An interview with Dr. Steve Hicks

Outer Banks 5k, 2009, from left: Mike G, Parenti, Hicks, Schab, Decker.

Steve Hicks was “only” at Marist for his final two years of undergraduate studies, but that brevity belies his strong relationship and ties with our school and our program. After you read today’s Pandemic Papers interview with the good doctor, that’ll become evident. One of the many great things about Steve is that makes complex topics accessible to the rest of us. As a medical researcher, he’s made national headlines with his findings, and we’re confident he will continue to do that.

In this pandemic, medical advice and knowledge is plentiful. Accurate information is crucial. In our Quarantine Questions with Steve, we grilled him with a lot of science-based questions. As usual, he answered them in a cogent, straight-forward way. We continue to plunder through uncertain times here. I have a firm belief that there is a bright light at the end of the tunnel, even if we don’t know how long that tunnel is. Steve's answers give us cause for concern, but mostly they give us cause for great hope. Through the years, I have pestered Steve with medical questions about my various maladies and occasionally my family's issues. He calmly and patiently and thoroughly and unfailingly answers my questions. Today in the Pandemic Papers, he does the same for the readers of this fancy blog. Thank you, Dr. Steven Hicks.

Describe your pathway to Marist, how you wound up here after initially going to CCSU. What made you come back "home" to Marist? Were you happy with this decision?

At the end of my sophomore year, my coach at CCSU (Central Connecticut State University) retired and I decided to switch my major from physical education to "pre-med." While I was home for Thanksgiving break I ran a local turkey trot with my family, and my father ended up running most of the 15.5-mile race alongside Pete. Although I really wanted to transfer to Cornell, my Dad suggested that I apply to Marist "just in case." Luckily, I did, because I was rejected from Cornell. It ended up being one of the best things that ever happened to me.

Although you were here for just two years, you made a great impact on our cross country/track program. What are some of your fondest memories of your time as an athlete at Marist?

2005 MAAC Championships: Hicks ran 10k, 5k, 1500!

It makes me smile to think that maybe I had some small impact on a program that gave me so much. I have so many great memories as a Marist athlete. Here are a few:

1. Singing "MAAC songs" on the team bus

2. Being attacked by a peregrine falcon while running across the Mid-Hudson bridge with Justin Harris ('07)

3. Running to the "tower", down the other side to the Highland track, and all the way back to campus (~18 miles) with Mike Schab ('06), Mike Rolek ('08), and Matt Walsh ('07).

4. Out-running campus security with Geoff Decker ('05) and Sean Hopkins ('05). (Coach Pete says: I was going to edit this out, but alas there is a statute of limitations for such hijinks)

5. Running 24 x 400 on the McCann 160-meter track with Kirk Dornton ('04) for "Kirk's Day".

More than these individual memories, what sticks with me is the sense of family that defines the Running Red Fox culture. I loved how a team with such a breadth of talent and personality could still be cohesive and churn out talented teams year after year. 

Academically, how do you feel Marist prepared you for your future in medicine? When did you decide that you wanted to pursue a career in medicine?

I knew when I transferred to Marist that I wanted to attend medical school. Marist is a hidden gem for students interested in medicine. The small class sizes, the dedicated and enthusiastic faculty, and the opportunities for research set science majors up for success. A story that I love telling people, which I think exemplifies the Marist XC/TF program, is about a research experience I had during my senior year. In February 2005, I was invited to present my research at the AAAS meeting in Washington DC. The conference was the same day as the MAAC Indoor Championships. Even though I had an opportunity to score points in the 3k and 5k, Pete encouraged me to go to the conference. I won an award at that conference, which ultimately helped me get into an MD/PhD program. Not many coaches would make those kind of sacrifices to support their student athletes.  

Talk about your post-collegiate running and how you were able to balance it with your many other academic and family pursuits. Are you still running today and at what level?

