WELCOME TO THE THIRD LECTURE IN OUR NEW MONTHLY SERIES, WOMEN LEADERS IN ACADEMIC RESEARCH BROUGHT TO YOU BY THE WOMEN AND MEN OF THE NIH CENTER FOR INTERVENTIONAL ONCOLOGY, RADIOLOGY AND IMAGING SCIENCES AT THE NIH CLINICAL CENTER AND THE NATIONAL CANCER INSTITUTE IN BETHESDA. PART OF THE INTRAMURAL RESEARCH PROGRAM AT NIH. I'M BROOD WOOD, CHIEF OF IR AND DIRECTOR OF THE NIH CIO AND ON BEHALF OF THE ORGANIZING COMMITTEE, IT'S MY HONOR AND PRIVILEGE TO WELCOME OUR FIRST INTERVENTIONAL RADIOLOGIST AND INTERVENTIONAL ONCOLOGIST TO GIVE THIS LECTURE. ONE OF OUR VERY OWN, ISABEL NEWTON. AS TODAY'S WOMEN LEADER IN ACADEMIC RESEARCH. I MET ISABEL AFTER ONE OF HER AMAZING COOL AND CHARISMATIC LECTURES AND SHE IS ENGAGING, INTELLIGENT, CREATIVE AND ELOQUENT AND IT'S A GREAT FIRST FACE OF IR AND IO, INTERVENTIONAL ONCOLOGY, FOR THIS LECTURE SERIES. WE WILL HAVE A FEW WISE WORDS IN PERSPECTIVE IN THE BEGINNING SHARED BY MY FRIENDS, JANICE LEE AND NATASHA. FOLLOWED BY THE LECTURE AND ENDING WITH A Q&A SESSION. I'LL SAY UPFRONT, AS A REAL-LIFE SCENARIO, ISABEL MAY HAVE AN EMERGENCY AND THAT'S ONE OF THE THINGS IN MEDICINE AND ACADEMIC TRANSLATIONAL AND CLINICAL RESEARCH THAT IS A FACT OF LIFE AND A REAL-LIFE SCENARIO AND ONE OF THOSE WORK CLINICAL RESEARCH TRAINING BALANCES. SO WE WILL, IF SHE NEEDS TO POP OFF EARLY, OR INTERMITTENTLY DURING THE LECTURE, WE WILL POP INTO A Q&A AD LIB CHAT SESSION ON THE TOPIC. SO THIS INTRODUCTORY PANEL, AS YOU SEE, IS NOT BALANCED. IT'S ALL WOMEN AND ME. I REALLY WANTED TO EXPERIENCE WHAT IT'S LIKE TO BE THE ONLY ONE AND TO FEEL IN THE MINORITY, AND IF YOU LOOK AROUND AND MAKE AN ISSUE OF IT, YOU FEEL A LITTLE UNCOMFORTABLE, AND I THINK UNCOMFORTABLE IS GOOD WHEN YOU'RE TALKING ABOUT SITUATIONS LIKE IMPLICIT BIAS AND UNDER REPRESENTED REPRESENTATION AND GETTING OUTSIDE OUR COMFORT ZONE THIS SERIES HONORS FRANCIS COLLINS LEADERSHIP AND CHALLENGING SCIENTIFIC LEADERS THROUGHOUT THE BIOMEDICAL ENTERPRISE FOR NO MORE ALL-MEN PANELS TO CREATE A LEVEL PLAYING FIELD, INCLUSION AND DIVERSITY WHERE SCIENCES OF ALL BACKGROUNDS ARE EVALUATED FAIRLY AND THINGS LIKE SPEAKING OPPORTUNITIES LIKE THIS AND OTHER OPPORTUNITIES, ARE PRESENTED BROADLY. THE BEST WAY TO ADVOCATE FOR CHANGE IN CULTURE IS FOR THE UNDER REPRESENTED AND UNDER PRIVILEGED -- ESPECIALLY WHITE MEN IN POSITIONS OF PRIVILEGE AND OF POWER WITHIN OUR SCIENTIFIC COMMUNITY. SO TODAY IN 2021, TO BE A WHITE MALE LEADER IN A POSITION OF POWER AND DECISION-MAKING, IT COMES WITH ADDED RESPONSIBILITIES. IT'S NOT STATUS QUO AND IT'S NOT COOL TO SIT STILL. THINGS WON'T UNDERCORRECT, UNDERREPRESENTATION WILL CONTINUE. WE NEED TO DO JUSTICE TO DIVERSITY INCLUSION AND UNDERREPRESENTATION BY ACTION. SO CONFRONTING IMPLICIT BIASES, REQUIRES RECOGNIZING THAT WE ARE OFTEN UNAWARE OF OUR OWN CULTURAL PROGRAMMING. WE ARE HUMAN. WE ARE BIASED AND WE TEND TO THINK ALIKE. WE LIKE TO THINK ALIKE. LIP SERVICE IS NOT ENOUGH. LEADERS HAVE TO DEMONSTRATE THEIR COMMITMENT TO EQUALITY AND BALANCES WITH WHAT OUR COUNTRY IS GOING THROUGH. OUR SCIENCE DEPENDS UPON IT. TODAY OUR COUNTRY DEPENDS UPON IT AS WELL. I HAVE ENJOYED SHARING A FEW QUOTES AT THE BEGINNING OF EACH OF THESE LECTURES. WE STARTED WITH ABB ABBY A MARTIN LUTHER KING'S DARKNESS CANNOT DRIVE OUT DARKNESS, IF YOU'RE NOT PART OF THE SOLUTION, YOU'RE PART OF THE PROBLEM. INSIDE OF EACH OF US IS ALL OF US. AND SOMETHING FROM BER NAY BROWN, AND THIS KIND OF DIVERSITY IS WHAT WE ARE ABOUT AND WHAT WE WANT TO PURSUE AND PROMOTE HERE AT NIH AND THROUGHOUT THE COMMUNITY. THIS IS THE WAY TO OPEN YOUR MIND. SO THIS SERIES, WOMEN LEADERS IN ACADEMIC RESEARCH WAS INITIATED AS AN EFFORT TO ACKNOWLEDGE, EDUCATE AND ADDRESS UNDER REPRESENTATION IN ROLE MODELING FOR FUTURE STARS WITHIN OUR SMALL MICROCOMMUNITY. WE DO THIS THROUGH A BETTER UNDERSTANDING OF IMPLICIT BIASES AND UNDER REPRESENTATION. WE WANT TO ASK WHY. WE WANT TO HIGHLIGHT SUCCESSFUL FEMALES AND OTHER ACADEMIC LEADERS AS ROLE MODELS FOR TRAINEES. A BROADER INTEREST GROUP SHOWS INTEREST IN THIS AS WELL INCLUDING INDUSTRY, ACADEMICS, PROFESSIONAL SOCIETIES, SIR AND RSNA, AND MANY CORNERS OF NIH. WE TRY TO LEAD BY EXAMPLE. ACKNOWLEDGING WHY ONE TENDS TO RECRUIT IN OUR OWN IMAGE WILL SHINE LIGHT ON THAT AND ON THE STEREOTYPES AND BLINDSPOTS THAT ARE INHERENT TO THAT PROCESS. THESE ARE NOT BAD WORDS. WE ALL HAVE STEREOTYPES AND BLINDSPOTS. WE HAVE TO RECOGNIZE IT, FIND OUT YOUR OWN AND I CHALLENGE EACH OF YOU TO FIND YOUR OWN STEREOTYPES AND BLINDSPOTS. THEY ARE THERE AND IF YOU THINK THAT YOU DON'T HAVE THEM, THEN THAT'S PART OF THE PROBLEM. TO REALIZE THIS IS STEP ONE. SO ARE EACH OF US DOING ALL WE CAN? ARE YOU DOING ALL YOU CAN? THAT'S THE QUESTION I WANT TO ASK YOU. THE BEST INTENTIONS ARE NOT ENOUGH. INTENT WITHOUT IMPACT IS MEANINGLESS. SO TODAY WE SEEK TO BETTER UNDERSTAND WHY LESS THAN ONLY 1-10 INTERVENTIONAL RADIOLOGISTS IS A WOMAN. SUPER COOL DISCIPLINE, IMAGE, GUIDANCE, MINIMALLY INVASIVE THERAPY, VIDEO GAME MEDICINE, THE NEWEST RESIDENCY, THE FIRST NEW RESIDENCY IN MANY YEARS. SUPER COOL SPECIALTY SO WHY 92% MEN? WHY? THINK ABOUT IT. LESS THAN 1-10 NURSES IS A MAN. IT'S THE SAME RATIO HERE. IF YOU ASK A CHILD TO DRAW A PICTURE OF A SCIENTIST, HE DRAWS A MAN. ASK HIM OR HER TO DRAW A PICTURE OF A DOCTOR, NOW IT BECOMES A WHITE MAN. IF YOU GOOGLE IMAGE SEARCH, AND I DID THIS LAST NIGHT. I TYPED IN INTERVENTIONAL RADIOLOGIST, WHAT COMES UP, THERE WERE 38 IMAGES BEFORE I SAW A WOMAN ALONE. WHEN YOU SEE THAT, EVEN THEN SHE'S NOT DOING A PROCEDURE, SHE'S CARRYING X-RAY FILM. THIS IS NOT RIGHT. SO I'M GOING TO QUOTE MY MOM WITH MY LAST PHILOSOPHY. YOU ARE WHO YOU HANG OUT WITH. YOU'RE ALSO WHAT YOU SEE AND WHAT YOU DIGEST. YOU DREAM AT NIGHT ABOUT WHAT YOU SAW DURING THAT DAY. WE NEED TO HAVE OUR CHILDREN AND THE FOLKS WHO ARE COMING UP AS TRAINEES DREAM BIG AND DREAM ABOUT WHAT THEY CAN BE. SO OUR SPEAKERS, JUST AS TODAY, HAVE A UNIQUE PATHWAY TO SUCCESS. THAT'S THE WAY TO SHINE THE LIGHT TO SHOW WHAT IS POSSIBLE. SEEING SOMEONE WHO LOOKS LIKE YOU DO SOMETHING GREAT ENABLES YOU TO DREAM BIG. MEDICAL STUDENTS DREAM BIG. 25% OF TRAINEES NOW ARE FEMALES IN IR. BETTER THAN THE 8% THAT CURRENTLY ARE PRACTICING. WE ARE IMPROVING, GOING THE RIGHT WAY. BUT THE WAY TO DO THIS IN THE FUTURE IS TO CONTINUE, HAVE TRAINEES AND YOUNGER FOLKS SEE THEMSELVES IN POSITIONS LIKE THIS. THEY WANT TO BE ABLE TO SEE PEOPLE DO THINGS JUST LIKE ISABEL WILL SHOW YOU TODAY. SHE IS