168. Peter Schmidt, From Math to Neuroscience

Show Notes:

Peter Schmidt talks about his senior year during the Iraq War, and how the news on the problem of jobless recovery led him to consider graduate school.

The Journey from Student to Dean

Peter studied biomechanics at Cornell, focusing on the mathematics of biological systems and modeling clinical trials in orthopedics. He was admitted into a fellowship program in New York at an orthopedic hospital where he worked on total joint replacement. His career path led him to neuroscience, where he led clinical research and worked for a nonprofit before becoming the vice dean of a medical school. He then moved on to running clinical trials and drug development.

A Focus on Parkinson's Disease

Pete shares his interest in Parkinson's disease and explains that Parkinson's affects a tractable part of the brain, the basal ganglia, which is easier to model mathematically. He enjoys thinking about neuronal signaling and the microstructure of the brain, which helps in understanding the macro structure. Pete's PhD work involved modeling bone at the cellular level, and he applies similar thinking to the basal ganglia in Parkinson's disease.

Research on Neurodegenerative Diseases

Pete discusses the challenges in determining whether a question in neurodegenerative diseases is a question of science or engineering. He explains the historical focus on stem cells and extracellular proteins as solutions for diseases like Alzheimer's and Parkinson's. Pete emphasizes the need to understand the role of extracellular proteins and the importance of scientific inquiry. He mentions the Nobel Prize-winning discovery of prion diseases and the subsequent focus on characteristic proteins in neurodegenerative diseases, which led to initiatives focused on proteins.

The Brain's Micro and Macro Structures

Pete discusses the current focus on extracellular proteins and the challenges in proving their role in diseases like Parkinson's. He mentions the drug Lecanemab for Alzheimer's, which slows the disease but does not reverse it. Pete predicts that future research will focus on intracellular proteins and the need to restore lost cells in the brain. He highlights the importance of understanding the microstructure to inform the macro structure of the brain.

The Logistics of Running Clinical Trials

Pete explains that success in clinical trials is more about logistics than science, with 90-95% of the work being logistical. He discusses the challenges of recruiting subjects and the importance of working with academic medical centers that have a high volume of patients. Pete emphasizes the need for fast-moving ethics boards and efficient contracting to ensure the success of clinical trials.

Incentives for Physicians

When asked about the incentives for physicians to participate in clinical trials, Pete explains that most physicians are driven by scientific interest rather than financial incentives. He mentions the importance of academic leaders who can influence the participation of residents and fellows in trials. Pete highlights the passion of physicians in diseases like Huntington's and cystic fibrosis, which drives their engagement in research.

The Role of Pharma Companies in Clinical Trials

Pete talks about his role at East Carolina University where he oversaw clinical care and research at the medical school. He discusses the changing role of pharma companies in running clinical trials. He explains that many drugs are now discovered in labs, leading to a shift in the need for pharma companies to own their data. Pete mentions the issue of trial fraud, where fake patients are used to inflate data, and the importance of tighter control over trial data. He shares his experience of rescuing a trial from fraudulent data and the challenges of identifying such issues.

Life on the Family Farm

The conversation turns to Pete's family life, and Pete shares that his youngest child recently went to college, and he inherited a family farm that has been in his wife's family for 200 years. He enjoys working with his hands, doing woodworking, and using a skid steer for various tasks on the farm. Pete describes his role as the farm handyman, fixing things and maintaining the farm equipment.

Harvard Reflections

Pete mentions taking a quantum mechanics course and a material science class with X-ray interferometry. He highlights the impact of a physics class on fits and tolerances, which taught him about the importance of clearance and interference fits. Pete also shares his experience taking a folklore course with his roommate, which was his only pass/fail course at Harvard.

Pete explains the concept of fits and tolerances in engineering. He discusses the importance of understanding whether a fit needs to be tight or loose and planning accordingly. Pete uses examples from finance to illustrate the principle of having a cushion in budgeting. He emphasizes the need to know the target fit (tight or loose) to optimize engineering and design solutions.

This episode on The 92 Report:https://92report.com/podcast/168-peter-schmidt-from-math-to-neuroscience/

Timestamps:

02:40: A focus on Parkinson's Disease

05:10: Challenges in Neurodegenerative Disease Research

09:50: The Role of Extracellular Proteins and Future Directions

17:34: Running Clinical Trials and Logistics

27:58: Incentives for Physicians to Participate in Clinical Trials

32:16: Pharma Companies and Clinical Trial Data

38:53: Personal Life and Farming

42:30: Reflections on Harvard Courses

46:23: Fits and Tolerances in Engineering

Links:

https://www.linkedin.com/in/pnschmidt

https://www.instagram.com/pnschmidt