Professor László Vécsei: Students have fantastic brains
With the changes taking place in and around the New Clinic, Professor Lászlo Vécsei’s office has relocated to the new Neurology Department. This is where I had the pleasure of conducting my interview. As always, Professor Vécsei was cheerful and friendly, eager to answer all my questions regardless of how random or personal! Professor Vécsei has a passion for research and education, spending time in laboratories around the world, as well as being appointed the Head of Neurology and Dean of Medicine at the University of Szeged!
Thank you for agreeing to take part in the interview, let’s start with a simple question! Where are you from?
I was born not to far from Szeged, in Kiskunfélegyháza.
When you were growing up what did you want to be?
I wanted to be a chemist, which is the reason I moved to a special chemistry school for secondary school. I got a special diploma in the field of chemistry. But I also loved physics. I spent a lot of time in the lab room in school. Finally, I became interested in biochemistry and biology, which was why I decided to start medical school, since all of this basic knowledge is what you need for medicine.
Where did you study Medicine?
I came to the Albert Szent-Györgyi Medical University in Szeged. I started scientific work at the Department of Experimental Surgery. Professor Petri was the head of the department back then. In the 3rd year, I moved to the department of Pathophysiology and under Professor Telegdy, started investigating the effects of different neuropeptides and how they influence the neurotransmission and behavior in experimental animals. When I finished my studies I stayed at the department, continued with my work and got a specialty in Clinical Laboratory Investigations and Neuroendocrinology.
I thought it was better to start a career as a scientist and follow as a clinician, so I moved to the University of Pécs and worked in the Department of Neurology. I defended my PhD thesis, in those days called the “Candidate of Sciences”, in 1986. After I passed the neurology specialist training I moved to Sweden, to Lund University, and worked in the field of neurochemical aspects in neurological disorders.
What drew you to Sweden?
I was quite lucky. I had the chance to continue my work in a very, very good lab. It was headed by Professor Rolf Ekman, and at that time it was probably one of the leaders in the field of neuropeptide research and in addition, it was also an excellent catecholamine lab. It measured many things but the peptides were the most exciting. We were quite lucky, I remember in 1987, Peter Goadsby and Lars Edvinsson made important discoveries. They removed jugular blood from migraine patients and measured the CGRP (Calcitonin Gene Related Peptide) levels. All of these measurements were performed at this lab and they found a high increase in CGRP which was very important in the field of migraine research. Most of the drugs that influence migraine work on CGRP.
During this time, I had the chance to measure somatostatin, corticotrophin releasing hormone, CGRP, and other neuropeptides like neuropeptide Y. I was quite lucky with this Swedish fellowship, because this place was excellent, the people were very helpful, and I was able to collect [data] and finish my PhD in 2 years. But, to tell you the truth, I got a lot of help from the assistants and professors at the department!
Did you learn Swedish while you were in Sweden?
Yes, but my Swedish is poor: Jag talar bara lite svenska!
Everyone spoke English, so my Swedish isn’t very good. My children spoke fluently. My whole family came with me to Sweden, my youngest son was born there. My family stayed there when I moved to Boston, Massachusetts.
Why did you move to Boston?
I spent one year at Massachusetts General Hospital of Harvard Medical School. I loved living in Boston. I was staying just across from the hospital and it only took me 5 minutes to get to there. It is a very good hospital. I worked there in the Department of Neurology. I was very lucky to work there since at that time excitotoxicity, which is a basic problem in neurology, had started to get attention, and my supervisor Professor Beal was deeply involved in it. Just a year or two before I arrived he published an important paper in Nature showing that the application of quinolinic acid had some kind of Huntington-like model in animals. I learnt a lot about cytotoxins, mitochondrial disturbances and when I put together the peptide abnormalities, the cytotoxicity and mitochondrial abnormalities, it gave me an excellent view about how to think about neurological disorders.
When you came back to Hungary, was it difficult to get settled back in after having lived in Sweden and America?
It was to some degree. One main reason was because I was deeply involved in science in these places. Another reason was because the way of life is different in these countries, but, to tell you the truth, I quickly got back in and it wasn’t difficult getting used to living in Hungary again. At that time I worked at the University of Pécs. I defended the Doctor of Sciences degree at the Hungarian Academy of Sciences in 1992. Soon after I was appointed Head of Neurology in Szeged, where I have worked for the last 22 years.
Did you ever experience any hurdles?
In secondary school I learned a lot of chemistry labs in organic and physical chemistry. I was lucky because this helped me a lot with all the subjects when I entered medical school. All of medicine is based on chemistry. So concerning chemistry I had no real problems. But I had difficulties in the first year – anatomy was quite a big thing for me and I even told my brother I wouldn’t be able to learn all of these things!
Students have fantastic brains. If you say to a student, “You should pass a Chinese language exam.” he will say: “Where is the book?” and “How many days?”. It is unbelievable how many things students can learn. So finally, I had no problem with anatomy, because you should just memorize a lot of names and thanks to chemistry, I didn’t have any other problems. I didn’t need to do the biochemistry exam because I got an exemption.
