Life thoughts

power of words

The power of words. We often say that words are powerful, that they are able to transform the world, and I think we want to sincerely believe this. I also think we say a lot of things that we want to believe but struggle to fully support. In today’s society, it seems that action is valued more than words. I’ve always been told to “pay attention to how someone treats you, not what they tell you.” This is great advice that I’ve always valued. People can say a lot of things. They can say that they like you, are happy for you, or support you but truly their actions are what enforce these sentiments. But should we totally discount words? Should we be so jaded by the broken promises and empty declarations that are given to us in this world that we don’t even bother to care for the words others tell us? I romanticize things too much to think this way. I’m a classic optimist. Because of this, I’m led to believe that words are very powerful, even more powerful than action. This morning, I sat thinking about the young lady who coerced her boyfriend to commit suicide. How powerful her own words were. She was served a 15-month sentence; she had no weapon for evidence, was far from the crime scene, and unfortunately left questionable doubt in the jurors. I’ve been grappling with our justice system quite a lot here lately, internally, so I’m not sure what I would have done if I had to make a decision in that case. Sometimes I think about our criminal justice system and become appalled, as if I am viewing this world from the sky, watching how we treat other human beings – that’s another topic for another day though. Nonetheless, I am convinced that her words powerfully persuaded someone else to take his own life; and that is worth talking about. This case raises the awareness of how powerful our words are. We can use our tongue to convince someone they’re insignificant, unimportant, or inferior. Conversely, we hold a powerful tool to lift people up, enlighten, and encourage. Our words matter.

I remember with high acuity the times that people said something that penetrated deep and hurt who I am. Sometimes, words cut deeper than a real knife ever could. I would never punch someone, especially someone I love, but maybe I do mindlessly let my words hurt as bad as physical wounds? It’s hard to think like that. It is painful to imagine our words causing pain to someone else, but they do. We separate what we say and what we do so well in this society. You can post all you want on social media, but it doesn’t necessarily follow what you do. Likewise, it makes sense that we are more inclined to ascribe meaning to physical punches than verbal ones. If I hit someone, I leave a visible mark of the damage I’ve done. When I shame someone with my words, though, the mark I leave is invisible. This translates to the unquestionable nature of a physical illness (measurable diseases, like atherosclerosis or hypertension) versus mental illness (less objective measurements like depression or anxiety). Why does this dichotomy exist? Why do we delineate between what is seen and what is said? Haven’t we observed the cruel effects of cutting language and mental diseases, both of which provoke beautiful, purposeful lives to truly consider their worth on this planet? Shouldn’t we start talking about this? I think this case of a young girl strongly persuading her boyfriend to kill himself should wake us up but not come as a surprise of the power of words. Instead, it should serve as a reminder of the power we have to convince and convey ideas, true or false, harmful or helpful. I think this issue moves beyond merely being nice to others but speaks of the false authority we give to tangible, physical qualities (punches, heart disease) over more abstract concepts (language, mental illness). What is the best way to eliminate this dichotomy? I don’t know. But we can always start by talking about it.

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Life thoughts

experiments

There’s this fleeting moment during an experiment, almost every time, where I stop and think I have completely messed up. I spent the past three days preparing to run an RT-qPCR (real time quantitative polymerase chain reaction if you’re interested) to see if our gene of interest is overexpressed in certain heart tissue. After 15 hours of work, today I put my eyes down, made sure I was ready to go, and began working with the tiniest volumes to prepare the final reaction. I manually pipetted into 96 wells twice (so 192 times). I was so focused on not messing up (this was my first time doing qPCR solo and they gave me the big experiment. . .) but that malevolent little thought rushed in once again. About halfway through the entire process I thought, oh no, you’ve messed up. What was the last sample used? Did you put the right primer in? Is the volume correct? Literally, every worst-case scenario entered my mind. In these often-had moments, I question my process, my accuracy, my proactive thinking, even my basic skills. No matter how confident I am, in these moments I lose all confidence and question things I know to be true. This happened to me today, and I’ve been experiencing this long enough to have mechanisms to mess-up-proof my experiments (like labeling everything, being very intentional in where samples are placed, and using my pipette box as a roadmap for where I’ve already been on the plate). Importantly, I catch my mind while immersed in this doubt and assure myself that I haven’t made a mistake, that I have been very cautious and attentive, and that I am doing just fine. If you’ve read this far despite nonsensical lab stuff, thank you. I realized that this self-initiated doubt is not confined to research but is universal in all of life.

