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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

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to build their own research program, whether or not they have a mentor.

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As clinicians, we spend a decade or more as trainees learning to take care of patients.

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When we finally start our careers, we want to build research programs, but then we find

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that our years of clinical training did not adequately prepare us to lead our research

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program.

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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

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However, clinicians hold the keys to the greatest research breakthroughs.

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For this reason, the Clinician Researcher podcast exists to give academic clinicians

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the tools to build their own research program, whether or not they have a mentor.

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Now introducing your host, Toyosi Onwuemene.

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Welcome to the Clinician Researcher podcast.

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I'm your host, Toyosi Onwuemene, and it is an absolute pleasure to be talking with you

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today.

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Thank you so much for tuning in.

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Today, I'm talking about how to get started with manuscript writing, how to get started

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with manuscript writing.

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And the reason this particular episode comes to me today is because I recently engaged

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with a couple of trainees who wanted to work with me to write their first paper, and I

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realized that they don't have experience writing manuscripts.

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And it's funny because if we go through college or we have done any measure of writing, you

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find that you've done writing, you've written term papers, you've written scientifically.

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But if you haven't actually worked through writing manuscripts, submitting it, revising

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manuscripts, then it's experience you don't have and you do need to gain.

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And so I think I didn't realize how much was needed in terms of training and helping them

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to get to where they needed to be as far as the writing.

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And for that reason, I realized that it's important to talk about how people can get

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started manuscript writing and what they need to expect along the way.

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Because we've written so much in the course of our career, right, we're always writing.

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We've written in college.

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We are writing as med students.

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We're writing as residents, as attendings.

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There's a sense that what we've been writing, therefore, of course, we should know how to

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write a manuscript and submit it for publication, but it's not so straightforward.

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So I wanted to talk about a couple of things that we should be thinking about, especially

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if you've never done this before, if you have done this very little.

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One thing you may have done is contributed to a manuscript, but you may not have been

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a first author in a manuscript, which is a different set of responsibilities.

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So I just want to go through those today.

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So the first thing I want to invite you to do is to seek out opportunities to write.

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Now I'm big on finding opportunities that you're super interested in and really excited

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about, and that is good.

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But I also realized that at the beginning, where you don't have much experience, you're

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really just seeking out experience.

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That's it.

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You just want to get on board.

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You just want to be able to help get the paper written.

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And so it is helpful when you first get started to co-author.

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So that's the first thing, seek out opportunities to co-author.

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You can start out as a first author and those opportunities seem less compared to the co-authorship.

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But if you can find a first author opportunity, good for you.

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That's great.

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Especially if you're working on a summer project or research project that you're ultimately

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going to be able to write up, that's excellent.

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And many people don't necessarily have those opportunities.

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And that's why it's probably easier to get started as a co-author.

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And what's the benefit of getting started as a co-author?

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Well, you get to help see the manuscript after it's been written.

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The first draft is written probably by the first author in collaboration with the senior

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author.

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You have a chance to review, give your edits, and at least contribute to the manuscript

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in some significant way.

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Now the thing about being a co-author is that co-authors do not tend to do the heavy lifting

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of a manuscript.

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Now there are some manuscripts where it really isn't involved or writing opportunity where

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someone's writing the introduction, someone's writing the materials and methods, someone's

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writing the discussion, the results section.

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There are those opportunities.

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Many times though, someone else is doing the work of putting together the first draft.

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And for that reason, as a co-author, many times the first time you see the manuscript,

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it's when it's already written in draft format.

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Now you still have opportunity to contribute, make it a stronger paper.

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And so your opportunity to be a co-author is an important, significant contribution,

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but it doesn't give you a good sense of how the whole paper should be written.

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You're really important as a co-author.

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And honestly, I'm so grateful for the co-authors who've helped me move my work forward.

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In one of my earliest manuscripts, I was a medical student when I first wrote the manuscript

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as a first author.

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And when the revisions came back, I was knee deep in residency.

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I was super busy.

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There was not even really space to think about writing the manuscript.

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And so a co-author came along to help me do the revisions.

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And that was so important because honestly, the manuscript wouldn't have been published

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at the time in which it was published if I had not had that kind of help.

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So co-authors are super important.

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And as a co-author, you gain some experience, but you don't really gain a sense of what

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it takes to pull a manuscript together.

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So number two is that when you can, work towards a first author opportunity.

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Okay.

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I might hear you saying, yeah, yeah, easy enough to say.

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Most of us don't have access to first author opportunities.

