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#BlackCardioInHistory: Dr. Hannah A Valantine

This is part of the #BlackCardioInHistory series.  #AHAEarlyCareerVoice is partnering with #BlackInCardio to feature a series of profiles of black/African American Cardiologists for #BlackInCardioWeek2020.  For more information: blackincardio.com


(3) The NIH Director. Statement on the Retirement of Dr. Hannah Valantine. 9-1-2020. https://www.nih.gov/about-nih/who-we-are/nih-director/statements/statement-retirement-dr-hannah-valantine

Originally from The Gambia, West Africa, Hannah Valantine moved to London, where she studied Biochemistry and then obtained a medical degree from St. George’s Hospital Medical School in 1978 (1). She completed her post-graduate work in cardiology at two hospitals in London: Brompton and Hammersmith (2). She moved to the United States, where she was awarded an NIH Director’s Pathfinder Award for Diversity in the Scientific Workforce (2). She became a fellow and worked her way up to being a Professor of Cardiovascular Medicine at the Stanford University School of Medicine before being appointed as Senior Associate Dean for Diversity and Faculty Development in 2005 (1).

In 2014 Dr. Valantine was appointed as NIH’s first Chief Officer for Scientific Workforce Diversity, a new position with the entire focus being on diversity in biomedicine (2).

During her time at the NIH, she established the Distinguished Scholars Program, which has had a dramatic, positive impact on the diversity of tenure-track investigators at NIH (3). To implement the recommendations of the NIH Equity Taskforce, she developed and implemented the first NIH Workplace Climate and Harassment Survey (3). This scientifically rigorous survey achieved a high response rate from NIH employees, contractors, fellows, and trainees who will have a lasting impact on institutions around the United States (3).

Dr. Valantine also designed the Faculty Institutional Recruitment for Sustainable Transformation (FIRST) program which is aimed at creating cultures of inclusivity at NIH-funded institutions (3). She also pioneered a program to mentor and support scientists from diverse racial and ethnic backgrounds in writing effective grant applications (3).

In September 2020, Dr Valantine’s retirement was announced after what has been a truly remarkable career (3). Dr. Valentine’s career embodies the representation that institutions around the country and world are striving to have, and she is a role model for what other underrepresented scientists can achieve. Her work has and will continue to open doors for people in underrepresented groups in science and medicine.

 

Reference

  1. Hannah Valantine. Wikipedia. https://en.wikipedia.org/wiki/Hannah_Valantine. Accessed 10-19-2020.2.
  2. Hannah Valantine, M.D., named NIH’s first Chief Officer for Scientific Workforce Diversity. 1-30-2014. https://www.nih.gov/news-events/news-releases/hannah-valantine-md-named-nihs-first-chief-officer-scientific-workforce-diversity
  3. The NIH Director. Stetement on the Retirement of Dr. Hannah Valantine. 9-1-2020. https://www.nih.gov/about-nih/who-we-are/nih-director/statements/statement-retirement-dr-hannah-valantine

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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#BlackCardioInHistory: A Profile of Dr. Charles Rotimi – Director of the Trans-National Institutes of Health (NIH) center for research in genomics and global health

This is part of #BlackCardioInHistory series.  #AHAEarlyCareerVoice is partnering with #BlackInCardio to feature a series of profiles of black/African American Cardiologists for #BlackInCardioWeek2020.  For more information: blackincardio.com


Photo Credit: Anna Azvolinsky (The scientist) https://www.the-scientist.com/profile/charles-rotimi-works-to-ensure-genetic-epidemiology-and-population-genetics-studies-include-dna-from-africannot-just-europeanpopulations–64818

Dr. Charles Rotimi (1957- ), originally from Benin city, Nigeria is the Director of the Trans-National Institutes of Health (NIH) center for research in genomics and global health (1, 2). Dr. Rotimi obtained his undergraduate degree in biochemistry from the University of Benin in Nigeria before immigrating to the United States for further studies (1). He started his education in the United States at the University of Mississippi, where he obtained a master’s degree in health care administration and then a second master’s degree and a doctorate in epidemiology from the University of Alabama at Birmingham School of Public Health (1). Dr. Rotimi was the director of the National Human Genome Center at Howard University before embarking on a new journey at the NIH (1).

In 2008  Dr. Rotimi joined the  NIH, He was instrumental in establishing the trans-institute Center for Research on Genomics and Global Health, with its mission to advance research in the role of culture, lifestyle, and genomics in disease etiology, health disparities, and variable drug response (1, 3). His lab develops genetic epidemiology models and conducts epidemiologic studies that explore the patterns and determinants of common complex diseases in human populations with particular emphasis on populations of the African Diaspora (1).

