STP perspectives podcast | Dr Cloutman-Green

Probably a bit much to call it a podcast at this point… but aim high, right?!

Late last year, Dr Elaine Cloutman-Green, Lead Healthcare Scientist at Great Ormond Street Hospital/@girlymicro, HCS social media influencer on Twitter, co-created a play with playwright and scriptwriter, Nicola Baldwin (@NicoBalders). The play was called Nosocomial and aimed to increase public awareness and understanding of healthcare scientists, as well as demonstrate the variety of roles and collaboration within healthcare science. The play is now a well-deserving finalist in the CSO awards.

Adriana and I, being the trend-spotters that we are, knew this wasn’t one to miss, so we got in contact with Elaine to ask if we could have a chat with her about all things #nosocomial, twitter and trainee advice, after watching the play ourselves. Luckily for you, we recorded our conversation so you can hear it all straight from the scientist’s mouth. So, if you like the sound of dull sirens from an underground theatre in the heart of Camden and an interviewer who didn’t realise we were going to turn this into our very first podcast(!) then this is definitely one for you. I jest- it’s a really interesting interview with some real home truths and gems of advice that are definitely going to stick with me throughout my career. Elaine is actually one of the main reasons I joined Twitter last year, after hearing her talk at a research event, and without that, I probably never would’ve agreed to collaborate on STP Perspectives with Adriana. So It was really exciting to talk to her again and I hope you enjoy listening as much as I did.

*Hot off the press*: there will be a reading of Nosocomial on Friday 8th March 2019, to kick off this years Healthcare Science Week at etc.venues County Hall, London, at 6pm and we would definitely recommend attending if you can! Here is a link for more information and to register: https://www.eventbrite.com/e/nosocomial-a-play-about-healthcare-scientists-tickets-57583515846

We’ve also transcribed the interview for those of you who forgot to bring your headphones on your commute or if podcasts just aren’t your thing. Disclaimer: the text is edited slightly in places for clarity.

Here’s the recording:

And here is the transcript of the audio:

Jes: Hi this is Jes from STP perspectives, and I’m here chatting with Dr Elaine Cloutman-Green, lead healthcare scientist at Great Ormond Street hospital, after watching her new play “Nosocomial”. I’m just going to ask her a few questions, so let’s get started.

Elaine: Thank you for asking me, I’m really honoured to be the first!

Jes: Gosh, no- absolutely, we feel very honoured that you’ve agreed to come and talk to us! So that’s great. So our first question is: how did the idea for this collaboration come about- who approached who? What’s the story there?

Elaine: So, I’m a bit of a science geek, you probably got that impression, and I got a random email – I have no idea how I ended up on the mailing list – for the NIHR BRC at Imperial, despite the fact that I’m based at UCL and GOSH. I must’ve signed up- I sign up for stuff in an excitable way all the time. They have a public engagement mailing list and I think I got very keen. It said they were running a workshop on anti-microbial resistance and they were looking for some people and it was probably going to get turned into a play. Because I’m quite excitable, I was like “that sounds amazing!”.

So I turned up as a member of the public along with chefs and porters and random other people. And there were actually only about 12 people in the room I think and they kind of had an equal number of medical professionals. But they were all doctors. There was one nurse – basically in full time research. There were no microbiologists there. They were all infectious disease doctors and they were all talking about AMR and how diagnosis works for AMR and I must admit that I got a bit mouthy- as the day progressed, I got a little bit more mouthy.

Nicola was the playwright, so that was the for Theatre of Debate who are a group lead by Nigel Townsend. Theatre of Debate is a really cool concept, basically what they do is run workshops with members of the public and subject matter experts and they use those workshops to then hand it over to a playwright who will go and write a play. But the plays always have a debate context to them, so they will find the contentious bit, the interesting bit and they’ll do a play that kind of covers different perspectives and then they’ll usually actually run a physical debate after it, either with subject matter experts or the actors who are representing those people and a lot of their stuff has been put online as content for schools. So you can download an entire thing with the different monologues and the debate questions to run it.

This particular one was on antimicrobial resistance- just a one off performance at the Imperial science festival. And so, me being a little mouthy, Nicola got back in touch and said “will you look at the first draft?”. So we ended up having a conversation about that and that then lead to a production called Mrs X that just ran for this one night. And obviously I’d talked a lot about the fact that lab diagnosis is actually done by healthcare scientists, and she was like “I don’t really know who they are…”. So she came to visit the lab; loved the lab, got very excited about it and so we just went for coffee, as you do- had some cake- and said let’s do something.