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And I would say that first author opportunities abound.

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Okay.

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So let me pause and just explain.

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So there are always things to be written.

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There's always opportunity to educate, to engage, to write about something that people

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care about.

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It's helpful if you have original research that you're writing up, but many of us don't

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start with original research.

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But perhaps it's a review article you could write.

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Perhaps there's a case that you could write up.

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I know a lot of people look down on case reports, but I have to say that case reports are still

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helpful.

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Okay.

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So manuscripts may not, journals may not accept case reports.

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So it's like, how do you write a case report where it's not really a case report, right?

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How do you write like a teaching case or an opinion piece or something where you're not

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really writing it as a look at this interesting case, you're pulling out a nuance and you're

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educating.

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So there are many of these opportunities in journals where you can do a case report format

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as an education piece.

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So what I'm saying is that there's so many opportunities.

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Now many of us are waiting for a mentor to hand us an opportunity and say, Hey, here's

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this paper I dreamed of.

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You go write it.

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And sometimes those opportunities come.

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And when you can find these opportunities, it's great.

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Invariably as mentors become more senior, they tend to have projects that just need someone

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to help them get to the finish line.

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And they may be able to pull out a manuscript that they started working on a couple of decades

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ago and they haven't finished.

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And that's great.

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But even when that's not available, it's possible for you to think, let's say you're within

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the construct of a mentor's program and you see what their work is, the bulk of what they're

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doing.

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You can even suggest to them a manuscript that you can author as a first author.

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So what I'm saying is that there are opportunities.

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You should go look for opportunities.

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And even when people don't know opportunities are present, you can present someone with

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an opportunity.

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You can say, Hey, love to do a systematic review with you.

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I'd love to write a review article with you.

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This is your area of expertise.

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Can we do this together?

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So what I'm asking you to do, if you haven't already done it, is take initiative.

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I know it would be so nice if someone can just pull you aside and say, Hey, here's this

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paper, write it.

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Many times that will not happen.

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And if it doesn't, if it does good, right.

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But if it doesn't happen, you go looking for the opportunity.

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You create the writing opportunity for yourself.

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So maybe start with being a co-author, but then create the writing opportunity for yourself

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so that you can have the experience of being a first author.

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Okay.

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Number three is that if possible, find a project you care about.

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Find a project you care about.

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Writing is hard.

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Even for those of us who love writing and I love writing, writing is hard.

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You're birthing words, you're trying to put them together and make them sound interesting

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and not boring, right?

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You have a lot of things to do with words that are hard.

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And so it's going to be hard, whether it's something you love writing about or something

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you hate writing about.

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So it's best to just figure out if you can write about something you actually care about.

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For example, let's say there's a manuscript opportunity about say receptor signaling and

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you're like, Oh, basic science.

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I don't really care about that.

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Okay.

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Ask about what other opportunities exist.

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Don't just say, Oh yes, I'm so desperate.

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I'm going to take up this thing that I hate.

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And you may not hate it.

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You may be like, okay, receptor signaling, maybe not my jam, but it's interesting enough.

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That's fine.

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Remember when you first starting, your goal is to put in your reps.

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Your goal is to get the experience.

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Your goal is to figure out how to write.

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It is icing on the cake for you to have a project that you're really excited about,

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but it's not impossible.

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So I would say where you have choices and you always have choices, ask for manuscripts

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that are similar to that in the area you care about.

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So for me, for example, when I was coming up, I didn't want to do basic science.

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I didn't think basic science wasn't interesting.

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I've always wanted to do research or write about scholarship.

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That's closer to the patients.

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I would prefer to write the case report, even if the basic science paper is more valuable

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because it's just more interesting.

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So anyway, I'm just saying that opportunities abound, don't feel pigeonholed.

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If someone offers you an opportunity that you're not excited about, it's okay to say,

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is there a different opportunity?

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And yes, sometimes people will be disappointed because they're like, well, you should be

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grateful and it's the way it always is and it's okay.

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But it is important that you get the experience.

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So if you had a choice of, should I wait for three more offers to see if I can get something

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that's more interesting?

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And here's an opportunity right now that I can work on, I would say that if you are still

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early in the game where you haven't necessarily gotten a lot of experience, putting a lot

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of reps, sometimes it's okay to take up the first manuscript and just get some experience

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in that.

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Now I would say that with a caveat that once you start being successful in one area, people

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expect you to continue to be successful in that area.

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So let's take the example of the receptor signaling manuscript.