THERE TO SHOW PEOPLE WHAT THEY CAN BE INVISIBLE, IMPACTFUL WAY AND WATCH THEM GET CELEBRATED FOR ACCOMPLISHMENTS. CAN WE DO BETTER? WHAT CAN YOU DO? WHY DOES THIS EXIST THIS WAY? SO I'LL LEAVE YOU WITH THAT AND WE ARE NOT HERE TO HEAR PRE RAMBLE ON. TODAY'S'S WOMAN LEADER AND ACADEMIC RESEARCH, ISABEL NEWTON. WE'LL HAVE A WORD HERE FROM DR. JANICE LEE AS WELL WHO IS DEPUTY DIRECTOR. >> THANK YOU, BRAD. IT REALLY IS A PLEASURE TO BE HERE TO REPRESENT THE OFFICE OF INTRAMURAL RESEARCH. AND BRAD, I WANT TO THANK YOU AND THE NIH CENTER FOR INTERVENTIONAL ONCOLOGY. IN YOUR EFFORTS TO ACCELERATE THE CHANGE AND TO SUPPORT DIVERSITY, EQUITY AND INCLUSIVITY IN STEM FIELDS. IN SOME WAYS YOU'RE MAKING UP FOR LOST GROUND SHOWCASING WOMEN LEADERS ALL YEAR LONG. AS I MENTIONED BEFORE, THE VISUAL ALONE OF SEEING SPEAKERS WHO LOOK LIKE ME IS INCREDIBLY ENCOURAGING. AND ONE THAT WE DON'T TAKE FOR GRANTED. AND BY DOING SO, WE ENCOURAGE OTHER WOMEN TO JOIN OUR MALE-DOMINATED SPECIALTIES AND WHILE WOMEN REMAIN THE MINORITY LIKE IN FIELDS LIKE MY OWN. IN 1889, A VIKING GRAVE WAS EXCAVATED IN NORWAY AND FOR A CENTURY IT WAS HAILED AS THE IDEAL VIKING MALE WARRIOR GRADE BASED ON THE IMPRESSIVE SWORD YOU CAN SEE, ARROWHEADS, SPEARS AND TWO SACRIFICED HORSES FOUND ALONGSIDE OF THIS WARRIOR. ADDITIONALLY THIS WARRIOR WAS CLEARLY A STRATEGIST AND LEADER BASED ON THESE GAME PIECES YOU SEE ON THIS PERSON'S LAP. THAT ALL CHANGED IN 2014 WHEN IT WAS EXAMINED, THE PELVIC BONES AND MANDIBLE AND THOUGHT, THESE ARE THE DIMENSIONS THAT MATCH A WOMAN. SHE RECEIVED PUSHBACK FROM THE ARCHAEOLOGICAL SOCIETIES AND SINCE THE EXCAVATION OCCURRED OVER A CENTURY AGO, THE QUESTION CAME UP, COULD THERE BE OTHER INDIVIDUALS MIXED IN WITH THIS WARRIOR? AND THEN IN 2017, CHARLOTTE JOHNSON CONDUCTED MITOCHONDRIAL DNA TESTS WHICH CONFIRMED THAT ALL THE BONES WERE FROM ONE WARRIOR. AND THAT WARRIOR WAS A WOMAN. SO YOU CAN SEE HOW THIS STORY OF THIS HIGHLY ACCLAIMED ARCHAEOLOGICAL FIND WAS VIEWED THROUGH THE LENSE OF A SOCIETY COLORED BY MODERN EXPECTATIONS OF GENDER ROLES, BIASES AND IDEALS. AND SO I'M LOOKING FORWARD TO THE CHANGES WE ARE GOING TO HEAR ABOUT. I LOOK FORWARD TO HEARING ABOUT HOW GENDER EXPECTATIONS ARE NO LONGER APPROPRIATE. I AM LOOKING FORWARD TO HEARING MORE FROM DR. ISABEL NEWTON ON HOW WE CAN BALANCE OUR CAREERS WITH OUR LIFE STORIES IN GENERAL. SO THANK YOU VERY MUCH AND WELCOME, DR. NEWTON. >> THANK YOU VERY MUCH, JANICE. THAT IS FASCINATING LITTLE INSIGHT AND WE ALL DO HAVE THESE PICTURES WE REFER TO AND REFERENCE. SO NATASHA IS NEXT UP WHO IS PH.D. IN IMMUNO-ONCOLOGY AND FOCUSED ULTRASOUND AND A FELLOW IN ARTIFICIAL INTELLIGENCE AT STANFORD AND IS PART OF THE ORGANIZING COMMITTEE HERE AND REALLY SPEAKS TO THE NEXT GENERATION OF FOLKS AND THE THINGS SHE REPRESENTS THAT PERSPECTIVE FOR THE ORGANIZING COMMITTEE. NATASHA. >> HELLO, EVERYONE. I JUST WANT TO FIRST AND FOREMOST THANK BRAD AND THE ORGANIZING COMMITTEE FOR PUTTING THIS TOGETHER. IT'S A REAL HONOR TO HAVE DR. NEWTON WITH US TODAY TO GIVE THIS LECTURE. IF I MAY BE SO BOLD AS TO SPEAK ON BEHALF OF THAT NEXT GENERATION, AS A TRAINEE IN THIS SPACE, I WANT TO SAY HOW IMPORTANT THESE CONVERSATIONS ARE AND HOW MUCH THEY MEAN TO OUR GENERATION AND WE CAN REALLY SEE THE DIFFERENCE THAT THESE CONVERSATIONS ARE ALREADY MAKING. I ALWAYS SAY DURING CONVERSATIONS LIKE THIS THAT WE ARE ALREADY IN A BETTER POSITION AND ARE SO LUCKY TO BE IN THAT POSITION AS HAVING PREDECESSORS LIKE THOSE ON THIS CALL WHO ARE BASICALLY FORGING A MUCH -- A PATH FOR TRAINEES LIKE MYSELF TO CLIMB HIGHER, DREAM BIGGER, MOVE FASTER AND IT WOULD BE REALLY A DISSERVICE TO YOU ALL IF WE DIDN'T PAY THAT FORWARD AND MAKE THE MOST OF IT. SO, IT'S A REAL HONOR TO BE HERE AND IT'S A PLEASURE TO BE PART OF THE ORGANIZING COMMITTEE FOR THIS LECTURE SERIES. AND ON THAT NOTE, IT'S MY ABSOLUTE PRIVILEGE TO FORMERLY WELCOME DR. ISABEL NEWTON WHO, AS MENTIONED, TODAY'S WOMEN LEADER IN ACADEMIC RESEARCH. SHE'LL BE GIVING A LECTURE ENTITLED, BUILDING NEW ROADS, THE IMPORTANCE OF TENACITY, RESILIENCE AND MENTORSHIP. AND I'M GOING TO SHARE BRIEFLY THE LECTURE SYNOPSIS WHICH ECHOS A LOT OF WHAT DR. WOOD MENTIONED. INNOVATION AND ADVANCEMENT ARE CRITICAL TO RADIOLOGY. BUT THE CULTURE AND STRUCTURE OF OUR FIELD AND TRAINING ARE RARELY CONDUCIVE TO THE DEVELOPMENT, GROWTH AND SUCCESS OF RADIOLOGISTS SCIENTISTS. COMPOUNDING THIS PROBLEM IS THE FACT THAT BOTH RADIOLOGY AND BIOMEDICAL RESEARCH SUFFER FROM A LACK OF DIVERSITY THAT IS ESSENTIAL TO INNOVATION AND GREAT WORKING ENVIRONMENTS. CRAFTING A CAREER AS AN IR PHYSICIAN SCIENTIST HAS REQUIRED A GREAT DEAL OF PERSISTENCE, RESILIENCE AND THE SUPPORT OF EXCELLENT MENTORS. BALANCING THIS CAREER WITH LIFE AS A HUMAN BEING HAS TAKEN A SKILL SET THAT IS NOT TAUGHT DURING OUR TRAINING. THIS TALK WILL EXPLORE THESE ISSUES AND INVITE DISCOURSE ON HOW TO SHAPE THE FUTURE OF OUR FIELD TO BE MORE SUPPORTIVE, INCLUSIVE AND INNOVATIVE. AND THIS IS OF COURSE ON BEHALF OF DR. ISABEL NEWTON WHO IS AN IR PHYSICIAN SCIENTIST AT THE V.A. SAN DIEGO AND UCSD. AT THE VASDMC, SHE IS CHIEF OF IR AND WELLNESS DIRECTOR OF RADIOLOGY. SHE SERVED AS CO-DIRECTOR OF THE T32-FUNDED CLINICIAN-SCIENTIST RADIOLOGY RESEARCH PROGRAM AND WAS THE PROGRAM DIRECTOR FOR INTERVENTIONAL RADIOLOGY. SHE IS AN ACTIVE MEMBER OF THE RADIOLOGY COMMITTEE ON EQUITY, DIVERSITY AND INCLUSION. HER TRANSLATIONAL RESEARCH FOCUSES ON THE EFFECTS OF THERMAL ABLATION FOR LIVER CANCER ON LIVER CANCER STEM CELLS AND THE IMMUNE RESPONSE. SHE IS ALSO CO-FOUNDER AND CHAIR OF THE INTERVENTIONAL INITIATIVE, A 501C3 ORGANIZATION DEDICATED TO INCREASING PUBLIC AWARENESS REST OF MINIMALLY INVASIVE, IMAGE-GUIDED PROCEDURES. DR. NEWTON HAS CO-DIRECTED AND CO-PRODUCED THE DOCUMENTARY SERIES "WITHOUT A SCALPEL". AND I WANT TO SAY AGAIN ON BEHALF OF TRAINEES EVERYWHERE, IT'S AWE INSPIRING TO SEE ALL YOU HAVE ACCOMPLISHED, DR. NEWTON AND WE ARE SO EXCITED TO HEAR YOUR TALK. SO WITH THAT, THE FLOOR IS YOURS. >> ISABEL NEWTON: THANK YOU NATASHA AND JANIS AND BRAD. REALLY AMAZING INTRODUCTION AND I'M HAPPY TO SAY THAT OUR PATIENT IS GOOD SO I'M GOING TO BE ABLE TO GIVE THIS TALK. IT IS AN HONOR TO BE INVITED TO SPEAK WITH YOU TODAY. I'M GRATEFUL TO DR. WOOD WHO IS -- I WOULD COUNT AS ONE OF MY SPONSORS FOR GIVING ME THIS OPPORTUNITY AND TO THE NIH FOR THIS REALLY WONDERFUL VISIONARY OPPORTUNITY AND TO ALL OF YOU WHO ARE ON THE COMMITTEE. TO BE PERFECTLY HONEST, THE LIST OF