A renowned neurologist and research scientist, Dr. Terence Sanger MD, PhD is is vice president for research and chief scientific officer at Children’s Hospital of Orange County (CHOC). He attended Harvard Medical School and completed his medical internship and residency training in pediatrics at the USC/Los Angeles County Medical Center.
Dr. Sanger completed residency and fellowship training in neurology at Boston Children’s Hospital, and additional fellowship training in the movement disorders unit at Toronto Western Hospital. In addition to his clinical fellowships, Dr. Sanger completed research fellowship training at the NASA Jet Propulsion Laboratory and at MIT.
He is also currently Professor of Electrical Engineering at the University of California Irvine (UCI), Vice Chair of Research, Pediatrics, (UCI) and Director of the Pediatric Movement Disorders Clinic and Deep Brain Stimulation Program at CHOC.
What did you want to be when you were a child?
My father is a child psychiatrist and I have several other doctors in the family so this was an area I always thought about. When I was five or six, I remember saying I wanted to be a neurosurgeon – despite not really knowing what a neurosurgeon was! I’m not sure I could even spell it but it sounded good. But I knew I really liked computers and was fascinated by these things the size of washing machines and wanted to understand how they worked and how I could control them. So by the time I got to high school I was pretty sure I wanted to be in computer science and probably something in robotics. Artificial intelligence as a concept existed back then but as a practical matter we didn’t have computers powerful enough to do anything like that. Nevertheless, in high school I did a project that involved large scale simulated neural networks so clearly I was always interested in that. But I didn’t become interested in medicine until my senior year at college when I was working in the robotics lab at Harvard. Back then the choices to continue in that vein were medical, industrial or military robotics. Medical was the only area that I was interested in so I went back and decided to go to medical school.
Who’s been the biggest influence on your career?
Several people have been tremendously influential in many different ways. My undergraduate advisor, Roger Brockett, was a classic mentor. I didn’t realise at the time how much of an honour it was to work with him. He was the one that started the Harvard robotics lab and allowed me to really get into it. Occasionally he would say ‘read this, this and this’ and they were always the perfect papers that would guide me in just the right direction. And of course they included the papers that he’d written thirty years before.
Other tremendous mentors on the neuroscience side were my good friend Terry Sejnowski at the Salk Institute. I loved bouncing ideas off him and always hugely admired him. In the medical science field, Tony Lang taught me movement disorders and is still the best clinician I’ve ever met. He’s one of those people who walks into a room and within three seconds knows the diagnosis even though only six other people in the world have had it but he read about it once. It’s amazing when you run into someone like that and you realise that’s what you need to be striving for.
But the most influential would be my piano teacher, Alys Terrien-Queen who was teaching me when I was in college. She had this incredible sense of creativity about motor learning. She taught me the experiential components of motor learning – and motor and movement is what I subsequently got into. But she had a tremendous insight into how people learnt and a real gift for understanding that motor learning is as much about the sensory as it is about motor. It’s cognitive but it’s feeling. The relationship between the emotional content of movement and the actual action of the movement – I felt as if that insight has guided so many of the ways in which I’ve thought about things. So you never really know where mentorship comes from but it’s often a team of people – many of whom will never know each other.
Professionally, what do you consider your greatest achievement?
I’ve written some algorithms in the field of neural networks and I’ve done some stuff in control theory that I’m very proud of. But it’s a tough question because the things that other people consider to be my great achievements are things that I just did because I had to get them done quickly. One time I was preparing what I thought was a fascinating mathematical analysis for a conference when I suddenly came down with appendicitis. I was in hospital for a week when I realised the deadline for this conference was right now so I just needed to write something down. So I rattled off something really stupid and sent it off and it became one of my most highly cited papers. So I guess that I’m not a very good judge of the impact of my own stuff!
What’s been your biggest disappointment?
I try to remain optimistic and look at disappointments as opportunities for progress. But I’ve had lots of disappointments. One of my major research areas is deep brain stimulation for childhood movement disorders and there’s been lots of times when you think ‘Okay I see what’s going wrong, I get it. If I can only just stimulate it this way, it’s going to fix the problem.’ You try it and nothing happens. So just recognising that Mother Nature is much more complicated than anything we can imagine. Yes our brains are very powerful but they’re a small part of what nature has developed. That’s why recognising the need for humility when making hypotheses is so important. No matter how smart you think you are, you still can be wrong.
Best piece of advice ever received?
When I finished my movement disorder fellowship, I asked Tony Lang what is the most important advice he could give me and he answered, ‘Get a nurse’. He wasn’t joking but what he meant was it’s impossible to do research and clinical care at the same time without a lot of support. So I hired a spectacular nurse, Sara Sherman-Levine, who worked with me for many years. I now work with the equally spectacular Jennifer MacLean and we work really well as a team, taking care of our patients. You have to have people working with you that you trust and who understand the mission and are as committed and passionate about it as you are.
What advice would you give to someone starting out on a career in medicine or healthcare?
There’s a statement in Judaism that says if you’re trying to convert you have to be told ‘no’ three times. And only if you persist after that, do they truly believe you want this. And I would say it’s the same for medicine. You should be told no three times by medical schools and only after that, if you still really want it, should you do it. I tell people this is painful. It is going to eat your life. To be any good at this you have to work really hard. A lot of the time you won’t be thanked for it and when things go wrong they go really wrong in lots of depressing ways. So you have to love this. But if you do love it, then it’s the most amazing thing you’ll ever do. You will interact with people in ways you could never imagine and you will be able to do things that are so meaningful to you and other people. But you have to do it for love. You can’t do it for money, for scientific interest or because your grandmother told you to. It has to be something you discover you truly love otherwise it’s far too painful.
Part two of this exclusive interview where Dr Sanger reveals why his patients inspire him, the ambitions that still drive him and the key insights he always tells his medical students can be read here.
Dr. Terry Sanger will be speaking at AIMed’s Global Summit taking place live and in person at the Ritz Carlton Laguna Niguel, CA on January 18-20, 2022.