I am so excited by todays’ guest blog post. I’ve been so eagerly awaiting sharing it with you all. I don’t have any tattoos myself but it is something that is common amongst my friendship group, and I get asked about tattoo related infections A LOT. Partly as I was involved in some of the investigations when there was an issue some time back. So, a post that could help address some of the risk assessment and best practices linked to this art form felt very necessary, even though I didn’t feel I was best placed to write one. Then I saw this great article from Julie Russell on LinkedIn and I just had to reach out and see if she fancies writing a guest blog for me, and thankfully she said yes!
I first met Julie as Head of Culture Collection at Public Health England, that has since changed it’s name to the UK Health Security Agency. She was an inspiring microbiologist, who just had so much knowledge, and she became a great phone a friend. Since then she has moved on to work in a really different area where she still gets to put her microbiology and infection prevention and control knowledge to good use, as the director of a tattoo/art studio in Muswell Hill. No one is better placed therefore to answer the questions that I always get asked and have not felt best placed to answer.
Blog post from Julie Russell
After years in NHS microbiology laboratories, I joined the Public Health Laboratory Service, where I provided external quality assessment schemes and reference materials to laboratories worldwide. After that, I decided to do something completely different. I now co-own and manage Old Marine Arts Group, a tattoo studio in Muswell Hill, London.
It hadn’t occurred to me that tattooing, one of the oldest art forms in the world, essentially creates controlled wounds on people to decorate their bodies. I’ve had tattoos since my 20s – my first done in a legalised squat by a friend who’d never tattooed anyone in his life before. There was no personal protective equipment (PPE) involved; it healed beautifully, and I didn’t think about it anymore.
Many thousands of people across the UK have similar stories with no ill effects. Yet infections linked to tattooing have been recognised since the 19th century, and the government quite reasonably seeks to minimise such risks.
Tattooing, Skin, and Infection Risk
Bear in mind that the skin has a rich, diverse microbiome consisting of millions of microorganisms, some of which can cause infections if the skin is broken. Tattooing involves puncturing the skin with needles thousands of times, to a depth of approximately 1.5-2 mm, to place pigment into the dermis, creating a permanent design. Invariably, the tattoo process causes some bleeding, and after it’s finished, short-term redness, swelling and scabbing are normal. Resisting the urge to scratch is essential to minimise the risk of infection.
A July 2024 YouGov1 poll suggests 28% of UK adults – around 15 million people – now have tattoos. The UK Health Security Agency (UKHSA) notes that the true prevalence of tattoo-associated infections is unknown. There are no statutory notification procedures in place for infections specifically caused by tattooing, and no indication that such infections significantly burden the NHS. Various estimates suggest that approximately 1-3% of tattoos become infected in the UK. Most infections are mild local skin infections that can be treated with a single course of antibiotics; severe infections remain rare.
Interpreting the Evidence
Publications on tattoo-related infections must be read with caution. A December 2024 paper in The Lancet Microbe2, “Microbiology of tattoo-associated infections since 1820”, highlights rare severe cases such as necrotising fasciitis, leprosy and atypical mycobacteria outbreaks. The authors state that, “Despite advancements in public health policies and increased awareness of tattoo-related risks, a notable rise in both the number and diversity of microbial infections has been observed with an increase in the population opting for tattoos, particularly since 2000”. However, they provide no population-level denominators and conflate expected irritation, redness and swelling with true microbial infections. The authors fail to note that severe cases are overrepresented in the literature precisely because they are unusual. The paper may be a useful clinical catalogue, but it is not an incidence study.
A Brief History of Safety
Tattooists and clinicians have long recognised infection risks in tattooing. In the late 1800s, some artists infamously spat into powdered ink and sucked the needles during the tattooing process. Meanwhile, London-based artists in the early 1900s, such as Alfred South, promoted “the most perfect antiseptic treatment, painless and absolutely harmless”, whilst Tom Riley warned: “Caution to Ladies and Gentlemen thinking of being tattooed – First see the work of two or three tattooists then make choice {sic}. See that a complete set of new needles are {sic} used at each sitting as well as antiseptics”. Some early tattooists even wore white coats to convey a clinical level of cleanliness.
Legal regulation, however, arrived much later. It was still legal to tattoo children in the UK until the Tattooing of Minors Act 1969. Some aristocratic families reportedly tattooed babies for identification – in case, for example, their children were hospitalised or kidnapped.
Modern Regulation
Mandatory licensing changed the landscape. Under the Local Government (Miscellaneous Provisions) Act 1982, tattoo studios need to be registered. More recently, there is the British Standard BS EN 17169:2020, which covers safe and hygienic practice, although not many councils use it as a benchmark. This standard covers workplace preparation, equipment sterilisation, PPE, client consultation and aftercare. It requires studio owners to implement a comprehensive hygiene protocol to protect clients and staff, and tattoo artists to provide evidence of continued professional development.
Wales now requires tattooists to complete and pass a regulated Level 2 Infection Prevention and Control Award. Requirements in England and Scotland are less specific. Barnet Council licenses my studio; their Code of Practice 13 details the specific requirements for tattooing activities, in addition to those laid down in the Regulations applicable to all special treatment licensed premises. It notes that tattoo artists who are unable to demonstrate hygiene competence may be asked to complete a Level 2 hygiene certificate.
Reducing the Risk
Infection risk can be reduced through:
Good personal hygiene (artist and client)
Effective cleaning
Separating clean and dirty materials
Correct sterilisation or disposable equipment
Artists must assess clients for skin issues (including rashes, moles and scarring), alcohol or drug use, and relevant health risks (e.g. allergies, immunosuppression, pregnancy). Artists must be vaccinated against Hepatitis B.
Tattoo stations should be treated as clinical areas. Equipment must be protected from contamination; inks must be decanted into disposable cups; distilled water used for dilution of ink and ‘green soap’ (a vegetable-oil-based surgical soap used in the tattoo industry) or for washing the needles between colours.
Dressings applied afterwards are usually transparent, self-adhesive, polyurethane film (known as second skin in the industry), similar to those used for burns and post-operative incisions, or cling film attached to the skin with surgical tape. Clear aftercare guidance should be provided verbally and in writing about how to care for the tattoo whilst it heals (no swimming, spa pools, sunbathing, perfumed soaps or scratching).
Unlicensed Tattooing
Although it is illegal to tattoo in unlicensed premises, this is rarely enforced. Anyone can buy machines and inks online and tattoo friends at home, often with limited knowledge of hygiene.
Inspections across the UK vary, with some councils inspecting only once when the studio opens, while others do so more regularly. Licensing rules differ widely outside the UK. Excellent tattoo studios can be found abroad, but so too can be deplorable hygiene. Getting a tattoo may be a more permanent souvenir of a fun holiday than a fridge magnet, but it can be risky, and alcohol and sunshine don’t help healing.
Final Thoughts
Tattooing in the UK, when performed by licensed professionals, carries a low risk of infection. I believe the demand for tattoos will grow, and I support nationally enforceable, pragmatic safety standards.
Takeaway messages:
Tattooing by licensed professionals in the UK is low risk
Nationally recognised training and regulation are likely to emerge
A tattoo is a controlled wound—so please, as I once observed, don’t let your dog lick it
Kondakala, Sandeep et al. Microbiology of tattoo-associated infections since 1820 The Lancet Microbe, Volume 6, Issue 4, 101005
Training For Aspiring Tattoo Artists:
After two years in the tattoo industry, I now work with licensed tattoo artist, TomCatTatt, to provide introductory training for aspiring tattoo artists, covering the basics in safety and hygiene, legislation and licensing, and an introduction to tattooing techniques. Contact me for more information: julieru13@hotmail.com.
I’ve just dipped my toe into the world of self publishing, so I am far from an expert. That said, one of the reasons it took me a while to move from ‘that is something I’m interested in knowing more about’ to ‘screw it, let’s just give it a go’ is because there is a lot to think about, and there are a lot of options. I thought it might be useful therefore to pull together some of the components that came up for me in an effort to pay it forward, so anyone else thinking about taking a leap can start a little further ahead than I did.
Fair warning, this is a long one as there’s a lot to cover.
The first thing to say, and this now sounds horribly naive, is that I thought that the writing would be the hard part, or the bit that took up most time. How wrong I was.
Before I properly kick off though, one quick word of warning. These are tips and reflections on the steps I took for the type and method of publishing that worked for me and the book I wanted to get out into the world. You will, of course, have your own aims, aspirations, and content type, so you will need to do research that links to the type of book that is in your mind. I found that there is all kinds of great content out there, but it is a bit like a jigsaw puzzle you need to put together to match your own personal needs. I would start by working out what personal resources you already have available to you, then go on an active search for the rest.
Places to consider accessing information include:
YouTube
Blogs
Websites
Books
Social media
Phone a friend
I am really fortunate to have a number of friends who have either written and published books, or who work in/with the publishing industry, and so the phone a friend option was particularly useful for me. I’m hoping that by writing this blog I am helping to pass that good fortune forward to support others.
Even without the assistance of someone who has greater knowledge than you in your friendship circle, I found places like YouTube a great way of learning some of the key phrases and structural terms that then enabled me to move onto more targeted research via other sources.
Writing is the easy part
I don’t know if I’m fortunate or cursed to live with a mind that constantly requires distraction or something challenging to process, but one advantage of it is that I will often arrive at an idea pretty fully formed as I’ve been putting it together in the back of my mind. That means that one day I just woke with a 40 chapter structure for a book that remained pretty much unchanged, even as the word count developed.
Even with this though, in my project plan most of my time was allocated to word count and far far too little of it was allocated to the other tasks. Partly this was because I just had no idea how long they would take in practice until I came to do them. In hindsight though, I think there was a fair amount of denial and ostriching as it was these other parts that triggered my anxiety and fear linked to not really being comfortable with the process. This denial got me to the finish line, but I think the whole book preparation would have gone more smoothly if I had focussed on my discomfort rather than the comfort zone that was the writing process.
What are you planning to publish?
Talking of your project plan. There are some components that it is really helpful if you make decisions about early, as they will impact not only your workload and structure, but also whether self publishing is the right route for you.
The first of these decisions is whether you are working towards a fiction or non-fiction book. I don’t think I’d ever sat down and made a list of the differences between the two until I started to plan both types of content. The first obvious difference is in the type of the content itself, but beyond the actual words, which may have legal and other impacts for non-fiction, there are differences in everything from word count expectations, to paper type, and book size, if you are thinking of including print versions.
This then brings you onto deciding what kinds of formats you are planning to publish in:
Ebook
Print:
paperback
hardback
Audiobook
Now, I haven’t done an audiobook so I’m not going to talk too much about that here. For the other format types it’s key to know what formats you are aiming for as this will dictate all of the formatting, cover and costing decisions you will make moving forward. That said, just because you decide to aim for more than one format it doesn’t mean that they all have to come out simultaneously. You could decide to aim for an Ebook first, with a plan to bring print editions later on.
It is worth doing some bench marking with similar book topics at this stage, not because you have to do what everyone else does, but because it can give you some parameters to work with and mean you feel less overwhelmed by the number of decisions you need to make. I ended up launching all content type pretty simultaneously, as that’s what worked for me, you may choose to take a route that is kinder to yourself and launch them in stages. For instance you may launch your Ebook first so you can incorporate feedback before you move to print editions.
What are your success criteria?
The other key thing to do at this point is to decide what does success look like for you? Almost all of your next steps and decision making will depend on what success looks like and what it is that you are wanting to achieve.
No one can tell you what the answer to this is as there are many different reasons people decide to write books, all of which can be valid:
To educate and inform
To raise awareness of an issue/topic
For financial reasons
To improve the authors profile
To entertain
To process experiences
To tell a story
To connect with others
For career development
To inspire/empower
Once determined your success criteria should play a big part in determining your approach. If you want to make money or sell thousands of books then you probably need to aim for a traditional publishing approach, and this will then impact the kind of topic that you might choose. If your aim is to get something out there for low cost or in a relatively niche topic, the self publishing is probably a way forward.
You need to be realistic with what you are aiming for. For instance, my book topic is relatively niche as it’s linked to post graduate study, and when I did my research it looked like I could expect to sell 2 copies a month based on amazon purchasing number (I used Book Bolt on free trial to run the numbers). My goals and expectations were therefore based on those figures. My initial goal was to sell 20 books in a year, with stretch goal of selling 60. My success criteria have never been about selling huge numbers or making money, but about finding a different way to support the Girlymicro community, and therefore my goals match that. What’s happened in practice in that I’m over the moon to have reached my stretch goal in the first six weeks since publication, but I am also aware that those numbers are likely to drop off and I can’t use them to continue to judge how well the book has landed. If you don’t want to be disappointed it’s important to choose the right success criteria to match your driver for publishing in the first place.
Traditional vs self publishing
Once you’ve decided what it is you want to write, why you want to write it, and what success looks like, then you need to choose your next steps. The biggest of which is to decide whether to pursue traditional publishing or go for self publishing. Now, don’t get me wrong, both are a lot of work and require a lot of prep, but the steps are very different.
For traditional publishing you will need to start to put together a proposal, which for a fiction book will include the entire manuscript of your book plus some additional information. For a non-fiction book it will usually include at least 2 chapters and chapter outlines with descriptors for the rest of your content, plus information on other things you have written, target audience, and other books on the market taht could be used as benchmarks. The aim is to get an agent who will then pitch your book to a publisher, although for some markets you can approach a publisher directly, who will then take care of onward processes such as editing, formatting, cover production. A lot of the non-writing work is therefore forward loaded. There’s lot of advice out there on how to put together a book pitch and there are websites such as Query Tracker that can help you in finding agents to send your pitch to. For fiction this is still a mainstay of publishing, especially as you are wanting to reach wider audiences and have your book available in book stores and libraries.
In terms of self publishing, a lot of my reading indicates that up to 90% of non-fiction books now go down the self publishing and print on demand routes. Non-fiction book deals either tend to be books that have wide audience appeal, such as general popular science books, or have authors with a pre-established audience, think influencers with a million+ followers. So, although it may be worth your while pursuing a traditional publishing approach, it is well worth considering exploring the self publishing route. The down side of this route is that there a lot of tasks that you will need to organise yourself, which would have been taken care of if you’d traditionally published, so be prepared for a steep learning curve.
One extra thing to think of is how strong is your vision is. If you go down a traditional publishing route there will be co-development of your concept with a number of stakeholders. This will make the idea better, but you need to be prepared to hold onto your concept loosely, especially as a new author, and so it is worth considering this aspect of development as part of your decision making. If you go down the self publishing route you will have to fight harder for the credibility that is given to traditionally published authors however, so both routes have pros and cons to consider.
What kind of content are you planning to include?
OK you’ve decided to go down the self publishing route but what does this mean for your content? Content restrictions weren’t something I had considered when I started drafting It Shouldn’t Happen to a PhD Student, and so I included a load of exercises to support the word count that included tables and other non-text formatting. When I then started to format however, I discovered that the templates are set up for text alone, as novels only include text content. This seems obvious in hindsight I guess. That meant that when I undertook my final formatting I ended up removing this content and setting up a new web page on the girlymicrobiologist.com blog in order to host it, as it felt that it was still important to have. This was a lesson for me in how important it is to consider what type of formats are needed to support your content and embed these considerations from the start, rather than finding an eleventh hour fix.
Having discovered the format restrictions of book based content I’ve been thinking of maybe putting together an academic journal set of content that can sit alongside the book in order to host some of these exercises, but that requires finding a whole different set of templates or learning waaay more in order to set ones up myself. Honestly I’m not sure I have the mental energy for that right now. One of the things this experience has taught me is to think hard about the payoff for any energy you will need to expend in order to make something happen and be conscious in your decision making and energy allocations.
Choose your budget
Another thing to consider is that there are many ways to accomplish the tasks you will need to tick off in order to self publish, and the decisions may be more complicated than you think. There are a number of steps, each with a number of component parts, all of which could be outsourced, semi-outsourced, or managed by you:
Editing
Cover
Formatting
Marketing
Printing
Publishing
Book coaching
If you decide to outsource all of these stages, the process of self publishing could, in fact, cost you thousands of pounds. If, like me, you don’t have thousands of pounds just lying around you may need to think carefully about what you can spend, and on what you are prepared to prioritise spending money on.
I didn’t really have a budget for publishing It Shouldn’t Happen to a PhD student, as I didn’t have the disposable income, even so publishing the book ended up costing me several hundred pounds. Costs included things like buying ISBN numbers as I didn’t want to be completely tied into Amazon as a platform. In addition to direct book costs, you need to think about how you will get the word out there or build your community. For instance, many people aren’t aware that running this blog costs rather providing income, with a few hundred pounds a year in outlay to cover hosting costs, email address etc*, which although not directly book related is the reason the my book came into existence. This can all be important to bear in mind when looking at costing your book, and thinking about marketing exercises such as book launches, as you will have to buy in copies of your book, spend money on food etc, all of which adds to your initial outlay.
If you do have personal budget that you are prepared to invest then it is still worth being discerning with how you invest, and especially being aware of predatory publishers. There are plenty of people out there who will take your money, but spending time to look at freelancers who will undertake components is probably better than paying someone £5000 who offers to do it all, especially if there is limited evidence of what the output would look like. Just like in scientific research, predatory publishers exist, and it is important to have undertaken sufficient research to invest your money well.
*NB a good friend mentioned to me that I don’t advertise the fact that you can help with the costs associated with running this blog through a variety of options, from supporting the annual fees (mentioned on the top of the homepage where is says gift the author a wordpress.com plan), buying me a cup of tea as mentioned on the bottom of the blogs by theme page, or even engaging with my new Patreon page. There you have it, I shall swallow my pride and share the details with no expectations or requirement for anyone who might be interested in offering a helping hand.
Where are you planning to sell?
A number of your outlay and pricing decisions will be linked to how and where you wish to sell your books. Obviously, if you are traditionally publishing, all of these options are somewhat easier as they will try to make sure your book is widely available. If you are self publishing you need to decide yourself where it is that you are prepared to sell. Some simple choices, like whether to use a free Amazon ISBN or buy your own, will have significant impacts on subsequent onward options. If you use a free print ISBN from Amazon, then it limits you to only selling on Amazon. Deciding to invest <£100 on ISBN numbers for each of your print editions means that you can choose to sell on different platforms in addition, but also has requirements about providing editions to the British Library, meaning you have to buy the print copies to send off and pay for postage. If you want your book to be in libraries you also need to select these options on your print on demand platform, but they are much less likely to be taken up than if you were going down a traditional publishing route. There are no right or wrong decisions here, only the decision that is right for your success criteria and the audience you are trying to reach.
If you are happy to go down the print on demand route, there a number of different free options available to you:
The best option will depend on what you are publishing and the countries that you are hoping to publish in. It is worth bearing in mind that some platforms (such as KDP) require you to give exclusive rights for you to be involved in certain marketing options, such as signing up to Kindle Unlimited. This may expand your reader market but will tie you into a specific platform. There are also paid for distributions platforms that you could utilise if you have decided to allocate budget in that direction. Of note, there are some interesting YouTube videos out there where authors compare how much they sell across different platforms which can help you make decisions. Utilising multiple platforms requires you to invest energy across multiple formats, and so it is also worth being honest with yourself about what your energy budget is before committing to more than one, even if that might restrict your sales.
Finding your templates
I’ve talked about deciding on your content, and that’s because formatting is time consuming and essential. You may be a wiz at this, in a way that I am not, but if it doesn’t lie in your skill set then being able to access and utilise pre-existing templates is key. Even this can be a mine field though as there are both free and paid for versions available to you. You also need to know a number of things before choosing your template i.e. is it for print or Ebook, as the templates are very different, but also what size of book are you aiming for, as your paperback version will be a different size to your hardback. I did a bunch of research into what are the most common book sizes for non-fiction hardback and paperback versions, but even this changes by country, so you will need to look into what works best for you. I ended up going for 6 x 9 inches for hardback and 5.5 x 8.5 for paperback.