In 1994, his team published the first genome-wide scan for hypertension and blood pressure in African Americans and type-2 diabetes in West Africans (4). One important piece of this study is that Dr Rotimi and his team compiled genomic data from ~6,000 individuals and came up with 21 different global genetic ancestries (4). The research demonstrated that more than 97 percent of humans have mixed ancestry (4), indicating that the traditional race labels such as “Black,” “white,” and “Hispanic” are insufficient ways to classify humans.

Dr. Rotimi followed this up with another paper published in 1997 that examined over 10,000 samples to estimate the impact of environmental factors on geographically separated Black populations in the United States, Caribbean, and West Africa (5). This study found that Black men and women in the United States had significantly higher rates of hypertension compared to the Caribbean, which had higher hypertension rates than West Africa (5). The increased rates of hypertension track with traditional migration patterns and suggest that environmental factors, including psychosocial stress, play a large role (5).

R(5) Figure 3 from C Rotimi, R Cooper, G Cao, C Sundarum, D McGee. Familial aggregation of cardiovascular diseases in African-American pedigrees. Genet Epidemiol . 1994;11(5):397-407. doi: 10.1002/gepi.1370110502. *Note – Maywood refers to Maywood, Illinois (the site in the United States)

With such a distinguished career, it is of no surprise that Dr. Charles Rotimi has been elected on to many boards, being bestowed with an honorary professorship at the University of Cape Town in South Africa and even more impressively being elected to the National Academy of Medicine in 2018 (1). Dr. Rotimi is a Senior Investigator within the Intramural Research Program at the National Human Genome Research Institute (NHGRI) of the NIH (1). He has won the NIH Director’s Award for leading the establishment of the Human Heredity and Health in Africa (H3Africa) Initiative (2012) and he is the first person of African ancestry to be elected to the Board of the American Society of Human Genetics (1). He was also a recipient of the HudsonAlpha Life Science Prize in 2018 (1).

 

Reference

  1. Genome Collector: A Profile of Charles Rotimi. TheScientist. 9/30/2018. Anna Azvolinsky. https://www.the-scientist.com/profile/charles-rotimi-works-to-ensure-genetic-epidemiology-and-population-genetics-studies-include-dna-from-africannot-just-europeanpopulations–64818
  2. Charles N. Rotimi. Genome.gov. https://www.genome.gov/staff/Charles-N-Rotimi-PhD
  3. Charles Rotimi, Ph.D. Principle Investigator – IRP-NIH. https://irp.nih.gov/pi/charles-rotimi
  4. R Cooper, C Rotimi, S Ataman, D McGee, B Osotimehin, S Kadiri, W Muna, S Kingue, H Fraser, T Forrester, F Bennett, and R Wilks. The prevalence of hypertension in seven populations of west African origin. Am J Public Health. 1997 February; 87(2): 160–168.
  5. C Rotimi, R Cooper, G Cao, C Sundarum, D McGee. Familial aggregation of cardiovascular diseases in African-American pedigrees. Genet Epidemiol . 1994;11(5):397-407. doi: 10.1002/gepi.1370110502.

 

 

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#BlackCardioInHistory: Daniel Hale Williams – Pioneer in open-heart surgery in the United States

This is part of the #BlackCardioInHistory series.  #AHAEarlyCareerVoice is partnering with #BlackInCardio to feature a series of profiles of black/African American Cardiologists for #BlackInCardioWeek2020.  For more information: blackincardio.com


Daniel Hale Williams III was born to a family that owned a barber business and worked in the Equal Rights League in Hollidaysburg, Pennsylvania, in 1856 (1). Young Daniel moved to Baltimore as a young boy to become a shoemaker’s apprentice when his father died but did not like the work (1). His family had moved to Illinois, so he moved back with them and began barbering with the long-term goal of pursuing his education (1).

Daniel Hale Williams III apprenticed with Dr. Henry Palmer, who was an accomplished surgeon. From there, Daniel attended the Chicago Medical College (1).

(2) Daniel Hale Williams (Pre 1923 photograph, public domain). https://en.wikipedia.org/wiki/File:Daniel_Hale_Williams.jpg From Wikipedia page: Daniel Hale Williams.

After completing medical school, Dr. Williams began to practice on Chicago’s south side while teaching anatomy at the Chicago Medical College (1). He was an early adopter of Louis Pasteur’s sterilization to prevent transmission of infection (1).

