Dr. Linda M. Liau is a brain cancer vaccine pioneer, the first Asian woman chair of a neurosurgery program.
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We are delighted to share and publish this exclusive interview by musician, singer, and philanthropist Maki Hsieh with neurosurgeon and neuroscientist Dr. Linda Liau. In this deep, and intimate interview, the President and CEO of the Asian Hall of Fame and Robert Chinn Foundation retraced with Dr. Liau, the path that led her to choose a career in science and research up to studies of a vaccine for the treatment of brain cancer. In 2021 Dr. Liau was included in the Asian Hall of Fame.
Related articles: Interview with Maki Hsieh
Dr. Linda M. Liau is an American neurosurgeon, neuroscientist, and the W. Eugene Stern Chair of the Department of Neurosurgery at the David Geffen School of Medicine at UCLA. She was elected to the Society of Neurological Surgeons in 2013 and the National Academy of Medicine in 2018. She has published over 200 research articles and a textbook, Brain Tumor Immunotherapy. She served as editor-in-chief of the Journal of Neuro-Oncology from 2007 to 2017. Dr. Liau received bachelor’s degrees in biochemistry and political science from Brown University in 1987 and completed medical school at Stanford University in 1991. She also obtained a Ph.D. in neuroscience in 1999 at UCLA, where she completed her residency and training in neurosurgery. She was inspired to pursue a career in neurosurgery after her mother died from breast cancer that had metastasized to her brain. One of her missions is to treat and transform the lives of patients suffering from the most debilitating neurological disorders, and also to improve and restore quality of life to patients and their families by enabling therapies. Liau’s primary research interest is the treatment of glioblastoma, a deadly form of brain cancer. Apart from surgical treatment, she has also worked on immunotherapy, and in the 1990s created one of the first personalized vaccines against brain cancer by using a sample of a patient’s own tumor and white blood cells to activate an immune response against cancer. She has since pioneered the use of dendritic cell-based vaccines in the treatment of glioblastoma. Other research she has performed includes the development of new techniques to map brain function during brain surgeries while the patient is awake.
Maki Hsieh: So, I am so excited to speak with you today because I actually wanted to be a neurosurgeon when I was in middle school. And the reason I chose it is because, for me, life started really hard. And it wasn’t like the others, they wanted to be a pediatrician or something, while I was a neurosurgeon, I found it very molecular. And I’m going to find a cure for all sorts of things.
Dr. Linda M. Liau: I wanted to be a singer, but I’m tone-deaf.
Maki Hsieh: So I got at Johns Hopkins because I wanted to go into neurosurgery. But I did a whole pre-med curriculum. I discovered I wasn’t as smart as they really required you to be very patient and very analytical and very smart. I just really wanted to sing while I was doing my studies, and that just did not work out. But I had a big thick book of neuroscience. It’s something that I always was fascinated by even today, I would just spell some random neuroscience factoid that nobody understands, but just you. So I was really excited when the nominees came forth to the selection committee, and you’re on the top there. First, because you’re just world-renowned. Second, because we Asian Hall of Fame is now headquartered in LA, and we hear a lot about your work, we hear a lot about your leadership at UCLA. So by geography, we’re hearing a lot about you. And then also with COVID, highlighting medicine and excellence in medical research has become really important for us. So I wanted to start by, first of all, I get a lot of questions. How do you say your name and what does the M stand for?
Dr. Linda M. Liau: Oh, yes. So my name is Linda Liau. And the M actually stands for Ming-Huei, it’s my middle name. It’s Chinese. I used to use the middle name, but it was just too difficult for people to pronounce so I just use the initial.
Maki Hsieh: I understand, it’s difficult because my last name is Hsieh. So as Maki Hsieh is a little bit tough for people to spell, I just use my middle name, Margaret, for this reason, my artist’s name is Maki Mae. It’s just easier.
Dr. Linda M. Liau: Right!
Maki Hsieh: I noticed that you’re born in Inglewood and you’re raised in LA. Is that true? How did your parents come here? Or were they here for a while? And what was that like growing up?
