The gifts of a research career

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 such a privilege to be talking with you today. Thank you for taking the time to tune in and to listen. I keep talking because you keep listening, and I want to thank you that you would create space for me to share my views and my thoughts with you.

1:21 And so thank you. Thank you for listening. I want to invite you, if you have time available, on Monday, November 20th at 6 p.m., I'll be talking about five key, five critical steps in the transition from clinician to research leader. You don't want to miss it. You should show up there. Use information on the podcast website, clinicianresearcherpodcast.com. The banner will give you information. Or you can go to our website, coedcoach.com, and look for events. And in case you miss it, there will be another webinar, and I will continue to do things and share things that will help you make your transition.

2:05 And I want to thank you for letting me help you do that. If you are not going to be available, you can still sign up, and that means that you will get the recording once it becomes available. So please sign up and learn all that I want to share about making that transition, which is critical. Okay. Today, I'm talking about the gift of a research career. And I really want to, you know, talk first about how my life has changed since I made the transition from being a full-time clinician to leading a research program.

2:45 I will tell you that I've always had the dream of leading a research program, but I didn't know how. I didn't understand what was necessary. I had no idea about the structures that needed to be created to support your research and your writing, I had no idea about how to write a research question, how to think about a research question, how to even answer a research question. And I think I was completely confused every time I would submit a grant and get all this awful feedback. And I kept thinking, why is this not working? But it was what I wanted to do.

3:26 The real of the pursuit was really because I had this dream of research just being my life, being my experience. So I may come across potentially as extroverted on the podcast, but I really love to be by myself. Give me a book and give me eight hours. I will like curl up in a corner and just read, read, read, read, read. At least that's what I did when I was younger. And even now as an adult, my happy place is sitting and writing and thinking big thoughts and synthesizing information and synthesizing data. It's what I've always enjoyed doing.

4:08 And so research really allows me to do that. And so, but I didn't know that. I didn't recognize that that would be a gift in the research for me until I really started to make the transition. And the reason, so I want to share with you the gift of a research career is that many times are very focused on the challenges of the research career. Oh, I have to write another grant again. Or the grant was rejected. What? It's been four times. It's been submitted four times. There's a lot of frustrations. Don't get me wrong. I am not even here to take your frustrations away. But what I am here to do is to show you the gift.

4:50 Just to show you the gift to look to because the moment you have a clear sense of the gift that you get from a particular endeavor that you undertake, it changes your experience. You're no longer, oh, I have to go through a slog. You're more really thinking about, okay, I just have to jump through four obstacles to get to the vision to get to my goal. Okay, I can do that. But the key is clarifying what your goal is. And that's why I want to share with you gifts, the gifts of leading a research career. And I want to share them with you so that you can focus on those gifts rather than focusing on the challenges because the challenges, again, they are just part of every endeavor.

5:39 So I would like you to point out, point to one place in your life where you have not had any challenges. And if you can do that, then I will submit to you that perhaps you can have a research career without challenges. But if life is full of challenges, then I'm going to assure you that your research career will be full of challenges. But I don't want you to focus on the challenges because the challenges are just a free gift that comes with their research career. I want you today to focus on the gift. The very first gift I want to share with you is the gift of intellectual freedom. That is such a beautiful gift.

6:20 The gift to think expansively, the gift to craft discourse, the gift to synthesize knowledge, the gift to write. It is the gift of intellectual freedom. No one has to tell you what to think. You don't even have to agree with all of the experts. You could be the one dissenting voice in the universe. And if you can write it eloquently enough, and if you can justify it well enough, and if you can cite enough literature, you can write it. Somebody will accept your publication. You will be that dissenting voice. It will be beautiful.

7:01 To most of us, not dissenters, we are kind of mostly, you know, we're like, yes, this is what the literature says. I agree wholeheartedly. But then the literature is obviously never all in harmony. There is always, you know, there are always things that are different from what we consider to be dogma. So the gift of intellectual freedom is really freedom to think. Think in the way you want. Think in a way that enhances you. Think in a way that transforms you. And you know, it is freedom of thought. And sometimes people balk at that because they're like, well, you can't just think anything you want. And in reality, I will say that as clinicians, we do love science.

7:47 I mean, science is what led us to patient care. We love patient care. We love to take care of the patient. We love to think critically about what it means to make things better. And so our intellectual freedom is about investigating that further and answering questions that benefit patients. So yes, I think that intellectual freedom for clinicians is a beautiful gift of a research career. And it really is. And I mean, it's the gift and the challenge, right? Because if people don't like your ideas, they may not want to fund them. But the most important person to like the ideas that come out of your mind is you. And if your intellectual abilities, if your intellectual freedom blesses you and you enjoy it, and you love it, you can be strategic and think about how to fund your continued intellectual freedom.

