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The other day, during a conversation, I was told that I was too cheerful to be a postdoc, and we all laughed about it. They said it was almost contradictory. I have a confession to make: It is true that I am a cheerful person. I am usually making fun of myself and lightening up things around me (both outside and inside the lab). Life is already too complicated to be concerned about small things that are not under my control. So, if you don’t mind, I like to take life with some humor and sarcasm. And coffee, of course!

However, that doesn’t mean I don’t care about important things; of course, I do. I am just a regular person: I doubt myself around 1000 times a day; I overthink and plan ahead with multiple options (parallel universes, time loops, what-ifs, alternative science paths).

Because of my cheerful character, some people might have the impression that I am a very confident person, which can seem contradictory in the scientific field. Others may think I am a fool. Neither of these is true. Like everyone else, I have suffered from the terrible imposter syndrome at some point, but over the past years, I have grown out of it.

I was once told that I was not a good scientist. I was too messy, too unfocused, and inconsistent. My ideas were terrible. I wasn’t a good communicator. I am definitely not a talented writer. My English is poor, and oh gosh, what a terrible (charming) accent I have! I apologize for bringing this up here, but nobody is good at something when they are just starting. Nobody was born knowing all the answers. Just as we learn to walk, speak, read, write, and everything else in life, we need to learn to be scientists.

My father taught me to ride my bike when I was a kid. I remember it vividly because it hurt. It was summer in the backyard of our country house, with a yellow bike that I inherited from my older brothers. I was trying to ride down a small slope but hit the wall. The third time, I was able to balance and turn on time. I tried, I failed, and I learned. It’s a simple process.

We are indeed surrounded by very talented people. Some of them have a gift, and they never got scratched learning to ride a bike. Others are great communicators and creative thinkers, or they can experiment with closed eyes. The rest of us have to go through a learning process.

I remember my first Western blot. I did everything wrong that you could possibly do with a Western blot. For a while, my gels did not want to polymerize. So, in my first lab, we had to figure out what went wrong. Then, I switched the charges while running the gel, and my protein was swimming in the running buffer. Something similar happened with the transfer. When I finally made it to the membrane, there was antibody drama. One day, I was so tired of repeating the same blot over and over that after getting a super ugly and dark film with no bands, I told my PI and my labmates, “It’s okay, I’m fine. I’m going to get some coffee and chocolate and think about what went wrong this time.” My former PI was not thrilled with my response, I guess. Everyone else laughed for a while, and they still make jokes about it. Suddenly, the blot worked one day, and I saved that film like a treasure. Some years later, I am able to tell what’s wrong with your western blot and troubleshoot quickly because I’ve been there before. I’m not an expert, but I’m comfortable with the method. I guess the blot and I made peace.

I tried, I failed, I learned. I can tell similar stories for almost every method or idea I had. But I should tell you something else. While I was fighting for the perfect blot, everyone else was getting them done nicely. Science is so unfair sometimes. I wondered what I was doing wrong if everyone else was using the same reagents. It had to be me. Something was wrong with me; I was not a good scientist if I couldn’t make a western blot work.

The truth is, the reason why the blot did not work was that I was learning. It has taken me a long time to realize how hard I was (sometimes still am) on myself. I was always comparing myself, my experiments, my results, my projects with everything else around me. Well, maybe I should say everyone else around me.

Science is such a competitive field, and we are always trying to be the best. The best student, the best communicator, the best researcher. THE BEST. Everyone is different, and we all possess diverse talents, skill sets, and backgrounds that can make us perfect players in a multidisciplinary team. But after being frustrated for years and engaging in unhealthy competition, I realized I did not want to be the best at everything. I ended up aspiring to be something else: THE BEST VERSION OF ME.

Stop comparing yourself to anyone else and try to be THE BEST VERSION OF YOURSELF. That’s how I grow now. I challenge myself to improve things that I don’t like. For example, writing is my weakness. It terrifies me. Obviously, the primary aspect of a scientist’s job is to write papers, grants, and abstracts, and you have to do it “right.” Also, I am a non-native speaker (don’t forget my charming accent), so it is a double effort. I cannot compare myself to my native speaker labmates because it’s not a fair battle. But I compare my first grant with the latest one and appreciate the improvement over these past years. They did not get funded, but that’s a topic for another post about gracefully accepting reviewers’ rejections.

