1 00:00:00,144 --> 00:00:02,811 (lively music) 2 00:00:05,460 --> 00:00:07,200 - This is Lab Medicine Rounds, 3 00:00:07,200 --> 00:00:09,360 a curated podcast for physicians, 4 00:00:09,360 --> 00:00:11,760 laboratory professionals, and students. 5 00:00:11,760 --> 00:00:13,200 I'm your host, Justin Kreuter, 6 00:00:13,200 --> 00:00:15,060 the Bow Tie Bandit of Blood, 7 00:00:15,060 --> 00:00:18,180 a transfusion medicine pathologist here at Mayo Clinic. 8 00:00:18,180 --> 00:00:20,670 And today we're rounding with Dr. Lynn Cornell, 9 00:00:20,670 --> 00:00:23,490 professor of laboratory medicine pathology, 10 00:00:23,490 --> 00:00:26,430 an anatomic pathologist here at Mayo Clinic 11 00:00:26,430 --> 00:00:29,730 to have a discussion around lifelong learning. 12 00:00:29,730 --> 00:00:32,193 So thanks for joining us today, Dr. Cornell. 13 00:00:33,330 --> 00:00:34,320 - Thank you so much. 14 00:00:34,320 --> 00:00:37,320 I enjoy listening to your podcast normally 15 00:00:37,320 --> 00:00:40,680 and I'm thrilled to be on the podcast. 16 00:00:40,680 --> 00:00:42,750 - Now you're flipping into a new role. 17 00:00:42,750 --> 00:00:47,750 And so exciting this idea where I think a lot of us 18 00:00:47,880 --> 00:00:51,510 in medicine are talking constantly about lifelong learning. 19 00:00:51,510 --> 00:00:54,150 We're always going to conferences 20 00:00:54,150 --> 00:00:56,133 and getting new training and such. 21 00:00:57,150 --> 00:00:59,310 Recently I was talking with you before, 22 00:00:59,310 --> 00:01:01,410 we had another committee meeting that was starting, 23 00:01:01,410 --> 00:01:02,580 and you were mentioning 24 00:01:02,580 --> 00:01:04,530 that you had a collaboration 25 00:01:04,530 --> 00:01:07,378 with a group of philosophers (chuckles) 26 00:01:07,378 --> 00:01:11,040 and it just really struck me as kind of amazing. 27 00:01:11,040 --> 00:01:13,050 And I was wondering if you could kind of share 28 00:01:13,050 --> 00:01:16,110 how'd you get started having a collaboration 29 00:01:16,110 --> 00:01:19,530 with a group of philosophers as a pathologist? 30 00:01:19,530 --> 00:01:24,240 - Right. It sounds kind of like a funny thing. 31 00:01:24,240 --> 00:01:28,140 But I just wanna take a step back and tell you 32 00:01:28,140 --> 00:01:31,500 I guess how I started getting involved in some things 33 00:01:31,500 --> 00:01:33,660 that seem like they may be outside 34 00:01:33,660 --> 00:01:37,800 or not traditionally related to pathology. 35 00:01:37,800 --> 00:01:39,934 Over 10 years ago now, 36 00:01:39,934 --> 00:01:43,650 I was on staff at Mayo Clinic of course, 37 00:01:43,650 --> 00:01:45,420 and I was on call one night. 38 00:01:45,420 --> 00:01:47,970 I was waiting for a rush transplant, 39 00:01:47,970 --> 00:01:49,920 kidney transplant biopsy, 40 00:01:49,920 --> 00:01:52,050 that was supposed to come in that night. 41 00:01:52,050 --> 00:01:54,540 And while I was waiting for the biopsy, 42 00:01:54,540 --> 00:01:56,700 the tissue to be processed and everything, 43 00:01:56,700 --> 00:01:59,130 and so I could look at the slides, 44 00:01:59,130 --> 00:02:01,320 I was looking through the clinical history, of course, 45 00:02:01,320 --> 00:02:03,630 as we do on kidney biopsies. 46 00:02:03,630 --> 00:02:07,920 And it was someone who had lost his job 47 00:02:07,920 --> 00:02:10,740 and consequently lost his insurance 48 00:02:10,740 --> 00:02:15,570 and then couldn't afford to take the immunosuppressive drugs 49 00:02:15,570 --> 00:02:18,690 to help prevent rejection of his kidney transplant. 