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You take the manuscript, you write it, you do a good job.

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And someone else is like, oh my gosh, you wrote a paper on the receptor signaling.

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Let's give you another manuscript in this area and another manuscript in this area.

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And before you know it, you could be knee deep in receptor signaling and you didn't

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even really care about it in the first place.

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Anyway, so that's to say that take opportunity and work on it, but be clear that, hey, this

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is a one time so I can learn because it's not something I want to do long term or be

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strategic about finding something you actually care about so that if you end up getting three

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or four or five or string of manuscripts to write, you still feel good about it.

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So you want to make sure that if possible, you find a project you care about.

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If not, just recognize that you still are gaining because you're learning the ropes

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of writing a manuscript.

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Okay.

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Number four, and this is really important, and I think this is something that doesn't

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come naturally to clinicians, is you've got to create space for writing.

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Now I hear you saying, of course, I recognize that Saturday I'm going to write from 8 a.m.

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until 5 p.m.

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The manuscript will be done in a day.

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It will not be done in a day because scientific writing doesn't magically appear like that.

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Now I do know a couple of scientists who've been doing this a long time who can literally

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churn out a paper in eight hours.

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I've seen it done.

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I know it's possible, but when you're starting, I think that's a little bit of a high expectation

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for yourself.

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And I know you're thinking back to college.

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When you pulled the all-nighter, you were able to create a manuscript or a paper that

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you got an A on.

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I totally get it.

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But scientific writing is a little bit different.

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And so I would say that even though you know you can do it in eight hours, I would say

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don't do it.

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Don't do it because it takes a long time to do.

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And if you're going to craft good writing, you're going to take time to craft it.

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So you want to create space for the writing, not just one weekend day where you're going

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to just binge write your weekend days, especially if you're in the midst of residency and you're

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working six days a week.

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Your day of rest is not a day of writing.

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And you may be like, oh no, I got to get this done.

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I got to get this done.

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And this is the only day available and it's okay for me to not take a break.

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I would say that, hey, hey, writing manuscripts is not about just churning out something and

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then saying, I did that.

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I'm done.

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It really is just a, it's a process you're beginning to be able to carry on long term.

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If you want to do research, then you're a writer by trade.

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Your work is writing.

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And so the whole idea of being able to binge write something in eight hours is kind of

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just counter to your role as a writer.

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You are a writer.

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As long as you're doing research, you are a writer.

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And so create space for your writing job.

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If you haven't done it, if you haven't figured out how to do it and happy to coach you through

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it, this is what I do.

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And I mean, it was a game changer for me.

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I was always looking for the eight hours space to write and eight hours doesn't come very

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easily, but do you know what comes easily?

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30 minutes.

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Most of us can find 30 minutes to write a day.

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And so if we write for 30 minutes here and then we pause and we write for 30 minutes

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there, right tomorrow, and we pause, we write for 30 minutes the next day, we will always

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achieve more than we do with an eight hour binge writing because eight hours of binge

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writing, first of all, not really sustainable.

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You get tired.

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I mean, remember when you took the MCATs and you went in that room for eight hours?

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Holy cow.

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It is hard to do.

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Writing is brain work.

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It is hard to do.

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And so again, I'm not saying that you're not a superstar.

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I'm not saying you can't just like pull it together in eight hours.

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I'm not denying your expertise and your skill.

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I'm just saying that writing is your job and the best writing happens over time because

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every day that you put it down and you lift it back up again, you have the time to think

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about it and bring a little bit more creativity to your writing.

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So if you want to move forward and be a scholar in any way, lead a research program, be part

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of a research program, recognize that writing is your job.

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And so create space to be able to write every day.

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Create space to write every day.

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You will always get more accomplished.

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Again, this is the story of the tortoise and the hare.

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You will always get more accomplished when you create space for writing daily.

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Okay.

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The next thing, number five, is engage for the long haul.

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Now, this is not me saying, oh, it could take you eight hours on a Saturday, but please

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stretch it out over the course of a week.

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That's not that.

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It's that scientific writing takes time.

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And more increasingly, scientific writing is a collaborative effort.

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So most of the time, you're not going to see a scientific paper that's written by one person.

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Maybe if it's an editorial, sure.

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Sometimes a review could be written by one person.

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But for the most part, it takes a lot of collaborators to come together to produce a scientific article.

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And guess what?

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Your collaborators are not waiting for you to send them the one article that they're

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going to say, oh, great, I've been waiting for this one article to come all week.