Dr. Linda M. Liau: Yeah. So, I was actually born in Tainan, Taiwan. My parents had an arranged marriage. And, I hear this, obviously second-hand, from my mom. But, one day my dad decided that he wanted to immigrate to the United States here. Actually, he just got a scholarship to study Russian. And so I guess this was back in the timeline, in the early 60s, during the Cold War. And, I think the federal government was trying to find Chinese people who could speak or interpret in Russian. So, right after I was born, my family immigrated to Cleveland, Ohio, because my dad went to school at Case Western Reserve, and I don’t remember much of those first few years. But I’ve seen pictures. It was very cold in the wintertime in Cleveland, Ohio. And then that’s where my younger sister was born. I think when I was about five we immigrated to downtown Los Angeles and I have been here ever since.
Maki Hsieh: Is your father involved in medicine? Was he a professor in linguistics or what was his background?
Dr. Linda M. Liau: No one in my family was involved in medicine. Basically, he taught languages and I think for a time, he was a translator for the CIA or NSA or something like that. I don’t know, really. But, we moved to Los Angeles near USC, actually, and went to 32nd Street Elementary School, which I think is still there. Actually, I drove by it recently, it’s very different from when I was there 50 years ago. But then eventually when I was in junior high my family moved to Cerritos and that’s where I went to high school. I went to Whitney High School in Cerritos and then I went to Brown for undergraduate Stanford for medical school, and then UCLA for my Ph.D., and I’ve been here at UCLA ever since.
Maki Hsieh: What’s interesting is that from California, you went to Brown and your double degree was a BS in biochem, and a BA in political science. Is that right? How did that happen for you? Was it because your father was interested in political science and languages? And then you were interested in it? So was your mother a scientist? Was she involved in research?
Dr. Linda M. Liau: No, my mom was not a scientist at all. My mom only had a high school education. But I must say she was the smartest person I’ve ever met. She was one of those people, she was incredibly good at maths and science. I mean, she was still able to help us, my sister and me with high school maths all the way till we graduated from high school. So, she has always been a huge inspiration for me, because I think she was one of those people that if she had the opportunity to go to college or grad school, she would have done incredibly well. But, that just wasn’t the time. What the opportunities had afforded to her. That’s why I really liked maths and science when I was in school. So that’s kind of why I majored in biochemistry. Yeah, the political science part was a little bit, I guess, just, listening to stories about, the Cold War, and, kind of what was happening, at the time, I just thought it was interesting to learn more about, kind of international politics and, I envy kind of what was going on in the world. And I remember for my thesis, we had to do an undergraduate thesis and took a class on the Sino-Soviet conflict. And I remember when in my own thesis I wrote and predicted that the Soviet Union would fall in the near future. And this was in the 80s. And I remember, I got a C on that paper because my professor was like, “Oh, that will never happen!”.
Maki Hsieh: Oh, my Godness. Wow.
Dr. Linda M. Liau: And then now, it’s like, in retrospect. So anyway, I did better in science than I did in political science. And actually, that’s why I went to Med school.
Maki Hsieh: That’s really exciting that you have such a wonderful path led by curiosity, and led by fascination. you’re genuinely interested in learning about the world we live in. I think that’s amazing. And the fact that your mom shepherds you along the way, it’s just such a beautiful story. I read in your biography that you were inspired by your mother because she had cancer and it metastasized in her brain. Did that happen when you were in grad school? How did that inspire you? And first of all, how did you react to that news? Was it a phone call? And I’m sure it was just harrowing for your whole family. And how does that part of that life experience inspire you to the next step?
