Pediatric hematology and transfusion medicine with Dr. Stella Chou

1 00:00:00,000 --> 00:00:05,860 Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills 2 00:00:05,860 --> 00:00:11,260 to build their own research program, whether or not they have a mentor. 3 00:00:11,260 --> 00:00:17,340 As clinicians, we spend a decade or more as trainees learning to take care of patients. 4 00:00:17,340 --> 00:00:22,380 When we finally start our careers, we want to build research programs, but then we find 5 00:00:22,380 --> 00:00:27,780 that our years of clinical training did not adequately prepare us to lead our research 6 00:00:27,780 --> 00:00:29,200 program. 7 00:00:29,200 --> 00:00:35,480 Through no fault of our own, we struggle to find mentors, and when we can't, we quit. 8 00:00:35,480 --> 00:00:40,580 However, clinicians hold the keys to the greatest research breakthroughs. 9 00:00:40,580 --> 00:00:46,200 For this reason, the Clinician Researcher podcast exists to give academic clinicians 10 00:00:46,200 --> 00:00:51,800 the tools to build their own research program, whether or not they have a mentor. 11 00:00:51,800 --> 00:01:01,100 Now introducing your host, Toyosi Onwuemene. 12 00:01:01,100 --> 00:01:03,640 Welcome to the Clinician Researcher podcast. 13 00:01:03,640 --> 00:01:06,860 I'm your host, Toyosi Onwuemene, and it is a pleasure to be here today. 14 00:01:06,860 --> 00:01:11,260 I have an outstanding clinician scientist to introduce to you today. 15 00:01:11,260 --> 00:01:13,520 Her name is Dr. Stella Chou. 16 00:01:13,520 --> 00:01:15,980 Stella, welcome to the show. 17 00:01:15,980 --> 00:01:16,980 Thank you. 18 00:01:16,980 --> 00:01:21,660 So, Stella, for our audience, would you please introduce yourself, especially in the context 19 00:01:21,660 --> 00:01:26,260 of how you came to be doing this thing, where you're a clinician and a scientist at the 20 00:01:26,260 --> 00:01:27,260 same time? 21 00:01:27,260 --> 00:01:28,260 Sure. 22 00:01:28,260 --> 00:01:35,620 So, I'm a pediatric hematologist by training, who then got a fellowship training in transfusion 23 00:01:35,620 --> 00:01:36,620 medicine. 24 00:01:36,620 --> 00:01:43,580 So, I practice both non-malignant hematology and transfusion medicine, primarily in pediatrics, 25 00:01:43,580 --> 00:01:46,900 but I do care for young adults as well. 26 00:01:46,900 --> 00:01:50,660 And I think really how I got here was pretty circuitous. 27 00:01:50,660 --> 00:01:57,580 I went to med school because I wanted to be a pediatrician, and during med school, I became 28 00:01:57,580 --> 00:02:00,940 interested actually in pediatric oncology. 29 00:02:00,940 --> 00:02:08,460 But when I came to CHUMP, I was exposed to all aspects of pediatric hematology that actually 30 00:02:08,460 --> 00:02:12,380 piqued my interests in a different way. 31 00:02:12,380 --> 00:02:19,260 And probably the reason why I ended up in hematology versus oncology, honestly, is because 32 00:02:19,260 --> 00:02:25,500 for my second year during fellowship, I chose to join the lab of Dr. Mitchell Weiss, who's 33 00:02:25,500 --> 00:02:28,300 now at St. Jude's. 34 00:02:28,300 --> 00:02:34,540 And I joined his lab to study a disease that affects children with Down syndrome. 35 00:02:34,540 --> 00:02:41,060 So, patients with trisomy 21 who get either transient abnormal myelopoiesis or myeloid 36 00:02:41,060 --> 00:02:42,620 leukemia. 37 00:02:42,620 --> 00:02:49,380 And at first, it really combined my interest in hematopoiesis as well as oncology. 38 00:02:49,380 --> 00:02:57,340 But I think in working with Mitch, I just leaned more and more towards hematology. 39 00:02:57,340 --> 00:03:03,260 And after I completed my fellowship, I ended up doing a transfusion medicine fellowship 40 00:03:03,260 --> 00:03:04,540 a few years later. 41 00:03:04,540 --> 00:03:10,060 And again, that was something that just was an opportunity that came my way, and I decided 42 00:03:10,060 --> 00:03:16,820 to take it and met a number of people in the transfusion medicine community who sort of 43 00:03:16,820 --> 00:03:19,580 helped me make that decision. 44 00:03:19,580 --> 00:03:26,140 And since then, I have primarily worked more in the hematology, transfusion, medicine space, 45 00:03:26,140 --> 00:03:32,100 but the project I came to do as a second year fellow, I guess now it's almost 20 years ago 46 00:03:32,100 --> 00:03:34,240 when I joined Mitch's lab. 47 00:03:34,240 --> 00:03:40,540 We still work on that problem in my own lab, but we have much better tools two decades 48 00:03:40,540 --> 00:03:41,540 later, I think. 49 00:03:41,540 --> 00:03:46,380 But it's interesting to look back and say, for instance, grants that I wrote as a fellow, 50 00:03:46,380 --> 00:03:48,860 what were the questions we were asking and trying to answer? 51 00:03:48,860 --> 00:03:54,020 And some of those questions are still unanswered and we're still trying to answer, which is 52 00:03:54,020 --> 00:03:55,900 part of science. 53 00:03:55,900 --> 00:04:01,820 But I guess my point is that I think I ended up here because of just different people in 54 00:04:01,820 --> 00:04:09,220 my career and then the different opportunities that came my way being at Chopin and Penn. 55 00:04:09,220 --> 00:04:10,220 Awesome. 56 00:04:10,220 --> 00:04:11,220 Thank you for sharing. 57 00:04:11,220 --> 00:04:18,900 Now, I see in your story, someone who was open to opportunities and someone who recognized 58 00:04:18,900 --> 00:04:20,820 and took opportunities. 59 00:04:20,820 --> 00:04:27,300 Can you tell me about what it was in your makeup, either your prior history or family 60 00:04:27,300 --> 00:04:32,620 history, your experiences that allowed you to be that kind of person who just kind of 61 00:04:32,620 --> 00:04:36,260 took opportunities as they came? 62 00:04:36,260 --> 00:04:38,340 I think probably it's how I was raised. 