SPEAKERS FOR THIS SERIES IS DAUNTING. THIS IS NOT A TALK FROM THE VANTAGE POINT OF SOMEONE WHO HAS MADE IT AND IS IMPARTING THEIR WISDOM FROM THE DESTINATION THAT EVERYONE IS SO YEARNING TO REACH. I'M GIVING THIS TALK FROM THE ROAD. THESE ARE THE WORDS FROM A FELLOW TRAVELER WHO IS SPECKLED WITH ASPHALT AND SPRAYED WITH MUD. GRITTY, SURE BUT ALSO ASPIRATIONAL. WE ARE GOING SOMEWHERE. FIRST WE NEED TO DECIDE WHERE WE ARE GOING. THIS IS TRUE FOR EVERY ONE OF US. IT IS TRUE FOR THOSE OF US IN MEDICINE AND IN SCIENCE BUT IT IS ALSO TRUE FOR RADIOLOGY AND SPECIFICALLY FOR IR. OUR FIELD IS AT A CROSSROADS. AFTER THE MIRACULOUS BIRTH OF OUR SPECIALTY, WE HAVE WITNESSED ITS BOOM AND RENAISSANCE AND NOW WITH ALL THIS POSSIBILITIES TEETERING IN THE BALANCE, IT IS UP TO US TO ENSURE WHAT WE OFFER TRULY HELPS OUR PATIENTS. ALL OUR PATIENTS, TO BE WELL. IT IS UP TO US TO RECOGNIZE WHAT IS GOOD AND THE OPPORTUNITIES FOR GROWTH. THIS PANDEMIC HAS GIVEN US THE PAUSE WE NEEDED TO SEE THE CULTURE WE INHABIT FOR WHAT IT IS AND DECIDE WHETHER IT IS ONE THAT WE WANT TO CONTINUE. THIS IS OUR CHANCE TO LISTEN TO OUR PATIENTS, UNDERSTAND WHAT MATTERS TO THEM AND SUPPORT THEM IN THEIR JOURNEY. NOW IS THE TIME TO PUSH OUR FIELD TO ITS GREATEST POTENTIAL IN THE SERVICE OF OTHERS. OR WE CAN JUST COLLECT A PAYCHECK AND LET NATURE TAKE ITS COURSE, UP TO US. SO PERHAPS THE BEST WAY TO UNDERSTAND THE ROAD THAT WE ARE ON IS TO ASK WHERE IT BEGAN AND INTERVENTIONAL RADIOLOGY STARTED WITH THIS GUY, AND HIS RADIOLOGY COLLEAGUE AND SO MANY OTHERS. IR WAS BORNE OUT OF INNOVATION. IN JUNE OF 1963, HE SPOKE THESE WORDS: THE ENGINE GRAPHIC CATHETER CAN BE MORE THAN A TOOL FOR PASSIVE MEANS OF DIAGNOSTIC OBSERVATION. USED WITH IMAGINATION, IT CAN BECOME AN IMPORTANT SURGICALLY INSTRUMENT. JUST SEVEN MONTHS LATER HE COMPLETED THE FIRST IR PROCEDURE DILATING A ARTERY IN THE THIGH OF A VERY BRAVE WOMAN, LAURA SHAW, WHO REFUSED TO HAVE AN AMPUTATION. I THINK SHE IS AS MUCH A HERO AS HE IS. SINCE THEN, OUR FIELD HAS EXPLODED TO DEVELOP MINIMALLY INVASIVE IMAGE-GUIDED SOLUTIONS FOR PROBLEMS THROUGHOUT THE BODY. OUR INNOVATIONS EMERGED SO RAPIDLY THAT REFERRING PHYSICIANS AND PATIENTS KEEP UP WITH THEM. IN A STUDY WE PUBLISHED IN 2018, WE FOUND THAT 72% OF THE GENERAL POPULATION DOES NOT RECOGNIZE THAT AN IR IS A PHYSICIAN. WE COMPARE THAT WITH THE UROLOGIST MOST PEOPLE KNOW THEY ARE DOCTORS. ALSO A PATIENT IN AN OUTPATIENT RADIOLOGY WAITING ROOM, THEY ARE WAITING FOR EITHER IR OR DIAGNOSTIC RADIOLOGY PROCEDURES. 35% HAD NEVER HEARD OF IR. BUT WHEN WE QUICKLY EXPLAINED WHAT A MINIMALLY INVASIVE IMAGE PROCEDURE IS, 61% SAID THEY WOULD PREFER THAT OVER SURGERY, WHICH IS SOMETHING THEY UNDERSTOOD MUCH MORE. WHEN I EMBARKED ON MY RADIOLOGY RESIDENCE NE2007, I HARDLY KNEW WHAT IR WAS MYSELF. AND THIS IS TRUE FOR MEDICAL STUDENTS WHO FOLLOWED ME. UNTIL IT BECAME ITS OWN SPECIALTY, DRAWING THE MOST COMPETITIVE APPLICANTS. EVEN WITH THE DIVERSITY OF PATIENTS AND DISEASES THAT WE TREAT IN THE VAST POTENTIAL FOR RESEARCH AND INNOVATION, IR IS DOMINATED BY MEN. 81% OF IR INTEGRATED RESIDENTS ARE MALE AND 90-93% OF FACULTY ARE MALE. AND I DID MUCH OF WHAT BRAD WOOD DID. I GOOGLED RADIOLOGISTS AND THIS PHOTO POPPED UP. DEPICTING THE MALE RADIOLOGIST INSPECTING THE BRAIN SCAN WHILE THE PINK-CLAD TECHNOLOGIST SHERIFF'S OFFICE THE PATIENT IN THE SCANNER AND EVERYTHING IS AS IT SHOULD BE. RADIOLOGY CERTAINLY IS NOT UNIQUE IN ATTRACTING FEWER WOMEN BUT IT'S ONE OF THE FIELDS THAT HAS THE HARDEST TIME ATTRACTING WOMEN. EVEN FEWER DECIDE TO BECOME RADIOLOGIST SCIENTISTS. SO THAT MEANS BY SIMPLY EXISTING, THOSE OF US WHO ARE IN IT ARE BUILDING NEW ROADS. WE CREATE EXPECTATIONS OF WHAT A FEMALE PHYSICIAN, A RADIOLOGIST, AN IR OR SCIENTIST IS SUPPOSED TO LOOK, SOUND AND ACT LIKE. ARE WE SUPPOSED TO LOOK SERIOUS? PRETTY? PLAIN? SEXY? FRUMPY? WHAT SHOULD WE WEAR? WE LIVE IN THE SHADOW OF OUR OWN APPEARANCE. WHEN WE EXPERIENCE SUCCESS, IS IT REALLY REFLECTION OF OUR OWN MERIT OR ARE THESE ACCOLADES BECAUSE OF THE WOMAN THING? WHEN WE TALK, SHOULD WE SOUND ASSERTIVE? WHETHER WE HUNG WITH THE BOYS AND SAID SOMETHING, SHOULD WE APOLOGIZE? WAIT, BETTER BE UNAPOLOGETIC. IMPATIENT, DEMANDING, A PUSH OVER? WHAT IF WE VOICE OR DISPLEASURE? WHAT IF WE USE DIRECT LANGUAGE TO ASK FOR WHAT WE NEED? WHAT HAPPENS IF WE HAVE A BAD DAY? THESE ARE QUESTIONS ASKED BY A GUEST IN A WORLD THAT IS NOT OUR OWN. THEY ARE QUESTIONS ASKED BY SOMEONE WHO IS TIP-TOEING AROUND, WONDERING WHERE THEY BELONG. IT IS TIME TO INHABIT THIS WORK FULLY AS IT BELONGS TO US TO ALL ALL OF US. IT IS NOT ONLY WHAT IS GOOD FOR US, IT'S WHAT IS GOOD FOR OUR SPECIALTY AND OUR PATIENTS. FOR TOO LONG WE HAVE BEEN POPULATING OUR FIELD WITH TYPE CASTS. INSTEAD OF SEEKING OUT ALL EXCEPTIONAL PEOPLE, WE FULFILL CULTURAL EXPECTATIONS OF SUCCESS, DEFINED BY THOSE IN CHARGE. WE PLACE VALUE ON THOSE WHO FULFILL NOTIONS OF EXCELLENCE. WE LOOK FOR CLONES OF THOSE WHO ARE ALREADY HERE. WE SCAN APPLICATIONS IN A WAY THAT FOSTERS BOX CHECKING RATHER THAN CONTRIBUTIONS. WE REWARD RESEARCH RATHER THAN SUBSTANTIVE EXPERIENCES. WE PRIZE A SHINY FACADE EVEN IF IT IS FALSE AND SHOULD ANYONE WHO ADMITS REAL WEAKNESS, EVEN THOUGH IT IS COMMON TO US ALL. INSTEAD, WE SHOULD BE LOOKING FOR THE INNOVATORS AND DISRUPTORS, THE PASSION AT PEOPLE WITH DIVERSE PERSPECTIVES WHO HAVE TRAVELED UNCONVENTIONAL PATHS AND HAVE FAILED BUT HAVE GOTTEN UP AGAIN. AND ONCE WE HAVE ALL THESE BRILLIANT PEOPLE IN OUR PROGRAMS, WE SHOULD HELP THEM GROW. INSTEAD, WE SUBJECT THEM TO RESIDENCY FOR THEIR OVER WORKED, UNDER PAID, SWALLOWING VOLUMES OF INFORMATION AS IF IT WERE FACT AT A PACE THAT DISCOURAGES SCRUTINY. WE UNDERMINE ORION PROGRESS AND THE EMPHASIS WE APPLIES SMALL PROJECTS AND INCREMENTAL STUDIES IN BOTH RESIDENCY AND ACADEMICS. WITH FEW EXCEPTIONS, WE DO NOT TRAIN TRAINEES ON HOW TO APPLY FOR GRANTS, WRITE BUDGETS, DEAL WITH AN IRB, DESIGN STUDIES, YET SOCIETIES STEPPED UP TO MEET THIS UNMET NEED BUT WHY? WHY SHOULD THEY HAVE TO? WE SHOULD BE DOING THIS. THE EMPHASIS DURING RESIDENCY IS ON PRODUCING RADIOLOGISTS CAPABLE OF CONSUMING VOLUMES OF INFORMATION AND PRODUCING VOLUMES OF REPORTS NOT ON NURTURING THE NEXT GAME CHANGER. APART FOR RESEARCH BASICS, WE IGNORE ETHICS, OUTREACH AND HOW WE CAN INTEGRATE WITH AND PARTICIPATE IN THE WIDER HEALTH CARE TEAM BEYOND JUST GENERATING REPORTS OR DOING PROCEDURES. AS ATTENDINGS, THE VALUE IS PLACED ON OUR GENERATION WITH A RACE