In the late 1880s in America, Black Americans were prevented from being admitted to hospitals and could not be hired at hospitals (1). While Black women had a long history of working as nurses, they were often denied opportunities for formal training (3). Dr. Daniel Hale Williams III disagreed with this practice and opened the Provident Hospital and Training School for Nurses which was the first hospital in the United States that was racially integrated (1).

(3) Provident Hospital and Training School for Nurses (36th and Dearborn Streets, Chicago). Chicago History Museum (ICHi-040212). https://www.chicagohistory.org/provident-hospital/. Brittany Hutchinson.

A few years later, in 1893, Dr. Williams treated a man with a significant stab wound to the chest, named James Cornish (1). Dr. Williams successfully sutured the man’s pericardium allowing Cornish to live for many years. Only 3 other surgeons, Dr. Francisco Romero, Dr. Henry Dalton, and Dr. Dominique Jean Larrey, have been credited as performing open-heart surgery previously (1,4). One year later, in 1894, Dr. Williams was appointed as Chief Surgeon of the Freedmen’s Hospital, which has seen a high relative mortality rate. He moved back to Chicago upon marrying Alice Johnson, where he continued working for Provident Hospital (1).

(2) Daniel Hale Williams (National Library of Medicine believes this to be public domain). https://commons.wikimedia.org/wiki/File:Daniel_H._Williams.jpg From Wikipedia page: Daniel Hale Williams.

In 1897 Dr. Williams was appointed to the Illinois Department of Public Health to increase medical standards in hospitals (2). In 1913, Dr. Williams was the only Black American member of the American College of Surgeons (5). Dr. Williams died in 1931 in Idlewild, Michigan from a stroke (2). Some of Dr. Williams’s honors include membership in the Chicago Surgical Society and American College of Surgeons, which were both uncommon for Black Americans at the time (2). Dr. Williams also received honorary degrees from Howard University in Washington DC and Wilberforce University in Wilberforce, Ohio (2).

 

Reference

  1. Biograhy.com Daniel Hale Williams Biography. 6/5/2020. https://www.biography.com/scientist/daniel-hale-williams. Accessed 10-19-2020.
  2. Daniel Hale Williams (Pre 1923 photograph, public domain). https://en.wikipedia.org/wiki/Daniel_Hale_Williams#cite_note-EB-6 From Wikipedia page: Daniel Hale Williams
  3. Provident Hospital and Training School for Nurses (36th and Dearborn Streets, Chicago). Chicago History Museum (ICHi-040212). https://www.chicagohistory.org/provident-hospital/. Brittany Hutchinson.
  4. Wikipedia.com Henry Dalton. 4/4/2020. https://en.wikipedia.org/wiki/Henry_Dalton. Accessed 10-19-20
  5. Daniel Hale Williams American Physician. Encyclopedia Britannica. 2018.

 

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

 

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#BlackCardioInHistory: Dr. Edward William Hawthorne

This is part of the #BlackCardioInHistory series.  #AHAEarlyCareerVoice is partnering with #BlackInCardio to feature a series of profiles of black/African American Cardiologists for #BlackInCardioWeek2020.  For more information: blackincardio.com


Edward William Hawthorne was born near Port Gibson, Mississippi as the son of a minister and teacher. He suffered from polio at the age of 7 (1). He graduated high school in Washington DC and began his undergraduate study at Fisk University but later transferred to Howard University (1). It was at Howard University where Hawthorne spent most of the rest of his life.

(2) https://www.acc.org/latest-in-cardiology/articles/2018/02/13/14/42/harold-on-history-black-history-month-and-pioneering-african-american-physicians. Photo Credit: Howard University.

Hawthorne earned his bachelor’s in science degree in 1941 and completed his medical degree in 1946 (1). Hawthorne was an intern at Freedmen’s Hospital from 1946-1947 and developed an interest in research, especially in the cardiovascular field (1). Dr. Hawthorne completed a Masters in Science in physiology in 1949, and then a Ph.D. in physiology in 1951, both from the University of Illinois in Chicago (1). This would be Hawthorne’s only stint away from Washington DC.

In 1951 Dr. Hawthorne moved back to Washington DC as he was appointed to faculty at Howard University(1). Dr. Howard helped organize masters and doctoral graduate programs in physiology at Howard and a laboratory focusing on cardiovascular research(1). Dr. Hawthorne was the head of the physiology department until 1969(1). All the while Dr. Hawthorne was moving ranks of the administration. He was assistant Dean of the College of Medicine from 1962-1967, associate Dean of the College of Medicine until 1970, and Dean of the Graduate School of Arts and Sciences in 1974. During these appointments, he was also Chairmen of the department of physiology and biophysics in 1969-1974(1).

