changes might you expect to see in your area of medicine in, say, five and 10 years’ time?
Dr Russell: What I would love to see, and this is particularly important in COPD, when someone with COPD gets the disease the changes which go on in their lungs are to a greater degree irreversible.
What I would love to see is a therapy produced which actually allows patients to repair and heal their lungs. We’ve not been able to do that yet, but something which actually then - re-growing is a very meaningless word - but actually will allow people to reform the damaged lungs to get their lung function back would be unbelievable. But that’s going to take at least 10 years.

Q: If you could chose an area of medicine outside of your specialty, what would you most like to know about?
Dr Russell: I’ve been mulling this one over and it’s also a very difficult question. I obviously love asking questions. It’s a great curse and also a great blessing. And there are many, many areas which are fascinating.
I still am interested in areas of inflammation and that’s what I was particularly interested in and that’s where there is crossover between many, many diseases.
Rheumatological diseases are very interesting in that it’s an area where you can take science from the bench and apply it at the bedside. They’ve got new therapies and exiting therapies in rheumatology which have been taken from bench to bedside very quickly and are very effective.

Q: If you could change one thing about yourself, what would it be?
Dr Russell: That’s easy. Two things, if I can. One of them would be to stop saying yes to things and to actually think about things first. And the other one would be to be slightly more strategic with my goals and actually have a little bit more focus on what I’m trying to achieve.

Q: Do you have any unfulfilled ambitions that you’d like to address in the future?
Dr Russell: Personally, very much I’d like to travel a lot more. I would love to come to New Zealand which would be an absolutely fantastic thing to be able to do. I do a little bit of work for the New Zealand Government and everyone who I meet from there tells me how beautiful the place is and I want to see it for myself.

Q: What’s your greatest achievement in your professional life, modesty aside?
Dr Russell: I don’t know. I don’t think I’ve done it yet. I don’t think I’ve achieved my greatest achievement. I’m not sure. I’m a little proud of lots of things. When you achieve a PhD you are proud of it. You’re very fed up of it as well because it’s taken a lot of work. But in doing the work you feel satisfied and proud that you’ve actually achieved something and contributed to something. 
I’m pleased with some of the things I’ve done nationally in contributing to the debate and also contributing to some of the policies that we have which have made things better.
And I’m proud locally of the way I treat my patients. I think I give my patients a good service. I try my very best for them. And while I keep on trying like that I think I’ll be a good doctor.

Q: What do you most dislike in your area of medicine?
Dr Russell: Not a lot. I actually enjoy many parts of what I do. I’m a bit of a control freak sometimes and I don’t like losing control but unfortunately sometimes disease does take over.
What I do dislike, I think, would have to be the effect that cigarette smoke has on lungs and the invidious and all-pervasive power that some tobacco companies seem to be able to have round the world. I think we have an obligation as respiratory disease physicians and indeed as doctors everywhere to try to stop this at every opportunity that we have.

Q: Which topics in your area of medicine are under-researched, in your opinion?
Dr Russell: Many, many, but a fundamental understanding of inflammation and the body’s responses to insults is not well understood. We don’t understand why, for example, when a particular insult occurs, such as pneumonia, the lung can be very badly damaged but then heal itself very quickly and thoroughly.
Whereas with cigarette smoke, for example, a different damage can occur which is not healable. The lung does not heal itself up at all and you just get progressive damage which eventually leads to COPD and problems with quality of life and even death in some cases. The fundamental mechanism of inflammation would be what I would want to know more about.

Q: What would you say are the benefits of “Open Access” journals such as the International Journal of COPD?
Dr Russell: It’s a great opportunity. The worldwide web has blown publishing wide open. We as scientists, all over the world, have access to information rapidly. As quickly as it’s published, it’s available. As quickly as it’s done, it’s almost available once it’s been reviewed.
That is a great opportunity for the spread of knowledge rapidly round the world. And, I hope, and I’m sure we’re seeing it, an acceleration of the pace of progress in all fields.
The other thing about Open Access is that with appropriate searching, people from other areas can maybe get hints on what they need to do in their fields from a similar study in a completely different disease area. So my idea of rheumatology working with respiratory physicians would be a fantastic one because inflammation is very similar in both diseases.

Q: What’s your vision for the International Journal of COPD?
Dr Russell: I want this journal to be the pre-eminent single disease journal in the world.
I want this journal to carry important primary research in the fields of service delivery, inflammation, drugs and therapeutics, in all areas and aspects of COPD. And to carry and contribute enormously to the debate that’s going on.

Dr Richard Russell was interviewed by Ruth Le Pla on behalf of Dove Medical Press. Ruth has setup interviews with some of our other Editors-in-Chief, so keep a look out for these, they should provide some compelling reading.

If there is someone in a specialist field you would like to read an interview about let us know and we will do our best to arrange it.