Bhama Ramkhelawon, Assistant Professor & Director of Vascular Surgery Scientific Research at NYU

November 24, 2020

Bhama Ramkhelawon, 2019 Class of Young Leaders

Q. At NYU’s Grossman School of Medicine, you’re an Assistant Professor in the departments of Surgery and Cell Biology and the Director of the institution’s Vascular Surgery Scientific Research. What inspired you to work in this field? 

The complexity of the cardiovascular system we inherit has been challenging my neurons for a long time. Many scientists’ visions and accomplishments have framed my academic trajectory as a scientist today. It always puzzled me that we don’t fully understand how the body functions, but we have to delve into what happens when it fails to operate properly and engends diseases. As you are reading these lines now, scientists have devoted their lives to understanding and decoding the circuitry of how our eyes capture light and consequently how our brain interprets this visible signal into a meaningful thought. This happens every day – for millions of events – those that are visible and many more that occur in silence.

I chose to focus my research on one of the invisible but essential phenomenon of our body: demystifying the molecular causes underlying vascular diseases. Beyond the eagerness of delving deeper into the complexities of the vascular system and serving a better cause for individuals inflicted with life-threatening vascular aneurysms, I am fascinated by how perhaps unconsciously we have framed a political society based on how we thought the body functions. Our vasculature are expert communicators that serve the immune pacifiers. From my perspective, there also seem to be Republicans and Democrats in our body. Perhaps the closest politicians would be cells of the immune system. They have to compromise between healing and spreading injury in our organs. Decisions have to be made promptly but wisely to serve the well-being of our body.

Politicians, take note, there are many lessons learnt from the immune cells. I dream of equipping the inflammatory cells with hidden headphones so that I could listen to the conversation about strategic decision making. Here is a sample of such interactions. We are invaded by SARS-COV2 virus. Virus, let’s be clear, you are unwelcome in our mansion. Shall we kill this intruder? Yes, but at what price? What is the strategy? Please negotiate with the lung epithelium cells (lining the tubular structure of lungs via which the virus invades our body). Arm – Attack to clear-SARS-COV2. Let’s use a Trojan horse strategy! These scenarios actually happen – muted of acoustics but loud of genomic and protein alterations. I get to investigate this! I embark on this journey with these cells. In our body, communication, education, and re-adaptation are key. No cells or organs can perpetuate mankind on its own. It’s a collective effort. Many humbled lessons learnt. I keep exploring. Inspiration comes in many flavors.

Q. You spoke at a French-American Foundation webinar in May titled Racing to a Vaccine. While politicians have promised to develop a vaccine for Covid-19 in one to two years, we know that the process usually takes much longer to complete. What are the stages a vaccine must pass through before distribution to the public, and what is your interpretation of an accelerated approach for the virus? 

Let me start by mentioning that animating debates to voice different opinions and defend individual hypothesis is our bread and better as scientists. It is important to have an attentive ear and try to understand the concerns raised by others regarding vaccination and the speed of discovery. These concerns might actually refine our approach and improve our strategy. Perhaps we should think about platforms where scientists could explain these processes in lay terms to minimize the communication gap.

With that said, one of the most empowering aspects of being a scientist is the truth bearing in the facts-the mighty evidence. We shall let our body speak and listen carefully to its echoes. We now understand that the journey to a vaccine is not a cup of tea. Actually, we learn a lot by “negative” results (not as expected) from previous experiments. Every failed experiment is an opportunity to learn. The history behind the word “vaccine” speaks for itself. English physician Edward Jenner, the founder of vaccinology in the West, inoculated a boy with vaccinia virus (cowpox), and demonstrated immunity to smallpox after observing that the re-exposure of the child with deadly virus did not kill him. The word vaccine is actually derived from the Latin word vacca for “cow.” Two years later, the first smallpox vaccine was developed. Over the 18th and 19th centuries, systematic implementation of mass smallpox immunization culminated in its global eradication in 1979 (smallpox). The approach is accelerated because we have amassed critical knowledge on vaccine designing protocols since the discovery of the smallpox vaccine. We are actually not accelerating, but putting into practice what we have learnt from our failures.

