Turning a Day Dream into a Reality: Trying out a technique to make concrete steps towards a secret ambition

January 3, 2022January 3, 2022 girlymicro Education, General, Science Communication Co-production, Healthcare Science, Infection Prevention and Control, public engagement, Science Communication, scientific writing

I’ve been thinking a lot about next steps in recent weeks. Thinking about what it is that I want, what do I want to achieve. I’ve been really fortunate to have achieved a lot of professional success. I’ve attained my Consultant post, which has been the aim for 16+ years. The question that I keep getting asked therefore is, what next?

Now I’ve been saying, and I think this is true, that I need to be in a holding pattern for a while. Like most people during the pandemic I’ve become tired and burn out and even when we get to the point where life becomes the ‘new normal’, whatever that is, it will take time to recover. The problem being that although those words come out of my mouth, my brain has other plans and ideas.

I’m beginning to think that this next goal will be more personal and less professional. It feels like a long time since I had a goal that was for the whole of me, rather than for Dr Cloutman-Green. So I’m going to write it here. Not because I think I will manage to achieve it any time soon, but because I want to make a commitment to myself. I want to write a book. I know, I know, it would make me spit out my tea too, but there I’ve said it. I’ve put it out into the world.

There are two schools of thought on whether sharing this is a wise move or not. One suggests that by sending it out into the world is the first stage in crystallising a thought or dream into reality. The other is that you are setting yourself up to fail as if you don’t then take the steps needed you appear as someone who can’t deliver, thus actually making your dream harder to achieve. I’m a glass is half full kind of girl and so I’m going with the making my dream more likely option. I am also being very clear and boundaried about what I am saying. I am saying I wish to write a book, that is under my control. I am not stating that such an item would ever get published, let alone earn money, as those things are less under my remit. My dream is to have the time and energy to create and produce, anything more would be a bonus.

Now, I acknowledge that my grammar is appalling and I don’t claim to be the best writer in the world. Writing the blog for the last year however has reminded me of how much I have always just loved to write. I find it cathartic and a much needed creative outlet. During the pandemic, where opportunities to network have been limited, I’ve also found it a great way to feel connected. I know I come across as very extroverted but in reality there’s little I love more than having my own space and so this blog has allowed me to connect without feeling the pressure of in person.

Now I wouldn’t be me if I didn’t have a plan. Afterall, a dream needs action in order to become a reality. This is something that is completely outside of my knowledge base so the first steps are about thinking and research in order to inform action:

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 (Norman I also haven’t forgotten about our project – sorry for being rubbish)
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 dont 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?

For me any dream is achievable, the main thing is to be realistic about what the dream actually is and what resource and commitment it will take. Dreams don’t just happen, they require work and so to understand what is needed takes some time. That is not a reason to not aim high. So here I am, at the start of the process knowing it might take years but excited to see where it might take me. Dream big people and take it one day at a time.

All opinions in this blog are my own

Girlymicro 2021: A Year in Review

January 1, 2022January 1, 2022 girlymicro Academic Life, General, Microbiology (Clinical), Microbiology (Research), Science Communication Healthcare Science, Infection Prevention and Control, public engagement, Work Life Balance

Firstly, before I begin I want to start by saying thank you all so much for being here. This blog and all of you have really helped with many of the challenges described below. It’s given me a focus and output that has enabled me to both reflect and feel like I have a voice. Despite not having been able to post much in November and December ~10,000 of you have visited the blog this year, with over 13,500 views. Numbers I would never have dreamt of. This community, your responses and sharing have really kept me going. My sincerest hope for 2022 is that we will be able to continue to find a way through together, supporting each other and sharing the learning.

It seems to be the thing to do a New Years post. I’m not really big on New Year, I’m much more of a Christmas kind of girl but this year has been A LOT and so I thought I should take a few minutes at the start of 2022 to at least acknowledge it happened; and to give some reflection on all it contained: the good, the bad and the oh so very ugly.

I want to end in a positive way so we are going to take a deep breath, drink a cup of tea and do this is reverse order.

The Ugly

I discovered this year that I am oh so very human. I used to think I could push through anything with enough willpower. It worked for my PhD, it worked for FRCPath. I have discovered that that doesn’t work for pandemics.

I think part of it is something to do with a lack of a defined end point. With an end point you can plan, you know when you can take breaks, you can plan downtime. There has been nothing planned about this. My first break away was the one and only time I’ve been pinged (I’m basically a hermit) and so my time away involved self isolating in a very small cottage, albeit with an amazing view. Christmas, which is my joy, involved working and being broken by the time it arrived. The constant responsive mode means you feel like you achieve nothing and that the ‘Control’ in Infection Prevention and Control has been lost and you don’t know when it will come back.

The other part of it, for me, is that there has been hardly any of the diversity that is the thing I love about Infection Prevention and Control. When the non SARS CoV2 work does escalate up the priority list it is on top of everything else and is therefore a burden rather than problem to be solved. It is the diversity of the role in normal times that energises me. This year therefore, has just felt like one constant drain on my batteries rather than the normal peaks and troughs that give recovery time.

So what am I going to do about it? Long and short I need to carve out some professional me time. I can’t manage a third year of just pushing through. I’ve hit a wall and something needs to change. I need to find time to write a paper, use a pipette, write a talk in more than 5 minutes. I need to feel like I’m making a difference again, making an impact. I need to end 2022 feeling like I’ve moved forward, even if the pandemic is still with us. I think collaboration for this is key, working together is one of the things I’ve missed, so if you’re up for a project give me a shout.

The Bad

The worst and most shocking thing of 2021 was that we lost Lee, the guru who made the grammar on this blog bearable, but who also helped run the Environment Network and some of my other events. He went from fine to deceased in a matter of weeks and to be really honest it’s been quite the wake up call. He was ~10 years older than me and still had so very much to give to the world. I don’t want my tombstone to say ‘She pulled a lot of hours’ I need to make time for the people and activities I love. I hadn’t seen him anywhere near enough since the pandemic started as I have prioritised work so much. Going into year 3 that has to change.