50 00:02:18,690 --> 00:02:21,690 So I was expecting the transplant biopsy 51 00:02:21,690 --> 00:02:25,440 to show rejection, and indeed it did. 52 00:02:25,440 --> 00:02:27,440 But as I was looking through this history, 53 00:02:27,440 --> 00:02:31,740 it really made me annoyed and angry 54 00:02:31,740 --> 00:02:33,510 that we have a system 55 00:02:33,510 --> 00:02:37,530 where we can do something so sophisticated 56 00:02:37,530 --> 00:02:40,320 as taking a kidney from one person 57 00:02:40,320 --> 00:02:42,540 and putting it into another person, 58 00:02:42,540 --> 00:02:45,150 and that kidney can last for many years. 59 00:02:45,150 --> 00:02:48,390 And why might it not survive, 60 00:02:48,390 --> 00:02:49,800 because of something as silly 61 00:02:49,800 --> 00:02:54,210 as, oh, someone gets insurance coverage through their work 62 00:02:54,210 --> 00:02:55,620 and if they lose their job, 63 00:02:55,620 --> 00:02:57,690 then they can't afford to take 64 00:02:57,690 --> 00:03:00,060 their immunosuppressive medications, 65 00:03:00,060 --> 00:03:02,730 and therefore don't take them regularly. 66 00:03:02,730 --> 00:03:06,933 So as I was waiting for this kidney biopsy to come in, 67 00:03:09,270 --> 00:03:12,720 an email came through in my inbox, 68 00:03:12,720 --> 00:03:15,547 from the Minnesota Medical Association and it said, 69 00:03:15,547 --> 00:03:17,340 "Volunteer for a committee". 70 00:03:17,340 --> 00:03:19,950 And I thought, well, maybe I could volunteer 71 00:03:19,950 --> 00:03:21,120 for a committee. 72 00:03:21,120 --> 00:03:23,160 So it turned out there was a committee 73 00:03:23,160 --> 00:03:24,180 that I volunteered for. 74 00:03:24,180 --> 00:03:26,231 It was called at that time, 75 00:03:26,231 --> 00:03:29,820 Healthcare Access, Financing, and Delivery. 76 00:03:29,820 --> 00:03:32,820 So I signed up for that and I started learning a little more 77 00:03:32,820 --> 00:03:37,200 about this really complicated field of healthcare policy. 78 00:03:37,200 --> 00:03:39,360 And there are real experts, I mean, 79 00:03:39,360 --> 00:03:41,981 of course these are physicians that are on committees, 80 00:03:41,981 --> 00:03:45,510 but, you know, generally not pathologists 81 00:03:45,510 --> 00:03:46,560 who are on these committees. 82 00:03:46,560 --> 00:03:49,170 So people who really have expertise 83 00:03:49,170 --> 00:03:52,410 in this complicated field of healthcare policy. 84 00:03:52,410 --> 00:03:54,780 I thought if there's anything I can do to try 85 00:03:54,780 --> 00:03:59,780 to help this issue 86 00:04:00,240 --> 00:04:04,290 including coverage for prescription drugs 87 00:04:04,290 --> 00:04:05,820 in transplant patients, 88 00:04:05,820 --> 00:04:09,510 I was going to do whatever I could do for that. 89 00:04:09,510 --> 00:04:11,490 So I ended up getting involved 90 00:04:11,490 --> 00:04:13,860 in the Minnesota Medical Association that way. 91 00:04:13,860 --> 00:04:16,590 And I eventually also signed up 92 00:04:16,590 --> 00:04:19,620 for another interesting committee, 93 00:04:19,620 --> 00:04:21,540 which was the Public Health committee. 94 00:04:21,540 --> 00:04:26,540 And there we cover many different aspects of public health, 95 00:04:26,670 --> 00:04:30,663 vaccinations and all different kinds of things. 96 00:04:32,340 --> 00:04:35,790 And there are some of the, I'll just add, as a pathologist, 97 00:04:35,790 --> 00:04:38,190 I'd encourage other people who are in pathology 98 00:04:38,190 --> 00:04:41,010 or lab medicine to get involved 99 00:04:41,010 --> 00:04:42,330 in these kinds of committees, 100 00:04:42,330 --> 00:04:45,690 even if it's not the thought to be the usual thing 101 00:04:45,690 --> 00:04:48,120 that pathologists do, 102 00:04:48,120 --> 00:04:50,760 because we really can give 103 00:04:50,760 --> 00:04:52,620 a different kind of perspective on things. 