Protecting your vital research asset

0:00 Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. As clinicians, we spend a decade or more as trainees learning to take care of patients. When we finally start our careers, we want to build research programs, but then we find that our years of clinical training did not adequately prepare us to lead our research program. Through no fault of our own, we struggle to find mentors, and when we can't, we quit. However, clinicians hold the keys to the greatest research breakthroughs.

0:40 For this reason, the Clinician Researcher podcast exists to give academic clinicians the tools to build their own research program, whether or not they have a mentor. Now introducing your host, Toyosi Onwuemene. Welcome to the Clinician Researcher podcast. I'm your host, Toyosi Onwuemene, and it is an absolute pleasure to be talking with you today. Today I am talking about a topic that is most interesting to me right now. My interest changed from day to day, clearly. But I want to talk about protecting your vital research asset, protecting your vital research asset.

1:24 And by talking about protecting your vital research asset, I'm actually talking about protecting your mind. I am talking about protecting your mind. Again, I'm JLC Unwomena, host of the Clinician Researcher podcast. I want to thank you so much for showing up today so that I can speak to you about this important topic. Now the impetus for this particular episode is being on call over the last week and recognizing that, gosh, it is exhausting to cover for a 24-7 period. It is exhausting. And in reality, and as you know, you're not working all the time, but it only takes being woken up once or twice.

2:08 It only takes being woken up once or twice over the course of a week for your whole week to be thrown off and for your sleep cycles to be thrown off. And different people handle it in different ways, but I certainly don't really do well with being woken up in the middle of the night as far as being able to continue to function actively during the day. So it's been an exhausting week. And yesterday I had a goal. I had some more creative type work that I needed to do, and I said, I'm going to lie down for just two minutes, just five, just ten. And of course, I woke up in the morning and thought, gosh, I was so tired.

2:48 And that's because clearly I was exhausted. And so good that I got some rest because I needed it. And recognizing that some of the things that we do make it challenging to do the creative work of writing and the creative work of charting a new research direction. And so I want to speak a little bit about that today. I'm going to speak about our minds and ways, things that we should consider. So I'm just actually just sharing thoughts about protecting our most vital asset. And I'm talking about our minds. The first thing I want to share that may be obvious, but is important to say is that the quality of your research always depends on the quality of your thinking.

3:32 Now I'm talking about the quality of your leadership, your leading your research program. Now, if you are participating, say with a research group or you're working in a mentor's program, the quality of your thinking is important. But if somebody else is doing most of the thinking, most of the creating the direction, deciding where to go, deciding how papers are written or what the structure is or the papers you're submitting, you may not have to do too much thinking. You can just do what you're told. And you still need a clear mind and a well rested mind to do that, but not to the extent to which you are creating new things. And when you're creating new things, I'm talking about you're deciding what's the new research direction.

4:16 How do we synthesize all the data we have? What are the next steps of the research program? What's our big picture? Those are things that really need you to be super creative because you've got to really think outside the box of where you are right now. You know what's easy in life? It's easy to do what you've always done. It's easy to do what you're currently doing. What's hard is to change direction and evaluating your research program critically, thinking about the direction that the program needs to go in, thinking about what new experiments you need to do, thinking about what new projects you need to start. That requires a change in direction. And so there's clearly a need for intense creative thinking in that space.

5:02 And for that reason, it's important to think about how do you create spaces where this important physical asset is protected? This important, actually it's kind of mental, spiritual, emotional asset really is protected as well. And there are many, many, many things to talk about as far as what are the things that distract our minds from doing its best work or doing their best work, distract our mind from doing its best work. And I'm going to talk about some of them, but I do want to just make the case that if we're going to do the creative work of writing, the creative work of thinking, the creative work of charting a new course for our research program, we've really got to be able to use our minds optimally.

5:46 All right, so the second thing I want to share is that it is important for your thinking to transcend what is known to what is unknown. And here I'm really speaking again about the need for creativity in your thinking. If all we focused on was what was known, and we were satisfied with what was known, there would actually be no need for research, no need for people creating new bodies of work. There'd be no need for that because what is known is satisfactory, but what is known, we know, has gaps, right? We have gaps in our knowledge. We don't know. Sometimes we don't know what we don't know, right?

6:27 Sometimes it's clear what we don't know, but sometimes we don't even know what we don't know. And so if we're going to make progress, but more specifically, if we're going to make impact through the work that we do, we've got to think not just about what is known. We've got to think not just about what is known that is unknown, but we've got to think to the place of what is not known that is unknown. And so that requires creative thinking, and it requires us to really stretch our minds to think outside the box of the way we do things, outside the box of the way we live, to really be able to think beyond what is known, to recognize what is known that is not known.

7:13 And so that really does require creative thinking, the ability for our minds to transcend what is known to what is not known, and even to think beyond what we don't even know that we don't know. Now, why do I emphasize that a lot? Because I've kind of repeated myself a few times. It's that, again, our minds would prefer the easy work, the easy work of just thinking about what is already in front of you. If you're going to do the work of thinking beyond what is already known, thinking beyond what is in front of you, you really got to have a mind that is sharp and focused, rested, and ready to go. And so your mind is critical if you are going to do any work that has impact, if you're going to do any work that doesn't already reveal what is already known.