In 2020/1 I learnt to fail, spectacularly. I learnt to fail at managing my workload, my inbox and my deadlines. I’ve failed to manage to keep on top of, let alone ahead of anything. I’ve learnt that this leads to 3am panic and exhaustion and after a year I’m trying to also learn to just let it go. Being a perfectionist in a pandemic is not a survival strategy. Assuming that everyone is judging you as harshly as you are judging yourself is not a wellness technique. Just working harder no longer cuts it, as to be honest there are simply just not enough hours in the day.

Over the last 2 years I’ve let myself be defined by work. I’ve stopped running and I basically am working, rushing to catch a meal or trying to sleep in order to prepare to do it all again. Between getting shingles and the number of angio oedema flares my body has basically let me know that this is not sustainable. To be honest I don’t think I could continue this way even if I wanted to, my body feels like it has given up on me. I need to cut it a break and heed the warning signs.

Having discovered I am not professionally or physically superwoman I have decided that I need to make some decisions about putting me first. No one benefits if I break, not me and not my team. I need to do my hours and come home in time to do something other than eat and sleep. I need to have some time for me, be that to read a book or go for a run. I cannot work every weekend. I need to trust that others will not judge me for stepping away and that the only person who is holding me to this standard is me. I’m going to walk in the sun, take bubble baths, drink tea and learn to be kinder to myself. I’m also making a commitment to give explicit permission to others to do the same, so that our head weasels have less power over us.

The Good

Well enough with the hard stuff, its really easy to forgot with so much challenge, the amount of good that has actually occurred. All the more reason to take the time to reflect. Times of challenge are when we learn most, not just in terms of academic knowledge but also about ourselves, and I have learnt a lot that I intend to build on in 2022.

I started 2021 announcing that I’d been awarded the British Empire Medal in the Queens New Years Honour list. Something that was always going to be difficult to top.

In this respect 2021 out did itself and was the year that I firmly set down roots to continue at GOSH, after a period of not really knowing what my future would hold and where my career would go. I got my dream job, as a Consultant Clinical Scientist in Infection Prevention and Control. I have a solid foundation for my future, I no longer need to have a plan A B and C about where I might end up. I work in an organisation aligned to my values with 2 amazing teams and in a job I love. I will always be grateful for that.

There have been some great moments from an education perspective. I’ve done podcasts, made it onto power lists and had mentees grow and develop in ways that have made me beyond proud. There are some wonderful projects in the pipeline that will give opportunities to my team and I believe will support change across the infection workforce. One of them is on whole genome sequencing and if you’re interested in learning more check it out and input on what you’d like included here. Being able to plan for the future is key to my mental wellbeing and so I’m so excited to have something that forces me to look forward, not just be in the moment.

Project Nosocomial has continued to grow and despite, or possibly because of, the unique demands on artistic and scientific collaboration in 2021 delivered some truly exciting new content. We ran 2 festivals to raise awareness of antimicrobial resistance. We ran comedy shows, quizzes, panels and featured poetry, drag, opera and gamification. If the pandemic has shown me anything its that we need to work harder to engage with and have dialogue with the public and wider communities. Science communication should no longer be seen as an indulgence but a central part of our roles. In 2022 I’m determined to continue to fight for this work to be valued and to increase the impact of our conversations.

So there you have it, despite feeling I’ve been standing still there has been a surprising amount of moving forward. I have learnt a lot and to summarise what from that I want to bring into 2022, it is simply this:

All opinions on this blog are my own.

Knowing Your Why: Why I’m passionate about how we talk with our paediatric patients

August 29, 2021August 29, 2021 girlymicro Microbiology (Clinical) Healthcare Science

Some of the clearest memories of my childhood are about things that happened to me in hospital, and to be frank most of them are not of good experiences with healthcare and clinicians. Those experiences have shaped my current relationship with medicine, for both good and ill. Yet when we are having interactions with our paediatric patients we rarely think about (outside the paeds world) what the legacy of those interactions will be. For some reason I’ve been reflecting on that legacy for me recently and have begun to start unpicking why its a driver for much that I am passionate about as an clinician.

What experience led me here

I didn’t deliberately choose to work in a paediatric setting but over the years I’ve had plenty of opportunities to leave and work in a more general setting. I’ve never really been able to articulate why maintaining my work in paediatrics has been so important and aligned to my personal values. Over the last 6 months however I’ve been involved in designing our new children’s cancer centre and the conversations have triggered some realisations about why it matters so much to me.

When I was nine I was in primary school (about 5 years before the picture of myself, my brother and sister above). At lunch time I started to cough, by PE class at the end of the day I was coughing so much I sat out the class, and remember watching the others running in the sun from the classroom window. I walked home after school, at which point the coughing was continuous. My father took me to the GP who offered to call an ambulance but said it might be quicker for him to just drive me to A and E with a letter from him. The GP didn’t speak to me, I just listened to him talk to my father.

I arrived at A and E. It was late, I was tired and my chest was really hurting with coughing so much. I didn’t really know why I was there, after all it was only a cough. I was placed in (what I now know) is a side room and 15 doctors/medical staff came into the room. They looked at me, they prodded me, they talked about giving me an emergency tracheostomy, no one spoke to me. I couldn’t even see my father due to the number of people. The only person in the room who talked to me was a nurse I remember to this day called Maxine. I remember her as this was the start of many journeys to A and E over the coming years and Maxine was almost always there and without fail was the only one who spoke to me.

The next thing I know my father is no longer there. I’ve been rolled into (again what I now know) is a theatre suite. Someone has put a massive black mask on my face and the world is swirling, people are going in and out of focus. It felt like a horror movie. I woke up in a dark room on my own. I was unable to move, unable to speak (I now know I was intubated). The only thing I could see was that right in front of me was a window to another room. The curtains were open and there was an adult in the other bed. He must have crashed as they were attempting resuscitation. There was beeping all around him and me. He died and I watched unable to move or speak.