8:46 So the first gift of a research career is your intellectual freedom. That may be for me the highest and most powerful gift that a research career has given me. That's number one. Number two is flexibility. Flexibility. The gift of a research career is flexibility. Now, the people who appreciate flexibility the most are people who have had to or have experience in flexibility in their careers. As an example, when I started in my faculty career, I was seeing patients five days a week.

9:32 Yes, it was 80% time. I was 20% protected to do research. But somehow that math came down to five days a week. It was rough. I had a young child at home, another one on the way. Clinic started at 8 a.m. every day I was in clinic. Procedures because at the time I was, I staffed apheresis procedures. They started between 730 and 8 a.m. and you needed to be there to see the patient. I was literally always running out the door to make it through traffic so that I could start to see the patients.

10:17 And then when the day ran long, I was literally there. Well, I can't say I was closing the door because the doors of the hospital actually never closed. But I was there late. So it was one of those things where, I mean, you know, I don't even have to say this. I'm preaching to the choir. When the patient shows up, you better be there. Like what is your excuse? The patient is in the room. Where are you? And so there's a kind of inflexibility with that. And the other piece of it is if the patient is crashing, do not tell me you have dinner reservations. It's the reality of patient care. And again, I'm preaching to the choir here.

10:58 And so to be honest, even though that's so noble and so awesome, and we do love to be able to really give of ourselves in that way and really serve someone to where you're like you are crashing and I was there for you because I'm your doctor, I'm responsible, I will do this for you. It is a beautiful thing. I do not denigrate it. But it is also a challenging thing. Is a beautiful thing to be able to give your life in service of another. And it is also a challenging thing when you have to do it Monday through Friday, every, every week, month after month, it is challenging.

11:38 And so one of the things, having come through that, having had that experience, one of the things that is a gift to me in my research career is flexibility. Now I said flexibility, I didn't say, oh, easy work, because being in research is actually pretty challenging. It's work in a different kind of way. It's not physically tasking, but it's very, very intellectually heavy and sometimes emotionally tasking as well. So you get up from a full day of working within your research program and you are tired. For me, it's good tired because I love the intellectual freedom that I get from the space.

12:23 So when I say flexibility, I'm not saying easy work, but I am saying flexibility in the hard work that you do. That means there is no such thing as a crashing research experiment. Maybe two, three days of cell culture type work went to waste, you will do it again. But there's no emergency within your research program. And because of that, it gives you flexibility to work around your needs. And so, for example, today I had a child who had a recital. You know, ordinarily, I would not break my clinic. I will not even cancel or end the clinic early so I could be at a recital.

13:06 It's just that the challenges of jumping through those hoops and then trying to reschedule patients who are moved is so big. Like the mere thought of it would cause me to shudder inside and I would be like, I will miss this recital because I don't want to have to deal with the fallout. But when it comes to my research program and I'm like, well, I pause meetings and I'm like, well, this paper, I'm coming back to you as soon as the recital is over. And it was such a beautiful thing to be able to get up, go do that, come back and keep the day going. It does mean that I was up later than I wanted to be, but I had the flexibility to do that. And that is one of the greatest gifts of my research career.

13:46 And I will say, to be honest, it's right there, right up there next to intellectual freedom. And sometimes I'm not sure which is the more beautiful gift. The flexibility is so important. It's so powerful because having the flexibility allows you also to continue to pursue intellectual freedom in the way you want to, in the way you desire to. So intellectual freedom, number one, and then flexibility is number two. And then within flexibility is designing your work, right? Creating your own schedule, choosing your own schedule. And all of that falls within the flexibility piece.

14:27 Number three, which these things are so, they're so high up there. It's like, is impact really number three? Impact is so, it's a close second to flexibility because the reason I came into medicine, I don't know about you, but the reason I came in was to make a difference. Because I look around and people are suffering and healthcare is just not where it could be and people are marginalized in our healthcare system and I want change. I want lives transformed. I want people changed. I want problems solved. I want diseases cured. It's my dream.

15:07 It's the reason I came into medicine. And honestly, it didn't take me until the end of residency before I started to see that the way we're doing healthcare now is not the way that moves us forward in the direction I want to go. Part of that is recognizing the limitations of the data we have available. I'm a hematologist. Most of the stuff we quote, okay, we do have clinical trials, but we don't have the kind of clinical trials that like cardiology has, for example. So there's a lot, especially in my field of rare thrombotic disorders where we're looking through the case series and we're like, this is a case series of 16 patients. This is pretty phenomenal.