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I'm now going to sit down and write on it for eight hours.

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No, they have all this other stuff going on.

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You send them your manuscript to critique, and they're like, great, in two weeks, I'll

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get back to you.

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And then two weeks later, you're like, hey, I haven't gotten any feedback.

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And they're like, oh, yeah, I forgot.

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I will tell you that I have one such manuscript that for two years, this author has not gotten

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to look at the manuscript.

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Now, you have to be careful.

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Choose your collaborators carefully.

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But the point is that it does take time.

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It takes time because it's not fully dependent on you.

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That's a good thing, right?

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It's good that you have collaborators because the synergy that you bring together really

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creates an outstanding manuscript.

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And the more people you bring together, the longer it takes.

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So this whole idea, again, I don't want you to take it as a judgment, but just I'm talking

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about why it's not practical.

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You set aside eight hours, and you're like, great, I've worked on it.

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And the manuscript is going to come back to you from your collaborators.

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And then you're looking for another eight hours, which usually nobody has, right?

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But again, if you have a practice of writing regularly, say 30 minutes a day, then you

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can find those 30 minutes when the manuscript is ready to move forward.

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So recognize that it's going to take time and be ready for that.

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Don't say, and someone come to me and say, I want to write a manuscript with you, but

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I only have three months.

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It takes longer than three months to write any manuscript worth its salt.

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Because first of all, you got to do the work of gathering the data for the manuscript,

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and if it's not an original research article, you got to be able to pull the data together,

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even for a review.

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The paper is already written.

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You got to go find them, and then you got to sort them out, organize them, and then

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present them and pull them together into your manuscript.

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It takes time.

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So the point I'm making is that it takes time.

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And if you're going to do this, you got to be ready to engage for the long haul.

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So get your mind ready.

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Don't be shocked that it took six months to write the manuscript and another three or

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four months to get it through revisions.

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It takes a long time.

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That's why you don't want to only have one manuscript that you're working on, because

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when one manuscript is in revisions by your co-authors, you can be working on the next

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one.

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But just be ready that it takes time.

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And again, writing is part of your scientific career.

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It's what you're going to be doing.

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And so create space to do it over the long haul.

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Number six is expect many revisions prior to submission.

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So you're working on it.

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Your first author, great for you.

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You have a senior author that hopefully is working closely together with you to shape

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this manuscript.

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And then you have other co-authors who really do need to contribute intellectually to this

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manuscript to be considered co-authors.

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So they're going to come back with feedback and you're going to incorporate it.

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So I will tell you that I had a manuscript that I was invited to be a co-author on and

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I was like, oh, here are all my edits.

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And they were like, oh, we don't have time for your edits.

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I was like, well, I guess I can't be an author then.

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And I've grown up a lot since then.

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I probably would figure out a way to make sure that my revisions counted.

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But I think I found out that I was an honorary author and I was taking my job seriously as

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an author.

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And so you should because there are requirements as to who counts as an author according to

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LCJME rules.

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And I don't know if that's the right acronym, but it's the committee that kind of makes

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rules about who's an author and things about the ethics of writing and publishing.

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So anyway, so they specify who an author is and you do need to contribute scientifically.

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So if you're going to contribute scientifically, you need space to contribute scientifically.

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So for someone to hand you a paper and say, it's due tomorrow.

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I hope you can get me your edits by tomorrow is not really realistic because it takes time

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for you to clear space on your schedule and make room for the writing.

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So I think a good rule of thumb is two weeks, knowing that it will probably take them a

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week longer to get it around.

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But just recognize that they're going to tell you that, hey, these are all the changes we

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think should happen.

364
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And if you really are honest in including them as collaborators, you're going to need

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to revise based on the recommendations they've given you.

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Those are your co-authors.

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Your senior author, if they're doing what they're supposed to do, is going to have a lot of

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edits because they've been doing writing a long time.

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This is why they're senior.

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They've been doing this.

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So they have a sense of what the reviewers are looking for, what makes for a good manuscript.

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They're going to give you a lot of feedback and it's okay.

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Sometimes I've had trainees that I'm working with and I will give them feedback and I'll

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say, this is excellent.

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And then they look at it and it's got red all over and that's the red of the track changes,

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not the red pen.

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I don't use those anymore.

378
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But I think they're demoralized because they're like, I thought I was done.

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And then you have all these edits for me.

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I do have all these edits for you.

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And then you're going to submit to me and then I'm going to have more edits for you.

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And then you submit, I'm going to have more edits because it takes time to craft a good

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manuscript.

