Sunday, 15 March 2015

Defying gravity, finding balance

I'm just done with a three day meeting in Chicago. It's been thought provoking, and has jump started my thinking about the next phase of my life and career. This postdoc, wonderful and intellectually enriching as it is, won't last forever. And if there's one thing my PhD taught me the hard way, it's that you can never start planning too early for the next move.
This conference was unlike any I've been to before. It was a clinical research conference at which Ph.D.s probably were a minority. Most of the paper presentations consisted of retrospective analysis of patient case studies, and one of the major keynotes was essentially grand rounds. The neurophysiology lectures were few, and only two labs presented work on animal models. My PI left frustrated at the state of the basic science in the field. I left... unenergised. I took notes on maybe three talks, and these are people whose work I'm already aware of. This meeting was also the first one I've ever been to where every session ended with several minutes of rambling interventions by questioners from the audience that added almost nothing to the presentation. In my own talk (generally well received) the dominant question was simply an attempt to invalidate the clinical relevance of the research based on something that, well (yes I'm biased) totally missed the forest for the trees.
I'm from a basic science background in a field with relatively little translational potential. Yes, people turn to paleo to understand the potential effects of climate change on faunal transitions, but the immediate applications of such knowledge are limited. And although I will defend with every inch of my being the notion that any useful knowledge on human biology cannot be derived without some understanding of mammalian evolution, again, there are several steps between this, and clinical research. I have, from the beginning, been somewhat apprehensive about working in a more clinical focus. At 18 and again at 21 I turned down the opportunity to become a physician to pursue science. I don't think like a physician. There is mutual frustration in the clinician/basic science researcher relationship, as there is between any two groups with a narrow area of collaborative interest but broadly different focuses and approaches. And I have a lot of sympathy for the clinical perspective. We may harp on about lack of mechanistic and physiological understanding of the symptoms we're studying, but clinicians still have patients that need care here and now and cannot wait for a new, physiology driven paradigm to emerge. Yet, to me, the frustration remains, and I have to decide if the potential benefits (increased opportunities for research and funding yes, but also the knowledge my research has a measurable impact on people's wellbeing) are worth coming to terms with that frustration, and learning to build a dialogue with the clinicians willing to take the field forward. Professionally, this postdoc is a crossroads with two very different paths out of it, and this meeting has re-emphasised that some commitment on my part will become necessary soon.
Related was my reaction to being back in a big city. I am a city boy at heart, and after over a year in rural North East Ohio the effect of being in Chicago was electric. Riding the blue line from O'Hare was exciting enough, but walking through downtown Chicago to the hotel, my heart rate doubled, my pace accelerated. For the next three days I was like a kid in a candy store. I went shopping with pleasure for the first time since I left London. We explored secret hipster bars and sang karaoke and went to wonderful, innovative restaurants. I miss that, so much. I miss there being a world of excitement and delight and pleasure on my doorstep. And so I am reminded that, next time I move, I don't want to end up at another great job in a place that bores me. And yes, I know that sounds snobbish and privileged. And I am aware that living in a place like Chicago is challenging on an academic salary (I turned down a postdoc there in part for that reason). But I am also now sure of what I want in terms of quality of life from where I live. It will be difficult to get a professor gig I enjoy. It will be harder still to get it in a place I enjoy. But for myself, I need to try and do both. And if I can't do both, I will have to choose (or, as my mother would put it, life is more likely to choose for me). On the one hand, compromise and choices from imperfect options are the essence of life. On the other, life is lived only once, and I intend to get as much out of it as I can. It's a dynamic, unstable equilibrium at best, but I am still young enough that I want to at least try to have it all.

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