Teamwork in Research

Good research is all about teamwork.  It is a multi-disciplinary, multi-professional affair. Formulating research questions, drafting protocols, securing funding, gathering data, analysing results — all these essential aspects of research delivery and many others will require you to interact with your colleagues.  As with everything else, there are right ways and wrongs ways to get things done.  As a busy researcher you need to get the most out of any dealings you have with others.  You need to use your time wisely and put your efforts where they will be most effective.

Here in my take on what are the most important things to think about when interacting with your colleagues from other fields and specialities.

  1. Don’t underestimate people

This is especially true of people who do jobs you don’t fully understand and whose knowledge and professionalism you will rely on to get the study done. For example, the laboratory staff, the finance officers, the regulators, the librarians, the clinicians are all highly trained professionals, just like you, and they know things and can do things you can’t.  All these people, like you, have key roles to play in the research process and you may have to work with them effectively to ensure the best outcome for your study.

2. Be clear

Often your interactions with colleagues will be about exchanging information.  The clarity of that exchange will usually determine the quality of the outcome.  If it’s hurried or muddled, the results are unlikely to be what you hope and will often involve you starting from scratch. This time round, however, you will have the disadvantage that whoever you have to deal with might have a negative opinion of you because at their last meeting you wasted their time.

3.  Be civil

You catch more flies with honey than vinegar. Occasionally, you will have to deal with people who are defensive or apparently unhelpful.  This is sometimes because they still have a bad taste in their mouths from their last interaction with a researcher, one perhaps that was less than courteous.  Such prejudice is unfair, but you just have to show them that you’re different — be polite, be professional and be appreciative of their help.  And next time you have to interact with them things might be a little easier.

4. Don’t waste people’s time

Be prepared for a meeting or even a phone call, have the facts and figures ready and don’t keep people waiting. Remember, respect is a two-way street.  You can’t expect to be given respect unless you offer it.  Respect means listening to people,  being punctual, being prepared and above all treating people as you would wish to be treated yourself.

5. Keep the big picture in mind

Research can be hard and some days it can seem impossible.  Relying on your own efforts is one thing, but when you have to chase other people to get things done, while juggling a dozen balls in the air, it can seem daunting.  Never forget what the effort is for — remember it’s about pushing forward the boundaries of knowledge and improving everyone’s life.

©️Allan Gaw 2021

If you want to read more of my writing, try these books. All are available on kindle, and if you’re on Kindle Unlimited, they’re free to download.

Doctor, Druid and Advocate of Cremation

On his death bed, the 92-year old William Price was attended by the wife he had married on his 81st birthday when she was 21.  He said, “Bring me champagne,” and these would be the last words of the most flamboyant, unconventional and controversial figure in Welsh medical history.

Price was born in a remote cottage near Caerphilly. His mother was an illiterate maidservant, while his father was an Oxford-educated Church of England priest, who would later suffer from severe mental illness.  Theirs was an unconventional pairing for the time that foreshadowed Price’s own bizarre life.  A native Welsh speaker, he acquired English when he attended school and despite only enjoying three years of formal schooling from age 10, he excelled academically.  At 14, against his father’s wishes, he left to pursue a medical education. He undertook a six-year apprenticeship with a local surgeon, after which he moved to London. There, he gained his membership of the Royal College of Surgeons before returning to Wales as a General Practitioner.

While many claims have been made regarding his medical abilities, what is certain is that he had a thriving practice for much of his life and also held the post of surgeon at a local factory for almost 50 years.  There, he is reputed to have performed the first skin-graft operation on an injured worker. His social conscience and concern for local people also prompted him to establish one of the first Co-Operative shops and what might be regarded as a early version of the National Health Service for his local community. Despite these achievements, it was his growing eccentricity that earned him his place in history.

In the early years, he became politically active, with left-wing leanings that developed into revolutionary activism as a leading member of the Chartist Movement. By 1839, he was supporting his fellow Chartists by obtaining arms for them, which were subsequently used in the abortive Newport Uprising.  Although not directly involved, Price could see the danger he was in and fled to France, disguised as a woman.

His Welsh nationalism had already begun to manifest itself as an interest in the ancient druids and their culture, but this was further fuelled while abroad. He interpreted an exhibit in the Louvre as an ancient Welsh prophesy that spoke directly to him, prompting him to return to Wales to free his people.  He did return and set himself up as the self-proclaimed Archdruid of Wales and founded a cult based on the practice of free love.  At this time, he also adopted what would become his trademark appearance: long white hair and beard, an emerald green suit with scarlet trim and a large fox-fur hat.  His increasingly erratic behaviour might also have prompted numerous law suits against him, but it was his failed business ventures that forced him to flee again to France, this time to escape his debtors.

In his mid-sixties, he returned home to set up another successful practice and in his early eighties married his young wife in a Druidic ceremony.  His first son, born a year later, was named Jesus Christ, but he lived only 5 months.  Price had long felt that burial was a corruption of the earth, so he duly undertook to cremate his own son on a Welsh hilltop.  The ceremony was interrupted and Price found himself in court charged with “a vicious act of blasphemy”.  He successfully argued that although the act was taboo, there was no law against it, and he was released.  The publicity around the case helped the promotion of cremation, and finally the passing of the Cremation Act in 1902.

The next year, his wife gave birth to a second son, whom they also named Jesus Christ, followed by a daughter two years later.

Price’s eccentricities were manifold: some mere foibles; others dangerous.  He was a nudist, vegetarian and opponent of vivisection and marriage.  But he also spoke out against vaccination, refused to treat any patient who smoked and called his fellow doctors “poison-peddlers”.