Hawthorne referred to his research as “a personal vendetta against ignorance”(1). Dr. Hawthorne was a leader in Renal physiology research and utilized animal models ranging from rats, rabbits, dogs, and horses(1). Dr. Hawthorne was a pioneer in using techniques to measure heart function and size in conscious animals(1). In 3 papers from 1959 and 1962, both published in Circulation Research, Hawthorne examines hypertension and left ventricle size in dogs (3, 4, 5). Dr. Hawthorne pioneered an experimental hypertension model in dogs consisting of constricting the brachiocephalic and left subclavian arteries surgically(5).

Figure 1 from Chronic experimental hypertension in dogs after constriction of brachiocephalic and left subclavian arteries. HAWTHORNE EW, et al. Circ Res. 1962. PMID: 13905535.

Dr. Hawthorne would go on to publish many papers on cardiovascular physiology, which ultimately led to his election as a fellow of the American College of Cardiology in 1969 and vice president of the American Heart Association from 1969-1972(1). He was also active in predominantly Black associations, including the John A. Andrew Clinical Society, Alpha Omega Alpha, Alpha Phi Alpha, and Association of Former Interns and Residents of Freedmen’s Hospital. In 1980 he was elected to the prestigious Institute of Medicine of the National Academy of Sciences(1). Dr. Hawthorne died in October 1986, only 4 months after his final manuscript was published(6). Dr. Hawthorne is remembered as a pioneer for cardiovascular physiology research and education and a pioneer in the field of hypertension.

 

Reference

  1. Hawthorne, Edward William. https://doi-org. /10.1093/anb/9780198606697.article.1201084 American National Biography. Accessed 10-19-2020
  2. https://www.acc.org/latest-in-cardiology/articles/2018/02/13/14/42/harold-on-history-black-history-month-and-pioneering-african-american-physicians. Photo Credit: Howard University.
  3. Instantaneous dimensional changes of the left ventricle in dogs. HAWTHORNE EW. Circ Res. 1961. PMID: 13712425.
  4. Telemetering of ventricular circumference in dogs. HAWTHORNE EW, et al. J Appl Physiol. 1961. PMID: 13905534.
  5. Chronic experimental hypertension in dogs after constriction of brachicephalic and left subclavian arteries. HAWTHORNE EW, et al. Circ Res. 1962. PMID: 13905535.
  6. Estimation of left ventricular mass in conscious dogs. B Coleman, L N Cothran, E L Ison-Franklin, E W Hawthorne. Among authors: hawthorne ew. Am J Physiol. 1986. PMID: 3789168

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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#BlackCardioInHistory: Dr. Marie Maynard Daly

This is part of the #BlackCardioInHistory series.  #AHAEarlyCareerVoice is partnering with #BlackInCardio to feature a series of profiles of black/African American Cardiologists for #BlackInCardioWeek2020.  For more information: blackincardio.com


Photo credit: Ted Burrows, Archives of the Albert Einstein College of Medicine (https://www.sciencehistory.org/historical-profile/marie-maynard-daly)

Dr. Marie Maynard Daly (1921-2003) became the first African American woman to receive a PhD in Chemistry. Dr. Daly was born in Queens, New York. She had the ambition to become a chemist through the influences of her father, who was on track to graduate from Cornell with an undergraduate degree in Chemistry when he was forced to drop out because of financial circumstances. Dr. Daly graduated magna cum laude from Queens College in New York with a bachelor’s degree in Chemistry. She then enrolled in a Master’s program in Chemistry at New York University and graduated in 1 year while working at Queens College as a part-time laboratory assistant.

Marie M. Daly Biography. Biography.com/scientist/marie-m-daly 08/26/2020

From NYU, soon to be Dr. Daly enrolled in a doctoral program at Columbia. Her dissertation was titled A Study of the Products Formed by Action of Pancreatic Amylase on Corn Starch. Dr. Daly received her PhD in Chemistry in 1947 and was the first African American woman to receive a PhD in chemistry in the United States. Dr. Daly went on to teach at Howard University and then began researching at the Rockefeller Institute in New York as a post-doctoral fellow. After 7 years at the Rockefeller Institute, Dr. Daly started to teach at the College of Physicians and Surgeons at Columbia University in New York in 1955. She continued her research while at Columbia studying arterial metabolism.

