Jared Soares | The Roanoke Times

Liwu Li (left), associate professor for the Laboratory of Innate Immunity and Inflammation in the Biology department at Virginia Tech, looks over material from Dr. Ralph Whatley, chairman of the Department of Medicine at Carilion Clinic.

Kyle Green | The Roanoke Times

Dennis Dean and Dr. Cynda Johnson are engineering the Virginia Tech Carilion School of Medicine and Research Institute from the ground up. Dean, a longtime Virginia Tech researcher, will serve as assistant director of the research institute and helped design it. Johnson, former dean of the Brody School of Medicine at East Carolina University, will serve as the medical school's first dean.

Physicians and researchers traditionally have had a distant relationship as they both strive to find better treatments for patients.

They have relied on each other to advance medicine, but often without meeting or interacting.

Carilion Clinic and Virginia Tech have set out to change that scenario. Instead of following the traditional line of medical discovery, the nonprofit health care provider and the state university want to strengthen the relationship between doctor and researcher -- and educate future generations of biomedical researchers and physicians.

So it was with audible excitement in his voice that Liwu Li, a Virginia Tech researcher, gave an hour-long presentation last month to about 30 people gathered in a sixth-floor auditorium at Carilion Roanoke Memorial Hospital.

After Li finished, another Virginia Tech researcher, Roop Mahajan, stood before the crowd and implored both sides to communicate with each other.

"I really hope this doesn't stop here," Mahajan said. "We really need to build these connections. [As researchers,] the missing piece we really don't have is the human data. So we are really excited about this, to have this time to share our work with you and for you to share your knowledge with us."

Mahajan is the recently appointed director of the Virginia Tech Carilion Research Institute, the sister component to the Virginia Tech Carilion School of Medicine.

Among his responsibilities, Mahajan has been charged with bridging the divide between researchers and clinicians.

He often describes this ideal partnership by focusing on one of the features in the new building that will house the research institute and the school: Cafe X.

Near the atrium, Cafe X is intended to be an informal spot where scholars can solve medical mysteries on the back of a napkin. After all, "X" is what is solved in a mathematical equation.

"X is the unknown," Mahajan said. "It's what we want to discover."

That the cafe doesn't yet exist hasn't stopped Mahajan from dreaming of the conversations that will take place over espresso.

"The possibilities are amazing," Mahajan said. "We can set a foundation for seeing research get implemented in life to make a positive impact on people, patients."

From handshake to potential partnership

Li's lecture was intended to kick off the process of cultivating physician-researcher relationships and conversations.

Li is an expert in inflammation -- a common aspect of many illnesses, including heart disease, diabetes, obesity, septic shock and many others. In short, any condition that causes redness, warmth, swelling and pain likely falls into Li's purview.

Inflammation is also one of four study areas the research institute plans to focus on. The other areas are cardiology, infectious disease and neuroscience.

In the lab, Li and his team of researchers discovered and published information on how certain genetic variations can predict the presence of inflammatory diseases.

Working at the molecular level, he was the first to pinpoint a genetic variation in humans that is associated with cardiovascular disease.

Li hopes one day his work will lead to customized medicine that can target the variations and uniquely treat each individual case. He wants to save lives, but he rarely comes in contact with patients or the physicians who care for them.

Sitting in the back row, Dr. Alexander Levitov was among the physicians listening to Li's lecture.

"What he is talking about is what kills my patients," Levitov said after the lecture.

Levitov is a critical care specialist who works in the intensive care unit at Carilion Roanoke Memorial Hospital. He is also the assistant director for internal medicine education at Carilion and among the first to shake Li's hand after the lecture.

The opportunity for physicians and researchers to work in close proximity will help close the gap between research and medicine, Li and Levitov said.

"The distance between the bench and bed is becoming smaller and smaller," Levitov said. "This is about developing a common language."

Building to promote 'water-cooler mentality'

It's also about creating a space for that common language to be cultivated. In a way, Cafe X is a blueprint microcosm for the entire VTC building.

Researchers, educators and physicians have each had a voice in the design of the building, which will owned by Virginia Tech on land owned by Carilion.

Dennis Dean, a longtime Tech researcher and the assistant director for the research institute, has spent the past several months living a researcher's dream as the lead voice in designing the state-of-the-art research laboratory.

In March, Dean was asked to head up the design of the research institute that will share a building with the new Virginia Tech Carilion School of Medicine, set to open in August 2010.

The institute will use about two-thirds of the building that will be constructed to hold both the school and the researchers. The school will be housed in the remaining one-third of the $59 million structure, funded with a state appropriation to Tech.

"It's one heck of a responsibility," Dean said, adding he was able to include all the bells and whistles that any lab guru would covet.

Those bells and whistles are estimated to cost about $50 million in start-up costs for the research institute alone. Another $20 million will go to outfit the school side of the building.

The goal of collaboration between students and researchers has set the tone for the design of the building.

"We won't make faculty get together, but what you do is design a building to promote that water-cooler mentality," Dean said.

The vacant lot that will house this joining of research, education and clinical expertise is part of the Carilion-led Riverside development at the corner of South Jefferson Street and Reserve Avenue.

Linking the old vision of the biomedical park and the new vision for the scholarship and research is the idea of developing solutions for health care that may one day be marketable.

The building isn't just being billed as the finest in bricks and mortar.

Instead, the future home for the school and research institute is intended to attract the brightest and most talented scientists and students as well as spur a relationship between research and medicine.

Roanoke officials excited about local benefits

Plans call for hiring 42 principal investigators by 2013. These principal investigators will each lead a research team of about five other scientists, bringing the total support staff to about 210 people.

The principal investigators will draw salaries between $80,000 and $185,000, while the other researchers will make between $30,000 and $60,000.

"On average they will make closer to $60,000," Dean said of the support staff.

In part, it's the large number of high-paying jobs that have many in Roanoke excited about the economic effects of the research institute and the medical school.

"The research part of this venture, I think that's where the economic impact is," said Beth Doughty, executive director of Roanoke Regional Partnership.

The key, she said, is in turning intellectual property into "real capital."

"Research is the first step to doing that," said Doughty, who also sits on the board of directors for Carilion Roanoke Memorial Hospital.

Still, both Doughty and Dean said the larger economic and community benefits rest with how the three components of research, education and clinical care are intertwined.

"It has the potential to be an incredible turning point for this region," Doughty said.

Dean said, "This is the best thing to happen to Roanoke since they laid down the railroad."

Looking beyond the high-salary jobs, and the research potential, Dean said the increased quality of medical care cannot be ignored.

"You have to look at the grand vision," he said. "The research is only a part of making a huge medical campus."

For Dean and Mahajan, the link to Carilion's physician-led clinical care system is the key. It helps connect research, education and clinical practice.

"What we really lack at Virginia Tech is the clinical side of all this," Dean said. "Now with the medical school and research institute together with the large emphasis on expanding Carilion into a clinic, there is an enormous opportunity to interact directly with patient care."