POWER OF ONE A balloon, the beach, biology and blood pressure Warwick P Anderson was the first in my family to The cane gang that cut our be able to go to university, 1On the farm crop for many years was from I and like so many other stu- the local Aboriginal settlement dents, I didn’t have any idea of on Ulgundahi Island, the next what I wanted to be. However, island to ours. They were digni- the offer of a teacher’s college fied men. I remember my father scholarship meant that this cane saying to me that we were the farmer’s son could afford to go to luckiest cane growers in the dis- the University of New England trict because this gang was the (UNE), with its great system of most reliable, hardworking and residential colleges. Raised on a honest. The settlement was later farm on Warregah (Box 1), an moved to Maclean, the local alluvial island in the Clarence town. My mother gave birth to River in northern New South my younger brother in Maclean Wales, I had attended Chats- hospital, sharing a room with an worth Island Primary School, Aboriginal woman with whom which boasted two or three she kept in touch. I remember teachers, depending on student Me (Warwick Anderson; back row, left), my father (front row, left) and being astonished when my numbers. The headmaster, Mr Anderson uncles and cousins from Warregah. ◆ mother told us that this Aborigi- Woolley, was a fan of English nal mother was terrified that the grammar and, as a result, many authorities would come and of my postdoctoral students (and my daughters) have had to take her baby away. I know now of course that this was the time endure grammar lectures. of the Stolen Generation, but at the time it seemed unthinkable High school was in Maclean, two river crossings away. Country and very alarming to us. I am very grateful to my parents for their high schools were then, as ever, under pressure. I remember involvement with these Aboriginal people, and for the values mathematics in second year needed to be taught in the headmas- they passed on to their children ter’s garage.The Medical There wereJournal two pivotalof Australia moments ISSN: at high school that My first residential college experience at UNE was of eight led me0025-729X into science; 6/20 one December involving 2010 a balloon193 11/12 and the other, the “freshers” sharing a long dormitory without heating through an beach.679-684 In first year science, our teacher Mr Whelan asked us Armidale winter. There were frozen pipes in the mornings and a ©The Medical Journal of Australia 2010 whether,www.mja.com.au in our opinion, air had weight. Of course we all said long, cold bus ride out to the university for breakfast. This was “no” —Power who of could One feel the weight of air on us! So he weighed a not an exceptionally conducive environment for studying, balloon deflated and then reweighed it inflated and, of course, although I can’t blame the accommodation for the modest four the balloon had gained weight. This was such a simple lesson and bare passes I managed in my first year, one only after a I can still recapture the thought that I had then — that what supplementary exam in January. Fortunately, in second year I seemed obvious was, in fact, wrong; a powerful message that has stumbled into the UNE subject, physiology, fell in love with stayed with me. Then, in my final year of school, Colin Cork, our learning about homoeostasis and integration of the body systems, biology teacher, showed us how to see what all of us NSW coastal and graduated in 1968 with first class honours. I will forever be kids had seen, but not seen — that the shore between low and indebted to Max Webster and the rest of the Physiology Depart- high tides was “understandable” on the basis of science, on the ment for such a stimulating learning environment. basis of the biology or the living flora and fauna and their interactions with this environment. We learned how plant and Beginning in research animal habitats were affected in understandable ways by their relative exposures to water, sun and the environment. In short, My interest in medical research as a power for good and for he showed that science made a familiar place for enjoyment also alleviating human suffering might be attributed, in part, to a place of understandable complexity and beauty. growing up in a small community where everyone knew every- one else, and knew all their trials and tribulations. In small communities, it is easy to understand that not everyone is born with the same opportunities, and that family circumstances and National Health and Medical Research Council, ill health or disability profoundly affect people’s start in life. In Canberra, ACT. our small school and community, people with disabilities, ill Warwick P Anderson BSc(Hons), PhD, health, bad luck or accidents were people we knew well and Chief Executive Officer lived near. Undoubtedly, too, my