Mudders and Grunters, 2012

I had a lot of running success during my 7 years as an MD/PhD student. I was able to PR in every distance from 3k (8:36) to the marathon (2:33). It was an activity that I shared with my wife, Christine (a 2006 Running Red Fox Alumnus). During medical school, running was important for my mental health, as much as my physical health. Just like running at Marist, the things that ended up being most important in my post-collegiate running experiences were not the PRs, but the people I met and the friendships that running sustained. Christine and I organized a track program for inner city children in Syracuse from 2010-2014. We had over 100 kids show up each week to throw foam javelins, hurdle over pizza boxes, hand off PVC batons, and toss bocce ball "shot puts". I also formed a tradition with other Marist alums, competing as a team in the Mudders and Grunters trail race from 2006-2012. It’s a unique European-style XC race that awards a traveling "skull" trophy to the 4-person team with the winning score (see picture). We had a heated rivalry with the Albany Running Exchange for quite a few years. One of the most rewarding things I did after college was to create a video blog with my MD/PhD friend, Sam Mackenzie (a 4:06 miler from Cornell). We crowd sourced workouts for six months in an effort to break 15:00 for 5k. Sam and I videotaped each workout and created a 3-minute clip featuring the person who gave us the workout. It was a great way to connect with people who had influenced our running careers and make one last effort toward a lofty running goal. I ended up running 15:02. In retrospect, it's sort of emblematic of what running is all about - connecting with friends, pushing yourself, and embracing the journey, even if the result isn't what you hoped for.

Talk about your pathway to your career in medicine in terms of your education and what you studied and where.

I studied biology at Marist. I completed MD/PhD training at SUNY Upstate Medical University. My PhD was in neuroscience, studying the epigenetics of brain development. Then, I completed a residency and chief residency in Pediatrics. After 14 years of post-high school education, I'm now an assistant professor of Pediatrics at the Penn State College of Medicine.  

How did you pick pediatrics as your area of specialty?

My parents were teachers. My wife is a teacher. All my life I've been surrounded by people who value the importance of children and education. As a pediatrician, I embrace both those concepts. I educate families about how to keep their child safe and healthy. I also take pride in providing medical care to the most vulnerable and precious resource our society has - our youth. It is a joy to build long-term relationships with my patients and watch them grow into brilliant, dynamic adults.  

Tell us specifically what you are doing -- research, seeing patients, etc. -- and where you are doing it?

As an MD/PhD, I split my time seeing patients in clinic and performing translational research in a lab. Basically, my research team collects samples from patients and we analyze them for small molecules (biomarkers) that may help us diagnose pediatric conditions like autism. In fact, our work in concussions was featured on NPR a couple years ago. Every once in a while, I also get to connect my work with my passion for running. In 2018, I worked with a few runners on the Marist team to define the molecular "signature" of a runner's high. Those results actually ended up in Runner's World! Recently, with the emergence of the Coronavirus, my team and I received a large grant to begin developing a prognostic test for acute respiratory distress. Basically, we are trying to use the immune response in a person's saliva to determine if they will require a ventilator as a result of their Coronavirus infection.

Pandemic question: When did you first start to "pay attention" to the Coronavirus pandemic and how the trajectory and scope of the pandemic surprised you?

I began paying attention in January. Based on past experiences with SARS and MERS, I was naive enough to think the US might avoid the epidemic. Unfortunately, that has not been the case. The thing that has surprised me most is how politicized Coronavirus has become. I think it is unfortunate that political posturing, and not science or medicine, dictated our initial response to this pandemic. Now, our economy and our society is paying a steep price.

How has it impacted your day-to-day life as a doctor?

As a general pediatrician, I am not on the front lines with dying patients like some of the other courageous Red Foxes highlighted in this blog. Our clinic sees some COVID-positive patients, but by-in-large they are not in respiratory failure. I worry about bringing the virus home to my family, as we all do. As a pediatrician, I am thankful that the virus does not seem to cause life-threatening illness in the majority of children. 

For us non-medical folks, what can we "expect" in terms of the length and breadth of this pandemic? How long will it "last", how will we know when it's "over" and what do you think we can expect -- in the coming weeks, months, years -- with regard to Covid-19?

Let me get out my crystal ball... My best guesses: Cases will peak in late April or early May. Isolation recommendations will begin to ease in late May or early June. The last cases will be reported in late June. By then, we should have an educated guess about whether COVID-19 will return in the fall (based on its activity in the southern hemisphere). No matter what, our society will need to make major changes to how we interact with one another, how we track disease, and how we respond to emerging infectious epidemics. Otherwise, I anticipate we will see another pandemic within 10 years.  

