Richard Faull: Giving back to the people

Taranaki hasn’t done a bad job of producing Māori movers and shakers in the medical world. Richard Faull is one of them. Already knighted but still making an international impact with the brain research he’s leading from his Auckland University base.

Here he’s discussing with Dale how that’s come about.

 

Kia ora, Sir Richard. Your natural habitat these days, so I understand, is Auckland University’s Centre for Brain Research which you set up nearly 10 years ago. But there you were, a few weeks ago, on Maui Pomare Day, at Ōwae marae in Waitara. What is your Taranaki connection?

I grew up in Taranaki. In Tikorangi, a little community where Mum and Dad ran a general store.

On the European side, our ancestors go back to the first emigrant boat to come here from Plymouth, in England. That was the William Bryan, which arrived in New Plymouth in 1841. We are the fourth generation descendants of Richard and Elisabeth Faull from Cornwall, who were on that boat.

And, on our Māori side, of course, we go back to the great fleet. Our Māori ancestry comes from my paternal grandmother, Blanche Eleanor Rolfe, whose mother (Emma Stockman) was a descendant of Kupe — through Rahiri, who founded the hapū of Ngāti Rahiri at Motunui, near Tikorangi.

It was the Taranaki Māori Trust Board which helped fund my medical research in the United States. So, coming back and setting up the Centre for Brain Research here in Auckland, it was natural to reach out to Taranaki whānau in my iwi and help people who have brain disease.

Taranaki is in my heart and in my soul. And also Ngāti Rahiri and Te Ātiawa, who are a vital part of my whakapapa.

Your background is a reminder that from small communities come big thinkers. Maui Pomare and Te Rangihiroa (Peter Buck), just to name a couple.

They’re two of my heroes — and it’s very humbling that they come from Te Ātiawa, from Ngāti Mutunga. They both studied medicine, and then went out in different ways to help people and to enhance Māoridom in Aotearoa and on the world stage.

Maui Pomare became a politician (1911-1930) and, as Minister of Health, he transformed Māori health and living conditions and was largely responsible for turning the tide on the population decline of Māori in the 1920s. He was the saviour of the health of Māori people and gave them huge dignity, respect, and mana through his leadership.

And, in my last year at Waitara High in 1962, I was privileged to be the recipient of the Te Rangihiroa Medal, in the first year it was awarded.

So I read a lot about his extraordinary life and got to know of his achievements as a pioneering and internationally renowned anthropologist. He was the first Māori to graduate as a medical doctor in Aotearoa New Zealand. A politician, soldier, sportsman, and Māori leader who extolled the virtues of his cross-cultural Māori-Pākehā roots.

He was committed to scientific rigour and was, amazingly, largely self-taught. The University of Hawai’i praised him for his “contribution to the knowledge of mankind”. And his honorary doctorate citation from Yale University lauded him in this way: “First among those who know the peoples and cultures of the Polynesian world, medical doctor, warrior, ethnologist, author and poet, you have brought many races of people to greater understanding and peace.”

So, to go back on to Ōwae Marae and be invited to give a lecture on Maui Pomare Day was humbling, and one of the most special privileges and honours I could ever receive.

Tell us a bit more about receiving that medal and how it influenced you.

Yes. I was in the sixth form and was dux of the school. There were only 13 of us in the sixth form, and only three of us were doing science. So, just like Te Rangihiroa, we virtually had to teach ourselves science in that sixth form year.

But that set me up, you see. It gave me skills and an enthusiasm and a passion for learning which was critical to my future. I always say that growing up in a small community and going to small schools — Tikorangi School first, and then Waitara High — gave me a background of the love of learning and learning how to learn.

What I’ve ended up doing in my research has deep roots in my time growing up in Tikorangi. Mum (Phyllis) and Dad (Wilfred) were pretty strict. With them, things were black and white. And they taught us really important values and principles. My dad always said: “You’ve got to look after the community, look after the people and care for them.”

They also gave us other values for life. Being true to yourself, being humble, being honest. Doing your very best, striving for excellence, and showing dignity and love for all. And my mum would say: “Always dream big. Never give up on your dreams”

What I’ve done in brain research is built on those values. There’s nothing special about me, but you learn to work as a team — and, when making decisions, simply ask the question: “Is this going to be good for the people?” And, if it is, you just do it.

You appear to have had a range of interests. For instance, as a boy I know you strung up a whole lot of wires across your whare into the land beyond, to pick up overseas radio broadcasts.

Yes. Radio was big in those days. There was an electrician who worked across the road and I used to go over there and pull the old radios apart and help repair them. I got interested in shortwave listening, too. So I built my own radio when I was still at Tikorangi Primary, and then put a big aerial up which went across one of our paddocks.

And I did a lot of listening to shortwave radio all around the world. Radio Peking, Radio America, Radio Moscow, the BBC and all the rest. I loved it. Listening in gave you a bigger, broader vision of what life’s about.