63 00:04:38,340 --> 00:04:40,620 My parents were both immigrants to the US. 64 00:04:40,620 --> 00:04:46,260 I think people oftentimes look at me now and just expect that I had every opportunity in 65 00:04:46,260 --> 00:04:53,420 my lifetime, but my grandfather actually immigrated here and was a magician and then ended up having 66 00:04:53,420 --> 00:04:59,900 his own laundry mat business, which provided him with the means to then end up buying real 67 00:04:59,900 --> 00:05:03,020 estate and doing very well for himself. 68 00:05:03,020 --> 00:05:09,540 But both my parents do not hold college degrees and still I'm actually the first generation 69 00:05:09,540 --> 00:05:14,140 of my family to have a college degree, which you can imagine is very different, especially 70 00:05:14,140 --> 00:05:20,540 now as my own daughter is applying for college for this next fall. 71 00:05:20,540 --> 00:05:24,260 It's the types of applications and the types of opportunities she has compared to what 72 00:05:24,260 --> 00:05:25,260 I have. 73 00:05:25,260 --> 00:05:30,780 But I think what my parents always instilled in me was that opportunities are in front 74 00:05:30,780 --> 00:05:31,780 of you. 75 00:05:31,780 --> 00:05:37,100 You just have to recognize when something's an opportunity and take it. 76 00:05:37,100 --> 00:05:40,860 And I think their opportunities were very different than the opportunities that I had 77 00:05:40,860 --> 00:05:41,860 to take. 78 00:05:41,860 --> 00:05:48,100 But I think nonetheless, it sort of was a lesson in life that I think my parents imparted 79 00:05:48,100 --> 00:05:52,500 on myself and my four siblings just by their actions. 80 00:05:52,500 --> 00:05:54,780 They never really said those words to us. 81 00:05:54,780 --> 00:06:00,180 I think it was really by their actions and how they just supported us. 82 00:06:00,180 --> 00:06:06,380 And they always tried to do everything for us that would allow us to have every opportunity, 83 00:06:06,380 --> 00:06:12,480 even though we didn't always have all the means that other people in my school had. 84 00:06:12,480 --> 00:06:17,300 So I think that's probably where it's most grounded from. 85 00:06:17,300 --> 00:06:18,300 Thank you for sharing that. 86 00:06:18,300 --> 00:06:25,100 I mean, I see just it sounds like a family culture of looking for opportunity, recognizing 87 00:06:25,100 --> 00:06:29,500 it and seizing it when it comes, but also being prepared for the opportunity when it 88 00:06:29,500 --> 00:06:30,500 arises. 89 00:06:30,500 --> 00:06:37,860 And I think I've been really fortunate to be a place where people are very supportive. 90 00:06:37,860 --> 00:06:42,940 And I think that helps because you can try something and if you fail, they're fine with 91 00:06:42,940 --> 00:06:46,340 that and you can try to do something else. 92 00:06:46,340 --> 00:06:54,660 And so I think always knowing that you can try things and if you're willing to take a 93 00:06:54,660 --> 00:07:01,220 little bit of failure or you're willing to not have the expectation always that you will 94 00:07:01,220 --> 00:07:04,520 succeed in the way you think you're going to succeed, because I think that's something 95 00:07:04,520 --> 00:07:12,260 else that I learned along the way, is what do we consider a success and what you might 96 00:07:12,260 --> 00:07:17,820 think of as success might be different from who you report to per se. 97 00:07:17,820 --> 00:07:24,340 But in the end, I think that it really matters what you think is success and what you think 98 00:07:24,340 --> 00:07:28,260 brings meaning to what you do when you come to work every day. 99 00:07:28,260 --> 00:07:29,260 Wow. 100 00:07:29,260 --> 00:07:33,580 You said two things that are really amazing and I just want to come back to. 101 00:07:33,580 --> 00:07:39,380 So first you talk about failure and not being afraid to fail and the importance of having 102 00:07:39,380 --> 00:07:43,860 environments that allow you to do that so that you don't feel as if you're taking a 103 00:07:43,860 --> 00:07:48,620 risk it's an unalterable risk or you can't change direction. 104 00:07:48,620 --> 00:07:53,540 I want you to speak a little bit more about what that looks like, do you think, in today's 105 00:07:53,540 --> 00:07:58,860 environments for clinicians who are trying to make this transition to research, do we 106 00:07:58,860 --> 00:08:02,220 have the same kinds of supportive environments today? 107 00:08:02,220 --> 00:08:04,020 I think so. 108 00:08:04,020 --> 00:08:10,860 I think actually over the years there's been more and more support to take an idea, make 109 00:08:10,860 --> 00:08:17,700 it a question, write it in a grant, hopefully get funded, and then bring it to realization. 110 00:08:17,700 --> 00:08:24,780 I think there's many routes that you might take and some of them are certainly baby steps 111 00:08:24,780 --> 00:08:27,940 whereas other things might seem like they are riskier. 112 00:08:27,940 --> 00:08:30,000 I'm really going to try this. 113 00:08:30,000 --> 00:08:39,180 But I think if you have the attitude that you can make it happen by garnering the right 114 00:08:39,180 --> 00:08:40,940 people to help you do it. 115 00:08:40,940 --> 00:08:43,940 So I think we never do anything by ourselves. 116 00:08:43,940 --> 00:08:49,220 We get the help from the trainees who are in our lab or the research assistants or the 117 00:08:49,220 --> 00:08:57,860 research coordinators who we work with to all the people who help get things done. 118 00:08:57,860 --> 00:09:05,900 The core labs, our admins, our sponsored projects office, there's so many people who are involved. 119 00:09:05,900 --> 00:09:10,980 And then also the people that you look to as mentors and sponsors. 120 00:09:10,980 --> 00:09:17,020 I think you know that you have so many different places where you might be able to get help. 121 00:09:17,020 --> 00:09:20,140 But I do think people is a major facet. 122 00:09:20,140 --> 00:09:29,700 I feel like if I find that there's a challenging problem, I think I have the mindset of, well, 123 00:09:29,700 --> 00:09:35,260 let me find someone who probably can solve this problem and see if I can work with them. 124 00:09:35,260 --> 00:09:37,620 And I think sometimes you have to choose wisely, right? 