Having tried a few different options, these happen to be the best templates that worked for me and my brain, you may find others work better for you:
Even with the best templates there is a good deal of fiddling once you’ve imported your content, so make sure you leave plenty of time for this part of the process. I didn’t and it meant a number of 14 hour days whilst on leave trying to ensure I could keep to my self imposed deadline.
Choosing your pricing
I, misguidedly, thought I could price my book at whatever price point I fancied, but rapidly learnt that this wasn’t the case. All of the free self publishing platforms take a cut of any print on demand book, which is how they cover their costs. Everything from number of pages to paper type will impact on what your minimum cost point will be. For Ebooks, if you want your book included in schemes, like Kindle Unlimited to maximise your reach, you will also need to have minimum pricing levels. This is one reason why you need to have decided on where you want to sell and some of the book details before you start to think about pricing. Think about the fact that certain paper types are used more commonly for certain book types, and that choosing between them will impact on cost.
Helpfully, you can use things like the https://kdp.amazon.com/en_US/royalty-calculator in order to play around with likely book parameters to start to think about what your pricing range might be, even before you have fully completed the templates, to know what the final page counts look like. I have included a random example below so you can see the type of information required:
Once you have entered the information, the royalty calculator will tell you what the minimum price point will be, and from that you can think about what price you may need to charge to cover your costs.
If, like me, you are publishing not to make money but merely to cover costs, you should think about charging minimal amounts in order to maximise accessibility for those who may benefit from your book. If you have spent more on bringing your book to market, you are also likely to need to charge more in order to make your accounts balance. This is another reason why I invested my resources in terms of time rather than financial, as I didn’t want to have to charge more which could limit the book reaching those who would benefit most. This aspect may be less relevant to you, depending on your reason for publishing in the first place and so costing is a personal choice.
The book blurb
Once you have your book written, one of the final steps is thinking about what you are going to write on the back cover in order to help it reach its target market. I found this part, well to be honest the cover in its entirety, a bit of a nightmare. So these are the points I thought about when deciding what to write:
Keep it 150–200 words — short enough to hold attention, long enough to inform
Write in the third person to help you connect directly with the reader
Test different versions — your blurb is a sales tool, not just a summary, no matter how uncomfortable that feels
Think about your structure:
Start with a hook
Open with a single sentence that speaks directly to your reader’s problem
Identify the reader’s goal
Show you understand their challenge or aspiration. Use empathetic, relatable language and speak to how you will address it
Give your unique selling point
Briefly explain what your book delivers and why it’s different
Be specific
Build credibility
Mention relevant credentials, or experience
Give a taste of what’s inside
List 3–5 bullet points of key takeaways
Finish with an invitation or call to action
You can then also use this to help write the wording you will need for the websites you are selling on as an expanded version, and even use shortened versions of it as part of your marketing tools, such as on postcards.
Recognise the skills you have and the skill you don’t
The biggest aid in all of this planning was to be very honest with myself about the skills I have and the skills I don’t have. I am not artistic in any way, and so I knew that I would struggle with not only cover formatting, but with cover design. I know that I am able to utilise a word template, but that I don’t have the skills to make a word template. I know that editing is not my thing. All of the components that I recognised as weaknesses I actively sought out support in order to help me address. I roped in a number of people to help with copy editing, including Mummy Girlymicro. I roped in Mr Girlymicro, who is a keen photographer with an artistic eye, who worked with our good friend who works in book design and publishing Alice Wallace, to help with the cover. I found templates that made up for my lack of formatting and design skills for the internal contents. I was prepared to be honest with myself about where I fell short, and I invested time in learning what options were available to compensate. All of these weaknesses could be countered by outsourcing, but that wasn’t a financial option for me, and I feel that I’ve learnt so much in going through the process and the discussions. Something I would have missed out on if I’d paid a third party. That said, the learning feels worth it for me as I have plans to get more books out, if you have budget and you are only doing this once the decision making is likely to be different.
Find your cheer squad and support team
All of this brings me onto the importance of finding your cheer squad. I spent a lot of hours and a lot of leave on turning an idea into reality, and you can never do it alone. I used my ‘phone a friend’ system, my network, and my family, all of which helped with getting this project across the line. They helped me not only with the technical aspects, but also in managing the emotional aspects. There were a lot of highs and lows. To be honest there still are. Putting yourself out there always requires a certain level of bravery. It is always easy for people to find a way to criticise, or use this as a way to comment or target what you’ve tried to achieve. The other side of this coin though is how wonderful it is when people get behind you, cheer you on, and take the time to invest in you and your concept. When people came out for my book launch it meant the world. No one has a lot of time or money right now, so anyone investing in something I care about has such meaning, and makes the whole thing worth it. When I hear negativity, it is that which I focus on to aid in processing my responses.
The nightmare of a cover
Now, I’m just going to use this section to give the biggest ever thank you shout outs to Mr Girlymicro and Alice Wallace. I genuinely believe that there is one part of this process that I couldn’t manage, even if you gave me a month of full time capacity to play with it. I’m talking about The Cover! I’ve attached the guide link below, but even with this I don’t think I could have achieved it. It is the one part that I just couldn’t get my head around.
There is so much maths involved, let alone the actual design process. That maths changes based on the precise number of pages, but also what those pages are. Can you believe that cream paper is a different thickness to white. I had no idea.
I mention this in order to be transparent that you too may hit certain components that you just can’t get your head around. That’s OK, you can’t be good at everything. More than that, it’s OK to have things that just fill you with so much anxiety that you can’t face them. For me that was the cover, for you it may be something else. The main thing is to have a plan in order to counter these obstacles before you get to the point where it will impact on your delivery.
The submission process
Once all this is done, it is time to submit. I had thought this process would be much faster than it was, and so now I’ve done it I would recommend allowing at least a month window between submission and having any marketing or other components planned. Nothing is immediate. Once uploaded, and this in itself took a number of attempts, all versions need to be checked out by the platform you upload to. For print versions you will also want to build in time to order proof copies (which will need paying for) in order to check you are happy and that your formatting has worked before you release them out into the wild.
My top tip for this stage is to have pre-completed the boxes and info where possible in order to allow you to focus on just the upload when the time comes. This means that fairly early on in the process you want to have set up accounts, provided registration information, undergone identity checks, so that you can start you populate the appropriate pages. I would do the account setting up as part of the research phase of your book development.
Bits I hadn’t thought about
There were several things I had not even thought about before I started this process. For instance, I didn’t know that you had to buy ISBN numbers, let alone that you need one per format and one per edition, and so you can end up needing to buy quite a few. You don’t need an ISBN for Ebooks but if you don’t want to be tied to Amazon (who will give you a free one for use on the Amazon platform) then you will need to buy them for your print versions from here (if UK based) https://www.nielsenisbnstore.com/.
This brings me onto another thing I didn’t realise. If you have a print book you will need to submit a copy to the British Library within a month of it going live for sale. This will require you to have a copy to send and to pay for postage. They may also request that you send 5 copies to a separate address which means they can then be considered for purchase by libraries. All of which is great, but will require you to have brought enough books to post and has cost implications.
Other outlays I hadn’t thought about were the fact that you need technology to sell books, by this I mean the ability to take card payments. This one completely passed me by until Mr Girlymicro mentioned it, and then thankfully he spent a bunch of time looking at how to make it happen before recommending something. He ended up recommending Zettle, which has worked really well. Again, there was no point in spending a lot of money on this as I wasn’t planning on going to book fairs and selling thousands of copies, however it did mean I could sell copies of my book at the book launch, which made the expenditure worth it.
Finally, I was so focussed on getting the book out there that I don’t think I’d prepared myself for some of the commentary. Now, I’ve been really fortunate so far that almost all of the comments have been positive, but there have been some people who I felt were less happy about me a) getting a book out there and b) it being well received. To be honest the same has been true about this blog on occasion. Questions such as why you? Why should anyone care what you have to say? Don’t you have better things to do with your time? Nothing is going to be universally well received, and at some point someone will no doubt put up a review that breaks my heart. That doesn’t make the endeavor any less worth while. It is better to have something real out there that can support people than wait until it reaches a point of perfection and not putting something out for years. Nothing will please everyone, and so being prepared to cope with critique thrown your way is something to be prepared for.
The discomfort of marketing
Once the book is live is to a certain extent when the real work actually starts. There is no getting around the fact that if you want your book to reach the people it could help or who will find it interesting then you are going to have to tell people about it. It is not comfortable but you have to channel why you decided to do this in the first place and focus on that to overcome the discomfort.
This is one of those things that if you have gone down a traditional publishing route may have been more supported but you would still be expected to drive sales on your own. Make sure that you have an idea of where to show content on social media, make accounts if you don’t have them. Think about using stores like Vistaprint to print postcards, book marks, and in my case giant foam boards of my own head, to help with advertising. Again, this is an initial outlay to be aware of. You will also need to buy a number of copies of your own book so you will have some to sell, and that requires thought as you don’t want a hundred copies that will just sit around and do nothing, so how many is enough?
Think about having an event to kick off and celebrate that you have turned a concept into a reality. I was so worried about having a book launch, but it was actually just a wonderful event. It felt so lovely to see people hold physical copies of the book in their hands for the first time and see their reactions. You can also see the people who are really there to show up for you, and it’s a great way of giving back and thanking the cheer leaders who’ve supported you along the way. Note of caution, this is another one of those things that is lovely but will also cost you money, so be prepared to outlay a few hundred pounds if you are going to do it, as you will need to pay for everything from books to catering.
If you have budget, this is another area where you can choose to invest. There are places on the Kindle Direct Publishing page for your book where you can choose to pay money to have your book featured, social media pages will let you run adverts, and you can even pay companies specifically that do this kind of work. I don’t have the budget to go down that kind of route but if you choose to give it a try let me know what your learning and advice is and I can share in a future post, or better yet write me a guest blog.
The long and short of it is that your book won’t reach the people you’ve written it for if they don’t know about it, so suck it up buttercup and get your marketing hat on. No matter how uncomfortable it makes you, and it makes me very uncomfortable, there is no getting around it. If you can find friends and/or champions who will talk about it on your behalf that is a life saver, but you will not be able to avoid putting yourself out there. You wrote a book for a reason, this is the time to remember that reason and step out bravely in order to make your success criteria happen.
In that vein, if you want to check out the final version of my labour of love, you can find the link below:
It’s the most wonderful time of the year! It’s time for the annual Environment Network meeting, where we get together to talk all things environmental microbiology; sharing new research and experience to improve practice. And your guide for the conference this year, live blogging the morning session, is the token immunologist in the group, Dr Claire Walker.
What is the environment network?
Before we get onto todays’ content, a little introduction to what the Environment Network is.
The Environment Network works to support people in clinical, engineering and scientific roles who are interested in environmental infection prevention and control (IPC) and/or the built environment
Do you want to know more about what to do with your water screening and air sampling results? Are you keen to understand the evidence behind equipment cleaning and the role of the environment in healthcare associated infection?
Then welcome to the Environment Network!
This is a network for people in clinical/scientific/engineering roles within the NHS and other associated organisations who are interested in the role of environmental infection prevention and control in preventing infection.
The aim of the network is to support infection prevention and control professionals involved in commissioning, environmental audit, water, air and surface testing within their Trusts. By working together we can share best practice between Trusts; as well as circulating the latest evidence and discussing personal experiences.
What are the aims of the network?
To support the development of member networks
To provide events where shared learning can be supported
To permit sharing of experiences and best practice to improve clinical interventions
To support and share research in order to achieve improvements in evidence based practice
What is our remit?
Environmental testing and monitoring within healthcare environments
On to today. First up we have Gavin Wood, an authorising engineer for water who acts as an independent advisor to Trusts. He is covering the fascinating topic of water associate outbreaks and what we can ask of our water safety groups during an outbreak. There should always be a policy which covers how to organise the estates teams and the water safety groups – covering who is responsible for each area during the outbreak. Regular outbreaks are caused by organisms like Legionella and Pseudomonas, but might include non-tuberculosis causing mycobacteria. Detection of these organisms during routine screening is reported to the water safety group to assess potential risk. Most pathogens that we look at will grow within a certain temperature range, so maintaining cold water as cold, and hot water as hot is essential. What we really don’t want is warm water stagnating in the system as the pathogens can thrive in it. On top of this, we need chemical control of organisms – mostly silver and copper ion systems. Stagnant areas of warm water are pockets where the pathogens might thrive so flushing the system and chemical controls are key in maintaining a healthy water supply in hospitals. Controls that are effective for indicator organisms that we routinely test for, like legionella, tend to be effective for any other outbreak organisms. In an outbreak situation the first port of call is the Legionella risk assessment which considers the efficacy of temperature and chemical control. After this, in line with guidance, all trusts should refer to their Water Safety Plan which is contains the detail on actions to take when results are outside the expected limits. Most of the time the authorised engineer already has the answers because the system is repeatedly routinely tested.
Like any system in a hospital, it is vital that the risk assessment and training is up to date. As Gavin says if we haven’t covered everything in the risk assessment, and if the water policy hasn’t been recently reviewed then the whole system is vulnerable. External audit by authorise engineers ensures the system remains optimal. Investigation of an outbreak focuses on the patient pathway – where has the visitor or patient been on their journey through the hospital. This process finds the clues to identify the source of the environmental outbreak. Surprisingly one of the main pieces of evidence comes from review of training and competence records, is everyone appropriately trained and acting in accordance with policy. If in doubt, going an witnessing monitoring and maintenance tasks can provide essential information in a high pressure outbreak situation. Gavin drives home how important practice is in this – we need this information as much on a random rainy Tuesday as much as we need it during a Legionella outbreak!
Our next talk comes from Karren Staniforth from UKHSA. She is a clinical scientist and UKHSA IPC specialist adviser, and is talking to us about the pros and cons of different outbreak investigation techniques. Karren invites us to imagine painting a busy ward in different colour 10cm squares, every single surface with a cotton tip swab. Imagine how long that could take and just how many squares you would end up with! Even if you took 200 samples, how many squares have you failed to test? Usually we can only take 20-40 samples…. So even if they all come back negative, it doesn’t necessarily mean there isn’t an organism there – its just that the sampling didn’t find it. The chances of going in and finding nothing is quite high, but if you put a patient in that room for a week, they will almost certainly find that organism (not that we recommend that as a testing method!).
Karren reminds us that reading environmental plates is quite an art and different from clinical samples, it’s a different skill and guidance from experts is essential. Clinical diagnostic laboratories aren’t accredited to process environmental samples and the staff aren’t trained to process and analyse this work. Commercial companies can come and do testing for you, and they are extremely good at routine work. Bespoke work is harder to commission, and that’s where knowing the network can really help! So if you have an outbreak of something unusual, it’s hard to find the information on what level of environmental organisms – like aspergillus – are ok, and what constitutes a danger to patients.
The questions becomes, what type of samples do we want to take and why? We need to understand basal levels of indicator organisms to work out when to act. Building on what Gavin has shared this morning, you need to look – really look- at what is happening in your environment. Karren reflects on how useful an audit can be but we don’t go into an outbreak with the information already in front of you, so your audit probably won’t ask exactly the right questions. Epidemiology provides the answers – which organisms and then which patients are affected, where and when? Identifying common exposures can be easy when infections match case distribution e.g. sequential patients with the same infection in the same room. However some are less obvious like laundry delivered to multiple sites causing infection clusters which are miles apart or commercial products that might only impact high risk patients in very low numbers, but at multiple sites across countries. This can be exceptionally difficult to trace. Though remember not every exposure results in colonisation and infection, and even if exposure is universal some patient groups are more likely to develop infections than others.
Knowing what kind of sample to take is essential, especially when sample numbers are limited. Negative results can be just as useful as positive results – and identifying the source of the outbreak is as much detective work as it is learning to read plates! Karren reminds us – ‘You don’t always need sampling, somethings are just WRONG!’.
To close the first session, we have Louise Clarke who knows everything there is to know about proper ventilation. Ventilation is essential the movement of air within a system. The law tells us we must provide ventilation under the Healthy and Safety at Work Act, and building regulations set a minimum standard for ventilation. The main reason for good ventilation is to have a safe and comfortable environment; to remove odours, to control temperature and importantly to protect from harmful organisms and toxic substances. We have natural ventilation (like opening a window!), mechanical ventilation which pushes air around the building and a mixed mode – a combination of the two. The preferred method for ventilating a hospital remains natural ventilation, something which really shocked the group. It might work well on a windy day but it certainly doesn’t cover all areas and some times of year, like winter, it’s really no good at all.
Like Lou says, simple is best. When we talk about ventilation, we need to ask what is the issue we are looking at? Human elements are usually a key element to understanding problems in ventilation – you need to think about when the issue arose and who was involved? Often there is a significant time lag between the problem starting and it’s detection in real time. You can be left scrabbling around for details long after the issue began. Lou walked us through the potential information sources to considering during an outbreak, including design records. Which tend to be a little less useful than you would imagine, considering they often tell you the purpose the room was designed for 30 years ago – perhaps not so relevant now! Echoing the sentiments of Karren earlier, one of the most important things you can do is go physically and take a look – not an audit, just turn up and use all your senses!
To kick off the session after a much needed cup of tea (Earl Grey, hot!) we have Dr Mariyam Mirfenderesky who is talking about the challenges of managing fungal outbreaks. Candidozyma auris (note the new name!) is probably one of the most difficult outbreak causing organism to manage. To help with this a Clinical Expert Reference Group was established in March 2025. Candida species are the dominating fungal pathogens of invasive fungal disease and account for >85% of fungaemia in Europe and the United States. Candidozyma auris was first identified in 2009 from a Japanese patient with ear discharge, and is a critical WHO priority fungal pathogen. It is fluconazole resistant and has a propensity to cause healthcare associated infection outbreaks. There are 6 independent clades, with clade 1 dominating in England. Mariyam walked us through the identification of the first neonatal case of C.auris from an eye swab – it was found in two infants, five weeks apart with no direct contact between the children. Fortunately both were colonisation with the fungus only. She then discussed the safety measures that should be in place to manage this difficult pathogen – particularly focusing on why the current cleaning protocols are insufficient to manage this threat. Her final points considered how to act when you detect C.auris – you must be decisive and act!
If you’d like to know more about C. auris, check out this blog post from earlier this year:
Next we have Dr John Hartley who is talking to us about investigating environmental surface mediated outbreaks – what you can’t see may still hurt you. Using the classic movie ‘the fiend without a face’ as a metaphor for IPC, John introduced the idea of modes of transmission between individuals. It feels like a simple problem, its just cleaning and handwashing after all! But we see there is a complex person-organism-environment dynamic system, and as John says, there is always a well known solution to every human problem – neat, plausible and wrong! John highlights the importance of continual surveillance and knowing ‘where the fiend is’. The controls are based on a four pronged approach – clean, replace, destroy or rebuild.
By way of a case study, John told us about his experience of managing adenovirus outbreaks in a paediatric BMT ward. This is a very common virus causing 5-10% of febrile illness in early childhood. Almost everyone has had it, and it can establish latency which can reactivate during BMT. More often it causes severe morbidity and mortality in these patients who can develop hepatitis. What you can’t tell is if the child caught adenovirus from the environment or if it has reactivated post latency. However, whole genome sequencing (WGS) can resolve 1-3 SNPs across genomes – its not like looking for a needle in a haystack, its rather like looking for a needle in the whole of Texas. But WGS can be used to confirm or refute cross infection events.
