sanguinemare

October 8, 2015

Antibacterial Soap is not Better than Regular Soap… and learning from death

So, fun fact of the day: according to our MSTP seminar speaker tonight, apparently the FDA agrees that “antibacterial” soap is not any more effective at preventing disease transmission than regular soap, assuming both are used to wash hands properly!  Did not know that.  And to back that up, here’s an article straight off the FDA site that speaks about that, from 2013.

He also described a painful experience he had had as a clinician, where he did a procedure on a patient, and that patient ended up dying, even though he had done everything technically right.  This, in itself, was one of his lessons – that you can be technically right, but mess up intellectually.  Because, as it turns out, after that, they did a retrospective study, and apparently that patient was at high risk for bleeding out after that procedure, as they’d had a bone marrow transplant before that.  That wasn’t known at the time, but it cost that patient their life.  There are two lessons I learned from this:

The first, which is rather scary and sobering, is that as a doctor, we’re all going to make mistakes at some point.  Mistakes that may even cost people their lives.  And some of them, like the case here, won’t really be our “fault”, in the sense that it wasn’t anything that could be prevented at the time due to lack of knowledge, but in hindsight, for whatever reason – new research coming out, a new technique our clinic/hospital was not aware of, etc… we’ll realize that our decision at that point in time was what directly or indirectly, caused harm to the patient.  To be quite honest, that scares me quite a lot.  I don’t know if I can handle that. I think that would tear me apart from the inside.  And yet… if no one makes those decisions… even more people may come to harm.  It’s a tough job.  I guess time will tell.  I just pray that over the course of my career, I will be fortunate enough not to do anything so bad that it costs a life or cripples someone the rest of their time on earth.

The 2nd is that even in one’s darkest moments/worst mistakes, something good can come of it.  In this case, research that probably has saved at least a few lives since.  He recognized that maybe there was something about this patient that made them susceptible to the procedure, even though he did nothing wrong, and they went back and looked at records and realized this predisposition, and published a paper on it.  So now, anyone encountering this type of patient before this procedure will know that it is a high risk thing to do in these people, so they may be much more cautious about ordering that test to be done.  So even when making mistakes, analyzing it and building off of it may lead to research that helps others in the future.  And I guess that’s how we have to look at it, in order to keep moving forward, lest we crumble from the guilt and sadness of those we were unable to help.

October 27, 2013

Oral Presentations, Conferences, and Publications – What’s the Big Deal?

Well, that was… interesting.

Today, I gave my first ever oral presentation at a conference.  For those who are unacquainted with how this all works, basically, after you’ve done research, you are in a sense under (ethical/moral, scientific, etc) obligation to share what you’ve learned somehow with the world.  Or at least put it out there someway, somehow, so that should someone develop an interest in whatever minute sector of the vast forest of science you have decided to devote x number of years to, they will be able to access it.

Why is this important?  Well, science would never advance without building upon what others have done, for one thing.  That’s what the whole “we’re standing on the shoulders of giants” thing is all about, after all.  Another very important reason that is related to this is the real-world application of this science, whether using principles of physics to build MRI’s and computers, or how to create poison darts from frogs, or invention of new treatments.  (Although medicine is traditionally actually quite poor on having good, solid, “scientific” evidence for the things they use to treat people… but that’s a different story.  Plus I think that is slowly starting to improve as information gets more widespread and people realize that more rigorous trials need to be done.)

Anyway, back to dissemination of research findings.  Ever hear the term “publish or perish”?  If you weren’t aware, the phrase is a semi-mocking commentary on how anyone who wants to survive in academia has to publish (papers) on a regular basis in order to stay competitive.  Everyone talks about how if there’s a say 3-4 year “gap” where one does not publish at all (for example, during residency), future employers for an academic position will look skeptically at that and wonder if perhaps this applicant was not that interested in science after all, and therefore not fit for the position.  This principle is clearly still very true today, as this conference reiterated whenever we talked about grants or career advancement.  So we publish.

Now, fortunately there are many different forms of publishing – the best of course being a first/primary-authored manuscript with primary data, especially in a high-impact journal like Science or Nature.  (I won’t go into all the vocab/nuances of the different types of journal articles today, but that last sentence was basically a fancy way of saying publishing work that you did yourself, that you wrote yourself, and in a famous and well-established/trusted scientific journal).  But another way you can be “published” or otherwise share what you learned with others (and learn from them in turn) is going to conferences.

The way this works is generally, at various conferences, you have the opportunity to submit an abstract (which is basically a short summary of your work including introduction/background, methods, results, and conclusions).  The people in charge of the conference will read through all the abstracts and decide which ones merit an oral presentation and the rest will end up as just poster presentations.  Sometimes, conferences will also throw in a travel award, which means if your abstract (and/or other assorted materials like a CV/statement of interest/letters of rec, etc) is good enough, they will subsidize either all or part of your travel/stay for the conference.