125 00:09:37,620 --> 00:09:41,540 So sometimes you don't go to like be the expert. 126 00:09:41,540 --> 00:09:48,020 You go to someone who, you know, knows the field well, but will also have the time and 127 00:09:48,020 --> 00:09:51,180 the space to work with you. 128 00:09:51,180 --> 00:09:57,140 And I think most things that we do end up really being a team effort. 129 00:09:57,140 --> 00:10:04,980 So I think nowadays, more than even when I started out, collaboration is really something 130 00:10:04,980 --> 00:10:12,580 that everybody supports and that institutions have found ways to allow for collaboration. 131 00:10:12,580 --> 00:10:17,620 So either they have small pilot grants for that or they have seminar series that try 132 00:10:17,620 --> 00:10:19,780 to bring different groups together. 133 00:10:19,780 --> 00:10:24,780 So then you meet people on a regular basis that you might not have had that interest 134 00:10:24,780 --> 00:10:26,900 group not have come together. 135 00:10:26,900 --> 00:10:33,460 And then certainly it seems like most funding agencies do support collaborative efforts. 136 00:10:33,460 --> 00:10:36,280 So I think that's a big piece of it. 137 00:10:36,280 --> 00:10:40,100 And I also think there is the element of being realistic. 138 00:10:40,100 --> 00:10:48,020 So for instance, when I started doing the work that has been done really in collaboration 139 00:10:48,020 --> 00:10:54,540 with New York Blood Center, with Connie Westoff and Sydney DeVege, looking at using molecular 140 00:10:54,540 --> 00:11:00,940 typing and doing high resolution typing at the RH locus to see how we could better match 141 00:11:00,940 --> 00:11:05,480 patients with sickle cell disease to their donors. 142 00:11:05,480 --> 00:11:10,580 I think we took baby steps, like first we showed that it was important. 143 00:11:10,580 --> 00:11:17,260 And now currently we have pilot clinical trials in a small subset of patients who were actually 144 00:11:17,260 --> 00:11:20,180 providing genotype matched blood. 145 00:11:20,180 --> 00:11:24,060 And we knew that logistically we had to get blood from the New York Blood Center, which 146 00:11:24,060 --> 00:11:28,900 is at a depot in Long Island City to Philadelphia. 147 00:11:28,900 --> 00:11:33,800 We know that patients reschedule or patients have other reasons why they might not come 148 00:11:33,800 --> 00:11:39,020 that particular day, or if we have something that shows up in their antibody screen that 149 00:11:39,020 --> 00:11:41,620 day and we might have to change course a little bit. 150 00:11:41,620 --> 00:11:44,380 So really we started out as a pilot study. 151 00:11:44,380 --> 00:11:49,780 And I think the next step will be to extend that study still as a single institution study 152 00:11:49,780 --> 00:11:55,780 before we can take it on to the next step, which is a multi-institutional study. 153 00:11:55,780 --> 00:11:59,800 But to do that will require even more collaboration. 154 00:11:59,800 --> 00:12:03,620 So we're going to need other blood centers aside from New York Blood Center being involved. 155 00:12:03,620 --> 00:12:11,020 We'll need multiple institutions who would be able and willing to participate. 156 00:12:11,020 --> 00:12:16,600 And there's probably a lot of other facets that we would have to figure out in terms 157 00:12:16,600 --> 00:12:21,620 of information technology, how we're going to transfer all that data between different 158 00:12:21,620 --> 00:12:28,660 blood centers, different hospital sites, and then having patient data on one side, donor 159 00:12:28,660 --> 00:12:30,440 data on the other side. 160 00:12:30,440 --> 00:12:31,800 It's pretty complex. 161 00:12:31,800 --> 00:12:34,380 So we've taken in baby steps to be realistic. 162 00:12:34,380 --> 00:12:39,900 We didn't go from, oh, this is important to let's try to get this directly in the clinic. 163 00:12:39,900 --> 00:12:47,360 But I think in the end, I hope that within my career that this is going to be something 164 00:12:47,360 --> 00:12:52,100 that's going to be available for patients because I think there's advances that are 165 00:12:52,100 --> 00:12:58,420 being made outside of the work that we're doing, which will allow methods that will 166 00:12:58,420 --> 00:13:02,580 allow us to sequence at a much more cost effective way. 167 00:13:02,580 --> 00:13:06,780 There's probably going to be other work that's done. 168 00:13:06,780 --> 00:13:15,380 For instance, there's a national group through the DHHS who's looking at an antibody registry 169 00:13:15,380 --> 00:13:18,220 for hospitals to report their antibodies. 170 00:13:18,220 --> 00:13:23,020 So in that sense, it's like trying to find a way where there's going to be a method to 171 00:13:23,020 --> 00:13:29,580 communicate information from different hospital sites about transfusion data, and that potentially 172 00:13:29,580 --> 00:13:33,580 would help be a platform for anything we would want to do in the future. 173 00:13:33,580 --> 00:13:39,260 So I think melding things that are things that you work on, but knowing what everybody 174 00:13:39,260 --> 00:13:42,740 else is working on and seeing how that might help. 175 00:13:42,740 --> 00:13:44,660 I feel like I've gotten way far off. 176 00:13:44,660 --> 00:13:47,980 You can try to bring it back. 177 00:13:47,980 --> 00:13:51,940 No, actually, I feel like you did a great job of just kind of... 178 00:13:51,940 --> 00:13:57,400 First of all, I think one of the things you did was go to a 30,000 foot view and talk 179 00:13:57,400 --> 00:14:00,380 to us about how this is big picture. 180 00:14:00,380 --> 00:14:01,500 There's so much going on. 181 00:14:01,500 --> 00:14:02,500 It's very complicated. 182 00:14:02,500 --> 00:14:07,900 And what you succeeded in doing is taking something that's a small piece of it and then 183 00:14:07,900 --> 00:14:10,900 just advancing it just a little step at a time. 184 00:14:10,900 --> 00:14:15,820 And even now, you are doing kind of collaborative projects even between centers and talking 185 00:14:15,820 --> 00:14:17,660 about how that gets bigger. 