Protecting your vital research asset

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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

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to build their own research program, whether or not they have a mentor.

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As clinicians, we spend a decade or more as trainees learning to take care of patients.

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When we finally start our careers, we want to build research programs, but then we find

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that our years of clinical training did not adequately prepare us to lead our research

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program.

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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

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However, clinicians hold the keys to the greatest research breakthroughs.

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For this reason, the Clinician Researcher podcast exists to give academic clinicians

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the tools to build their own research program, whether or not they have a mentor.

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Now introducing your host, Toyosi Onwuemene.

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Welcome to the Clinician Researcher podcast.

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I'm your host, Toyosi Onwuemene, and it is an absolute pleasure to be talking with you today.

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Today I am talking about a topic that is most interesting to me right now.

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My interest changed from day to day, clearly.

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But I want to talk about protecting your vital research asset, protecting your vital research

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asset.

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And by talking about protecting your vital research asset, I'm actually talking about

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protecting your mind.

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I am talking about protecting your mind.

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Again, I'm JLC Unwomena, host of the Clinician Researcher podcast.

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I want to thank you so much for showing up today so that I can speak to you about this

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important topic.

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Now the impetus for this particular episode is being on call over the last week and recognizing

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that, gosh, it is exhausting to cover for a 24-7 period.

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It is exhausting.

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And in reality, and as you know, you're not working all the time, but it only takes being

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woken up once or twice.

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It only takes being woken up once or twice over the course of a week for your whole week

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to be thrown off and for your sleep cycles to be thrown off.

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And different people handle it in different ways, but I certainly don't really do well

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with being woken up in the middle of the night as far as being able to continue to function

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actively during the day.

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So it's been an exhausting week.

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And yesterday I had a goal.

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I had some more creative type work that I needed to do, and I said, I'm going to lie

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down for just two minutes, just five, just ten.

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And of course, I woke up in the morning and thought, gosh, I was so tired.

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And that's because clearly I was exhausted.

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And so good that I got some rest because I needed it.

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And recognizing that some of the things that we do make it challenging to do the creative

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work of writing and the creative work of charting a new research direction.

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And so I want to speak a little bit about that today.

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I'm going to speak about our minds and ways, things that we should consider.

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So I'm just actually just sharing thoughts about protecting our most vital asset.

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And I'm talking about our minds.

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The first thing I want to share that may be obvious, but is important to say is that the

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quality of your research always depends on the quality of your thinking.

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Now I'm talking about the quality of your leadership, your leading your research program.

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Now, if you are participating, say with a research group or you're working in a mentor's

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program, the quality of your thinking is important.

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But if somebody else is doing most of the thinking, most of the creating the direction,

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deciding where to go, deciding how papers are written or what the structure is or the papers

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you're submitting, you may not have to do too much thinking.

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You can just do what you're told.

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And you still need a clear mind and a well rested mind to do that, but not to the extent

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to which you are creating new things.

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And when you're creating new things, I'm talking about you're deciding what's the new research

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direction.

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How do we synthesize all the data we have?

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What are the next steps of the research program?

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What's our big picture?

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Those are things that really need you to be super creative because you've got to really

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think outside the box of where you are right now.

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You know what's easy in life?

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It's easy to do what you've always done.

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It's easy to do what you're currently doing.

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What's hard is to change direction and evaluating your research program critically, thinking

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about the direction that the program needs to go in, thinking about what new experiments

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you need to do, thinking about what new projects you need to start.

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That requires a change in direction.

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And so there's clearly a need for intense creative thinking in that space.

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And for that reason, it's important to think about how do you create spaces where this

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important physical asset is protected?

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This important, actually it's kind of mental, spiritual, emotional asset really is protected

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as well.

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And there are many, many, many things to talk about as far as what are the things that distract

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our minds from doing its best work or doing their best work, distract our mind from doing

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its best work.

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And I'm going to talk about some of them, but I do want to just make the case that if

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we're going to do the creative work of writing, the creative work of thinking, the creative

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work of charting a new course for our research program, we've really got to be able to use

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our minds optimally.

