Heart to Heart
In his day-to-day life, Dr. Stephen Archer wears two hats – two extremely large and important ones. On the administrative side, Dr. Archer is the Head of Medicine at Queen’s and affiliate hospitals. With 13 divisions, Medicine is the largest department in the Faculty of Health Sciences. He expertly balances this with his role as an internationally-respected clinician scientist and cardiologist who has made discoveries in oxygen sensing, mitochondrial dynamics, and new therapies for pulmonary hypertension and lung cancer.
Recently, Karen Richardson sat down with Dr. Archer to discuss his research successes and how he is working to promote medical innovation and ensure that Kingston elevates its international profile in medicine, research and education.
What inspires you?
I am inspired by the important lessons that I have learned from my parents, my mentor (Dr. E. Kenneth Weir) and my trainees. As well, the patients serve as a daily reminder that we have both the privilege, and the responsibility, of providing advanced care for a population of over 600,000 people. Although Kingston is not large, we “punch above our weight” as a university, a hospital network and a Department of Medicine … and we can do even better! Complacency is not in my nature and I am closely engaged with the hospitals, foundations and the Faculty of Health Sciences to ensure patients get the care they need without needing to leave for Ottawa or Toronto.
What are some priorities for you as head of Medicine?
To elevate the standards of care in the city and region. And we are doing this through the development of new tools and resources. For example, we’ve initiated the process of obtaining a regional electronic health record to enhance patient care and research.
I also promote clinical programs of distinction – the types of high-tech, clinical care that must be provided by a competent university-hospital system. For example, we’ve just launched an academic dermatology program, created a successful program to place heart valves without opening the chest (TAVR) and secured support to start a living-related donor renal transplantation program.
Opportunities for professional development are also important to me, and one way they have been achieved is through new electronic media. We created an iPad program here for the house staff, which our trainees now use to interact with health records and to assist in patient education. Our medical students have also used new media to create the Queen’s Medical Student Survival Guide, which explains everything you need to know as a medical student.
Since my arrival I have focused on growing the department and increasing its research intensity. We bring in about $10 million in research funding a year, and my goal is to roughly double that, as well as to increase the number of endowed chairs and lectureships in the department. We’re also recruiting clinician scientists – physicians who have protected time to do research.
What is your research claim to fame?
As a cardiologist I study the mechanisms of oxygen sensing in the lung blood vessels. Among other things, my team has identified the role of mitochondria as oxygen sensors in lung circulation, and the biochemical pathways that make these blood vessels either constrict or relax. Building on this, we have found that these oxygen-sensing mechanisms fail in many diseases, such as cancer and pulmonary hypertension.
My current research focus is on the role of mitochondrial dynamics in human diseases. Mitochondria are traditionally thought of as the cell’s powerhouse making the energy-containing molecule adenosine triphosphate or “ATP.” However, they are also dynamic organelles that are continuously dividing (fission) and joining together (fusion). My lab studies the how and why of these dynamic processes. When fission and fusion are abnormal, many cellular processes cease to function normally. In diseases such as pulmonary hypertension, for example, impaired fusion and increased fission contribute to disease progression. We have identified the enzymes that cause this fission/fusion imbalance and showed that in both pulmonary hypertension and lung cancer we can achieve therapeutic benefit by blocking fission or enhancing fusion. This research has brought funding to Queen’s from the National Institutes of Health, the Canada Foundation for Innovation and the Canadian Institutes of Health Research.
The discoveries related to oxygen sensing were made with my mentor, Dr. Weir, at the University of Minnesota and Dr. Thébaud, then at the University of Alberta. The research on pulmonary hypertension was conducted with Dr. Michelakis and Dr. Bonnet, formerly at the University of Alberta, and the mitochondrial dynamics research was with Drs. Rehman, Ryan, and Marsboom, formerly at the University of Chicago and the University of Ottawa. We were assisted in each case by talented trainees, most of whom now lead their own research programs. We translated some of our basic science discoveries into therapies for pulmonary hypertension and cancer. The discovery that sildenafil (Viagra®) was useful for treating pulmonary hypertension has contributed to the approval of this drug as a standard therapy. Other discoveries, such as the use of dichloroacetate to treat cancer, have been tested in patients and show promise.
What is your proudest achievement?
I am probably proudest of the Coeur D’Or Award from the American Heart Association. I received this award for my leadership in creating a Network of Care for Heart Attack (STEMI) Patients in Chicago in 2011-2012. This initiative was part of a national strategy called “Mission: Lifeline” and its goal was to ensure that patients received timely angioplasty upon activation of the 911 emergency system. The final product established PCI-capable hospitals (specialized cardiac care), equipped ambulances with 12-lead EKGs, and most importantly, improved the care of those suffering from myocardial infarction in America’s thirdlargest city.
I would be remiss if I didn’t mention the Queen’s Gold Medal in Medicine, which I received during my time in medical school. I’ve always been proud of that, because when I first came to Queen’s from the Maritimes, recruited by Padre Laverty himself, I struggled as a first-year student. Ralph Clench, a unique calculus professor, helped me get through first year. No one was more surprised than I was that I had success in medicine at Queen’s.
What do you do when you’re not practicing medicine?
I really enjoy spending time with my family whenever I can. My wife, Kathie, is an epidemiologist with Public Health Ontario, and our common interest in health leads to some great conversations. We have three children, one of whom is a student here at Queen’s. My other interests include playing classical guitar, photography, reading and travel. I’m also an avid old-timers hockey player.
What is the future of the Department of Medicine?
When I hear concerns that our size or proximity to larger centres are limitations, I think of Shakespeare’s quote: “The fault … is not in our stars, but in ourselves.” The only serious limitations on the growth of excellence in the department are those we impose from lack of ambition or vision. We need only to follow our curiosity and passion, and we will play a leading role on national and international stages.
(e)Affect Issue 5 Spring 2014