Inside El Paso’s medical school, internationally renowned scientists work on cures for HIV, search for genes that underlie major mental illnesses, and study new treatments for cancer. It’s all part of the school’s ballooning $12-million research portfolio.

And the man heading up that new research at the fledgling, four-year-old school is Dr. Charles Miller, associate dean for research at Texas Tech’s Paul L. Foster School of Medicine.

Forget the image of a pale researcher peering through beakers in a cold lab. Lean and tan, Miller is a runner first, then a mountain biker. Easy access to good places to do both are some of what Miller says attracted him to El Paso.

Miller, 50, began college as a philosophy student. But he dumped its big picture questions for the detail-oriented field of clinical research, after taking a job doing statistical programming while working on his master’s thesis in philosophy.

“I started getting interested in those sorts of problems, instead of the abstract problems about life and death,” Miller says, “You could do things that actually reduce people’s suffering.”

And that is what his research has done.

He says his most fulfilling project was probably working with a team whose research led to a new way of repairing a type of aortic aneurysm, a dilation or enlargement of the aorta.

At the time, people diagnosed with the aneurysm essentially had to choose between dying or surgery that resulted in paralysis for one-third of those who went under the knife.

When Miller left the University of Texas Health Science Center at Houston in 2009, he says the paraplegic rates for those who had the surgery were less than 5 percent.

“There are probably about 500 people walking around right now who wouldn’t have been if we hadn’t done this work,” Miller says.

Miller spent the first 20 years of his career on the faculties of Baylor College of Medicine and University of Texas Health Science Center in Houston, where he became a tenured professor. Both are behemoths with hundred of millions of dollars in grant portfolios and thousands of employees.

Miller has a master’s degree from Rice University and earned his doctorate at the University of Texas Health Science Center in Houston. He is author or co-author of more than 160 peer-reviewed scientific articles and numerous books.

At the Foster med school, he also holds the positions of professor and chair of the Department of Biomedical Sciences and associate dean for the Graduate School of Biomedical Sciences.

Miller sat down with El Paso Inc. and talked about the groundbreaking research at the school, a study about chocolate and sperm, and why some new scientists and researchers are sharing benches.

Q: How has research at the Foster med school grown over the last three years?
It has gone up by roughly eightfold in terms of funding. We had a low base to start with, so it’s easy to make these early wins. Maintaining that multiplier is going to be a bit more difficult as the size of the program grows.

Going to, say, $80 million and multiplying by the same factor again will be a much more complicated procedure. It will require more square footage and much more support from the state and federal funding authorities.

Q: With the massive budget shortfall in Texas, not much support came from the Legislature this year. How was the med school impacted by the cuts to higher education?
We came out better than we feared we might, but we certainly weren’t untouched. Because this is a new school, we’re not on formula funding yet. We’re funded by line items that pay for education, research and infrastructure here.

This Legislature took the position that all line items should be cut. We were facing 30 percent cuts, as opposed to the other educational institutions that faced cuts along the lines of 6, 8 or 12 percent.

But our congressional delegation really went the extra mile for us. Our local supporters really pushed hard to help us maintain as much of that funding as we could. We ended up with a cut that was closer to about 18 percent.

The dean of the med school, Jose Manuel de la Rosa, was also able to mobilize some other funding – some tobacco settlement funds and some practice plan funding – so the cut that we actually sustained is closer to 10 percent.

Q: Where are the cuts to the med school’s budget being made?
We’ve dealt with the cuts by closing positions that were open, and we are slowing recruitment. Part of the problem with that is if you don’t recruit somebody, you don’t bring in the grant that that person comes with.

If you pay somebody $110,000 a year for four years, that’s $440,000. But they may have come here with a $1-million grant. That gap between the salary and the amount of the grant creates jobs for other people, technicians, research assistants, the FedEx guy.

We closed at least one open position in each of our four centers. When people have resigned, we haven’t filled their positions.

We are no longer awarding seed grants of about $25,000 to investigators to start a new line of research, or to clinicians to develop some sort of a research program. We’ve also had to cut back on our equipment purchasing.

We can’t step back from the momentum. We don’t have quite as much wind in the sails at this point, but we have to continue.

Q: Will new researchers be hired?
There are five or six positions that we’re recruiting for at the moment.

Q: How many researchers are here now?
There are 96 researchers.