This is why I started writing non-scientific blogs – to improve my writing and communication skills. It may not be perfect, and it certainly isn’t the best, but I promise you it challenges me and pushes me out of my comfort zone. Every day, I do something new that sometimes scares me and is not science-related. This is why I am smiling and cheerful. I am trying to balance myself. This is my way, so please let me discover the best version of me!

… and let me ask, is someone getting the best, the best, the best, the best of you?

P.S: After more than five years since this post was first published, I am still too cheerful, but now to be a PI. I feel I make hundreds of mistakes every day, and I doubt myself even more than when I was a postdoc. I keep comparing myself with my peers. But I am still true to this post, I have accepted I am who I am and my path may differ slightly. I am still working on confronting my fears and trying to be the best of me. Now that I have my own lab, I hope I will be the best mentor and help my team to aim for their very own best.

More Resources

Honing Resiliency: Reminders from a Recent Disappointment

Celebrating “The Climb”

Choosing What to Do or Not Do on the Job

Go slow was the theme of a recent visit by Janice L. Gabrilove, MD.  She met with K-level faculty in small groups and gave a talk to over 60 mentors, early career faculty, and postdocs at dinner as the honored guest for Visiting Scholar’s Day.

Take the more deliberate route, even when others seem to be whizzing by, she said.  Stay focused on your goals and get the training you need to accomplish them.  The process is as important as the product.

Dr. Gabrilove highlighted how her own career had benefited from slowing down and persisting.

Rather than leaping for an Assistant Professorship at the same time as her peers, she followed a fellowship with an additional year of research training to continue build skills in the lab of Dr. Malcolm Moore.  She attributes her discovery of new applications for human granulocyte colony stimulating factor (G-CSF) in part to this extra training.  Having time to parse unexpected findings from her work and that of others allowed for incubation of ideas that have revolutionized chemotherapy and bone marrow transplantation. Depth of knowledge and growing a strong research team ultimately led to four patents.

She encouraged those who are still postdocs to take instructorships or non-tenure track positions if offered, rather than racing to start the tenure clock, creating more time for training and exploration.  One scholar wrote she encouraged him to insist that his “career trajectory be dependent primarily on my own aspirations for my research, not just on the timeline and path laid out by mentors or peers.”

Dr. Gabrilove encouraged  all to explore and to center careers on one’s passions.  Scholars noted her best advice was to: “Align your job with your passion and your personality and you will excel in what you do,” and “love what you do. Each person has a different career path.”

A K08 recipient herself, her genuine enthusiasm for mentored research experiences filled the day.  She encouraged those on mentored research awards to make the most of the time by learning and exploring what you love.  Seek help from others, such as mentors, in helping you identify what you have yet to learn and explore.  “You can’t ask for enough constructive criticism,” she said, and advised early career faculty to not be afraid to email other scientists to ask for advice, conversation, or help.

She also advised what not to do: Specifically, think carefully about mentoring someone else. You become responsible for guiding them to success.

Your mentoring should feed into your research (as with giving a talk on your work to undergrads, or allowing high schoolers to spend a day in the lab) and not distract from it.  A mentor who is still focused on their own career growth—rightly so—is not good for the mentee’s own career development either.

The mentoring experience should value emotional and intellectual growth in concert, and balance character development and academic acumen.  Dr. Gabrilove said her time as a mentee turned her from a daydreamer to imaginative and open-minded; from talkative to articulate, inventive to inventor, inquisitive to investigative, and unsure to confident.  Slow down and use the time to grow.

Today is World Lupus Day, which has been designated to call attention to the impact of lupus around the world.  More than five million people globally struggle with this potentially fatal autoimmune disease that can damage virtually any part of the body from skin to eyes, heart to lungs, kidneys to brain, and anything in between.

April Barnado, MD, MSCI, is a Building Interdisciplinary Careers in Women’s Health (BIRCWH) K12 Scholar at Vanderbilt pioneering novel methods to use the electronic health record (EHR) to study outcomes in systemic lupus erythematosus (SLE). She’s gained international visibility for using phenome-wide association (PheWAS) techniques to show that men with lupus have an increased risk of atrial fibrillation compared to females with SLE.