TO CRUSH MORE AND MORE VOLUME IN LESS AND LESS TIME. WITHOUT AN IMPROVEMENT IN HEALTH CARE, AND QUALITY F OUR TRAINEES MAKE IT THROUGH WITH THEIR RESOLVE INTACT, THEN THESE ARE SURE TO DISSOLVE DURING THEIR EARLY YEARS AS AN ATTENDING. SO HOW DO WE GROW THE NEXT GROUP OF INNOVATORS IN RADIOLOGY? HERE IS ONE EXAMPLE. AT UCSD WE HAVE A PROGRAM THAT OFFERS DEDICATED RESEARCH TIME, A FULL YEAR AT THE OUTSET IN SIX WEEKS OR SUBSEQUENT YEARS OVER FOUR YEARS TO OUR RESIDENTS. WHETHER THEY ARE IN THE DR PROGRAM OR IN THE IR PROGRAM. I MYSELF AM I GRADUATE OF THIS PROGRAM AND I CO-LED IT WITH ANOTHER. EVEN SO, THE RIPTIDE OF CONVENTION AND THE PACE OF PRODUCTIVITY CAN SWALLOW EVEN OUR MOST ENTHUSIASTIC AND ACCOMPLISHED GRADUATES. IN FACT, FORGING A CAREER IN I R AND RESEARCH IS SO DIFFICULT THAT THE MINORITY OF US WERE ACTUALLY DOING IT CLINGING TO ONE ANOTHER LIKE THE SURVIVORS ON AN ISLAND. IT IS NOT ENOUGH TO GIVE RESIDENTS TIME AND OPPORTUNITIES TO BUILD A CAREER AS A RADIOLOGIST SCIENTIST. IT TAKES INVESTMENT ON A MUCH MORE FUNDAMENTAL LEVEL, WILLINGNESS TO REIMAGINE OUR OWN CULTURE. I AM TALKING TO YOU TODAY AS SOMEONE WHO IS NOT A SMASHING SUCCESS. I AM INVESTED IN RESEARCH BUT TRUTHFULLY I'M BARELY HANGING ON. I HAVE A SMALL LAB BUT NO DEDICATED RESEARCH TIME. I HAVE WRITTEN MORE FAILED GRANTS THAN FUNDED ONES AND I STILL HAVEN'T LEARNED TO PUBLISH QUICKLY AND NOT WAIT FOR EVERYTHING TO BE AIRTIGHT. SO HOW DID I GET HERE? WELL, THIS IS AS LINEAR AS IT CAN BE. I STARTED IN CHILDHOOD WHERE I HAD A NATURAL PROCLIVITY FOR SCIENCE. I GREW UP BILINGUAL. MY MOM IS FROM SPAIN. MY DAD WAS AMERICAN. AND I LOVED SCIENCE AND LOVED ANYTHING TO DO WITH SCIENCE BUT NOBODY ELSE IN MY FAMILY KNEW ABOUT SCIENCE SO I KIND OF PROCEEDOD MY OWN. ALTHOUGH WE ARE RELATED TO ISSAC NEWTON AS A SIDE NOTE. SO WHEN I WENT TO COLLEGE, I KNEW I WANTED TO BE A MOLECULAR BIOLOGIST AND I DID GRADUATE IN MOLECULAR BIOLOGY AND THOUGHT I WAS GOING TO GO TO GRADUATE SCHOOL BUT I SAW IT WAS HARD TO ACCEL IN SCIENCE AND EVEN THESE SMART PEOPLE HAD TO RELY ON A GREAT DEAL OF LUCK TO BE SUCCESSFUL. SO I THOUGHT I NEEDED A BACKUP PLAN. AT THE TIME, MY BACKUP PLAN R. WAS TO GET AN MD. I DIDN'T REALIZE I WOULD COME TO ENJOY CLINICAL MEDICINE AS WELL. SO I WAS ACCEPTED AT WAKE FOREST IN THE M.D., PH.D. PROGRAM AND DID MY PH.D. IN NEUROSCIENCE AND I LIVED SCIENCE SO MUCH EVEN THOUGH MY FIRST EXPERIENCE IN A LAB WAS IN A TOXIC LAB, IT WAS TERRIBLE, I ENDED UP GOING TO A WONDERFUL LAB WHERE MY MENTOR SO NURTURED THE LOVE OF RESEARCH IN ME THAT I WENT TO UCSD EXPRESSLY BECAUSE OF THE RESEARCH RESIDENCY PROGRAM. THERE I SHIFTED MY FIELD TO CANCER RESEARCH AND AFTER THAT, DURING MY RESIDENCY I REALIZED THAT I ABSOLUTELY LOVE INTERVENTIONAL RADIOLOGY AND THAT IT OFFERED THE OPPORTUNITY FOR HANDS ON, FOR ANALYTICAL AND ALSO FOR RESEARCH THAT I WAS LOOKING FOR. SO AFTER MY IR FELLOWSHIP AT UCSD, I STAYED ON AT THE VA AND IR ENDED IN BREAST. I DID RESEARCH IN MOST PARTS OF MY CAREER. I GUESS IN CHILDHOOD YOU CAN INCLUDE THE EXPERIMENTS WHERE I WOULD CUT THE WORMS IN HALF AND WATCH THE BOTH PARTS SEPARATE. BUT MY PATH TO BECOMING A RESEARCH SCIENTIST WAS DEFINITELY NOT AS DIRECT AS ONE MIGHT EXPECT, EVEN THOUGH IT SEEMS AS THOUGH I WAS BREWED FOR THE PART. MORE THAN JUST A PATH, HAS BEEN A MAZE AT TIMES. THERE HAVE BEEN PLENTY OF DARK CORNERS AND DEAD ENDS AND EVEN THE OCCASIONAL MINA TAR. BUT THE SINGLE MOST IMPORTANT ELEMENT FOR NAVIGATING ALL OF THESE IS PEOPLE. MY MENTORS AND SPONSORS HAVE GIVEN ME OPPORTUNITIES THAT HAVE LAUNCHED MY CAREER IN WAYS BIG AND SMALL. MY MENTEES HAVE ENRICHED MY CAREER WITH THEIR PERSPECTIVE, WISDOM, HARD WORK AND INSIGHT BIDIRECTIONAL RELATIONSHIPS IN WHICH WE SUPPORT ONE ANOTHER. AND THANKS TO MY COLLABORATORS, MY AREAS OF INTEREST HAVE GROWN AS EVER WIDENING DIAGRAMS OF EXCITING RESEARCH QUESTIONS MADE ALL THE MORE ENTICING BY THE PROSPECT OF PURSUING THEM WITH A TRUSTED COLLEAGUE I AND WANT ADMIRE. SO HERE ARE MY AREAS OF INTEREST AS THEY HAVE EVOLVED OVER TIME. I BEGAN IN NEUROSCIENCE OF MEMORY AND AGING AND CALORIC RESTRICTION. I WENT ON TO STUDY CANCER STEM CELLS AND CELLULAR HONING AS A RESIDENT. THEN AS AN ATTENDING, I STARTED TO BECOME INTERESTED IN LIVER CANCER REOCCURRENCE. CHRIOGEN AS A MEANS NOT ONLY TOW DESTROY LIVER CANCER BUT ALSO OF STOKING IMMUNE RESPONSE. I HAD SIDE PROJECTS LOOKING AT LYMPH NODES BEFORE AND AFTER VACCINES WHICH HAVE BROUGHT INTO THE FOLDS BRILLIANT IMMUNOLOGISTS AND HAVE ALLOWED ME TO FOCUS ON IMMUNO-ONCOLOGY AND NOW WE ARE BACK FULL CIRCLE TO INTERMITTENT FASTING AS WAYING OF CHANGING THE ENVIRONMENT IN THE LIVER AND REDUCING LIVER CANCER REOCCURRENCE. SO SOMETIMES THE PATH, IT FORKS, AND YOU HAVE TO CHOOSE. MAYBE YOU CHOOSE TO NOTICE THE FLOWERS ALONG THE EDGE. IT'S TAKEN ME A WHILE TO FIGURE OUT HOW TO DO THAT. OR MAYBE YOU TAKE A HARD LEFT TO THE HOME OF ONE OF MY MENTORS. SO RIGHT AFTER FELLOWSHIP BEFORE I FOUND MY CURRENT RESEARCH TEAM, WHICH I LOVE, I COULD NOT GET A FOOTHOLD IN RESEARCH. I FACED SET BACK AFTER SET BACK RELATED TO DIFFICULTY GETTING FUNDING AND DEDICATED TIME. I WAS ALSO A NEW ATTENDING IN TRYING TO HONE MY IR SKILLS. SO ONE OF MY SPONSORS, WHO IS NOW RETIRED, GAVE ME UNUSUAL OPPORTUNITY THAT BECAME OUR DOCK YOU SERIES, WITHOUT A SCALPEL AND OUR NON-PROFIT. THESE ARE AVAILABLE ON DEMAND BUT WE ARE GOING TO PUT WITHOUT A SCALPEL FOR FREE ON YouTube. THE MISSION OF THE INTERVENTIONAL INITIATIVE IS TO EDUCATE AND ENGAGE THE PUBLIC ABOUT MINIMALLY INVASIVE IMAGE-GUIDED PROCEDURES. OUR GOAL IS TO EMPOWER PATIENTS WITH THE INFORMATION THEY NEED TO MAKE THE BEST HEALTH CARE DECISIONS FOR THEMSELVES. BECAUSE STUDIES SHOW THAT THEY DO A BETTER JOB THAN WE DO ONCE THEY HAVE THE INFORMATION THEY NEED. BUT THIS00 BEEN MY ONLY DETOUR. I ALSO THOSE HAVE KIDS. WONDER DURING RESIDENCY AND TWO AS A YOUNG ATTENDING. LIFE ALSO THREW ITS OWN DETOURS AS IT DOES TO EVERYONE. AND I CHOSE TO RESPOND BY UPGRADING MY HUSBAND. SO SOMETIMES I HAD TO CHOOSE TO GO FORWARD, OFF THE PATH, AND INTO THE UNKNOWN. AND HERE IS WHERE THINGS GET REALLY SCARY. WHERE DOES THIS ROAD GO TO? THE NOT KNOWING CAN BE PARALYZING, SO MUCH SO THAT MANY PEOPLE STICK TO THE PATH CONFUSING FAMILIARITY WITH SAFETY AND CLARITY. OR THEY PUT THEIR HEAD DOWN, SLOGGING ALONG THE ROAD FOR YEARS WITH THE EXPECTATION THAT THEY WILL EVENTUALLY ARRIVE AT SOME MAGICAL DESTINATION THAT THEY WILL GET TO IN HABIT LIKE A PRIZE. SO WRAPPED UP IN