186 00:14:17,660 --> 00:14:20,980 Multiple centers will need to be involved, multiple blood centers. 187 00:14:20,980 --> 00:14:25,220 And I think what you're talking about is just the cascading effect of the work that we do 188 00:14:25,220 --> 00:14:27,740 when we start small and not expecting... 189 00:14:27,740 --> 00:14:32,180 Because many times, and Stella, you're senior enough that people look to you and they're 190 00:14:32,180 --> 00:14:33,700 like, oh my gosh, she's so successful. 191 00:14:33,700 --> 00:14:35,580 Look at all the awesome stuff she's doing. 192 00:14:35,580 --> 00:14:40,420 And what people miss is the baby steps that you took when you first started and the fact 193 00:14:40,420 --> 00:14:44,180 that you still are taking baby steps and that's what's moving you forward. 194 00:14:44,180 --> 00:14:47,340 And I think it's important that people recognize that. 195 00:14:47,340 --> 00:14:51,900 I think the other thing I love that you said at the very beginning is you talked about 196 00:14:51,900 --> 00:14:54,780 collaboration, but you didn't start with mentors. 197 00:14:54,780 --> 00:14:57,980 You started with those around you immediately. 198 00:14:57,980 --> 00:15:01,100 And I feel like you talked about your trainees in the lab. 199 00:15:01,100 --> 00:15:03,260 You talked about the research assistants. 200 00:15:03,260 --> 00:15:06,860 You talked about choosing specialized mentors carefully. 201 00:15:06,860 --> 00:15:11,700 And I really love that because sometimes I think there's a sense from, I think especially 202 00:15:11,700 --> 00:15:15,760 people who are just starting out, that there is one mentor, one senior person who's going 203 00:15:15,760 --> 00:15:19,580 to open the door and all things are going to fall in place. 204 00:15:19,580 --> 00:15:23,500 And I think many people are disappointed when they find that that doesn't happen. 205 00:15:23,500 --> 00:15:28,180 And I love that you started really with the reality of starting with who's around you, 206 00:15:28,180 --> 00:15:30,540 who's immediately available to help you. 207 00:15:30,540 --> 00:15:34,620 And when you look ahead to those who've gone far ahead, it's like who is specifically suited 208 00:15:34,620 --> 00:15:39,740 to help you, not just because of their expertise, but actually having the time and the interest 209 00:15:39,740 --> 00:15:40,740 to help you. 210 00:15:40,740 --> 00:15:42,720 So I love that you put so many things together. 211 00:15:42,720 --> 00:15:46,980 And I wonder if you want to speak to the whole piece of mentorship and how that plays a role 212 00:15:46,980 --> 00:15:47,980 in your advancement. 213 00:15:47,980 --> 00:15:54,680 I mean, certainly, I think I was also really fortunate because I had multiple mentors in 214 00:15:54,680 --> 00:15:55,680 my early career. 215 00:15:55,680 --> 00:16:03,020 So I chose to work at Mitch Weiss's lab and he was my primary mentor and he was a phenomenal 216 00:16:03,020 --> 00:16:04,020 mentor. 217 00:16:04,020 --> 00:16:05,300 He was a great manager in the lab. 218 00:16:05,300 --> 00:16:10,780 He thought it was fun to come into the lab and show me how to do things like literally 219 00:16:10,780 --> 00:16:12,180 hands on. 220 00:16:12,180 --> 00:16:16,540 But at the same time, he was more than just an academic mentor. 221 00:16:16,540 --> 00:16:22,940 I think he is one of the few men who I have seen in science who really partnered with 222 00:16:22,940 --> 00:16:25,420 his wife, who is also a physician scientist. 223 00:16:25,420 --> 00:16:32,100 And I always found it refreshing to see his contributions to their family. 224 00:16:32,100 --> 00:16:35,900 So he would sometimes just have a hard stop at five o'clock because he was the one who 225 00:16:35,900 --> 00:16:39,120 was responsible to pick up his children from daycare. 226 00:16:39,120 --> 00:16:48,140 So I think his way of just balancing work and life as well was important to me. 227 00:16:48,140 --> 00:16:50,080 But he was also a sponsor. 228 00:16:50,080 --> 00:16:55,980 So I think one of the things that I always tell trainees that I interact with now is 229 00:16:55,980 --> 00:16:59,820 that you really have to find something that you love doing. 230 00:16:59,820 --> 00:17:04,740 And like you said, looking back now, I went through a period in his lab where I said, 231 00:17:04,740 --> 00:17:08,620 I'm going to finish my project and then I'm going to move on. 232 00:17:08,620 --> 00:17:13,060 So I came to his lab without any basic lab research experience. 233 00:17:13,060 --> 00:17:16,820 I picked up a pipette the first time coming to his lab. 234 00:17:16,820 --> 00:17:21,580 And I didn't think that that was where my career was going. 235 00:17:21,580 --> 00:17:26,860 I wanted it for the experience, but not necessarily to run my own lab. 236 00:17:26,860 --> 00:17:31,740 And I would say that finishing fellowship, I thought that I was going to finish my project 237 00:17:31,740 --> 00:17:33,340 and move on. 238 00:17:33,340 --> 00:17:37,220 And he said, you have to do what makes you happy. 239 00:17:37,220 --> 00:17:42,380 If this is not what makes you happy, then you should choose to move on. 240 00:17:42,380 --> 00:17:47,340 And I thought that at the time I would get a master's in clinical epidemiology next and 241 00:17:47,340 --> 00:17:50,500 move on to really more clinical research. 242 00:17:50,500 --> 00:17:56,660 But as it happened, just other forces that were happening in my life and being married 243 00:17:56,660 --> 00:18:02,180 also to a physician and having two people that would need the right choice of an institution 244 00:18:02,180 --> 00:18:05,060 in their next career steps, we stayed here. 245 00:18:05,060 --> 00:18:08,500 And that was one of the reasons why I ended up doing the transfusion medicine fellowship 246 00:18:08,500 --> 00:18:10,380 a few years later. 247 00:18:10,380 --> 00:18:14,820 But I think just finding what makes you happy is what's really important. 248 00:18:14,820 --> 00:18:16,660 And sometimes it's a little transition period. 