When he died, he was cremated according to his own instructions, and the ceremony was attended by some 20,000 people.  There was a carnival atmosphere in Llantrisant that day and its twenty or more pubs ran dry during the festivities. A fitting end to a man described by one biographer as “a maverick and a rebel” and who was also undoubtedly a showman who always enjoyed playing to the gallery. However, it is also possible that he was mentally ill.  Whatever the truth, he remains one of the most colourful members of the medical profession to come from Wales.

If you want to read more about the History of Medicine and Research, try these books. All are available on kindle, and if you’re on Kindle Unlimited, they’re free to download.

The Erasure of Memory

Between the daffodils and the last of the crocuses, the sandstone memorials stand slightly stooped with age.  Leaning forwards or to the side they mark the resting places of the long dead, but marking is all they can now do for age has not only wearied them but worn away all trace of their memorial.  Nameless and dateless, these sad stones stand vigil in the church yard of St Mary Magdalen on Oxford’s Magdalen Street.

Forgotten, the dead are erased from their headstones by the elements.  Layer by layer the stones are peeled apart by the same forces of nature that formed them in the first place, long before they ever found their place in a church yard.  Wind and rain and time have done their inevitable work.  For such a brief moment in their geological history these stones carried the name of the person who was once the body buried beneath them, but all too soon they have returned to the anonymity they had known for millennia before and will know for the remaining years to come.  The people beneath them existed for a fraction of the life of their headstones and all trace of them is now gone, even though stone seemed, in comparison to their fragile lives, such a permanent reminder of their existence.

We memorialise to remember.  Those we have lost, we hold in our memories; keeping them alive in our thoughts.  As time passes and the pain of bereavement is blunted, we may be disturbed to realise that some of the details are slipping away.  Like a fading photograph in the sun, the definition goes and the image is softened and finally lost.  Headstones offer loved ones the false reassurance of permanence.  A resting place is marked forever and some of the heavy work of remembrance will be taken from our shoulders. Stone, however, as we can see in this church yard, is only a short-term solution, lasting a few hundred years at most.  But that’s more than enough for most.  Memories die with us and few of us live on in the remembrance of more than one or two generations.

For some, however, the legacy of memory is the hallmark of success.  A life memorialised, or perhaps more importantly, a life’s work remembered, is to some all that really matters.  When we think of the great who have gone before, we sometimes have tangible evidence that they lived and that they breathed the same air as us.  Museums are filled with the paraphernalia of lives gone by—the gloves worn by a princess, the spectacles worn by a scientist, the lock of hair of an author—but these are insignificant in comparison to the thoughts and ideas that these people left behind.  Ideas can, and do, change lives.  They move worlds and shape futures and live on long after the flesh has rotted from our bones and even our headstones have regressed into anonymous slabs.

But for ideas to survive they must be recorded and documented, and the written word has proved more permanent than any stone to pass a memory down through the ages.  We know what philosophers and kings thought because of what they wrote, or what has been written about them.  We know of discoveries ancient and modern because they have been shared in the scientific literature and now sit on our library shelves.  The works of dead scientists are there to be read and climbed upon that we might see just that little bit further than them.  And we know how timeless our human emotions are because they have been written about in much the same ways for thousands of years by countless story tellers. Songs of love and sorrow, joy and heartache, jealously and rage fill the scrolls of ancient sagas just as they do the pages of any Hollywood script today.

The words of all these writers are their headstones, un-weathered by rain, spoken sometimes across centuries, yet still heard, still listened to, still making a difference.

Most of St. Mary Magdalen’s stones are worn and weathered, but one small headstone near the iron railing that encloses the church yard is now completely covered in ivy.  Whether the name is still there beneath this mound of overgrowth is impossible to see.  While it is tempting to part the leaves to reveal who lies beneath, to do so, however, feels unseemly.  This stone is in effect veiled.  Just as the forces of nature have erased the names on the other stones, another force of nature—life itself—has chosen to obscure this one from view.  The dead in St Mary Magdalen’s sleep on anonymous.  Their identities, like ours one day, may be lost, but not necessarily their thoughts.  These can live on in the memory of the written word.

© Allan Gaw 2021

This is taken from my book Tales from an Oxford Bench which is available on kindle where it is free to download if you’re on Kindle Unlimited, and as a paperback from Amazon.



Also available on kindle:What can we learn from the past that may be relevant to modern drug research?

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“I cannot recommend it highly enough: even if you read nothing else about the origins of drug research and what it can (should?) teach us, read this….This is a ‘buy’.”  Madhu Davis review in Pharmaceutical Physician

Also available on kindle:

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Picking Up the Pieces

Look up and look closely. 

The ribbons of multicoloured glass that frame the panels of the lower lights in the window reveal themselves not to be deliberate images, but collages of broken fragments — shards of glass collected from the ruins of bombed out churches in London during the Second World War.  This is medieval artistry destroyed by war and given new life in the majestic setting of the Cathedral of Christ Church, Oxford.  Most visit this college and come to its church to marvel at the famous fan-vaulted ceiling and many miss the Becket window tucked away in the side chapel, but this in many ways is the church’s greatest and rarest treasure.

The top panels of the tracery are as bright and vivid today as when they were installed in around 1320 — making it the oldest stained glass in the place.  In a central panel, there is a kneeling figure in ecclesiastical garb.  Behind him there are soldiers with ominously raised swords, for these are his assassins.  The victim is the 12th century Archbishop of Canterbury Thomas Becket, and this is one of the very few surviving images of the martyred saint.  The lower half of the window is thought originally to have contained a larger image of Becket, but this portion was destroyed on the orders of that Church lover Henry VIII.  What we can see today is a reconstruction, reuse and recycling of what would have otherwise been lost.