How often am I moving right along, doing just fine, everything is working out, and my mind says to me, Oh no. You have really messed up. You’ve made a big mistake. Everything you’re doing is wrong. I’ll admit, very often. We have experiences, trials and errors, that guide us in life. We make decisions based on knowledge and feelings that we have previously experienced (either in hopes to feel or not feel that way in the future). For the most part, I’d say we are not blindly navigating through life without any guidance (like that cherished from friends, mentors, learning from past mistakes, intentional thinking, etc.). We live like skilled researchers, already filled with the knowledge of how to do our task or with the capability to obtain what we need to know to carry on. It is not that we are taking the wrong path or doing the wrong thing. It is that our minds are telling us that we are. Self-initiated doubt is a destroyer. In the middle of my experiments, it causes me to question what I know is right. In the middle of my life, it causes me to question my actions and pursuits. I so often am living my life, completely satisfied and happy, when that deceptive voice urges me to question everything. Unlike my research skills, I’m not as disciplined to channel my confidence and squander the doubts. This parallel became so clear to me today – doubt creeps in everywhere and to everyone (well, to me at least). Instead of worrying about everything I’ve done wrong or may do wrong, I hope to instead take a note from my laboratory self and remember that I’m capable, skillful, and perfectly fine carrying on in the way that makes me happy. While this example is very specific to my experience, I feel like anyone can think of a place they are skillful (on the court or field, in a job, as a mom or dad, in any hobby) where they don’t let doubt affect their ability to do that skill well. My hope is to live my life a little more like that so the nagging worry and unnecessary questioning don’t invade my happiness and peace of my mind. I guess I hope to live like a crazy scientist that trusts her hand, her skills, and her process – because we all deserve the peace of mind that comes from confidence and self-assurance.

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Life thoughts

Google searches

I just Googled “How to know to pursue an MD-PhD.” Then I stopped, stepped back, and laughed at myself. How in the world would a quick Google search give me any kind of reliable, meaningful, and honest information about such a big – and personal – question? It was so absurd that I actually laughed out loud to myself. While a funny example, I took a peek at the other auto-fill suggestions that Google supplied as I was typing: “How to know about my future” or “How to know if you’re in love” or “How to know to trust someone”. I thought about how deep, and complex, those questions are and, consequently, how deeply we yearn for quick and easy answers to them. I’m convinced that we all long for easy answers to hard questions. We desire for someone to tell us what to pursue in life, who to marry, when to make big investments, when to change careers, etc. Maybe you don’t wish for answers and enjoy the waiting game, but most of us would love to have an infinite collection of those answers at our fingertips. They make life simpler, less stressful, and more predictable. They make things easy.

But we don’t. We don’t have the answers to life’s big decisions – like whether or not to spend 7-8 years in school pursuing an MD-PhD or when to get married or when to change careers. We are sometimes lost, indefinitely, for answers at all. After I did my quick search and realized how silly it was, I thought about how blessed I am to be in a position of such difficult decisions. I am okay with not finding anything that resolved my questioning at the end of that Google search. I’m okay because I understand that we have hard decisions in life because that means we are living it, robustly and consciously. We are not sitting around waiting for life to happen but are instead posed against challenging and thought-provoking questions; if you’re asking when to get married that means you appreciate and are active in the process of finding lifelong love. If you’re worrying about a career change, it means you are thinking about the condition and happiness of your future. I am considering “next step” decisions in my education, and I’m blessed to have the opportunity to consider those options. After my quick-and-easy Google search, I, unsurprisingly, didn’t find anything that answered my question. I found some helpful sites with anecdotal advice or frequently asked questions, but ultimately these hard decisions are answered based on our own considerations, life experiences and goals, and provisions for what we consider to be important and meaningful. Instead of mindlessly searching for answers, on the internet or otherwise, it may be better just to have a conversation with someone – yourself, a friend, a mentor – about why you’re asking that question and what are the considerations that led you there. In life, it is okay to not have answers to these questions just yet. I really believe they are coming and only require patience, grit, and perseverance before they show up in full view. Sometimes, all it takes is a silly search on the internet to remind you that life is far more complex than Google can answer, and that is perfectly okay.