Over the next week I stayed in a cubicle on an adult intensive care until. Frequently on my own I had my toy popple and I would shake the tail to try and get attention. My mum was often there and I was mostly sedated but I don’t remember any member of the medical team apart from the odd nurse ever speaking to me. I was given a book to write in and on one night they brought in a TV so that I could watch Agatha Christie’s Poirot. I fell asleep as I was sedated. When I woke up the TV was still there and on. Hours has passed and a horror movie was on, I couldn’t turn it off and no one came. Again I just lay there scared.

So why am I telling you this? Afterall medicine must have changed a lot in the last 30 years and this wouldn’t happen now.

This was the start for me of years of being ignored in rooms and having procedures undertaken without being included in the decision. It was part of time spent in hospital without being able to get out of a bed or interact with anyone else, no access to school or even a space to play when feeling better. Although things have improved I’m not sure things have truly changed in many spaces. That’s the reason I’m writing this post. To raise awareness of the importance of not just seeing children as little adults in healthcare but as people with specific needs that need to be catered to.

How do we do things differently?

I recently posted about how I felt we needed to challenge ourselves more on delivering patient centred care. When children and families are involved however I think many people feel even less skilled to adapt what they are doing in order to engage the patient as well as their families in discussions and decision making.

There is a great course run out of GOSH called MeFirst which I try to encourage my Healthcare Science staff to engage with and which I strongly believe would beneficially to anyone working I healthcare. Even if you don’t work in paediatrics you are likely to need to communicate with children and young people at some point. It provides a communication model which will support us in putting children and young people first in any interaction. If you come through the standard medical and nursing training route you are likely to have much more embedded training in this than those of use who belong to other healthcare professions. It is especially important therefore for those of use who haven’t had this training as part of our standard curriculum to search out opportunities to upskill ourselves and improve our practice.

What tips do I try to use in my practice?

Speak to the patient as well as their families when you’re introducing who you are and starting your conversation:
Try using images and cue cards to support patients articulating how they feel about options, decisions and interventions – if appropriate for the patient
Spend time with the patient and family to try to understand their level of understanding in order to make them feel heard, not patronised or baffled by information
Avoid using technical terminology whilst not dumbing down what you are saying
Remember to use active listening to try to really hear what it is that patients and their families want. They will all have different prioritise and things that are really important to them. Plans should not be one size fits all

My interactions with healthcare as a child led to me being completely terrified of engaging with healthcare as an adult. I experience a really primal fear reaction which no amount of rationalisation can overcome. I think its why I got the job I have, now in hospital I am the person who feels able to make decisions and who is in control and listened to, rather than ignored and scared. Most importantly however I am also the person who can sit in a room and advocate for us to do it better. In my world I have the lowest skill level as I’m surrounded by brilliant paediatricians who are better at this than I will ever be. However if I can make a difference for one child to feel less scared then that is success for me!

All opinions on this blog are my own

My Sunday Afternoon Rage – The Mask Goes Over the Nose, People!

December 29, 2020January 26, 2021 girlymicro General, Microbiology (Clinical), Science Communication Healthcare Science, Infection Prevention and Control, SARS CoV2

You may or may not know this about me, but I’m a pretty big sports fan. Not the kind that remembers statistics or can quote drivers/players, but a screaming-at-the-TV-or radio in-support-of-my-team kind of fan. When I lived at home in Birmingham, I had a season ticket for the Holte End at Villa Park to see my boys (Aston Villa); now the main live sport I get time to see close up are the London Games when the NFL comes to town (I’m a Green Bay Packers fan and they’ll never visit). Sport is a massive release for me: Watching Sunday night NFL football and F1 is something that my hubby and I really enjoy doing together as these are our shared passions (N.B. in our household, I’m the big general sports fan rather than him).

So imagine what my Sundays in 2020 have become. Imagine that at the end of every race you sat and watched images of Max Verstappen engaging in face-touching whilst wearing a mask that is barely positioned to cover his nose.

The content of the interview is not important, but he rubs the edge of his mask, then moves his finger to his eye, then messes with the vent, then re-positions it by touching the front. All in a video that lasts less than 55 seconds.

The NFL is even worse. At least in F1 drivers are – for the most part – wearing masks, even if they appear to not know how to control their face-touching impulses. Within the NFL, the numbers of coaches not wearing masks at all has led to fines for individuals and for clubs. The NFL is big money in the US. A number of teams have been shut down for SARS CoV2 outbreaks, and yet the behaviour has continued.

So, Why I am Writing this Post?

Every week I get on tube trains to travel to work. During the first lockdown there was ~90% compliance with appropriate mask wearing. In recent weeks, compliance was less than 50% and I’ve seen all the variations in the image below and more. All this whilst I’m having to live with increasing numbers of clinical cases and receiving daily reports of the same elsewhere. I’m writing this as, although some of it is because of a decision to be non-compliant, I think a lot of it is about the fact that we are not really getting the message out about why appropriate mask wearing is important: not just box-ticking to have one near your face. I don’t think we’ve taught people about which bits of masks are contaminated and that touching those areas is where a big portion of the risk lies. This is why I was pretty much against selective mask use when it was introduced. Universal mask use is much more scientifically valid, but it’s not a panacea and actually increases personal risk if not done appropriately.

I’ve seen all of these variations and more

Why Does it Matter That I Wear My Mask Like a Necklace?

We know respiratory pathogens on the outer surface of masks may result in self-contamination. In my PhD thesis back in 2015, I discussed this as a potential route for hand/face contamination. However, in the context of a respiratory pandemic, and mass mask-wearing without training, the implications are much more significant.