We asked her to tell us about what has made her successful in research.

Tell us a bit about what you’re studying and where you plan to take it.

I have developed algorithms that incorporate billing codes, labs, and medications to identify SLE patients accurately in the EHR. Prior to this work, there were no validated algorithms in the literature. In collaboration with Vanderbilt biomedical informatics, I am performing phenome-wide association studies (PheWAS) in SLE to understand differences in comorbidities and outcomes in different groups of SLE patients.

SLE is a very heterogeneous disease where patients can have mild disease to life-threatening complications such as renal and neuropsychiatric involvement. My goal is to identify clusters of SLE patients who are at highest risk for developing these complications. Ultimately, I plan to expand this clustering to identify which SLE patients will respond to specific immunosuppressants.

Why does your project interest you?

I’m passionate about my project because it addresses challenges that impact patients, clinicians, and researchers while using novel methods in SLE. By better understanding why certain patients develop specific features of SLE and have different treatment responses, clinicians could deliver more personalized and effective care. Further, researchers could design better clinical trials to increase the chances of getting more medications approved for SLE.

How did you decide on it?

I wanted to address everyday clinical problems that impact both patients and clinicians. I also was drawn to Vanderbilt’s novel bioinformatics resources to study outcomes in SLE using a personalized medicine approach.

What made you decide to go into science and how did you get where you are now?

I have always had an interest in science, particularly in asking questions and then formulating a plan to answer these questions. I also had a desire to use that knowledge to impact people, so pursuing medicine seemed like a natural fit. I became interested in rheumatology in medical school while on a rheumatology rotation and was intrigued by SLE and how different patients suffered such different outcomes. I was fortunate to have worked with great faculty who encouraged me to pursue clinical research in SLE and supported and mentored me through medical school, residency, and fellowship.

What are you working on now or about to work on?

I submitted my K08 in February. I survived the submission process by starting early, tackling the grant piece by piece, and working closely with my mentors and administrative staff. I also was fortunate to get to present preliminary aims to a group of SLE experts at a conference to receive helpful feedback. I also took advantage of a studio and internal study section.

What’s your best advice for researchers coming up behind you?

Persistence is key in conducting studies and submitting manuscripts and grants. I also highly recommend resources such as Studios to get expert review on study design, manuscripts, and grants. [Ed. note: Studios pull together 3-10 experts to spend an hour and a half discussing your grant, paper, hypothesis, aims, or other topic.]

Read more…

Dr. Barnado just had a paper come out last month that’s gotten attention in the rheumatology world: Developing Electronic Health Record Algorithms that Accurately Identify Patients with Systemic Lupus Erythematosus (in Arthritis Care Res).

Rheumatologists’ Perception of Systemic Lupus Erythematosus Quality Indicators: Significant Interest and Perceived Barriers (Clin Rheumatol)

Association of Estimated Sodium and Potassium Intake with Blood Pressure in Patients with Systemic Lupus Erythematosus (Lupus)

At the Bedside: Neutrophil Extracellular Traps (NETs) as Targets for Biomarkers and Therapies in Autoimmune Diseases (J Leukoc Biol)

Conference and other work travel always comes with high points and drawbacks. Maximize the high points by adding new dimensions to your planning and by disrupting some conventional ideas about work travel.

Getting Ready:

Create a trip summary, either by making a personalized itinerary with all your details like confirmation numbers and times in one place, or by using the more relaxed approach and saving your airline, hotel, conference, car or other booking receipts as pdfs and then use the stitching feature to link them all together in one document to email to yourself and save on your phone or device. There are also new apps (such as Apple wallet) where you can save your boarding passes and reservations.

After a few years, we all begin to loop through common cities on our travel paths. Create digital bookmarks or analog files about things to see and do in cities you suspect you’ll get back to. Mine include public libraries with great reading spaces, museums with nice gardens, restaurant reviews, and gyms that have features I like.