Dr. Linda M. Liau: Yeah. I mean, it’s one of those kinds of things that still impacts me today. I remember that she was initially diagnosed with breast cancer when I was in medical school. And, she had a mastectomy. I didn’t really think that much of it, because she did find it for a while, and then when it came back, she got very sick. That was when I was in towards the end of medical school. And that’s actually why I decided to come back home to LA for residency. So actually, I came back to UCLA for residency, and unfortunately, she passed away when I was a fourth-year resident, and I think what really frustrated me at the time was that I felt like, with all the current medical knowledge that was available, there was nothing that I could do to help her. And I think that’s now, 25 years later, I’ve seen 1000s of patients now with metastatic cancer and primary brain cancer, and it’s so gratifying to be able to help even just a little bit. But then at the same time, it’s frustrating when we can’t, and that’s kind of the reason I do what I do. I love the clinical aspects of taking care of brain cancer patients. But I also love the research aspects of being able to work on, hopefully, new treatments and new cures for the disease.
Maki Hsieh: So we have a lot of people tuning in who are not familiar with medical research and health care, and neurosciences the study of and the clinical research surrounding neuroscience. But then Neurosurgery it’s a related but entirely different practice. Is that right? So then you actually, you love the clinical side of it. So you can be innovative and continue to develop the field, but you’d like to also apply it practically through surgery. Did I say that correctly?
Dr. Linda M. Liau: Yes, yeah! That’s exactly what I love about my job. I get to develop and detect.
Maki Hsieh: I think you’re the only reason why I would support human cloning, we need to clone you, Dr. Liau, we need to multiple Dr. Liau. Because I have never met someone who is so humble, and so tied to legacy and heritage and family. And at the same time, very fascinated by innovation. And I love to hear, I know that our audience loves to hear more about your ideas of how you came up with a vaccine for brain cancer. And at the same time, then go deep, deep into it, and actually surgically remove cancer. That’s just amazing, really is. My mother actually has two masters and a Ph.D. in cognitive linguistics and East Asian Law. And she taught at the 臺大 (National Taiwan University) for 38 years. And maybe a couple of weeks before Mother’s Day this year, I heard that she was lost in Taiwan. She was sleeping in train stations, she was not going home. She was lost. And then we connected via email. And day after day, she would start to reveal that she was hearing voices and there were four chips in her ears and she was hearing broadcasts telling her that she was in danger. And these North Korean communists were fighting amongst each other led by these two Japanese gangsters who were trying to take over her apartment, which is why she wasn’t going home. And she had completely gone from being very cognitively aware to fully shattered. I mean, maybe it seemed a full reversal to me, but maybe it was progressive over time. And then the doctors at the National Taiwan University are saying that she has Alzheimer’s or has delusional effects with dementia. But then they also say no, it’s actually schizophrenia, with dementia, and then there’s maybe some kind of high chronic hypertension that’s causing some blood pressure in her brain. That’s also so the medication keeps adjusting based on the diagnosis and it’s really annoying. I’m frustrated, too. I’m with you. With all the young people creating new PokemonGo games, why can’t we harness their brains to create new solutions for healthcare? So how did that come to your mind when you were talking about or thinking in your mind about the brain cancer vaccine? Did you just ask yourself? What if we had a vaccine? Or did you ask yourself, well, how can we don’t have one? Or how can we prevent one? How did that in a nutshell, progress from here to a full-blown vaccine for humanity?