The T-zone includes the mucous membranes within the eyes, nose and mouth. It has been noted that, even within a healthcare setting, members of staff engage in frequent face-touching, with one study noting that healthcare workers touched the T-zones a mean number of 19 times over a two-hour period, which may place healthcare workers at risk of organism acquisition/transfer. Additionally, organisms could survive on the skin for minutes to hours and thus present a source of hand contamination when touched in the future, with a possible spread to patients and surfaces.^{(Journal of the American Board of Family Medicine. 2014;27(3):339-46)}
My thes i s (2015)

*BMC Infectious Diseases* **volume 19**, Article number: 491 (2019)

Fabric masks can protect by filtering up to 50% of particles, reducing exposure. The risk from inhalation is not the only one, however: viruses can survive on skin, paper and fabric, for hours in the case of SARS CoV2. The virus can also infect by self-inoculation into the eyes and contact with other mucous membranes, for instance people rubbing their nose after removing the mask. The above paper used fluorescent particles to demonstrate how contamination of the external of a mask works, and to help visualise the risk of moving that contamination around the mask and skin. If masks are not put on and taken off appropriately, if they are not worn the right way, and if we don’t wash our hands and think about how we touch our faces, we put ourselves at risk. We make the problem worse.

Back to Sport

Role modelling is so important in raising awareness. Teams and individuals have a massive platform to get this message out. People will say that sportsmen and women are not medically trained, so why should they take responsibility to get this message out? I would say that sports like F1 and NFL have huge levels of access to the worlds best clinicians; they have huge levels of medical investment and there is no doubt that these individuals will have been trained and taught. So they need to lead by example and enable me to get back to using Sunday afternoon sport as an escape, rather than a lesson in IPC failures.

Top tips for safe mask wearing:

Wash your hands or use a minimum 70% alcohol gel before putting on (donning) and removing (doffing) a mask.
If using a fabric mask, ensure that you are washing between each use.
If you remove a disposable mask, throw it away: both sides will be contaminated and if you store it you just move that contamination around.
Make sure your mask covers your nose and mouth.
Be aware of face-touching and use hand hygiene if you accidently contaminate.
Know that the outside of your mask is NOT CLEAN!

All views on this blog are my own

The Awards Season is Almost Over – It’s not Quite the Oscars, but Still…

November 27, 2020January 23, 2021 girlymicro Education, General, Microbiology (Clinical), Science Communication antimicrobial resistance, Healthcare Science, public engagement

As I write this, it’s the morning after the Antimicrobial Guardian Awards 2020. We were lucky enough to be considered for the Public Engagement category for the Nosocomial Project. Much to my jaw-dropping shock, we were lucky enough to win. This post isn’t really about that, though. This post is about why I think it’s important that such awards exist, which is not a universally held opinion.

Every year there are a number of local and national awards for NHS and Public Health related activity. I’ve been lucky enough to have been nominated for, and won, some of these awards. I have experienced many lovely responses but I’ve also received negative ones. These have indicated that the same people always win everything and that my success makes others uncomfortable. So would I put my awards somewhere where they can’t be seen? There is obviously a whole blog topic on how we do a better job at celebrating others’ success and taking it as an opportunity to lift up the whole; but there are also some very practical reasons why these kinds of awards are important.

Why Do I Think Awards Matter?

The NHS has traditionally been a very siloed environment, with professions working very separately. Many awards have categories that are targeted at, or recognise, collaboration across silo’s. This is one way of getting people to actively think about their working environment and start to take steps to break down barriers that have long existed.

If you work in a professional group that is often pretty invisible at organisational or national level, these awards present a wonderful opportunity to highlight the work that these groups do, which might go unnoticed in the general day-to-day workings of healthcare. This can have a direct impact on how valued these groups feel, but also in inspiring how practices could be integrated for the benefit of the system.

Many of these rewards are for projects that are done on top of the day job. Although there are prizes for individuals, a lot of the time these projects can only be delivered by teams. Within the day-to-day NHS, we don’t really have a way to recognise these teams when compared to private industry. It’s important for me, as a leader, to acknowledge the hard work of my teams by nominating them and ensuring they feel seen and their work appreciated.

Projects such as Nosocomial require external funding to be able to develop and progress. Winning awards for the work is pretty much the same as a paper going through external peer review and being accepted. When applying for further money to continue the work, or for other project applying to Trust Board for support, having an external stamp of approval can be the thing that moves decisions in your favour. They can also provide valuable free promotion to support building new collaborations or expanding the work to increase impact.

Nominating work for awards can provide a great moment for reflection and self-evaluation of the project. Projects often develop organically and, because they are often done in addition to other work, we don’t always take the time to reflect on the strengths and failures of what we’re doing. The process of nominating can highlight gaps, especially when it comes to evaluating work. These can then be addressed and you may decide to hold off on the nomination until you have the extra data. Most importantly it will make the work itself better, irrespective of whether you win.

Something I feel really strongly about is the removal of hierarchies and empowerment in terms of the future of healthcare. Many awards now have specific categories for inclusion of the public in work, or a focus on diversity and inclusion. These specific categories demonstrate the values of the NHS and encourage work that lives up to those values. If we really want to create an NHS that works for the modern world, the more that can be done to embed these values in everyday working, the more successful the change will be.

Lastly, and most significantly, these awards offer the chance to share learning. To discover what works. To be inspired by the work of others. Although awards are often considered to primarily benefit the individual or team, the truth of the matter is that that the people that really benefit are those that are part of the system that the awards represent. This is fundamentally why we should work to support these events, not for the ‘me’ but for the ‘we!’

So celebrate the success of yourself and others! Know that by doing so you benefit everyone

Top tips for nominations:

Read the category criteria so you are applying for the right one.
Understand the scoring scheme (which is usually listed somewhere) so you know what the judges will be interested in.
If there are questions, make sure you answer the question asked, not what you think they are asking.
Think whether now is the time. Ensure that it is the right time to nominate, or consider whether you would be better to wait to the subsequent year to have appropriate evaluation data etc. to improve your chances.
Know that it’s not about the winning and that this (like submitting a grant or paper) is worth celebrating in itself.