Of course the next question is, what can be done? Visual assessment is not a reliable indicator of surface cleanliness, John described the varied methods which can be used to detect adenovirus. Then we need to develop the right tools to manage it – including development of environmental PCR as a measure of cleaning efficacy by GirlyMicro herself! Finishing on a Dr Who reference to delight a crowd of scientists is always a win – even if it is comparing adenovirus to the scariest episode, the weeping angels! Of course, when monitoring adenovirus, the most important advice is ‘Don’t Blink’.
To close the morning session we have Dr Sam Watkin discussing research tools to help predict the future of outbreaks. Sam began acknowledging the current challenges facing preventing transmission of environmental organisms. In his PhD he aimed to identify how microbes disseminate through the clinical space, if the starting contamination site determined how is was disseminated and if the usage of space influenced microbial transmission risk. IPC is often retrospective to the aim was to develop research tools to allow the development of prospective knowledge. Sam used cauliflower mosaic virus DNA markers as a surrogate for pathogens, and followed its movement around two different units. It was shocking to see how far this benign organism could spread in such a short time.
I think if we take away anything this morning it’s that nobody likes the new name for C.auris, and death, death to recirculating air conditioning units!
The morning was followed in the afternoon by a series of case discussions in order to help implement the learning from the morning, help everyone get to know each other, and support the sharing of peer to peer learning. The case discussions this year included:
Case discussion one (Facilitated by Dr John Hartley):
Seek and remove: approaches to source control for environmental surface mediated outbreaks
Case discussion two (Facilitated by Professor Elaine Cloutman-Green):
How to implement a multi-disciplinary approach to investigation of water borne outbreaks
Case discussion three (Facilitated by Louise Clarke):
Interpretation of ventilation data and applying it to ventilation risk assessments
Case discussion four (Facilitated by Dr Sam Watkin):
Determining the role of equipment in outbreaks: how do you investigate?
Case discussion five (Facilitated by Karren Staniforth):
Introducing new cleaning process: what should you consider?
Case discussion six (Facilitated by Dr Claire Walker):
Choosing new equipment and furnishings: what questions should you ask?
It was truly inspiring to hear the buzz in the room that all of the discussion created. Thank you to Mr Girlymicro (Jon Cloutman-Green) for being in charge of photography, and to all of our speakers and facilitators for making the day happen. Also, massive shout out to Ant De Souza for pulling the day together, Angela McGee for making sure we all turned up to the right place at the right time, Mummy Girlymicro for running the reception desk, and to Richard Axell for supporting all of the tech on the day.
Now it is all over, the only thing to do is to tap our feet until we all get to meet again in 2026, although the presentations and discussion sheets should go up some time during 2025. Until then however, if you want to know more either head to the Environment Network website to look at info from previous years, or read some of the other blog posts linked to environmental IPC down below.
I must admit I shed a bit of a happy tear when this arrived unsolicited in my inbox, it’s been a bit of a week. My next thought was that there is no way I could share it, as it would be the epitome of self promotion, and that’s never considered to be a good look. Then I sat and thought, what would I advise a friend to do if they were in the same situation and I decided something. I decided to be proud of what I’d achieved. To be proud of the hours spent to achieve the output earned, and to be proud to have someone so invested they would take the time to write an unsolicited review for this blog. I know that is what I would advise and hope that all of you would do, and so this is my moment I decided to model the advice I would give. We all have the right to own our achievements and not make ourselves small to avoid the commentary of others.
Dr Walker is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for The Girlymicrobiologist, including one on turning criticism into a catalyst for change.
Full disclosure: I wasn’t invited to write this review, I insisted. I also haven’t been paid for it; quite the opposite, in fact. I went out and bought two copies of Professor Elaine Cloutman-Green’s book with my own money: one for me and one for my PhD students to share (or squabble over). And yes, I did get her to sign them. What can I say? I’m a lifelong fangirl.
Professor Cloutman-Green’s It Shouldn’t Happen to a PhD Student is a rare gem in academic literature a compassionate, wise, and profoundly practical guide that feels like a conversation with the mentor every research student wishes they had. Written with warmth, humour, and candour, the book demystifies the PhD journey from start to finish, transforming what can often be an isolating experience into one filled with clarity, community, and hope.
Elaine, known affectionately as my favourite Professor or the GirlyMicrobiologist, draws upon two decades of experience as both scientist and supervisor to craft a guide that balances rigour with humanity. Structured in three accessible sections; getting onto a PhD programme, surviving and thriving during it, and using it as a springboard for the future. The book serves as both a roadmap and a reassuring companion. Each chapter blends actionable advice with reflections that acknowledge the emotional highs and lows of research life, creating a tone that is both authoritative and deeply empathetic.
From the very first chapter, “Knowing Your Why,” Elaine invites readers to pause and reflect on their motivations, an exercise that sets the tone for the entire book. Rather than treating doctoral study as a mechanical career step, she frames it as a personal journey of purpose and growth. As she writes, “A PhD should be a step towards delivering on your aspirations, not just a title to put in front of your name.” It’s a line that perfectly encapsulates her philosophy that research is not about prestige, but about purpose.
What truly elevates this book above other graduate-school guides is its inclusivity and warmth. Elaine writes as a mentor who has seen it all: the sleepless nights, the imposter syndrome, the joy of a successful experiment, and the power of perseverance. Her anecdotes and checklists are peppered with practical wisdom not the vague “work harder” platitudes found elsewhere, but concrete steps to manage deadlines, develop professional skills, and build meaningful academic networks. The inclusion of “Top Tips” sections at the end of each stage provides digestible summaries that make the book easy to dip in and out of throughout the PhD journey.
And it’s not just students who need this book. Supervisors – myself included – will find plenty here that resonates. Elaine reminds us, gently but firmly, that supervisors are people too: flawed, human, and still learning alongside our students. Her reflections on empathy, communication, and shared growth are as valuable for those guiding PhDs as for those undertaking them. Every research group could benefit from having this guide on their shelf, it’s as much a manual for mentorship as it is for PhD survival.
Of course I must acknowledge my own bias, Elaine was my mentor during my own PhD, and many of the insights in this book feel like familiar echoes of the advice that got me through my hardest days. She taught me so much about science but more importantly that research, like life, is all about surrounding yourself with people who lift you up when you falter. It Shouldn’t Happen to a PhD Student captures that same generous spirit, showing that the best kind of academic success is shared success: when mentors and students grow together, celebrate each other’s wins, and keep curiosity at the heart of everything they do. Everyone deserves a mentor like Elaine someone who reminds you that with compassion, courage, and community, the PhD journey can be one of the most transformative experiences of your life. Oh, and she provides the most excellent of snacks, the occasional much needed gin and tonic, and a rousing rendition of ‘Drop it like it’s hot!’… but that’s a story for another time.
I am not a big Halloween girly, to be honest I can take it or leave it because I’m mostly excited about the build up to Christmas. That said, what I do love are movies and TV, and despite never being someone who can tolerate a lot of slasher or gore based horror movies, I love a good vampire movie.
A lot of this may be because I enjoy the world building and lore that seems to be more integral to vampire movies and series. This is because, although they share some of the same rules, depending on how the world is built they always need to explain which of the nuance comes into play in that particular setting. It felt fun this Halloween therefore, to write a blog post that talks about some of those tropes when vampirism is linked to infection, and how those rules compare to the real world.
Common vampire tropes to be aware of and to bear in mind as you read on:
Experiencing pain or physical damage in relation to sunlight
Needing to consume blood as a protein source
Inability to eat or digest food other than blood
Avoidance of animals
Ability to influence humans to undertake acts that may be against their will
Violent reactions to garlic
Inability to see themselves in mirrors or via cameras
Death only by beheading
Death by wooden stakes
Damage linked to holy water
Aversion to signs of faith
Aversion to alcohol or drug use
Not all of these are present in every piece of world building, hence why I find the variety of vampire mythos so interesting. The choice of which ones go together combined with different origin stories and creation processes enable a pretty large tapestry to be created from some similar thematic components.
Mystical, infections or something else?
The place to start I guess is by discussing whether all vampire world building includes infectious transmission? And the answer is a definitive no. Sometimes the way that the creation of new vampires works isn’t discussed. Sometimes the rules about the underlying process is unclear. That said, the fear of becoming something new is a frequently used trope for dramatic purposes and so the process by which a human is turned into or by which vampires exist is discussed pretty frequently as part of world building, and from what I can see there are three main routes:
Mystical – some form of occult/magic/cause not routed in science
Genetic – vampires are born and exist as a stand alone species
Infection – transmission via blood or other infectious transfer, even if the agent is unclear or unspecified
Now, I’m not going to cover the mystical/magically as that’s not anything based in science and the science is what I’m here for. The other two, however, are often based (sometimes loosely) in science as they are often inspired by things that actually exist and so I’m going to talk about both of those in a bit more details.
Genetic
I’m going to kick off by talking all things genetics. There are an increasingly large number of vampire movies and TV series where the vampires that featured were born vampires. This includes movies like Abigail, Perfect Creatures, the finale of the Twilight series, but also TV series such as A Discovery of Witches, First Kill and Vampire Academy. Sometimes within these there are vampires that are made through other means (discussed below) in the same world. Often these genetic vampires exist as a separate species to their Homo sapien neighbours either openly or in hiding.
There is often much discussion about where the vampire myth comes from, and in many way these stories of genetic vampires who are birthed through a similar route to standard human deliveries, links in most with what is considered to be a real world inspiration for many vampire myths. The origin is thought to be linked to a rare inherited condition known as Porphyria, the presentation for which may account for for some of the common components of vampire portrayals.
Porphyria is a rare, inherited blood disorder that occurs when the body can’t convert porphyrins into haeme, a vital component of haemoglobin. The resulting symptoms vary depending on the type of porphyria. Acute porphyria presentations include symptoms such as gastro intestinal pain and symptoms like nausea and vomiting – symptoms that are often portrayed linked to vampires attempting to eat normal food. Whilst cutaneous porphyria symptoms include pain, burning and swelling in response to sunlight, skin fragility and a tendency towards skin blistering – all of which are frequently included as vampire responses to exposure to sunlight.
Porphyria D. Montgomery Bissell, M.D., Karl E. Anderson, M.D., and Herbert L. Bonkovsky, N Engl J Med 2017;377:862-872 VOL. 377 NO. 9
Interestingly, in some of the genetic origin vampire stories, the impact of some of the limitations of the lifestyle limitation of traditional vampires are not so extreme. In some of these cases they can be seen in daylight, although not for long and don’t enjoy it, and they may be able to tolerate some, if not all, of human food. They are possibly therefore most aligned to their real world inspirations. I could write pages and pages on this, but infection is where my heart lies so I’m going to crack on.
Virus, parasitic, others?
Now we’ve covered off those born vampires, let’s move onto the most common version of vampirism outside of the traditional Dracula more mystical inspiration, that is vampires who are created linked to transfer of infection by blood or other means.
There are three main ways that this commonly comes into play:
Viral causes
Parasitic routes
Bacteria intoxication
I’m still trying to find a vampire movie where the main infectious agent is fungal, but it seems that most of the movies based on fungi are linked to zombie outbreaks. That makes a lot of sense, due to the fact that fungi are eukaryotes (like us) rather than prokaryotes (like bacteria), and so fungi tend to be linked to changing behaviour linked to interfering with the human nervous system. If you’ve seen a vampire version though please do let me know as I’m collating a list of where different organisms might come into play.
By far the most common route depicted is where the causative agent is a virus. Viruses are featured in movies such as Blade and Daybreakers and TV series such as Ultraviolet. This is because viral transmission in general is associated with transfer of bodily fluids, be that faecal-oral, respiratory via saliva, bodily fluids such as breast milk, or in the case of vampire movies via blood.
The most uncommon causative agent I’ve discovered is the parasitic cause of vampirism as shown in The Strain TV series. During the series transmission of the virus to create a full vampire is via something known as ‘The White’ that contains parasitic worms. These then lead to anatomical changes, including the growth of a proboscis that enables the biting and transmission of the parasite to others.
Bacterial coverage is mostly linked to potential methods of intoxication that supports the control over humans by vampires. Rather than being a direct cause of the vampirism, this seems to be about how transfer of the bacteria releases, or causes anatomical change, which then changes behaviour via things like hormonal or neurological changes. I’ve talked before about why bacteria may feature less in horror movies than other causes, but this can mostly be summed up by the fact that audiences tend to know more about bacteria and therefore it is less tempting for writers, but also horror tends to sit better in ‘the possible but not too close to us’.
Transmission
Obviously it’s not just the infectious agent that is important, but the mode of transmission for that agent. This being all about vampires the biggest mode of transmission is by bite, but it’s not always so straight forward. In mystical vampire movies, there’s usually a whole lot of removing of the original human blood and then transfer of the vampire blood, leading to a mystical baptism and rebirth. Infectious causes are much more one way, any bite could lead to someone turning into a vampire and the most important thing is load related. If someone is in contact for longer, if more blood is drunk and therefore more saliva and fluids exchanged, then the chances of conversion are much higher.
It’s not just blood as a bodily fluid that features in conversion during vampire movies. There are also films, such as Requiem for a Vampire and Trouble Every Day, where vampirism is treated more like a sexually transmitted disease, rather than transfer occurring during feeding on the blood of their victims. It seems that these films have increased since the 1980s, maybe as a result of fear processing linked to the HIV/AIDS pandemic during that time period or maybe because our knowledge about and ability to detect infections has increased and therefore there are a larger part of the collective public awareness. It will be interesting to see how the SAR CoV2 pandemic will impact this further.
The most unusual transmission, and one that aligns most highly with blood borne transmission is the presence of congenital transmission as featured in Blade. Where the main character Blade becomes a vampire hybrid by acquiring the vampire virus at birth, due to his mother being bitten and placental crossing of the virus into his blood stream. As a result, he exhibits some of the characteristics of a vampire due to the virus, but the effects are attenuated linked to his exposure route. It can often be that congenital infection presents differently to primary infection via other causes, and it appears vampirism is no different.
The other variable is linked to the time to turning once the infection has been introduced. I would speculate that this too is load related, as well as the infectious agent behind the symptoms. Viruses, for instance, are likely to reproduce and induce change at a much higher rate than anything linked to bacteria or parasites. This is partly due to their reproductive rate, but also linked to the level of dose that tends to be available. The exception to viruses resulting in the fastest change is likely to be bacterial intoxication and influencing. As the toxin acts immediately, when this is present in media and TV the change is almost instantaneous, but also time limited and therefore requires top up or re-application. Not all impacts are until beheading, some require a more time boundaried set of interventions.
Interventions
Once your characters are aware that vampires exist within their mist, then they will want to look for actions in order to protect themselves. One of the classic ones as featured in many movies, including the classic Lost Boys, is garlic.
In some ways the impact of garlic makes even more sense if you think of vampirism through an infectious transmission route, as garlic has been considered to have anti-infective properties for a long time, although warning you may have to ingest a LOT of it!
Another common feature in vampire movies is the roles that animals play as protectors. For instance, in 30 Days of Night, the vampires kill all of the dogs before they launch their main attack. This kind of thing also often happens in films and TV where vampires are hiding in plain sight. It could be that they are taking out animals as they don’t want to be found, and animals are easier than humans, but I have another proposition. There are a number of infections where animals can be used to sniff out and identify infected individuals. Therefore, if animals could detect vampires they are much more likely to be a risk and warrant removal. Animals could therefore act as a front line of diagnostic defence to enable you to tell friend from foe.
Having determine that a common weakness of vampires is their damage response to ultraviolet light (UV), films such as Underworld weaponise light against the vampire protagonists. Light, and especially UV-C (200 – 280nm), has been known to impact viruses and bacteria for well over 100 years. When light is in this frequency is can damage both RNA and DNA, resulting in cell death, and it is possible that if the infectious agent is the only thing that is keeping your body moving the damage would be more pronounced. We’ve also discussed how the lack of some biochemical pathways can lead to UV-C causing much larger amounts of pain an damage.
Normally, penetration of the light to cause damage might be an issue, but if you are using bullets or other means this may not impact. The most important thing I have to say here is, that despite what is shown in Blade 2, light does not bend around corners. This is also important for when you are considering using UV-C in hospitals to support cleaning, it doesn’t have good penetration and doesn’t go around corners of work in shadows. Using UV-C may work against your vampires but you are going to need to think carefully about where you use it so it does what you think it can.
Vampire movies have amazing world building and are often my favourite genera in terms of their string internal logic. I love the fact that so many types of infection and route of transmission that reflect real world cases are present as part of these pieces of entertainment. They can actually teach us a lot, even when we don’t realise it, and so much of it has origins in real world knowledge, even if only loosely. So, this Halloween evening find one you haven’t seen before and let me know which intervention you would use to stop your town being turned into creatures of the night!
Before I go, I thought I would share a few of the previous years Halloween blog posts in case you are looking for some more spooky season and infection reading:
This week marks the 5th anniversary of regular posting on Girlymicrobiologist.com. I can’t believe that time has flown by so quickly. I also can’t believe that something that started out with such small expectations has grown to play such an important part in my life, and in my sense of identity. This was all really cemented for me in something that also happened this week, the publication of my first ever book.
Now, it’s been no secret that I have been putting some time aside to try and write something for the last few months. You have all been very patient with me whilst I posted a little less frequently, and I cannot help but give a massive thank you shout out to Dr Claire Walker who has curated some wonderful guest blogs in order to keep the content flowing. It’s a world of different having an idea and starting to write it, to holding the real thing in your hand, and so my brain is still catching up to the reality. I plan to write a bit more of a step by step guide to what the experience has taught me about self publishing, and why I thought self publishing was the right choice for this particular book, but for today I wanted to focus on moving something from a vague wish to a reality you can hold in your hand.
So how did I get here?
Back in 2022 I wrote a post about the fact that I was playing with the idea of writing a book, although I wasn’t quite sure about the direction that book would take, and listing a number of steps:
Further formulate the concept i.e. what kind of book? I actually have 2 ideas. One is turning this blog into a book format. The second is that I also have an outline structure for a Pathology murder mystery. I’m excited by both, but right now I think option 1 is more achievable with my current resources
Review what I already have. If I go for a non fiction book I need to undertake a gap analysis of what I have, what can be modified and what new content is needed. For the fiction version I need to start getting my concepts down so that I know how viable they are
What good resources are available to me? This is an ambition of plenty of people and there is a wealth of information out there. I need to explore, quality assess and curate what there is so I don’t waste time and energy making unforced errors. There is no point in reinventing the wheel, modify it so it works for me, but let’s not start from square one.
Undertake some appreciative enquiry. Success is often about asking the right questions and making the right connections in order to increase your odds. I have some friends in this field but not in the area I’m thinking of working in. I need to be brave and put myself out there to gain insight into the ‘Known Unknowns’
Use the knowledge and information gained to put together a project plan. Establish some small steps that can make the project as a whole less overwhelming
Establish my success criteria. What does success look like? For right now it’s the process of creating that will feel like a success with a stretch goal of sharing what is produced, but that might change based on what I discover
Research your audience. If I decided to include sharing what is produced as part of my success criteria who would like to see such a book? If I were to share the content what would that look like and what would be needed?
You’ll notice that those early steps involved a lot of information gathering, and reflection before formulating a plan. Writing that blog post encouraged me to do just that, but more than that it meant that I had made a declaration to all of you and started talking about what the next steps would look like, so I could be held to account by others as well as myself.
One of the things that my research led me to understand with greater clarity, is that to get from where I was to publishing a book required both the formulation of a plan, but also the development and practicing of skills. To a certain extent, the project plan was the easy bit, as long as my research was effective. The skill development piece was harder. It seemed to me, that the best way to go about this was to support others by being involved with their work in order to learn and develop more.
This led to me being involved with everything from textbooks, to a book on the impact of waste on our society. Every encounter taught me something. Every encounter helped me to refine what I was interested in and how I was interested in working. It also supported me in developing an author page so that I had a place where I could sign post others to the work.