We are also now equipped with state-of-the-art technologies that facilitates such studies. For example, the most advanced pipelines for COVID-19 vaccines are investigating the use of messenger RNA technology (mRNA) immunizations instead of classical immunization with the virus snippets that allows our body to build an immune response against the virus by producing protective antibodies that will destroy the virus in future encounters. This technology is a pioneer in the field of vaccination – a cherished dream of many immunologists. This has been possible through the relentless work of scientists that have now broken the secret of how mRNA instructs the cells of the body to produce proteins. Importantly, these vaccine development pipelines were aided by prompt financial support that accelerated the COVID-19 vaccine manufacturing and design. Once a vaccine formulation is validated, respected authorities heavily scrutinize the final approval phase. The FDA and other institutions will carefully analyze the data collected from all clinical phases. Safety is prioritized. However, we cannot entirely predict how the vaccine will behave in the population. But let’s hope for the best. Best alternative, we will have an antibody to treat symptomatic individuals infected with COVID-19. These strategies will be beneficial to alleviate the medico-socio-economico burden inflicted by this pandemic. COVID-25, swallow your pain, Homo erectus is armed.

Q. How has the pandemic impacted your work specifically? 

At multiple levels. We were unable to perform experiments in the laboratory for several months. This has significantly delayed the progress of our research. Like many of you, we rapidly shifted from an in-person team interaction to an isolated virtual platform. Our interactions with researchers in the field were also reduced to online platforms hindering networking efforts. Significant space was occupied by COVID-19 related research in esteemed journals which diminished, at least for this time-lapse, the publication priority of other important discoveries. However, there has been some silver linings. I wrote grant proposal to support my research and completed a draft of a manuscript that I have been pushing to work on for a while. Checked. Working from home in isolation has also pondered self-reflection on the purpose of my research. How will it impact society at large? How can I restructure my work in the event of future pandemics? How can we help in the fight? Most importantly, it has given me the opportunity to press PAUSE and look back in time to appreciate our accomplishments and contemplate how we can improve our weaknesses.

Q. From what you’ve seen so far, have international political tensions, like the US’ intent to withdraw from the WHO, affected the collaboration of scientists and medical professionals across borders?

This is a timely question. No, for the most part. But yes, to some extent. Expertise and knowledge are worldwide. Amputating a vital organ of our body will impact its function and most likely be life-threatening. Politicians, scientists, and medical profession need to talk together. Hindering these pacific communication pipelines is not an advisable approach. Our worldwide research and medical discoveries are shared with the whole community through publications catalogued on the NIH website and during meetings. Diverse opinion fosters comprehensive guidelines for the population such as what we experienced during COVID-19 pandemic. Our research is individual with a shared common vision of disseminating our findings to serve a better common cause. Scientists openly agree to disagree. It is most probably engrailed in our DNA. Ambient political tensions such as cutting down of visas for students will negatively impact the diverse intellectual talents and innovation that fuels our scientific community in the USA. Hindering the freedom of a scientist is comparable to restricting the amount of fabric given to the creative designer of Dior for one of the most epic collections. My opinion is that there should be no quota for politico-intellectual dialogue.

Q. You’re a 2019 French-American Foundation Young Leader and completed your PhD in Paris before beginning your work at NYU. What are some of the similarities and differences between the scientific communities in France & the US? 

I wished we were having this interview on a live platform so I could share some personal anecdotes. But for the sake of space, I’ll summarize my opinion with these few points. I’ll start with the unifying theme of scientific discoveries. Making scientific discoveries is not an easy task. I am sure that the intellectual pools from both sides of the Atlantic will agree that one has to be armed with resilient strengths on this scientific journey. In contrast, the differences lie in the essence of what defines US and French culture. It’s technical. The savoir-faire? The je ne sais quoi?

Some examples include the funding mechanisms to support our research. Scientists, Principal Investigators (PI) in academic institutions in the USA compete for funding from the National Institute of Health that supports project-based research. Funding efforts can be supplemented by foundation research activities and other philanthropic initiatives. These resources are usually unequivocally unmatched to what is available on the French side.

The way research is structured is also different. In the USA, there is usually one PI who oversees all operations per lab while in France, there is a hierarchical system where multiple “smaller” PIs perform research under the direction of one lab leader. From my experience, I also feel that the access to technology is facilitated (easily available) in the USA as opposed to French institutions. From a career development perspective, the trainees have access to multiple and diverse career alternatives after graduating in the USA. The choices seem to be more restricted and less versatile in the French system.

I would like to use this space to also address that the effort to increase diversity and inclusion in the scientific community in the USA is more visible. Strategies exist to increase diversity in the field Unfortunately, this aspect seems to be lagging in the French scientific community. In closing, having experienced both intellectual ambiances, I will note that the “education for all” mindset in France in the spirit of “Liberté, Egalité, Fraternité” is moving. The meritocracy system implanted in the USA uplifts this endeavor. There are ups and downs in both transatlantic academic milieus. So, let’s imbue ourselves with the best, from the best!

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