Meet Dr Gary Hammer, MD, PhD, a scientist and endocrinologist who specialises in endocrine oncology and is Director of the Endocrine Oncology Program at the Rogel Cancer Center at the University of Michigan. 

In June this year, Dr Hammer was awarded first place for his adrenal gland image ‘Stress Deconvoluted’, in the Endocrine Society’s inaugural Endocrine Images Art Competition, a contest celebrating the beauty of endocrinology. ‘Stress Deconvoluted’ raises awareness of the adrenal gland and its role within our bodies, grabbing people’s attention with its intriguing beauty. 

For many of us as people living with Addison’s disease and adrenal insufficiency, this is the first time we’ve seen the gland within us which ‘doesn’t work’, portrayed in this way. Dr Hammer kindly allowed our charity to use his image as our Winter 2022 Magazine artwork.

 

We were delighted to sit down with Dr Hammer over Zoom, where he shared with Philippa from the ADSHG more about how he created the image, what it means and the importance, not just of endocrine science and clinical care, but the patient voice and collaboration for the benefit of all with rare diseases.

 

What sparked your interest in Endocrinology?

“Sometimes we fall into things, and it goes a long way back to college. I was always interested in stress and stress hormones, probably trying to understand myself as a youth! This led to medical school, endocrinology, studying various aspects of the hypothalamic–pituitary–adrenal axis and ultimately now to my job at Michigan where I serve as the Millie Schembechler Professorship in Adrenal Cancer," Dr Hammer says.

"I came to Michigan in 1999 because famed University of Michigan football coach Bo Schembechler tragically lost his wife to adrenal cancer. He therefore became empowered to build a programme around adrenal disease. So I came to be part of that growth and development. Here we have developed a multidisciplinary team of scientists and clinicians to advance science, provide care and build an international network that advocates, educates and collaborates to find effective treatments for adrenal cancer and associated endocrine malignancies."

Why did you create the image?

“The idea of the image is to highlight a couple of things. One is how an organ is composed and also how it maintains its life. For this you need to know how the organ forms and the adrenal formation is a fascinating process and I wanted to capture that in the image,” Dr Hammer explains. 

“Art is a great way to educate folks about science and biology – the art of medicine and the art of science.  In art you can inspire young folk to go into science, show that it isn’t boring, science is fun when you figure things out. So we were able to figure out that those yellow cells you see in the image become the red cells and we figured out the rules by which that outer adrenal capsule is a critical component to maintain those red cells throughout life.”

 

'Stress Deconvoluted' - when science meets art

Dr Hammer explains: “The top image is our original image. In the middle and bottom images, we have manipulated the image of the adrenal using Photoshop filters to give it different definition. I wanted to capture the early and different aspects of adrenal formation, then the cortex and the medulla, and those are immunohistochemical stains that marks those cells. In the bottom image, each of those octagons are individual cells, that have a different identity.”

“The adrenal gland is a critical organ surrounded by a capsule, like the rind of the orange - these are the outside blue cells in the image. The red cells mark the adrenal cortex, that produce aldosterone, mineralocorticoid and glucocorticoid. If you look at the yellow cells, those are the remaining cells of the fetal adrenal cortex. The blue cells in the middle show the medulla, the region where epinephrine (adrenaline) is produced.”

“So my idea was to photoshop the original image to deconvolute it, using filters to basically take the image and artistically change the pixel diameters to make it cool to look at!”

 

How did come up with the title for the image – 'Stress Deconvoluted'?

“Our lab has been interested in ‘deconvoluting’ the adrenal cortex particularly, into its component parts. In a sense, deconstructing the adrenal gland into its minimal functional units. And science requires two different approaches, one is deconstructing an organ, and another is a more holistic approach, to understand how the whole unit functions in the organ and in the body. And in the Endocrine system is really requires both," Dr Hammer says.

"The endocrine system is unique and the adrenal system has to respond to hormonal queues such as from the pituitary. So we’ve been interested in 'deconvoluting’ various cell types in the adrenal, and understanding how those cells participate in organ maintenance and in response to whole body needs, i.e. stress response. So Stress Deconvoluted!"

 

What are your highlights in your career in endocrinology to date?

“That’s a big one! I don’t define by accomplishment, but I’m proud of advocating for patients with rare endocrine diseases. I have worked on Capitol Hill with senators on rare cancer legislation where I focus exclusively on endocrine disease to advocate and get support.”

