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Although he didn’t originally envision a career in pediatric oncology, Richard Ho fell in love with it during a rotation in his fourth year of medical school.  The relationships he developed with the patients’ families were too rewarding to give up.  “It’s obviously an intense emotional situation when you have a child that’s diagnosed with cancer,” he says, and “to be able to be involved in the care of those children, with those families, is really a privilege for me.  It’s something I just knew at the time that I was meant to do.”

I was recently asked by a colleague to name a favorite ‘life hack’ for research or academic life.   My first thoughts centered around productivity tips and tricks.  However, the more I reflected, the more I came back to the concept that success isn’t really measured in getting more things done faster.  Rather, success is getting the right things done – period.

Years ago, a trusted colleague and mentor advised me to ‘spend time with smart people … and good things will happen’.  I honestly didn’t get it at the time, but eventually understood that taking time to listen and aggregate information gleaned from spending time with ‘smart people’ would help me define and focus my career goals on ‘important’ problems.

Meira Epplein, PhD, came to epidemiology by a more scenic route than most. She has always been fascinated by China, from Chinese art to culture and modern history. After getting an MA in Chinese Studies, she began working for an Asian research think tank, studying military, political, and security issues surrounding China. Because she frequently went to China’s big cities for work, she also took her vacations there, in the countryside.

“China’s a fascinating country,” she says, “because it’s part developed and part developing. There’s a big divide between city and country. When I was there, it was very easy to see that the people in the countryside could use some very basic improvements and their lives would be so much better.”

To make an impact on the lives of people in rural areas, Dr. Epplein decided to get into public health. She discovered it wasn’t that simple. “I tried to get a job, and no one would give me a job. They said, you have no background in science, you have to go back to school. I already had a master’s degree, I didn’t want to go back to school!”

But go back she did, receiving an MS and a PhD from the University of Washington. Along the way, she took a job as an administrative coordinator at the Fred Hutchinson Cancer Research Center in Seattle, where she worked for cancer epidemiologist John Potter. She organized a conference on Helicobacter pylori in 2002 and became fascinated by the bug.

H. pylori is a bacteria that lives in the stomachs of about half the world’s population. While “we used to think nothing could live in this highly acidic environment, it turns out there’s evidence H. pylori has lived in the stomachs of humans for over 50,000 years.” It is the great causative agent of gastric cancer, one of the most fatal types of cancer, but the curious thing is that not everyone who has it develops the disease. For Epplein, the goal is to understand more about this bug and its relationship with cancer and with humans, particularly in Asia, where there is a high incidence of gastric cancer. “What’s become exciting is trying to understand, maybe from the bug’s point of view, is that it also does good things. It wouldn’t have lasted all this time and become very genetically heterogeneous to survive in all these different stomachs unless there were some good things it did for the host, and vice versa.”

For example, just to live in the stomach, the bacteria must be able to moderate levels of acid. People who harbor H. pylori thus have less likelihood of gastro-esophageal reflux disease. They are also more protected from esophageal adenocarcinoma. Presence of the bug may also be protective for conditions like obesity, allergies, and asthma.

Because not all people who harbor H. pylori develop gastric cancer, there must be cofactors involved, such as different strains of bacteria, bacterial load, and/or—Epplein’s key interest due to her study of Chinese culture—dietary factors. A high intake of salt, for instance, irritates the lining of the stomach and makes it easier for the bacteria to colonize, leading to a higher risk of cancer. “If you change the cofactors so that you can live with your bug, and it does the good things” without causing cancer (which creates an environment terminal to H. pylori as well), then that’s a win for humans and bacteria alike.

Because of her passion for H. pylori and the people it affects, Epplein’s R01 application practically wrote itself. She started in the first year of her K07, “which was too early,” she says, “but I was so excited about the preliminary data, and so excited about the reactions I was getting [to the idea of pinpointing a novel biomarker for gastric cancer risk in China]. I think that when you write with excitement, your readers read with excitement, and everything goes better.”

One of her touchstones during the writing process was Writing the NIH Grant Proposal: A Step-by-Step Guide by William Gerin et al. Although aimed at basic scientists, she found the strategy tips such as using white space, bullet points, and underlining to emphasize key points about impact valuable.

With her award from the National Cancer Institute, Epplein is now searching for a way to identify the population at highest risk of gastric cancer because of the sub-type of H. pylori they have, and then screen them, making it possible to prevent cancer by eradicating the bacteria. “That’s the cool thing about public health,” she says. With the anthropology PhD she originally contemplated, “you try to be an observer—you don’t want to affect their culture—whereas with public health, you do. You want to get in there and change something to make people’s lives better.”

When you read the word “meditation,” what image first comes to mind?