Fairly early on I realised that I didn’t have the time or bandwidth to develop my pathology murder mysteries right now, although I am still drafting plot on the side. The writing style is just too different for me to be able to dip in and out of , and I need to put in many hours of practice to get that style to a point where it would be acceptable.
That left me with content linked to this blog. Many of you will know that I started drafting, and am still working on a book called White Coat Syndrome (or similar). This is still in the works but a wise friend suggested that I keep working on getting it traditionally published, so I need to give it some focussed time. That left me with looking at the content I already have for trying out what the self publishing process could look like. Over 90% of non-fiction books are self published these days, and of the ones that are traditionally published still, most are linked to people in the public eye or with social media followers in the millions. It will be a surprise to no one that I do not fall into either of those categories, and so exploring the process of self publishing felt like the right move, not just for this book but to understand more moving forward.
So why this topic? In a moment of frustration about life, the universe, and everything, I was having a late evening rant and Mr Girlymicro and he said ‘Why don’t you write a book on how to do a PhD? You talk about it all the time. You spend lots of time supporting others through it, and you have already written thousands of words on your blog linked to it’. I just looked at him, went to bed, and woke up with a 40 chapter book outline. It just felt right. Something in my brain just clicked, and so the writing in the end was the easy part. After all, Mr Girlymicro is pretty much always right, and yet again he proved it.
Once the topic and method of publishing was chosen, then all that was left was pulling it together. It was so important for me that this book came from a place of authenticity, a place where I don’t pretend that things are easy, perfect or even equitable. In fact, it was that sense of inequity as I was writing that became a real motivator for finishing the book. As I reflected and wrote I became increasingly aware of how inequitable access to PhD programmes have become. How the way access routes are set up to be even more challenging if you have health or caring needs, but also if you don’t have access to someone who has done one to advise you on how to apply and what factors might be significant to talk about.
The next factor was to to decide on a time scale. Now, this part might be a little piece of madness but I know how busy IPC gets once we hit winter, and so allowing a 4 month time frame in order to get the book out before winter pressures and to align the release with the start of the academic year seemed like a good idea. I’m not saying that it was a good idea…just that it felt like one at the time. I think tasks take up the time that is allowed to them, however. I think if I’d allowed a year it would have spread to take that much time. It is sometimes better to set a tight timescale and stick to it, rather than allowing a window which could extend the project for longer than is really needed.
I also gradually became aware that providing some practical exercises would add value in a way that I could not include in a book format, and so decided early on that several of the chapters would have these hosted on the Girlymicro website so they would be free to access and download. Providing a holistic, interactive approach was key to my thinking, as was making sure that at its heart the book is about community and supporting each other, the same as this blog. I didn’t want to pretend to be someone else, or write in a way that was more academic, as I think there are enough of those styles of books out there. I wanted this book to support everyone to bring their whole selves to their PhD and their topic, and so it was important to me to write in a way that I also did the same.
Now the book is ready. Now that it is a real thing that I can hold in my hand. There are two main tasks taking up my thinking. The first is trying to work out how to get it to people that it might help, something that I would be grateful for any advice that you can give to me. The second is about how I can help others by sharing the knowledge I’ve picked up myself as part of going through the writing and self publishing process, to make it easier for others to get their voice out there. There are benefits to both ways of publishing, but there is something empowering about being able to feel like you can speak directly to your readers by maintaining more control over the content, rather than it being seen through a commercial lens. I’m not in this for the money after all.
There is still one thing that I talked about on my list of steps, way back when, and haven’t yet addressed, and that was success criteria and decided how to benchmark what success looks like. As I’ve said, I’m not doing this to make money, I’m doing this in the hope that it might assist others, and so for me it has never been about a commercial approach. I still need some way of judging progress however. On doing some reading I discovered that many books never sell more than 20 copies, and most others don’t sell more than 250 copies in their first year. My aspirations are pretty small therefore, as this is something I’m just beginning. I would consider the book a success if I sold more than 20 copies. I would be over the moon if I sold anywhere between 50 and 100 copies in the first year. The topic is fairly niche after all. Mostly I just want to mark the event and use it as my own benchmark for improving during future projects. We all have to start somewhere.
If however, you’d like to add to those 20 I’ve included the link for purchasing below:
Thinking about what’s next
Like everything is life, my first thought when I finish something is to think…what’s next? I have learnt so much and my plan is to take a little time to reflect on that learning and to enjoy focussing on blog writing for a while. That said, I am now going to return some of my focus to the book pitch for the Girlymicro general book, and I do have to admit I have the title of my next book in mind if I decide to try another self publishing exercise. Mostly I would like a few weekends off as it’s been a while since I could embrace the sofa and fully rot for a weekend. So while I cogitate, I intend to treat myself with some truly awful reality TV, and spending quality time with mummy and Mr Girlymicro.
Taking a moment to enjoy, celebrate, and mark the occasion
Before I slob off to the sofa though…you all know that I am a strong believer in celebrating and marking the moments that impact our lives, and this book is no different. To mark the moment I’m a having a small, low key book launch on Friday 17th October and there are just a couple of free tickets still available if you’d like to join.
Whether you can make it or not, I’d love to hear what you think as I’m all about improvement and learning. If you do get the book it would also be amazing if you could leave a review on Amazon with your honest thoughts. Apparently reviews really help increase visibility, whether good or bad, and so it would be wonderful to think that this book is finding its way to those who would need it.
I want to sign off with a thank you. I would never have gone through the process of thinking about writing a book if it wasn’t for all your support. I wouldn’t have had the content or undertaken the self reflection needed to know what to write if you hadn’t kept reading this blog. Finally, I wouldn’t have had the motivation to get through writing it and working out so very many templates and decisions if I didn’t know you would support me in the effort. So thank you. I appreciate every read, every interaction, and every conversation we have.
You’ll notice Friday came and went without me posting. I’m about to head off on leave and it turned out I just had too much work and real life stuff to do to make writing a blog post happen.
I was going to try and write two blog posts today so you could have one on Monday and one this coming Friday, to cover during my time away. Instead I have decided to practice what I preach here and put myself and my wellbeing first.
So, instead, I am going to spend the day gradually packing, watching TV and having a bubble bath to start my de-stress. Normal service will resume on the 3rd October.
For my birthday in 2014, I celebrated by submitted by PhD thesis for printing. I ripped off the band aid and committed.
For this birthday, 11 years later, I’m taking another leap of faith, and once more rolling the dice on myself. This time it’s still PhD related, but rather different. This time it’s to let you all know that I have written a book, which will hopefully go live on Amazon on Friday the 17th October.
It feels like birthday launches could become a tradition.
I’ve been talking about a super secret project for a while now, and the wonderful Dr Claire Walker has been taking on some heavy lifting in terms of arranging some guest blogs, so that I could write a book on my weekends rather than writing a blog. But what is the book, and why did it come about?
The Book
The book is entitled ‘It Shouldn’t Happen to a PhD Student: How to thrive, not just survive, during your PhD’. It has 40 chapters that take you all the way through from deciding you want to do to PhD, and thinking about where and what type, to submitting your thesis, and what kind of skills you may need to develop during your PhD to maximise your career success after it is done.
Professor Elaine Cloutman-Green, otherwise known as “The Girlymicrobiologist”, is a clinical academic with over 2 decades of experience leading research projects and supporting students at all levels, including PhDs. She also runs the popular Girlymicrobiologist blog, which aims to de-mystify science and support those wanting to engage with academic careers from A-level all the way through to career enrichment.
In this book, Girlymicro talks about the reality of what it is like to study for a PhD, what gateways you may need to pass through, and how to manage key relationships in order to achieve success.
This book starts at the very beginning, with why you might want to do a PhD, how you might decide what route to PhD is right for you, and what a successful application might look like.
It then takes you through your PhD journey, year by year, with tips about how to approach and succeed during significant moments, such as attending your first conference, or writing your first academic paper.
Finally, you will discover what other skills you need to develop during your PhD to give you the best route to success after your viva. All of this supported by links to activities on the Girlymicrobiologist blog, to help you with practical exercises in order to apply what you have learned.
Whether you’re planning your PhD, a healthcare professional looking to develop, or simply curious to know about how the world of academia works, The Girlymicrobiologist offers a refreshing blend of knowledge and relatable experiences. Get ready to laugh, learn, and be inspired to find a way into, what she describes as the best job on the planet.
This is the book I wish that someone had given me when I started on my PhD. I was pretty clueless and spent a lot of time finding my way, and making heaps of mistakes. It seemed only fair to write all of my learning down so that I can share it, not just with my own students but more widely, so that everyone is free to make their own new mistakes, not just repeat ones I’ve already made.
The Why
I’ve been talking about writing a book for ages, and I still have the original Girlymicro book I’d planned going on in the background. I was prompted to do this book now though, after spending an afternoon at an awards event and realising that I could tell you every person who was going to win in every category before the dinner even started. It made me think a lot about access and privilege. That night I came home and I was really glum, and I couldn’t quite process why I was feeling that way.
I slept on it and spent some time speaking to Mr Girlymicro the next day to process my thoughts. I talked about how much access to healthcare professions and even academic training schemes are now based on who you know, to describe the best way to get through gateways like applications and interviews. How, even once you are in them, to feel like you understand how things work and the undisclosed boxes that need ticking, you need to have someone who will let you in and tell you the unwritten rules, and frankly not all supervisors see that as their role. This means that I really feel like we are missing out on some amazing talent. People who would make wonderful PhD students, or academics, because they can’t get across the threshold or see themselves in the role.
Not everyone has strong connections with a university. Still fewer people know someone who has a PhD. The way the system currently feels is that if you can access information you really have such an advantage over those that don’t. I therefore see a lot of my medical colleagues getting access to PhD funding, and yet fewer and fewer of my nursing and scientific colleagues. I increasingly encounter more and more undergraduates who are reaching out because they need help to know why they aren’t being successful, because they don’t know what is expected of them. It has always been hard to get onto PhD programmes, and it should be. What it shouldn’t be is hard because you don’t have access to the right people to give you the knowledge you need to level the playing field.
I realised that was why I was feeling upset and unsettled. I don’t like unfairness. I don’t like inequity. I don’t like realising that I’m part of the problem. Mr Girlymicro commented, as I was off loading, that I had plenty of blog posts that talk about how to apply for and do a PhD, and so why didn’t I take the way I was feeling and turn it into something positive. A book. So, this book concept was born. A book where I set out to play my role in fixing the disparities as I see them.
The Vision
That conversation happened right at the end of May. I gave myself 3 months to take some content form this blog, as well as creating new content, to come up with a book of ~80,000 words that captures the advice I give to my PhD students, and those approaching me floating the concept of applying for a PhD.
Why 3 months? Well, if I allowed myself a year, I would take a year, and remember that other book? I still want that to happen at some point. The other thing was that I wanted it finished as close to the start of the academic year as possible, so that it could start benefiting people right away. We all also know that I have no patience, and so using my birthday as a cut off always felt right.
The book was finished at the end of August, and I’m in final edits before upload at the end of the month. I want it to be the kind of resource that people can dip in and out of, whether they are doing a PhD or not. Chapters, such as developing goals, or on public speaking, should stand alone to benefit even those who are not in academic study. The activities that can be accessed alongside the book, to help things like developing your elevator pitch, should only grow in number over time, and hopefully will be a good general resource for anyone that finds them, not just for those who are studying for a PhD.
My main hope however, is that people who are on a PhD will find it not only helpful, but something that will help them feel a little less alone in the process. There were times, as I was doing my PhD outside of a standard academic department, that I felt really lonely, and sometimes even very lost. Not everyone has a super supportive supervisor, not everyone finds those peers that keep you going. I was lucky that I had great colleagues who picked me, not everyone has that. I hope that this book can act a little like the friend you need, who you can turn to for advice, and to know that others have been there before and found a way to succeed.
What to Expect
I don’t know what to expect to be honest. I’ve never written a book entirely alone before, with thanks to Dr Helen Rickard and Dr Sam Watkin who have contributed text. I know why I needed to write this book, and as I say in the first chapter, knowing your why is the most important thing. I don’t expect it to be perfect, nothing is, but as I say to my students, the main thing is that it is done.
The book should go live on Amazon (depending on their turn around time) on Friday 17th October. It should be purchasable in 3 forms:
Ebook for £2.99 or included in your ebook subscription if you have one and free to download
Paperback for £9.99
Hardback for £15.99
None of this is about making money for me, but Amazon have minimum costs, especially if you want it to be available widely, so there we go.
To mark the occasion, although it is terrifying me at the moment, I’m holding a small book launch event at UCL on the same night. If you fancy, come and join me. After all, we should all do a little something that scares us, and I’m hoping if I feed you wine you will forgive any deficiencies knowing the reasons why this book came into being in the first place.
If you like, I’m kinda hoping you might also tell your friends…
I am currently in the middle of secret project, which I hope to announce more about in late August/early September. I’m really excited about it but it’s taking a bunch of my time. I’m hoping that you will be just as excited when I can share more details. The wonderful Dr Claire Walker is helping me deliver my passion project by curating the Girlymicrobiologist blog for a few weeks. This means that I hope you all enjoy getting some great guest blogs from a range of topics. Girlymicrobiologist is a community, and all of the wonderful authors stepping up, sharing their thoughts and projects, to support me in mine means the world. I hope you enjoy this guest blog series. Drop me a line if you too would be interested in joining this community by writing a guest blog.
Dr Walker who is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for the Girlymicrobiologist, including The Clinical Academic Path – From the Lab to the Lectern.
This weeks blog post is from Dr Shayda Karimi, who is a medical doctor and self published author, discussing how important creativity is in science.
Blog by Shayda Karimi
Hello! My name is Shayda.
I’m a medical doctor, specialising in anaesthesia and pre-hospital emergency care. Medicine has always been considered one of the ‘softer’ sciences, but never the less is more of a science than a humanity, and the subject takes pride in adhering to evidence based practice. Creativity lies at the heart of problem solving, and problem solving is key to providing high quality, innovative medical care, especially in dynamic specialities like emergency care. For example, I was recently faced with the dilemma of a man impaled on a large segment of aluminium ladder. The metal couldn’t be removed without a CT scan to determine which structures it had damaged, and due to the angle of penetration, the patient couldn’t fit through the scanner with it in place. The creative solution was to put a 999 call out to the fire service, who with specialist cutting equipment were able to reduce the size on the metal segment. The patient safely had his scan.
Creativity in science should be encouraged. Through my time at medical school, opportunities to be creative were very limited- most lectures were on never changing topics- anatomy and physiology. I took a student component module called ‘medicine in literature’- even that was factual. To resolve this gap in my undergraduate education, in my F3 year (a common point for junior doctors to take a year out of training, having completed two foundation years and before commencing higher specialist training) I decided to complete a masters degree in creative writing. I was the only person on my course with a ‘science’ background.
The dissertation for this course was a long piece of writing. Which for the first time in my post primary school life, could be completely and utterly false. This dissertation turned into my first novel. Writing fiction develops problem solving skills- characters must resolve the obstacles put into their path, and this must be believable with the rules they are living in. I learned about how language can be used to invoke emotions and atmosphere- this is of vital importance when speaking to patients and colleagues. Or even when writing emails! I developed an appreciation that though creativity is not fact- it can also be to a certain degree taught and developed.
The dissertation turned into my first published novel ‘Heirs’, set in a future dystopian London, conjoined twins are born next in line to the throne. They end up separated and in a fight for power. This was fun experience; taking the science I knew as fact, and adding a whole load of fiction to turn it into a familiar but bizarre future.
Creativity and science go hand in hand. We should all endeavour to leave the cold hard world of facts every once in a while and dive into something purely imaginative; an art class or high fantasy novel.
“The true sign of intelligence is not knowledge, but imagination” – Albert Einstein
I am currently in the middle of secret project, which I hope to announce more about in late August/early September. I’m really excited about it but it’s taking a bunch of my time. I’m hoping that you will be just as excited when I can share more details. The wonderful Dr Claire Walker is helping me deliver my passion project by curating the Girlymicrobiologist blog for a few weeks. This means that I hope you all enjoy getting some great guest blogs from a range of topics. Girlymicrobiologist is a community, and all of the wonderful authors stepping up, sharing their thoughts and projects, to support me in mine means the world. I hope you enjoy this guest blog series. Drop me a line if you too would be interested in joining this community by writing a guest blog.
Dr Walker is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for the Girlymicrobiologist, including Simulating Success – Enhancing Biomedical Science Education through Clinical Simulation. This blog was written by a group of her final year students on their experiences of trying to teach differently.
Blog by Yvana, Nicole and Ellie
We were a small group of three final-year Biomedical students—Yvana, Nicole, and Ellie who were brought together by a shared goal to create something useful for other students by us students. In our final year at the University of Lincoln, we were offered the opportunity to work on a collaborative project focused on improving on how ELISA (enzyme-linked immunosorbent assay) is taught to students- a commonly used technique in the immunology department to quantify and detect biological molecules.
Meet the Team
Yvana
Hello, I’m Yvana – Three years ago, I began my journey as a Biomedical Science student at the University of Lincoln. Like many, I was unsure of the exact career path I wanted to follow, but I knew one thing for certain, I was deeply fascinated by diagnostics and disease. Over time, that interest developed into a love for laboratory work, especially when I had the opportunity to experience clinical simulation sessions led by Dr Claire Walker which stood out to me as they offered a taste of what a real-life clinical lab feels like beyond university.
One of the highlights of my third year was engaging in a unique series of laboratory-based activities known as Laboratory Skills, coordinated by Dr Andy Gilbert. These sessions were designed to strengthen our core technical abilities and confidence in the lab through a series of activities covering microbiology to biochemistry!. After completing 6 weeks of lab skills, Dr Andy Gilbert approached me with an exciting opportunity to collaborate with two other students, Nicole and Elle, also led by Dr Claire Walker on a co-creation lab skills project. Our task? To design a step-by-step resource that would deconstruct one of the most widely used techniques in immunology, ELISA – making it easier for students to understand and perform.
Ellie
Hi everyone, my name’s Ellie! I’m 1/3 of the amazing group that have carried out the ELISA workshop, led by students, for students. During my years at the University of Lincoln, I’ve grown to love the fascinating world of microbiology and I’m even going back this September to do a Microbiology Masters! I have really enjoyed my time at Lincoln and part of that is thanks to Andy Gilbert for putting on his extra lab skills sessions, which allowed me and other students to gain that vital extra laboratory knowledge and practice important techniques.
I’ve just finished the final year of my undergraduate Biomedical Science degree and throughout this year I was able to create something incredible. I, Yvana and Nicole, were given the opportunity to collaborate and develop a practical booklet as a building point of the skills needed to carry out an ELISA. The main reason I agreed to take part in this task is that we, as students, do not get many chances to have such a hands-on experience with many complex techniques, like an ELISA, during this degree. Because of this amazing opportunity, we were able to give students across all years at Lincoln the chance to gain more knowledge and extra practice in learning this crucial technique!
Nicole
Hi, I’m Nicole – one of the final-year Biomedical Science students behind this project. Starting at the University of Lincoln, I wasn’t entirely sure which direction I wanted to take within biomedical science. As the course progressed, I enjoyed the hands-on lab work, particularly how it transformed theoretical knowledge into practical application. This became evident in my second year during Laboratory Skills sessions led by Dr. Andy Gilbert. These weekly sessions focused on core techniques like centrifugation, microscopy, and microbiology.
Co-creating the ELISA workshop booklet felt like more than just a project; it was an opportunity to make lab-based learning more accessible and less intimidating. Since ELISA is a technique, we limited experience with as students, developing this protocol felt was crucial. Working with Ellie and Yvana to bring our ideas together was fulfilling. My favourite part was seeing the complete protocol, knowing it would support students to tackle the ELISA confidentially.
