Interview with Hilde Løland von Volkmann
Background
Hilde was born in Bergen, studied abroad and came back to work at Haukeland University Hospital.
- My goal has always been to study medicine. Therefore I also chose German language at high school.
Then I continued to study for Medical Doctor (MD) in Düsseldorf in Germany at Heinrich Heine
University in the period 1985-1991. Düsseldorf is actually not a typical student city, although known
for its beautiful “Altstadt”, having a rich business life and nice and expensive shopping areas. The
study was quite theoretical and less practical compared to the medical study in Norway, and had
implemented multiple choice questionnaires on almost all written exams, plus oral examination.
There were 1500 new medical students each year in Düsseldorf, compared to only 300 per year in
Norway in total at the same time. I also met my husband in Düsseldorf when I was about to finish my
studies. Richard is also MD and is now working at Åsane Øyeklinikk. He is originally from the city of
Wuppertal and got his family name from his great, great, great-grandfather Richard von Volkmann
who was knighted in 1885 by Kaiser Willhelm the 1st due to his excellent work as surgeon. So, there
are some funny coincidences, Hilde says.
MD Hilde Løland von Volkmann at Gastroenterological
Section, Medical Dept., Haukeland University Hospital.
Hilde took her internship in 1992-1993 at Tynset and at Sandviken Hospitals, and did her district duty
in Florø. -Then I carried on with HES work for industrial companies in Bergen, Sotra and Askøy, and
worked at Bergen Emergency Clinic (Legevakten) for 1.5 year. I came to Haukeland University
Hospital (HUH) in 1994 and was engaged in different deputy positions in several departments before
I got a permanent position at the Gastroenterological Section, Medical Department in 2002. In the
mean time we got two children (presently 15 and 18 years). All this different practice has given me
useful experience, Hilde points out. -My specialty, however, is in internal medicine with subspecialty
in gastroenterology with main focus on Inflammatory Bowel Disease, IBD.
Ph.D studies
-Due to all my work and family related activities, it took a while before I decided to go on with a Ph.D
study, which I am currently enjoying. It is great to be in a position to set aside time just for reading
and digging deeper into interesting gastroenterological challenges, Hilde says with enthusiasm. Hilde
has worked in the clinics for 20 years and gradually she became more and more concerned about
patients with Crohn’s Disease. Another researcher at HUH, MD Torunn Fiskerstrand at Center for
Medical Genetics and Molecular Medicine observed and published in New England Journal of
Medicine a study revealing that a genetic mutation caused a familial diarrhea syndrome (Fiskerstrand
et al. 2012). This observation came as a consequence of previous phenomena observed in children by
MD in pediatrics Rune Tronstad and gastroenterologist Birgitte Emken, both working at HUH. Hilde
became interested in the gene mutation, mainly because 20 % of the patients in the family have
Crohn’s Disease.
–So, then I started my Ph.D studies with the tentative title “GUCY2C genotypes – Intestinal
inflammation and dysmotility –is there a link to Crohn’s Disease?”, supervised by Professor Odd
Helge Gilja, postdoc Dr. Kim Nylund and postdoc Dr. Torunn Fiskerstrand. The mutation causes
diarrhea and liquid loss, especially in the new-born period. In order to obtain more information
about the fluid distribution in the small and large bowel and the motility as well, we performed an
abdominal ultrasonography of 23 members of the family with the genetic disorder. Interestingly, we
found fluid filled small bowel loops and dysmotility in all, results which we are publishing right now.
-In my next study I will study the effect of a meal on the small bowel in these patients. A panel of test
persons will be examined with a capsule, which they have to swallow, and which is measuring pH and
transit time, and I will also examine them with ultrasound.
-Isn’t tricky to interpret the ultrasound images from the vast amount of activity in the intestines?
-Well, in the beginning the images seemed to be quite messy, until you get proper training and
experience, Hilde says. –Take a look at these pictures and the short video clip, which I have named
“The snow globe”, showing a form of turbulence in the intestine, with non-propulsive movements
mimicking a snow globe. The most interesting about this is that it seems as the content in the small
bowel is not transported further down for a long time, as it should, and this is probably the reason
for the discomfort these family members all have. It is known that different hormones are generated
in the intestine cells, and can cause different symptoms if the interplay is disturbed. My further plan
is to look into the levels of particular hormones and see if they are related to inflammation or
dysmotility, and even find a practical treatment.
- What has been the most challenging part of your Ph.D study so far?
- The most challenging part has definitely been the statistics. Since I speak German at home, I also
have some challenges with English oral presentations. However, the study per se is very interesting
indeed, and it gives more meaning to my work. It is very interesting how the different scientific fields
of gastroenterology and genetics can be combined to improve communication between researchers
and thus the understanding of the Crohn’s Disease, Hilde states.
As a result of Hilde’s work, she won the fellowship price (10.000 NOK) from NFUD (Norsk Forening for
Ultralyddiagnostikk) in April and achieved the 3rd price at the Research School in Clinical Medicine at
UiB for an oral presentation in January this year.
Future plans
-In the near future I will go on with my Ph.D studies and I have planned for defence of the Ph.D
dissertation in 2017. Then I will hopefully be in position to continue my research in the same
direction as I have started and dig even deeper in the gastroenterological mysteries. I also want to
strengthen my network and become more active in MedViz’ different projects and activities, Hilde
concludes.
Reference
Fiskerstrand T, Arshad N, Haukanes BI, Tronstad RR, Pham KD-C, Johansson S, Håvik B, Tønder SL, Levy SE,
Brackman D, Boman H, Biswas KH, Apold J, Hovdenak N, Visweswariah SS & Knappskog PM. Familial Diarrhea
Syndrome caused by an activating GUCY2C mutation. The New England Journal of Medicine, 2012, 366: 158695.