All views in this blog are my own

Guest Blog with Kip Heath:

November 12, 2020August 4, 2021 girlymicro General, Science Communication Healthcare Science

Starting out as a Science Comic

A massive thank you to Kip Heath for being our first every guest blog on Girlymicrobiologist. If you have something you would like to share with me (Girlymicro) and the world, drop me a line and we’ll see what we can do. Now over to Kip…

For a number of reasons 2019 was a very difficult year for me. In December 2019 I started a new job and, like many others, used the arbitrarily selected day of January 1 2020 to set a collection of resolutions to improve my life. A few weeks later I was at the London STEM Ambassador Forum event and saw Dr Steve Cross speak about Science Showoff.

The following week Steve asked on Twitter if anyone was interested in performing at a Science Showoff in St Albans. Why not? I thought and signed up. I’m still not sure quite what possessed me to do it. A few weeks later I would be standing in a toilet cubicle in St Alban’s museum, desperately fighting the urge to throw up, as I remembered several very important things:

I had no experience and no flipping idea what I was doing.
No one in my life has ever implied I was particularly funny.
Public speaking of any kind makes me feel vaguely ill.

By this point it was a little late to back out and escaping from a converted magistrate’s court (which was now a café and event venue) was a little tricky. After the first act, I was announced and the crowd cheered as I clambered into the dock with all the elegance of a newborn giraffe.

With nothing else for it, I introduced myself. ‘Hi, my name is Kip Heath and I’m a healthcare scientist. For those that don’t know (and why would you?) it means that I work in an NHS laboratory doing 80% of the work in diagnosing a patient, so a doctor can come along and take 100% of the credit.’

And people laughed!

I don’t remember much of the rest of set but when I finished I felt a rush of adrenaline. I left feeling that this is something I wanted to do again, and that all of the other performers were friendly, welcoming and supportive. So I continued, and in September 2020 I was selected for the Talent Factory which is a year-long communication and performance development scheme.

This seemed like a great way to raise the profile of healthcare scientists and I desperately wanted to share what I had discovered with others in my field. Plus, I was really keen to get some training in the hope I would one day seem competent. So I applied for a public engagement grant from the Society for Applied Microbiology. They were wonderful enough to support my crazy plan and we had a science comedy training session on Monday 12 October 2020. I was thrilled to see there was a fair amount of interest and it was fully booked.

Now that we had the training, it was time for the show! National Pathology Week seemed like a great backdrop, and I was thrilled that we managed a full line-up with people who had attended the training. This included my ever supportive boss, who I am grateful is always there for me. (And I’m not just saying that because this is her blog!)

We set a date of Friday 6th November and opened up an Eventbrite for tickets. By the day over 100 people had booked and bookings kept trickling in. It was incredible, but also terrifying. I have a habit of planning for the worst, so I started to panic about technical issues and performers dropping out at the last minute.

Steve set up the livestream on YouTube (saving me from the stress) and at 7pm all of the performers met online. We had performers, we had a functioning YouTube stream, and – not long after – we had an audience!

As the person who organised the event, I was up first. Performing comedy online is very different to performing live. It’s almost impossible to read the room which can be difficult, and I find that I am much more likely to rely on my notes, which can lead to sounding as if I’m just reading the set. Probably because that’s exactly what I’m doing.

Still, what it meant was that once I was done I could sit back and enjoy the other performances. And they were brilliant. From comparing Immunology to the mafia, or an entire bakery’s worth of doughnut puns in one set, everyone was fabulous.

We were popular, too. There were 70 devices logged into the live stream on the night, and over 300 views of the show on YouTube over the weekend. It surpassed all of my expectations and I am thrilled to have been able to share the experience with others in my profession.

If you’re a healthcare scientist and this sounds like something you’d be interested in – drop me a message on Twitter (@miceheath).

All opinions on this blog are those of Girlymicro

A Week With Antimicrobial Resistance on my mind

October 30, 2020October 2, 2022 girlymicro Microbiology (Clinical), Microbiology (Research), Research/Academia antimicrobial resistance, antimicrobials, Clinical trials, Healthcare Science

This one gets a bit technical in places. Bear with me – the next one will be less so. Pinky swear.

This month has been a pretty one big for me. Last week, a clinical trial I’m involved with kicked off in Mali. 10% of Malian children die before their fifth birthday and this trial aims to reduce the level of infant mortality. The study is called the Lakana Trial and aims to recruit 100,000 infants born in Mali over the next three years.

In a separate post, at some point, I’ll tell you the ‘Mali not Bali’ story, but I’ll need a double G&T in front of me first. (Or register for free for Stand up for Healthcare Science on 6th November.)

At this point you’re probably thinking what on earth does this have to do with antimicrobial resistance (AMR)?

The thing is, to save all these lives, we’re giving antibiotics to every child (some will get a placebo). Nothing special about that, you might be saying, we give antibiotics to children all the time.

This is different because we aren’t treating symptoms of a known infection. We are giving antibiotics in order to reduce infection risk/inflammatory response in asymptomatic (symptom free) children under one.

The antibiotic we’re giving is a drug called azithromycin and it’s from a class of antibiotics called the macrolides (see my A Starter for 10 on Antimicrobials post).

The LAKANA study follows on from the MORDOR study (the best study name in the world, in my personal opinion!) which gave two doses of Azithromycin/placebo to >190,000 children born in Malawi, Niger and Tanzania. The difference between that study and ours: they always gave two doses and the infants recruited were up to 59 months.

Mortality in the MORDOR study was 13.5% lower overall in communities receiving azithromycin vs those that were given the placebo (paper link here if you’d like more detail). Interestingly, there were differences in the survival increase by both country and by age group, with the highest mortality reduction seen in Niger. The greatest effects were seen in the one-to-five month age group which is why the under ones were selected for the LAKANA study.