8:02 It's going to be really important for your mind to be sharp, focused, and well rested. Okay, for that reason, and I've kind of said this before, but this is point number three, is that your thinking has to be creative. Now, you may say, well, all thinking is creative. No, not necessarily. If you think about it, if you listen to the news this morning, your thinking is probably focused on the news you listen to. That's not creative. That's just kind of regurgitating what you have. Now, I will tell you though what you've listened to, sorry, but I will tell you though, so usually you listen to bad news and the news is mostly bad, but you listen to bad news, your mind does become creative, but it becomes creative in creating more of what it listened to.

8:52 Your mind is good at taking what it's received and then creating more of it, right? It kind of like is like a machine that reproduces, but reproduces at a higher level. And so perhaps someone says, oh, there was an accident on highway 40, and the next thing you're thinking, wow, that's where I go, usually when I'm on my way to work, that's the path that I take. What if I'm going to have an accident? Oh my gosh, what if it's a 17 car pileup? Your mind keeps going, keeps going. So one thing that happens when you focus on what you can see is that you produce more of what you can see and you don't just produce more of what you can see, you amplify what you can see so that in some ways that is creative because you're making a new strap, you're making a new thing from what you already see, but in many ways it's not creative because what we need you to do as a research scientist is to think about what other people are not thinking about.

9:54 That means to focus on what other people are not talking about. That means to focus on the gaps that are not explicit, right? And so that's the level of creative thinking that I'm talking about. So that level of creative thinking almost has to say, I don't want to listen to all of you talking about the news of dogma, telling me about all the things we already know to be true. I need to focus on what is it that may not be written here? What may not be in the news that I need to be thinking about? Now I'm not saying you should be thinking about making up stuff. Please do not do that. That's an integrity issue. But what I'm saying is how do you leave the space where everybody you know is in an echo chamber and they're just talking about the same thing over and over again.

10:38 They're like, oh, this is the way it's always been. How do you leave that space and go to a different space where people have the same problem, but presenting in a different way and think about how are they thinking about it? For example, how do you leave the space of medicine and go to engineering and say, well, how have you guys solved this engineering problems for yourself? Because this may be relevant in cardiology or this may be relevant in GI. Do you see what I'm saying? It's focusing on what you see because what you see is going to still be important in the creative process, but it's leaving the echo chamber of the space you know well and everybody around you is saying the same things over and over again and going into a different space, going and connecting with people who are not like you, researchers who are not like minded, not even necessarily researchers in science, but researchers, I mean, all researchers are kind of researching science for the most part, but researchers in other disciplines so that you amplify and enhance the quality of your creative thinking.

11:43 And so creativity is one of the most important things you will do or being creative is important. Your creativity is one of the most important assets you will protect as you work on protecting the asset that is your mind. So your thinking must be creative and you actually have to create space and create opportunity to be more creative. Okay. I want to share what you may know and that fatigue is a barrier to creative thinking. Fatigue is a barrier to creative thinking and I've kind of alluded to it in some of the earlier points that I made.

12:24 When you are so tired, you don't want to think creatively. You just want whatever somebody gives you. It's like when you're super hungry and somebody brings in like a really greasy burger that's dripping at the sides and you may love burgers, but you probably would prefer less fat dripping from the burger, but you're super hungry. Are you really going to discriminate? Are you going to say, no, I want a salad? You're going to say, no, I am famished. Give me this food right this moment. And that's what I'm saying. So no, no, this is not a judgment on greasy burgers, please do not hold this against me. I really am just making a point. I'm just using this as an example.

13:05 It could be the salad that you are going to eat even if you don't care for salads. But what I'm saying is that when you're super hungry, you're just going to take whatever is before you without discriminating. And it's the same thing when you are super tired, you're just going to take whatever is before you without discriminating. You're like, yeah, just let me have it. Right? And honestly, and this is what I found for myself too in this last week, when you're super tired, you can't even really do any writing. It's like creative or not creative. Like the work you're supposed to do that your mentor gave to you or not, it is hard to do when you're tired. So fatigue is a thief of creativity. And the question is, how do you protect yourself from that fatigue?

13:50 The other thing I want to share is that if you're going to be somebody who is not always tired to the point where you are not able to be creative, then it is important to avoid exhaustion. And I want to pause now and start laughing or smile. That's what I'm doing right now with smiling because I recognize that as clinicians who are also scientists, our work is hard and the work of being a clinician is super hard. And here's what's interesting. We love being clinicians. Many of us do. Most of us do. I think I can say with certainty because we came into medicine because we want to care for patients.