I especially loved pathophysiology because it explains everything – all of the things you can explain in a disorder. Clinical work is essentially a lot of basic knowledge together with experience.
Was it your love for chemistry that drove you towards neurology?
Yes, the reason I moved to neurology because in the Pathophysiology Department in Szeged I started to investigate, together with my supervisor, the effect of different hormones on the central nervous system – different monoamines, catecholamines and serotonin. I also investigated the neurological status of animals after the application of vasopressin, oxytocin and somatostatin. I worked with the central nervous system and it was quite a logical step to move in the field of neurology, and what I liked was the chemical aspects of neurological disorders so it was a good combination for me.
Which field of neurology do you specialize in?
I am mainly interested in neurodegenerative disorders, multiple sclerosis and headache. These are my favorite.
Do you think that more students should do an undergraduate degree in a basic science?
The best students are motivated! Research is also very important. Students interested in it should go to the departments and learn what is behind the clinical part of medicine. Spend as much time close to research as possible.
Do you enjoy teaching?
I started teaching in my 5th year of medical studies. I was responsible for teaching pathophysiology to a group in 3rd year. I love teaching because students can be encouraged and most of them are interested in the topics. I love small groups especially, as it is a good chance to teach students directly. It is more effective. Seminars are the best way to teach!
Do you have any favorite memories from teaching?
What I love to do when teaching is to give a case and the students prepare themselves and present the case. Several years later, students have come to me, or I met some of them around the world, and they tell me they were very satisfied with this way of teaching. It gave me a lot of happiness.
Would you change anything, any of the career paths or choices?
It’s very difficult to answer, I don’t think about the “what would be” – had I stayed in the States or Sweden maybe I’d be more successful, but maybe not.
What do you like to do in your spare time?
As most of the doctors, my spare time is very, very little, but what I like to do is to be at home, spend time in the garden, biking, reading and travelling with my wife. However, I have so many conferences and responsibilities around the world that it’s nice to just be at home.
Do you play any instruments?
I learned the piano when I was young but I didn’t practice it, but if I had time, I would love to play.
Did you learn English in school?
In my generation, we didn’t learn English in school but my mother pushed me to learn it. When I started working in the Pathophysiology Department, I read many, many articles in English. At the conferences, everything is in English, so you need to learn it. You cannot survive if you don’t learn it.
What has been your favorite thing about practicing medicine?
I love neurology because it is very logical. I often tell the students, “Ask the patient the anamnesis and then carry out a neurological investigation”. Based on the history, you can have a theory about the type of damage, maybe it’s an infarction, a tumor, a hemorrhage or inflammation. Based on the neurological findings, we can localize it and determine where the damage in the brain is. When we put together the history with the type of the damage, you can set up the differential diagnosis. What are the disorders you should think about? Based on the differential diagnosis, you can plan the diagnostic steps – CT, MRI, lumbar puncture, ECG etc. Based on this “evidence based medicine”, you can plan the treatment. It’s so logical and so nice that I really love it.
Can you tell me about the other roles you have had during your career?
I have had different elective positions in the field of neurology. I was the General Secretary of the European Society of Clinical Neuropharmacology. I worked 20 years in European Federation of Neurological Societies. Finally, I was one of the regional Vice President of this big organizations. We organized a congress in Budapest in 2011, and 5000 neurologist from all around the world came there. We organized another congress called, “Controversies of Neurology”, also in Budapest, together with Prof. Amos Korczyn from Israel, and we had around 900 neurologist attending. We also organized one about Vascular Dementia a couple of years ago.
I was the Dean of Medicine at the University of Szeged for 4 years. I am a member of Hungarian Academy of Sciences and I was the Vice President and President of the Medical Chapter of the Academy for nearly 10 years.
It was really challenging job. Every day I come to the clinic at 6 am and I am working until the afternoon, to tell you the truth when I go home, I continue working, because otherwise it is impossible to do all of these things. It’s a lot of work but I don’t want to complain because I like it.
I’m still the General Secretary of the Danube Symposium for Neurological Sciences, which includes surrounding countries, every year we organize a conference, this year it will be in Düsseldorf and in 2 years it will be in Hungary.
Do you foresee any big breakthroughs in neurology in the future?
It’s difficult to say what is will happen in the future. Stem cell transplantation will be very good if it becomes successful. The other is monoclonal antibodies that we use in multiple sclerosis and other neurological disorders. They are also very important because they work on certain cells. Nowadays the treatments are much more sophisticated and much more specific. For example, in the field of multiple sclerosis, when I started my career, we only had steroids. Today we have very sophisticated diagnostic methods such as specific MRI, TSF methods; and we also have several compounds, interferons, Copaxone, perorally active drugs, monoclonal antibodies. It is a fantastic change!
Another very important step is the so called “personalized medicine”, it means making the decision based on the patient’s genomic, proteomic structure – we will need specific biomarkers for this. These more sophisticated treatments will arise. I think that is a big step, hopefully, not just in neurology but in many fields of medicine.
Thank you Professor Vécsei for taking time out of your busy schedule to take part in the Interview Series. It has been very interesting and fascinating to hear about your exciting career. I’m sure all our readers will enjoy hearing your story, I know I certainly did!