PUTTING ONE FOOT IN FRONT OF THE OTHER, THEY FAIL TO QUESTION OR EVEN TO NOTICE WHERE THEY ARE GOING. I CALL THIS SLEEPWALKING. I WOULD RATHER WALK CONFIDENTLY INTO A DEAD END THAN SLEEPWALK BECAUSE INEVITABLY, THIS HAPPENS. EITHER YOU'RE EXPLORING THE TERRAIN, BUILDING NEW ROADS OR FOLLOWING ESTABLISHED PATHS. BECAUSE IF YOU'RE NOT CAREFUL, YOU CAN FIND YOURSELF ON A ROAD LEADING TO NOWHERE OR WORSE, SOMEWHERE YOU STRIVED TO REACH OUT OF HABIT AND EXPECTATION BUT WHEN YOU FINALLY ARRIVE, IT'S NOWHERE YOU WANT TO BE. EVEN WHEN YOU FEEL LIKE HAVE YOU IT ALL TOGETHER, AND YOU'RE FORGING YOUR OWN PATH TOWARDS THE LIGHT, EVEN WHEN EVERYTHING SEEMS TO BE GOING SO WELL, THE SHADOW MAY BE HARDER TO LIVE UP TO THAN THE REALITY. AND THE REALITY CAN BE A PRETTY BAD BURN. BALANCING A CAREER WITH LIFE AS A HUMAN BEING TAKES THE SKILL SET THAT IS NOT TAUGHT DURING OUR TRAINING. AND WE TALK ABOUT WOMEN IN MEDICINE, WE MENTION BALANCE, POISING CAREER WITH FAMILY LIFE. BUT IT'S A CHALLENGING NEED. AND NOW WOMEN HAVE CHILDREN OR DEPENDENT RELATIVES. BALANCE IS A CHALLENGE FOR ALL OF US BECAUSE IT MEANS RECOGNIZING AND HONORING OUR OWN HUMANITY AND GIVING IT THE SAME ATTENTION AND IMPORTANCE AS OUR CAREERS. A DIFFICULT PROSPECT SINCE PART OF OUR SUCCESS COMES FROM OUR PROFESSIONAL SELF ABROGATION AND OUR FEAR OF MISSING OUT. WHILE WE ARE TRAINING, LIFE HAPPENS. WE BECOME EXPERT IN NEGATING OUR OWN HUMANITY, THE NEED TO STOP, EAT, SLEEP, EXERCISE, HAVE FUN, BE WITH THE ONES WE LOVE. WHAT HAPPENS WHEN THE VERY DARK TIMES STRIKE? WE ARE ILL-EQUIPPED TO MANAGE. WE DO NOT FEEL LIKE WE CAN TAKE TIME AWAY OR ASK FOR HELP. OUR INSTITUTIONS PUSH PRODUCTIVITY AT ALL COSTS AND THIS LEADS TO BURN OUT, DEPRESSION, AND IN SOME CASES, SUICIDAL IDEATIONS. BURN SOUGHT A SYNDROME OF BROKEN SYSTEMS THAT NEED MAJOR OVERHAULING. WE ARE LEFT TO FEND FOR OUR OWN WELL-BEING. IN TIMES LIKE THESE, WE TEND TO PUSH ON. WE EVEN GIVE MORE OF OURSELVES AND THIS REMINDS ME OF THE STORY THAT IS EN GRADE IN US FROM AN EARLY AGE, THE GIVING TREE. MOST PEOPLE VAGUELY KNOW IT'S A SWEET STORY ABOUT A BOY AND A TREE THAT LOVES HIM AND AFTER EVERY PAGE IS A LINE THAT THE TREE WAS HAPPY. AS A CHILD, THE TREE AND THE BOY PLAYED TOGETHER, THE BOY CLIMBS THE TREE,S IN HER LEAVES AND HE RETURNS TO THE TREE TO SATISFY HIS NEEDS AS HE GETS OLDER. THE TREE GIVES HIM ALL SHE HAS TO GIVE, HER APPLES, HER BRANCHES, HER TRUNK. UNTIL THE TREE IS JUST A STUMP AND BECOMES A SEAT FOR THE BOY NOW AN OLD MAN TO SIT. THE PHRASE AND THE TREE WAS HAPPY, HAS MADE IT ON TO JEWELRY, INSPIRATIONAL POSTERS AND PLAQUES. PEOPLE USUALLY REGARD THIS AS A BEAUTIFUL STORY OF SELFLESS LOVE. IT REALLY TOOK READING IT TO MY 5-YEAR-OLD TO SEE IT FOR WHAT IT IS. A HORROR STORY. SHE GOES, WHAT? WHY IS HE DOING THAT TO HER? WHY IS HE KILLING HER? AWAKENED BY HER OUTCRY I SAW IT DIFFERENTLY. I ASKED MYSELF WHY WAS SHE GIVING INTO THIS SELF-DESTRUCTIVE UNILATERAL AND ROMANTICIZED NOTION OF WHAT IT MEANS TO CARE FOR OTHERS? BECAUSE SELF SACRIFICE DOES NOT RESULT IN SELF ANNIHILATION. IT OFTEN RESULTS IN THIS, UTTER COLLAPSE. IN SELF SACRIFICE, IT'S SIMPLY DESTRUCTIVE F YOU'RE DESTROYED, YOU ARE NO USE TO ANYONE, LEAST OF ALL TO YOURSELF OR THE PEOPLE YOU'RE TRYING TO CARE FOR. THE ROAD IS GOING TO BE ROUGH. THERE IS NO ESCAPING IT. BUT THE ANSWER IS NOT TO SLEEPWALK ALONG IT OR TO PLOW ALONG DENYING YOUR OWN HUMANITY. IT IS POSSIBLE TO DERIVE STRENGTH FROM ANNIVERSITY, THIS IS CALLED RESILIENCE AND THAT CAN BE CULTIVATED. WE ALL HAVE RESILIENCE WITHIN US BUT WE CAN MAKE IT STRONGER. IT'S POSSIBLE TO EXPERIENCE FAILURE AND COME OUT BETTER AND STRONGER AS A RESULT. I WAS RAISED NOT TO BE A QUITTER. SO I DIDN'T. I FAMOUSLY HUNG ON FOR FAR TOO LONG, DRAGGING ALONG THE ROUGH ROAD WHEN ANY RATIONAL PERSON WOULD HAVE LET GO MILES BEFORE. I SINCE LEARNED THAT KNOWING WHEN TO STOP IS ANOTHER LEVEL OF THE ROAD. SO KNOWING WHAT THE ROAD IS HARD AND THAT WE HAVE OUTGROWN THE CONVENTIONAL EXPECTATIONS, HOW DO WE HELP THE NEXT GROUP OF IR INNOVATORS FIND THEIR PATH? WELL, THE FIRST STEP IS TO DRAW UPON A WIDER POOL OF UNCONVENTIONAL APPLICANTS. AND THEN WHEN THEY COME TO US, RESPECT THE PRIVACY OF THEIR EDUCATION. THEY ARE NOT HERE TO SOLVE STAFFING ISSUES. THEY ARE HERE TO BE EDUCATED AND THAT SHOULD BE AREN'TED ABOVE ALL ELSE. WE SHOULD ENRICH THEIR EXPERIENCES WITH RESEARCH OPPORTUNITIES LIKE THEY GIVE IN SURGERY OR INTERNAL MEDICINE. AND THESE SHOULD NOT BE ONE OFFS. THEY SHOULD BE STANDARD ACROSS-THE-BOARD. WE SHOULD RESPECT OUR HUMAN SIDE AND RESPECT THE HUMAN SIDE OF RESIDENTS. THEY WILL BE HAVING CHILDREN DURING THIS TIME OR MAYBE THEY WON'T. THEY MIGHT BE GETTING SICK. THEY MAY HAVE PROBLEMS WITH PERSONAL ISSUES OR MENTAL ILLNESS. THESE ARE NOT THINGS TO BE SHUNNED OR TALKED ABOUT QUIETLY. THEY ARE THINGS TO BE EMBRACED AS PART OF THE ENTIRE HUMAN EXPERIENCE AND ONES THAT WE, AS A COMMUNITY, SHOULD BE EQUIPPED TO ABSORB AND SUPPORT. WHEN WE HAVE THESE BRILLIANT PEOPLE IN OUR CARE, WE SHOULD GUIDE THEM WITH CAREER DEVELOPMENT ADVICE THAT BEGINS WHEN THEY HIT OUR DOORS AND CONTINUES THROUGHOUT THEIR EXPERIENCE AND PREPARES THEM FOR THEIR NEXT STEPS SO WHEN THEY LEAVE US THEY CAN BEGIN THEIR CAREERS AS PHYSICIAN-SCIENTISTS, IF THAT IS WHAT THEY WANT. OR IN PRIVATE PRACTICE. AND FOR THAT MATTER, WE SHOULD BE ENGAGING THE RICH TALENT WITHIN THE PRIVATE PRACTICE COMMUNITY NOT ONLY FOR TEACHING BUT ALSO FOR RESEARCH. AND HAVE MORE INTERACTIONS WITH THESE PEOPLE. YOU KNOW, IN CLOSING, WE ARE THE ONES WHO BUILD THE ROADS. AND WE ARE THE ONES WHO CREATE THE FUTURE. SO IT IS UP TO US TO DECIDE. AND IF THERE IS ANYTHING MOST WONDERFUL ABOUT THIS MOMENT IS THE FACT THAT IT HAS BROAD US TO THIS POINT WHERE WE ARE WILLING TO QUESTION, WILLING TO BE VULNERABLE, WILLING TO BRING EVERYONE TO THE TABLE AND THIS FOCUSES ON WOMEN BUT THIS INCLUDES PEOPLE OF COLOR, LGBTQ, ANYONE WHO IS NOT MAINSTREAM PERSON WHO IS IN CHARGE. THIS IS A TIME TO BE INCLUSIVE AND TO WELCOME TALENT HOWEVER IT COMES AND NOT SQUANDER IT WHEN WE GET IT. WITH THAT, I'LL TAKE QUESTIONS. >> WOW. BRAVO. BRAVO, ISABEL. I KNEW YOU WERE ELOQUENT AND INSIGHTFUL. NOW I SORT OF BETTER UNDERSTAND WHY I THINK AFTER HEARING YOU SPEAK AND CHATTING WITH YOU INFORMALLY, IS ONE OF THOSE CONVERSATIONS THAT JUST WENT ON AND CONTINUED BECAUSE I THINK TO HEAR YOU TALK, THERE IS ENGAGING SPEAKERS THAT YOU LISTEN TO BUT THIS ONE, YOU SIT ON EVERY WORD. IT'S FULL OF WISDOM, FULL OF LITTLE