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All right, so the second thing I want to share is that it is important for your thinking

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to transcend what is known to what is unknown.

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And here I'm really speaking again about the need for creativity in your thinking.

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If all we focused on was what was known, and we were satisfied with what was known, there

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would actually be no need for research, no need for people creating new bodies of work.

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There'd be no need for that because what is known is satisfactory, but what is known,

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we know, has gaps, right?

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We have gaps in our knowledge.

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We don't know.

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Sometimes we don't know what we don't know, right?

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Sometimes it's clear what we don't know, but sometimes we don't even know what we don't

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know.

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And so if we're going to make progress, but more specifically, if we're going to make

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impact through the work that we do, we've got to think not just about what is known.

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We've got to think not just about what is known that is unknown, but we've got to think

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to the place of what is not known that is unknown.

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And so that requires creative thinking, and it requires us to really stretch our minds

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to think outside the box of the way we do things, outside the box of the way we live,

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to really be able to think beyond what is known, to recognize what is known that is

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not known.

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And so that really does require creative thinking, the ability for our minds to transcend what

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is known to what is not known, and even to think beyond what we don't even know that

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we don't know.

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Now, why do I emphasize that a lot?

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Because I've kind of repeated myself a few times.

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It's that, again, our minds would prefer the easy work, the easy work of just thinking

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about what is already in front of you.

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If you're going to do the work of thinking beyond what is already known, thinking beyond

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what is in front of you, you really got to have a mind that is sharp and focused, rested,

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and ready to go.

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And so your mind is critical if you are going to do any work that has impact, if you're

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going to do any work that doesn't already reveal what is already known.

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It's going to be really important for your mind to be sharp, focused, and well rested.

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Okay, for that reason, and I've kind of said this before, but this is point number three,

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is that your thinking has to be creative.

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Now, you may say, well, all thinking is creative.

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No, not necessarily.

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If you think about it, if you listen to the news this morning, your thinking is probably

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focused on the news you listen to.

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That's not creative.

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That's just kind of regurgitating what you have.

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Now, I will tell you though what you've listened to, sorry, but I will tell you though, so

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usually you listen to bad news and the news is mostly bad, but you listen to bad news,

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your mind does become creative, but it becomes creative in creating more of what it listened

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to.

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Your mind is good at taking what it's received and then creating more of it, right?

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It kind of like is like a machine that reproduces, but reproduces at a higher level.

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And so perhaps someone says, oh, there was an accident on highway 40, and the next thing

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you're thinking, wow, that's where I go, usually when I'm on my way to work, that's the path

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that I take.

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What if I'm going to have an accident?

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Oh my gosh, what if it's a 17 car pileup?

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Your mind keeps going, keeps going.

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So one thing that happens when you focus on what you can see is that you produce more

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of what you can see and you don't just produce more of what you can see, you amplify what

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you can see so that in some ways that is creative because you're making a new strap, you're

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making a new thing from what you already see, but in many ways it's not creative because

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what we need you to do as a research scientist is to think about what other people are not

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thinking about.

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That means to focus on what other people are not talking about.

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That means to focus on the gaps that are not explicit, right?

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And so that's the level of creative thinking that I'm talking about.

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So that level of creative thinking almost has to say, I don't want to listen to all

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of you talking about the news of dogma, telling me about all the things we already know to

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be true.

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I need to focus on what is it that may not be written here?

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What may not be in the news that I need to be thinking about?

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Now I'm not saying you should be thinking about making up stuff.

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Please do not do that.

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That's an integrity issue.

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But what I'm saying is how do you leave the space where everybody you know is in an echo

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chamber and they're just talking about the same thing over and over again.

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They're like, oh, this is the way it's always been.

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How do you leave that space and go to a different space where people have the same problem,

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but presenting in a different way and think about how are they thinking about it?

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For example, how do you leave the space of medicine and go to engineering and say, well,

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how have you guys solved this engineering problems for yourself?

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Because this may be relevant in cardiology or this may be relevant in GI.

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Do you see what I'm saying?