Now that I’ve given you some background on all this, so far, all of my submitted abstracts have only resulted in poster presentations.  This is not really surprising, given that all of my posters so far are from either 6 or 8 week rotations (which is generally understood to be not nearly enough time to accomplish much of anything if one is doing basic science benchwork – aka lab work – as versus analyzing data or making models on a computer, for example). In fact, I am usually quite impressed by anyone who does get an oral presentation (or a paper!) from a rotation project, which some students actually get, believe it or not, because it means they either worked really hard, were extremely lucky (both data-gathering-wise and timing wise coming into the project towards the end point), or both.

In my case, I think it was probably the latter, and the fact that 1) this conference is student run, meaning students were the ones reading the abstracts, and 2) my abstract fell in the “other” category because it didn’t fit any of the usual departments like neuroscience, cancer, or pathology, and they probably wanted to make sure the topics of the talks were diverse.   (Huh, side note: now that I think of it, I’ve only really submitted an abstract to one other conference, and that was only because I had to in order for our program to fund me to go to the national MD/PhD conference in Keystone after my first rotation… long story.  But yeah, all my other abstracts were just submitted because we have to every year for our school’s Medical Student Research Day, which is not really a conference). ANYWAY, the point is that this was my first oral presentation at a conference.

So… if you’ve never done an oral presentation before… it takes a LOT of time.  Even presentations for graduate courses take me quite a while, but for this one, I spent at least a couple full days trying to put together the presentation the first time, then presented it at our lab meeting on Monday.  I was critiqued on literally every slide, and spent all of the last week when not in class or doing homework working on the slides, and then a few additional hours on rehearsing.  I have discovered that rehearsing in one’s head is good for putting together the “story” and figuring out the order to talk about things in.  However, it is not enough, because once I started trying to speak out loud, I would realize I didn’t know how to phrase things, or there would be gaps in my understanding of something, or, as one of our collaborators said, I said “um” as a placeholder way too much.   So I wrote notes on the side to remind myself of phraseology, I looked up things I didn’t fully understand, and practiced – while drying my hair, walking to school, walking to the conference, mentally rehearsing when I didn’t have it in front of it, etc.

And despite my efforts, perfectionism on the visuals, and practice, and despite the fact that I had to present my poster the hour beforehand, which theoretically should have helped me practice even more through interacting with people, the actual presentation still turned out less than stellar.  In fact, I would say I messed up quite a bit.  I was nervous, and it showed.  It felt like my tongue kept getting in the way of my words, so I would be simultaneously blurting things out while stumbling and stuttering on pronunciation.  Word vomit, really.  And I remember saying “Sorry, I can’t talk today” at least 3 times throughout the talk after trying repeatedly (and failing) to pronounce a word correctly, as well as literally stopping after a particularly miserable failure, taking a deep breath, apologizing again for my inability to (ironically) say “ability”, and attempting to move on.

In addition, I’m not sure if this influenced me or not, (it probably did subconsciously – I was probably just too nervous about presenting to consciously realize this until later, fortunately) but I think there was literally only 1 person in my room who was from my school listening to my talk, and that person was the guy who is probably my closest friend from the MSTP.  It’s a little discouraging when it looks like everyone in your entire program is not interested in your talk or in supporting you.  But I was grateful that my friend was nice enough to be there, even though it meant he would witness the train-wreck that was my performance today.

So practice doesn’t make perfect. At least not yet.  And practice definitely doesn’t mean people will be interested in what one has to say.  But hopefully that will change as I get more experienced (and when I actually know better what I’m talking about/have my own project that I am leading with more work under my belt).  And while there was a lot in today’s presentation that went wrong, there were a few small victories: I was able to finish in the allotted time (usually I go over), I think I was able to answer the two questions that were asked to me in a reasonable way, and my friend actually said he thought my presentation was good, that I had a good story, and that it was interesting!  That last one made my day, as he is generally pretty analytical/critical (in a good way), is often bored by talks unrelated to his research/things he finds interesting, and he’s pretty straightforward about his thoughts.  (In hindsight, I realized that I didn’t remember seeing him engrossed in his phone, which is often the case during talks, reinforcing the claim that he thought it was interesting. Yay! Of course, it could simply be that my talk was just much shorter haha.  But hey, I’ll take what I can get.)

I’m told I’m lucky my first presentation was at this kind of conference with peers rather than a research-area-specific conference with lots of faculty etc who would probably grill me much harder on the science behind what I did.  Thinking about it that way, I am pretty grateful that I had this chance to “practice” before having to get up in front of renowned experts in my field and deal with hard questions about my work.

Sooo yup!  That is a summary of my first experience of giving an oral presentation at a conference, as well as a bit of background on why publishing and sharing information is so important for us as scientists and researchers (and medical/health care professionals as well).  Conferences are also great because sometimes when you’re listening to a poster or oral presentation, it can give you ideas for your own work and help remind you that what you’re doing actually is pretty cool.  I experienced that for the first time myself at this conference, talking with someone from my school about his work at his poster.  It was actually pretty invigorating – I think I’ll be checking in with him on how his research is going more in the future, and/or maybe consider a collaboration… hmm we’ll see!

Anyway, I hope this post was informative in some way, shape or fashion, and that you have a better understanding of why publishing is so important in academia, how people publish, what it’s like preparing for an oral presentation (n=1 hah), and why conferences are cool.  Thanks for reading!  It’s sleep time for me… goodnight!

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