Dr. Daly made seminal findings in arterial metabolism. In particular, she published findings of how respiration and cytochrome oxidase activity are altered in rat aortas during hypertension which was published in the Journal of Experimental Medicine in 1958. In 1960 Dr. Daly moved to Albert Einstein College of Medicine at Yeshiva University and from 1958 to 1963, Dr. Daly was an investigator for the American Heart Association.

M.M. DALY, E.G. GURPIDE. J Exp Med. 1959 Feb 1;109(2):187-95. doi: 10.1084/jem.109.2.187. PMID: 13620848

In 1963 Dr. Daly published another paper, this time examining the concentration of cholesterol and cholesterol synthesis in hypertensive rats, which she published in the Journal of Clinical Investigation. In 1970 Dr. Daly published a methods paper on how to isolate intimal-medial tissues in arteries from rabbits. Dr. Daly was an integral part of the early molecular study using small mammal models to examine atherosclerosis and hypertension and was a pioneer in cardiovascular research.

M.M. DALY, Q.B. DEMING, V.M. RAEFF, L.M. BRUN. J Clin Invest. 1963 Oct;42(10):1606-12. doi: 10.1172/JCI104845. PMID: 14074354

H. WOLINSKY, M.M. DALY. Proc Soc Exp Biol Med. 1970 Nov;135(2):364-8. doi: 10.3181/00379727-135-35052. PMID: 4921030

WOLINSKY, M.M. DALY. Proc Soc Exp Biol Med. 1970 Nov;135(2):364-8. doi: 10.3181/00379727-135-35052. PMID: 4921030

Thus, it is not surprising that Dr. Daly was a member of the board of governors of the New York Academy of Sciences along with being a fellow of the American Cancer Society, American Association for the Advancement of Science, New York Academy of Sciences, and Council of the American Heart Association. In 1999, just 4 years before her death, the National Technical Association recognized Dr. Daly as one of the top 50 women in Science, Engineering, and Technology. Finally, in 2016, a new elementary school was named The Dr. Marie M. Daly Academy of Excellence after Dr. Daly and her many achievements.

 

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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R.E.D. C.U.P.: FROM BURNOUT TO WELLNESS

American Heart Association Early Career Guest Blog

Sherry-Ann Brown MD PhD FAHA, Krishna Doshi BS

We cannot ignore what a recent president of the World Medical Association describes as the “physician burnout pandemic”. We must find ways to transform our professional lives from a state of burnout to a state of wellness. A study from the American College of Cardiology reported that 27% of cardiologists experience burnout (compared to 43% from Medscape), while 49.5% reported being under stress with limited energy (1). In another study, approximately 15% of cardiologists reported experiencing depression, and among these 33% easily became exasperated by patients and 32% felt less engaged with patients (2). Similarly, burned-out physicians noted an effect on their professional activities with both patients and colleagues (1).

Neither subspecialty nor practice setting appears to have an impact on burnout (1). Contributors to burnout among cardiologists have been listed as excessive workloads, large bureaucratic loads, balancing work and life, and after work emergencies impacting lifestyle (1)(2). The constantly evolving technology was also identified as a culprit, with 57% of cardiologists reportedly accessing the electronic medical record at home (1)(4). I think we may all be guilty of some of this. Further, in the era of COVID-19, most of our professional and social interactions have been transferred to virtual interfaces. The absence of physical togetherness can take its toll on our emotional or mental wellness, coupled with decreased social support for many in the pandemic (5).

One cardiologist wrote in a survey that our profession is the ‘most unhappy’ specialty, but also the least likely to seek professional help. Thus, to cope many physicians turn to food, alcohol, drugs, or smoking (2). The struggle is real across our professions, and we must as a society pursue recommendations for burnout mitigation strategies (4). These initiatives must be conducted in shared responsibility for physician wellness (4). Resilience-based interventions should consider job design, leadership, and management training (4), and must be endorsed by the C-suite, with commitment to broad-sweeping implantation across the institution. Reduction in administrative tasks for physicians, increasing non-physician support staff, and emphasizing teamwork can make a world of difference, as can fostering self-awareness, life-work balance or more aptly integration, and regular check-ins for mental health (4).

 R.E.D. C.U.P.

To avoid or overcome being in a state of burnout, there are key components of the journey to wellness that should also be embraced.

 Relationships

When we informally survey individuals in person or on social media, undoubtedly the number one catalyst for wellness is noted as relationships. Frequent personal interactions with others who know and understand us can help relieve some of the altruistic burdens we carry in our daily professional lives.