We ended up- so I put in an application to SfAM between Nicola and I for just short of £3000, with a very general brief on the same day as Camden peoples theatre emailed around saying we’ve got a space- and you had to bid for it and bid an outline. So Nicola chucked together a paragraph and went “what do you think of this” and I went “yeah alright”, I had no idea what I was getting into. Sent it, next week she was like “so that’s great they’ve accepted it – by the way we have 3 nights in September” and this was August. And we were like ok so we don’t actually have anything… we have a one paragraph concept, lets better crack on.

Luckily we got the SfAM money and we also put in an application to the hospital infection society because you have to pay the actors, if nothing else. So Nicola is pretty much kind of investing in it mostly for free and Camden Peoples Theatre is great because they do a box office split. So they take 50% and 50% can go to the production. So that to lead us having a conversation about how we needed to actually make a play from the 1 paragraph, so we ran 3 workshops in the end. I sent an invite out to healthcare scientists across London. I lead healthcare scientists at GOSH as the lead healthcare scientist there. So we’re 11% of the workforce at GOSH, so we’re quite large numbers, we’re about 700. So I sent it to all of my workforce and we sent it out to really try and make sure that we had different disciplines represented. So that we had the clinical engineers, so we had the physiologists, so we had the laboratory guys. We did- at one point- even have a bioinformatician for a short period of time. And we also had some medics and nurses and other people that turned up and that’s kind of how it came about.

Jes: That’s great – I actually did notice some of the references to other specialisms, especially the engineering one, I did like that one.

Elaine:We did try quite hard

Jes: Yeah I really liked that

Elaine: And each of the 4 characters kind of represent different aspects of the healthcare science background and pathway. So we wanted to have a very patient facing healthcare scientist, we wanted to have a very “I’m comfortable in the laboratory, never seeing anybody” kind of healthcare scientist, and somebody that was a bit more removed because they’re management or other reasons, so that you got a feeling for the fact that we are all involved, but in different ways.

Jes: Yeah- I think that was great actually because, not only do you show the public all the different sides to it, but there’s also someone that all scientists can relate to as well. You can be like I’m more of a lab person or I’m more of a “I go and talk to patients” so I really liked that, yeah.

Elaine: And I must admit, until I started as lead healthcare scientist, I had no idea how many different scientists worked in my organisation, let alone anywhere else. One of the things I spend a lot of time doing is trying to get those different scientists in a room, even in our trust, to really see what other people do. Because, the way we’re going to develop as a workforce is by cross-fertilisation, by going “actually, I need communication skills, let’s ask the person that does a lot of patient facing work” or that person who does a lot of patient facing work with IQIPS and things coming out for physiology- they need to understand quality assurance and audit in a way they have never done so before. So, tap in to the stuff that the laboratory guys already have done. We have to be savvy in a resource-limited setting about mixing that up for ourselves as well as kind of having that relationship with the wider public.

Jes: Great thank you! Okay so, what does this project mean to you and what are you hoping is going to come out of it?

Elaine: Love it! So obviously I’m just a failed actress at heart, without any form of actual skill! I think the interesting thing for me is, as I have progressed, especially now as I do more and more research as part of my role, I think I’ve become really aware that science is actually essentially a creative field. People don’t really see it that way, but a lot of it is about having ideas and inspiration and having the capacity to flip something on its head and look at it in a way that no one’s ever looked at it before. To be able to work with very creative people who do that all the time and see how your science can be made better by that has been amazing. I really want it to get to the point where we take that next step- not just to do a full production, but I think it would be a great opportunity to do some really good science communication for those people coming through the door who want more; to run it alongside a series of workshops, either in practical science in terms of STEM or just science communication. We’ve talked about things like having “the science behind zombie movies” or, those kinds of cool things, where you can talk about “what is the science behind it” but in a way that people can actually relate to. I think people try to impart science as experts, and I think that’s not what we’re about. I think the NHS is about co-creation of healthcare with patients and science should be about co-creation of ideas and frameworks and sharing it without having an expert in the room. That’s increasingly important in things like grant applications and it’s definitely where we should be going. Research is funded by the public, for the public, so why shouldn’t we be working with the public to enable them to interrogate us and to up-skill them so they can be more involved and engaged in those processes. I have no idea if I actually answered your question!