Personalize ways to keep your packing lean and predictable. On the road routine is a plus. Make a travel checklist for work trips so that you don’t rely on memory to prompt getting the razor or pair of dress shoes packed. Mine is divided into things that can be done (scheduling dog sitters, setting away message) or packed ahead (outfits known to travel well), and things I need to grab or take care of on the way out the door (take a medication, then pack it; separate house keys from car keys). If you average a trip every other month or so, consider keeping duplicates of clothing items (like socks and underwear) and toiletries so that you always have them ready to go. This is a psychological trick – if it feels like less of a hassle to get ready, going also seems like less of a hassle.

On the way:

Find a routine that makes it pleasant for you: a snack you crave but don’t often have, earbuds for music, specific types of reading, inflatable lumbar support pillow, lap blanket, and sleeping from take-off until you have inevitably missed beverage requests.

Consider driving. Even if the drive is three or four hours it can sometimes be a wash given airport security and on-time flight constraints. The time can be redeemed if others come along and you have a plan. Some of my favorite road trips have included trainees – one year one individual went to the meeting by car and a different one returned so we could spend extensive time strategizing about a dissertation proposal and the analysis plan for a publication. Do be sure to check on insurance liability first if you drive trainees. (Our team is still waiting on a conference that lets us take an Amtrak trip through the central US.)

If you have funds from work for travel/professional needs, consider an unlimited or increased data limit for a personal hotspot from your carrier. I don’t need lots of wireless until I’m on the road and those are exactly the networks I shouldn’t be using. A personal hotspot for your laptop or iPad is worth the investment.

In situ:

Ask for two room cards. Put one in the back slot of your namebadge holder and the other in your wallet for safe keeping. The first can set you free from carrying anything else when you’re hanging around the conference center. The second will save you the walk back down to check-in when the magnetic strip functions poorly or you can’t find the other. Better yet, determine if your hotel has a digital key you can utilize from your phone.

Join travel clubs. If you are allowed to keep the points, work travel is a little bit sweeter when it comes with potential flight bonuses and hotel nights for leisure travel. Develop loyalties and the perks add up. A side benefit is hotel loyalty programs allow you to have a profile that includes details like whether you prefer a higher floor or have no preference except away from elevators and ice machines, or want hypoallergenic pillows, or need a refrigerator.

Since a refrigerator isn’t a given anymore, I indicate I need one “for health reasons.” My health reason is so that I can dodge by Trader Joe’s or a local store for healthier, cheaper fresh food for breakfast, snacks, and pre-workout. The walk for supplies is a good way to see territory but take a cab if you need. It still comes out cheaper. Haven’t had grocery receipts declined for reimbursement yet.

Ask in advance for separate checks for meals and alcohol. Wait staff understand. For the hotel receipt too, this saves loads of calculation hassle if you separate the room service Caesar salad from the glass of red wine. Room service, you say? Yes, even if you have to personally eat the cost of the delivery fee or the tip, it can be a good way to make sure that you get something approximating a nutritious meal when you arrive late, can keep working if needed (hopefully not on your slides), or recharge with a bit of downtime if you are an introvert.

Consider if there is anything that can add consistency to all your travel. For some this is a photograph or lap blanket for the flight and the hotel room – yes, a grown-up blankie. For me this is a clean pillow case from my home. I’m not a good sleeper. Having one pillow that feels and smells right makes a difference and it doubles as a laptop cover for my computer that gets packed in carry-on. (See more on good sleep when you travel below.)

Heresy alert. Take time to be a local. Unless you are sworn to attend every session on all days, scope out a time to take a break. One friend of mine hits vintage vinyl stores on every trip, another is a gym tourist using the “drop in” rate at Crossfits around the country, and the DC Zoo and monuments should not be missed if you get there. Pick something; it usually doesn’t take more time than an offsite meal. That said, it is poor form if someone else, like your PI or training grant, is paying to ditch a full day. For longer conferences a little time away can be the difference between conference burn out – that feeling when you hear only Charlie Brown’s teacher – and staying tuned-in at key sessions. If you plan in advance or shortly after on-site registration, you’ll find the time and it adds another facet to look forward to. A group of my peers affectionately call this step “plotting our escape” and it’s a tradition.