To decide how many doses of azithromycin are needed to reduce infant mortality, the LAKANA study will gather evidence to answer three specific research questions:

Does biannual azithromycin MDA (Mass Dosing of Azithromycin) to 1-11 month old infants reduce their mortality?
Does quarterly azithromycin MDA to 1-11 month old infants reduce their mortality?
Does quarterly azithromycin MDA result in a greater reduction in mortality than biannual MDA?

What has this got to do with antimicrobial resistance?

The AMR component of this study is the part that is being lead by UCL and the Institute of Child Health and so is sitting with me as a co-applicant. As we are giving antibiotics to children (and not treating a specific infection), it is crucial to understand whether this will impact on the level of antimicrobial resistance detected in them, their families and their communities.

Questions that we’re looking to answer (and that are currently running around my brain:)

If we do detect antimicrobial resistance is it stable? (I’ll explain this in a future post.)
Does detectable resistance return to baseline after a period of weeks, or does it lead to a permanent shift in their colonising bacteria?
Does any resistance detected make a difference to clinical treatment options? Macrolide resistance is usually due to accumulation of single nucleotide changes (single letters in the DNA code changing). This doesn’t necessarily mean the antibiotic will stop working.
Is resistance detected only in the Macrolide class of antibiotics, or does it lead to selective pressure that causes other resistance changes?
(Not AMR, but fascinating to me) How does azithromycin work? What is the mechanism? You would have thought this is well understood but, despite being available for decades, how it works as an anti-inflammatory is really not understood. Is the reduction in mortality because of its use as an antibiotic or because of this anti-inflammatory action.

What is incredibly important when doing this kind of work is that the first priority is to maintain the safety of participants. To that end we are working closely with the The World Health Organization who have recommended consideration of azithromycin MDA to under-one-year old infants, in areas with high childhood mortality.

Reducing infant mortality is so important: not just to survival but to quality of life and prosperity within these communities. These kinds of studies also need to be aware of their legacy. We are all incredibly keen to build laboratory capacity and infrastructure, not just in terms of equipment but also in terms of skills and skill infrastructure.

It’s early days and we won’t have any results from the AMR section for at least a year. I mostly wanted to record that this work is going on and the questions I have at the start. I also have some questions about balancing clinical outcomes which are pretty philosophical in my mind right now. If we see development of AMR, especially if it’s non-stable, but mortality is decreasing, where is the balance between those two things? How do you perform the risk assessment for the individual about short-term vs long-term outcomes? These thoughts convince me that this study is just the next step on a journey and that (as always) we have a lot to learn and a long way to go.

All opinions in this blog are my own

Remember, Remember! Step back in time to save the King

October 27, 2020January 12, 2021 girlymicro Science Communication Healthcare Science, National Pathology Week, Science Communication

Join Us to Help Celebrate National Pathology Week 2020!

Remember, Remember!

Remember, remember the fifth of November.

Gunpowder, treason and plot.

We see no reason

Why gunpowder treason

Should ever be forgot……

What can you do to help our scientists who’ve been sucked back in time to 1605 to find the gunpowder plotters and help Princess Elizabeth?

Full play on YouTube, scripts and activity packs are available here

Join in our digital competition, watch the play and complete the activity packs to help the Healthcare Science Education Team celebrate the work of Healthcare Scientists and the work they do for patients and families!

2018 Cast Rehearsal Photos by Rabbit Hole Photography

Watch the great play by Nicola Baldwin (2018) Remember, Remember! on our YouTube Channel (available Friday 30th October)

See how your hard work can help our scientists by completing the activity packs that accompany the show (download links below)

Also

Take photos, record a video or create other content (blog, tik tok, artwork etc) linked to your completed activities OR answers one of the following questions for a chance to win a £50 Amazon voucher!

– What do I think of when I hear the words microbiology / bug?

– What does antimicrobial resistance mean to me?

– What will antimicrobial resistance mean for my family?

– Are bugs good or bad?

– What do I think scientists do in hospitals?

Email: we transfer your entries to hcs.education@gosh.nhs.uk by Sunday 8th November

Lily, Rosa and Frank are Healthcare Scientists working in the laboratories. They work to help patients understand what is making them unwell, or to help with making them better.
It’s November and there is fog hanging in the air. The leaves have begun to fall and the street lights have started to come on by the time they leave work.
Scientists often work late into the night and Lily is waiting for Rosa and Frank to finish for the day.
Whilst waiting for them she decides to run one more test using her favourite piece of lab equipment, a MALDI-ToF she’s called Bonnie. Bonnie is a pretty cool piece of equipment: it has a laser and can get a result for Lily in less than 5 minutes for something she used to have to wait 2 days for.
Just as she presses the big red button, Rosa and Frank walk through the door to the laboratory. Suddenly a message appears on the screen, where no message should be saying ‘HELPE…’
Then the message changes and gives an address at the top of Lamb’s Conduit Street and what looks like a map.
Lily is so surprised she jumps back and tries to turn Bonnie off, but the machine doesn’t respond and the message just stays on the screen.
Not knowing what to do Lily, Rosa and Frank decide to leave the lab and find somewhere to sit and chat to work out what might have happened;, After all this is a piece of scientific equipment not a computer game.
As they leave the lab, they are suddenly surrounded by the fog they had seen outside the window until they can barely see what’s in front of them.
As they walk towards where they believe the tube to be, they suddenly realise they are on Lamb’s Conduit Street and the fog begins to clear.
A child is waiting. She has a Scottish accent and demands they call her Princess Elizabeth! They must all bow to her!
She tells them there is a plot to get rid of her father by blowing up the Houses of Parliament. The scientists are amazed – do you mean the Gunpowder Plot of 1605?
She says she will tell them later how she managed that.
Even then, they don’t believe she is a princess….
But she is
Remember, Remember! by Nicola Baldwin 2018

The scientists must find a way to help Princess Elizabeth find the Gunpowder Plotters. Then maybe they’ll be able to find out how to get back to 2020!