Q: Besides the funding cuts, how has the school been impacted by the space shortage – especially since the planned third building didn’t get state funding?
We do have some construction going on. We’ve started construction on a 30,000-square-foot expansion to the Medical Science Building that will be used for research. We’ll build the shell one year and build the floors a year at a time, as we scrape the money together from things like tobacco settlement funds or overhead from grants.

Q: When do you run out of lab space?
We have three laboratories left. That space will be filled when we fill the five open positions. We’re going to be squishing five people into three labs, basically.

Q: What about people the school has already recruited? What reaction have you gotten from them about cuts and sharing benches?
There has been some grumbling, but generally they understand the challenges. Almost all of them came to a situation that’s better than where they were, maybe they were more space restrained or had lesser start-up salaries.

We did recruit people under certain expectations for their start-up package, and we cut them all by 10 percent. We didn’t reduce anyone’s salary, and that’s one of the first things that gets the attention of families.

Q: How is the school’s location on the border shaping the research being done here?
A major part of our mission is to serve the needs of the people who live here, and to work on research problems that are related to the population.

We’ve put together four centers of excellence that follow those themes: cancer, diabetes and obesity, infectious diseases, and neuroscience.

In the cancer program, we’re working on how breast cancer, prostate cancer, those kinds of things, are different in the Hispanic population, because roughly 80 percent of the El Paso population is Hispanic.

It’s important nationally because we can think of a majority Hispanic population as being a 21st century representation of Texas, and maybe a mid-21st century population of the U.S.

Q: What makes research and medicine different on the border?
The border is not like other places. You have highly mobile populations, you have a lot of genetic mixture, and you have cultural norms that are not really American and not really Mexican.

So you have a culture that’s unique to that environment. You need to figure out how to get people to accept medical treatment and what medical treatments are most effective. It requires a special set of skills on the part of the researchers. It’s important for clinicians to know what kinds of treatments are acceptable to people.

So you have to study the sort of evidence-based guidelines, but you also have to figure out how to get people to accept that treatment. The pill is only good if people take it.

Q: I’ve always thought of studies as having long, clinical titles. What’s with “Germs, Sperm, and Chocolate: Novel Risk Factors for Preeclampsia”?
Researchers frequently name things like that because it makes it a little bit more interesting to the general public. Also, a punchy title may make reporters pay more attention.

In this particular study, the researchers are looking at risk factors for preeclampsia, which is an endocrine-related disorder in the late stages of pregnancy that leads to rampant hypertension in the mother. It’s not entirely understood what it is and how it works, and what the risk factors involved are.

Some have said that chocolate is involved; others have said it involves an allergic reaction to sperm.

Q: What’s one notable research project being done here?
One of the big, fundamental research programs here involves HIV and a receptor called CCR5. There’s a T-cell receptor mutation that some people who have a natural resistance to the HIV infection seem to have.

Dr. Ghalib Alkhativ, our principal investigator in that area, discovered it in the early 1990s. They thought that they would just figure out how to find a treatment that would mimic this, and the vaccine would stop the spread of HIV.

Naturally, it was a little bit more complicated than that. But that was a major discovery, and that paper has been cited over 2,000 times.

So this is a very high profile, prominent investigator, and he’s working away in the lab. He doesn’t get a huge amount of recognition in the area, but this is a fundamental science program that’s here in El Paso.

Q: What attracted him to the school?
We have a pretty established HIV group here already, and the work of Dr. Manjunath Swamy and Dr. Premlata Shankar, the heads of the infectious disease center, is well known.

There is also a sort of sense of adventure that comes along with starting in a new place and being able to build a research program where one isn’t well established. When you go to big universities, typically, their programs are ossified and change is very difficult, because you have huge constituencies that are entrenched in that sort of thing.

Here, you can have a significant impact. I mean, it’s not just the medical school. This is a fantastic time to be in El Paso. I can see the energy created by the city, the local population and the philanthropists all focusing on the same problems at the same time. You have Woody Hunt and Paul Foster, the university executives and students, and people who have been here all their lives incredibly energized.

There’s a tremendous mixture of new ideas and new thinking. Being caught up in that energy and feeling like there’s an opportunity to produce something that’s meaningful for the city is very exciting.

Q: Why is research so important for a medical school?
When you think about it, most every treatment that’s out there today was discovered by a researcher of some kind.