15:47 For example, I presented a case conference today and I pulled out a paper that had 71 patients and that was amazing. And so we know that there are limitations to the data that we cite to care for our patients and you're either going to settle and say, well, this is the way it is, or you're going to contribute to the data. You're going to contribute to the literature and that's what I want to do. I came for impact. I came for transformation. I came for impact. I came for transformation. And my research program gives me opportunity to do that.

16:29 And so, you know, every time we submit a paper, not even that it gets published, but we submit a paper, we look at this paper and we say, this was good work we did. Oh my goodness, the satisfaction of that is amazing. Like we already know it's going to have a home. Yes, it may be, you know, three rejections away from its home, but we know it has a home. And when it's finally published, other than the relief that the publication finally was accepted, there is just the feeling of satisfaction that no matter how small, it is a contribution to the literature and it makes a difference in somebody else's life.

17:09 And that is an unbelievable, wonderful thing to have as part of my career as a research leader. It is, you know, impact. You can get impact in seeing patients, but for me, what I was looking for was more than just, you know, the impact of seeing one patient after the other. I really wanted to be able to help a lot of patients. And so research is a vehicle by which I'm able to do that. The fourth thing, and again, these things are so amazing. They're so, so, so beneficial is mentorship. Oh my goodness, mentorship.

17:50 I don't know about you, but one of my favorite parts of being a clinician is being a teacher. I love to see the next generation of physicians be transformed. I love to see it. I will tell you that my favorite thing to do clinically now is to work with residents and fellows. I love the joy and the enthusiasm that they bring. And they just remind me of how, you know, how I was when I was a young person, when everything was new and so exciting and so amazing. I'm not a cynical person today, but you know, a lot of that stuff has lost its novelty. It's like, yeah, I've seen it before. I've seen TTP respond to plasma exchange. It's a beautiful thing, but I've seen it before.

18:33 They haven't seen it before. And it's just delightful to watch their joy and excitement. It really literally is like watching a little child and not in a derogatory way, but just in the excitement and the joy. Oh, it's such a powerful thing. And so mentorship is so important to me, not just because I get to help another clinician scientist on their journey or even a clinician in my role as a clinician, but because of how it changes me, because of how it humbles me, because of how it reminds me of all the things I still don't know. And it's okay. And because of all the brilliant sharp minds that surround me and challenge me to think differently or to make my thinking explicit, to lay it on the table and say, this is why I think the way I think, or to say, this is why I think this paper should take this shape.

19:30 To be able to share that with another generation of physicians is incredible. And so your research career gives you the gift of being a mentor, because in being a mentor you're being transformed in the process. And it is unbelievable. Number five, and this definitely is not one of the top four, but it's a very important one too, is collaboration synergy. You know, I think I wanted to say collaboration, but then I added the synergy because it's not just the collaboration, it's the synergy that comes from collaboration.

20:12 So the book that's on my mind right now that I need to share with you, it's called Who, Not How, The Formula to Achieve Bigger Goals Through Accelerating Teamwork. It's by Dan Sullivan and Dr. Benjamin Hardy. Great book, I totally recommend it. And I think it's so relevant to this conversation of collaboration synergy, because if you think about it, you are a master clinician in your own right, you have your field of expertise, you are good in this area. And what you're not so good at is other stuff. I'm a master hematologist. I'm good on the rare thrombotic disorders. But am I a cardiologist? No. Do I want to be? Definitely not.

20:53 No disrespect to any cardiologist listening to me. I think cardiology is a great field, just not for me. But many of the things that I do are relevant to cardiology. For example, I'm particularly interested in thrombotic thrombocytopenic purpura, TTP, and it presents sometimes as myocardial infarction. That's a cardiology problem. But I'm a hematologist treating a hematologic disorder, and I need a cardiologist on my team as my partner working with me. And so I bring my hematology, hemostasis thrombosis brain, and my cardiology partner brings their heart amazingness.

21:39 And we come together. Oh, the synergy of that is beautiful. I don't have to learn more cardiology. I don't need to go back to fellowship, shudder, shudder. Oh, real shudder. I don't have to go back and do another residency or a fellowship in cardiology. I don't have to do that. But I can connect with my cardiology colleague, and we can make amazing things happen in our research program, as I think critically about the hemostasis thrombosis issues, and they think critically about cardiology issues. The synergy is beautiful. I enjoy that. Just two minds coming together and just, oh my gosh, it's so beautiful. Mm-hmm. It's amazing.

22:22 And that's when you leave where you're trying to do everything by yourself, because being a research leader is definitely not about doing all things by yourself. It's definitely about doing as little as possible by yourself and really resourcing teams to support you to do that. That sounds like business. Yes. Yes, it kind of is like business. And the most beautiful things in business relationships are just when you can partner with another partner. The synergy is really amazing. So that's number five, collaboration, synergy. And I can't separate the two because it's so beautiful. They can't be separated. Okay. Number six is big picture thinking. Oh, I love when I sit down and I think about the data before me, and I think, hmm, what does this mean?