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It's focusing on what you see because what you see is going to still be important in

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the creative process, but it's leaving the echo chamber of the space you know well and

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everybody around you is saying the same things over and over again and going into a different

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space, going and connecting with people who are not like you, researchers who are not

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like minded, not even necessarily researchers in science, but researchers, I mean, all researchers

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are kind of researching science for the most part, but researchers in other disciplines

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so that you amplify and enhance the quality of your creative thinking.

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And so creativity is one of the most important things you will do or being creative is important.

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Your creativity is one of the most important assets you will protect as you work on protecting

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the asset that is your mind.

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So your thinking must be creative and you actually have to create space and create opportunity

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to be more creative.

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Okay.

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I want to share what you may know and that fatigue is a barrier to creative thinking.

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Fatigue is a barrier to creative thinking and I've kind of alluded to it in some of

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the earlier points that I made.

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When you are so tired, you don't want to think creatively.

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You just want whatever somebody gives you.

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It's like when you're super hungry and somebody brings in like a really greasy burger that's

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dripping at the sides and you may love burgers, but you probably would prefer less fat dripping

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from the burger, but you're super hungry.

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Are you really going to discriminate?

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Are you going to say, no, I want a salad?

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You're going to say, no, I am famished.

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Give me this food right this moment.

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And that's what I'm saying.

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So no, no, this is not a judgment on greasy burgers, please do not hold this against me.

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I really am just making a point.

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I'm just using this as an example.

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It could be the salad that you are going to eat even if you don't care for salads.

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But what I'm saying is that when you're super hungry, you're just going to take whatever

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is before you without discriminating.

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And it's the same thing when you are super tired, you're just going to take whatever

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is before you without discriminating.

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You're like, yeah, just let me have it.

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Right?

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And honestly, and this is what I found for myself too in this last week, when you're

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super tired, you can't even really do any writing.

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It's like creative or not creative.

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Like the work you're supposed to do that your mentor gave to you or not, it is hard to do

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when you're tired.

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So fatigue is a thief of creativity.

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And the question is, how do you protect yourself from that fatigue?

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The other thing I want to share is that if you're going to be somebody who is not always

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tired to the point where you are not able to be creative, then it is important to avoid

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exhaustion.

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And I want to pause now and start laughing or smile.

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That's what I'm doing right now with smiling because I recognize that as clinicians who

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are also scientists, our work is hard and the work of being a clinician is super hard.

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And here's what's interesting.

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We love being clinicians.

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Many of us do.

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Most of us do.

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I think I can say with certainty because we came into medicine because we want to care

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for patients.

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And so many of us love that work.

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We love, we are energized by the work that we do in talking with our patients.

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We really enjoy that.

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And so it is hard to imagine a life where we're not doing that, but it is also very

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exhausting.

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Working with people can be challenging, whether we're in healthcare or we're outside of healthcare,

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but it can be really exhausting.

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And then when you add to that life and death situations, critical acute situations, and

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then you add to that taking call overnight, holy cow, it is super exhausting.

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This is the work we love to do.

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Does it mean we stop patient care?

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I think the answer is no, but we've got to think creatively about our patient care and

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how it impacts upon our ability to generate new knowledge.

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Now I've had conversations with physician scientists who are like, I love patient care

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so much I could never quit doing that.

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And I'm not inviting you to do that.

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I am inviting you to think about how do you become strategic about how you deliver patient

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care so that it doesn't exhaust you to the point where you cannot create new knowledge.

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Now everybody doesn't have to create new knowledge.

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It's not required, but for the people who are working to create new knowledge, protecting

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your vital asset is important.

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How do you do that?

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And if we don't have a cadre of people, a group of people who are creating new knowledge,

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we're just going to be stuck in the status quo.

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And as I always preach from this platform, clinicians are critical to creating new knowledge

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that is relevant to patient care, that really is actionable and that matters.

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And so I want more clinicians doing research and clinicians love to do clinical work and

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clinical work can be exhausting and can limit your ability to do the research that actually

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changes the knowledge and changes the way we practice.