Jes: No- that was a really great answer! So, you’ve kind of already answered this, but how long did it take and how many people put this whole thing together?

Elaine: So, we had an initial meeting in February, I think that we got news that we were definitely starting the project late June/early July, and the workshops started in August. So, from start to finish with the workshops it’s been 6 weeks, so it’s been pretty intensive in terms of making it happen. So, we’ve had 3 workshops over that time period and obviously there’s Nicola and I who are involved, Colin’s been involved in terms of videography, my husband, John that I roped in- who does photography- it’s kind of a family affair! And then, we’ve had the 3 workshops, I think we’ve probably had 20 or 30 different scientists turn up at various points. And they were awesome, because how often do you get to spend 3 hours drinking wine and eating food and just talking about stuff you love, with people that you’ve never worked with before? Some of which I’d never met before and actually really kind of got to dig into what makes them tick, what makes them do what they do and how they feel about it, the things that make them say “I love my job” and the things that they kind of carry with them that they don’t get over, that other people wouldn’t necessarily understand. Because, that is what makes the crux of a story and Nicola’s done an amazing job of taking those really honest words that have been expressed in a situation where a lot of trust was built and actually turn it in to something that really is an honest reflection of the people that were involved in that process.

Jes: Great- and obviously the people you were working with were really passionate too to get it done so quickly so that’s great.

Elaine: Yeah! Also, feed people. Provide wine. If you need something done in a rush offer food and alcohol and people will come.

Jes: So, my next question is moving away from the play a little bit- it’s just a general question. You’re very active on social media, do you have any advice for other scientists, and particularly trainees, who are also active on social media?

Elaine: Ah- ‘tis the place to be! So, I suppose the first thing is I would never say anything on social media that I wouldn’t say directly to someone’s face. And actually- that can be harder than I imagine sometimes. I have been followed by anti-vaccination lawyers and all kinds of things. I’ve had some very interesting conversations with medical doctors about why they have a doctor’s mess and why other professions don’t have access to it and why in the current state of healthcare they get special privileges. Just to start a conversation, but just asking the question it’s really interesting how that response comes back. And so I think lively debate is useful but I would never say anything that I’m not prepared to have come back at me.

Never retweet anything you haven’t at least looked at, one of the things I’m aware of is you see really good sounding articles and you think “oh well you know, it would be really good to kind of pass that on”. I know a number of people who have been really caught out by retweeting bad science, and you only have to do that once. You’re kind of acting as a filter for a lot of people, especially if you are on social media a lot, you almost have a duty of trust to those people that if you’re retweeting stuff- it should be of a kind of quality. Not something that you retweeted at 3 o’clock in the morning without even having bothered to have opened the link and suddenly it’s an Andrew Wakefield study that you’ve passed on- that kind of magnitude of bad science.

And, I suppose finally, follow up:  it is great to have links on social media. It is even better to get to the point where you follow those up in person because that’s when the real great stuff starts. If you’re at a conference where there is somebody that you tweet all the time then say “let’s meet for a coffee”, because our careers these days are so reliant on collaboration and networking and who you know. We’d all like it to be different, but actually, that is what the world of science is. So if you are making those connections early in your career they will really work for you. Things like this- I would never have been able to do if I hadn’t said to Nicola “oh yeah, my twitter tag is this”, she sent me a thing, we sat down, we had coffee, and look where we are now. And so, use it as a launchpad and not an end to itself.

Jes: That is some really, really good advice. Especially the first one where you know, a lot of the time when you say things, you can’t read tone in a tweet, so you could say something completely innocently…

Elaine: And flippantly! So many people get caught out with sarcasm or flippancy! If someone is reading cold, and you have to bear in mind that no-one’s necessarily going to read your thread and see the context with which you have made a statement.

The other thing that’s worth bearing in mind is that your organisation watches you- which is something I didn’t know. Phrase this carefully in your blog but I was at a meeting only last month, where I did not realise that the social media team/comms team watch and they have a hit list of people that they watch linked to the trust and so they keep an eye on you. So if you’re someone who has a lot of followers or somebody that they think might say something, then they will be keeping an eye on you so, it’s not like this stuff is just hidden in the background. And it may be really tempting to go out and comment on something that’s kind of out there but if you’re doing it and it’s likely to get a response then you have to be really careful about how you make that work. Because, the days where people won’t be googling your twitter account years down the line are kind of behind us and you don’t want this to come back and bite you when you’re applying for that professorship or anything else. Because, at that point no one will remember the context of that really witty comment that you made because it will be 15 years ago old news and so you’ll just be left with the comment.