Figure depicting how ELISA works step-by-step
Building the booklet
This project was a collaborative effort and not something we did alone- we brought our own strengths together to create the now called ELISA Team (given by Claire Walker herself!). We spent countless hours in the lab, testing and refining each activity to make sure it worked as intended and delivered the essential skills students would need to confidently complete an ELISA in real time. We held regular meetings, worked on it during lectures (sorry Claire and Andy!), and genuinely had a lot of fun creating something meaningful that we hope will support future students just like us.
Under the guidance of Dr Claire Walker and Dr Andy Gilbert, we set out to create a resource that would feel practical, and genuinely useful for students. We didn’t want a booklet created from a lecturer’s perspective of what students might find helpful. We wanted to build something we would have found helpful when we first encountered ELISA, a step-by-step walkthrough from a student’s perspective.
Overview of ELISA (Enzyme-Linked Immunosorbent Assay) booklet use to educate students
The booklet breaks down ELISA into its fundamental components, from how to properly use a multichannel pipette (which was a nightmare to handle!) to interpreting results and avoiding common mistakes students might fall for. For instance, one key focus was on the washing stages, an often-overlooked step that if done incorrectly, can lead to high background noise and inaccurate results, which in a diagnostic lab can be the difference between a patient receiving an accurate diagnosis or potentially missing one altogether.
What made this project especially rewarding was the opportunity to run our session with real students from first year undergraduates in Biomedical Science to postgraduates in Biotechnology. The feedback we received was overwhelmingly positive. Many said the booklet helped them better understand ELISA both in theory and in practice. We focused heavily on visual learning using diagrams, photos, and annotated guides because we knew from our own experience that clarity and visual support were essential when learning complex lab techniques.
Initial plate setup demonstrating serial dilutions and pipette accuracy during the first activity, comparing multichannel versus single-channel pipetting.
Our final thoughts
Our co-creation project not only gave us a chance to give back to the large community of students, but we were able to bridge a gap that many lectures hadn’t quite managed before, true co-creation between students and lecturers. Together, we created something that students appreciated and benefited from which was entirely made by their peers through mutual experience.
Looking back, we are incredibly proud of what we achieved as a team. It showed us how impactful student-led projects can be when they’re supported by passionate educators and built around supporting the educational needs of the community.
I am currently in the middle of secret project, which I hope to announce more about in late August/early September. I’m really excited about it but it’s taking a bunch of my time. I’m hoping that you will be just as excited when I can share more details. The wonderful Dr Claire Walker is helping me deliver my passion project by curating the Girlymicrobiologist blog for a few weeks. This means that I hope you all enjoy getting some great guest blogs from a range of topics. Girlymicrobiologist is a community, and all of the wonderful authors stepping up, sharing their thoughts and projects, to support me in mine means the world. I hope you enjoy this guest blog series. Drop me a line if you too would be interested in joining this community by writing a guest blog.
Callum is a disciple of the biomedical sciences, current master’s student creating a more authentic lab experience for those after me, aspiring consultant microbiologist (the best discipline, sorry Claire – you see he understands, like me, that micro will always trump immunology).
Callum is supervised by Dr Walker who is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for the Girlymicrobiologist, including Exome Sequencing and the Hunt for New Genetic Diseases.
Blog by Callum Barnes
Hello again everyone! It certainly feels weird to be writing another one of these, but my supervisor the lovely Dr Claire Walker thought it would be a great idea considering the outcome of my research that I discussed here.
A small recap for those that don’t want to read two blogposts – I am an Mbio Biomedical Science student at the University of Lincoln and completed my portfolio on a placement year in a local microbiology lab. It was great and I became so much more confident in both my practical and theoretical work, which really showed me the value of clinical placements. The problem is that these placements are too few and too competitive nationwide, and only a fraction of those that want to join the biomedical workforce get to experience them despite their value. Long story short, we created a clinical simulation that was as authentic to a real pathology lab as possible, with patient request cards and a functioning (front-end) LIMS, both seen below:
Can you believe no one got the Star Trek references? Anyway. The results were honestly incredible, with basically everyone that participated getting value out of it. I can’t share too much as we are yet to publish, but here are some quotes that really highlight how the clinical simulation increased confidence and was effective as a learning tool.
“Getting hands on experience in the lab. It gave me the confidence to continue in the lab setting.”
“Overall, the lab practicals have been helpful. I think my lab skills have drastically improved, especially my microscopy skills and interpreting my lab results.”
“I like the opportunity we had to practice new skills and learn about it in the contrast of a case study.”
These results were really good, but during my background research I came to realise that other medical disciplines are ahead of us in utilising learning tools to teach university students – like really ahead. Trainee doctors have actors, manikins, and in the last decade have extensively integrated VR/AR/XR technologies into their teachings. We are left with a couple of practical sessions per discipline to cover the hundreds of different diagnostic processes that biomedical scientists go through. And this is almost entirely down to cost, practicals cost a fortune after all. They take setting up, and time, which staff don’t have enough of as is. Which brings us back to virtual reality…
Virtual reality (can be) cheap, accessible, and most importantly repeatable. Other medical disciplines have already identified this, and there is good data to back up the use of VR in those disciplines. But none in biomedical science, because clinical simulation is only just being recognised as a worthy endeavour.
And so, this is going to be my goal. I am going to develop software to train biomedical scientists in virtual reality. It’s going to be tough, but I do truly believe that this is a sorely neglected part of training the next generation of pathologists here in the UK, and honestly hopefully the world too. And if everything goes well (and even if it doesn’t), I’ll be back here in a year to let you all know how it went.
There’s a lot going on right now, and life is busy for everyone. Despite the challenges, this lack of time can mean that reflection and taking a moment to catch your breath can be even more beneficial. I can’t believe this is the 250th post on this blog and so, if you’ll forgive the indulgence, I’m going to be taking my own advice and spending a little time celebrating this milestone by remembering why I started, what I wanted to achieve, whether that has worked out, and where I would like Girlymicro to go in the future.
Where did it start?
When I chose Girlymicro as my twitter handle back in 2012 I had no idea of the decision I was actually making. I didn’t set out to have a ‘brand’, I never imagined that it would exist outside of a platform that I had newly encountered and was trying to learn how to use. That said Girlymicro was chosen with purpose even back then. I wanted something that allowed me to represent, and consciously go against some of the advice that I had heard during my career. Advice that said that I could be good but I would be better if I tried to fit in and not bring my whole self to the table. To accept that fact that I should be a scientist first and a woman second, and that by putting my femineity and female perspective forward I would isolate myself and limit my ability to succeed. That scientists didn’t look like me. I also wanted to show that I can be Girly in a non-traditional way, I don’t wear lots of makeup, I don’t worry about my appearance, but I enjoy being feminine despite all of those things. I wanted to say I like wearing pinks and purples, and I can also still be good at science. So, Girlymicro was born.
Roll forward to the end of my PhD and I had discovered a love for science communication, and how education can be done differently. It didn’t all need to be lectures, where someone knowledgeable stood at the front of the room and gifted knowledge to those who sat passively within the space. That knowledge could be co-produced instead of given.
This inspired me to start thinking about how I could make a difference in this space. In 2015 I didn’t really know what it was that I wanted, I was still very much thinking about options but I hadn’t pinned anything down. For me, looking back, this shows that sometimes having a passion is the best place to start. You don’t have to have all the detail mapped out, and sometimes knowing what you don’t want to do is almost as important.
When I started to investigate the science blogging space, a lot of the blogs were very technical, highly referenced, and very science forward. These were all brilliant blogs, the trouble was I was pretty sure they weren’t what I wanted to write. This was for a couple of reasons, I’d just finished writing a PhD thesis and a whole bunch of papers. I knew that I could write that kind of work but I was aware that writing that every week would be incredibly time consuming, not necessarily teach me new skills, and not reach the audience I wanted to speak to. I also knew that I wanted to keep the Girlymicro mentality of bringing my whole self and so something that felt one dimensional didn’t tick my boxes for a project that I knew would require a big time investment. I knew that wasn’t right for me, but I had yet to work out what right looked like.
Where have I been?
In 2015 I registered the Girlymicrobiologist domain therefore, whilst not completely sure what it was that I wanted to do. Sometimes I knew you just have to get started. I put out my first, very short blog post, and then frankly kind of chickened out.
It wasn’t until the pandemic that I finally crystalised what it was I wanted to write and who it was I wanted to speak to. By the time my second blog post was launched I’d worked with Nicola Baldwin, as a playwright, on the Nosocomial project. I’d really started to find my feet in terms of knowing who I was as a communicator. I had also spent over 6 months doing various radio and comms linked to the pandemic, and I was getting really frustrated at the fact that all of it boiled down to sound bite communication. I didn’t have a space where I could speak without an intermediary, or where I could explore the complexity of what was happening. That dissatisfaction combined with the fact that I was increasingly aware of the fact that there may be people who were interested in engaging with this kind of content, due to questions across social media and from my friends, meant that I finally got over my fear and put out my first real blog post.
You’ll see that these early blogs are all pretty short. They are definitely Girlymicro blogs, but they fit into the expectations of the time when they will written.
We all know I love a bit of research, and when I started writing regularly I obeyed the rules of the time. That was that blogs should be 500 – 900 words and three pictures. I also really felt the need to demonstrate my credibility, to show that I had the right to be writing. I felt I had to prove to people that I was worthy of their time (not that I don’t now, but it feels different). All of this means that the early blogs feel a bit different to the ones I post today.
It took me longer than I would have thought to get to the point where I could finally do what I had set up my Girlymicro twitter handle for back in 2012, and that was bring my whole self, good, bad and sometimes mortifying, to my blogs. To share weakness as well as strength, and on occasion to write blog posts that are about things I’m exploring and don’t have any answers to. It took me quite a while to be brave and find the courage to throw it out there and deal with whatever reception happened.
It also took me a while to share the big moments, and to think that was OK, rather than being considered boastful. I clearly remember the anxiety of posting about receiving a New Years Honour, and even making consultant. Despite that anxiety I have chosen to live by ‘you can’t be what you can’t see’. It’s really important to show that someone as normal as me can achieve, and that those routes are open to everyone. It’s not about being special, or exceptional, it’s about bringing your whole self and continuing to show up, even on the bad days. Therefore being out there and visible is important both to show what can happen and options to get there.
It took me even longer to think of myself (and I’m not entirely sure I still do) as a writer, rather than someone who writes. I don’t think of myself as a particularly good writer, my knowledge of grammar is super weak. What I’ve learnt though is that, if you write from the heart, if you have something to say that is well intentioned and written to support others, then people forgive you for any lack of skill. You also won’t learn and get better if you don’t practice, so I’m practicing in a safe space with a load of supporters who are prepared to think the best of me.
Over the last 10 years, whether actively writing or not, I’ve learnt a lot about myself, how I want to communicate, and who I want to communicate and build a community with. It is that learning that has helped me develop and build. The feedback and support has been invaluable, and it’s help me to know that it is OK to learn and evolve as I go. It’s then so important to share that learning so that the next person looking to start a blog can build upon knowledge already gained and make something that works for them.
Life gets busy for all of us, and it can be challenging sometimes to get a blog out every week, plus we all know that sometimes I fail to deliver. Frequency is key though, both because I don’t want to let everyone down, and because it is all too easy to fall out of the habit of writing if you start skipping weeks. Those were the reasons for posting regularly at the start anyway. If you read any ‘how to start a blog’ page it will tell you about the importance of regular content updates.
I don’t think that’s the reason why I post regularly now and feel unsettled if I miss posts these days however. I think that I have come to find writing an invaluable way of sorting through my thoughts and processing my responses. I started writing a blog for the benefit of others, but I have discovered how much creating a regular space for reflection, as part of writing, has massive benefits for me and my well being. It’s become a habit that I absolutely don’t want to break, plus I have 350 plus posts in draft so it’ll take me time to get through them.
I also feel that as you build and develop you are able to see the vision more and more clearly, and so what you build naturally changes. I didn’t deliberately set out to post on key topics such as Infection Prevention and Control, Healthcare Science, Leadership, Academia/research and personal growth, but looking back now I can’t see that Girlymicro could have been anything but what it is. It started from a place of authenticity, and so what has developed is something that is uniquely me, and I couldn’t be happier.
What’s my current reality?
Talking about what Girlymicro is now, in the world of AI I thought it would be interesting to see what Gemini (Googles AI) thinks of the Girlymicro blog. So If you hit up Google and ask ‘what is the Girlymicrobiologist blog’ it comes up (as of the 22nd June 2025) with the below:
The Girlymicro blog is a science blog written by a Healthcare Scientist and Infection Prevention and Control Consultant named Professor Elaine Cloutman-Green. It focuses on various topics including leadership, academia, Healthcare Science, infection control, and personal experiences, with a strong emphasis on community and raising awareness within these fields.
Here’s a more detailed breakdown:
Focus Areas:The blog covers a range of topics, including leadership, PhD tips, Healthcare Science, infection control and microbiology, personal experiences, and guest blogs/book reviews.
Purpose:The blog aims to demystify science, make it accessible to everyone, and build a supportive community for those working in or interested in these fields.
Community Engagement:The blog actively encourages interaction with the audience, featuring guest blogs to broaden perspectives and inviting feedback to improve content.
Author’s Perspective:The author, Professor Cloutman-Green, shares her expertise as a scientist and consultant while also offering insights into her personal journey and experiences.
Content Style:The blog features a mix of informative posts, personal reflections, and discussions on current issues related to science and healthcare.
Now I know that AI will scrape a lot of what I wrote and therefore may be seen as just posting positive reinforcement, but I have to say that summary did not make me miserable. I’m pretty happy that it covers a lot of what I hope it would cover. When it is hard to write, it is sometimes nice to reflect and see if whether what you are doing still fits your purpose and the reason you started, so that alignment with my ‘why’ feels pretty good.
What am I proudest of?
Talking about evolution, when I first started I had never considered guest blogs or what they could look like. It took about a year for me to feel like I knew what I was doing enough to put out a call for people who would be willing to write guest blogs. Now, out of the posts published, ~13% are guest blogs, This is so important to me. I’ve always wanted Girlymicro to be a community, a community where we listen to and support each other. Guest blogs are an important component of that as they work to offer others a voice, and to be able to practice within what I hope is a safe and supportive space. Writing guest blogs enables others to feel supported in sharing their views, but also to try out a type of writing that authors may not have done before, and to build confidence. I’m especially happy that many of those who write guest blogs are undergraduates or early post graduates, where developing these skills and potentially raising their profile, might help them in their future.
I know that I asked AI what they thought of the blog, but in order to be a little more thorough I also reached out across social media platforms in order to ask others what they thought. What they liked and found helpful, but also where it could get better. So whilst I’m talking about gratitude, I’m so proud and grateful for the responses received. When everyone is up against it, the fact that people took time to respond and give their thoughts means the world:
What are the lessons I’ve learnt?
One of the thing I’ve discovered when speaking to people about this blog is that people read blogs for all kinds of reasons. Now, I know I said that I don’t write Girlymicro as a hard science blog, but I do always want to include interesting other pieces of reading where I can. Apparently, according to the article below, people read science blogs for a variety of reasons, and you can either try to double down on one of them, or do what I do, and hope to achieve all of the different aspects but at different moments and in different articles. This is probably quite obvious if you spend time thinking about it, but it was not something I had particularly realised. It is however one of the reasons why posting a variety of different types of content seems to work. Every day is a school day.
I knew none of those things when I started, and I will always continue to write the things that speak to me in the hope it is helpful to others, rather than trying to hit an algorithm or meet requirements laid out by others. That said, and as food for thought, I thought I would shared some of the lessons I’ve learnt over the last ten years, many of which could be applied to just life in general:
You don’t have to have it all figured out, but you need to have a direction of travel and a purpose
Things will change so don’t cling to where you started, be open to learning and evolution
Just keep showing up, even when you don’t want to, especially when it’s hard
Sometimes knowing what you don’t want to do is helpful and shouldn’t be dismissed
Take the risk, and make the jump. Nothing is perfect, failure will happen, but you will end up better for it
Have a little faith. Have faith in your gut. Have faith that others will be there to catch you and support you when you need it
Try to think about your community and building your networks. Focus on what serves them than what serves you only
Everything takes longer than you think and nothing is ever finished. Starting a project like this is a commitment of years with no end date. Make sure you have the passion to see you through
If you bring your whole self it will always be a success, as it will be truly and uniquely you
What are my hopes and aspirations for the future?
I still aspire to turning the blog into a book, I’m still working on it. I have big dreams and I’m not done yet. Most of my hopes are about continuing to build community though, that’s where my dreams are all seated. What can we do better to learn from each other? How can I do this better in order to help? How can I reach people who might find this useful? People who don’t read blogs in this way or exist on the platforms I use? This blog, like me, is a work in progress, and long may that continue.
The one thing that I am certain of is that I want to continue to be grateful, to see what we are building together and to continue to experience awe that I get to be a part of it. Girlymicro was never meant to be a brand but I’m beyond grateful for the fact that, with the support of all of you, it kind of is, and it’s a platform that I commit to using for the good of all of us. To support, to inform, and hopefully to enable positive change. Thank you so much for being part of this and here’s to the next 250!
I am currently in the middle of secret project, which I hope to announce more about in late August/early September. I’m really excited about it but it’s taking a bunch of my time. I’m hoping that you will be just as excited when I can share more details. The wonderful Dr Claire Walker is helping me deliver my passion project by curating the Girlymicrobiologist blog for a few weeks. This means that I hope you all enjoy getting some great guest blogs from a range of topics. Girlymicrobiologist is a community, and all of the wonderful authors stepping up, sharing their thoughts and projects, to support me in mine means the world. I hope you enjoy this guest blog series. Drop me a line if you too would be interested in joining this community by writing a guest blog.
Dr Walker who is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for the Girlymicrobiologist, including Microbial Culture: An Immunologist’s Side Project Gone Wild.
This weeks blog post continues this months fungal theme (all things yeast) and is from the absolutely amazing Kate Rennie. Kate is a born microbiologist, even if she was diverted by the world of nursing and has gone on to become a cracking Infection Prevention and Control nurse. Her curiosity and willingness to learn and expand her skill sets, makes it no surprise to me that when she decided to expand her hobbies, she decided to go down a route that touches on all things micro.
Before we get into the sour dough however, let’s start by talking what coeliac disease (the condition that leads to the requirement for gluten free bread) as written for us by Dr Claire Walker, our in-house immunologist:
Coeliac disease is a serious autoimmune condition where eating gluten, a protein in wheat, barley, and rye, triggers the immune system to attack an enzyme in the gut called tissue transglutaminase. This damages the villi, tiny structures in the small intestine that absorb nutrients. The result? Symptoms like bloating, diarrhoea, fatigue, and iron deficiency. But it doesn’t stop at the gut. Some people develop dermatitis herpetiformis, an intensely itchy, blistering skin rash. Others experience neurological symptoms such as brain fog, headaches, and numbness or tingling in the limbs. It’s often misdiagnosed or missed entirely.
Around 1 in 100 people in the UK have coeliac disease, but most remain undiagnosed. Diagnosis usually starts with blood tests (like the tTG-IgA), followed by a small bowel biopsy to confirm intestinal damage. These tests only work if you’re currently eating gluten. So if someone’s already gone gluten-free and are feeling better, they need to reintroduce it for several weeks which can cause symptoms to reappear and puts many people off testing.
There’s no cure and the only treatment is a strict, lifelong gluten-free diet. That means no “cheat days” as even tiny amounts can cause damage. It takes serious commitment: careful label reading, avoiding cross-contamination, and asking awkward questions when eating out. But for most, removing gluten thankfully leads to major improvements in symptoms and overall wellbeing.