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imperfect

Social media paints layers onto our lives that are flawless, perfect, and fantastical. Many talk about how our Instagram feeds are “highlight reels” of everyone we follow, and this is so true – why would anyone want to flaunt their mistakes, imperfections, and difficulties? There are some people who do “keep it real” but even then, it is always in the context of a happy ending or an edited, attractive picture. I follow a few who bare it all without reservation, and I applaud them and thank them for their sincerity. If I’m being honest, though, probably 95% of the images and messages I see online are glowing with happiness and success, highlighting beautiful faces and bodies, and exhibiting the highs of life. There is absolutely nothing wrong with this! Life is beautiful and should be celebrated as such. It only stings on the days when nothing you do goes right, you fall into the sticky trap of comparison, you cry because of loneliness, you learn of sad or heartbreaking news, you feel unattractive and tired, or you just downright have a bad day. Except for those days. I would argue that more times than not a pretty picture is covering up layers upon layers of real, true human flaws and imperfections. We are not perfect people, and I’m tired of acting like we are. I’m tired of trendy photos that I hope will get me likes, or posting photos that I think others will find interesting. I am tired of narcissism running rampant through online outlets, making young girls feel the need to flaunt their bodies to attract boys or post photos with silly captions to fit in. The stakes are high when it comes to social media – what will other people think of this? Will I look trendy? Will this impress people? Am I going to be accepted if I post this photo of myself? These are things I think all the time, and I have a feeling I’m not alone. I am trying to use my social media to grow readership, but in all honesty, I would still write even if no one read my writings (and, in fact, I do write things that I don’t let anyone read). I write because I love it and it is an outlet for my wandering, captive thoughts. Despite this, the truth is that I am human. I have bad days where I feel overwhelmed, inept, and lonely. I have days were my world feels shaken and hopeless. I have days where I feel unloved and unappreciated. I question my choices, my circumstances, and my feelings all the time. To act like things are all good, all the time is unfair and inauthentic. No one lives that way. So, if you’re like me, out there reading and seeing images of beautiful people with their lives perfectly held together with a smile and a list of accomplishments, please know you are not alone and that you are not the oddball out. I am right there with you, holding my head high on the days I feel inadequate and exhausted and bowing down in thanks on the days I feel untouchable and accomplished. The good outnumber the bad, but the bad enable me to fully appreciate and experience the good. Feeling uncertain makes the times I feel certain even more confirming and exclamatory. Feeling inadequate intensifies the times I feel competent and appreciated, successful and rewarded. Feeling alone makes those times I am surrounded by friends and laughing with sincerity even more sweet. All of these things make me feel innately human, wrapped up in the whirlwind of life; sometimes bound to reality by the steel anchor of defeat and other times floating in the clouds with the kite of triumph. It’s all a balancing game, and I’m here to proudly admit to feeling down some days. I am here to forgo what others want to hear and will instead speak the unwavering words of truth: we will fall, hurt ourselves, experience the pain, dwell in the defeat, and then pick ourselves up, wipe off the hurt, and smile for others to see how far we have come, what we have accomplished, and how cool we look doing it. Just don’t forget that before that ending occurs – the part you see on Instagram and on Facebook – the first few steps have already happened and will happen again, too. It may not always be pretty but it is simply the circle of life; despite the hard days, we are all so blessed and should be thankful we get to live it.

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remembering names

I write this (admittedly random) post as somewhat of a disclaimer, an apology, and a public service announcement. Everyone has those qualities about themselves that are of utmost annoyance. (Admit that you do.) For me, my inability to remember names really causes me a lot of grief, stress, and embarrassment. People laugh whenever I say to them, “It is so nice to meet you! I will try so hard to remember your name, but please forgive me if I don’t.” The truth is, nine times out of ten I do forget that person’s name and have to battle the shame and humility of asking again. This really isn’t a good quality to have. People like it when you remember their names, naturally, and it may come across as an insult if you don’t. This post isn’t a “I struggle with this but here are three things to do so you don’t”, because I haven’t figured out how to remember people’s names. If you know a way, please enlighten me.

Let me start by explaining why I don’t remember names. First and foremost, I feel that a name is somewhat meaningless and insignificant. I could meet you and say my name is Samantha and then proceed with every other accurate description of who I am without changing anything about who I really am. A name is a label, literally, and I don’t think labels are as important as the objects they describe. You could call my coffee “valendwarf” and I would still love it because I love the object of coffee, not the name that it holds. So when I meet someone, yes, their name is often the first fact I learn about them and often the first I forget. The other stuff, the good stuff, is what matters so much to me. I care more about a person’s interests, passions, ambitions, relationships, and every other aspect of their life way more than a name. SO forgetting a name isn’t as bad as it seems – it just means someone is paying more attention to the other details that are more important.

I have tried ways to remember names. I first Googled, “Ways to remember names” which later escalated to a frustrated, “Why do I forget names?” search. These two proved to be helpful as I was met with some useful tips. Some of the most common ones include things like as soon as you meet a person, connect their name with a physical quality about them. Sarah has red hair and blue eyes. Or connect their name to an aspect of their personality. Auguste is very outspoken and likes to talk. Another helpful tip I’ve discovered: use their name almost immediately in a sentence. I have found that this actually is helpful. I don’t know the psychology behind it, but it seems that by taking an external, arbitrary name and internalizing it into your own vocabulary helps establish its importance in your short-term memory and later long-term memory. This reduces my rate of forgetting to about 50%, which is a big increase from 90%. Nonetheless, these little tips are helpful but not totally effective.