Dr. Linda M. Liau: Well, I think one thing I love about medicine and sciences is the ability to be curious and to try to solve problems. I really liked solving problems. I was one of those kids that just liked to do maths problems, just for fun, when I was younger. So one thing that was always frustrating to me when I was starting out in Neurosurgery is that for instance, with malignant brain tumours. We do a great surgery to kick out the tumour, and then six months later the tumour is back, despite the radiation and chemotherapy, and that was just, incredibly frustrating. And part of the problem is that there are cells that we can’t see, and that’s a problem with a lot of cancers is that the reason cancers come back, is because you can’t see them, so you can’t take them out surgically, you can’t really target them within, drugs or radiation very well. And then in the brain, you certainly don’t want to damage those surrounding brain tissue in attempts to try to take out more or radiate the tissue. So we don’t get big margins as you did for other types of surgeries. So, I guess, when thought about, what could you do to get to cells that you can’t see, and if you really think about it, the only thing that can do that is your immune system. Because the immune system, they’re able to get to the viruses and bacteria that we could never see, I mean, there’s no way you could surgically take out the COVID virus in someone’s body, or you can’t see them. So I think it’s the same concept of tumour cells. The tumour cells are different, they’re foreign to the patient. So there should be some way to train your body to recognise them, as a foreign invader, and try to really, prevent these tumours from coming back. So that was the initial concept at the time, and then I think, a lot of the research that, my group and I were doing was just predicated on a lot of other things that were going on at the time, in terms of other types of, immunotherapies, and vaccines for other types of cancers, and how to help people were kind of developing, immune responses for other cancers. I think one thing that’s different about the brain is that for the longest time, the brain was thought to be immune-privileged. If you remember neurosciences used to teach you that there’s a blood-brain barrier and that the immune system doesn’t get into the brain. And, I remember when I was writing, applying for my first grants for research, that would be the comment I always get, “Oh, this project won’t work, because we all know that the brain is immune privileged, how can you induce an immune response into the brain.” So, I think that was something that was thought to not be plausible at that time. But, now, in retrospect, people do hard work in immunotherapy for brain tumours and as well as other cancers. But I think at that time, that was viewed as I said as an area that wasn’t feasible because these immune cells didn’t get into the brain.
Maki Hsieh: Do you feel that eventually, we will have a vaccine against most cancers, like breast cancer or other cancers. Do you think that’s the foreseeable future?
Dr. Linda M. Liau: I think so, as we learn more about these cancers and these diseases, and as we get better at making vaccines because there’s right now, it’s still a lot of the immunotherapies for cancer are still quite difficult to manufacture, especially the cellular therapies, but I think as we learn more about what the antigens are for these cancers, hopefully, that’ll be the case. I mean, there are already vaccines for instance, for cervical cancer, teenage girls get that now. So, it’s just a matter of figuring out what the antigens are, what potentially would cause these cancers, and then vaccinating people against that. And we have seen now with the new research that’s been done, with the COVID vaccines in the mRNA types of vaccines, the ability to design new vaccines. I think it is quite exciting. And you can imagine making an mRNA vaccine for 50 different antigens that could potentially cause different cancers and trying to prevent those from actually forming tumours.
Maki Hsieh: Another thing that people always have trouble with is that cancer a lot of times is misdiagnosed with something else. So by the time, it is actually discovered that the pain you’re experiencing is cancer, sometimes it’s a little bit late, you’re already in stage three or four. So with brain cancer, what are some of the symptoms that people feel that sometimes they can confuse with another condition?
Dr. Linda M. Liau: Yeah, that’s a great question. Actually, a lot and many of the symptoms that arise due to brain cancer, kind of similar to what you’re saying, actually happen to your mom.
Maki Hsieh: I’m thinking I should bring her from Taiwan to see you.
Dr. Linda M. Liau: I think we should get an MRI scan, to be sure that there’s nothing there. Because a lot of times the symptoms are very similar to Alzheimer’s or other types of dementia or stroke. Because all it is really a mass that’s invaded a certain part of the brain. And if that part of the brain controls, for instance, language areas, and people would have problems, talking or comprehending language, if it controls motor areas, and people would have problems walking, or moving and in other times, with tumours in the brain, you get cognitive changes and memory loss or seizures. So yes, so actually, a lot of the patients that I see were initially diagnosed with something different, and then finally, they got an MRI scan of the brain and, discovered to have a brain tumour, and then that’s how we find out about them.
Maki Hsieh: In the global sphere of medical care, do you feel that the United States is top when it comes to medical research and neuroscience neurosurgery in terms of technology funding and support? I’m hearing that Europe is a little ahead of us, like Sweden and Denmark? Is that true? Do you feel there is a bit of a dichotomy sometimes and the way care is handled? Or the funding and support available to care?
