School of Medicine

Washington People: Robert Gereau

Robert W. Gereau, PhD, and DBBS student Jiwon Yi discuss their work. Gereau is a neuroscientist working to discover the genetic and molecular roots of pain, with a goal of reversing the processes that cause pain and make it so disabling, bringing relief to people in new, better, safer ways. (Photo: Matt Miller)

Not too long after he started working in academic medicine, Robert W. Gereau IV, PhD — then on the faculty at Baylor College of Medicine in Houston — accepted an invitation to lecture about his work to doctors and scientists at the Washington University Pain Center.

His research and training involved cellular changes in the brain in response to experience — how people learn and adapt to the environment.

“We looked at plasticity and memory and learning, and coming from that context, I began to think of chronic pain as a way that the brain’s plasticity could become maladaptive,” Gereau recalled. “We had made what I thought were some interesting discoveries about how tissue inflammation could lead to hypersensitivity to heat. For example, when you get a sunburn, if you use warm water to wash your hands or take a shower, you tend to experience pain because your sunburned skin is very sensitive to heat.”

From that observation, Gereau’s lab began to zero in on how heat-sensitive signals are transmitted and what ion channels in cells carry those signals. He was searching for new ways to treat the problem of heat hypersensitivity by uncovering the cellular mechanisms that create the problem. Those were the findings he presented in that initial lecture at Washington University.

He remembers being surprised by the number of white coats in attendance that day. He was accustomed to addressing bench scientists at his lectures, but a number of physicians from the School of Medicine were in the room, too. One of them spoke with Gereau after the talk.

“He said something like, ‘That’s really impressive work you guys have done, but, of course, it’s meaningless for our patients,’” Gereau recalled.

“I asked what he meant, and I told him about sunburn and warm water. And he said, ‘Yeah, but that’s not really a clinical problem. You can solve it by lowering the water temperature in the shower.’”

Gereau recalls that conversation as his Eureka moment.

“I was a little hurt at first, but as I thought about having worked so hard on a problem that wasn’t really a problem, it illustrated the importance of basic scientists and clinicians talking to each other,” Gereau said. “If I was going to conduct research on pain, I needed to try to do it in ways that would help patients.”

He has come a long way since.

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