104 00:04:52,620 --> 00:04:57,620 For example, we were evaluating a proposal 105 00:04:57,960 --> 00:05:02,583 that had to do with a human breast milk bank. 106 00:05:03,540 --> 00:05:05,100 And I looked into it. 107 00:05:05,100 --> 00:05:07,290 The way that it was kind of described 108 00:05:07,290 --> 00:05:10,410 was kind of like there, these specimen, 109 00:05:10,410 --> 00:05:11,610 these were specimens, 110 00:05:11,610 --> 00:05:13,950 kind of like a blood bank sample, you know. 111 00:05:13,950 --> 00:05:15,480 But then when I looked into it, 112 00:05:15,480 --> 00:05:17,250 it turned out it's actually regulated 113 00:05:17,250 --> 00:05:22,170 more like a food and it's not subject to testing like HIV. 114 00:05:22,170 --> 00:05:23,617 And their response was, 115 00:05:23,617 --> 00:05:27,750 "Oh, well we've never had an issue with HIV." 116 00:05:27,750 --> 00:05:29,220 Well, as you'll know in the blood bank, 117 00:05:29,220 --> 00:05:31,530 there was never a problem with HIV transmission 118 00:05:31,530 --> 00:05:35,100 through the blood until we started testing for it. 119 00:05:35,100 --> 00:05:37,710 So those kinds of things, you know, 120 00:05:37,710 --> 00:05:42,240 may seem totally acceptable for a clinician 121 00:05:42,240 --> 00:05:44,190 to say, "Oh yeah, this is a great idea." 122 00:05:44,190 --> 00:05:47,407 But then the pathologist can go in and say, 123 00:05:47,407 --> 00:05:50,370 "Well, wait, maybe we should look 124 00:05:50,370 --> 00:05:53,520 at some of the other issues that might arise with this." 125 00:05:53,520 --> 00:05:55,380 So that's kind of how I got involved 126 00:05:55,380 --> 00:05:57,930 with some of these different committees. 127 00:05:57,930 --> 00:05:58,763 And I'm currently 128 00:05:58,763 --> 00:06:03,603 on the Minnesota Medical Association Board of Trustees. 129 00:06:04,620 --> 00:06:06,300 So we end up looking 130 00:06:06,300 --> 00:06:09,330 at all interesting kinds of policy proposals. 131 00:06:09,330 --> 00:06:12,870 And also just to put a plug in for pathologists involvement 132 00:06:12,870 --> 00:06:15,690 in their state medical associations, 133 00:06:15,690 --> 00:06:18,030 our Minnesota Medical Association, 134 00:06:18,030 --> 00:06:22,350 other states are often accepting policy proposals. 135 00:06:22,350 --> 00:06:24,810 So I encourage people to get involved, 136 00:06:24,810 --> 00:06:27,060 volunteer, especially pathologists, 137 00:06:27,060 --> 00:06:31,290 because we can offer a unique perspective sometimes. 138 00:06:31,290 --> 00:06:35,103 And generally pathologists don't volunteer for those things. 139 00:06:36,120 --> 00:06:39,873 So now moving on to the newer project. 140 00:06:41,010 --> 00:06:45,570 So I mentioned before I was interested in kidney transplants 141 00:06:45,570 --> 00:06:48,540 and transplant immunology, 142 00:06:48,540 --> 00:06:50,610 and rejection of kidney transplants, 143 00:06:50,610 --> 00:06:53,190 and also coverage of immunosuppressive drugs 144 00:06:53,190 --> 00:06:54,720 for kidney transplants. 145 00:06:54,720 --> 00:06:55,830 So I've been involved 146 00:06:55,830 --> 00:06:59,103 in the American Society of Transplantation. 147 00:07:00,480 --> 00:07:03,300 The American Society of Transplantation 148 00:07:03,300 --> 00:07:07,260 has different kinds of committees 149 00:07:07,260 --> 00:07:11,730 and groups called communities of practice. 150 00:07:11,730 --> 00:07:16,260 And I have been involved in one community of practice 151 00:07:16,260 --> 00:07:18,930 called the Transplant Regenerative Medicine 152 00:07:18,930 --> 00:07:20,580 Community of Practice. 153 00:07:20,580 --> 00:07:24,390 Another renal pathologist from Edmonton, 154 00:07:24,390 --> 00:07:26,580 Kim Solez is his name, 155 00:07:26,580 --> 00:07:29,010 he had encouraged me to run 156 00:07:29,010 --> 00:07:30,930 for the executive committee 157 00:07:30,930 --> 00:07:34,140 for this Transplant Regenerative Medicine 158 00:07:34,140 --> 00:07:36,210 Community of Practice. 