You were one of five Faull kids, weren’t you?

Yes. Five boys. We didn’t have any sisters, unfortunately. Mum always wanted the last one to be a girl, but it didn’t work out that way. We were a very close family, brought up with strict Christian principles, involved with the church, involved with our general store and all of the local activities. We’re still very close. And, when I spoke at the marae, two of my brothers came with their whānau.

I’m the second oldest. The oldest is Allan, who was a dean at Auckland Grammar School, looking after all the international students. The third brother is Gavin, whose company manages over 150 hotels across Asia and into the Middle East and Australia. So he looks after people in a different way.

Then there’s Bernard, who went into the church and became an archdeacon in the Wellington diocese. He retired about a year ago. He looked after people and their souls. The youngest one, Nigel, is the CEO of a major healthcare facility in Brisbane, looking after older people. So, while we’ve all gone in different directions, we’re following the same principles in life. And our families are all very close.

From high school, you went on to study medicine at Otago University. How did that go?

When you’re a young medical student, you start out studying anatomy, physiology, and the biochemistry of what makes the body work. It wasn’t until I was in my third year that I saw the human brain for the first time, and I was blown away. I just couldn’t learn enough about it. So I took a year out to do research.

My mentor in Dunedin, Professor John Carman, had just come back from Oxford, and he was interested in the parts of the brain which are associated with Parkinson’s and Huntington’s disease. I did a year’s research with him in 1967, studying the equivalent pathways in rat brains which were affected by Parkinson’s and Huntington’s disease.

That was the most beautiful year of my life. In the course of that work, I found a new pathway in the brain and I met the love of my life, Diana Millar. We married two days after I graduated in 1970.

When I completed my medical training, I came to Auckland and worked in neurosurgery to see if I was interested in that field. It was great. But I decided that we still knew so little about the brain that I should go back into research.

So I did a PhD, looking at the parts of the brain involved with the control of movement. And, after I finished my PhD in 1975, I was awarded a Harkness Fellowship which enabled me to get more experience with top brain scientists in the US. One was in San Francisco, Professor Bill Mehler. The second was at MIT in Boston, Professor Wally Nauta, who was the world authority on tracing pathways in the brain.

Those three people were my foundation mentors. They gave me the scientific rigour, dream, and passion to pursue what I’ve done over the last 40 years.

And along the way, I understand, you became more focused in Huntington’s disease?

When I started my research in Auckland, I was still working on rat brains. If you did experimental studies on the brain, you had to work on animal brains.

Then, in my second year of research, I was visited by a geneticist, Arthur Veale, who was also from Taranaki and whose father had taught me at New Plymouth Boys’ High School, in my final year at school. He was a world authority on the genetics of Huntington’s disease.

He said: “We know Huntington’s is caused by a dominant gene, but we don’t know what that gene is yet, and we can’t identify it. So, when families learn that a family member has Huntington’s disease, it’s got huge implications because that gene is passed on from one generation to the next.

“These families out there who’re affected by Huntington’s, they’d like someone to look at the brain of their mum and dad after they die, to make sure that the diagnosis was correct — and that they really did have this disease. Would you do that for all these whānau?”

So, in my lab, we started looking at these brains from around the country so we could report back to the family to say whether the deceased had this disease. In most cases, it was yes, they did.

But then, what the families did was something incredible. They said: “You keep the brain. Do research on it and find out why these brain cells are dying in our family.”

And that changed my whole career. From then on, I worked on post-mortem human brains which had been given to us by whānau to do research to help those families.

We found that you can learn an enormous lot from such brains. And one of the things we learned is there is a lot of variation within each disease we studied — Huntington’s, Alzheimer’s, Parkinson’s.

So we had to go back to the whānau and get the history of their mum or dad, whoever had died, and find out what symptoms they had. When did they get the disease? How did it progress? What were their distinctive symptoms and pattern of disease development?

Now that may sound pretty straightforward, but this was revolutionary at the time. We ended up leading the world on this — and it’s all because whānau supported our research, and said: “Do this research for us.”

It was their love, their faith in us which, years later, enabled us to show that the human brain can repair itself by making new brain cells throughout life. And to grow cells from those brains in the lab, which enabled us to trial new drugs on them and see what’s different about cells from people who die from Parkinson’s, Huntington’s, motor neuron disease, epilepsy and multiple sclerosis.

And that has made us the world’s leading research group on the human brain.

How big is your group?

Well, I started in 1978 by myself. One person. Now, in the Centre for Brain Research, we’ve got 76 research groups from across the university with over 450 people studying all different parts of the brain from different perspectives. I could never have dreamed of doing such exciting work as I’ve ended up doing.

We collaborate with 25 different groups around the world — in Boston, Zurich, Cambridge, Oxford, Cardiff, Gothenburg, and so on. And we can work more effectively than any of these other groups in terms of working with family and gaining consent.