A New Yorker Magazine cartoon once depicted two monks in robes, one young, one old, sitting side-by-side, cross-legged in the lotus position on the floor. The younger monk is looking somewhat quizzically at the older one, who is turned toward him saying, “Nothing happens next. This is it!”

The truth about meditation (and the formal practice of mindfulness) is that actually EVERYTHING happens next.  Mindfulness teacher and MBSR (Mindfulness Based Stress Reduction) founder Jon Kabat-Zinn says, “Mindfulness is a practice of letting go and letting be, of waking up to our truest self, our innate nature.”

And most people don’t get this point right away.  Waking up to what?

If asked what is the shortest distance between two points, one might respond, predictably, with “a straight line.”  The practice of mindfulness is somewhat like this.  It is transitioning from the discursive, meaning-making, chattering mind at Point A to the gentle, quiet, and present-moment observant mind at Point B.  And it is also arriving at Point B with one’s collective sanity intact without leaving a mess behind. Now that’s waking up!

For me, mindfulness practice, which includes the formal practice of meditation and movement (tai chi, qigong, yoga) is really a love affair with what is: What is beautiful, what is unknown, what is possible, what is here now, what is true.  And as Jon Kabat-Zinn explains in his seminal text Wherever You Go, There You Are, EVERYTHING is already here, at the same time, everywhere, because “here” can be anywhere at all.

There are some common myths about meditation that deserve some clarification and understanding.  Myths like meditation helps STOP the thinking mind.  Try this: For the next 60 seconds, close your eyes and do NOT think about anything. NO THOUGHTS!

How did you do?

Meditation is NOT about stopping our thoughts or eliminating them completely.  Meditation is about learning to recognize thoughts as they arise, and at the same time, not be fixated on them or allow them to hijack our attention and exhaust our energy.  Author Anne Lamont writes, “The mind is a dangerous place. Don’t go in there alone.” The practice of meditation is always escorted by the breath and armed with the intention of “letting go and beginning again” at any moment, so you are never alone.

Another common myth about meditation is that it is an “ism” in disguise, e.g., Buddhism, Hinduism, etc.  The truth is, meditation is neither a religion or a dogma, but rather a practice of bringing kind awareness to the present moment and at the same time increasing the gray matter in the brain’s frontal lobe responsible for activating the body’s “relaxation response” to stress-producing (fight, flight, freeze) events.

My favorite definition of mindfulness comes from Dr. Ellen Langer at Harvard University, sometimes referred to as the “Mother” of Mindfulness.  She says mindfulness is “the simple act of actively noticing things.”

So before arriving at Point B today, try noticing something new.

Elmo Shade is the Founder / Principle of Mindful Foundations, Inc, a holistic business intervention committed to improving personal health, performance, leadership effectiveness, and well-being through a combination of mindfulness-based and emotional intelligence practices.  He currently facilitates Mindfulness Based Stress Reduction (MBSR) Workshops at the Osher Center for Integrative Medicine at Vanderbilt in Nashville, TN; serves as an Executive & Leadership Coach for the Owen Graduate School at Vanderbilt MBA Program, and practices Mindful Leadership and Coaching as a Consultant.  Contactelmo@mindfulfoundations.com.

www.mindfulfoundations.com
www.halemindandbody.com

A few weeks back, my mentor had us watch Amy Schumer’s parody video about women at the top of their respective fields continuously saying, “I’m sorry,” and then we talked about why it’s just not what you want or need to say.

Well, yesterday morning I had my chances to prove that I took that advice to heart – and I blew it. I had a 9:00 meeting – which on a typical day is doable: wake up, let dogs out, eat, get a shower (hopefully while baby is still sleeping), feed baby, wash baby, dress baby, throw food at dogs, pack car, drive baby to daycare, go to work. But of course, the night before was a marathon of my husband and I trading off sleeping in the rocking chair holding baby at the perfect angle because she’s having coughing fits and waking herself up. And now it’s the morning and because I actually had a time I needed to be at work, baby is awake and still coughing like a champ with super rosy cheeks (she’s definitely not feeling well). I call my mentor to make sure the meeting is still on and she says, “Yep.” – and instead of just saying. “I don’t think I can make it, the baby is really not feeling well,” I chicken out and say, “OK, just checking. See you soon.” Meanwhile dog 1 decides to check out the entire neighborhood (because his giant yard isn’t enough) and gets caught in a live animal trap. So, after a good 45 minute search, I find and release said dog from trap (baby and dog 2 in tow) and take everyone home safely. But now there’s no time to take baby to daycare and make the meeting on time. So plans change – baby’s coming to meeting with me, there’s nothing else I can do, I put myself in this position.