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When you're starting out, it takes even longer.

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And so you're going to want to just be ready that, okay, I'm going to submit this.

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It's going to be put through some revisions.

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I'm going to submit it.

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I'm going to have to do some revisions and there's going to be a lot of iterations.

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So perhaps the point I'm making here, this point number six, is that it is an iterative

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process.

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You've got to be ready for that.

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And don't be disappointed just because your mentor didn't like the first draft.

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The first draft is the draft no one is ever going to read because it's the draft that

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just helps you put things on paper and then you're going to transform it.

395
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And when you compare your first draft to the final manuscript, it's going to be a world

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of difference.

397
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The first draft is kind of the thing that gives you power to pull the words out of you.

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And then you can really get to writing.

399
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So don't be disappointed when your first draft is trashed.

400
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And I hope that it's trashed in a respectful way because your writing must always be respected.

401
00:22:03,680 --> 00:22:08,640
But just recognize that, hey, it is part of the process.

402
00:22:08,640 --> 00:22:09,920
Revisions are part of the process.

403
00:22:09,920 --> 00:22:12,960
So expect to revise.

404
00:22:12,960 --> 00:22:15,440
Don't be disappointed when you get revisions.

405
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And when you get many revisions, each time they come, just go ahead and work through

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00:22:19,840 --> 00:22:20,840
them.

407
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Okay?

408
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All right.

409
00:22:22,920 --> 00:22:26,200
Number seven is expect to revise and resubmit.

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Now I've had instances and probably out of maybe 40 some manuscripts that I've written,

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I've had two that have been accepted outright, which it's just a rare event.

412
00:22:38,520 --> 00:22:40,560
And don't count on it, right?

413
00:22:40,560 --> 00:22:43,580
Because the reviewers want to help shape your writing too.

414
00:22:43,580 --> 00:22:46,680
It's rare that they take a manuscript and they're like, oh my gosh, my writing is so

415
00:22:46,680 --> 00:22:47,680
good.

416
00:22:47,680 --> 00:22:49,960
I'm not going to have any edits.

417
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All the time reviewers want to help shape the manuscript.

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And so whenever your reviewers send you critiques, just appreciate it because it takes a lot

419
00:22:58,720 --> 00:23:02,440
to review somebody else's work and then give them feedback for improvement.

420
00:23:02,440 --> 00:23:05,700
But it's going to come back to you more often than not.

421
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So be ready.

422
00:23:06,700 --> 00:23:09,400
So you submitted the manuscript three months ago.

423
00:23:09,400 --> 00:23:13,280
You're like by now there should be a decision from the journal.

424
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And then it comes back major revisions.

425
00:23:15,720 --> 00:23:16,720
It's okay.

426
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It's part of the process.

427
00:23:17,720 --> 00:23:23,440
And what you want to do is work with someone who's been through a revise and resubmit to

428
00:23:23,440 --> 00:23:28,680
see how you structure the response to reviewers and how you pull it together to make a really

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00:23:28,680 --> 00:23:32,240
good and compelling response to reviewers document.

430
00:23:32,240 --> 00:23:36,720
So I probably am going to do a podcast episode on how to respond to reviewers because it

431
00:23:36,720 --> 00:23:41,920
came up in a recent conversation I was having with some of my mentees about writing and

432
00:23:41,920 --> 00:23:44,520
I didn't realize that they didn't know how to do that.

433
00:23:44,520 --> 00:23:48,800
And so anyway, whatever you don't know, just ask.

434
00:23:48,800 --> 00:23:53,000
Don't expect that you should know it because this whole process is hard and your mentors

435
00:23:53,000 --> 00:23:54,000
realize that.

436
00:23:54,000 --> 00:23:58,760
But sometimes they forget because they forget how much they've learned over time.

437
00:23:58,760 --> 00:24:01,560
And you know, over time you really do learn a lot.

438
00:24:01,560 --> 00:24:07,720
And so if you have never done something before, don't be...

439
00:24:07,720 --> 00:24:08,720
What's the word?

440
00:24:08,720 --> 00:24:09,880
I'm not even sure what I'm trying to say.

441
00:24:09,880 --> 00:24:11,400
Don't pretend that you know.

442
00:24:11,400 --> 00:24:15,280
And then go spending all this time looking up how to do it.

443
00:24:15,280 --> 00:24:16,280
Ask for what you need.

444
00:24:16,280 --> 00:24:18,480
Say, hey, I've never done one of these before.