Blog by Kate Rennie
What am I growing in my kitchen… a gluten free sourdough journey through the eyes of an IPC nurse
I’m Kate, I’m an infection control nurse at GOSH. I’ve worked in infection control since 2020 (1.5 years in primary care, 9 months in community/mental health and I’ve been at GOSH since April 2022). I was diagnosed with Coeliac disease in 2013 and decided 2025 would be the year of new hobbies and I am bored of gluten free bread that resembles cardboard.
I decided to embark on my sourdough journey (albeit slightly late to the party as I know this was a lockdown thing). I didn’t actually know what I was getting into with making sourdough, I read the first few steps and thought it sounded pretty simple, flour and water in a jar.
My flour and water sat on my kitchen side in a jar for 2 weeks (gross), and I named it Marilyn (Mondough)… I nurtured her and fed her daily, for those who may remember Tamagotchi’s, this is how I can describe it and as a previous Tamagotchi owner, I loved it.
Part of me was obsessed with what have created and look forward to waking up each morning to see how it’s looking (highlight of your late 20s) but the infection control nurse in me is slightly grossed out by it. I’ve read a bit more and learnt a lot, she just needed a little bit of extra love and care (troubleshooting) at a few days old.
HOOCH – I’ve only ever known hooch as this from my late teens/early 20s.
Fast forward to my late 20s, this is a sign that your sourdough starter is hungry, it’s eaten all its nutrients, and you must feed it more frequently. I was reluctant to throw her away and start fresh so I added teff flour in the hope she would perk up and SHE DID.
But she smelt disgusting… A familiar reminder of my 16 year old, pre-nurse self, having my long acrylic nails removed in the salon. ACETONE?? Apparently, it’s a byproduct of fermentation…
So, I wondered if this was actually safe to have something fermenting in my kitchen with absolutely 0 knowledge and thinking I’m probably going to poison myself. After a bit of research, I learnt this is normal and how to fix it, yet again, she’s hungry and I’m a rubbish mother.
Whatever is happening inside that jar is creating its own yeast to make it grow which is quite cool! I’m not sure how many people have actually gone this deep into the thought of a sourdough starter, but my IPC brain is fascinated yet disgusted and I want to know more. Do I want to culture it in the lab? Probably not. Am I going to eat it? Most definitely.
Fast forward 2 weeks… My sourdough journey ended abruptly after my first loaf. I felt disheartened that it didn’t turn out like the GF loaves I’d spent too much time obsessing over on Tik Tok. The perfectionist I am wanted the perfect loaf to happen first time, so I abandoned sourdough and ventured into making non-sourdough gluten free bread. I popped Marilyn in the fridge for when I decided to revisit sourdough making and there she stayed for a good 3 months. Apparently, this puts it to sleep, and you can later revive it… but after pulling it out the fridge and seeing a layer of black liquid on top of the starter, my IPC brain got the better of me and I decided with my limited knowledge of sourdough and fermentation at home, it probably was best that I didn’t consume this and decided to throw it in the bin and I spared a brief thought for what Marilyn was and could have been if I had more patience.
I’d hoped this would be a success story about my gluten free sourdough rather than a failure but basically, sourdough isn’t easy and gluten free sourdough, really isn’t easy. It truly is a science.
Gluten free bread making in general is a delicate science because it lacks the key protein—gluten—that gives traditional bread its structure, elasticity, and chew. In wheat-based breads, gluten forms a stretchy network that traps gas bubbles from yeast, allowing the dough to rise and hold its shape. Without gluten, you have to rely on a blend of alternative flours—like rice, sorghum, or buckwheat—each contributing unique properties such as starch, protein, or flavour. Binding agents like psyllium husk are also essential to mimic gluten’s elasticity. No single gluten-free flour can replicate all the functions of wheat flour, which is why crafting a successful gluten-free loaf requires a carefully balanced mix rather than just throwing in a single substitute flour and hoping for the best.
I have been successful on a few occasions in making non-sourdough gluten free bread which has still been a real insight into science in everyday life.
To all life’s problems there are solutions if only we are curious and passionate enough to see them and change direction in order to maximise our successes. It appears Kates’ experience with sour dough as part of her coeliac journey is no different.
I am currently in the middle of secret project, which I hope to announce more about in late August/early September. I’m really excited about it but it’s taking a bunch of my time. I’m hoping that you will be just as excited when I can share more details. The wonderful Dr Claire Walker is helping me deliver my passion project by curating the Girlymicrobiologist blog for a few weeks. This means that I hope you all enjoy getting some great guest blogs from a range of topics. Girlymicrobiologist is a community, and all of the wonderful authors stepping up, sharing their thoughts and projects, to support me in mine means the world. I hope you enjoy this guest blog series. Drop me a line if you too would be interested in joining this community by writing a guest blog.
Previous mycology posts have covered how fungal mycotoxins can cause us harm, and how the new yeast on the block, C. auris, is causing problems in healthcare, but the next two posts will talk about how beneficial fungi can be in our every day lives.
The blog posts will look at how certain yeasts can be used in something that brings me a lot of joy, bread. Many of you will know I’m dairy free, and although I know I should cut down on carbs, you can take my bread from my cold dead hands. It’s one of the few things I can eat without fear and makes me happy. In celebration of this oft overlooked area of microbiology we shall be talking all things baking over the next two weeks.
The first of these posts is written by Dr Walker who is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for the Girlymicrobiologist, including Exome Sequencing and the Hunt for New Genetic Diseases.
Before I hand over to Claire though, I thought I would talk a little about baking and fermentation. About 50% of all the PhD students I speak to have dreamt at some point of throwing their research out the window, running away and starting a bakery. This may be because baking has a surprising amount of science within it when compared to some other forms of cooking, hence the need to closely align to a recipe. A lot of this is actually because you are working with yeast, a living organism, hence the fact that we are talking about this on the Girlymicro blog, as micro is just cool in so many ways
Fermentation is an anaerobic (occurs without the presence of oxygen) process where microorganisms, like bacteria and yeast, convert sugars into energy and various byproducts, like acids, gases, or alcohol. In baking, it causes yeast and bacteria to convert sugars into carbon dioxide, among other things. This is what causes the dough to rise, as well as adding flavour, and is therefore essential to all things yummy and bread related. The most commonly used yeast is Saccharomyces cerevisiae, and this is one of the reason baking can behave so variably on times of the day or seasons, as both temperature and pH can impact on how well the fermentation process works. It can also mean, if you are impatient like me, you add water at far too high a temperature and effectively kill off your yeast so it doesn’t work at all. Fermentation, and its use in food production, is one of the many examples of how microbiology and microbes impact our every day lives, and of how much poorer our lives would be without them. So I hope you’ll enjoy the next couple of blogs about how baking has both microbiological and immunological links.
Blog by Dr Claire Walker
As I’ve confessed on this blog before,I am, what I like to call, a ‘failed microbiologist’. Many moons ago I completed a master’s qualification in environmental microbiology and dreamed of a career tracking pathogens through our water systems guaranteeing safe water for all. However, I graduated during a recession and started applying for any job that would have me. As luck would have it, I ended up on the immunology clinical scientist training scheme (the story of that fateful application I will save for a later date), and the rest is history. However, I’ve always loved a bit of microbiology and my fascination with all things fermented has taken me on many adventures. Including baking afternoon tea for a GirlyMicro special event!
My treat for finishing my marking this year was a fermentation course at the Welbeck School of Artisanal food learning all about the transformation of food by microorganisms. The word fermentation comes from the Latin fervere meaning ‘to boil’ after Romans watched the bubbles forming when they fermented grapes into wine. Name a scientist who doesn’t love a bit of Latin? There are several biological processes occurring when we ferment foods like grapes, but essentially it is a process by which large chains of molecules are broken down by enzymes into their smaller, tastier, more nutritious, and more easily digestible parts.
The area of fermentation about which I am really passionate is sourdough. Yes, I lived in East London for many years, and yes, I owned a banneton before it was cool. Sourdough doesn’t just indulge my microbiology side project; it became unexpectedly personal. After picking up a particularly unpleasant microbe while travelling in India, I developed amoebic dysentery, and my gut never fully bounced back. I couldn’t tolerate shop-bought bread or much of anything, really. It wasn’t until I began incorporating fermented foods, especially sourdough, into my diet that I noticed slow but steady improvement. (Though let me be clear: this is my experience, not medical advice – if you’re unwell, definitely speak to your clinician!)
For the uninitiated, a sourdough mother, or starter, is a living culture of wild yeast and lactic acid bacteria that needs regular feeding with flour and water to stay active. As a failed microbiologist, I found something oddly fulfilling about sustaining a microbial ecosystem especially one that produces bread with real health benefits. What’s not to love about a culture that feeds you back?
Of course, I’m a dyed in the wool clinical immunologist so I can’t finish up this post without waxing lyrical about the immunology of sourdough. What makes sourdough really special, from an immunologists perspective, is how it supports our gut, which is home to about 70% of our immune cells. By encouraging a healthy mix of gut bacteria, sourdough helps produce bioactive compounds that keep our immune system balanced, strengthening our defenses without overreacting. This means it can help protect us from infections while calming down low-grade chronic inflammation that might otherwise cause problems. So, sourdough isn’t just tasty, it’s a simple, natural way to support a well-regulated immune response. Of course, sourdough isn’t for everyone, especially not for coeliacs. After all, even the most dedicated immunologist moonlighting as a microbiologist hasn’t yet figured out how to turn gluten into something completely safe. Guess some mysteries are still off the menu!
Following on from the wonderful fungal post on fungal toxins (mycotoxins) last week from Dr Sam Watkin, I wanted to follow up with a post on the latest fungi of interest from a clinical perspective, Candidozyma auris. This fungi is getting more and more coverage, as well as becoming more important in healthcare, so I thought I would take a moment to talk about what it is, what it does, how to find it, and what to do when you do.
In a pre-pandemic world, which feels like a long time ago, Professor Lena Ciric was working at a media fellowship, and as part of that work wrote an article for the BBC on Candida auris, which has subsequently been renamed to Candidozyma auris.
This article came out in 2019, so maybe C. auris is not so new but in terms of the numbers of cases we are seeing within the NHS, and the changing prevalence out in healthcare systems more widely, it is definitely more of a feature and a concern than it was back then. Reflecting this change the UKHSA guidance Candidozyma auris (formerly Candida auris): guidance for acute healthcare settings which was originally published in 2016, has been updated recently (19th March 2025). It feels timely therefore to put something out in order to raise awareness of this organism and the unique challenges it presents.
NB I can neither spell nor pronounce Candidozyma auris and so we’re sticking to C. auris from this point out.
Yeast are a type of fungus, and Candida species are often associated with colonisation (present without causing infection or symptoms) on skin, in the mouth or within the vagina. If they grow up to high levels they can cause an infection called candidiasis, which often causes symptoms like itching or discharge. Common infections include Thrush and nappy rash. Candida albicans is one of the most common yeast infections seen within the healthcare setting, and in this kind of environment more serious infections can be seen, especially those linked to the blood stream, and occasionally serious organ infections.
C. auris was originally believed to be a relatively new species of genus Candida, as it often behaves in a similar way to the other Candida species. The reason for the name change to Candidozyma auris, was because, although in many ways it behaves similarly to its Candida cousins, it does have some differences in the way it behaves. These include features such as intrinsic antifungal resistance and growth conditions, that make it useful to characterise in a way that acknowledges it as a novel genus in its own right.
What is the difference between C. auris and the other Candida species that you know?
Many Candida species can cause severe infections within specific settings, however C. auris has been known to not only cause a wide variety of infections (bloodstream, intra-abdominal, bone and cerebrospinal fluid (CSF) infections), but ones which lead to significant mortality rates, with an estimated rate of 30 – 72% in severe infection reported in the literature.
Infections can occur in any patient group, although UK outbreaks have been most frequent associated with adult settings. Augmented care settings (such as intensive care and transplant settings) are at highest risk due to the vulnerable, long stay nature of many of their patients. Management of any infection occurring is complicated by the fact that C. auris has developed resistance to many available classes of antifungals, with emergence of pan-resistant strains, which add to the mortality risk.
C. auris also appears able to both easily transmit and colonise the skin of patients, with most patients being colonised before they go on to develop any subsequent infection. These colonised patients can then contaminate their healthcare environments, and unlike other yeast species, C. auris is able to survive and represent a continued risk within the environment for prolonged periods, all of which contributes to outbreak risk.
It was first identified in the ear canal of a patient in Japan in 2009, but has since been found globally, and is now separated into six genetically distinct clades:
Clade I = the South Asian clade, first detected in India and Pakistan
Clade II = the East Asian clade, first detected in Japan
Clade III = the South African clade, first detected in South Africa
Clade IV = the South American clade, first detected in Venezuela
Within the UK from January 2013 – December 2024, 637 C. auris isolates were reported through laboratory surveillance in England, with 59 (9.3%) isolated from blood culture specimens. It should be noted that not all labs report, and for some time many labs could not accurately identify C. auris, or actively screened for it, and so this may represent under reporting. A routine whole genome sequencing service is not currently available for typing, although it can be undertaken linked to specific outbreaks. Hopefully this will be up and running soon to better understand how the different clades discussed above are represented in the UK, and whether any of them are linked to more challenging outcomes than others.
Due to its global distribution, overseas patients may also be at increased risk of introducing C. auris into UK healthcare settings, with one centre reported 1.6% of their overseas admission detected as colonised, with patients coming from the Middle East, India and Pakistan, showing higher levels of recovery.
UKHSA guidance suggests we should screen any patient who has had an overnight stay in a healthcare facility outside of the UK in the previous year, as well as patients patients coming from affected units in the UK. This sounds relatively straight forward, but it can be challenging to identify patients who have had an overnight stay overseas on admission if they are not being admitted from overseas. It also relies on clear communication from other centres that they have an issue, if we are to screen patients from impacted units. Many centres have therefore decided to screen all patients on high-risk wards, such as intensive care, to address some of this unknown risk.
Risk factors for developing C. auris colonisation or infection should be considered when deciding on screening strategies and the list within the UKHSA guidance includes patients who have experience:
healthcare abroad, including repatriations or international patient transfers to UK hospitals for medical care, especially from countries with ongoing transmissions
recent surgery, including vascular surgery within 30 days
prolonged stay in critical care
severe underlying disease with immunosuppression, such as HIV and bone marrow transplantation
corticosteroid therapy
neutropenia
malignancy
chronic kidney disease or diabetes mellitus
mechanical ventilation
presence of a central-venous catheter or urinary catheter
extra-ventricular CSF drainage device
prolonged exposure to broad-spectrum antibiotic or antifungal use
Screening is undertaken by taking swabs from the axilla (armpit), groin and nose, although different patient groups may require additional screening. Patient surveillance is important for two reasons:
1) to understand which patients are colonised in order to introduce additional precautions to limit risk of transmission to other patients or the environment
2) to support improved patient management but allowing patients to be put on the most effective antifungal if they go on to develop any signs of yeast infection, in order to improve outcomes
If a patient is detected as positive, other screening sites can help manage individual patients and so UKHSA say additional site screening should be considered:
urine (especially if there is a urinary catheter in-situ, including intermittent self-catheterisation)
throat swab
perineal swab
rectal swab (in paediatrics we would consider a stool sample instead)
low vaginal swab
sputum or endotracheal secretions
drain fluid (abdominal, pelvic or mediastinal)
vascular access sites
wounds or broken skin
ear
umbilical area (neonates)
Swabs should ideally be processed on chromogenic media (colour changing agar plates) and fungal colonies confirmed using MALDI ToF or a validated PCR (my previous post on PCR may help with this). It can also be helpful to incubate plates at 40oC, as C. auris can grow as much higher temperatures than its Candida cousins, which can help with identification. If grown then the yeast should be stored in case you need them for future typing to help in understanding transmissions or outbreaks.
Why should we care about it?
Due to the high mortality rates for patients who develop infections, and the issues with choosing antifungals that work, it is really important that we know when we have patients who are colonised with C. auris. Controlling spread, even if patients don’t become infected, is incredibly important for the individual. This is because if a patient is detected as positive they won’t be de-alerted (have IPC precautions stopped) at any point and so it will impact them for months, if not years. These IPC precautions include isolation (keeping separate from other patients), and sometimes only being nursed by specific members of staff. These patient and staff impacts are so significant they’ve even been acknowledged in popular media, with a three episode arch covering C. auris in The Resident on Netflix (season three, episodes 18, 19 and 20).
Are there differences in how you might treat?
As I’ve already said, C. auris is pretty resistant to treatment compared to its Candida cousins. UK data indicates that isolates are resistant (don’t respond to) to the normal first line treatment of fluconazole, and often to other antifungals within the azole class. Some isolates have been resistant to other commonly used antifungals, such as amphotericin B (20%) and echinocandins (10%). Resistance to other antifungals can also occur whilst infections are being treated, and so it is important to monitor sensitivities (whether the drug works) and send to reference labs in order to understand the most appropriate therapy. Its resistance profile is one of the reasons the WHO have highlighted C. auris as a priority fungal pathogen for further research and to highlight clinical risk.
Its not just antifungals that are important however, antimicrobial stewardship is important in general, as prolonged exposure to broad-spectrum antibiotics and antifungal agents are risk factors for both C. auris colonisation and infection (again this links back to the high risk patient groups impacted). Therefore, doing a better job of monitoring and controlling antimicrobials in general is likely to have a beneficial impact on C. auris risk.
Challenges with environmental control
One of the many things I love about the new C. auris guidance is its focus on multidisciplinary input ‘Healthcare workers are encouraged to work in multi-disciplinary teams, including Clinical Infection Specialists and IPC teams, to risk assess and support the management of patients infected or colonised with C. auris‘. I think this is so important, especially with an organism that is so challenging and can present such a high risk.
Environmental control is a particular issue for C. auris as we know it’s ability to survive and can grow at higher temperatures than many other fungi, means that it is likely to survive well in the environment. It also has the ability to form environmental biofilms, which can mean it is difficult to impact effectively using standard cleaning techniques, and once within the environment has been been detected for 4 weeks.
Within the UKHSA documentation, environmental contamination for C. auris has been found on the following surfaces during outbreaks:
beds, bedside equipment, bedding materials including mattresses, bed sheets and pillows
ventilation grilles and air conditioning units
radiators
windowsills and other horizontal surfaces
hand wash basins, sink drains and taps
floors
bathrooms doors and walls
disposable and reusable equipment such as ventilators, skin-surface temperature probes, blood pressure cuffs, electrocardiogram leads, stethoscopes, pulse oximeters and cloth lanyards
Basically most of your healthcare environment, whether fixed or movable features. In order to help stop the transfer from patients to the environment, via staff, the use of personal protective equipment is really important. Therefore the use of gowns and gloves is suggested. Single use and disposable equipment should also be used whenever possible, and patients should be kept in single, ensuite rooms, to minimise the risk of C. auris escaping from within the bed space to adjacent clinical environments. Any items within the space should either be cleanable with a disinfectant, or disposed of after a patient leaves. One thousand ppm of available chlorine should be used for cleaning, but needs to be used in concert with an appropriate contact time if it is to be effective.
WHO fungal priority pathogens list to guide research, development and public health action 2022
Outbreaks
Most detections of C. auris cases detected are colonisation rather than infection (though colonisations can lead to subsequent infections). Within the UK there have been 5 significant outbreak of C. auris, each with over 50 cases, in addition to many sporadic introductions of single cases, frequently from overseas. Many of these have been in London or the South of England, and have resulted in considerable disruption to services over a prolonged period of time. This disruption can, in itself, be a risk to patients as it can result in delayed access to care. Outbreaks are also financially significant, with outbreaks reported as costing over £1 million for a service impacted for 7 months.