249 00:18:16,660 --> 00:18:20,380 So I will admit, I wrote my KOE. 250 00:18:20,380 --> 00:18:25,260 And I thought, in my mind, I'm not exactly sure why I'm writing my KOE because I'm not 251 00:18:25,260 --> 00:18:26,860 really going to be doing this anymore. 252 00:18:26,860 --> 00:18:28,600 But I wrote it and then I got it. 253 00:18:28,600 --> 00:18:30,780 So then I stayed in the lab for a few more years. 254 00:18:30,780 --> 00:18:37,580 And I think really what happened was it took time to gain more skills and gain more confidence 255 00:18:37,580 --> 00:18:43,300 in the lab, which I did not have initially because I did not have a PhD prior to my lab 256 00:18:43,300 --> 00:18:44,300 experience. 257 00:18:44,300 --> 00:18:50,420 And then I think what really catches you is you actually discover something and just the 258 00:18:50,420 --> 00:18:58,380 satisfaction and the joy you get of discovering something, having a body of work that you 259 00:18:58,380 --> 00:19:01,500 publish is quite satisfying. 260 00:19:01,500 --> 00:19:06,140 And I think that's probably what hooked me was the high you get off of that. 261 00:19:06,140 --> 00:19:15,300 So I still do think of Mitch as a mentor, a sponsor, a friend, a colleague. 262 00:19:15,300 --> 00:19:19,620 She's been a wonderful person in my life. 263 00:19:19,620 --> 00:19:24,020 I also was really lucky that through him, actually, I met Connie Westhoff, who is a 264 00:19:24,020 --> 00:19:30,060 giant in the field of transfusion medicine and R.H. genetics, and she too was also a 265 00:19:30,060 --> 00:19:32,700 mentor and a sponsor. 266 00:19:32,700 --> 00:19:34,660 And obviously we still collaborate. 267 00:19:34,660 --> 00:19:40,820 And even as she is moving on, probably in the next few years, she's slowly trying to 268 00:19:40,820 --> 00:19:42,340 take on retirement. 269 00:19:42,340 --> 00:19:49,020 I still go to her all the time because she has this wealth of knowledge, which I'm convinced 270 00:19:49,020 --> 00:19:57,780 nobody else on the planet Earth has besides her, but she was also a wonderful mentor and 271 00:19:57,780 --> 00:19:59,780 career advocate for me. 272 00:19:59,780 --> 00:20:05,500 And then I also had to mention Katie Mano, who was my clinical mentor in hematology. 273 00:20:05,500 --> 00:20:12,100 And she's the one who actually provided the opportunity of considering a transfusion medicine 274 00:20:12,100 --> 00:20:13,100 fellowship. 275 00:20:13,100 --> 00:20:20,740 And I think at the time, looking from her point of view, she saw it as a place where 276 00:20:20,740 --> 00:20:25,660 Chopp could probably use another person who was well versed in both hematology and transfusion 277 00:20:25,660 --> 00:20:27,180 medicine. 278 00:20:27,180 --> 00:20:32,540 And she probably just saw certain things in me that seemed like that would be a good fit 279 00:20:32,540 --> 00:20:33,540 for me. 280 00:20:33,540 --> 00:20:35,540 And she was super duper right. 281 00:20:35,540 --> 00:20:42,540 So I think just having, I've just been really lucky to have people in my career who have 282 00:20:42,540 --> 00:20:44,800 helped me find that opportunity. 283 00:20:44,800 --> 00:20:49,340 And partly, I think because they've taken the time to get to know me and really know 284 00:20:49,340 --> 00:20:54,460 me to help me choose the right pathway. 285 00:20:54,460 --> 00:20:55,460 I love it. 286 00:20:55,460 --> 00:20:56,620 I love it. 287 00:20:56,620 --> 00:21:01,260 One of the things that really resonates with me as you're sharing is that you really had 288 00:21:01,260 --> 00:21:05,100 multiple relationships that were instrumental in your forward motion. 289 00:21:05,100 --> 00:21:11,420 And it was mentoring relationships, but it was also the intersection between what's going 290 00:21:11,420 --> 00:21:16,420 on in your career, what was going on in your personal life and making things work. 291 00:21:16,420 --> 00:21:22,980 And so ultimately, I think what I'm hearing you also say is just how you have to look 292 00:21:22,980 --> 00:21:27,860 at everything in the context of your life, also in the context of what you enjoy doing, 293 00:21:27,860 --> 00:21:31,640 and then see what opportunities make the most sense for you. 294 00:21:31,640 --> 00:21:35,680 So then I'm almost hearing you say there's no cookie cutter way forward, and there is 295 00:21:35,680 --> 00:21:42,100 no one person or one thing that is in charge of moving everything forward. 296 00:21:42,100 --> 00:21:48,160 It's just really integrating all the experiences that you're having to pick the thing that 297 00:21:48,160 --> 00:21:50,200 makes the most sense to move forward in. 298 00:21:50,200 --> 00:21:51,200 Is that fair to say? 299 00:21:51,200 --> 00:21:52,200 Exactly. 300 00:21:52,200 --> 00:21:53,200 Yep. 301 00:21:53,200 --> 00:21:54,200 That's what I tried to convey to you. 302 00:21:54,200 --> 00:21:55,200 Yeah. 303 00:21:55,200 --> 00:21:56,200 Now I like it. 304 00:21:56,200 --> 00:22:00,920 I love it because I think it's that we are, we're hard workers as clinicians. 305 00:22:00,920 --> 00:22:06,480 I don't think that's anything that has to be said, but just even as we work hard, seeing 306 00:22:06,480 --> 00:22:10,820 what opportunities arise and not feeling like there has to be just one way, because then 307 00:22:10,820 --> 00:22:13,780 I think we could be disappointed. 308 00:22:13,780 --> 00:22:16,100 Which brings me to what you talked about, success. 309 00:22:16,100 --> 00:22:17,260 Let's talk about success. 310 00:22:17,260 --> 00:22:23,780 So what were you referring to when you talked about the different definitions of success? 311 00:22:23,780 --> 00:22:31,700 Well, I think how you define success, even just in the realm of say a clinician researcher, 312 00:22:31,700 --> 00:22:38,380 some might define success because they get promoted or they publish in a really high 313 00:22:38,380 --> 00:22:40,260 impact journal. 