I text my mentor from the parking garage to say I’m running a little late – maybe 5 or 10 minutes max and start the trek across campus looking like a Sherpa with computer bag, baby bag, stroller, etc… and the whole time I’m thinking to myself, don’t worry, everyone will understand and most importantly, DO NOT apologize. But what do I do the minute I push the stroller through the door? I blurt out, “I’m so sorry about this!” (Really?!?!? Did I just say that out loud?) And what does my mentor say? “Don’t apologize, life happens…” Why can I not get this through my thick skull? So now I’m in the meeting, trying to listen, while silently chastising myself for doing just what I had planned not to do and just what my mentor wants me to stop doing. Sometime into the meeting (because why not), baby projectile vomits everywhere – and what do I do? Yep, I apologize – AGAIN!!! Meeting ends and I take baby home because now on top of everything else, I feel like the worst mom on the planet.

Today baby is still not feeling well, so I’ve decided to stay home with her as opposed to subjecting other kids at daycare to her grossness, or her to theirs. Since she didn’t sleep well again last night, she’s napping now and I’m using this time to reflect on what happened yesterday. I really, really, really didn’t NEED to be at that meeting. My mentor and the others that where there (in full capacity – as opposed to somewhere in insane person land, like myself) wouldn’t have been mad, upset or disappointed in me for doing what I needed to do – be a mom. And while I definitely didn’t have to apologize to them, I should be apologizing to myself and my family for not recognizing that fact before it was too late and I blurted it out not once, but twice in less than an hour… It seems like such a simple thing to do – just stop saying two little words but I sure am finding it difficult, even when I’m actively thinking about it.

Being a principal investigator with tons of grant funding is awesome.  But what if it’s not quite for you?  Chronicle Vitae recently ran an interview with Dr. Chris Pickett, a science policy analyst at the American Society for Biomechmistry and Molecular Biology who analyzes how public policy affects scientists, from funding to training to regularory burden.  He talks about how he got into his current field, the skills and background needed (including why experience doing science is invaluable), and what he’s doing today.

Excerpt:

What kind of experience is needed to do the job you have now?

If you’re coming from the lab bench, you need to have good communication skills. You need to be comfortable relating what you know to a variety of audiences. Typically, the work you’ll do in policy has very little to do with your specific research area. In addition to communication skills, critical thinking skills — and the tenacity that you learn in the lab to pursue lines of investigation to their logical conclusion — are also necessary in policy.

Aside from that, you don’t need anything specific, policywise, to get into science policy. What you need to have is a passion for policy, and a commitment to a policy career path.

When I was applying for positions, a lot of places would ask: “What do you plan to do after the fellowship?” And I would say, “I don’t know. I really like policy, but who knows?” And I never got any callbacks. It wasn’t until I started saying, “I’m interested in policy, and I’m going to have a career in policy, I’m committed to it. I would love to have the opportunity to have a fellowship with you to start it off right, but either way I will have a career in policy,” that I was successful. So I think you need to be clearly committed and passionate about what you are doing.

Read more

To help you think about what you want to do with your PhD, check out myIDP.  It offers skills, interests, and values assessments to help you decide on careers that would be a good fit, then allows you to read up on them and gives you interactive tools to help you reach career goals you set.

Every day, Anna Hemnes, MD, treats patients with pulmonary arterial hypertension.  Every day, she works to find a cure.

Pulmonary arterial hypertension is a rare disease that narrows and stiffens the arteries connected to and within the lungs.  The increased work of pumping blood through these arteries eventually causes failure of the right side of the heart.  Half of those diagnosed with the disease die within five years of their diagnosis.

Dr. Hemnes became interested in the disease when she joined the Vanderbilt faculty in 2008 and began working with Dr. John Newman’s team, which studies insulin resistance in people with pulmonary arterial hypertension.  This, she says, got her thinking about whether systemic metabolic disease might also be affecting the right heart.

So she began to focus on the hearts of people with this disease, and that was when serendipity intervened.  About five years ago, she was sharing space with an unrelated lab group.  The husband of one of the postdocs in that group worked in bariatric surgery, and “he was the one who suggested that we look for lipids in the heart—and it worked.  And now I have a whole R01 on it.”

Many people with pulmonary arterial hypertension have fatty deposits, typically made of triglycerides, in the right heart.  Dr. Hemnes’s R01 focuses on understanding two things: Where the deposits come from, and what they do.  Hemnes has always liked asking questions, and she has plenty about where the lipids come from.  “Is it that more fat is being transported into cells?  Is it that cells aren’t burning fat as fuel?”  The other half of the investigation questions whether the lipids causes myocyte, or heart muscle cell, dysfunction or if it kills heart cells, leading to heart failure.