The small 14th century image of Becket is thought to have survived because his features were not apparent in the clear glass fragment that was his head.  Today this has been replaced by a plain pink piece of stained glass, still featureless — perhaps to protect him from any further royal rout.

This is a window that makes you pause, or at least it should.  In the cathedral, you are drowned in the grandeur of centuries of art and worship; you walk on the graves of dignitaries, and the walls are lined with commemoration.  In short, there is a lot to see and altogether too much to take in, but you should take the moment or two necessary to stand before the Becket window and think about what it represents. 

No matter what bombs are thrown, and what beauty they destroy, we have the capacity, quite literally, to pick up the pieces and rebuild.  In this case, there could be no attempt to recreate what was there before — too much of the original windows from which these fragments fell was irretrievably lost — but what has been done is simultaneously a silent homage to medieval craftsmen and a nose thumbing at iconoclastic zeal. 

By taking pieces of robes, slices of trees and quarters of faces, and welding them together, a modern yet medieval beauty has emerged.  Henry VIII did not succeed, nor did Nazi bombs.  And a window that was originally designed to celebrate a slain archbishop has become not only symbolic of that saint, but also of renaissance in general.

There are undoubtedly mixed emotions to be felt before this work of art, or should I say works of art.  On the one hand, we are witnessing a mob hit on the altar of a church, as well as the tangible brutality towards art and beauty that all wars bring.  But, on the other, we are also presented with the resolution of belief and the tremendous human capacity for healing and reconciliation.  We have before us what can be achieved by putting aside the past, moving on from the pain and concentrating on rediscovering the beauty that is always there, if we look.

It was Goethe who said, ‘Thinking is more interesting than knowing, but less interesting than looking’. Standing in front of this window, I spent a while looking and since then I have spent much longer thinking.  Like most, I have scarcely arrived at the point of knowing, although I am hopeful.  But it began with looking — it almost always does — and the visual stimulus lights the spark of thought, of new ideas, of new wonder.  Observation is at the heart of science, but it is also undoubtedly the genesis of all creative thought.  Whether we observe the world around us or the inner world of our consciousness, what we see lights the way and helps us choose a path to follow.

Along the way, we collect the fragments, sort them through, piece them together and find the new patchwork that is formed.  You may discover a synthesis of new ideas.  Or you may even find you have created ribbons of medieval coloured glass to delight a new generation and pay respect to one long gone.  

The Becket window is a metaphor, but it is also a work of art fused across the centuries, showing what can be done when we choose to begin by looking.

© Allan Gaw 2021

SlideEasy and The Business of Discovery are now published and available on kindle and they’re free to download if you’re on Kindle Unlimited.

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Also available on kindle:What can we learn from the past that may be relevant to modern drug research?

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“I cannot recommend it highly enough: even if you read nothing else about the origins of drug research and what it can (should?) teach us, read this….This is a ‘buy’.”  Madhu Davis review in Pharmaceutical Physician

Also available on kindle:

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Why do we call it a vaccine?

Introduction

The world is currently holding its breath, awaiting the development of a safe, effective vaccination that will deliver us from the constraints of the coronavirus lockdowns. There is a flurry of research activity across the globe evaluating numerous contenders, and there is growing confidence that the solution to the pandemic is in sight. Of course, such a strategy is not new.  When it comes to infectious diseases, modern prevention is built upon the use of well-tested vaccines.  But why do we call them vaccines and what might have been their origin?  To answer these questions, we have to go back over two centuries to the work of an English country doctor.

Edward Jenner

Edward Jenner was born in Berkeley, Gloucestershire in 1749. As a teenager he was apprenticed to a surgeon, and at 21 he moved to London to complete his medical training under the charismatic and influential John Hunter at St George’s Medical School.  At the age of 23, Jenner returned to his birthplace to set up practice and would remain there for the rest of his life.

Like others of his time, he was man of the Enlightenment and pursued diverse interests.  He was a musician, poet, balloonist, geologist and his interest in ornithology earned him his Fellowship of the Royal Society when he worked out that it was the cuckoo hatchling that evicted the eggs and chicks from its foster parents’ nest and not the adult bird.  But it is not for the study of the cuckoo that we best remember Jenner today; it is his contribution to the prevention of smallpox.

Smallpox and its prevention

Smallpox is a viral disease that has had devastating effects on humans throughout history.  It is associated with a high death rate — particularly in infants — and many survivors are left blind or with disfiguring scars.  However, it was well known throughout the ages that survivors of smallpox were immune to re-infection.  It was perhaps a small logical step to think of deliberately infecting non-immune individuals with a mild case of smallpox in order to render them immune to a more serious and potentially life-threatening one.

Such a practice had been carried out since at least the 17th century and probably much longer before that, and included the inoculation, or grafting, of pus from smallpox lesions under the skin of non-immune subjects.  This form of inoculation was also known as variolation from the Latin for smallpox: variola.  Jenner himself had been variolated as an eight-year old boy, as had countless others.  Variolation was of course potentially dangerous — not only did 2-3% of those inoculated die from smallpox as a direct result of the deliberate infection, others contracted blood borne diseases such as syphilis from the procedure.  However, its widespread use did significantly reduce the death toll from natural infection.

Cowpox

It was also widely known that cowpox, a much milder infection that milkmaids and farmers might contract from their infected cattle, could protect against its more deadly viral relative, smallpox. The usual version of how Jenner came to be acquainted with this idea is that, while a surgical apprentice, he heard a dairymaid say, ‘I shall never have smallpox for I have had cowpox. I shall never have an ugly pockmarked face.’  However, it was not only milkmaids who were aware of the protective effects of a cowpox infection; the medical profession was also well-acquainted with this form of prophylaxis.  Indeed, in 1765, the Gloucestershire surgeon-apothecary John Frewster presented a paper to the London Medical Society entitled, Cowpox and its ability to prevent smallpox.  Frewster also recalled discussing his findings at a local medical society dinner attended by a surgeon and his young apprentice, Edward Jenner.