The scientists have asked you to complete a number of activities in order to help them find the plotters. You are the detectives, guiding the scientists so that they can get home.

Complete the following activities and we’ll find a way to get the results back in time to the scientists in 1605.

Activity Pack One – primary school group 2020 v1.2 Download

Activity Pack Two – pre GCSE group 2020 v1.2.docx Download

Activity Pack Three – GCSE group 2020 v1.2 Download

Science Communication: Reflections from an Ivory Tower

October 15, 2020September 11, 2022 girlymicro Education, General, Microbiology (Clinical), Research/Academia, Science Communication Co-production, Communication, Healthcare Science, Social Media

This week I was going to post about Antimicrobial Resistance (AMR) as, in many ways, it has been quite a momentous week in my professional life and it all ties into AMR. I may still… but I wanted to raise something that has been playing on my mind this week in light of the social media reactions I’ve seen to the new COVID-19 (don’t call it a lockdown) tiers.

Let me say now that this isn’t a political post, purely one linked to reflections that have been triggered for me that are linked to some of the pitfalls of traditional communication, medicine and dissemination.

On Wednesday, I saw this tweet. The scientist in me responded with, ‘well of course’ and ‘surely people understand the ramifications for everyone if we don’t find working containment measures’.

Twitter post related to the new YouGov poll

When I see posts like this, I usually scroll through the comments. I think it’s important to read what people are posting and see what the challenge is like, as it’s all too easy to see the world through the eyes of those in your bubble. Those people in similar situations to us, with similar views to us, who then use stats like this to reinforce the positions we already hold.

Then, as part of the comments, I saw this:

My first reaction to this post was to blow out my cheeks and sigh. “The needs of the many outweigh the needs of the few” and all that. That’s an economic problem that should be addressed, not an infection issue: think of the number of people who will die etc.

Then I stopped and realised there is truth to this

I do live in an Ivory Tower

Now that’s not to say that I am rich, and it’s not to say that my response to the the poll is wrong. It is to say that we must reflect and admit the truth to ourselves. I can pay my mortgage. My job is not at risk (although my husband’s may well be). I can buy food and cover my bills. That gives me a privileged position where I can engage with and make decisions about how I feel about the science, the justification, and the way they are implemented. I don’t have to react from a place of worry and fear. That privilege means that I can digest information from a place of logic and not emotion. That privilege also means that I can lose perspective about how others may receive the same information and I certainly have to be aware of that privilege when it comes to judgement.

However the key word in the above paragraph is “receive”. This is where I come to the real point of my post. One of the problems with the current situation is the feeling of disempowerment of being the recipient of information and not the co-creator of response. This has been a problem in the health setting for pretty much as long as it’s existed, but its only in recent years that it’s been recognised as such.

Too many times in medicine we implement from a position of expertise and authority without engaging the lived experience and knowledge of others. I’m a passionate believer in the power of true co-production, where we work in partnership to create something that neither group could deliver on their own. I work in a hospital where we see patients who may be one of only 20 in the world with their condition. It is naïve and arrogant of me to believe that I will understand more about their experience of living with their disease. I can input, support and advise on the basis of biology and my experience. It will never be truly effective without considering theirs.

So my thought on this Friday evening is actually more of a plea. We all have our Ivory Tower, our bubble, our version of the truth. If you work in healthcare it’s important to give yourself time to reflect on what that means for your practice. Are you doing everything you can to move from being the authority in the room to being the person who is prepared to truly listen and co-create the best possible outcome for the patient in front of you?

Are we ready to enter a new period in healthcare where it is much more about the patient in front of us than it is about our years of training and education?

All opinions most definitely my own

Adventures in Science Communication – Stand-up comedy edition

October 12, 2020September 11, 2022 girlymicro Education, Science Communication comedy, Healthcare Science, outreach, Science Communication

I’m not funny. Well, I’m not “laugh out loud” funny. I’ve never been the kind of person who has told jokes and, unlike many in an American genre TV programme, I would never have won the ‘Class Clown’ award. So how on earth did I end up spending three hours this week in a stand-up comedy training session?

There’s obviously the answer that a lot of the 11 people on the call would give: i.e. we need continuous professional development (CPD) points and, as Healthcare Scientists in the time of COVID-19, that’s not as easy. For anyone that doesn’t work in our profession, we have to show that we engage in a set number of hours of active learning and updating our practice. This helps us stay safe but also encourages a growth mindset where we learn new skills.

Secondly, the funding for the sessions is from a public engagement grant that my brilliant deputy was awarded by the Society for Applied Microbiology (SfAM). My deputy is super brave and was invited to do a show last year, having never done any stand-up comedy. As part of my role as leader, I felt it was incredibly important to actively participate in something that she had put energy into and believed would make us better communicators. Also, I’m a Trustee for SfAM and they do great work in supporting scientists in stepping out of their boxes and trying something new to communicate differently. I really buy into this and so, despite being slightly terrified, it was the right thing to do.

The session was delivered by Dr Steve Cross who is a consultant in public engagement and education. He started off the session by saying that he enjoys teaching nerds to be funny. Well, as a self confessed mega-nerd, this was a good start from where I was sitting. The session was a real mix of scientific backgrounds: from social science, infection specialists, pathologists, physiologists, through to medical physicists. This is one of the great things about sessions like these: networking is a great and often unexpected benefit and you get to spend hours with scientists you would never encounter otherwise and learn about their worlds.

Never underestimate the power of stories

We started out by discussing what we thought was funny. I had failed to do my homework and so hadn’t brought a clip with me (I know, an automatic F!) But the better prepared participants showed YouTube clips that made them laugh and discussed why. In an attempt to raise my grade from an F to a D, the clip below (belatedly) is something that makes me chuckle.