Another heresy. Staying with the pack is the path of least resistance and has plenty to commend it – negotiated hotel rates, maximal proximity, bumping into people you know around the hotel. You’re typically not obligated to be at the conference hotel and can still get good networking done if you pick another location and are strategic. So if finances, other factors like bringing along a child and helper, or hotel points (see above) matter, then consider an alternative within a short walking distance. A studio apartment from Airbnb or VRBO may be your ticket and often the cost is similar. If you would be spending more seek approval and offer to cover the difference.

Have a recurring travel requirement like sitting on a study section, monthly board meetings, or a steering committee for a consortium? Consider leaving things behind. You can typically check a reasonable size bag for an indefinite time if they know you will be back (write next reservation date and contact information on tag). Leaving a retired but serviceable laptop and mouse, or sports gear like shoes, swim suit, kickboard, and goggles, or a racket on site can reduce the hassle of traveling with them. It also lessens travel aversion if you can easily do things that make your week “normal.”

Add your favorite travel hacks as comments and enjoy the trip.

Other travel hacks for savvy travelers:

US News Ranks Best Hotel Loyalty Clubs

33 Ways to Sleep Better at Hotels

Video with 17 Tips for Packing Better (with one Ixigo Ad)

Today is World Tuberculosis Day, held every year on March 24 to commemorate  the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes tuberculosis (TB).

Dr. van der Heijden reviewing clinical records at Brooklyn Chest Hospital in Cape Town, South Africa.

One of our former VUMC Faculty Research Scholars, who has since received a K08 award from NIH, studies the epidemiology of tuberculosis and drug resistance in TB treatment.  Yuri van der Heijden, MD, MPH, agreed to tell us a little about his research and give his best advice to folks working toward that career development award.

What are you studying and what are you hoping to find?

My main project focuses on the acquisition of resistance to drugs used to treat tuberculosis. The traditional thinking has been that interruptions in tuberculosis treatment – which usually occur when patients do not take their medications – explain why patients develop resistance to tuberculosis medications. More recently, some studies have shown that even patients who take their medications consistently sometimes develop drug resistance. In my study, we are trying to assess how big of a problem this is in the Western Cape Province of South Africa among patients who already have resistance to the primary two drugs used to treat tuberculosis. Then we are testing tuberculosis isolates and capturing clinical data for patients who acquired further drug resistance to understand the clinical and molecular epidemiology of this problem. We hope to identify risk factors for the development of further drug resistance that can guide treatment decisions in order to prevent the development of drug resistance in patients and preserve important drugs for tuberculosis treatment.

Why does your project interest you?

On a recent trip to South Africa, I met an 18-year-old man at a Médecins Sans Frontières’ tuberculosis treatment center who was struggling to accept what he had been told a few weeks prior – that he had incurable extensively drug-resistant tuberculosis, and that he was going to die from this disease. The sad truth is that his story is not unique. It is scandalous that we have a cure for tuberculosis, yet 1.8 million people still died from it in 2015. Similarly, it is alarming that we now have substantial numbers of patients who do not have any treatment options remaining because they have developed resistance to all available drugs. My project is but one small piece of an enormously complex puzzle that will hopefully allow us to identify ways to prevent the progression to incurable disease.

View from the Brooklyn Chest Hospital in Cape Town.

What’s been the most fun experience you’ve had doing your work?

My family and I moved to South Africa for almost a year so that I could work on my main research project. I had the opportunity to work closely with my South African mentors at Stellenbosch University and University of Cape Town, all of whom are world-renowned experts in their fields. The time spent there was invaluable for my research and a treasured time together with my family.

How did you survive the grant-writing process?

Wow, the grant writing process for the career development award was eye-opening. There was a lot of trial-and-error in the writing process. Ultimately, my collaborators and mentors were extremely helpful, and I was grateful for the many resources at Vanderbilt that helped get me through the process – particularly the bank of previously successful grant applications and several VICTR Studios for critical feedback.

What’s your best advice for researchers coming up behind you?

I cannot emphasize enough the importance of strong mentorship and sound guidance, which can come through a main scientific mentor, but also through friendships with colleagues who are ahead of you in this process and a mentorship committee focused on your career trajectory. I would also highly recommend familiarizing yourself with the many outstanding resources available to you at Vanderbilt, ranging from relevant lectures hosted by the Elliott Newman Society to biostatistics clinics and access to specialized research cores, and most importantly the people who work here. For grant writing, especially the first one, I recommend starting early and making sure you familiarize yourself with all the necessary components far in advance. I wish I had taken advantage of a grant pacing workshop when crafting my career development award application. [Editor’s note: our grant pacing workshop leader is currently blogging a digital version of a grant pacing workshop. Start here to get the goods.]