father’s type 1 diabetes, which killed him at 51, had a significant effect on my career choices. How could it be that the failure of such a small and, on the face [email protected] of it, simple gland could result in so much ill health, even when insulin was replaced by injection? MJA • Volume 193 Number 11/12 • 6/20 December 2010 679 POWER OF ONE Research in the past decade has 2 Renal haemodynamic responses to renal remarkable careers: Victor Dzau is now shown us that early environment is artery stenosis in dogs chancellor for health affairs at Duke crucial. So, it is very probable that my University and president and Chief love of learning, a belief in fairness, in Stenosis Executive Officer (CEO) of Duke Uni- taking responsibility for one’s actions versity Health System, and Ed Miller is and in working hard and in helping 120 Dean and CEO of Johns Hopkins Medi- others comes from growing up in a cine. Aorta hardworking rural farming community, 100 Hypertension is a major health prob- consisting largely of third- and fourth- lem in both developed and developing generation immigrants from Scotland. countries. The World Health Organiza- The Chatsworth district was then Arterial 80 tion estimates that it causes over seven almost entirely populated by 19th cen- pressure million deaths each year.4 It has been (mmHg) Renal artery tury Scottish immigrants. This may be 60 estimated that almost a billion people pushing an argument too far, but the world-wide have high blood pressure, values of the Scottish enlightenment with two-thirds of these living in devel- were strong in that society. I find it 40 oping countries.5 High blood pressure disturbing that now, in the 21st century, is not glamorous, but is a silent disorder there is an apparent retreat from reason and still largely of unknown cause and in many Western societies, and often a 20 therefore hard to prevent. It is astonish- retreat from science. Many people seem ing to think that for most people with to regard their own views and beliefs as 400 hypertension, we still have no real being of equal value to any other, understanding of what causes their Renal whether or not they are founded on any blood blood pressure to rise. This rise is slow factual, scientific or logical base. There flow 200 and incremental in most people and we are many examples, such as the wide- (mL/min) rely on animal research for much of our spread use of such alleged therapies as progress towards understanding the homoeopathy, or the belief that crystals 0 pathogenesis. That the kidney is at the have magic healing powers. centre of causation seems likely. To My father died when I was in my 0.4 maintain plasma filtration, and thus Renal third year at university, but thanks to resistance continued body fluid homoeostasis and support from the War Widows Guild (mmHg/mL/min) 0.2 life, ultrafiltration in the kidney (established by Jessie Vasey), I was able requires blood pressure in the kidney’s to complete my Bachelor of Science glomeruli to be more than 15 mmHg degree with honours. I joined John 0 higher than the oncotic pressure 1 h Ludbrook, Professor of Surgery at the Resistance of the stenosis exerted by plasma proteins. That is, the on the renal artery University of New South Wales, as a 0 1 2 3 4 blood pressure in the kidney matters, Resistance of the vasculature Day PhD student, and then transferred to whereas for other organs it’s the flow of the University of Adelaide with him Error bars on Day 2 show standard error of the mean blood and its delivery of oxygen that is when he became Professor of Surgery change in aortic pressure, renal artery pressure and renal mainly regulated. To be teleological, it there. South Australia was in the throes blood flow, over the 3 days of stenosis. The arrows indicate can be argued that there has been pow- the beginning of stenosis. ◆ of electing Don Dunstan as its state erful evolutionary pressure to establish political leader, and the 3 years of my physiological control mechanisms that PhD and living in a postgraduate college in the great city of set overall arterial pressure in order to maintain just this Adelaide at the end of the 1960s were memorable. John Lud- glomerular blood pressure at the levels required. This reasoning brook talked Francis Moore, Professor of Surgery at Harvard can explain the results of experiments shown in Box 2 — when Medical School and the (then) Peter Bent Brigham Hospital, into glomerular pressure was reduced by abruptly narrowing the taking on a science-trained Australian postdoctoral Fellow, and I supplying renal artery, arterial pressure soon rose and restored had a marvellous time for two and a half years working on a wide the renal arterial pressure beyond the narrowing, but at the range of research topics, eventually publishing 11 articles from expense of much higher arterial blood pressure overall.6,7 that time.