While writing her R01, Hemnes learned “you cannot do it at the last minute.  It takes months and months and months” to write a grant like this.  Laughing, she adds, “I have done other ones at the last minute, and they didn’t get funded.”  She recommends at least six to eight months of planning and writing.

In part, the extended timeline is to give the grant writer ample time to “shop it around to colleagues and people you think are good writers, even people who don’t know much about your topic.  Ask them to critique your ideas and your plan.”  Hemnes also used a VICTR Studio for expert input on her grant, and notes that the timeline forced her to have a draft ready early.  This ensured she had the time to shop it around to colleagues and mentors in addition to receiving valuable comments from other faculty at the Studio.

Looking forward, Hemnes wants to translate her research into treatments for pulmonary arterial hypertension.  “We’re trying to understand if we could give medications to reverse the process” of lipid buildup in the right heart, she says.  “We have some ideas, but if we understood the mechanisms a little better, we could be more selective about the medications.”  Eventually, she plans to do human trials of metabolic therapeutics such as metformin to see if these drugs decrease lipid deposits in the right heart for people with pulmonary arterial hypertension.

This will lead her right back to patients she sees every day, for whom she is working towards a cure.  “It would be really meaningful,” she says, to not only treat these patients, but also “use my career to try to cure the disease.”

You might even say preventing or reversing heart failure for them is her heart’s calling.

Discovering meaning in a massive amount of random-seeming data is nothing new to Todd Edwards, PhD, a genetic epidemiologist.  His career has made meaning out of many disparate parts, beginning with six years in the US Army as a Print Journalist, pre-med and biology classes in college, and a job in biotech developing kits to sequence human drug metabolism genes, all of which eventually led to a master’s degree in applied statistics and a PhD in genetics at Vanderbilt.  Or, as he puts it, “I stochastically wandered through life and ended up here.”

“Here” is PI of an R21 investigating genetic causes of high blood pressure in African Americans and co-PI of a U01 examining calcium-gene interactions in colon cancer, as well as a strong collaborator with his wife, Digna Velez Edwards, PhD, working to understand the genetics of uterine fibroids.  As if that weren’t enough, he is also the Associate Director of Graduate Studies for Vanderbilt’s PhD program in epidemiology.

Although busy, he says it’s the most fun he’s had in his career.  “Now is an optimistic time to be a geneticist at Vanderbilt,” he says, citing the hiring of Dr. Nancy Cox, who recently arrived from the University of Chicago to head the genetics institute.  And he and Dr. Velez Edwards “have had some successes”—both were on K awards and became independent investigators in the last year—and expect more in the near future.  Dr. Edwards recently finished evaluating a new statistical method he developed to detect genetic variants with effect modifiers through effects on trait variability.  “We believe the approach is really interesting and is one that people will want to use,” he says.  At the same time, the fibroids team is in the middle of analyzing an immense amount of genetic and imaging data from BioVU and a network of collaborators across the country.  “No one has ever even come close to the magnitude or the quality of the data that we have for this analysis, so we really expect to make some novel discoveries,” he notes.  These discoveries may include an explanation for why African American women have a much higher incidence of fibroids than women of other ethnicities, a question researchers have been asking for some time.

Of course, it’s not always been so fun.  Dr. Edwards had to submit many grant applications—multiple cycles with multiple R01s—before he had success.  “I remember there was a cycle in 2013 where I had submitted three grants the previous June as PI while also submitting multiple grants that February.  The week before my grants were due, my other grants from the earlier cycle got scored, and all three of them were not discussed.  On top of that, a paper that had gone through two revisions at Nature Genetics got rejected—all within three days.  And I was in the midst of the crucial, final time to prepare all these applications and get them submitted.  It was devastating.  You’re working so hard—late nights, long days—and you get all this bad news right when you need to be the most focused.

“I tell this story to emphasize that you’ve got to stay mentally organized and focused on what you’re doing.  It’s easy to get discouraged or lose your motivation or get distracted by other things.  But it’s really key to devote yourself to the process of writing the grant.”  It worked for him—he was awarded the R21 and U01 he put in during that cycle.

Edwards also swears by organized, team-based editing: Everyone in a room with the grant up on a projector, editing sentence by sentence.  As well, he advises, “A lot of the time what makes the difference between a successful R and a not so successful R isn’t necessarily the quality of the ideas, but the evidence you can provide that supports why you’re doing what you’re doing, demonstrating some productivity in the area, showing that you have the experience with the resources that you plan to use.  All of those things dispel the common criticisms reviewers like to write about incoming applications.”

Finding signals in the noise requires a lot of hard work, but as Dr. Edwards has found, the work can be its own reward.