From watching the different clips I began to reflect on the power of stories. One of the reasons that Nicola Baldwin (the playwright I work with) and I utilise drama is because we believe in the power of drama to communicate, break down barriers and alter behaviour. It was fascinating to think about how comedy can be used to:

See things from a new direction
Explore differing opinions in a confrontation-free way
To confront and explore upsetting/worrying topics avoiding direct triggers
Enable the voicing of secret thoughts that are very common but we fear discussing openly
Talk about common experiences as if they are new in order to gain fresh insight
Subvert expectations
Inspire or start conversations

A lot of these points can be extrapolated to the reason Nicola and I use drama. The power of comedy is the portability and equal access nature of it. It doesn’t require huge amounts of resources to prepare a set, it doesn’t require a lot of resources to deliver a set, and it can be delivered flexibly across zoom or in person.

Steve ran us through a bunch of very easy to access and non terrifying exercises. Many of these involved us taking a story or event and reflecting on it in order to delve deeper into emotions connected with it. We then discussed how these stories and linked emotions could be used to make people laugh. Obviously there’s way more to it, but Steve is the king and we are running more of these sessions if you’d like to give it a go and participate yourself.

My main reflections from the session were:

Undertaking this kind of training can enable you to see situations differently and explore ways of seeing them from another’s point of view
Learning to break situations down and actively think about how to communicate them is a transferrable skill which is really useful in your professional practice
Understanding how stories can be used to create empathy and engage audiences isn’t just important for comedy. This technique can be used to support you bringing your whole self to work and break down communication barriers

All opinions in this blog are my own

Why Have I Waited 5 Years?

October 11, 2020September 4, 2022 girlymicro General FRCPath, Healthcare Science, PhD, Work Life Balance

It’s been five years since my last (and, embarrassingly, only) post on this blog. I started it when I’d just been awarded my PhD. After four years of focusing on my research and thesis, I thought that I would have the mental space and time to really invest in something that I’m personally passionate about – science communication.

I think when many of us finish a big project, like a PhD, there’s almost a grieving feeling at the end. What do I do now? This thing that has been a massive part of your every waking (and in my case also so sleeping) moment is now done. It makes sense to rest, recuperate and reflect. This is what I should have done. Sadly, as those of you who know me can attest, I’m not very good at any of those things. It’s a a skill set I’m working to develop.

So, instead of stopping, I decided to sit the exams to become a Fellow of the Royal College of Pathologists (FRCPath). This was a big deal for me. Not that many Healthcare Scientists in microbiology at the time has sat the Medical Microbiology exam, and no one who only worked in paediatrics. It was important to me though, as I see patients and felt the need to be as equally qualified as my medical colleagues. It was the final step to getting on the Higher Specialist Scientific register and being eligible for a Consultant Healthcare Scientist post.

I started to prepare for the ‘Great British Bake Off’ of professional exams but without the comfort of cake. Four days, 30 hours of exams with lab and written sections! If I thought the PhD was tricky, FRCPath was another level.

Five years ago I posted on Facebook:

Elaine Cloutman-Green is feeling drained.

30 September 2015 · Shared with Your friends

Day 3. It’s 6 am and I’m reading brain abscess guidelines. I’m exhausted, I feel sick, and I really want to go home. It’s been so much harder than I had dreamed and I have cocked up on so many things. I get to leave tomorrow and that is all I care about now, I no longer care if I pass – I just want it to stop. Whining over. Eyes on the finish line. When I leave here, let’s never mention these days again.

Sometimes you have to face the failure and the difficulties head on to come out stronger. Fortunately I came through the other side and was gobsmacked in 2015 to find out that I had passed.

The Face of Complete Relief at the Fellowship Ceremony (2016)

2016 you say, but that’s still years ago . So why nothing since then?

At the same time as recovering from FRCPath exams, I decided to apply for an NIHR Clinical Lectureship. I know! I’ve got a problem, right?

From 2016 to 2019, I’ve been beavering away on my clinical academic career as part of an NIHR ICA Fellowship (see the top right corner of the progression image). More on that and what a Clinical Academic is will be posted on a separate blog in a bit.

After an intense five years with a lot of highs, and some level of stress, I’m back! I promise to not make you wait five years for another post.

What have I learnt:

Learn to rest, regenerate and reflect. These skills are undervalued.
Sometimes you have to face your fears in order to thrive. In my case the fear of failure.
You are capable of anything you can dream of if you work hard enough. Dream big and aim high!

All opinions in this blog are my own

Hello world!

December 5, 2015September 4, 2022 girlymicro General Healthcare Science

So, this is my first ever blog post. Bear with me as I don’t really know what I’m doing.

I’m what is know as a Clinical Scientist and I work in Infection Control.

https://nationalcareersservice.direct.gov.uk/advice/planning/jobprofiles/Pages/clinicalscientist.aspx

Most people don’t know what a Clinical Scientist is so I thought I should briefly explain.

Most scientists that work within hospitals are involved with imaging (X-rays, CTs etc) or processing patient samples. We all work to support diagnosing patients. Did you know that scientists are involved with >80% of all diagnoses within the NHS? Their work is crucial to improving patient care, but the scientists are often unsung heroes as they often never meet the patients they help.

I do not work in the lab all the time like many scientists. I’m a clinical scientist, so half my time is spent working in a patient facing role within infection control and the other half involves bringing science to infection control to make it more efficient/evidence based. I work within a hospital with a team comprised of nurses, doctors and scientists. I have a PhD in infection control. I am also working towards my final clinical qualification (Fellowship of the Royal College of Pathologists) which is the same as my medical colleagues. My job is to help the translation of the science into a form that healthcare professionals can work with. Sometimes this means working with language so we are all on the same page. Other times this means working with the latest science and technology and developing new tests that will help.

I’m passionate about my job, but I’m also aware that many people don’t know that it exists and I’m hoping that this blog will help to change that. I plan to share a bit about what my day to day life is like as well as the science which I hope will inspire others to become healthcare scientists. After all, I have the greatest job in the world. And that is worth shouting about.