Dr. Linda M. Liau: Yeah, I don’t know enough about the international kind of funding models for research to really say for sure, but I do think in terms of research in the United States there are high levels of research here. And, part of that is driven by the funding to academic medical centers, but also part of that is driven by the pharmaceutical industry and kind of trying to get patents and kind of developments of new treatments. But I think perhaps in other countries, there’s maybe a little bit a broader distribution of treatments. It seems like sometimes certain treatments are more accessible to patients in certain countries, depending on what the regulations are, with the different regulatory agencies. So I think there are pros, and cons to both scenarios. I think the US has a lot of very innovative research, and they’re certainly incentives for that, in the twilight that is done here. But, in European countries, they’re different incentives that drive very high-quality research.
Maki Hsieh: So you are an example of how an amazing woman with a heart of gold and a brain that goes like 10 professors in one petite body can actually lead a major programme. What would you say to women and girls in science who are wanting to go into the field and they’re maybe getting a little frustrated not just by society, and the systemic establishment of the way hospitals rank people but maybe even from their family telling them all it’s a lot of work or what are some words of encouragement that you would like to say to women and girls going into the field?
Dr. Linda M. Liau: Something I’d like to say is something that my mom taught me is just, “Don’t let anyone tell you no.” And I guess, I’ve always, kind of believed that. And, I mean, I’ve worked hard, it’s not that I didn’t have a lot of sleepless nights to get to where I am in terms of my career. But with that being said, I think, I picked a career that I really love, I mean, quite frankly, I’m actually so grateful for the opportunity to be able to be part of the lives of all the patients that I’ve, kind of gotten to know, over the years, and it sounds weird, but I wake up, often wonder, like, “They actually pay me to do this!”, because it’s something that I just love doing, and I think that’s what’s important, I mean, in terms of encouraging young Asian women to go into fields that are not traditionally, filled by women or minorities is to really find something that you love, and are passionate about, and then just do it. So, I really never thought of it much other than that, I just love to do it. And I kept trying. And I just stand even if people tell me No. And also, I think, one thing that I kind of learned about myself is, I am an extreme introvert …
Maki Hsieh: You are very, very humble. And yeah, I can tell that you love to solve problems, and you enjoy it.
Dr. Linda M. Liau: .. and which is unusual, because the usual, if you go to business school, they’d say, you need to be extroverted and very kind, like out there. I actually prefer to stay at home and watch TV. But I think, what I’ve learned is that it’s important to just be yourself as opposed to trying to model leadership skills or leadership approaches, after other people. So, I guess, yeah, for anybody out there who wants to be a neurosurgeon, I really recommend it. And I think it is hard work. But if it’s something that you love, or you want to do, I think there should be ways that you could do that. And, as I mentioned, I had wanted to be a singer. So there are some things that I think, if you don’t have the skillset, it may not work out.
Maki Hsieh: Well, we can cover the singing for you. We’re happy to sing for you at any time. A little concert with Dr. Liau. and any of your fundraisers, we’re happy to support from the Asian Hall of Fame.
Dr. Linda M. Liau: So yeah, I know.
Maki Hsieh: Do you have philanthropy or a cause that you’d like to lend your voice to? Is there something that’s close to your heart or that you’ve done for a couple of years now?
Dr. Linda M. Liau: We do fundraise for the research we do here at UCLA, because a lot of what we do is funded by philanthropy, particularly, for our brain cancer research, as well.
Maki Hsieh: I noticed that Geffen School, it’s named after David Geffen of LA. I didn’t realise that philanthropists play such a large role in advancing research and medical science. And in America, that’s really interesting for people to hear because when they hear a hospital or a programme that’s affiliated with a school or university, they assume automatically that it’s just covered, that it’s just fine in the part of the school’s budget, but that’s really good for our listeners to understand that their $1 does go a long way.
Dr. Linda M. Liau: Oh, yeah, definitely. And I think most academic medical centers, actually do fund a majority of the research on philanthropy as well as their medical education. The funding provided by David Geffen who funds this programme here called the Geffen scholars, where they provide free tuition for medical students who are academically qualified to come to medical school here. And I think that really has opened up the access for people who may think that medical schools are not what they want to do because it’s too expensive. I mean, medical school debt these days is quite hard.