Jenner then was undoubtedly aware of Frewster’s work, but he may have been ignorant of that of the Dorset farmer Benjamin Jesty.  Jesty was as aware as any dairy farmer of the link between cowpox and immunity from smallpox.  When a smallpox outbreak threatened his own family, he decided to put his observations into practice.  Rather than having his wife and two toddler sons variolated, he took the bold step of inoculating them himself with cowpox.  All three survived the smallpox outbreak, but Jesty was vilified locally for what he had done to his family.  This was in 1774 — some 22 years before Jenner’s experiments. 

Jenner’s Experiments

In the spring of 1796, a local milkmaid called Sarah Nelms had contracted cowpox, and Jenner found her to have fresh lesions on her hands.  The responsible cow was called Blossom, whose hide and horns can be seen today in St George’s Medical School and The Edward Jenner Museum respectively.  There are, however, a number of other antique cow horns around that purport to be Blossom’s, and unless she was a very unusual cow, we might conclude that not all are authentic.

On 14 May, Jenner took pus from Nelms’ lesions and inoculated the son of his gardener.  The boy, James Phipps, was 8-years old at the time, and he subsequently developed a mild fever and discomfort in the axillae, but quickly recovered. Almost seven weeks after the cowpox inoculation, Jenner inoculated the boy again, this time with pus from a fresh smallpox lesion. Phipps, despite this challenge, did not develop the disease and Jenner concluded he was immune.

Jenner wrote jubilantly to a friend,

“…I have at last accomplished what I have been so long waiting for, the passing of the vaccine Virus from one human being to another by the ordinary mode of Inoculation…  But now listen to the most delightful part of my story.  The Boy has since been inoculated for the small pox which as I ventured to predict produced no effect.  I shall now pursue my Experiments with redoubled ardour.”

However, he first decided to publish this single experiment and submitted a paper to the Royal Society, which was quickly rejected as being too premature.  It took Jenner another year to get over his initial excitement and subsequent disappointment and to apply that ‘redoubled ardour’ to further experiments.  These included inoculating another dozen subjects with cowpox.  These were mostly children and included his own one-year old son.  Jenner now felt he had enough to publish and prepared a report, which this time he chose to self-publish.  It was far from clear or well-written, but it made him famous.

The process of cowpox inoculation was soon after termed vaccination (from Latin vaccinus, of cows) by Plymouth surgeon, Richard Dunning and almost 80 years later, Louis Pasteur proposed that all immunisations for infections should be termed vaccinations in honour of Jenner.

In the years following his publication, Jenner tirelessly promoted vaccination as a preventive measure and although he was lauded in some quarters, he received nothing but ridicule in others.  Undoubtedly, professional jealously played a part in the latter and after a decade Jenner decided to withdraw from the public debate and return to his roots in rural Gloucestershire.  When he died in 1823, his first vaccinee, the boy Phipps, was now a married man and served as one of Jenner’s pallbearers.

What began in a country doctor’s home with the inoculation of a young boy would end 184 years later in 1980, when it was declared that, following a global immunisation campaign led by the WHO, smallpox had been eradicated from the world.

Conclusions

Jenner, was not the first to suggest, nor the first to try out, inoculation with cowpox as a prevention for smallpox.  Why then do we celebrate him as the innovator? Perhaps we choose to honour Jenner because it is easier to focus our attentions, however erroneously, on a single investigator rather than acknowledge the disconnected teams who have contributed to an achievement.  The myth of the lone genius making a medical breakthrough is compelling, even in science. 

However, if we try to evaluate Jenner’s contributions a little more objectively, we see that he took what was merely folklore and anecdote and placed it on a firm scientific footing through careful experimentation. Furthermore, he also told the world about it and worked hard for it to be implemented.

Covid-19 is just the latest viral disease to ravage the world and unfortunately it will not be the last.  But, once again, modern medical science is following in Jenner’s footsteps. By developing, evaluating and implementing an effective prevention strategy through vaccination, we hope to see the end of this pandemic.

Testing the Waters: Lessons from the History of Drug Research

What can we learn from the past that may be relevant to modern drug research?

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“I cannot recommend it highly enough: even if you read nothing else about the origins of drug research and what it can (should?) teach us, read this….This is a ‘buy’.”  Madhu Davis review in Pharmaceutical Physician May 2016.

My other books currently available on kindle:

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A New Year — A New Writing Habit

Some say we need to do something everyday for more than 21 consecutive days for it to become a habit. Some say it’s 66 days and others 90. I rather suspect it depends what the something in question is.  I mean, if you eat beans on toast every day for three weeks, quite apart from the gastrointestinal consequences, are you really going to keep on doing it?  And no matter how long I practice my triple Salchow, I doubt it will ever become second nature.  

We talk about habits as automatic actions — the habit of brushing our teeth every morning, or looking both ways before we cross a road, or switching off the news as soon as Trump’s face appears — although the last example might be more of a reflex than a habit.  Some habits are good for us — others not so.  But we often identify things we want to do, and that we know we should do regularly but which always seem to fall off the bottom of our daily to-do lists.  For many people, writing is one of those.

In academia, the importance of being able to write well and effectively cannot be overstated.  Quite simply, we and our work are judged by our writing.  Qualifications depend on writing essays, dissertations and theses and promotion is contingent on being able to produce the published goods.  But all that necessity doesn’t make it any easier, especially for those who despair about their writing abilities. “I don’t know how to start,” they tell me.  “I don’t know where to start.  I don’t know how to make it better.  I just don’t know how to write at all.” Writing for them has acquired some mystical quality.  It has become a skill that they feel others have somehow managed to learn but which has eluded them.  