Exercise/Hobbies

Quite often exercise and hobbies are listed as mediators of wellness. Exercise can relieve stress and release endorphins that help improve mood. Hobbies can give an object of focus that takes our minds away from what troubles us, or perhaps what might otherwise consume or overwhelm us. Hobbies can also help us share our inner selves, interests, and creative skills with others.

Diversity/Delegate

Welcoming a diversity of perspectives and selectively delegating to individuals with the appropriate level of training and preparation can offload some of the pressure on our generally full plates. Surrounding yourselves with individuals who enjoy taking initiative and being resourceful can be mutually beneficial.

Compassion for self

Giving yourself permission to have compassion for yourself is tremendously underrated, especially by women. We are so used to caring for everyone else around us and sharing our compassion selflessly that we often forget to do so for ourselves. To bring our best selves to the table and to truly give our best to others, we need to first invest in our own selves in ways that matter most to each of us.

Unplug

The ability to intermittently unplug from sources of time-consuming or draining asks can free up incredible amounts of time and mental space that can be used on more enriching and life-affirming activities.

Purpose

A sense of purpose can give clear direction and allow us to prioritize opportunities more effectively.

Pursuing R.E.D. C.U.P. may help us collectively and collaboratively as we grow together on our journey from burnout to wellness.

 

 

References:

  1. Mehta LS, Lewis SJ, Duvernoy CS, Rzeszut AK, Walsh MN, Harrington RA, et al. Burnout and Career Satisfaction Among U.S. Cardiologists. J Am Coll Cardiol. 2019;73(25):3345-8.
  2. Nicholls M. Cardiologists and the Burnout scenario. Eur Heart J. 2019;40(1):5-6.
  3. Rotenstein LS, Torre M, Ramos MA, Rosales RC, Guille C, Sen S, et al. Prevalence of Burnout Among Physicians: A Systematic Review. JAMA. 2018;320(11):1131-50.
  4. Panagioti M, Geraghty K, Johnson J. How to prevent burnout in cardiologists? A review of the current evidence, gaps, and future directions. Trends Cardiovasc Med. 2018;28(1):1-7.
  5. Graham MM, Higginson L, Brindley PG, Jetly R. Feel Better, Work Better: The COVID-19 Perspective. Can J Cardiol. 2020;36(6):789-91.

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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HOW TO SAY NO: R5

American Heart Association Early Career Guest Blog

Sherry-Ann Brown MD PhD FAHA, Mehnaz Rahman MD

For many of us, to nurture our continuous and whole sense of well-being, we are in a constant process of learning to say “no”. Here is one scenario that can help provide an effective framework for saying “no”.

Consider a new junior attending faculty member at the same academic institution where she trained as a Cardiology fellow. Her pursuit of wellness in this new role has fallen to the sidelines, as she first tries to establish a sense of authority within a society that has only ever known her as a trainee. While navigating this unfamiliar territory, a surprising source of anxiety has come from responding to requests to collaborate on projects. She consistently accepted almost every single one. The fellow in her aimed to please.

Although she approached each with the same work ethic, her interest in them was not as equitably distributed. At the end of her first year, her cup had “runneth over” – she was overworked and overcommitted admittedly she felt by her own doing.

She then realized that she had agreed to those undertakings because she did not quite have the words ready at the tip of her tongue to say “no”.  When respectfully declining a specific ask, she determined that it can help to have a practiced approach to the conversation, one that can produce a beneficial result for both parties.

As we discuss this scenario, we can recognize that in general, people appreciate ideas and potential solutions. Accordingly, we may not be able to fulfill every request, yet we can still be a resource and offer alternatives.

One framework for saying “no” is grounded in R5: Reframe, Refer, Reduce, Reorient, and Recommend. Saying “no” can be challenging. Sometimes we need to say “no” to the way the ask is presented or the specific focus of the ask.

If we can perceive benefit from modifying the ask so that it actually fits with our career goals and specialty interests, then we can say “no” to the original ask while reframing it to a more fitting ask for us.

If we choose not to reframe the ask, we can refer the asker to someone else who we feel could be interested in working on such a task.

Alternatively, we could reduce the original ask to limit the portion for which we would be responsible.

Further, often those asking do not know how full our plates are and may need to be kindly informed or reoriented, so that they can better understand your perspective as you say “no”; you can even solicit their input as you think about how to prioritize your time on pre-existing projects.

Finally, recommend a new deadline or seeking out more resources if you would find working on the opportunity valuable but time-consuming or limited in available resources.

Remember, those asking for your involvement are genuinely interested in working with you, recognize you as an asset, and will more often than not be receptive to your counteroffer. Saying “no” the right way will leave the door open to future opportunities that you may be waiting or looking for.