Maki Hsieh: Medical school tuition is quite high. Yes. Well, I wanted to wrap up with my last question, which actually was supposed to be my first question, but I was so into your background that this is now our last question, which goes back to the Hall of Fame. When you hear Asian Hall of Fame normally right away, you think okay, well, there are these golfers and tennis players and athletes and musicians. How did you feel when you got the phone call and the email that you’re inducted, you are nominated and voted into the Asian Hall of Fame, which has inducted Bruce Lee Kristi Yamaguchi, Connie Chung, and you are the first-ever neuroscientist to be inducted? How did that make you feel? And how, what does it mean to you personally to be inducted into the Asian Hall of Fame?
Dr. Linda M. Liau: Yeah, well, I am so honoured. When I heard about it, I was like, I’m with these bold, these people are such icons for me growing up. I mean, I must say that I really looked up to people like Connie Chung. I remember watching her on the channel 2 news when I was growing up, and I think these people are movie stars and athletes, and politicians and just phenomenal people, and to be included among that group, I don’t know what to say. I mean, I’m humbled. And I’m also excited that you did include a scientist, because, I guess you don’t want to give a plug for science as being a kind of a sexy career. So for a lot of the others, in the area means that Asians do excel at, and I think we can really make huge impacts in this field, as with all the other fields, I just want to say thank you, and it’s really such an honour.
Maki Hsieh: Well, welcome to the Asian Hall of Fame, and congratulations on being the 2021 inductee, Dr. Liau. You’re a fabulous inspiration, a wonderful human being and we are thrilled and honoured by you.
Dr. Linda M. Liau: Oh, thank you.
Maki Hsieh: Thank you, Dr. Well, I have just one question from the Italian magazine Planet China. And here is this one, that we didn’t talk about. And their question, is this, Is there a case or a study more than others, that has remained imprinted in your memory? A case or a study that has affected your perspective or your research?
Dr. Linda M. Liau: Yeah, there have been so many over the years.
Maki Hsieh: It’s hard to pinpoint just one!
Dr. Linda M. Liau: I guess, a recent encounter I thought was very interesting. I’ve done these clinical trials for brain cancer patients, and we have this vaccine trial that’s been ongoing for a while, and we’ve had patients who’ve done very well over the years. So, one patient who’s been going on almost 20 years, after his diagnosis of glioblastoma. And, I remember, when I first met him, his wife was pregnant, and now his son is an adult, a young adult. So I think that was incredibly impactful. And the other side, I also have had patients we’ve tested treatments on, and they eventually passed away. And I remember this: one woman very specifically that was one of the very first patients we had, she actually was from Alaska. And we enrolled her in the trial, and she initially did well, but then eventually succumbed to her disease. And I remember she had a young daughter at the time, she didn’t talk with me, she was about five years old or something. And, then just more recently, actually, her daughter wound up going to school here in Los Angeles. And, she contacted me and invited me to an art show that she was putting on because she became an artist.
Maki Hsieh: Oh! That’s wonderful!
Dr. Linda M. Liau: And I guess, I have hundreds of stories like that. I think what’s so impactful is that, sometimes, you don’t realise the impact that you make, not only on the patients but also on their families. And so, I guess, that’s why I feel so passionate about hopefully trying to cure brain cancer because it is something I mean, that I really want to do because there are so many of these people that have lost their mothers, their husbands, their daughters, to this disease. Those kinds of things really stick in my memory.
Special thanks to Maki Hsieh for sharing with us her interview
Interview with Dr. Linda M. Liau, M.D., Ph.D., M.B.A. Professor & Chair of Neurosurgery at the David Geffen School of Medicine at UCLA; Co-director, UCLA Brain Tumor Center; Neurosurgeon-scientist in UCLA’s Jonsson Comprehensive Cancer Center; Member, UCLA Brain Research Institute. Special thanks to Maki Hsieh for sharing with us her interview.