PEARLS. I THINK REALLY A BEAUTIFUL LECTURE. THANK YOU VERY MUCH FOR THAT. SIR ISSAC NEWTON WOULD BE PROUD AND YOU HAVE DONE HIM JUSTICE. THE SLEEPWALKING, THE BALANCE, CULTIVATION OF RESILIENCE, CARING ABOUT EACH OTHER. THIS IS A PROFOUNDLY IMPACTFUL LECTURE AND WITH VISION AND CHARISMA AND I THINK YOU'RE GOING TO DO GREAT THINGS AND I THINK AS A ROLE MODEL FOR FOLKS, IT'S REALLY AMAZING. SO FEEL FREE TO TAP IN QUESTIONS INTO THE CHAT BOX AS WELL. SO A COUPLE OF QUESTIONS FROM FOLKS IN CIO. HOW DO YOU MANAGE THE DUTIES OF PARENTHOOD WHILE BEING AN IR PHYSICIAN SCIENTIST? THIS SPEAKS TO THE BALANCE QUESTION. PEOPLE CALL IT WORK-LIFE BALANCE. CLEARLY YOU HAVE SPOKEN ABOUT CAREER AND PROFESSIONALISM AND I THINK YOU HAVE A BEAUTIFUL FAMILY YOU SHOWED US, AND THE WHOLE OTHER SIDE OF PEOPLE THAT REALLY REPRESENTS THEIR CORE OF WHO THEY ARE SUSPECT OFTEN DIFFERENT FROM CAREER. HOW DO YOU BALANCE THOSE THINGS AND HOW HAVE YOU MET CHALLENGES IN DOING SO? AND HOW DOES THAT INFLUENCE OUR QUESTION OF HOW WE ARE, EACH OF US ARE TRYING TO BE BETTER? >> THANK YOU FOR THAT QUESTION. I THINK THE WAY THAT WE CAN SEE THE BALANCE IS ALL WRONG. WE THINK OF BALANCE AS SOMETHING THAT WE ACHIEVE AND THEN IT IS STATIC. AND IF YOU LOOK AT WHAT IS BALANCE, WE THINK OF IT AS BEING A SORT OF EQUAL PIE CHART WHERE WE HAVE A CERTAIN PART OF THE PIE IS FAMILY, A CERTAIN PART OF THE PIE IS RESEARCH AND THEN THE OTHER PART IS CLINICAL AND THAT'S COMPLETELY WRONG. BALANCE IS TO BE REINVENTED AND RENEGOTIATED EVERY DAY. AND SOMETIMES MANY TIMES DURING THE DAY. AND THAT IS BECAUSE EVERY DAY OUR PRIORITIES CHANGE. SO A BALANCED DAY FOR ME MAY BE, I GET UP AND I WORK ON A GRANT ALL DAY LONG AND HARDLY SAY HELLO TO MY KIDS AND I GO TO BED AT 2:00 YAM I GET THE GRANT IN ON TIME. AND THAT'S BECAUSE THE GRAND IS DUE. IF THAT IS HOW IT IS EVERY DAY IT'S IMBALANCED LIFE. BUT IF IT'S BECAUSE I NEED TO PULL THIS LAST EFFORT TO MEET SOME DEADLINES AND MY EFFORTS TO TRY TO AVOID THE LAST CRUNCH WERE NOT EFFECTIVE, THEN THAT IS BALANCE. THAT'S BALANCE. BUT IT'S BECAUSE I CHOSE AND I WAS CONSCIOUS IN SAYING THIS IS HOW THIS DAY WILL BE. THERE WAS NO SLEEPWALKING ABOUT IT. OVERALL, HOWEVER, THE WAY I MANAGE, HAS BEEN GREATLY INFLUENCED BY THE PANDEMIC. I AM SOMEONE WHO LOVES MY WORK. I LOVE THE PEOPLE I WORK WITH. I LOVE THE KIND OF WORK I DO. I WOULD MAKE EXACTLY THE SAME AMOUNT OF MONEY IF I DID RESEARCH THAN IF I DIDN'T. I'D MAKE THE SAME AMOUNT OF MONEY IF I SHOWED UP AND DIDN'T DO ANYTHING. I WORK FOR THE GOVERNMENT. SO EVERYTHING I DO IS PASSION AND I LOVE TO DO IT. AND SO IT TOOK REALLY IN THE PANDEMIC FOR EVERYBODY TO SLOW DOWN, FOR ME TO LEARN HOW TO SLOW DOWN. AND FOR ME TO LEARN HOW TO MAKE BARRIERS. BECAUSE IT BECAME ACCEPTED TO SAY, LOOK, KIDS ARE AT HOME. I'M GOING TO NEED TO LEAVE TO GO PICK UP MY KIDS OR MY KIDS ARE DOING DISTANCE LEARNING OR WHATEVER. AND SO THAT ACTUALLY REALLY HELPED ME DO SOMETHING THAT I WAS ALREADY STARTING BEFORE, WHICH IS TO DECIDE IN MY MIND WHAT ARE THE HARD STOPS? SO IF I GO HOME, FIRST OF ALL I CHOSE A CAREER, I WORK AT THE V.A. WHERE IT'S MORE FLEXIBLE. THEIR EFFICIENCIES ARE MY OPPORTUNITIES. I SHOULD GET THAT ON AMENT T-SHIRT. SO I'M ABLE TO CAPITALIZE ON THAT. >> AND WE DON'T HAVE THAT HERE AT THE NIH BY THE WAY. >> NOT AT ALL. AND I LOVE THE V.A. I LOVE THE PATIENTS THAT I TREAT AND MY TEAM. BUT IT'S TRUE. IT'S A SLOWER PACE. SO FOR THAT, I GET TO PARTICIPATE MORE IN THINGS. WE USUALLY SHUT DOWN AROUND 4:00. EVEN IF YOU DON'T HAVE THAT KIND OF SETUP, I HAVE CHOSEN TO HIRE OUT THINGS I DON'T WANT TO DO, LIKE CLEAN MY HOUSE OR THAT I DON'T HAVE TIME TO DO. AND THEN WHEN I AM WITH MY KIDS, I'M REALLY WITH MY KIDS. I MAKE DINNER. WE TALK ABOUT THINGS, WE PLAY GAMES. AND THEN A LOT OF TIMES I GET IT WRONG. A LOT OF TIMES I'M NOT BALANCED AND THAT DOESN'T MEAN SERVING OUT THE WINDOW AND A TERRIBLE PARENT. IT MEANS THAT TOMORROW IS THE NEXT DAY AND I'M GOING TO RENEGOTIATE THAT BALANCE ALL OVER AGAIN. AND SO, I THINK THAT IS THE MOST IMPORTANT SECRET ABOUT BALANCE. >> VERY WELL SAID, ISABEL. I LOVE THE SLEEPWALKING ANALOGY AND I REFER TO IT AS MIND NUMBING AND NUMBNESS OF LIGHTS THAT MANY PEOPLE, ALL OF US, FADE IN AND OUT OF RELEVANCE AND THE DEPTH OF OUR EXPERIENCES AND WHAT WE CAN APPRECIATE AND FEEL AND TOUCH PEOPLE AND HAVE FRIENDSHIPS AND COMMUNICATIONS AND THEY ARE -- IT CAN'T ALWAYS BE COMPLETELY DEEP AND MOVING AND IMPACTFUL. BUT I THINK LIKE YOU SAID, A LOT OF US GO THROUGH A CERTAIN AMOUNT OF OUR LIFE NUMB. WE WALK AROUND NUMB WITHOUT ANY NERVES. AND I THINK THE MORE THAT WE CAN MAKE EVERY DAY LITTLE MINUTIA, MICRODECISIONS RECOGNIZE AS HAVING IMPACT. AND MAYBE A DISCUSSION YOU HAVE IN PUBLIC WITH PEOPLE AT WORK OR MAYBE SOMETHING WITH YOUR CHILDREN OR BEST FRIEND, WHATEVER IT IS. THESE ARE LITTLE DECISIONS THAT OFTEN WE DON'T SEE THE WAVES OF THE ROCK THAT WE THROW IN THE WATER AND THESE LITTLE DECISIONS ARE WHAT MAKE US WHO WE ARE, THEY ARE WHAT MAKE OUR SURROUNDINGS AND OUR CULTURE WHAT IT IS AND THEY REPRESENT THE PROBLEMS THAT WE ARE TALKING ABOUT TOO TODAY. SO, I THINK THE ANALOGY IS A GOOD ONE IN TERMS OF THE PANDEMIC IS THE IMPACT UPON YOU, IT'S DIFFERENT FOR EVERYBODY AND I THINK LOOKING AT BRIGHT SILVER LININGS OF THINGS LIKE THIS PANDEMIC, IT'S REALLY I THINK MOST PEOPLE PROBABLY SLOWED DOWN A LITTLE BIT, THINK ABOUT WHAT MATTERS AND HAVE HAD TIME TO REALLY RECALIBRATE. AND I THINK CERTAINLY YOU LOOK AROUND, I SEE THE NIGHT SKY A LOT CLEARER THAN I USED TO AND THE BIRDS ARE MUCH LOUDER THAN THEY USED TO BE FOR THE SMALL THINGS. BUT IN OUR DAY-TO-DAY ALSO, I THINK THAT IS CERTAINLY TRUE. SO ANOTHER QUESTION IS, HOW DO YOU BALANCE EDUCATING THE PUBLIC ABOUT IR AND YOUR WORK? AND I THINK THAT SPEAKS TO SOME OF YOUR WORK YOU HAVE DONE IN TERMS OF EDUCATING WHAT IS IMAGE-GUIDED THERAPY. AND A CAVEAT THERE. WHEN YOU SEE THINGS LIKE FIBROID EMBOLISM, WHEN IT FIRST CAME AROUND FOR THE FIRST DECADE OR SO, IT WAS NOT WIDELY KNOWN ABOUT, WIDELY OFFERED AND MANY TIMES MANY WOMEN WOULD HAVE HYSTERECTOMIES WITHOUT A DISCUSSION OF ITS EXISTENCE. NOW I THINK SOME OF THIS IS IN TERMS OF HOW OUR HEALTH CARE IS DELIVERED, PERHAPS, BUT MAYBE YOU COULD SPEAK A LITTLE BIT ABOUT THAT PASSION IN YOUR LIFE. >> RIGHT. SO I ALLUDED TO THIS DETOUR INTO, WITHOUT A SCALPEL, WHICH BY THE WAY I HAVE NO FILMMAKING EXPERIENCE. I TEAMED UP WITH A BRILLIANT PARTNER, SUSAN JACKSON, WHO HAS NEVER MET A CHALLENGE SHE CAN'T JUST SURMOUNT