“How can we regenerate these tiny hair cells of the inner ear?”
Born in Perth, Prof Marcus Atlas is passionate about giving back to the community the benefits he has received.
“I don’t remember being pressured as a kid, I just remember my parents saying you need a fantastic education to be successful and think about the community that gave you this opportunity.”
“This was a theme that I suspect my parents got from their parents who were immigrants. My grandparents were Polish. Australia is a lovely country to live in. As a family we accepted that we should make sure that we make a contribution to the community that took such good care of us.”
“My father was in the furniture industry. Dad died of cerebral dementia aged 90.”
Dementia became one of Marcus’s medical research interests. His mother is 90 and he has an older sister (in Sydney) and a younger brother (married and living with his family in Singapore).
How did I get interested in ears?
“Medicine was full of science and biology and really cool. I did it and I loved it. I loved the complexity of it all as well as the human endeavour involved in it. Most doctors end up loving patients; this wonderful relationship with helping their patients.”
“At UWA I started my surgical training and met some Ear Nose and Throat surgeons, now retired, who I really liked. They had a big influence on me. I realised though I had to see what the rest of the world is doing in ENT.”
“I went to Cambridge and Pittsburg in the US, taking up Research and Clinical Fellowships. I returned to Sydney to join St. Vincent’s Clinic and the Garvin Institute in Sydney. I worked for 10 years in Sydney, which was the most wonderful time, I absolutely loved it.”
“The idea of doing something special in medicine relies on knowing what everyone else is doing. How they achieve things. How they make things. How they innovate. How things change. In a big city there is a real opportunity to see that. I saw it in Cambridge. I saw it in Pittsburg. I saw it in America and all the places I visited. I saw it an opportunity to do it in Sydney and in the back of my mind in Perth. How could this be good in Australia and all the people I loved in Perth.”
In Sydney, Marcus was exposed to the work of other key people emerging in the cochlear research, not least Prof Graeme Clark, based in Melbourne. “I remember as a young registrar Graeme Clark coming to meetings. He was basically a scientist and he would go and talk about these unusual things and I remember my colleagues, particularly in Sydney, but also in Melbourne, saying that he would never succeed.”
“Cochlear implantation, early ideas; it dawned on me, that really fantastic ideas weren’t always going to be embraced by clinicians early on and that you had to battle through, battle through. Anything really new is a serious battle.”
Lions and philanthropy in WA
Marcus returned to Perth as the first Professor of Otolaryngology in Western Australia. His work as a consultant otolaryngologist at St Vincents and Concord Hospitals in Sydney between 1990 and 2000 and his interest in translating research into practice carried over to the establishment of the Ear Science Institute Australia (ESIA).
“I have learnt that you have to take a business-like approach to be successful in this endeavour of the combination of research, clinical activity and education and training.. It was never going to happen because the government wanted to give it to you. There were models I had seen around the world where if you combined your clinical work with your research activities, not only would they inform each other but they would fund each other. They would create a critical mass of activity”
“I realised that we had to do it that way, so we had to think about philanthropy and people in the community who could embrace it and help us carry it out in what we call a sustainable way. Our clinical and our business activities could fund our research and education activities.”
“Lions were there right from the start. Lions Hearing Foundation said that we will support you. It was really because we started to recruit wonderful people. Our boards have been full of people in the community. It began with business people, lawyers.
“The Lions Hearing Clinics at the time were barely sustainable. They just did not know what to do with them. Lions had this tradition of taking care of people’s eyes and hearing in our community in Western Australia. They were trying to run hearing clinics, but the hearing foundation did not really have the expertise in that. To their credit they wanted to be better; they wanted to be informed by evidence; modern audiology facilities, modern audiologists; and they felt that they could not do that.”
“They saw this bloke who was interested in the area of hearing and said, “can you do it?” The clinics are now all part of the Ear Science Institute of Australia. I am so proud of Lions clinics. We employ 35 audiologists, 13 clinics and 10,000 patients a year .”
The ESIA’s critical mass of researchers and clinical skills, has made it the third largest centre of excellence in Australia and recognised internationally. ESIA works with the World Health Organisation (WHO) in its collaborative work to assist nations with evolving audiology teaching needs and hearing aid rehabilitation, especially in the Asia Pacific and China.
Links between hearing loss and dementia
The growth of scientific research into hearing loss has a very personal dimension for Marcus. The emerging research demonstrating strong links between hearing loss and dementia touches on his father’s fate.
“We have discovered that hearing loss and dementia are intimately associated with each other. Hearing loss predisposes you to getting dementia and the treatment of hearing loss might stave off dementia, delay the onset of dementia, and even the improve some of the symptoms associated with dementia.”
“It is one of the strongest risk factors for dementia, which has all just been relatively new. We have got this group who are trying to unravel the why and then at the same time beginning programs of hearing rehabilitation in patients who are predisposed to getting dementia (NCI, mild cognitive impairment).”
“If we get mild cognitive impairment, which you and I are scared of getting, we are losing our membrane, and we have a hearing loss. If we treat the hearing loss will it prevent, delay, change the dementia occurrence. It’s very possible. So that is what we are doing. That for me is a very personal and important part of what we do.”
“We have a group that is particularly interested in regeneration of the cells. This is the holy grail of hearing research; regenerate these little nerve fibres so we do not get age related hearing loss. We have got this wonderful group who are from Hong Kong; working with scientists in US and in Europe, about how we can regenerate these tiny hair cells of the inner ear. If we were to make progress on that, then it would be a massive chance for hearing people and hearing loss in the world.”
Legacy
Marcus does not want the Western Australian momentum in translational research in ear science to stop. He has left the public health system after 30 years and resigned from his UWA Chair, but he does not plan to stop research or his clinical practice.
“I have been thinking about succession planning for ages now, because I have seen it done badly and seen it done really well, both here in WA and other places. I am actively working for succession for members and myself. I can’t tell you what we are doing, but we are really actively involved in planning. The Board wants me to stay on and continue my involvement and whilst we are going to look for the right people, people both internally and externally.”
The Wellcome project is an example of the type of legacy Marcus sees from excellent translational research. Going to clinical trial next year it restores hearing to patients with painful damaged eardrums by combining science and silkworms to create a tiny device known as ClearDrum. “To do clinical trials that you began from basic science, it is a real thing. I think that has been a tremendous accomplishment for us. That will be exciting. To be able to translate that into clinical care will be a brilliant proof that if that you join your clinical activities and research activities together, you can really do something special. I think that that is proof of that.”