“I was the president of the Endocrine Society (the world's largest professional organisation of endocrinologists and scientists) for 2020–2021. That was a highlight but a challenge as that was through COVID so a tough time to lead. I learnt through that experience that leadership is not a noun but a verb. You don’t need a title to lead, leadership is important, we all need to step up to the plate and be leaders, to make a difference that we want in the world.”

 

Rare Diseases

Speaking with Dr Hammer, his deep commitment to not just endocrine science and clinical care, but the patient voice and collaboration for the benefit of rare diseases is clear. He says, “What we’ve learnt about rare diseases is that to make a difference you need to collaborate. I see my focus on developing international collaborative groups for adrenal disease really important such as the European Network for the Study of Adrenal Tumours (ENS@T), and the A5 (American Australian Asian Adrenal Alliance). Last year as a visiting professor for the British Society for Endocrinology (SfE) I got to visit Glasgow, Edinburgh, Sheffield, Oxford and London to give lectures, it was a whirlwind tour but I love the UK.”

“It’s only through collaboration that you can have enough patient samples, enough patients engaged to gain leverage with funding agencies and pharma for trials. We push it forward by doing it ourselves, forming companies to develop drugs and resources, by giving talks around the world ranging from patient groups, to scientists. In my role as the adrenal editor of the DeGroot's textbook of Endocrinology, I do my best to involve the entire adrenal community to get the word out about adrenal biology and disease.”

“We have to collaborate to investigate, to participate to advocate, we have to communicate to educate and activate to legislate”.

 

Advancing the Patient’s Voice

"I’m involved in patient advocacy groups, particularly in the adrenal cancer space but also the National Adrenal Disease Foundation in the US and that is really important because the patient voice, whilst it has always been important, is gaining increasing influence, power and importance as your ADSHG group will know. In the US and Europe, the patient voice is becoming increasingly important, heard and valuable, patients are part of advisory boards for funding agencies, for the non-profit foundations and the governmental agencies as an essential component of drug approval, trial design, funding of grants etc."

"I’m proud of all our involvement in the rise of the empowered patients. It’s about time right! We’re all patients, no one escapes this earth without being a patient and it’s important to remember that."

 

Do you have any advice that you would give to other Endocrinologists?

"For those interested in science or medicine, always ground your questions in the best science, always ground your clinical work in the best patient care. And don’t be afraid to stick your neck out! You can’t complain if you don’t step up to the plate yourself. Take a swing at the plate and get out there and do it. Frankly no one knows what they are doing until they do it!"

 

What would you say to anyone wanting to take part in the Endocrine Society’s Endocrine Images Art Competition 2023?

"I would recommend to put the adrenal front and centre and come up with the best adrenal image you can! I say that tongue and cheek but of course the adrenal gland is the master gland of the body, go for it."

 

How do you spend your free time?

"My family rock climbs! My wife and I were gymnasts through college but we found climbing through my son when he walked into a gym one day and enjoyed it. Climbing is great because you can also just hike and be outside. My three kids have all competed for the US National team over the years, so we get to climb all over the world. We try to get outside whenever we can. My son who is in Edinburgh at the moment seems to be in the Highlands every weekend!"

Dr Gary Hammer leaves us with one of his favourite quotes, from Margaret Mead, the famous anthropologist.

"Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has."

He continues, “I view the adrenal community - patients, scientists and doctors as that group to make a difference.” 

Gary D. Hammer, MD, PhD.  Millie Schembechler Professor of Adrenal Cancer Director - Endocrine Oncology Program, Rogel Cancer Center, University of Michigan  Twitter: @DrGaryHammer

Thank you Dr Hammer for speaking with the ADSHG, sharing your beautiful Stress Deconvoluted image with us and all you do to advance care and research in Endocrinology.

A shorter version of this article was first published in the Winter 2022 edition of the ADSHG magazine.

Whether you're newly diagnosed or have lived with the condition for years - please join our community and support our cause! You'll receive the latest expert advice, guidance and ADSHG news, whilst being part of our inspiring and supportive community. Become a member today! 

Join the ADSHG 

Connect on social media! Follow us on X / Twitter, Facebook, Instagram, LinkedIn, Threads, TikTok and YouTube.