WITH RESEARCH AND HARD WORK. SO WHEN I TALKED ABOUT PEOPLE, IT'S REALLY AS IMPORTANT ABOUT FINDING PEOPLE. I HAVE NOT DONE ANY OF THESE THINGS BY MYSELF, NOT HAVING KIDS, NOTHING. ALL OF THIS HAS BEEN ABOUT PARTNERSHIPS. AND SO SUSAN AND I STARTED AND THOUGHT WE'D MAKE JUST A DOCUMENTARY, ONE DOCUMENTARY. BUT THEN IT TURNED INTO THE DOCK YOU SERIES. AND WE WERE FILMING WITH A FILM CREW GOING AROUND PLACES, INTERFACING WITH THE HOSPITALS. IT WAS A LOT OF TIME. AND I'LL TELL YOU IT WAS A TIME WHEN MY RESEARCH, MY LAB DIDN'T EXIST OR IT WAS SORT OF SLOWLY HAPPENING DURING THAT TIME I GOT MY VERY FIRST BREAK WITH THE SIR WHO GAVE ME THIS TINY GRANT THAT ALLOWED ME TO FUND SOME BENCH WORK. AND THAT RESEARCH LED TO A JDIR PAPER THAT GOT THE EDITOR'S AWARD AND MY FIRST GRADUATE STUDENT WHO IS JUST AMAZING, JUST GOT INTO YALE. SO EXCITED FOR HER. SO I THINK IT'S THE TIMING. DURING THE PANDEMIC, WE HAVEN'T BEEN FILMING. WE'LL PROBABLY GO BACK TO FILMING BUT NOT AT THE PACE WE WERE DOING BEFORE. BUT IT'S ABOUT CHOICES, ABOUT CONSCIOUS CHOICES. I WILL SAY THIS, ONE THING THAT REALLY, REALLY BOTHERS ME WHEN I SPENT A LONG TIME IN EDUCATION, WHEN I TALK TO STUDENTS OR TRAINEES OR APPLICANTS, WHEN I ASKED THEM WHERE WILL YOU BE IN 5-10 YEARS? WHAT IS YOUR ULTIMATE GOAL, KNOWING THIS WILL CHANGE. AND THEY GIVE ME SOME RESPONSES, COUCHED IN THEIR ESTIMATE OF WHAT THE MARKET LOOKS LIKE OR WHAT THE CHANCES ARE. THEY SAY WELL, I THINK IT WILL BE HARD TO GET A JOB IN THIS PART OF THE COUNTRY SO I'M GOING TO DO THIS INSTEAD. AND I GO, HOLD UP. IF YOU'RE ALREADY CUTTING YOUR OPTIONS SHORT BECAUSE OF SOME IMAGINED IDEA OF WHAT THE LANDSCAPE IS GOING TO BE WHEN YOU FINALLY GET OUT THERE, YOU'RE NOT GOING ANYWHERE. YOU SHOULD BE, HEY THE RULES DON'T APPLY TO YOU AND BEHAVE AS THOUGH THE ROADS ARE YOURS TO BUILD AND TO FORGE. SO THAT IS WHY A LOT OF THESE THINGS, WHEN YOU SAY HOW DO YOU BALANCE ALL OF THIS STUFF? I THINK IT'S BECAUSE YOU ARE LOOKING AT A SYSTEM THAT ALREADY ACTIVITIES IN YOU'RE TRYING TO FIT YOURSELF WITHIN THAT SYSTEM AND THAT SYSTEM DOESN'T WORK. IT DOESN'T WORK FOR YOUR MALE COLLEAGUES EITHER. AS WOMEN WE TRY TO MAKE OURSELVES SMALL AND TRY TO NOT DRAW TOO MUCH ATTENTION AND CONFORM TO THESE AREAS AND NEVER SAY NO AND NOT BE A PROBLEM AND BE THE GOOD COLLEAGUE AND JUST SUCK IT UP. AND I HAVE DONE THAT FOR MANY YEARS AND BUT WHAT I FOUND, MY MALE COLLEAGUES HAVE TOUT ME -- CHRIS FRIEND AND THE BEST COLLEAGUES I COULD HAVE HERE AT THE V.A. THEY TAUGHT ME LIFE IS ALSO IMPORTANT AND IT'S OKAY TO TAKE A DAY OFF IT'S OKAY TO USE A VACATION THAT IS YOURS. I HAVE SO MUCH VACATION AT THE V.A., THEY ARE GOING TO START TAKING IT AWAY FROM ME. SO YOU LEARN FROM EACH OTHER. SO SOME OF THE THINGS THAT MAY BE NEEDS YOU HAVE, MAY ALSO BE NEEDS THAT YOUR MALE COLLEAGUES HAVE. AND WE CAN CHANGE THE RULES. WE CAN CHANGE THE CULTURE. WE JUST HAVE TO HAVE THE COURAGE TO DO SO. >> WELL SAID. AND I THINK YOU GET BY WITH A LITTLE HELP FROM OUR FRIENDS TO QUOTE THE BEATLES. AND I THINK IT'S SO TRUE IN THE DAY-TO-DAY, AND THIS CAN BE WITH YOUR PARTNERS IN A PRACTICE AND IR BUT IT'S REALLY ACROSS-THE-BOARD. THERE IS NOT A MOMENT THAT GOES BY WHERE THERE MIGHT BE SOMETHING THAT YOU REALLY ARE HAVING TO LEAN ON SOMEONE ELSE TO GET BY. AND THAT IS OKAY. ALL THESE LITTLE PATTERNS AND LABELS THAT WE CALL OURSELVES, WE THINK WE GET SOMEWHERE WITH THE DEGREE AT THE END OF OUR NAME. WE THINK WE ARE GOING TO BE SOMETHING WHEN WE GOAT A CERTAIN STAGE OF WHATEVER IT IS, PUBLICATIONS OR WHATEVER YOUR GOALS ARE AND PROFESSIONALLY OR PERSONALLY, HAVING CHILDREN. WHATEVER THE THING IS. AND IT'S A PLATEAU THAT DOESN'T EXIST IT'S ALL ABOUT PROGRESS AND ABOUT THE JOURNEY AND AS YOU SO CLEARLY OUTLINED. AND I THINK YOUR ASSESSMENT OF HANGING ON, YOU'RE MORE THAN HANGING ON, MY FRIEND, AND WE ALL DEFINE OURSELVES BY DIFFERENT METRICS WHETHER SUCCESS OR HOW WE VIEW OURSELVES. WE ARE REALLY APPLYING LABELS AND DEFINING OURSELVES IN A CERTAIN WAY. AND I THINK WE HAVE THREE OF OUR PREVIOUS TRAINEES HAVE BEEN IN YOUR PROGRAM AND YOUR IMPACT UPON THEM IS WHAT YOU MAY NOT FULLY APPRECIATE. AND THAT'S THE IMPACT THAT I'D THROW OUT IS ONE OF THE MOST IMPORTANT ONES. AND EACH OF THEM IS A CHALLENGE UNTIL A WAY, IMPACT UPON THEIR CAREER TRAJECTORY OR PERSONAL TRAJECTORY. EACH OF THESE MICROINTERACTIONS ARE IMPORTANT. AND AS MUCH AS WE TALK ABOUT THE TERMINOLOGY, MICRO-AGGRESSION, FOCUS ON THE POSITIVE. THE MEDIA POINTS OUT THE NEGATIVE NEWS OUT THERE ALL THE TIME. BUT THERE IS A WHOLE LOT OF GOOD GOING ON AND THE POSITIVE ASPECTS OF ALL THESE MICRODECISIONS THAT YOU HAVE MADE I'D LIKE TO THROW OUT, THANK YOU. AND ON BEHALF OF THE THINGS OR THE IMPACT YOU DON'T SEE FROM TRAINEE THAT IS HAPPEN TO HAVE SOME SMALL NETWORK THAT WE HAVE SHARED, THEY ALL HAVE BEEN INCREDIBLY TOUCHED AND MOVED IN A DIFFERENT DIRECTION BY YOU. SO FOR THAT, I THANK YOU AND IT'S BEEN REALLY AMAZING HOUR. I WISH WE HAD FIVE MORE. ANY OTHER QUESTIONS FROM THE CROWD? >> THERE IS ONE AT THE TOP THAT WE SKIPPED OVER. >> IF YOU WERE THE HEAD OF NIH TO INCREASE THE NUMBER OF WOMEN SCIENTISTS WORKING IN HEALTH CARE, WHAT WOULD YOU DO AND WHAT DO YOU THINK ABOUT AFFIRMATIVE ACTION AND ACTIONS SUCH AS THAT? >> YES, SO WOULDN'T THAT BE AMAZING? SO I THINK THE WAY TO INCREASE WOMEN IS TO DO THE THINGS THAT LIKE WE ARE DOING TODAY. DEFINITELY TOW HAVE MORE WOMEN BE MENTORS BUT ALSO TO RECOGNIZE THAT FLEXIBILITY AND AUTONOMY ARE GOOD THINGS. WHEN YOU EMPOWER A TALENTED PERSON WITH AUTONOMY AND GIVE THEM THE FLEXIBILITY TO ACCOMPLISH WHAT THEY WANT TO ACCOMPLISH, THEY GET A WHOLE LOT MORE DONE. GOOGLE HAS REALIZED THIS. AND SO I THINK A LOT OF WOMEN, EVEN WOMEN WHO ARE NOT TRYING TO JUGGLE FAMILY LIFE, ARE JUGGLING MANY DIFFERENT INTERESTS, RESEARCH, LOTS OF OTHER THINGS, AND THEN AS WELL I THINK WE WOULD ALL THRIVE IN THAT TYPE OF ENVIRONMENT. SO TO RECOGNIZE THE VALUE OF AUTONOMY, WHICH IS ALSO AN ANTIDOTE TO BURNOUT AND TO GIVE PEOPLE THE ABILITY TO MAKE SCHEDULES THAT WORK FOR THEM. THAT WOULD BE ONE THING. FOR AFFIRMATIVE ACTION, THE WAY THAT I SORT OF VIEW THAT IS, I REALLY THOUGHT A LOT, AND HAVE BEEN WRITING A LOT ABOUT BLACK AND BROWN AMERICANS AND THE STRUGGLE THAT THEY HAVE HAD AND I THOUGHT A LOT ABOUT THE PARALLELS WITH WOMEN AND WHAT DOES IT MEAN TO HAVE AFFIRMATIVE ACTION? YOU'RE TRYING TO REALLY LEVEL THE PLAYING FIELD. SO YOU'RE TAKING PEOPLE WHO HAVE NOT HAD ALL OF THE SAME OPPORTUNITIES. YOU LOOK AT