We can continue to recalibrate our expectations of ourselves, as we engage in projects that keep us passionate and hope that our journeys to wellness become smoother with time and practice.

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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How to Engage with Content & Colleagues at a Virtual Meeting (And Like It!)

Now that AHA20 is going virtual, you might have some questions: Is it worth it? How can I connect with my council? Will the valuable networking still happen? Will I actually learn anything? So many of our regular touchstones have been canceled in 2020, but you don’t have to give up Scientific Sessions. It won’t be the same, but with a little planning, it will be great in different ways.

I polled the AHA early career bloggers for their best virtual meeting tips, and here’s their rundown on how to make virtual meetings work for you:

  • Use multiple channels. While the meeting may be streaming on a designated platform, you might also find engagement using outside tools or social media platforms.
    • Follow the official hashtag (#AHA20) on twitter. This is a great way to highlight key presentations, engage with other participants, and connect with experts and presenters. (If you haven’t used twitter professionally before, take the time to set up your bio, make sure your existing content is safe for work, and make your avatar a good picture of you. Or consider a dedicated profile for work. Do some legwork ahead of time to follow people and organizations you’re interested in connecting with during the conference).
    • You could create a Slack Channel with others in your institution or research area to share resources and have ongoing conversations.
    • You could make a Strava group to engage in a little healthy competition and give one another kudos— who got their workout in today?
  • Take breaks. At a face-to-face event, you spend time walking between sessions and break for meals. When everything is online, it’s easy to forget to get up, rest your eyes, and move around.  Hydrate. Take bio breaks. Bonus points if you go outside and don’t take your phone.
  • Consider using a standing desk, or even a makeshift setup, to help you be more mobile throughout the day. Changing position frequently is one of the keys to avoiding pain from being sedentary.
  • Take notes! Things start to run together and a good note-taking strategy will help you remember key information. Maybe you use a good, old-fashioned paper notebook, or maybe you prefer a tool like Evernote. Up to you.
  • Use the interactive tools to ask questions. Especially if you haven’t gotten up the gumption to stand up and ask questions at a live session, you might find the online format more accessible.
  • Connect with colleagues before the meeting starts, and schedule times to debrief and share key takeaways. This helps to keep momentum and excitement going.
  • Constant on-screen interaction can be very taxing. If available, try the on-demand option to give yourself more flexibility. Also consider taking a break from being on camera and just listen.
  • Let yourself be immersed. When you travel to a meeting or conference, you may arrange child care, get someone to cover your clinical or teaching duties, and put up your out-of-office message. While it might be tempting to squeeze conference sessions around your regular responsibilities, you’ll miss the value that the immersion experience provides.

And remember, the virtual conference is accessible to all– if you might ordinarily be limited by difficulty traveling or cost, this is could be your year.

Share other tips (@AHAmeetings and #AHAEarlyCareerBlogger on twitter), connect with the Early Career Community, and grow your network!

And register for sessions: https://professional.heart.org/en/meetings/scientific-sessions

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WELLNESS MATTERS

American Heart Association Early Career Guest Blog

Sherry-Ann Brown MD PhD FAHA

WELLNESS

The World Health Organization defines wellness as “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity”. The terms in this definition inspire similar words such as continuous (state), whole (complete), tangible (physical) and intangible (mental), as well as togetherness or community (social).

 PANDEMIC WELLNESS

Indeed, during the pandemic, we often say or hear, “We are all in this together”. The global community has rallied around each other to get through the coronavirus disease of 2019 (COVID-19) well. In the midst of a nation in turmoil with pandemics juxtaposed (coronavirus and racial and ethnic inequities), we find ourselves in the middle of it all as physicians.

SAFETY & WELLNESS

Along with everyone else in medical authority, we encourage those around us and all we serve to distance physically more so than socially. We want people to remain social, to enhance wellness. Yet, we need that socialization to be safe and physically distant, to foster tangible wellness.

 WELLNESS NOT CANCELLED

We encourage everyone to recognize that conversations, relationships, love, songs, reading, hope, joy, getting outdoors, music, family, and self-care should not and will not be canceled. This is the good stuff. The intangible components of wellness.

WELLNESS HEROES

So many of us in health care are sacrificing this period of our lives or in fact our very lives so that our patients can be whole. This altruism that led us here is continuous and indestructible by the #rona. Many of us turn to visual wellness inspired by COVID-19 to help capture the essence and sentiments of these challenging times. Art and other forms of creative expression of what’s inside of us or in society can motivate us to see more, be more, and serve more.