Well, here are two simple truths about academic writing. First, everyone finds it hard and second, anyone can learn how to do it.  No one is born with the ability to write good academic English, and everyone who does has had to learn it the same way we learn everything else — through work and practice. Everyone in academia knows how to work, but for some reason the importance of practice, when it comes to developing our writing skills, seems to have escaped them.  And that’s where the habit comes in.

When we are faced with a task that we perceive to be difficult, awkward, or challenging many of us simply put it off.  As we procrastinate, however, that task starts to swell in our imaginations.  Its perceived difficulty doubles as does the effort we think we will need to take it on. With every day that we postpone the inevitable, the magnitude of the task grows.  Finally, of course, we have to face it or miss the deadline.  At that point, we are left with no choice but to start, but the effort involved and the anxiety that it provokes can be deeply unpleasant.  How much easier might it have been if we had only done a little every day, instead of frantically cramming it all into the last possible hours before the deadline?  Of course, that would require a habit — the habit of writing something everyday.  If you don’t like writing, or you don’t enjoy it, why would you choose to do it every day?  Simply because it will make your life easier, your job more fulfilling and your day altogether sweeter.  

So, how do you develop the writing habit?  Not too surprisingly, all that is required is for you to start.  But you should start slowly and easily — no need to fall at the first hurdle.  Decide that you are going to write something short every day.  This can be a single sentence to begin with.  Choose when you are going to do this — first thing in the morning or maybe last thing before you go home.  Choose what you are going to write about — usually your own work or some aspect of your professional life.  But just start with a sentence.  Some like to write about what they plan to do that day, or perhaps reflect on what they have done.  It might be a thought about a conversation had, or a paper read or a lecture attended.  Whatever it is, confine yourself to one sentence.  Very quickly, you will find that you want to write a second or even a third sentence but don’t, not yet.

Start to realise just how easy it is to write that one sentence every day.  Of course, at this stage you are asking what the point of this is — after all, a sentence a day is hardly going to get the thesis written or the report finished.  But we’re not trying to do that yet; we’re trying to develop a habit.

After a week, treat yourself to two sentences a day and again keep doing this until it’s effortless.  The quality of these sentences is unimportant at this stage because all that can come later.  Remember, all we’re trying to do is become a habitual daily writer.

Before the second week is up, you will be finding it so easy to write two sentences a day that it will seem trivial. But it’s far from that — it’s the beginning of a habit.  Try three sentences or four, or perhaps you will aim for a paragraph a day.  Needless to say, if you take it gently and train yourself, it won’t be long before the thought of writing a page of 500 words a day will no longer seem daunting.  On the contrary, it will just be something you do.

Once you can generate text on a daily basis, you can stop worrying about finding time to write and concentrate your efforts on improving and refining the quality of what you get down on paper.  No one gets it right first time and all academic writers should live by the age-old adage of writers everywhere: there is no such thing as good writing, only good re-writing.

Editing, redrafting and working to improve your writing style are all important skills that we need to acquire, but somewhat irrelevant if we have nothing to work on in the first place.  It all begins with getting words on paper and doing that on a daily basis.  And for that we need a habit.

“When do you write?” they will ask.  And you will be able to say, quite truthfully, “Everyday.”


© Allan Gaw 2021

If you want to read more about getting started with your writing and how you might make it effective, try my books, “WriteEasy”, “WordEasy” and “Abstract Expressions”. All are available on kindle, and if you’re on Kindle Unlimited, they’re free to download.

And check out my other writing related blogs on the Business of Discovery:

Who’s afraid of the big blank page?

This is a golden opportunity to make a start with that writing project, but how do you get started?

https://wp.me/p2v7Al-hr

Tell me a story

…but what’s the story you have to tell?

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Last words of a fool

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Include, Involve, Inform

For us all to reap the benefits of research, we all need to be part of that research.  When it comes to healthcare research, the stakes are particularly high, and we cannot afford to get the wrong answer.  But given the diversity of the human population, will there only be one answer to every question?

In other words, if research studies only include select patient groups, how can we be sure that any results will apply to everyone?  With even a cursory glance at ongoing research studies, it is clear that modern clinical research is not as inclusive as it could be.  Some groups of the population are poorly represented in studies and the reasons for this are complex and overlapping.  If there was a single strategy we could put into place to solve this, we would, but there is not.  The reasons lie in part with research staff and their training and their attitudes, in part with potential participants and their level of  understanding and their prejudices. There are also more overarching reasons involving the funding and governance frameworks within which we work, as well as very practical considerations, like whether a patient can read and understand the participant information sheet, manage the stairs at the clinic or afford the bus fare to the study visit.  The reasons are a mixture of misunderstanding, imperfect communication, and the consequences of cultural, ethnic, religious and economic diversity.  And, as with many problems, there is often at the root of it all, ignorance of the very problem itself in the first place.

One group that is especially affected by many of these issues is the elderly.  We know from many studies that older adults are consistently under-represented in trials, with many study protocols having upper age limits for recruitment.  Another problem across the board is gender bias.  Although this was a larger issue in previous decades, where more men than women were regularly recruited into studies, it is still a recognised problem today. Disability in its various forms is also often a barrier to clinical research as is socio-economic status.  And of course race and ethnicity are not only poorly reported when it comes to the results of clinical trials, but many minority groups are systematically excluded from studies.  This may be because of geographical, language, religious or cultural barriers that need to be overcome before they can be included.