314 00:22:40,260 --> 00:22:48,580 For me, success is, I think success is doing every day what I truly love. 315 00:22:48,580 --> 00:22:54,380 I wake up in the morning and I think about what I'm going to try to tackle in a day and 316 00:22:54,380 --> 00:23:00,380 you never get it all done, but you just have that motivation every day to go to work and 317 00:23:00,380 --> 00:23:02,580 get something accomplished. 318 00:23:02,580 --> 00:23:08,820 I think for me, the thing that's been the most meaningful is seeing, again, we're taking 319 00:23:08,820 --> 00:23:15,260 baby steps, but seeing how some of the work that we do actually impacts patient care and 320 00:23:15,260 --> 00:23:21,740 seeing that we're moving the needle slowly, but we're moving the needle. 321 00:23:21,740 --> 00:23:29,300 I think for me, knowing that what we do every day in the lab or in our clinical research 322 00:23:29,300 --> 00:23:36,460 studies, there's going to be an outcome that actually matters is how I define success. 323 00:23:36,460 --> 00:23:42,380 Whereas on the other side, we do some pretty basic stuff in the lab and sometimes we're 324 00:23:42,380 --> 00:23:43,380 successful too. 325 00:23:43,380 --> 00:23:49,100 We figure out what are proteins doing or we have a certain hypothesis and we're right 326 00:23:49,100 --> 00:23:51,140 in our hypothesis. 327 00:23:51,140 --> 00:23:58,300 That's satisfying also, but to me, that's less satisfying than knowing that the work 328 00:23:58,300 --> 00:24:02,460 we do can impact patient care or patient outcomes. 329 00:24:02,460 --> 00:24:07,740 I think that's the part that drives me the most and probably because I think I'm a clinician 330 00:24:07,740 --> 00:24:15,380 at heart and the questions I ask and the questions I tried to answer for myself are really clinical 331 00:24:15,380 --> 00:24:19,020 questions at the heart, but just using different tools. 332 00:24:19,020 --> 00:24:20,340 Absolutely. 333 00:24:20,340 --> 00:24:25,220 I feel like you speak to a lot of perspectives of clinicians because ultimately for many 334 00:24:25,220 --> 00:24:30,420 of us, we started out as clinicians first and then we made this transition to research. 335 00:24:30,420 --> 00:24:35,580 Really at the heart of our clinical heart is making things better for patients. 336 00:24:35,580 --> 00:24:40,660 I hear you speak about the opportunities you have to make an impact in the lives of patients 337 00:24:40,660 --> 00:24:44,940 and seeing your research turn into that is very satisfying for you. 338 00:24:44,940 --> 00:24:51,180 I also hear you talking about success as success and enjoying every day, success and enjoying 339 00:24:51,180 --> 00:24:52,620 your journey. 340 00:24:52,620 --> 00:24:58,180 Not looking for the end goal, though you have a lot of wonderful things that you've accomplished 341 00:24:58,180 --> 00:24:59,620 over the course of your career. 342 00:24:59,620 --> 00:25:04,020 You've gotten those things too, but not looking at those items as the things that define you 343 00:25:04,020 --> 00:25:06,740 as successful, but the fact that you're making an impact. 344 00:25:06,740 --> 00:25:09,100 You're doing work that you find meaningful. 345 00:25:09,100 --> 00:25:10,240 You're doing it every day. 346 00:25:10,240 --> 00:25:14,820 You're making discoveries that are interesting and important to you. 347 00:25:14,820 --> 00:25:18,820 I'm just hearing the threat of personal daily satisfaction. 348 00:25:18,820 --> 00:25:19,820 Yeah. 349 00:25:19,820 --> 00:25:26,580 I think that's what's really important because otherwise it'd be really hard to do our jobs 350 00:25:26,580 --> 00:25:31,180 where we're pulled in so many different directions and we have so many different responsibilities 351 00:25:31,180 --> 00:25:40,020 and we're just trying to always do our best in each of the different arenas, but we know 352 00:25:40,020 --> 00:25:43,100 that that's always challenging. 353 00:25:43,100 --> 00:25:44,100 It is. 354 00:25:44,100 --> 00:25:45,100 It is. 355 00:25:45,100 --> 00:25:47,340 And something that you didn't say that I feel like is part of the theme of what you're saying 356 00:25:47,340 --> 00:25:51,740 is you can't live somebody else's dream because that's very hard to do. 357 00:25:51,740 --> 00:25:56,060 And the fact that you're living your own dream allows you to manage all the challenges that 358 00:25:56,060 --> 00:25:59,980 are surrounding it and still move things forward. 359 00:25:59,980 --> 00:26:03,020 I don't know if you want to speak a little bit about that. 360 00:26:03,020 --> 00:26:06,780 I think the way I see it is I prioritize things. 361 00:26:06,780 --> 00:26:16,980 So I see sometimes I prioritize based on what I feel like I need to do versus what other 362 00:26:16,980 --> 00:26:18,180 people can do. 363 00:26:18,180 --> 00:26:27,460 So I could volunteer to say cover another clinic or something, but would that really 364 00:26:27,460 --> 00:26:32,780 be the best use of my time or would I contribute the most to us as a group? 365 00:26:32,780 --> 00:26:34,440 And that's probably no. 366 00:26:34,440 --> 00:26:39,360 But there are other things that I know I can do. 367 00:26:39,360 --> 00:26:44,300 So for instance, somebody asked me to look at their specific aims page for their K award 368 00:26:44,300 --> 00:26:49,060 and I know that's particularly important that I could potentially give them feedback at 369 00:26:49,060 --> 00:26:55,980 this stage where they still have a month to do it and I prioritize that much higher. 370 00:26:55,980 --> 00:27:00,740 So I think you really have to prioritize what's really important. 