Although outbreak numbers are currently small, they are becoming more frequent, and even if infrequent have significant impacts. The need to control this risk before it becomes endemic within the UK health system is therefore significant. It is crucial therefore to collect more data and understand transmission routes of C. auris better.
Despite probable under reporting, it is clear that C. auris is becoming more common within UK healthcare settings, and has the ability to both cause significant issues for both individual patients and for services, due to outbreak impacts. Although fairly new on the scene there is increasing recognition of how C. auris could change fungal risks within healthcare, and even long stay residential settings. If we are going to adjust approaches in order to react to the new risks C. auris represents we need to both update our current practices, and invest in research, in order to learn how to do things even better. This is the reason that it feels important to share a post that is a little more technical than normal, both to help myself by learning more, but also to ensure that we are having conversations about an organism that has the ability to impact us all.
I’m so excited by this weeks guest blog post. I’m a massive murder mystery fan, and from Agatha Christie onwards there have been multiple books where mushrooms and mushroom toxins (mycotoxins) have been used, either deliberately or accidently, as a pivotal component of the plot. In recent months however, mycotoxins have been in the news in a real world sense, as the case of Erin Patterson has been heard and the jury are deliberating as I write. Erin Patterson is accused of 3 charges of murder, and one of attempted murder, linked to feeding guests a poisonous dish of Beef Wellington at a dinner party.
This led me to speak to my go to guy for mushroom (mycological) based questions. Sam is in love with all things shroom, and even has a mushroom foraging based Instagram. Who better to go to with a request to write a blog post on mycotoxins and to learn more about this intriguing topic?
Blog by Dr Sam Watkin
Hello Girlymicro blog readers! I’m Sam, a previous PhD student of Elaine’s with research focused on investigating trends in microbial dissemination in hospitals. I’m taking the blog astray from the world of IPC however with this post, and instead will focus in on one of my other interests. As people who know me have probably come to realise, I’m a big fan of mushroom foraging. There is something so rewarding to me about finding excellent edible mushrooms that you just can’t buy in shops and exploring the different flavours they can add to food. My partner had to put up with me having a Cauliflower fungus (Sparassis crispa) the size of a football in our freezer for well over a year. We would break bits off and make fantastic soups and stew bases with it – it has a really unique nutty flavour. More than just the pursuit of a free dinner though, I find it very enjoyable finding fungi that I haven’t seen before, or that are particularly rare. I imagine it is similar to the enjoyment a twitcher gets from sighting a rare bird, although mushrooms tend to stay put so there is less pressure on being constantly focussed. Having said that, searching for fungi does often devolve into a game of looking at the brown forest floor trying to spot the slightly-different-brown mushroom. More than once have I run over to a promising shade of brown or yellow, only to be disappointed by a frustratingly deceptive leaf. It is nevertheless a pursuit I thoroughly enjoy, despite the frequent soakings in rain showers and occasional run-ins with brambles.
One aspect of foraging (and indeed looking to identify fungi) is being aware of what ones you can eat and what ones are to be avoided. The old adage “All fungi are edible, some fungi are only edible once” absolutely holds true. While my professional life involves researching microbial transmission and how best to prevent infection, I am fascinated by the toxic nature of fungi. I did consider becoming a toxicologist in my teens, but rapidly realised that the amount of chemistry required was simply not my idea of joy. I do find it very interesting however how fungi are capable of producing some of the most unpleasant, and also strangest, toxins that can be found in the natural world (or at least I think so). So here I am going to run through a few of the fungi that I find most fascinating when it comes to their chemical makeup and the influence they have had on humans through history.
A fairytale classic – Amanita muscaria
Few fungi are more iconic than A. muscaria (known in English as the Fly Agaric). Their characteristic red caps and white flakes are often illustrated in children’s books and are probably what comes to mind when one pictures a ‘toadstool’. They are in every respect the archetypal fungus. This being said; however, you absolutely would not want to eat one. If someone were unfortunate enough to eat a specimen on A. muscaria, they would most likely experience a range of unpleasant neurological symptoms. Confusion, dizziness, ataxia, hallucinations, muscle twitching are often reported, as well as nausea and vomiting. In severe cases, a loss of consciousness and dangerous decreases in blood pressure can occur. These unpleasant effects are due to the makeup of alkaloids present in the fungus, with ibotenic acid and muscimol being predominantly responsible for these effects. Muscimol has a similar molecular structure to GABA-A – the most abundant inhibitory neurotransmitter in the human brain. Ingesting a chemical which mimics such an important neurotransmitter as part of your supper is unlikely to be good news. It acts as an agonist for GABA-A receptors, causing a reduction in the excitability of neurons, causing the range of neurological symptoms. Muscimol is by no means alone here however – A. muscaria also contains ibotenic acid which further acts as an agonist of a host of neurotransmitter receptors (for instance metabotropic glutamate receptors – another widespread neurotransmitter receptor class. Oh, and ibotenic acid is metabolically converted to muscimol in the body. More fun to go around!
It’s not only the alkaloid balance or popular culture appearance of A. muscaria that makes it interesting however – it has had significant historical and cultural influences. It has been traditionally consumed by shaman in northern Europe as a part of winter solstice celebrations. This is due to the intoxicating effects of consumption, where the experience was likened to flying. Part of the rituals would involve the fungi being collected while wearing ceremonial red robes. The fungi were also often fed to reindeer before ingestion to metabolise out some of the more toxic components, with the hallucinatory agents collected in the reindeer’s urine which was then consumed. I’ll pass. But, an association with winter and red robes, feelings of flying and reindeer… these rituals have indeed been credited as a potential origin of the popular imagery of Santa Claus. I guess everything must start somewhere!
An explosive pufferfish – Gyromitra esculenta
I find this to be one of the most fascinating fungi in existence. Partly fuelled by the fact that I still am yet to find this species growing wild (one day my persistence will pay off) and partly by how unique these fungi are both in shape, cultural perceptions and toxicity. Looking like mini brains, they can be found under pine trees on sandy soil in autumn (or so I’m told… maybe they are deliberately avoiding me). They are found in Europe and certain parts of North America, and are called False Morels due to their relation and similarity to the delicious Morels.
Despite being well known as a poisonous fungus their name would suggest otherwise, with “esculenta” being Latin for “edible”. And these fungi are indeed eaten in large quantities! When prepared correctly. As such, they have been likened to the pufferfish of the fungal world, which is quite the title! Appropriately prepared they are supposed to be a delicacy – I can’t speak from experience on this one, my adventures into free fungal food doesn’t quite stretch this far – however raw or improperly cooked they can be fatal. This toxicity is down to the presence of a volatile toxin called gyromitrin. When ingested, gyromitrin is metabolised to monomethyl hydrazine. This goes on to wreak havoc on a wide range of enzymes and processes, inhibiting cytochrome P450, amine oxidases and preventing the formation of pyridoxal 5-phosphate. This compound is a key cofactor in the synthesis of our old friend GABA. This causes a reduction of GABA present, preventing neuronal inhibition and causing to a prolonged excitatory state in the brain – almost the opposite of the effect seen in A. muscaria. This is still not good news however, with symptoms including severe gastrointestinal distress, kidney and liver damage and seizures and death in severe cases. Interestingly, the toxic metabolite produced here is used amongst other chemicals as a rocket propellant. I can’t but help imagine a future where we have spacecraft fuelled by fungi (albeit from a poisonous metabolite of a mycotoxin). Somehow, I doubt it.
Building up to it – Paxillus involutus
Following on from the theme of the last fungus, P. involutus is no stranger to gastronomic controversies. This very common, fairly non-descript fungus is a rather boring shade of brown (sorry if this is your favourite fungus!), although its cap does have a uniquely rolled-over rim (hence the imaginative English name – Brown Roll-Rim). It has historically been considered to be an edible mushroom, with many guidebooks simply stating that once cooked, it was safe to consume. Needless to say, these guidebooks are now firmly out of date and it is now recognised as a deadly poisonous fungus. Unlike the previous two fungi I’ve described here, this fungus does not contain any psychoactive alkaloids or toxic rocket fuel precursors. Instead, this species contains some rather unpleasant irritants which, upon consumption of raw specimens, result in severe gastroenteritis. These toxins however are degraded on heating, hence why it used to be considered edible after cooking. No, the real toxins are much more sinister in this fungus.
True to the weird nature of fungi, this species rebels against the “only edible once” saying quoted earlier. This fungus can actually be edible quite a few times before it poisons you. Unlike other toxins which you may expect to have a rapid onset after consumption (maybe a few days after ingestion at the most), the compounds responsible for the fatal poisonings attributed to P. involutus can take months to manifest. This is because the toxic effects often become apparent after repeated exposure, usually through the repeated consumption of the fungus. This is because the toxic compound here is in fact an antigen, which the body becomes sensitised to over time. Once enough meals of P. involutus have been eaten, the antigen present stimulates a rare autoimmune response where the body produces antibodies which attach to and disrupt red blood cells (autoimmune haemolytic anaemia). This causes life-threatening reductions in red blood cell counts, kidney damage and multi-organ failure. There is no antidote. If in doubt…
So, there are three of the fungi that I find most interesting in terms of their toxicity. This only scratches the surface of the wild world that is mycotoxins – there are hundreds of others. From St Anthony’s Fire (a range of medieval diseases attributed to Ergot (Claviceps purpurea) to the near-certain fatality after consumption of Amanita phalloides or Amanita virosa (named the Death Cap and Destroying Angel respectively – foreboding!), mycotoxins are truly fascinating. These show the massive variety of toxins out there and how they influence both our health but our culture and relationship with wild foods. From a foraging perspective, the range of dangerous fungi out there clearly shows the importance of only foraging with an experienced guide and only collecting what you can identify with 100% confidence. If in doubt, leave it out!
NB from Girlymicro – Whilst we’re delving into some mycological (fungal) joy over a couple of blog posts I thought I would take the opportunity to re-share this four part article series on the fungi of The Last of Us, which was a real joy to be involved with, and a clinical article that may surprise you:
It’s a real privilege for me to share a guest blog today in continued celebration of Pride month and acknowledging the work that is left for us to do to address the ongoing impacts of discrimination and bias on the everyday lives of so many. Ant was the previous Chair of the GOSH Pride network, and in his role as Head of Healthcare Science Education, has also undertaken substantial work on tackling health inequalities through awareness of, and contribution to, the differential attainment toolkit.
We celebrate Pride month every June highlighting the need for visibility, acceptance and equality. This is marked by peaceful protest, a show of diversity in all its forms rising in unity providing a sense of belonging for those that belong to the LGBTQIA+ community as well as those who vibe with the same value set.
The feeling of belonging that is cultivated during pride, where flags are flying, culture and history is more visible etc can be eroded away by subtle moments throughout the day. Typically they arise in the form of everyday comments, assumptions or questions, often unintentional but always land uncomfortably. While these are called microaggressions, they can feel macro-aggressive.
What is a microaggression?
Microaggression as a term describes a form of discrimination that can be communicated through verbal, nonverbal and environmental messages often unintentionally. These in isolation can be relatively small, they hurt, kinda like a papercut which isn’t a huge deal. It stings, you heal, you move on. Having 10 or more papercuts over the day from the moment you wake up to the moment you go to sleep cuts a little deeper causing more distress. To an outsider your reaction to the tenth microaggression of the day may appear disproportionate but they won’t know what you’ve experienced thus far.
Here are some examples of microaggressions, this is not an exhaustive list:
‘So…. who’s the man in the relationship?’
‘I do not see colour’
‘We are all a bit autistic’
‘Do you not want any children?’
‘You are bisexual! Does that not make your partner feel insecure?’
‘You are too pretty to be a lesbian’
‘Your name is hard to pronounce. Can I call you Kerry’
‘You are not like other Muslim people’
‘You do so well for a disabled person’
‘You are so pretty. People have a hard time taking you seriously’
‘You do not look trans’
‘When was the last time you went ‘home’?
‘Given what your husband does, do you really need to work?’
In 2007 the term microaggression was subcategorised into types (microassaults, microinsults, and microinvalidations). The definition was also expanded to include any marginalised identity.
This past month I’ve experienced an increase in microaggressions or outright racism often in environments where it is hard to get away or confront without some sort of collateral damage to myself or others e.g. Intoxicated individuals/groups on trains. If I have had a challenging week at work or am dealing with a personal issue, I find my cognitive load is high making me feel more vulnerable to microaggressions and compounding their impact.
I, like others find it difficult to deal with microagressions as they are often not just directed at one aspect of myself, for instance my sexuality, and often we can experience these acts which relate to multiple parts of ourselves.
Growing up with brown skin and gay I’ve always felt different. This gets compounded when you or those that you relate to are treated adversely. This has really affected my feeling of belonging even into my adult years where my sense of self and place in society is constantly questioned especially when those in power use ‘otherness’ as a political tool legitimising people’s inappropriate behaviour. This can be further damaging when community spaces which should be safe for you are not, further leading to isolation.
So how can we deal with microaggressions?
Know your boundaries
Depending on the situation it may be more appropriate for you to respond in the moment, later on, directly, indirectly or not at all.
Addressing every microaggression can be exhausting and it may do you more harm to address them all.
Highlight what is under the surface
You can try ‘You’ll have to explain that one to me’
‘Can you explain what you meant by that?’
This may help the individual recognise and self correct.
Disarm and dismantle
Interrupt the individual before they get to finish, especially if it’s an inappropriate joke.
‘That is not an appropriate conversation’
Redirect the conversation
Express your discomfort – ‘Id rather not discuss that’
Educate the perpetrator
‘It may not be your intention, but this is how I perceive what you said, and this is how it makes me feel’
I used to say that or had that thought but then I learnt this.
‘I think you are trying to support me but when you say things like that it feels invalidating’
Focus on the impact not the intent – they may not have intended offense, but it is important to address its impact on you.
Use clear and direct language to explain how you felt but don’t use personal attacks in your response.
As a witness you can also
Validate their experience and highlight that you also witnessed and heard.
Ask if they need to vent or need any advice. Or simply ask what they need.
Ask if they’d like you to follow up with the person in question.
Even making eye contact helps
Physically positioning yourself next to the individual for a show of support
Intervening using some of the phrasing in the other sections.
Seek help
If you are in the work place you can get advice from HR, trainee networks or forums, freedom to speak up guardian.
Share your experiences with a friend over a coffee or a slice of pizza.
Going forward
I think it’s important to say whilst one can experience microaggressions we can all be perpetrators and need to be self-reflective in our verbal & physical language and our actions.
We can create a supportive environment building a culture of respect and inclusivity, we can speak up when we witness microaggressions even if directed at others, educate ourselves by learning about how microaggressions affect different people, try and understand and recognise your own internal bias.
If you found this helpful, below is a link to last weeks post on allyship, that may also be of interest:
I often worry about writing posts like this one, not because I’m worried about how needed they are, but because I’m not an expert. As a scientist I usually post in areas that I feel I have expertise in, and as Girlymicro I frequently post about my own lived experience. This post is different, as I’m in no way claiming any expertise on this, just a wish to do more and do it better.
The thing that led me to post is that I’ve been thinking about how many of us who are in influential positions, and placed to be better allies to make a difference to others, do not always feel like we know enough about how to be effective in that role. I tell myself that I will lead with intention in this area, and will just always try to do my best in every encounter and situation. Aiming for that rather than perfection. The problem with that entire sentence is that there are far too many I’s in it, however, and I feel like I’m missing the point. It should never be about me, but about the people I serve and those that I am in a position to support.
So, in that spirit, and after listening to a talk this month where BAME interviewees described that they felt they were not able to bring their 100% authentic selves to work, and in support of Pride month, I thought it’s time to stop making this about my uncertainty, stand up and post what I can about how we can be better allies.
Create safe spaces
I have a saying at work that what happens in the bathroom stays in the bathroom. Now, if you don’t read this blog regularly that sentence may make no sense at all. My office at work is a converted bathroom cubicle, and it still says on-call bathroom on the door. I wrote last week how I didn’t feel like I had a safe space to cry or express how I was feeling when I was a trainee. I hope that the bathroom is now that space. Anyone can come into the bathroom for a chat, and what happens during that chat stays within those 4 walls. Sometimes people need to vent. Sometimes people need a safe space to be upset. Sometimes people need a safe space to check in and see whether something that has happened is OK or not. To raise concerns or talk something through. I’m also happy to be booted out of it at any time so someone has a safe space to process and have some time alone as needed.
Safe spaces aren’t just physical however, they are more often what you can provide to someone else as part of your interactions. A place where anyone can bring what they need for discussion, but also a space where they can be fully themselves without fear of judgement. A safe harbour so that, even if it’s for a few minutes each day, they don’t have to wear a mask. A place where they will feel heard and validated. This can be 1:1, but also ensuring you have networks and other peer spaces that can provide support. It is also about making spaces for others, in terms of creating space for opportunities and progression, that feel open and inclusive to anyone who wants to take them up.
Call out in the moment
It’s all very well trying to create safe spaces, but how do people know about them or that you can help and support. This one is about walking the walk. Not just talking about action, but being the action. It’s about being the person in the room who is fortunate enough to have a voice and being able to challenge in the moment when behaviour happens. Challenging when someone makes a homophobic joke, or reaches out to touch the hair of a colleague without their consent. To challenge the person who refuses to use someone’s chosen pronouns, makes inappropriate comments about someone else’s appearance, or calling out microaggressions to make their behaviour visible. Challenging in the moment, rather than making excuses for the behaviour, or letting it go ‘as it was just a one off’.
For me, this one is about being prepared to experience one tiny component of the level of discomfort of the person being targeted, in order to challenge the behaviour and demonstrate both allyship and, hopefully, lead to behaviour change from the instigator. Having sat and been the target in moments like this and been so shocked that I couldn’t respond. Having felt voiceless to protect myself. I’m so aware of the importance of someone else stepping up in that moment and how it can completely change how you then feel about having to continue to exist in that dynamic after the moment has happened. We have the capacity to be the person that steps in and with one sentence shuts down the scenario, and then follow on by offering support to the person impacted. All of which is much more powerful if you do it as it happens rather than at a later date.
Challenge the status quote
Culture is a difficult thing to change. I’ve worked in environments like warehouses and pubs, during my student days, where certain ways of speaking to people or joking were common place, but I found them very uncomfortable. I’ve been there and not had the courage to speak out. Now that I am older, hopefully more confident, and certainly a little braver, I see it as my job to try to raise awareness and tackle some of those cultural norms, as and when I find them. Trying to remind others, and challenge in a consistent way to address the culture as a whole, in an attempt to help with making that culture feel welcoming to everyone.
Another part of trying to influence and impact cultural change is awareness about how I offer opportunities. I used to think that just asking for volunteers and being open about the fact that the opportunity existed was enough. I’m now very aware now that that isn’t enough, as if someone feels marginalised, or invisible, they are unlikely to step forward. This is a work in progress for me as I’m aware that tapping people on the shoulder for opportunities is also not fair and transparent. So I’m currently trying to support individuals and boost confidence to throw their name into the hat, whilst still retaining the openness of opportunities. I’m sure over time I’ll find better ways, but I think as a starting point we should be aware of the complexities and not assume we’ve ‘fixed’ the disparity by taking a single straight forward approach. It’s also about being very open to feedback and input into how to do this better.
Demonstrate curiosity
As part of the acknowledgement that I need to do better, I’ve been thinking a lot about and trying to engage with, how I can be better at tackling inequity in all the areas I’m involved with, and how to be a better ally. For me, at least, the first step is to always seating any change in openness and genuine curiosity. Curiosity and a wish to learn about different identities, biases, and how systemic issues impact the very people that the system should be set up to support.