Although challenging, these are problems that we must address. How can we use the findings from a study that has only recruited men to inform the healthcare of women, or a study that has only recruited Caucasians to help us find the best treatments for patients of African descent?  What about Australian Aborigines, elderly Japanese, African-American children, Middle Eastern women, wheelchair users, those living in poverty — would a study done exclusively in, say, a middle-class, white British population provide the right answer for all these groups?  Of course not.  The one thing we know about the human population is that we are all different.

So, we need to start by openly acknowledging the imperfect design of many modern studies when it comes to inclusivity and, at the very least, treat broad healthcare recommendations that derive from narrow studies with some degree of caution.  Next, we have to examine the specific reasons why different groups are underrepresented in research and address these, as best we can, one by one.  Do we not recruit older people because we simply don’t ask them to take part? Do we ignore certain ethnic groups because of a perception that they will not wish to participate? Do we fail to include those with physical disabilities because of the inaccessibility of our clinics? Do some groups shy away from research because they are frightened of it, because they misunderstand what it is all about, because they cannot afford to participate in it or because they have never heard about it?

To be inclusive we also need to involve more people in research, and by this I mean ensuring that as diverse a group of people as possible are involved at every stage of a trial’s inception and delivery.  There has been a growing movement in recent years to promote greater involvement of the public and patients in research. This may include study participants, patients and members of the public helping to identify research priorities — the questions we should be trying to answer — as well as working with researchers in the design and delivery of such research.   While this is an important step forward, we must also ask how representative such involvement is and whether the resulting studies are better and more meaningful to the general population as a result.

Ultimately, we all want the best studies that we can deliver.  This should mean the safest, most efficient, most relevant studies, and it is likely that we will only achieve this goal if we strive to improve levels of inclusivity and involvement in research.  To ensure this, perhaps the single most important thing we can all do is to work at improving the level of information available about research.

We all acknowledge that meaningful decisions can only be made by people who are informed, people who understand and who are unburdened by the myths perpetuated about healthcare and about research. But how do we give that information? Again, there is no single answer to this question.  We need to ensure everyone — and that includes healthcare professionals, researchers, patients, the public, all of them — have easy access to relevant, accurate information about modern research.  We should begin in schools, we should work with the media, we should be involved in the training of professionals and ultimately we should strive to build a research literate population aware of the opportunities as well as the challenges in healthcare research and who are able to play a meaningful part in it all. And that doesn’t mean necessarily taking part in a research study for everyone has a right to decide what’s best for them.  But perhaps with that right also comes the duty to be informed and to understand the importance of research in healthcare.  Whether we know it or not, whether we like it or not, whether we agree with it or not, research belongs to everyone, affects everyone and should involve everyone.

© Allan Gaw 2020

SlideEasy and The Business of Discovery are now published and available on kindle and they’re free to download if you’re on Kindle Unlimited.

Also available on kindle:What can we learn from the past that may be relevant to modern drug research?

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“I cannot recommend it highly enough: even if you read nothing else about the origins of drug research and what it can (should?) teach us, read this….This is a ‘buy’.”  Madhu Davis review in Pharmaceutical Physician

Also available on kindle:

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Please also check out the new YouTube Channel — Writing Space. Short animated videos to help you with your writing.

Networking in Lockdown

Networking is one of those words that make people cringe.  The notion that in some Machiavellian way you need to “work the room” satisfying your barely concealed ulterior motives along the way is, to many people, an anathema.  Their thoughts turn to the embarrassment of being pushy at the drinks reception, or disturbing someone else’s peace during the coffee break.  Or maybe they think of the awkwardness of cold calling, or more likely cold emailing — fawning over a complete stranger before asking for their help. Even those who see the advantages to their career that such an approach might bring are still uncomfortable, and very few actually claim to enjoy it.

But is this what networking is really about?  Is it a spider weaving a web to catch advantage and patronage?  No, it’s not about cunning and intrigue. Neither is it about idle chit-chat, nor aggressive intrusion, and it should never be about asking for things.  Networking is about building a nexus of people with whom you share some common ground and who can help you, but more importantly whom you can help.

Networking begins by making contact, but it doesn’t end there.  All effective networking is built on sustained nurturing of relationships.  And whether a network is a traditional one, forged through face-to-face contact, or a virtual one created at a distance, the same principle applies.

Before lockdown, we may have bumped into someone at a meeting or a conference or by chance at a social gathering. We may have been introduced by a mutual contact.  Now, with social distancing in place and traditional avenues for meeting people closed off, at least temporarily, we might wonder how we can “bump into” anyone.  Fortunately, we have the biggest drinks reception in the world and the largest room full of strangers that we could ever hope “to work” at our fingertips.  It’s just a few clicks away, and it’s called the internet.  But its very scale makes it unmanageable, and we would do well to narrow our focus for the sake of efficiency.  Platforms like LinkedIn are essentially global professional networking sites, but just how useful they are in building a meaningful network is questionable.  Yes, you might have more than 500 contacts, but do you really know any of them? Would you help any of them; could you expect their help in return?

Perhaps smaller is more beautiful, and it will certainly be more useful.  For many of us, our professional network will be built, in the first instance, from those we work with and then, as we move around, with those we have worked with in the past.  Add to these the people whom you meet in the course of your work — those based in other companies, institutions and even other countries — and quickly the network is built of people you have met and interacted with in person or with whom you have some professional history.  In a virtual setting, we can still activate many of these past contacts that we have let slip.  Most are only an email, or a short video call away.  This is not cold calling, but a reheating of a previous relationship that has simply been allowed to cool. 