Jes: Great, that’s fantastic advice. So, do you have any other advice for trainees in general? Sorry- I feel like I’ve kind of moved away from the play, but we are a trainee blog!

Elaine: No, Absolutely! And not everyone will get to see the play, hopefully it will happen again, but if it doesn’t then you don’t want to make this all about something that people now can’t actually access. I don’t know, I feel really bad saying this because you saw my talk, I probably gave all my good advice then! It is also online so you can always link to it.

Jes: Oh is it?

Elaine: Yeah it’s online in full because they videoed it.

Jes: Oh great- we will definitely do that, yeah. (http://mahse.co.uk/mahse-research-day-2018/)

Elaine: If people want to sit and watch me rabbit on for 45 minutes! So, I suppose there are a couple of things. It is always worth having a plan. Everyone told me when I started in healthcare science that it was a 9 year training route to consultant. That was blatantly not true and it is no truer now than it was then. Things don’t just happen to you. It requires more fight and more effort than you deserve to have to put into it to make things happen. But you will get amazing opportunities and you will get to do great things, but you won’t get them if you just sit at your desk and speak to the colleagues in your department. You have to be sticking your head above that parapet and taking risks. For instance, I was told on the first workshop for nosocomial that I was taking a massive professional risk undertaking a project like this. Because, if people saw it and didn’t like the way I was portraying our profession then it could massively backfire. I believe in what I do and I am passionate enough about what I do that I’m prepared to take that risk. I’m not saying to go out and be massive risk takers, but you have to be driving forward because we’re not like the medics where they have this lovely route where you’ll go from A to B to C to D. That isn’t the reality for us, but that has huge opportunities for you to create the thing that you want to do, because we’re not tied into this straight forward career path. You can basically make the career that you want, but you have to make it. Nobody- most of the time- is going to say no to you. Most of the time, people will let you walk through whatever door you want to walk through, but you are going to have to go out there and get the funding. You are going to have to go out there and make the connection who says “Yes, come on my ward round, come to X, come to Y, and get this experience”. This is why social media is so important because, you guys have access to people in a way that I fought and had to really struggle to get access when I was a trainee. Because, you were in such a bubble that it was really hard to find people outside of your bubble to make those initial links. Whereas you guys can reach out to anybody and never be afraid to – the worst that can happen is they ignore your message – that’s really not the end of the world, right? And also never just send one.  Because, I get 300 emails a day and I will really want to hear from you and if you just send me one it will disappear into the depth of the inbox.

Jes: Sorry to interrupt you- but I remember you saying that in your talk, and I’ve recently been talking about going out for my elective and I remembered what you said and I thought “you know what, I’m just going to send another email”. Because the worst they can do is say no, and then I never see them and it doesn’t matter or they say yes and it worked. So yeah that was actually a really, really great bit of advice that has really stuck with me and I remember and I act on it.

Elaine: Yeah- because to be honest, if someone emails me 3 times I’m like “oh yeah, they’re really keen”. If you just email me once, then I will see it in my inbox and go “I should do something with that”, probably find it 8 months later and I’ll be like “yeah, they’ve probably moved on now and aren’t that interested”.  So it is all about maintaining your momentum, so that’s where you have to find the things that work for you, because you won’t be able to keep up the passion and the momentum if you’re doing something to tick somebody else’s boxes. If you find the things that tick your boxes then you will and you guys have years ahead of you, you have amazing careers that can be yours, but you’ll only have the energy to make it there if you find it in the area that works for you. Because you do have to fight- I still fight. I still fight all the time for stuff that I want. The grants that I want that I just get turned down for over and over again because that is the world that we live in and I think that’s not what anyone ever said to me as a trainee. We live in a world of failure; science is a world of failure, so it requires you to think that failure is a learning experience. Failure isn’t this horrible, bad thing that no one should ever do, that we’re raised to never fail an exam. We’re all academically pretty good, most of us have never failed anything, so when you’re suddenly applying for all this stuff or trying to meet people and it’s not working I think it’s really hard to keep not thinking that you’re really bad at what you’re doing. 20% success rate is amazing for most of the stuff that we do. It’s just it doesn’t feel amazing – says the girl who got a grant rejection last week when you’ve had 6 grant rejections this year. It’s then hard to know that it’s worth it. Whereas if you’re doing something that really matters, you have your 48 hours of mourning, you eat your cake and then you’re like “alright let’s go on, let’s do the next one”.