THE BEGINNINGS OF IR. WHY IS IT POPULATED BY SO MANY MEN? WHY IS IR POPULATED BY SO MANY MEN NOW? BECAUSE WOMEN CAN'T DO IT? NO BECAUSE THE ENTRANCE TO IT WAS NOT LEVEL. AND YOU'RE TRYING TO LEVEL IT TO KIND OF IN A RETROSPECTIVE FASHION. IS THAT GOING TO BE CLUNKY AND AWKWARD AND WEIRD SOMETIMES? YES, LET'S JUST GET OVER IT. SO THE WAY TO GET OVER IT, I THINK, IS TO TRY TO ENRICH THE NUMBER OF WOMEN AND THE PEOPLE OF COLOR NOT DISCOUNTING YOUR FOCUS ON TALENT OR CRITERIA, BUT IF THERE ARE PEOPLE OF EQUAL BACKGROUND, BRING IN THE WOMEN. AND DON'T BE AFRAID OF HAVING MORE WOMEN THAN MEN. I HEARD PEOPLE, NOW WE HAVE -- THERE IS MORE WOMEN THAN THERE ARE MEN. NOW THIS IS A PROBLEM. LIKE, WELCOME TO HOW IT HAS BEEN FOR THE REST OF ALL OF ETERNITY. SO THAT'S OKAY TOO. SO I WISH I HAD MORE INSIGHT AND LIKE THE MAGIC BULLET FOR THIS, BUT I THINK IT REALLY IS GOING TO TAKE THE CULTURE CHANGE AND HAVING ALLIES LIKE YOU, BRAD, AND FRANCIS COLLINS AND PEOPLE AT THE IHI -- PEOPLE REALLY VISIONARY PEOPLE WHO RECOGNIZE THE NEED FOR DIVERSITY ARE GOING TO BE THE WAY TO ATTRACT AND RETAIN WOMEN. ONE THING IS TO ATTRACT PEOPLE WHO ARE DIVERSE, THE OTHER TO RETAIN THEM WHILE THEY ARE HERE. >> WELL SAID, AGAIN. AND I THINK THIS HAS BEEN AN INCREDIBLY POETIC, SOME OF THE QUESTIONS AND COMMENTS IN THE CHAT BOX HAVE BEEN -- HAVE CALLED YOUR LECTURE POETRY. REALLY IT HAS BEEN WONDERFUL. I THINK ANOTHER ONE POSSIBILITY MAY BE REQUIRING MEN AND WOMEN CO-DIRECTORS, CO-CHAIRS. YOU SAID YOU SHARED SOMETHING WITH CLAWED SERLING EARLY IN YOUR CAREER, AND I THINK THAT IS AWESOME. I HAD ONE OR TWO-YEAR THING WITH LIZ JONES HERE WHERE WE CO-DIRECTED AND I THINK IT'S A VERY EMPOWERING MODEL AND ONE THAT REALLY PLAYS OFF OF EACH OTHER. MAYBE THAT IS SOMETHING WE MIGHT BE ABLE TO THINK ABOUT FURTHER AND SEE THEY MIGHT FIND AN AUDIENCE SOMEWHERE. >> I THINK THAT'S A GREAT POINT. AND I SHOULD MENTION THAT MY LAB IS WITHIN THE LAB OF NICK WEBSTER WHO IS MY MENTOR AND ALSO MY COLLABORATOR. AND HE IS A WONDERFUL SCIENTIST. AND SOMEONE WHO KIND OF PROVIDES THE STRUCTURE BUT ALSO THE KNOWLEDGE WITHIN WHICH -- NOT JUST MY RESEARCH PURSUITS BUT THOSE OF MY RESIDENTS CAN BE SUPPORTED AND EXPANDED UPON. SO IT'S A GREAT COLLABORATION AND ONE THAT I THINK HAS BEEN VERY SATISFYING MUTUALLY. HE ENJOYS THE FORAS INTO CLINICAL RELEVANCE AND SOME OF THE THINGS I BRING AND I REALLY DO NEED HIM. STOW IS A CO-DIRECTORSHIP IN THAT RESPECT AS WELL. >> ANYTHING ELSE FROM THE CROWD OR AUDIENCE? NATASHA? ANYBODY? >> I DO HAVE A QUESTION BUT FIRST I JUST WANT TO ECHO ALL OF THE THANKS FOR WHAT I AGREE WAS TRULY POET RE, DR. NEWTON. YOU'RE SO ELOQUENT AND I THINK JUST AS A WOMAN, IT'S VERY INSPIRING TO HEAR ANOTHER WOMAN SPEAK ON THESE TOPICS WITH THE ELOQUENCE YOU DO AND I AM CURIOUS. WE TALKED A LOT ABOUT THE TOP-DOWN APPROACH OF WHAT PEOPLE CAN AND PERHAPS SHOULD BE DOING AT THESE HIGHER LEVELS OF ADMINISTRATION, BUT FOR THOSE WHO, IF WE THINK ABOUT THE BOTTOM-UP APPROACH FOR THOSE WHO ARE COMING THROUGH THE PIPELINE IN EARLIER STAGES OF THEIR CAREERS, WHAT RECOMMENDATIONS DO YOU HAVE FOR WHAT WE SHOULD BE DOING TO PROMOTE OURSELVES AND BALANCE MORE EFFECTIVELY AND ALSO SORT OF USHER THAT FOR THE NEXT GENERATION? >> I ACTUALLY CREDIT YOUR GENERATION WITH A LOT OF THE REVOLUTION AND WELLNESS. SO I CAME INTO THIS WHOLE WELLNESS SPACE IN A FUNNY WAY, WHICH IS A WHOLE OTHER STORY. WHEN YOU LOOK AT THE DIFFERENT GENERATIONS, OUR GENERATION WAS ABOUT JUST LIKE SUCKING IT UP. AND THE GENERATIONS THAT HAVE FOLLOWED ARE ONES WE GO, NO IT'S OKAY TO BE A PERSON. SO I THINK YOU GUYS ARE ACTUALLYICALITY LIFTS FOR THIS CHANGE AND I THINK -- CATALYSTS -- AND I THINK IT'S OKAY TO EXPECT IT. PEOPLE SAY YOU'RE ENTITLED. I DON'T CALL IT ENTITLEMENT. I CALL IT RATIONAL EXPECTATIONS. AND SO YOU CAN SET THE TONE OF WHAT WE SHOULD BE RESPONDING TO. YOU LOOK AT NOW IN INDUSTRY, THEY ARE HAVING TO CHANGE THE WAY THAT THEY STRUCTURE JOBS AND COMPENSATION PACKAGES AND VACATION AND EVERYTHING TO MEET THE EVOLVING EXPECTATION THAT WE ARE GOING TO HONOR OUR OWN HUMANITY ALSO. IT'S NOT THAT YOU GUYS WANT TO WORK LESS HARD, IT'S THAT YOU WANT TO WORK HARD AND ALSO BE A PERSON. SO I THINK FROM THE BOTTOM -- BOOTS ON THE GROUND LEVEL, YOU GUYS ARE THE PALACE FOR A NEW CULTURE AND YOU CAN DEMAND THAT CULTURE. AND JUST BECAUSE YOU ARE YOUNG AND YOU ARE NEW TO THE SCENE DOESN'T MAKE YOUR VOICE ANY LESS POWERFUL. IN FACT IT'S MORE POWERFUL. YOUR VOICES SCREAM LOUDER. ON THE UCSD CAMPUS WITH ALL OF THE ANTI-RACISM THAT IS HAPPENING, THE LOUDEST MOST POIGNANT VOICES ARE THOSE OF THE UNDERGRADUATE STUDENTS. AND THEY HAVE LED US. THEY HAVE LAPPED US IN THEIR VISION AND THEIR DEMANDS FOR CHANGE. AND SO YOU REALLY HAVE A PULPIT AND YOU SHOULD USE IT. IT'S YOUR VISION, IT'S YOUR TENAC AND IT ALSO YOUR FEARLESSNESS. -- TENACITY. >> A MOTIVATIONAL FOUNTAIN, ISABEL. AND I CAN'T THANK YOU ENOUGH FOR TAKING THE TIME TOUT PREPARE AND DO THIS AND SHARE YOUR COMMENTS. I'M GOING TO GO BACK AND PLAY THIS AGAIN BECAUSE I ENJOYED IT SO MUCH. FROM THE BOTTOM OF MY HEART AND ON BEHALF OF ALL OF THE MEN AND WOMEN IN THE AUDIENCE, THANK YOU SO MUCH. I'M HAPPY TO HONOR YOU TODAY AS WELL AND I LOOK FORWARD TO MANY MORE CONVERSATIONS. I FEEL AT THE END OF A REALLY GOOD LECTURE, A CONVERSATION OR COMMUNICATION OR CHAT OR ANYTHING LIKE OF THAT NATURE, AT THE END YOU'RE MOTIVATED AND ENTHUSIASTIC, YOU'RE GLAD TO BE A PART OF IT AND YOU'RE LOOKING FORWARD TO THE NEXT CHAPTER. AND I CAN SAY HONESTLYIY LEFT US WITH ALL THOSE THINGS AND THAT'S A SIGN OF SOMEBODY WHO REALLY HAS SOMETHING TO SAY. YOU HAVE VISION. AND I LOOK FORWARD TO SEEING YOU CONTINUE TO GROW. AND THANKS FOR SHARING YOUR WISDOM WITH US TODAY. SO THANK YOU ISABEL NEWTON. TODAY'S WOMEN LEADER IN ACADEMIC RESEARCH. AND TOMORROW'S. >> THANK YOU. MY E-MAIL IS IN THE CHAT BECAUSE THERE ARE A FEW OTHER QUESTIONS AND I'M HAPPY TO CONTINUE THE DIALOGUE. >> ISABEL, I'M GOING TO -- WE HAVE A LAB MEETING THAT STARTS RIGHT NOW. SO TAKE A BREAK, GET SOMETHING TO DRINK AND I'M GOING HIT YOU UP. IF YOU WANT TO POP IN AND JOIN US, WE'D LOVE TO HAVE YOU. >> ALL RIGHT, I PROBABLY SHOULD GET BACK TO THE CLINIC BUT I JUST WANTED TO INCLUDE MY E-MAIL IN CASE ANYONE WANTED TO CONTINUE THE CONVERSATION LATER. THERE WERE A COUPLE OF EXTRA QUESTIONS I DIDN'T GET TO. SO I'D BE HAPPY TO ANSWER THEM LATER. TAKE CARE, GUYS. >> TAKE CARE. THANK YOU. HAVE A GREAT DAY. >> THANK YOU VERY MUCH. >> APPRECIATE IT.