But we also need to add new blood to this network and not simply rest on past laurels.  How can we “bump into” the right people without leaving our desks?  The conference is one excellent opportunity.  Many professional conferences are now going online, and they will usually offer networking opportunities for attendees.  Here you will have the chance to connect with like-minded people, perhaps to exchange contact information specifically with a view to keeping in touch. And you might even get the chance to work together on some conference activities with people you have never met.  All of this allows you to meet, albeit virtually, with new people.  With some your paths will never cross again, but with others you may build the contact into a lasting professional relationship.

But how do we nurture the relationship?  Well, we need to keep in contact, but we should not rely solely on email to do that. Contact of any kind is good — to remind people who you are, where you are and what you’re up to — but human relationships are built on more than words.  We need to see each other, so if circumstances preclude any physical meeting, make sure you get on zoom to have your next chat. However, although nurturing is about continuity of contact, it’s not about overpowering— take it gently and be guided by the level of enthusiasm you receive for your suggestion that we might “meet up and have a chat.”  And remember the most important thing about networking is not to ask the question, “what can this person do for me?” but rather, “what can I do for this person?”

Most of the awkwardness and embarrassment that infects our idea of networking are based around the premise that it’s about asking people for things.  Turn that on its head and you will find that networking suddenly takes on a new, fresher and significantly more fragrant feel.  If you approach any encounter with this, “what can I do for you?” attitude, you will quickly find that people respond very differently.  They will recognise your worth to them, but more importantly they will naturally offer you their help in return.

Giving of yourself without any expectation of return is the surest way to receive.  And the things you thought of as apparently small and insignificant that you do for people may result in what seems to be overwhelming generosity.  For example, you send someone a simple piece of information and in return they recommend you for a job.  But of course, although what you gave was only of little value to you, it may have been priceless to them.  Just as although their recommendation cost them nothing, it could change your career.

So, what practical steps can you take?  Here are what I consider to be the five key things:

  • Be active — networks don’t build themselves and you need to put the work in to make new contacts and to keep those you have alive.
  • Be genuine — you don’t want to be associated with someone who is untrustworthy, indiscreet, or fails to deliver, so why would anyone else?
  • Be kind — there are already plenty of unpleasant people working in every professional sphere, so why not distinguish yourself by refusing to be one of them.
  • Be valuable — work at helping the contacts in your network, give of yourself and your time and don’t simply activate relationships when you need something.
  • Be thankful — good manners cost nothing, but they go a long way to lubricating human relationships.  Say thank you, send thank you notes and publicly acknowledge your gratitude when someone helps you.

Putting these into practice in an online setting is just as easy, or just as difficult, as it is in a traditional one.  But if you manage it, you will find yourself effortlessly expanding your professional network and will in turn reap the benefits.

It is possible to live and work without a network, but it is neither as easy nor as fulfilling.  We all achieve much more when we work together; we go further when we pull in the same direction.  Just because we are now working from home, apparently bereft of new contact opportunities, does not mean we cannot work to build our professional networks.  And perhaps now more than ever we might need them.

© Allan Gaw 2020

SlideEasy and The Business of Discovery are now published and available on kindle and they’re free to download if you’re on Kindle Unlimited.

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Also available on kindle:What can we learn from the past that may be relevant to modern drug research?

Screen Shot 2015-10-14 at 21.22.11

“I cannot recommend it highly enough: even if you read nothing else about the origins of drug research and what it can (should?) teach us, read this….This is a ‘buy’.”  Madhu Davis review in Pharmaceutical Physician

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BIS Cover copy
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Please also check out the new YouTube Channel — Writing Space. Short animated videos to help you with your writing.

Putting it together — key aspects of project management

They say that no matter what our role is, we are all project managers.  However, no one ever says that we are all equally good at it.    In reality, many projects fail to complete on time and on budget, and some may struggle even to get off the ground.  In considering how best to meet these challenges, it is useful to define very broadly what we mean by a ‘project’. Yes, it includes those specific pieces of work that we are allocated or get caught up in by chance, but it also includes almost every one-off thing we do—buying a new printer, writing a dissertation or even organizing a family holiday.  All are projects, and all can succeed or fail.

Here are my top tips for ensuring that your project, whatever it may be, will get started, get finished and create as little stress as possible.

  1. Actively manage your project

We know that dinners don’t cook themselves, buildings don’t build themselves and similarly projects don’t manage themselves.  All successful projects need to be actively managed, so the first key to success is simply the recognition that you need to take a very active role. This requires effort, attention to detail and often simply being around to ensure the pieces are fitting together as they should.

  1. Plan your project

The first step in all project management is the planning stage.  To plan well, you need to know where you are going and what it is you are trying to achieve.  This may be easy and well-defined, but often it can be vague, especially if you are trying to put into action someone else’s idea. If the latter is the case, then the first job is to formulate a clear objective. As one wag put it, ‘If you don’t know where you’re going, you’ll probably end up somewhere else.’

  1. Keep your objectives SMART

You may be familiar with the little acronym SMART, standing for Specific, Measureable, Attainable, Relevant and Time-bound.  Put simply, unless your objective is SMART—as specific and measureable as possible and with a clear time-line attached to it—it is unlikely ever to come to a successful conclusion.  Many people have vague wish-lists—think about your New Year’s resolutions—but how many of them ever come to fruition?  That’s not the approach we should take in successful project management.

  1. Recognise the tensions between resources, quality and time

In planning and carrying out your work, remember that in every project there is a tension between the amount of time you have to do it, the available resources you have to complete it and the desired quality of the outcome.  Change any one of these factors and it affects the others.  For example, if you suddenly find you have less time, this may impact upon the quality of what you can achieve, or if the quality cannot be compromised, force you to look for additional resources—often more money or more resources.