Jes: Great, my final question is, you spoke about where you wanted this to go. Did you have any thoughts about any other collaborations or work that you might like to work on in the future?

Elaine: Nicola and I are trying to gain grant funding to do something a bit different about education related to clinical trials. We want to get an app with some educational content using theatre and other things to really engage debate. A lot of people don’t follow on from clinical trials recruitment because they don’t really understand what it means, so we want to be getting the information out there earlier so that you increase your take up of clinical trials from the 50% that it currently is. But, that was the grant that I just got rejected for last week so we will see if we get some more. And then obviously all the science!

And lastly, finally, the big thing that I’ve got going on over the next couple of months is we’re launching @girlymicro’s Science CommuniTea. T-E-A, because there’s going to be a lot of tea, and cake, involved and that’s going to be based around healthcare science. So there’s going to be three streams of content; there will be a stream of content about the scope and diversity of what scientists do. Both bits about immunologists or bioinformaticians saying “actually, this is what my day is like, this is how I got into it”. Also, some content about people who have done things like PhDs and gone on to do other things, to try and encourage people to say actually there’s a whole world of careers out there for people who are doing science, with the aim of getting undergraduates and early postgraduates to engage. We’re also going to be shooting go pro footage of science experiments and things that people are doing in the lab. I don’t know what it was like for you, but when I was at uni and people were describing things like PCR, it sounded like the hardest thing in the world. I was like “I don’t understand!” and then I did it and I was like “OH, so you put the colourless fluid into the colourless fluid and then you put it in the machine? Great- I can do that.” Because, it’s really hard to describe some of the stuff, whereas if you see it you’re like “yeah, that’s right- I could probably teach a GCSE student to do that”. So, we’re going to be shooting some actual footage so that people who are going through uni can see that it’s not so hard and they don’t get that block that happens where people are like “Actually science isn’t for me because it’s for excessively smart people”. Because, you know, I’m not excessively smart. I just like science. So, try and engage people with that, and then some panels perhaps. On topics like “what is it like to be a woman in science”, “what is it like to do a PhD”, “How do you go about getting grant funding”. Things that will be a bit longer, have two or three experts chatting, drinking tea and eating cake, to support trainees, people who are starting out who are maybe really established as healthcare scientists but haven’t really done research before. To have some really approachable content, and then hopefully that’s another way of increasing networking because people will see the videos and think “oh- I can contact that person- they’re doing that thing that I’m really interested in”. Plus some content about good science and bad science in the news, things like that, so that people can follow up.

Jes: Great, it sounds like you’ve got some exciting stuff coming up.

Elaine: Hopefully! So yes if anyone wants to actually see when the content starts coming online – so we’re hoping to launch early November – if people follow @CommuniTeaLab on both Instagram and twitter, they’ll see when stuff starts to come online, and we’ll be really glad if people subscribe, but also, it’s about us communicating to each other. So I’m really hoping people will go “why don’t you cover this” or “actually I’d like to really hear about this topic” and also, if there are good papers that are coming out, I’m really keen for people to do like 3 minute videos if they’re publishing something that actually gives a lay summary of what their paper is and why it matters, to try and give back and make us a community in a way that I don’t necessarily feel that we can be. Because we’re so spread over so many different organisations, we’re small numbers and labs and I feel twitter has done a great job of starting that conversation, but you’re always limited by the 280 characters, right? If we have something where we have personality and faces and can talk about what drives us, then surely that can only be a good thing for healthcare science and healthcare scientists.

Jes: Honestly, thank you so much for answering our questions, you’ve given us more advice and answered our questions better than we could’ve hoped. And also, thank you for doing the play- and putting so much passion into it. You know, some of the things that were said in the play really actually reminded me why I started doing healthcare science as well – and I’m sure that’s what you wanted to get out of it.

Elaine: Yeah! And hopefully #Nosocomial will go on and we will find more funding and take it forward.

Thank you so much for reading/listening! If you like us branching out into different forms of media – please do let us know and we can try to do more podcast style things! But then we might actually have to learn how to edit audio rather than asking Adriana’s dad to do it for us (thanks for that by the way!).

Author: Jes

I am a trainee clinical bioinformatician working at the Royal Devon and Exeter NHS Foundation Trust. I am passionate about increasing awareness and discussion about healthcare science and particularly the routes into the field.

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