23:10 How do we interpret this one? What do we say about it? And to start to think, okay, where does it fit in the big picture of the literature? And you know, oh my goodness, you know, people have been writing papers for a long time. There's a lot of stuff that's accumulated over time. It's a lot. And so when you write a manuscript, or even when you're, you know, writing the introduction to your grant and you're trying to situate your work within the context of other people's work, it's a big, big deal. And you really have to like step back and expand your mind to grab it all. And then you can't even do that. It's so big. And so it is such a powerful thing to think big and to think, okay, well, what's possible here?

23:56 Based on this data, what's possible? And even to think big about, can I solve this problem of early TTP diagnosis? Can I be the one to do that? How would I do that? It is so wonderful to be able to think big. It just transforms you. It just, you know, takes you out of your mind. It's like, whoa, this is so good. Yes. Big picture thinking is gift number six. Gift number seven. Gift number seven is creating the future. I love the fact that when I'm writing my research proposals, and this is not thinking about whether they're going to be accepted or funded or not, it's that I have to create a future that does not yet exist on paper or in a Word document or pages, if that's what you use.

24:43 Yes, I am creating the future as I write. And sometimes I'm creating the future and there's this sense of incredulity, like, hmm, this sounds fanciful, but I'm going to put it down anyway. Because what, you know, research proposals help you do is to take the big pie in the sky idea and just make it practical and concrete. It's like, great. I know that you're going to transform health care and tell me your approach. And then, you know, the reality check. It's like someone pours a bucket of cold water in your head and you have to, like, make it real. But you're writing the future. It's a future that hasn't happened yet. And because you write it down and you think about the critical components of it, you're giving voice to a future that's going to come to pass because you dared to put it down on paper.

25:32 That is incredible. And I hear some of you cynics saying, yeah, that's if it gets funded. And the truth is, no, it's not about whether it gets funded or not. It's about the fact that you dare to put an idea down on paper that you all of a sudden have now created space to bring to pass. Because the kinds of ideas that you work on, I hope you're working on ideas that you actually care about, are the kinds of ideas that are so exciting or should be. But I hope that's what you do, that the moment you commit it to paper or you commit it to a Word document, your mind starts to go to work thinking, how can we get this done? How can we get this done? And OK, so maybe the first funder doesn't fund you.

26:14 Who else can fund you? And all of a sudden it activates within you a desire to see your work go all the way. And all of a sudden you become creative about how do we get this future that we just put down on paper? How do we get it to come to pass? And yes, maybe that means that you're submitting a couple of grants here and there and then you're piecemealing it and sending this piece off and that piece off doesn't matter. All that matters is that you've created a future with your mind. And all of a sudden you want to see it come to pass. It is so amazing. It's so good. I really enjoy that.

26:54 I enjoy sitting down and just thinking, wow, I'm creating a future that does not yet exist. It's a beautiful thing. And so, yeah, six months later, somebody may come back around and say, rejected. Ha ha, not discussed. And yeah, that's painful, but they cannot take away. They cannot take away the fact that you've already birthed. You birthed something amazing and they cannot take away the fact that whatever you birthed is already taking root in your mind and you're already thinking about how do I bring it to pass whether they fund me or not. And so creating the future is gift number seven of your research career.

27:36 So I just told you about seven gifts. Number one is intellectual freedom. Number two is flexibility. Number three is impact. Number four is mentorship. Number five is collaboration synergy. Number six is big picture thinking. And number seven is creating the future. And I tell you, these are amazing gifts. These are amazing gifts. And I invite you, I invite you to think about your research career. Think about the gifts that you already have from your career. I only told you seven. There's so much more. What are some of those gifts? Now I want to invite you to make a list today of all the gifts that have come to you from your research career. Or maybe you don't yet have a research career. You're imagining one. You're dreaming of one. What are the gifts that you hope your research career will give you beyond the ones that I've already said?

28:22 Write them down and share some of them with me. Come find me. Come find me on Instagram. Find me on Facebook. Find me on LinkedIn and share the gifts that you either already have or you're expecting from your research program. I would love to hear them. Better still, leave me a voicemail on the podcast voicemail. That's clinicianresearcherpodcast.com. And then leave me a podcast voicemail and I will incorporate your podcast, I mean your voicemail into a future episode. I have to tell you that it's been a pleasure to talk with you today. That was so fun telling you about the gifts of my research career. I want to go now and create so many more of those gifts.

29:06 And I hope you do too. Thanks for taking the time to listen. It's been a pleasure to talk with you today. Have a great, great day. 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.