"The way bones heal is fascinating"
Prof. Stange, what scientific topic are you working on right now?
I’m investigating regeneration in musculoskeletal tissue. What I’m looking at especially is how bones heal – or rather, what happens when the healing process doesn’t work, in particular under special conditions such as inflammation, in old age or after an accident. My team is investigating that at the molecular level, in cells, but also in the entire organism as well. What’s actually special about it is that we always have a medical question in the back of our mind and that our results should, ideally, benefit the patient. At the moment, for example, we are working on an active substance to combat osteoporosis. The basis for our approach is a newly discovered molecular mechanism. In another project, we’re aiming to visualize whether the healing process is working properly – whether, for example, bone-forming cells travel to where they are needed, or whether too many bone-resorbing cells are there.
What characterizes you personally as a scientist?
I’m a physician who’s engaged in research. What’s really important for me is the close link between patient care and science. At the same time, I’m very curious and want to see what’s behind diseases. As a trauma surgeon, I can also be very impatient. That’s natural, because in daily hospital practice we have to make very fast decisions and act swiftly. Many of the members of my team are natural scientists who approach matters very differently – and who bring me down to earth, I’m glad to say, and point out the interim steps that need to be taken when I’m already looking for the end results. We complement each other well, and it’s extremely inspiring.
What is your greatest aim as a scientist?
My great aim is to use my scientific findings to improve things for patients. For example, I’d like to develop “biological” forms of treatment in which, in effect, a person’s entire system is used for the healing process. To really find out why something heals or not – and, when something goes wrong, to intervene at an early stage. That’s the horizon we’re aiming for, so to speak.
What’s your favourite “toy” for research – and what can it do?
Actually, there are always a lot of methods that you bring together to reach an aim. Something I think is really fascinating are the new possibilities offered by genetic manipulation. With Crispr/Cas9, for example, we can systematically switch genes in cells on or off in order to investigate their function. On the other hand, we have many methods for visualizing processes in the body, as well as in individual cells. In doing so, we use optical microscopy a lot, as well as radiological methods. For example, we are developing ceramic implants with which we can analyse structures and tissue with the aid of magnetic resonance imaging. The implants used to be made of metal, and under MRI all you could see was a big black spot. So we have a lot of “toys” at our disposal.
Can you remember your happiest moment as a scientist?
You always invest a lot of hours in your work, deal with the setbacks, have a rethink. When it’s all crowned by success at some point – that’s your happiest moment as a scientist. But these moments exist in hospital life too. I once had a patient who had been living with a bone in her upper arm which had not healed in 37 years. We undertook special treatment in her case, and after three months she was able to move her arm again fully and the bone was healed. Those are the moments of happiness that ultimately come from scientific work – when we manage to transfer to people something we have discovered in animal experiments.
And what was your biggest frustration?
Well, of course there are always moments of frustration, but I wouldn’t say there was a biggest one. I think that as a trauma surgeon you have to have relatively high frustration tolerance anyway, because you often have to deal with suffering. But I’m a very optimistic person, so frustration tends rather to motivate me to carry on. And perhaps also to think outside the box whenever carrying on straight ahead doesn’t lead to the result you’re hoping for.
Which scientific phenomenon still regularly fascinates you today?
The healing process in the bone and its regenerative capacity. It is one of the few organs which are able to regenerate themselves completely – and in such a way that later you can’t see where the fracture actually was, because really new bone tissue has been created. Bones are also able, day in day out, to adapt to the varying demands made on them and to change accordingly. That is one of the most fascinating phenomena in my field of work.
What big scientific question would you like to have an answer to?
Questions such as: Why do some things heal, and others don’t? But of course there are lots of other fascinating questions which have nothing to do with my area of research. For example: Why do we age? What connection do consciousness and the psyche have with somatic illnesses? The more you work in a scientific field, and the deeper you go, the more you discover how little you actually know.
How much artistry, creativity and craftsmanship is there in your scientific work?
As surgeons, we actually see what our hands “craft” every day. And what we do depends not only on our knowledge, but also on our very own personal creativity. The result has to match a certain picture, because afterwards we want the body to be just as it once was, as far as possible. This, in turn, has something to do with art and with beauty. After all, each person is different and each person is beautiful in his or her own way. I believe that as a doctor you need to have a lot of respect. As far as the scientific side is concerned, craftsmanship always plays a part, of course. You have to have mastered a variety of methods, and you have to bring them together. If you use the wrong tools of the trade, it can all go wrong – even though the hypothesis may have been good.