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But it is important that we think in a way that's, I don't want to say balanced because

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it's a little bit more than just balanced because clinical care is so time intensive

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and can be exhausting.

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But I'm talking specifically about how do you shape your clinical care such that you're

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still able to continue to do this creative work?

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So let's say you have clinic, how do you stop being the primary provider in this clinic

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so that there are trainees perhaps who come to work with you who do the bulk of the heavy

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lifting?

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For example, writing notes is kind of, you know, seeing patients can be easy for us because

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we're the expert, we know exactly what to ask, what to say, we love talking with people.

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Oh, the administrative clinical work in the background can be hard.

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And so if you have trainees as part of your program, let's say you're supervising a fellow's

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clinic and you're helping them think through the difficulties of caring for the patient

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and they're writing the notes, that does relieve a huge burden for you because it can be tiring

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to put all this together in a note.

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They do that for you at first and then you're able to come and look at it and then say,

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okay, yes, this makes sense.

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Now let's tweak this, right?

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And so even though I was on call this past week and it was super tiring because of all

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those late night calls, it is still easier for me to look at a note that one of the trainees

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working with me has written and endorse that and then add some thoughts to it rather than

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trying to go back to the very beginning and say, wait a minute, was that patient a smoker

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or not a smoker?

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It's going to impact years.

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And so it's saying, how can you be strategic about the work you do so that it does not

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overwhelm and exhaust you and you're able to have continued mental capacity to do the

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research that you need to do?

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How can you get creative about that?

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You might say, I'm just, this is just me.

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I'm the only one in my clinic and I have clinic four days a week.

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There's no way it's saying, how can you structure your clinical work such that it doesn't take

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all of your emotional and mental energy and there is enough emotional and mental energy

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left to do the research.

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How can you get creative about that?

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And even if you're not necessarily in charge of the fellows clinic, how do you draw trainees

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to work with you so that you can begin to have a sort of fellows clinic, even if it's

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not official?

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How can you, how can you think?

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How can I?

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And I just invite you to think about how do you structure your clinical care so that your

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research can keep going and can keep going in a way that is creative and fulfilling.

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The seventh thing I want to say is that it's not enough just to be a creative thinker.

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It's important to be surrounded by creative thinkers.

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To some extent, I alluded to this when I talked about the importance of going and being among

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other types of thinkers or other types of researchers, not just clinicians, not just

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clinician scientists, is going outside of your discipline, going outside of your mental

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space so that you get ideas from people who are thinking creatively.

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And so many times for me, I'm thinking about digital solutions to early diagnosis.

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Who are those who are using digital solutions for other things that might not be early diagnosis,

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but have to do with identifying things early that other people may not identify?

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How do I do that?

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Because that gives me ideas that I can use and apply to my research.

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What are other researchers doing who don't have this particular disease state in mind,

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but they're solving the problem for other disease states?

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How can I get with them so that I can expand the quality or the creativity of my thinking?

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And so these are some strategies to think about as you are protecting or working to

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protect your most valuable asset, your mind.

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Number one, the quality of your research depends on the quality of your thinking.

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Number two, your thinking must transcend what is known to focus on the unknown.

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Number three, your thinking must be creative.

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Number four, fatigue is a barrier to creative thinking.

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Number five, avoiding parts of the work that exhaust you is key, creating strategies so

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that you can allow your clinical work not to overwhelm and exhaust you is important.

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Number six, creating space for thinking is key.

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And number seven, being around creative and unique thinkers, different thinkers from you

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is important as well.

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All right.

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It's been a pleasure talking with you today.

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I am so grateful for having had this opportunity to talk with you.

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Thanks for listening.

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And I look forward to seeing you the next time on the Clinician Researcher Podcast.

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Thanks for listening to this episode of the Clinician Researcher Podcast, where academic

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clinicians learn the skills to build their own research program, whether or not they

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have a mentor.

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If you found the information in this episode to be helpful, don't keep it all to yourself.

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Someone else needs to hear it.

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So take a minute right now and share it.

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As you share this episode, you become part of our mission to help launch a new generation

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of clinician researchers who make transformative discoveries that change the way we do healthcare.