For example, if we want to send small samples of tissue for other world-leading groups to work on overseas — to do research which we can’t do in New Zealand — we always ask whānau and families whether they’re happy with this. And, every single time, they’re enthusiastic supporters and happily give consent.

One family member said to me: “It’s like Dad lives on forever, caring and providing new science directions for our whānau.”

Another person said: “Mum’s having all the travel in death that she didn’t get in life!”

Thank you, Richard. It’s a remarkable story. Can we talk about Māori and brain research because I’m aware that there’s some anxiety about taking body parts post-mortem? And also, because we’ve been brought up in a cultural climate where there’s been the suggestion that indigenous people’s brains weren’t as developed as European brains. Can you quash that idea from the get-go?

The fact is that the human brain is pretty uniform in its shape, numbers of cells (there’s a hundred billion cells), and all the rest of it. Our ancestors, whether they be the Pacific ones that came in the waka or the European ones that came on sailing ships, those people were as intelligent and as bright as each other or as any one of us. The basic elements of the human brain are the same.

And the message I take from that is that everyone can do exciting things in their lives. The mission for anyone growing up is to find out what it is that turns you on, and follow it.

Okay, so we’ve all got the same brain, and it’s what we do with it that counts. But let’s come back to the whānau connection. It must’ve been hard for families to part with the brain of a loved one when there’s a strong tradition of keeping the tūpāpaku whole.

I remember the very first brain we received. It was from a whānau in the Wellington area. The person affected by this Huntington’s disease was European and his wife was Māori. It was the father’s wish to donate his brain after he died, and he was gradually deteriorating.

I was approached by his Māori wife, who said: “My husband wants to donate his brain after death. It’s really hard for Māori to do this, but our family and hapū have had a discussion and we want to honour his wishes. It’s important for our family’s future that we have this research done. We’ve had a hui and everyone agrees that this is a good thing to do to help our whānau.”

When he died, after he was blessed, the brain was sent to us, and the whānau came and visited us soon after. The brain was a gift, you see, and we are the custodians. The family always owns that brain tissue. We’re just using it to help their whānau.

I call this the most invaluable gift any whānau can make to research. It’s allowed us to do the most exciting and imaginative research in the world on the human brain. And, if you respect their wishes and keep them informed on our research, they all believe this is the most wonderful way to look after the future of their whānau and to contribute to the health of all people.

We’ve also had Māori students coming to do a PhD on the brain. One was very excited about looking at the Huntington’s brain and growing the cells and just seeing what the difference was between normal and Huntington’s brain cells.

But then she said: “There’s a little problem here. This is human tissue I’m going to work with, so I need to go back to my whānau, hapū and iwi, and have a hui and get their blessing for this research.”

I said: “I’ll go with you.”

So I went with her, along with two or three of my senior research fellows and other Māori colleagues. And we spent a day on the marae telling the people what we were trying to do with our research and that it was all directed towards helping the whānau by understanding why the brain cells were dying — and by developing new treatments. We reassured them too that we’d use the tissue ethically and with the upmost respect.

How did that go down?

It created huge discussion on the marae, but it was fantastic. And, after all the talk, they gave her their blessing. It also reinforced to all our researchers that you must always undertake research on human tissue in a respectful, dignified way, in partnership with the donor family and wider whānau.

We went back to the marae when she graduated and formed a close association with all the people there. Through that process, I learned a huge amount about the importance of cultural values no matter which community you’re working with, whether it be Māori, European or whatever.

Our research, you see, has not only a scientific aspect to it — it also has a life value. Recognising the importance of the spirit. Recognising the importance of people as unique.

So, in a way, having this interaction with Māori has formed the foundation for our whole research ethos. It has taken our research along pathways of valuing and appreciating the special quality of working on human brain tissue. I’ve become closer to the people by doing this. That’s why we go back to Taranaki every year

I love this community side of our research. I call it giving back to the people.

My last question may sound a bit negative. What do we need to do to prepare for the projected increase in neurodegenerative disorders: Alzheimer’s, dementia, and so on? How do we prepare for what seems to be a worsening problem? Is there an aspect to this that makes you pessimistic?

I’m not pessimistic in the least. People are living longer, so there’s a natural reason more people are getting Alzheimer’s and these other ageing diseases. So, in a way, it’s a good problem. Well, these diseases are never good, but when I grew up, the average age of death in our whānau was 49. I remember my Dad was worried when he got to 49. That’s no longer the case.

So we only have this problem because we’re living longer. The challenge is to give a higher quality of life in our ageing years.

On the positive side, we’re working on a new treatment for Huntington’s where, using genetics, we can slow the disease down. And that’s going to happen in the next few years.

We’re also doing the same with Alzheimer’s. And if we can slow it down by five years, we would cut the number of people with Alzheimer’s in half — because they would live longer, have a higher quality and value of life, and probably die of something else.

So your negative question is actually a positive question.

 

This interview has been condensed and edited for clarity.

© E-Tangata, 2018