These matters at hand are crucial to help maintain our state of complete physical, mental, and social well-being. If we are honest with ourselves, we recognize that most of us live at best in a state of incomplete well-being. Yet, we can stand together against cancellation of our will and empower each other on this journey to wellness. It’s never been a destination. It’s always been a process that we continue to learn daily.

 

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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Work life balance- Is This a Myth?

Work-life balance: for many in Cardiology it’s an elusive idea. Now, our worlds of work and “life outside of work” are even more blurred among Zoom meetings and facemasks.  However, over the years, I have learned 3 important concepts (Figure 1) that has made work-life balance POSSIBLE, not just a myth.

Figure 1. Outlining the three key concepts of work-life balance.

Concept #1: Who are you outside of work?

As Cardiologists, researchers, educators, and team members we know the day, night, and weekend hours that define our careers. However, how do you describe yourself outside of work? Who are “you” after shedding the scrubs and white coat, away from the office, hospital, and lab?   Beyond Cardiology, what are your interests?  The answers to these questions help to define you and an important part of your life. When we lose our work-life balance, we are losing a part of ourselves.

To begin recapturing your interests, look at your calendar over the next month, and schedule small increments of time (just 5-10 minutes!) to reconnect with your personal interests (of course staying safely physically distant for now).  These baby steps will move you closer to capturing the “life” in work-life balance.

Concept #2: “Balance” is dynamic.

How do you define “work-life balance”? Is it an equal distribution of time? Is it a certain quantity of time for specific activities?

Work-life balance is very similar to the field of Cardiology – it is constantly changing. For most people, work-life balance will not mean that there is “equal” or balanced time between work and personal life. Especially in Cardiology, our job usually engulfs the majority of hours in a week – clinical duties, grant deadlines, presentations, emails… and the list continues.  However, for work-life balance, one of the goals is to “balance” the transition from work to “life outside of work”. This means your presence, attention, and focus should completely shift from work to your personal interests and interactions. Work-life balance is beyond physically leaving the job, but balancing the mental transition to fully shift away from work.  It will take practice to avoid checking email or mulling over work.  The amount of time between work and your personal life will remain dynamic; but the “balance” is your ability to commit your focus and attention to those precious personal moments, just as you do for work.

Concept #3:   You are Responsible for You! 

Cardiology requires you to constantly learn and practice to achieve and maintain competency. You are upholding a professional commitment. The same commitment is required to grasp work-life balance.  You have to make a personal commitment to you!!  It is not sufficient to just “wish for it”.  We cannot expect anyone else to understand our needs or create our work-life balance.

To reframe this important concept, consider your self-care and work-life balance as critical as filling your car with gas (or charging your car):  you cannot function without it!  Your personal commitment has to be as strong as your professional commitment.   No, it’s not easy, but it is possible.  Some find it helpful to be accountable to a colleague or friend, check-in regularly (set a reminder) about small steps to promote work-life balance. We understand our responsibility to patients.  Now, it’s time understand your responsibility to you!

During these uncertain times of the COVID-19 pandemic, healthcare workers are working longer hours and under even greater stress. It is normal to feel overwhelmed. Now, more than ever, it is important to find creative ways to focus on precious moments and commit to your well-being!  Below are 5 tips to stay committed to yourself and safely connect with others:

  1. Take three minutes.  Listen to your favorite song, dance while nobody’s watching, or take a few extra minutes in a hot shower. You do not need a long time to be kind to yourself.
  2. Join a Virtual group or class.  Physical distancing and long work hours can be very isolating. Take advantage of the numerous virtual options to safely connect with others who have similar interests.
  3. Share and listen.  Try moving beyond texting and talk on the phone. Commit to that moment, engage in the conversation and focus on listening.  The human connection remains very powerful to strengthen our mind and body.
  4. Protect Your Time. I know it is easier said than done. However, learning to set boundaries is critical to sustain your commitment to work and participate in the joys of life.
  5. Be Kind to Your Body. Find time to sleep, eat healthy snacks, and participate in small amounts of physical activity. Mental health and physical health are equally important.

In summary, work-life balance is a journey, not a destination.  Remember, that “balance” in work-life balance is dynamic – the amount of personal time will change, but your commitment and focus to that time should only grow.

 

About the Author:

Heather M. Johnson, MD, MMM, FAHA, FACC is a Cardiologist & Preventive Cardiologist at the Christine E. Lynn Women’s Health & Wellness Institute at Boca Raton Regional Hospital/Baptist Health South Florida.

 

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”