371 00:27:00,740 --> 00:27:05,420 I think one of the challenges we all have these days is that there seems to be a lot 372 00:27:05,420 --> 00:27:08,700 of tasks that we all have to do. 373 00:27:08,700 --> 00:27:16,540 There's endless emails about things that you need to fill out or do and it can be onerous 374 00:27:16,540 --> 00:27:17,900 to get all those things done. 375 00:27:17,900 --> 00:27:24,380 But I think prioritizing them and then seeing where you can delegate things or seeing where 376 00:27:24,380 --> 00:27:31,380 you can do something quickly rather than spend too much time on it helps me at least manage 377 00:27:31,380 --> 00:27:36,380 the day to day so that I get to spend time on things that I think are what's really important 378 00:27:36,380 --> 00:27:41,900 and what I really want to do so that you don't get overwhelmed by all that other task-oriented 379 00:27:41,900 --> 00:27:44,460 work that we oftentimes have. 380 00:27:44,460 --> 00:27:46,460 I love it. 381 00:27:46,460 --> 00:27:52,220 I found that I think you gave us some kind of organization of type gems in all of that. 382 00:27:52,220 --> 00:27:54,340 One you talk about working in your zone of genius. 383 00:27:54,340 --> 00:27:58,380 So there are many things you can do but what are the things that you are uniquely qualified 384 00:27:58,380 --> 00:28:00,860 to do that you actually like to do? 385 00:28:00,860 --> 00:28:04,380 Another thing is recognizing that while everything needs to get done, everything doesn't need 386 00:28:04,380 --> 00:28:05,980 to get done equally well. 387 00:28:05,980 --> 00:28:11,100 And what are the things that you can drop your standards on but still get done? 388 00:28:11,100 --> 00:28:14,260 And what are the things that you absolutely need to focus on? 389 00:28:14,260 --> 00:28:18,580 And then one thing you said also that I really, really, really, I don't know, it gets me excited 390 00:28:18,580 --> 00:28:21,700 to think about is moving your work forward. 391 00:28:21,700 --> 00:28:26,660 And that's so important because if you don't move your work forward, nobody else will. 392 00:28:26,660 --> 00:28:30,660 And other work needs to be moved forward and you surely do need to be part of that as a 393 00:28:30,660 --> 00:28:32,260 collaborative person. 394 00:28:32,260 --> 00:28:38,260 But prioritizing the work that really means a lot to you, really moves your career forward 395 00:28:38,260 --> 00:28:39,260 is important. 396 00:28:39,260 --> 00:28:45,520 And I do think that many of us early on always think about, well, how do we satisfy the needs 397 00:28:45,520 --> 00:28:46,520 of everybody else? 398 00:28:46,520 --> 00:28:50,100 And then at the end of the day, we hope there's time to move our work forward. 399 00:28:50,100 --> 00:28:52,500 It's really our work comes first. 400 00:28:52,500 --> 00:28:56,900 And then we find time later to move other people's work forward as well. 401 00:28:56,900 --> 00:28:57,900 Right. 402 00:28:57,900 --> 00:29:03,860 And I think it's particularly true because there aren't too many of us that practice 403 00:29:03,860 --> 00:29:10,140 hematology, transfusion medicine, and then have a particular skill set. 404 00:29:10,140 --> 00:29:17,580 So for instance, we had a project where we were making in-vitro derived red cells from 405 00:29:17,580 --> 00:29:24,380 induced cloripotent stem cells that we genetically engineered to have specific Rh variants or 406 00:29:24,380 --> 00:29:26,580 Rh null. 407 00:29:26,580 --> 00:29:33,900 And I think what was special about that project was that I was sort of like a matchmaker in 408 00:29:33,900 --> 00:29:38,540 the sense that we had Connie Westhoff from the New York Blood Center who's like an Rh 409 00:29:38,540 --> 00:29:44,820 expert and we had Gordon Keller from Canada who's an expert in developmental hematopoiesis 410 00:29:44,820 --> 00:29:54,100 and cloripotent stem cells and Jim Pallas at Rochester who also really understands developmental 411 00:29:54,100 --> 00:29:55,760 red cell development. 412 00:29:55,760 --> 00:29:57,300 And then we had people from CHOP. 413 00:29:57,300 --> 00:30:03,420 So Paul Gaudu and Dina French who are long time collaborators at CHOP who work mostly 414 00:30:03,420 --> 00:30:05,260 on iPS cells. 415 00:30:05,260 --> 00:30:11,740 But bringing all of that different expertise to put together in this project was very unique 416 00:30:11,740 --> 00:30:17,980 because it was like little pieces of the puzzle and getting it all together. 417 00:30:17,980 --> 00:30:23,700 And we're so far from, you know, that's another goal of mine is by the end of my career, I'd 418 00:30:23,700 --> 00:30:29,540 like to know that that work went somewhere where, you know, it's actually in the blood 419 00:30:29,540 --> 00:30:30,540 bank. 420 00:30:30,540 --> 00:30:34,180 We actually have reagents that we developed in the blood bank helping us to facilitate 421 00:30:34,180 --> 00:30:36,500 antibody identification. 422 00:30:36,500 --> 00:30:42,300 Or maybe, you know, and this is probably a much higher goal, is that we see the Rh null 423 00:30:42,300 --> 00:30:48,460 cells that we created actually get to a place where we can make an ass that they can be 424 00:30:48,460 --> 00:30:49,460 used. 425 00:30:49,460 --> 00:30:53,180 I don't know for transfusion unless we're going to transfuse neonates with them, but 426 00:30:53,180 --> 00:30:58,780 as like a drug carrier or something where you use it for immune modulation, but something 427 00:30:58,780 --> 00:30:59,980 in the clinic. 428 00:30:59,980 --> 00:31:01,900 And I think it has like a certain utility. 429 00:31:01,900 --> 00:31:07,600 I think, again, it's there's so many aspects of it, which we're good at some of those aspects. 430 00:31:07,600 --> 00:31:12,660 And I'm still looking for, you know, collaborators to help with some of the other aspects of 431 00:31:12,660 --> 00:31:14,580 making it a reality. 432 00:31:14,580 --> 00:31:20,820 But it's, again, bringing together all these different people that have different expertise 433 00:31:20,820 --> 00:31:25,540 is one of the most enjoyable parts, I think, of the work that we do. 434 00:31:25,540 --> 00:31:27,260 I love it. 435 00:31:27,260 --> 00:31:30,260 It's I love how you use the term matchmaker. 436 00:31:30,260 --> 00:31:34,660 It's recognizing where you're strong and where you're not strong, and then looking around 437 00:31:34,660 --> 00:31:39,340 to see who are the people in your network that can fill the gaps. 438 00:31:39,340 --> 00:31:43,100 And even if they're not in your network, you know, how do you expand your networks to fill 439 00:31:43,100 --> 00:31:47,540 gaps that allow your work to move forward because you can't do it by yourself. 