  1. Plan for time

Especially with longer and more complex tasks you may have to put particular efforts into keeping the project running on time. It may help to use scheduling tools such as Gantt Charts and approaches such as critical path analysis, but, most of the time, it involves much simpler strategies.  These invariably include making sure you have the bigger picture in mind while also attending to the details, and simply keeping a close eye on the project, especially if you are relying on other people to help out.

  1. Break down projects into small manageable parts

How do you eat an elephant? One spoonful at a time.  No matter how big and daunting the task in hand is, by breaking it down into smaller and smaller steps we can tackle just about anything.  And if you’re working in a team, having a series of discrete tasks is always easier to allocate and monitor.

  1. Consider the opportunity costs

Sometimes when we are planning a project, we delude ourselves into thinking something or someone we plan to use is free, just because the resource is already in place and available.  But, someone is paying for that piece of equipment or that staff member, so to cost a project accurately we need to recognise this and be familiar with the notion of opportunity costs.  What else could you have spent that money on, or used that equipment for, or had that staff member working on?

  1. Be realistic

This last point is probably the most important and tends to come with experience, often painfully so.  The knowledge that almost everything you’ll ever do will take longer, use more resources and cost more than you originally planned will allow you to make better, more realistic plans and ultimately help you complete your projects.

© Allan Gaw 2020

SlideEasy and The Business of Discovery are now published and available on kindle and they’re free to download if you’re on Kindle Unlimited.

Also available on kindle:What can we learn from the past that may be relevant to modern drug research?

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“I cannot recommend it highly enough: even if you read nothing else about the origins of drug research and what it can (should?) teach us, read this….This is a ‘buy’.”  Madhu Davis review in Pharmaceutical Physician

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The Fading Rainbows

 

Like many of you, I’ve spent hours during this lockdown walking.  If I had kept going in the same direction over these weeks and now months, I’m sure I would be in Australia by now. Or at least Cornwall.   I’ve watched the seasons bloom and change, and I’ve seen my fellow walkers change too.  At the start, as we side-stepped each other to avoid any close contact, we would smile and nod and exchange a cheery greeting to soften the distance we had so rudely placed between ourselves. In recent weeks, perhaps as the fatigue of it all has taken its toll and as some seem to think it’s all over and back to normal, those smiles and nods have noticeably diminished.  And what has also changed are the rainbows.

In the spring, when all this began, the windows of many of the houses I walked by on my daily trudge to get my steps done, started to be adorned by brightly drawn and painted rainbows.  Most, I’m sure, crafted by eager young hands, but surely at the urging of their equally eager parents.  It was a show of solidarity for the NHS in a time when everyone suddenly realised just how important health was and the relative unimportance of just about everything else.  But, over the months, these rainbows have slowly lost their colour.  And one today in the front window of the corner house on my morning march, was almost gone completely.  As the coloured felt-tips of our four-year olds fade, it might be the moment to contemplate what might be on the other side of that rainbow.

I have worked in or closely allied to the NHS for the last 36 years and I am not a hero.  Indeed, I have never met any.  Nor have I encountered any angels or saints along the way.  What I have met are women and men who work tirelessly at doing an often very difficult job.  They train long and hard and continuously for their diverse roles and most of them are paid less for their work than the person who fixes your computer, your roof or your leaky tap.  During this pandemic, the NHS workers have been at the forefront of people’s minds, or at least they were.  Now the clapping on a Thursday evening has ended, and much of the news coverage has quietly shifted away from scenes of exhausted staff overladen with the burdens of poorly fitting protective clothing and long shifts.  There is understandably a great desire to get back to the normal we took so much for granted only six months ago, but need that normal include taking our NHS for granted all over again?  We watch the hypocrisy of politicians rhapsodising about the selfless sacrifice of NHS workers and almost in the same breath denying them free parking in their hospitals. And we will undoubtedly see no reflection of this national outpouring of appreciation in the pay packets of the most poorly paid in the NHS or in the funding for newer, better facilities in which to work.  Indeed, we are hurtling towards a very different NHS, if our present administration has its way.  Those NHS services that can be readily monetised will be and are almost certainly on any negotiating table for future trade deals with the United States.  As well as working in the NHS, I have also lived and worked in the US, where I have been a user and observer of healthcare.  Let me say in simple, unequivocal terms that their whole approach to healthcare will mean the end of our NHS.  No matter how ill my child was, I had to provide my credit card details before I could get through the locked door of A&E; the patients I saw would sit in the waiting room wondering which of the two drugs they had been prescribed they could afford to buy; and I witnessed people and their loved ones bankrupted by their cancer care.

Because almost everyone alive today in the UK has lived their entire adult lives in the security of the NHS, we have all but forgotten what it was like before.  It is up to everyone to make sure that no one is under the illusion that something from America must be better.  Better for financiers, for investors, for commercial healthcare providers, yes, but not for anyone who ever gets ill, and that of course is everyone.

The NHS staff do not want rainbows, although I’m sure few objected to the bright drawings of countless children up and down the country.  What they want is acknowledgement of their worth in tangible ways and the pledge that the NHS is safe from outside interference which will ultimately destroy it.  And it’s not simply altruism, NHS workers are just people and they need the NHS too. Let’s ensure those fading rainbows are not a metaphor for what’s to come.

© Allan Gaw 2020

 

 

SlideEasy and The Business of Discovery are now published and available on kindle and they’re free to download if you’re on Kindle Unlimited.

What can we learn from the past that may be relevant to modern drug research?

Screen Shot 2015-10-14 at 21.22.11

“I cannot recommend it highly enough: even if you read nothing else about the origins of drug research and what it can (should?) teach us, read this….This is a ‘buy’.”  Madhu Davis review in Pharmaceutical Physician

Also available on kindle:

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