445
00:24:18,480 --> 00:24:20,240
Do you have an example that I could look at?

446
00:24:20,240 --> 00:24:23,200
And people would love to share examples with you.

447
00:24:23,200 --> 00:24:25,360
Now you want to look at the example and you want to follow it.

448
00:24:25,360 --> 00:24:28,440
You want to look at the example and then make up your own thing.

449
00:24:28,440 --> 00:24:30,560
You do want to use the resource you're given.

450
00:24:30,560 --> 00:24:35,200
But what I'm asking you to do, I'm inviting you to do, is not to pretend that you know

451
00:24:35,200 --> 00:24:39,640
and then go spend all this time trying to figure it out, but just admit that you don't

452
00:24:39,640 --> 00:24:40,640
know.

453
00:24:40,640 --> 00:24:41,920
You shouldn't be shamed for that.

454
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No one should judge you for that.

455
00:24:43,040 --> 00:24:45,680
And if they do, they're in the wrong.

456
00:24:45,680 --> 00:24:47,280
I'm judging them.

457
00:24:47,280 --> 00:24:52,440
But I'm just saying that it takes a lot to learn to write a manuscript well.

458
00:24:52,440 --> 00:24:56,880
And people don't always remember what they used to wonder about that they don't wonder

459
00:24:56,880 --> 00:24:57,880
about anymore.

460
00:24:57,880 --> 00:24:58,940
They already know.

461
00:24:58,940 --> 00:25:00,520
So ask for what you need.

462
00:25:00,520 --> 00:25:04,680
Ask for the support that you need so that you can do this job of writing manuscript

463
00:25:04,680 --> 00:25:05,680
well.

464
00:25:05,680 --> 00:25:06,680
Okay.

465
00:25:06,680 --> 00:25:10,800
So that's my, that's those are my thoughts as far as how to get started in manuscript

466
00:25:10,800 --> 00:25:11,800
writing.

467
00:25:11,800 --> 00:25:12,800
I'm going to summarize.

468
00:25:12,800 --> 00:25:15,360
First of all, you want to seek out an opportunity to co-author.

469
00:25:15,360 --> 00:25:19,800
If you can, number two, you want to actually work towards a first author opportunity where

470
00:25:19,800 --> 00:25:21,840
you're doing all the heavy lifting.

471
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If three, number three, if possible, you want to find an area that you're actually interested

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in.

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However, even if you're not able to find an area that you're interested in, recognize

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that putting in the reps is part of growing.

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And so accept what you have and work at it so that you can grow and increase your capacity

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and your strengths as a writer.

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Number four, create space for writing.

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It takes a long time.

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Don't try to do it all in one weekend.

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Your weekends are for rest, but make sure that writing is built into your daily schedule

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and make it a habit, a habit that you do every day.

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Number five, engage with the long haul.

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It takes a really long time, especially when you have collaborators.

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Don't get frustrated.

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Don't quit.

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Don't think that it's going to take months.

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Okay.

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Expect many revisions prior to submission.

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Hey, a revision is an opportunity for your manuscript to be better.

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Accept them as gifts and don't let them weigh you down.

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Definitely do them.

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Don't be overwhelmed.

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And finally, expect a revise and resubmit.

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You're going to write a beautiful paper.

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You're going to be so proud of it and the reviewers are going to just tear it down and

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00:26:23,920 --> 00:26:24,920
it's going to be okay.

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You're going to take their feedback and transform the paper, make it even better and the rest

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of the world to be better for the work that you've put out there.

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All right.

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That's all I have for you today.

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Thank you so much for tuning in.

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I look forward to talking with you again next time on the Clinician Researcher Podcast.

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Have a great week.

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00:26:49,040 --> 00:26:54,440
Thanks for listening to this episode of the Clinician Researcher Podcast where academic

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00:26:54,440 --> 00:26:59,640
clinicians learn the skills to build their own research program, whether or not they

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00:26:59,640 --> 00:27:01,200
have a mentor.

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00:27:01,200 --> 00:27:07,160
If you found the information in this episode to be helpful, don't keep it all to yourself.

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00:27:07,160 --> 00:27:09,040
Someone else needs to hear it.

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00:27:09,040 --> 00:27:13,100
So take a minute right now and share it.

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00:27:13,100 --> 00:27:18,560
As you share this episode, you become part of our mission to help launch a new generation

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00:27:18,560 --> 00:27:31,440
of clinician researchers who make transformative discoveries that change the way we do healthcare.