14:33 And so many of us love that work. We love, we are energized by the work that we do in talking with our patients. We really enjoy that. And so it is hard to imagine a life where we're not doing that, but it is also very exhausting. Working with people can be challenging, whether we're in healthcare or we're outside of healthcare, but it can be really exhausting. And then when you add to that life and death situations, critical acute situations, and then you add to that taking call overnight, holy cow, it is super exhausting. This is the work we love to do.

15:14 Does it mean we stop patient care? I think the answer is no, but we've got to think creatively about our patient care and how it impacts upon our ability to generate new knowledge. Now I've had conversations with physician scientists who are like, I love patient care so much I could never quit doing that. And I'm not inviting you to do that. I am inviting you to think about how do you become strategic about how you deliver patient care so that it doesn't exhaust you to the point where you cannot create new knowledge. Now everybody doesn't have to create new knowledge. It's not required, but for the people who are working to create new knowledge, protecting your vital asset is important.

15:54 How do you do that? And if we don't have a cadre of people, a group of people who are creating new knowledge, we're just going to be stuck in the status quo. And as I always preach from this platform, clinicians are critical to creating new knowledge that is relevant to patient care, that really is actionable and that matters. And so I want more clinicians doing research and clinicians love to do clinical work and clinical work can be exhausting and can limit your ability to do the research that actually changes the knowledge and changes the way we practice. But it is important that we think in a way that's, I don't want to say balanced because it's a little bit more than just balanced because clinical care is so time intensive and can be exhausting.

16:44 But I'm talking specifically about how do you shape your clinical care such that you're still able to continue to do this creative work? So let's say you have clinic, how do you stop being the primary provider in this clinic so that there are trainees perhaps who come to work with you who do the bulk of the heavy lifting? For example, writing notes is kind of, you know, seeing patients can be easy for us because we're the expert, we know exactly what to ask, what to say, we love talking with people. Oh, the administrative clinical work in the background can be hard. And so if you have trainees as part of your program, let's say you're supervising a fellow's clinic and you're helping them think through the difficulties of caring for the patient and they're writing the notes, that does relieve a huge burden for you because it can be tiring to put all this together in a note.

17:34 They do that for you at first and then you're able to come and look at it and then say, okay, yes, this makes sense. Now let's tweak this, right? And so even though I was on call this past week and it was super tiring because of all those late night calls, it is still easier for me to look at a note that one of the trainees working with me has written and endorse that and then add some thoughts to it rather than trying to go back to the very beginning and say, wait a minute, was that patient a smoker or not a smoker? It's going to impact years. And so it's saying, how can you be strategic about the work you do so that it does not overwhelm and exhaust you and you're able to have continued mental capacity to do the research that you need to do? How can you get creative about that?

18:15 You might say, I'm just, this is just me. I'm the only one in my clinic and I have clinic four days a week. There's no way it's saying, how can you structure your clinical work such that it doesn't take all of your emotional and mental energy and there is enough emotional and mental energy left to do the research. How can you get creative about that? And even if you're not necessarily in charge of the fellows clinic, how do you draw trainees to work with you so that you can begin to have a sort of fellows clinic, even if it's not official? How can you, how can you think? How can I? And I just invite you to think about how do you structure your clinical care so that your research can keep going and can keep going in a way that is creative and fulfilling.

19:02 The seventh thing I want to say is that it's not enough just to be a creative thinker. It's important to be surrounded by creative thinkers. To some extent, I alluded to this when I talked about the importance of going and being among other types of thinkers or other types of researchers, not just clinicians, not just clinician scientists, is going outside of your discipline, going outside of your mental space so that you get ideas from people who are thinking creatively. And so many times for me, I'm thinking about digital solutions to early diagnosis. Who are those who are using digital solutions for other things that might not be early diagnosis, but have to do with identifying things early that other people may not identify?

19:51 How do I do that? Because that gives me ideas that I can use and apply to my research. What are other researchers doing who don't have this particular disease state in mind, but they're solving the problem for other disease states? How can I get with them so that I can expand the quality or the creativity of my thinking? And so these are some strategies to think about as you are protecting or working to protect your most valuable asset, your mind. Number one, the quality of your research depends on the quality of your thinking. Number two, your thinking must transcend what is known to focus on the unknown. Number three, your thinking must be creative.

20:33 Number four, fatigue is a barrier to creative thinking. Number five, avoiding parts of the work that exhaust you is key, creating strategies so that you can allow your clinical work not to overwhelm and exhaust you is important. Number six, creating space for thinking is key. And number seven, being around creative and unique thinkers, different thinkers from you is important as well. All right. It's been a pleasure talking with you today. I am so grateful for having had this opportunity to talk with you. Thanks for listening. And I look forward to seeing you the next time on the Clinician Researcher Podcast.

21:14 Thanks for listening to this episode of the Clinician Researcher Podcast, where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. If you found the information in this episode to be helpful, don't keep it all to yourself. Someone else needs to hear it. So take a minute right now and share it. As you share this episode, you become part of our mission to help launch a new generation of clinician researchers who make transformative discoveries that change the way we do healthcare.