159 00:07:36,210 --> 00:07:40,500 I said I would do it as long as another friend of mine 160 00:07:40,500 --> 00:07:43,410 would run also. (laughing) 161 00:07:43,410 --> 00:07:46,890 So it turned out we both were elected and we were on this. 162 00:07:46,890 --> 00:07:48,390 Well, I don't really have much to do 163 00:07:48,390 --> 00:07:51,600 with regenerative medicine (laughing) in my practice, 164 00:07:51,600 --> 00:07:53,250 which is just renal pathology, 165 00:07:53,250 --> 00:07:55,860 although I am interested in the topic 166 00:07:55,860 --> 00:07:58,593 and new topics in transplantation. 167 00:08:00,330 --> 00:08:04,950 So as you recall, about one year ago, 168 00:08:04,950 --> 00:08:09,660 in New York, some surgeons and scientists, researchers, 169 00:08:09,660 --> 00:08:14,430 they had a project and they had, 170 00:08:14,430 --> 00:08:17,640 I mean, of course it's been a longterm goal 171 00:08:17,640 --> 00:08:22,560 of some researchers and some surgeons 172 00:08:22,560 --> 00:08:27,560 to engage in xenotransplantation. 173 00:08:27,600 --> 00:08:31,020 So that is when we take an animal organ 174 00:08:31,020 --> 00:08:33,450 and put it into a human. 175 00:08:33,450 --> 00:08:37,050 So about one year ago in New York, 176 00:08:37,050 --> 00:08:40,830 some researchers put a kidney transplant 177 00:08:40,830 --> 00:08:45,750 into a human brain dead recipient. 178 00:08:45,750 --> 00:08:50,100 And those kidneys lasted for a brief period of time, 179 00:08:50,100 --> 00:08:52,890 but this experiment showed 180 00:08:52,890 --> 00:08:54,903 that that actually could be done. 181 00:08:56,070 --> 00:08:57,870 And then as everyone, 182 00:08:57,870 --> 00:09:01,350 or because it was big news, in January of this year, 183 00:09:01,350 --> 00:09:04,590 some researchers in Maryland actually took a heart 184 00:09:04,590 --> 00:09:08,280 from a pig and put that into a human. 185 00:09:08,280 --> 00:09:11,640 And that was actually meant to be 186 00:09:11,640 --> 00:09:13,593 a functioning heart in the human. 187 00:09:14,730 --> 00:09:18,900 And that heart actually functioned for about two months 188 00:09:18,900 --> 00:09:20,310 and then the patient died 189 00:09:20,310 --> 00:09:24,690 probably because of a pig virus infection 190 00:09:24,690 --> 00:09:25,860 that was in that heart 191 00:09:25,860 --> 00:09:27,513 that caused the heart to fail. 192 00:09:28,470 --> 00:09:31,350 Anyway, I'd been interested in this topic 193 00:09:31,350 --> 00:09:33,480 even back in college. 194 00:09:33,480 --> 00:09:36,450 Many years ago, I did a little bit of research 195 00:09:36,450 --> 00:09:40,113 in the field of xenotransplant immunology. 196 00:09:41,820 --> 00:09:44,717 And so I've kind of been following the field 197 00:09:44,717 --> 00:09:48,153 on the immunology side of it for many years. 198 00:09:49,800 --> 00:09:54,800 But when I saw, you know, I read about this in the news 199 00:09:55,140 --> 00:09:58,990 and I also read about, I read interviews 200 00:09:59,970 --> 00:10:02,970 just in the lay press of the surgeons and the scientists 201 00:10:02,970 --> 00:10:04,890 that were working on this, 202 00:10:04,890 --> 00:10:08,130 it seemed to me the ethics side of it 203 00:10:08,130 --> 00:10:09,960 wasn't really considered. 204 00:10:09,960 --> 00:10:13,410 And they weren't really, seemed to me, 205 00:10:13,410 --> 00:10:17,610 weren't really able to express 206 00:10:17,610 --> 00:10:21,660 their arguments in favor of xenotransplantation 207 00:10:21,660 --> 00:10:25,830 when it has really huge ethical implications. 208 00:10:25,830 --> 00:10:28,680 So I started reading all of this myself, 209 00:10:28,680 --> 00:10:31,230 and around that time earlier this year, 210 00:10:31,230 --> 00:10:33,840 I proposed to the American Society of Transplantation 211 00:10:33,840 --> 00:10:35,790 that we start a work group 212 00:10:35,790 --> 00:10:38,760 on ethics of xenotransplantation. 