Too often, as part of that wish to learn, we want to take the easy route and ask those most impacted to invest their time and energy to educate us, to tell us the answers, to validate that we are doing OK. This places a burden onto those who are already having to deal with the consequences of discrimination and bias, for the benefit of the very group that may be enacting the behaviour. If I want to know more about MRSA, I don’t ask the organism, and my starting place isn’t talking to others with the expectation that they will give me all their baseline knowledge. My starting place is to do my research, to read and access resources in order to give me the foundation to learn more. Being a better ally is no different. There are some great books out there. There is a trove of internet and other resources. More than that though, so much of this is about using that starting point to then undertake the self-reflection and self-work to start this journey. The more I think and explore, the more complex I realise this subject is, how much it depends on individuals and circumstances, and so being open to constant learning and development is key.
See with your eyes wide open
It is easy to be so focussed on your life, your lens, in the moment that you don’t pay enough attention to how others are acting and what they may be saying through actions other than words, that you aren’t present enough to be the ally that you want to be. You can fail to pay attention to the experiences of others, and fail to read their reactions, and thus fail to provide the support that is needed.
It is crucial that we challenge our own internal bias. There is so much from my position of white privilege that I need to recognise, that I need to actively be aware of and self monitor, as well as being aware of in others. It can be uncomfortable to turn that reflection onto ourselves, but to me that is a symbol of the very privilege we need to be aware of. Those from marginalised groups don’t have the option to choose to be uncomfortable or not, and so we need to be prepared to experience discomfort and face up to the fact that we will all have bias. There is often also a tendency to excuse or forgive behaviour that is linked to that privilege, and to impose standards or acceptance criteria on others based on that very biased starting point. We need to enter situations with our eyes wide open, prepared to fully see ourselves as well as others.
Own your own privilege
I come from a white middle class background. I am a female with a chronic health condition, but I would in no way consider myself to be disabled. I apply all of these labels to myself and I’m pretty certain that these and other labels are applied to me by others. I have experienced challenge because of those labels, but I am also aware of how much some of those labels protect me from the injustice, discrimination and physical risk felt by others. I’m aware of how much my privilege protects me and how much it has permitted me to have a voice that is not available to others.
No matter how much self reflection you do, it can be challenging to recognise your own bias, it’s referred to as hidden bias for a reason. You can reach out to peers, and those who know you well, but those responses often come with their own bias, and will be through a lens that probably takes into account your intent, rather than truly neutral. There are some good resources out there that you can use to recognise your own bias, and then include that awareness as part of your improvement journey. One of the big ones was developed by Harvard University, although there are plenty of other options out there:
Implicit Association Test (IAT): This is a widely recognised test developed by Harvard University that helps individuals assess their own hidden biases.
These tests are based on speed of decision making and can be really enlightening as to underlying levels of bias across all kinds of different characteristics.
Address the systematic issues
There is bias and discrimination in all settings. Some of it is embedded in the very systems that should be there to protect from and remove it. Some settings are definitely worse than others, and some characteristics are definitely more targeted than others. It is everywhere though, and we should all acknowledge that and actively look for it in order to tackle it, rather than sitting in our comfortable space as we are less impacted.
The start of this for me is to own the responsibility and look at policies and structure with fresh eyes to determine whether our systems actually are fit for purpose. Whether they are merely ticking boxes, or are actually set up in a way that excludes people, and then work to be the change and influence it to make those systems better. This can be everything from basic things, like are meetings routinely organised at 8am or 6pm, thus excluding people with caring commitments, or the lack of provision of prayer space, to the need to look at recruitment processes to remove the influence of intrinsic bias. There is so much that can be done, and we all have a responsibility to start somewhere and drive for continuous improvement.
Connect with other leaders
One key way to make sure that we make enough impact is to ensure that we are including these discussions in all the leadership spaces that we occupy. Making sure that it is including on evaluation and review criteria, as well as on agendas to support reflection and action. Collective leadership is much more likely to lead to sustained change, and so it is crucial to build the networks that will allow this change to happen. A word of warning on this one, if you look at the make up of equality, diversity and inclusion committees, they are often made up more of the individuals with characteristics that face the challenges than the allies that have power in places that would support improvements. As leaders, we need to be prepared to invest our time and energy, even in the spaces that may not benefit us as individuals, in fact, even more so if we are not the ones that will benefit. We also need to share the learning and data we get, so that the same lesson doesn’t have to be learned multiple times, but that a single experience leads to positive change for everyone.
Embrace advocacy
There are all kinds of ways to be an ally, but the most important thing is that you are consistent in your behaviour, and that you lead the way in behaving as you would want others to behave. Sometimes, the most appropriate kind of ally role will depend upon the situation and circumstance you find yourself in. Most types of behaviours, however, are ones that we should embed in all of our interactions. It is just good practice to acknowledge the work of others and give recognition of work done, so that it is recognised by everyone in the room. All of us should defer to individuals who have greater knowledge than ourselves, and hold spaces, so that the person with the most amount of expertise is able to fulfil that role. These behaviours are beneficial as a leader irrespective of scenario, but are especially important to ensure that those who are often overlooked, or silenced, are heard.
Consciously signal support
Finally, part of the power of leadership is the impact that conscious signalling of support can have, not just for individuals, but on changing culture. These can be small steps, like the inclusion of pronouns on your email signature, meaning that you are open to others sharing theirs with you in return. It can be something like wearing an inclusive lanyard or badge, that signals you are open and supportive. One of the big things for me is being clear that I am open to challenge and willing to learn and grow from my mistakes. I will, on occasion, mess up someone’s pronouns or name pronunciation, never on purpose. I will always try and clarify and act on the information received, but I am far from perfect. I want to accept criticism and correction, to hear it constructively and become better as a result. It is no good knowing you wish to be a safe space if you don’t let others know. People won’t give you constructive feedback if you don’t signal that you are open to the learning. Let’s make sure that we the only part of this conversation that is about us is on how we can do it better, in order to be better leaders, followers, and members of our communities.
I’ve been putting some work into trying to purposefully regain some work life balance, to re-find who I am outside of my work roles. It sounds easy but actually I’ve been so work focussed for so long I’ve been finding it pretty stressful. Trying to be at peace with not working every weekend, and therefore not being responsive or on top of my inbox, makes me feel an ongoing sense of panic. Nothing will change if I don’t however, so I’m making conscious steps to be aware of the anxiety but to carry on regardless.
Some of this had been about finding time for something as simple as having Sunday Tea Time with Mr Girlymicro, where we have a pot of tea and just spend some time together, enjoying each others company.
The other thing we’ve been trying to do is get out for a walk to also spend time together without the distraction of technology, as I’m a monster for always being on my phone or a laptop. Fully stepping away, removing the temptation to have ‘just one quick look’, helps me try to be fully in the moment with the man I love more than anything.
It has also, completely coincidentally, allowed me to discover a children’s book series called Brambly Hedge. On our walking route the council have commissioned wooden carvings of the characters, that then greet you as you walk around the lake, as the author was local to our home. Learning who all these woodland creatures are has also brought me great joy, and has reminded me how much we can learn and be inspired by, just by stepping out of our homes. In honour of this thought process on the benefit of taking a wander, I’ve included pictures of them in the hope they will bring a little of that joy to you when reading this post.
Counting to 10
When I was first a trainee, life was pretty tough. I wasn’t exactly welcomed in my department. I’d just moved down to London, and the learning curve was steep. My fellow trainee was also having a pretty hard time. There was no space we could go if were just having a moment, and there are only so many times a day you can cry in the toilets before someone notices. Thus the lap count was born.
The lap count was a numerical shortcut to being able to describe how your day was going. The lap in question was a full lap of the outside of hospital, and the count referred to how many of these full laps were required to enable you to pull yourself back together in order to carry on. In general, a one lap day was pretty good, and a four lap day was terrible.
Hopefully none of you need a lap count in your working lives, but the principle stands. Sometimes, walking away from a situation, and the act of being in motion, can enable you to remove yourself from a reactive space. Ideally before you react and say something that might not be pitched as well as you’d like.
Re-centering
There is something about being in motion that can also help to shake off the cobwebs or allow you to recentre yourself and decide whether things actually matter. It could just be me, but I find that I calm much more quickly if I am moving. It’s like the act itself enables me to shed unnecessary emotions and leave them behind as I walk. I don’t know if its because, when I walk to centre myself and my thinking, it’s a deliberate choice that means I’m ready to move on? Or whether it is the walking that helps, but the results are the same either way.
I suspect that part of it is because I’m removing myself from any of the external drivers of the emotion and am deliberately moving into a space that allows me to feel and process, rather than trying to ‘keep it together’ or ‘be on top of things’. The aim of the moment is to ride the wave and move through it so I can get to a logical rather than emotional place. Somehow doing this on the move, uninterrupted, feels better than trying to do it where someone could find and try to pep you up half way through. On occasion I just need to guilt free sit in my feelings, and ironically this happens best, for me, when I’m on the move.
Space for creativity
I don’t know about you, but I think for a long time I forgot the benefits of being aimless. If I do something it’s always linked to an outcome, as I’m so time limited and balancing more spinning plates than is physically possible to keep in the air. I’d forgotten that I’m pretty creative, intellectually that is, I have no capacity for practical acts. I had forgotten that if I just walk and let my mind drift the interesting spaces it will take me to. I think I have been a lesser me by not making room for that to happen.
Creating space for creativity helps me think about problems differently and gives me new insights when it comes to work, but it also enables me to be open to inspirations in my personal life, be that for this blog, cooking, or plotting a new murder for my future murder mystery writing ambitions. It may sound odd but it is in these moments that I feel fully myself and I am a happier better person for it. I guess I’m saying I need to be more purposeful about creating space for me to be aimless.
Removal of distractions
I’m a great prevaricator. If there is a way to be distracted I will find it. Sometimes, that distraction can actually help my thought process, as I continue to work through a problem without it being at the centre of my thinking. Sometimes, that’s just not an approach that will work. If I have a tricky problem that I am avoiding as I’m not sure I’ll be able to find a solution , and yet I really need to, I will find any route I can to avoid facing that possible issue as it triggers all of my fear of failure, however invalid. This can happen for work issues, like an experiment that just keeps failing, or for personal stuff where I’m trying to work out what the outcome I want actually is. In these settings sitting and staring is not helpful, as I have a tendency to create my spaces full of distractions as they please me. The best thing is to go to a new space where those things just don’t exist.
Don’t get me wrong, I think I could be distracted in a white empty box, but going to a space that isn’t mine and moving so that I don’t have time to focus on my surroundings enough to be distracted, is a great way of tricking my brain into being able to tackle the thing that needs to be resolved. It’s not that there aren’t distractions, it’s just that they aren’t ones that I’ve custom made to work for me.
Time to eat, drink and exercise
I spend so much of my time sitting and working at a laptop. I do so at work, and then when I’m at home, I’m usually writing this blog or working on other projects, such as papers, all of which include much sitting and very minimal movement. One of the things I love about walking this particular walk is that It makes me feel so much healthier, whilst enjoying myself so much feeding the ducks and other birds, sometimes even with tea. It’s many of my favourite things all rolled into one, especially when you throw Mr Girlymicro into the mix.
It’s so easy to forget that we have to find time to also look after ourselves, to move and get some steps in, as well as to look after the work stuff, or the house stuff. It’s easy to only make space in our lives for the box ticking. I know that exercise can also be considered box ticking, but if I can do it in a way that also brings me pleasure, it stops being the thing that I put off and can become something that I feel motivated to make time for, and embed in my every day approach. The more I have land on my plate the harder I find to make the time, and so making it easier and joyful is key.
Feeling the sun on your face
I work, when I’m on-site, in a windowless unventilated converted toilet as my office. I love it. I’ve written before about how much pleasure my space brings me. It does mean, however, that if I don’t find a reason to leave my office I will spend months of the year in darkness or away from natural light, as I arrive in the dark, sit in my delightful safe space, and then leave in the dark. There is always a moment in ~March where I step outside and I feel the sun, and I can quite literally feel the internal change in my mood. I always find January and February such hard going, and all of a sudden I feel energised and as if I can really tackle those changes I want to make. The sun just makes me feel like a different person.
This probably seems nonsense, but I only ever have the ‘aha’ moment in March that it is the lack of sun that has been driving my low spirits. I never seem to be able to remember when I’m in it that January and February are always grim. Knowing the difference this makes to me, and despite not really being an outdoor girlie, I am trying to remember the lesson. I am trying to remember to go out for lunch. To go for short walks if I can find a gap between meetings. I’m pretty sure that this impact probably happens all year, it’s just I recognise it more during the change from darker to lighter months. So, I’m trying to keep the sun on my face for a little every day to help cling to that feeling of being able to change the world.
Creates space for focus
I used to run, badly, and one of the things about it was that I hated the start so much that all I could focus on was putting one foot in front of the other. All other thoughts left my mind. It was like a mental stop gap, and when I got over the start, one of the things I loved about running was the mental freedom that intercept from spiralling and other thoughts gave me. I thought until recently that I’d lost that route to focus alongside losing my running confidence, but I think I’ve kind of got it back through walking.
Now, some of this will be down to the removal of distractions I’ve already talked about, but some of it is because that I find a place where the rhythm of walking can get me to the same mental headspace. Especially if I’m walking somewhere where I don’t have to worry too much about my surroundings and safety. It let’s me find a head space where I can locate the mental thread I want to pull on, and just keep pulling. I can walk until I’ve gone as far down the rabbit hole as I need to go. The only person placing limits is me, and that is tremendously freeing.
Dedicated time
I am a great one for doing multiple things at once. For instance, this blog gets written during the commute, or whilst Mr Girlymicro and I catch on movies/games/TV. That means I’m pretty appalling at spending focused one on one time with the people I love. My mind is always running 100 miles per hour or having a random debate with itself. One of the reasons we’re trying to get out for walks together is to allow that rare and precious one on one time with people we care about. Time without the distraction of devices (that would be me), or feeling like we should be doing chores rather than chilling out ( way more Mr Girlymicro).
Walking together and just valuing being in each others company, even after over 20 years together, really brings me a joy I find hard to describe. It is also a joy that is easy to miss out on if you don’t priorise and make time for it. The world screams and loads priorities upon us, and some days we just have to deliberately choose ourselves and each other, over all that noise.
Room for discovery
I like to walk in interesting places, places that have signs about wild life, places like museums, or interesting streets with Blue Plaques. Places where I will see things that make me think, remember old knowledge, or learn something new. I would never be writing a post centred around Brambly Hedge if I hadn’t stepped out for a walk. I like making space in my life for discovery and learning. I am a curious girl at my core. Walking in this way feeds into the core of who I am as a person. I’m sure many people walk outside because they like the outside. I am not an outdoor girly. I’m allergic to most of the outside world. Love of the outdoors is never going to be my motivation to get up and go for a walk, although I acknowledge that works for many people. For me, the motivation to step foot outside is that I can engage with a different kind of learning. The accidental kind, where I never know what I’ll discover. That speaks to me and who I am at my core.
Cortisol reduction
Speaking of walking in interesting places, I thought I would also share some of the evidence base, I am a scientist afterall.
There are some really nice studies out there that demonstrate the impact on cortisol, the stress hornone, from going to places like museums and art galleries, and just looking at the exhibits. I’m sure the same is likely to be true for looking at the real world exhibits outside if you go and take a walk somewhere interesting or beautiful. In the rather stressful world we live in currently, now of all times, it’s probably time to get our walk on, lower our stress and get back to the real us.
Dr Claire Walker has been a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for The Girlymicrobiologist, including one on turning criticism into a catalyst for change.
What may be less well known, even to regular readers of this blog, is that she did her PhD on finding genetic diseases, and as this ties in so well with the recent blog series I’ve been doing on DNA I thought having a guest blog from Claire might be the cherry on top of this particular ice cream sunday!
If you’ve missed any of the blog series of posts, especially if you want a refresher on how DNA works before reading about Claire’s work, I’ve included links to all the posts the below:
Having spent some time covering what is however, I thought I would follow up with a couple of book reviews that focus on how the world of DNA, DNA editing and DNA interpretation could change the lives of everyone involved.
When I was 26 I finished my Clinical Scientist training and was offered a full-time position at the hospital I trained in, with a good pay increase and a view to becoming a laboratory manager in the next few years. It was a great gig with a lovely team, good earning potential and support to further my clinical training. Unfortunately for them, I had just completed a secondment to a famous children’s hospital and had my mind absolutely blown. I had seen how immunology was being influenced by the study of human genetics, at the forefront of the field with cutting edge techniques which seemed, frankly, indistinguishable from magic. Suddenly, working in adult rheumatology and learning how to manage NHS laboratory budgets just didn’t seem so interesting anymore. So I turned down the job, went home, looked my husband in the eye, and said the words he’d been quietly dreading ever since I’d first jumped from environmental microbiology to human immunology: ‘I think I want to retrain… again.’
I applied for a PhD in genetics and immunology at University College London Institute of Child Health. Specifically, I focused on children with rare syndromes that didn’t have a clear diagnosis often called “syndromes without a name.” These kids and their families had often been on a long and frustrating diagnostic journey, seeing specialist after specialist, with no real answers. That’s where exome sequencing came in. By reading the protein-coding parts of the genome — the exome — we hoped to find clues hidden deep in their DNA that could point to the cause of their symptoms. Think of it like a high-stakes game of genetic detective work. Each patient’s exome was a puzzle, and sometimes, we’d find that one variant that explained it all. Other times, we discovered new candidate genes that had never been linked to disease before. Conversely, we found that some quite well-known genetic diseases could have highly unusual presentations – what we call expanding the clinical phenotype of a condition.
The disease I was assigned to work on was the oh-so-easy to pronounce and explain, Haemophagocytic Lymphohistiocytosis (HLH). HLH is a rare but serious condition where the immune system goes into overdrive and won’t switch off. Instead of protecting the body, it causes severe inflammation and can damage organs including the liver, brain, and bone marrow. It can look like a really bad infection, but it’s actually the immune system attacking the body from within. Some cases are triggered by infections or cancer, but others are caused by inherited defects in genes like UNC13D or PRF1. The children in my student were amongst the big chunk of patients where none of the usual suspects showed up on molecular testing.
But finding a genetic change through exome sequencing was only the beginning — I still had to figure out if it actually meant anything. Not all changes in our DNA cause disease, so we looked for the presence of the mutation in healthy controls and used predictive software like PolyPhen2 to solve the first clue: what would this mutation do to the protein the gene encoded? Then came the hard part — proving it. I had to design and run experiments to test how the genetic fault affected the protein’s job in the immune system, and whether that could explain the symptoms we were seeing in the child.
The hard work paid off, in my study we found: one case that was UNC13D protein defective HLH, but only affected the brain; one that turned out to be a totally different (and very rare) immune disorder; and one that revealed a brand-new genetic disease caused by defects in DNaseII resulting in something akin to HLH and another inflammatory condition. In all of these cases what this really gave us was the opportunity to get these kids an answer and onto treatment that could actually work for them.
Figure 3. Defects in DNaseII sit downstream of defects known to cause HLH. Image credit – Claire Walker, thesis.
For me what’s really fascinating about genetics is that what took me years of research is fast becoming a routine test – an incredible reminder of how quickly genetic technologies can evolve. What was once a complex puzzle of genetic mysteries is now providing families with the answers they’ve long needed, turning uncertainty into hope and paving the way for more personalized, effective care in the future. I think that alone was worth putting my husband through yet another ‘re-training’ episode, who knows what I’ll come up with next?
I hope this addition has given you an insight into why working to learn more about how our genes impact us is so important, but also how needed specialists like Claire are for us to do this safely and make the difference we want to make. Sometimes all patients need is an answer, a name to put to what they are going through, something that can provide a route forward even if it doesn’t provide a complete fix. Something so simple can be so difficult to achieve, but just because something is hard doesn’t mean that we shouldn’t try.
Girlymicro 