Another aspect is we don’t want clinicians to be just writing prescriptions and moving along. We want people to learn to be physicians that have mindsets of inquiry. We want to develop a culture of thinking and problem solving, not just remembering what you read in the textbook.

Many of the things that researchers have taken into the laboratory and developed treatments for have come from a couple of observations by astute physicians.

That constant feedback and cross pollination is a critical part not only of medical education but of the discipline of practice for medical care and feeding the need to discover.

Q: Will the growing research portfolio here mean opportunities for El Pasoans to take part in studies and maybe take advantage of the latest treatments?
Yeah, absolutely. There are a couple of great examples of that. Dr. Richard McCallum, who is our founding chairman of internal medicine, works on a sort of arcane problem called gastroparesis, that’s not extremely common but it’s a huge problem for the people who have it.

He’s got one of the handful of centers in the U.S. that are recognized for being able to provide treatment, so people actually come to El Paso to be treated for gastroparesis.

Dr. Zeina Nahleh, our new director of clinical oncology, has just gotten Southwest Oncology Group membership for the oncology services here. Now we can participate in any clinical trial that the Southwest Oncology Group sponsors.

If you have somebody with a certain type of breast cancer that’s resistant to conventional treatments, you can enroll that person in a clinical trial here, have the drugs shipped to them, put them on the protocol, and do all the monitoring here. They get an early access to a treatment that they wouldn’t have had access to otherwise, and you keep them home with their family.

Q: What’s being done to turn the research into marketable products?
That is something that we’re doing with great interest with our partners at the University of Texas at El Paso and at the Medical Center of the Americas Foundation.

The MCA is very focused on commercialization and is working to develop a research and technology park. They have funding but are in the early planning stages.

Q: Why is commercialization separated from the med school?
Conflict of interest. You don’t want a person who invents a treatment to get paid money for that treatment and then to apply that treatment to people. There are longstanding rules that clinical trials cannot be performed by people who have a financial interest in the outcome.

Universities are great at inventing things, but they’re not very good at developing them. That’s really not our mission. Ordinarily, what universities do is license those discoveries, somebody takes that, pays a royalty to the investigator and the university, and takes the discovery to Silicon Valley or New Jersey where they commercialize and develop it.

We would like to capture more of that life cycle development here, doing the trials and making the prototypes in El Paso and maybe even manufacturing the product in Juárez.

Q: The idea of El Paso growing into a Silicon Valley of sorts seems to come up a lot these days. Is that a pipe dream? Or is there a sense that something is happening here?
Well, the answer to the first question is I can’t tell yet – you just have to reach. The second is that there’s definitely something happening here. There are some very active citizens who are very interested in development, who have a lot of assets that they can mobilize.

So what has to happen? You have to have an investment; the city made a huge step forward with that. You have to have talent; there are a lot of talented people here right now. You have to figure out incentives to get people to work together.

UTEP and Texas Tech have been working together. Richard Schoephoerster, the dean of Engineering at UTEP, and I, we’ve made a conscious effort to pull things together. We’ve been doing it faculty to faculty. We’ve hosted joint research programs. We go over there, and they come over here.

Q: Can you be more specific?
This summer, we have UTEP graduate students in engineering in our clinics looking at processes and asking questions like “Why is it taking an hour to turn over an operating room?” “How do you deal with intrusive medical records technology?” or “What from medical science can you take back to engineering to help them improve?”

We like to say that scientists are people with problems in search of a solution, and engineers are people with solutions in search of a problem.

We have a summer accelerated biomedical research program as well. That’s a pipeline for people who are considering careers in science, especially potential Ph.D. students. Most of those students in that program are recent UTEP graduates.

Q: Engineers and doctors?
When I was in Houston, I was part of a major cardiovascular surgery group, and we used to have a meeting every other year with a bunch of petroleum engineers called “Pumps and Pipes.”

How a petroleum engineer pushes fluid through a conduit of a certain length with a certain amount of tolerance for turbulence and those kinds of things, for example, can be cross applied.

That’s one of the reasons why we work so closely with the engineers at UTEP. Medicine is becoming increasingly technical. You don’t want to step back from the art of medicine, which diagnosis always will be, but medicine is becoming more and more standardized. It’s almost becoming an engineering discipline.