As academics, most of us are in overdrive—racing from meetings to emails, writing to teaching, and maintaining some semblance of a balanced life.

Two fallacies about how we operate ourselves in overdrive:

1. I can multitask: Multitasking is a misnomer.¹ When we multitask, we are moving serially between tasks. This gives us the perception that we are accomplishing more. The downside of vacillating is that each task does not receive focused attention. Overall, our attention scatters producing a fragmented experience which tends to increase stress.
2. I am in control: No, most of the time we are not in control of ourselves.² Before you challenge this one, understand I believe in free will. However, on a moment to moment basis a majority of our actions, thoughts, words, and feelings are habitual responses from patterned experiences over a lifetime. We are running on autopilot most of the time. If we operate in overdrive, it is largely a patterned behavior.

So how can we be on the edge while maintaining balance? Some answers from Yoga.

Despite secular trends, yoga is associated more with philosophy than a type of pants. Yoga is defined by ability to focus the mind in a single direction. Two major objectives of yoga are to develop the capacity for sustained attention (AKA monotasking) and self-regulation (influence and awareness of self in relation to experience getting in control).

1. Sustained attention is cultivated with two qualities: ease (i.e. effort with no physical or mental strain) and stability (effective focus with some penetration). Think Sherlock Holmes—he is highly attentive, which appears effortless (elementary), but is profound in quality.
2. Self-regulation: Yoga proposes practices/exercises that change our habitual patterned behaviors. The proposal here is simple: To change patterns we need to create new experiences. New experiences will produce new patterns. If we repeatedly do these new practices, our old patterns (actions, thoughts, feelings etc.) will be replaced with new ones (hopefully better).

One very accessible practice is slow breathing techniques from Viniyoga (a style of yoga). Breathing is uniquely positioned as a largely involuntary process that we can voluntarily influence or guide. Breathing is highly susceptible to our mental state; when we’re agitated we breathe raggedly versus breathing slowly and deeply when we are calm. Yoga proposes consciously shifting our breathing pattern to shift our physical and mental state. Specifically, slow breathing with focused attention, ease, and stability produces a new experience that begins to shift our habitual patterns. While breath technique can become complex, beginning is quite simple:

1. Close your eyes and place your hand on your lower abdomen.
2. As you breathe, observe your abdomen move with the movement of your hand.
3. Gradually make your breath deeper, but remember to breathe with both ease and stability.
4. If you get short of breath, you are breathing too slowly past your comfort level. Adjust the length to stay comfortable. With gentleness and ease, the breath will lengthen over time without strain.
5. If you are distracted, just redirect your mind back to your breath.

Try to work your way up to doing 24 breaths this way, and do it once a day.

Next, try to reflect on how the breathing practice makes you feel:

Observe how you feel before and immediately after a practice, and later in the day/night. When starting out, some find a journal useful to jot down some notes. Examples: How does my body feel? What was my breath like? Was I able to concentrate? Reflecting on your practice allows you to integrate the experience with the rest of your day. Yoga proposes that a regular practice of focused attention and self-regulation with slow breathing will gradually rewire our stressful habits and reactions to a more sustainable and self-controlled state.

For more information on breathing techniques from Viniyoga consider the following:

1. Book: The Heart of Yoga by T.K.V. Desikachar³
2. Online: Yoga Well Institute (http://www.yogawellinstitute.com): Online and in-person classes on breathing and other yoga techniques for balance and health.

References:

1. von PFETTEN V. Read This Story Without Distraction (Can You?). New York Times 2016.
2. Duhigg C. The power of habit: Why we do what we do in life and business. Vol 34: Random House; 2012.
3. Desikachar T. The heart of yoga: Developing a personal practice. Inner Traditions International: Rochester, Vermont; 1999.

More Resources

Just Breathe: Mindfulness Apps in a Pressured Time

Finding Your Science Flow: Yoga Lessons to Increase Productivity

Building Resiliency with Hypnosis and Mindfulness