I guess I’m trying to say, if you forget names, don’t beat yourself up about it like I do. Maybe it just means you’re more interested in the other aspects of a person instead of a simple label they use. I love meeting new people and hearing about their life and goals and personality, but I hate forgetting names. It is one of my worst qualities and something I hope to improve on. If you have tips for improving this, let me know – and I’ll try to remember your name 🙂

 

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who you are

Your life experiences unquestionably define who you are and guide where you belong in the world. We are each given unique stories – challenges, triumphs, memories, passions – that aid us in figuring out what type of life we are to live. Since I’ve been in college, I have met people from SO many different walks of life, and it has been one of my favorite aspects of moving out of a small town and into a more culturally and ethnically diverse city. The people I’ve become very close friends with come from all over the world and from every background – Russian, African, Indian, Egyptian, Irish, Ukrainian, American, Muslim, Christian, Hindu, atheist, agnostic, poor, rich, sick, and every quality or descriptor in between. The love I have for each of these people is specific and unique to the friendship that we share, and I’m so glad that I’ve come to know them and their story. Along this journey though, I often found myself asking “Who am I? Where do I come from? What characteristics define me?” and yesterday I again happened upon this internal self-discussion after a conversation I had with a friend in my lab. He very casually told me, “Mary, I can finally hear your Southern accent!” which lead down a rabbit hole of conversation on the lifetime struggle of talking with a “twang” and how “cute” it is (Ha). I told him that sometimes people assume others with a Southern accent are less intelligent, less capable, or have certain ideologies. For this reason, I had become accustomed to avoiding phrases that make me sound more Southern. What I have learned though, through encountering others that embrace and welcome their cultural identity, is that I am Southern and I do have a Southern accent. I was raised in a small town and my identity is comprised of those memories that I created as a child. I had this unnerving feeling when I entered college of not having an identity at all, not belonging to a defined “group” with certain values. I often felt like others were very different from me (because, well, they were and still are in many ways) and didn’t share a lot of the experiences I had while growing up. Instead of shaming away from this I began to cherish my own culture. I shared with people what it was like growing up in a small town in Tennessee (as compared to Chicago or Memphis or New York City). I delighted in the fact that I had (and have) certain challenges different from others and that those things make me, me. This acceptance and confidence has permeated into other aspects of my life. Previously at work, I sought to make myself very . . . uniform. I dressed simply and didn’t feel comfortable sharing the intricacies and details of my personality. This was largely in part because I worked with male supervisors and male colleagues and didn’t want to be perceived as less intelligent or less focused on my career. I’ve learned though, by being surrounded by team members that fully accept and cherish who they are, that who I am doesn’t negate my abilities but encourages them. Speaking of my passions and my childhood memories, wearing the clothes that make me feel confident and feminine, and accepting that I am an empowered, capable female, has strengthened my work ethic and confidence, not taken away from it. Yes, I wear eyeliner and like to do yoga. I didn’t take ten AP classes or go to a private, preparatory high school, but I do have the capability to learn and to succeed just as my peers do and have demonstrated that learning is more important than formal education. This is so important, because I really feel like people who may not fit into certain groups need to be encouraged to come from a position of strength instead of weakness. Don’t let the influence of those around you – their maleness (or femaleness), intelligence, appearance, or success – alter the way that you view yourself. What I have learned since accepting that I have a past that makes me better, not worse, and a future that is as bright as the person next to me, is that people love me and appreciate my work for exactly who I am. They like that I can have a conversation about growing up in a small town and how I like to enjoy myself in Nashville. Just because I wear makeup and have my hair fixed doesn’t mean I don’t get called on during meetings to answer hard questions or given hard tasks to complete. I no longer feel like I have no identity because instead of trying to create one that didn’t exist, I accepted the one I already have. There is great power in knowing who you are, growing in who you are, and loving who you are. Not only is there power, but there is indefinite peace.

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aha! moments in cancer treatment

I think we can all appreciate those “wow, this is amazing” moments of life. They can be many and varied, but at some point everyone has those intense feelings of gratitude and satisfaction. I’ve had a few of these moments lately when reading about immunotherapies for my research. I love the idea of using the defenses and machinery that our bodies already possess to fight off foreign invaders, such as cancer. The human body is pretty extraordinary — and the ways we fight off cancer are as well.

