Monday, February 1, 2016

Seven Minutes in Stroke - Thalia Field

Thalia Field MD FRCPC MHSc
Assistant Professor, Faculty of Medicine, University of British Columbia
Stroke Neurologist, Vancouver Stroke Program



1 - I don’t know if I was so much inspired towards neuroscience as I was running away from geology! I did my undergraduate program in geology because I though mountains were pretty to look at and I could go on field trips instead of sitting in class. I quickly realized that I did not have the appropriate temperament - on fieldwork trips, my classmates were much more interested in filling their backpacks with shiny, interesting (and very heavy!) rocks while I was more interested in eating and drinking anything heavy as quickly as I could, finding the warmest spot possible, and waiting for the day to be over. I applied for summer research jobs to be close to my family in Calgary, and by luck a young Michael Hill was finishing his fellowship and was looking for an Earth Sciences-inclined student to look at weather data to define Chinooks, a warm wind phenomenon that can trigger migraines and, as he wondered, possibly strokes. My alternative gig was searching for meteorites on my own in Northern Alberta (my interviewer took one look at me and said, “we work in all sorts of weather, even the pouring rain…you don’t want to work in the pouring rain, do you?” I didn’t!) and the rest is history.

2 - Stroke seemed to me the diametric opposite of geology - instead of looking at change over millions and billions of years, the Calgary Stroke Program was focusing on that critical moment where one minute you are independent and enjoying your life and the next you are hemiplegic and unable to speak. tPA had recently been introduced and the Calgary Stroke Program had a dynamic group of young, enthusiastic clinician-researchers who were changing clinical practice and making people better. I wanted to be a part of that.

3- The highs are always patients with excellent outcomes and students working with me who achieve successes like grants, abstracts, and manuscripts - the future of stroke depends on training more young talent and I want to continue that tradition.

4 - The lows are having to give bad news to patients and families, and being excessively tired after a week of service - I once tried to brush my teeth with lipstick.

5- It’s tricky- you’ll have to ask my partner and my friends whether I really pull off this balance - but on a weekly basis I work out, try to read one novel and month and get sucked into Podcasts and Netflix - my current favourites, respectively, are “Grownups Read Things they Wrote as Kids” and “Fargo.” And I am committed to taking vacations twice a year- I find the time off allows my brain to work in different ways and actually helps me to consolidate ideas with regards to my research.

6 - I have been incredibly lucky to have the support of a number of key mentors. My most important mentors during my training have been Michael Hill, who inspired me to go into stroke neurology and who I still rely on for honest advice and clarity of thought; Gord Gubitz and Steve Phillips in Halifax, who were models of clinical excellence and patient rapport while I was a medical student; Oscar Benavente, who inspired my interest in clinical research and clinical trials, developed and supported my interest in secondary prevention and lacunar stroke, and never fails to make me laugh; and Eric Smith and Joanna Wardlaw, who have led me to ask new questions about the natural history of cerebral small vessel disease and how we can develop new treatments, and have generously integrated me into the international network of small vessel disease researchers. The stroke community is small, and I’ve found my mentors through the support and generosity of my other mentors.

7 - I’m currently trying to forge connections outside of stroke, as I feel that we might learn valuable lessons and strategies by looking outwards: big data and machine learning may give important tools for risk prediction and selection of optimal patients to enrich future clinical trials; other systemic conditions that advance brain aging may teach us about the mechanisms of cerebral small vessel disease; cardiology remains a model for how stroke can expand research funding and instrastructure. But my most important collaboration is with my partner, Glenn, who ensures that I close my laptop from time to time and tries to keep my feet just a millimetre off the ground. 




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