440 00:31:47,540 --> 00:31:50,100 So really speaking to the power of collaboration. 441 00:31:50,100 --> 00:31:51,820 Yeah, that's that's really awesome. 442 00:31:51,820 --> 00:31:55,600 Well, Stella, we're coming to the end of this time. 443 00:31:55,600 --> 00:32:00,580 And I really want you, if you could just, you know, speaking to someone who let's say 444 00:32:00,580 --> 00:32:05,180 we have a clinician who's in their early fellowship years, they're like, well, I've never picked 445 00:32:05,180 --> 00:32:06,180 up a pipette. 446 00:32:06,180 --> 00:32:08,780 I have no idea how I would contribute. 447 00:32:08,780 --> 00:32:12,260 I don't even know that I could be successful as a scientist. 448 00:32:12,260 --> 00:32:13,260 What would you say to them? 449 00:32:13,260 --> 00:32:16,980 I would say they 100% could do it. 450 00:32:16,980 --> 00:32:23,220 I think if you've gotten to this part of your career, you are motivated and intelligent 451 00:32:23,220 --> 00:32:29,900 enough to pick up a pipette in your early 30s and you have many, many more decades to 452 00:32:29,900 --> 00:32:30,900 come. 453 00:32:30,900 --> 00:32:32,460 So I think they can definitely do it. 454 00:32:32,460 --> 00:32:39,580 I think, again, probably choosing the right project and the right mentor is, of course, 455 00:32:39,580 --> 00:32:40,580 critical. 456 00:32:40,580 --> 00:32:46,460 So choose a project that, you know, sparks a real interest to you and choose a mentor 457 00:32:46,460 --> 00:32:48,820 who you really think you're going to connect with. 458 00:32:48,820 --> 00:32:54,660 So I think, you know, you have to find a mentor who will have the time to mentor you, who 459 00:32:54,660 --> 00:32:56,140 has experience mentoring. 460 00:32:56,140 --> 00:33:02,420 But ultimately, I think just knowing if the two of you connect on a personal level, I 461 00:33:02,420 --> 00:33:08,380 think really matters because that person should be someone you spent a lot of time with and 462 00:33:08,380 --> 00:33:14,300 who you're going to spend time with for probably the duration of your career, I think, if they're 463 00:33:14,300 --> 00:33:16,140 a good mentor. 464 00:33:16,140 --> 00:33:19,100 So that's a really important aspect. 465 00:33:19,100 --> 00:33:20,100 Absolutely. 466 00:33:20,100 --> 00:33:21,100 Absolutely. 467 00:33:21,100 --> 00:33:25,100 And Stella, if you don't mind, what about someone who says, holy cow, I owe so much 468 00:33:25,100 --> 00:33:26,100 money. 469 00:33:26,100 --> 00:33:30,420 Like, is this a viable career? 470 00:33:30,420 --> 00:33:31,420 I think so. 471 00:33:31,420 --> 00:33:37,460 And I think that recently there has actually been more programs that will pay for your 472 00:33:37,460 --> 00:33:41,540 educational expenses, at least for medical school in that sense. 473 00:33:41,540 --> 00:33:47,940 I was lucky because I had all of my med school loans essentially paid for by the NIH because 474 00:33:47,940 --> 00:33:48,980 I stayed in research. 475 00:33:48,980 --> 00:33:55,060 And that wasn't the reason why I stayed in research, but there are those opportunities. 476 00:33:55,060 --> 00:34:01,060 And I think in the end, we do come out with a fair amount of debt when you go to medical 477 00:34:01,060 --> 00:34:02,060 school. 478 00:34:02,060 --> 00:34:07,140 But I think that over time, you pay that down. 479 00:34:07,140 --> 00:34:14,860 And I think in general, we make a significant enough salary that you should choose to do 480 00:34:14,860 --> 00:34:20,620 something you really want to do and not worry about the debt because it will over time seem 481 00:34:20,620 --> 00:34:22,580 like a smaller and smaller issue. 482 00:34:22,580 --> 00:34:24,020 Thank you, Stella. 483 00:34:24,020 --> 00:34:26,620 I really appreciate you speaking to that. 484 00:34:26,620 --> 00:34:29,700 So everyone, you heard Dr. Chow. 485 00:34:29,700 --> 00:34:33,120 Don't let debt be the driving factor for your career decision. 486 00:34:33,120 --> 00:34:37,200 You want to do something you love and then you figure out how to make everything else 487 00:34:37,200 --> 00:34:38,940 work and it will work. 488 00:34:38,940 --> 00:34:39,940 You can make it happen. 489 00:34:39,940 --> 00:34:41,100 You're an innovative person. 490 00:34:41,100 --> 00:34:43,260 You've come this far in your career. 491 00:34:43,260 --> 00:34:44,880 You can make hard things happen. 492 00:34:44,880 --> 00:34:49,980 So definitely if you want to consider this career or you're in the process and think 493 00:34:49,980 --> 00:34:52,260 you have quitting, don't quit. 494 00:34:52,260 --> 00:34:54,300 You have the capacity to succeed. 495 00:34:54,300 --> 00:34:56,540 So Stella, I want to thank you for being on the show. 496 00:34:56,540 --> 00:34:58,200 Thank you for your words of wisdom. 497 00:34:58,200 --> 00:35:01,180 And it just was a fantastic, fantastic time. 498 00:35:01,180 --> 00:35:03,100 And I want to thank you for your time. 499 00:35:03,100 --> 00:35:04,100 Thanks for the invitation. 500 00:35:04,100 --> 00:35:05,100 All right, everyone. 501 00:35:05,100 --> 00:35:16,620 We'll see you next time on the Clinician Researcher Podcast. 502 00:35:16,620 --> 00:35:21,980 Thanks for listening to this episode of the Clinician Researcher Podcast where academic 503 00:35:21,980 --> 00:35:27,300 clinicians learn the skills to build their own research program, whether or not they 504 00:35:27,300 --> 00:35:28,780 have a mentor. 505 00:35:28,780 --> 00:35:34,740 If you found the information in this episode to be helpful, don't keep it all to yourself. 506 00:35:34,740 --> 00:35:36,620 Someone else needs to hear it. 507 00:35:36,620 --> 00:35:40,680 So take a minute right now and share it. 508 00:35:40,680 --> 00:35:46,140 As you share this episode, you become part of our mission to help launch a new generation 509 00:35:46,140 --> 00:35:59,660 of clinician researchers who make transformative discoveries that change the way we do health