Pandemic lightning round! (Note: Idea stolen from “Science Rules” podcast with Bill Nye …)

Everybody seems to think they are experts in public health and epidemiology. Although these are not your direct areas of expertise, you are a physician, so your input is crucial to the following questions: 

1. How long does it typically take to create a vaccine that is effective in combating a virus like this? The most recent vaccine that was created for virus prevention (HPV) took almost 10 years to develop. On the other hand, we modify and scale unique vaccines for Flu on a yearly basis. Previous efforts to develop vaccines for other coronaviruses (SARS) ran into a multitude of complications. Hopefully, COVID-19 will by different. 

2. The process with Covid seems to be rapidly accelerated. How long do you think it will take for a vaccine in THIS case? My guess is 12-18 months. 

3. There are a lot of experimental drugs and therapies being tossed around out there. Which ones do you think show promise and which ones should we be wary of? Antibiotics that have been developed to kill other viruses (e.g. hydroxychloroquine, remdesivir) show promise by killing the virus in a petri dish, but it remains to be seen whether they will be effective in human patients. One benefit to these therapies is that their side effect profile is fairly well studied, because they have been used in other diseases. We know that supportive therapies (like ventilators) are crucial, and we should be doing everything we can to make sure they are available for the sickest patients. Ultimately, what we really need is a vaccine. 

4. Do you think the plasma therapy has promise and can you explain how it works? Plasma therapy is meant to provide a very sick patient with COVID-19 antibodies from the plasma (blood) of a patient who was previously infected with COVID-19. The premise is that these "borrowed" antibodies will help fight the COVID virus while the sick patient's immune system learns to recognize and fight the infection. This approach has been used with other infections (such as measles), but the timing and dose of plasma therapy are very difficult to determine. Also, the treatment is not meant for patients with mild illness. 

5. Beyond mitigation, what other steps do you feel we as a society need to take to tamp down the effects of Covid? Social distancing remains our best weapon. It may seem insignificant to people sitting at home, but it really is vital to saving lives. 

6. What's your take on what we need to do in terms of testing? The main role for testing is to contain virus spread (by identifying index cases and isolating them from the population). Ideally, we should have developed and scaled a test in January. The test we have has a high number of false negatives (i.e. it says a person doesn't have the illness, when they actually do). This is partly because of the physiologic characteristics of the "positive control gene" that the test uses, and partly because so many samples sit around for days, waiting to be tested. The amount of time it takes to run a test (>4 hours), coupled with our capacity to run samples, has really hurt our ability to "stay ahead" of this thing and contain it. Currently, I'm leading a research team that's trying to develop a saliva test to determine which patients with COVID are at risk for developing respiratory failure. Such a test could help identify people that may need respiratory support before they begin "crashing". The test is based on a person's immune response to their initial infection.

As I'm sure you are aware, the pandemic shuttered college athletics for the spring season. What message would you give to our senior athletes who lost their final seasons of competition as well as their final months in college?

My heart goes out to all college athletes, particularly seniors, and senior Red Foxes who will never get their final season back. I cannot begin to imagine how devastating that must be. The beauty of running (unlike some other team sports) is that you can continue to compete beyond college. For the athletes that choose that path, I wish them many future successes in their running careers. 

If you could give our current (or future) athletes any advice about Marist and being a student-athlete here, what would it be?

--Be a student first and an athlete second.

--Fifteen years later, you'll realize that the practices were actually more important than the races.

--Nothing good ever happens after midnight.

--When given the choice, ride the van instead of the bus.

--Run in the woods whenever you can.

--Remember that puns are the most elevated form of humor. 

Anything else you'd like to add ...

Go Red Foxes!!!

MAAC XC Championships 2004. Pete told us to "dress up" for the plane ride to Disney, so Geoff Decker, Sean Hopkins, Bryan Quinn, and I went to the Salvation Army and purchased the finest threads that money could buy. I'm surprised they let us on the plane.