One of the steepest learning curves for me has been remembering the names, classes, and side effects of cancer drugs. There are SO many cancer drugs out there, and more get approved for clinical use every single day! With the help of some charts created by my PI (like this one published in the New England Journal of Medicine) and some really extensive notes, I feel way more comfortable with cancer therapies than when I started. Most people have heard of “chemotherapy” as a treatment for cancer. For years, chemotherapy has long been the go-to induction treatment for many types of cancer. I think of chemotherapy as the biological version of carpet-bombing – it is very limited in specificity and comes at a cost of collateral damage. Chemotherapies (literally “chemical treatments”) induce apoptosis, or cell death, of cancer cells through many mechanisms. They may interfere with DNA replication or alter the metabolic machinery necessary for providing fuel for cellular survival and reproduction. Chemotherapy drugs are most efficacious against cells that divide rapidly (i.e. tumor cells) but come with many of the side effects we associate with cancer – fatigue, loss of hair, dry skin, and general myalgia. Traditional chemotherapies are still used but mostly in combination with newer drugs and at lower cumulative dosages.

The advent of targeted therapies for cancer has redefined the specificity of cancer treatment (the word “targeted” gives it away). These are usually small molecules or antibodies that target kinases, or phosphorylating enzymes, that are overexpressed on cancer cells. Targeted therapies may work intracellularly through small molecules that slip inside the cell and stop cancer-promoting enzymes or extracellularly by recognizing receptors involved in tumor pathogenesis. Instead of using a carpet-bombing approach, targeted therapies are designed to selectively target cancer cells. One of the targeted therapies we study is trastuzumab (Herceptin). This is a monoclonal antibody (an immune system molecule that recognizes one complementary receptor) that binds HER2, a kinase expressed on cells. HER2 is overexpressed on HER2+ breast cancer cells, among other HER2+ cancer types. Once trastuzumab binds HER2, it inhibits a signaling pathway that normally promotes cell survival. Trastuzumab is one example among many, many other types of targeted therapies used to treat cancers. Targeted therapies have literally saved hundreds of thousands of lives and will continue to do so as scientists “fine tune” their targeted activity.

Now, immunotherapies. These are the current Holy Grail of cancer treatments. I am still learning a lot about the biology behind immunotherapies. Surprisingly, most immunotherapy treatments don’t care at all about the cancer cells. Instead, they focus on the cells of the immune system. We have cells in our bodies called T cells that essentially patrol for foreign invaders. Dendritic cells, another type of immune cell, “show” the T cells pieces of degraded protein, or polypeptide. The T cell then either recognizes the polypeptide as a normal part of the body or as foreign. If it recognizes it as foreign, the T cell will become activated and initiate an immune response. This is a normal process and keeps our bodies healthy and free of disease. Except in the case of cancer. Like most things, the immune system has its own set of checks and balances. The T cells (those monitoring cells that give approval for an immune response) have a protein called programmed death-1 or PD-1. Other immune cells have the receptor to this protein called programmed death ligand-1 or PD-L1. These two molecules fit together like puzzle pieces. If the T cells inappropriately initiate an immune response, cells with PD-L1 will bind PD-1 and effectively stop the T cells from killing anything.

Unfortunately, some cancer cells overexpress PD-L1 so that the immune system is always put on hold and does not attack them (which it should because they are foreign). The cancer cells become “hidden” from the immune system and continue to thrive and reproduce. But, aha!, some scientists much smarter than me once asked, but why doesn’t the immune system recognize cancer cells as foreign? And after a lot of research, thousands of pipette tips, and some vigilant clinical trials, today people are being cured by their own immune system. A new cancer drug, pembrolizumab (Keytruda) is a PD-1 inhibitor that binds to PD-1 on the T cell that normally functions as a brake (or as a signal to not kill). It is like sliding in another puzzle piece so that the original cannot fit anymore. This means that those pesky cancer cells that overexpress PD-L1 can no longer hide from the immune system. Pembrolizumab and nivolumab (Opdivo) have had remarkable response rates. A recent paper published in the journal Science (here) demonstrated how these immune checkpoint inhibitors may be used to treat cancer cells with a shared genetic deficiency. This recent publication and growing knowledge of immuno-oncology, cancer genetics, and precision medicine are transforming cancer treatment. I think this stuff is pretty cool, and I always leave feeling amazed, humbled, and grateful for the work that people are doing to save lives.

If you think this stuff is also pretty cool, check out the New York Times dedicated section on immunotherapy. A few articles from my lab are here and here as well. Thanks for reading!

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