213 00:10:38,760 --> 00:10:43,050 So after that long story that I've just told you, (laughing) 214 00:10:43,050 --> 00:10:45,630 the AST, American Society of Transplantation 215 00:10:45,630 --> 00:10:47,970 did approve this work group 216 00:10:47,970 --> 00:10:52,710 and I started inviting people to join. 217 00:10:52,710 --> 00:10:57,150 This was between our Transplant Regenerative Medicine 218 00:10:57,150 --> 00:10:58,080 Community of Practice 219 00:10:58,080 --> 00:11:01,200 and there's another community of practice or committee 220 00:11:01,200 --> 00:11:03,960 that has to do with psychosocial and ethics issues. 221 00:11:03,960 --> 00:11:08,960 So both of our committees or communities of practice 222 00:11:09,390 --> 00:11:13,320 are contributing to this work group. 223 00:11:13,320 --> 00:11:15,630 - Wow, I really like that story you told us. 224 00:11:15,630 --> 00:11:17,940 You know, it's highlighting for our listeners 225 00:11:17,940 --> 00:11:21,990 the idea of to not discount our perspective 226 00:11:21,990 --> 00:11:24,270 that we're bringing to things. 227 00:11:24,270 --> 00:11:26,880 It's also encouraging us to become more involved 228 00:11:26,880 --> 00:11:30,450 in our broader healthcare community as a result 229 00:11:30,450 --> 00:11:32,854 to share our perspectives. 230 00:11:32,854 --> 00:11:35,100 (chuckles) And then you're really a, 231 00:11:35,100 --> 00:11:36,510 I guess in movie terms, 232 00:11:36,510 --> 00:11:39,840 a strong character and that you're really now able 233 00:11:39,840 --> 00:11:42,600 and in positions to really affect change, right? 234 00:11:42,600 --> 00:11:45,060 Like you proposed this work group 235 00:11:45,060 --> 00:11:48,840 that would not have existed otherwise presumably, 236 00:11:48,840 --> 00:11:51,360 and are really pulling together people 237 00:11:51,360 --> 00:11:54,810 to kind of flush out this topic 238 00:11:54,810 --> 00:11:58,503 of xenotransplantation for the next steps forward. 239 00:11:59,790 --> 00:12:00,623 - Right. 240 00:12:00,623 --> 00:12:02,820 And you know, of course a lot of people 241 00:12:02,820 --> 00:12:04,560 are interested in this now 242 00:12:04,560 --> 00:12:07,620 but the American Society of Transplantation 243 00:12:07,620 --> 00:12:12,240 really has had very little to do with xenotransplantation 244 00:12:12,240 --> 00:12:15,300 and especially ethics of xenotransplantation. 245 00:12:15,300 --> 00:12:18,720 So there are, we've gathered together 246 00:12:18,720 --> 00:12:21,903 really a broad range of people for this work group, 247 00:12:23,580 --> 00:12:26,850 people who have, philosophy professors 248 00:12:26,850 --> 00:12:29,220 and bioethicists, 249 00:12:29,220 --> 00:12:31,290 and a variety of other people, 250 00:12:31,290 --> 00:12:34,470 psychiatrists, and all kinds of people to examine 251 00:12:34,470 --> 00:12:37,860 all these issues of ethics in xenotransplantation. 252 00:12:37,860 --> 00:12:40,050 And as I got into it, 253 00:12:40,050 --> 00:12:43,290 I realized like it is much more broad 254 00:12:43,290 --> 00:12:46,290 than (chuckles) I ever imagined. 255 00:12:46,290 --> 00:12:49,410 So now I'm going back, I'm trying to study, 256 00:12:49,410 --> 00:12:51,180 like I mentioned before, I was looking 257 00:12:51,180 --> 00:12:55,650 at how are these researchers 258 00:12:55,650 --> 00:12:56,940 and transplant surgeons, 259 00:12:56,940 --> 00:12:58,950 who don't generally have a background 260 00:12:58,950 --> 00:13:02,463 in ethics or philosophy, how are they, 261 00:13:03,750 --> 00:13:07,710 what's their argument for xenotransplantation? 262 00:13:07,710 --> 00:13:11,130 So I have been reading 263 00:13:11,130 --> 00:13:13,860 about what's a valid argument 264 00:13:13,860 --> 00:13:17,130 and what are logical conclusions from premises 265 00:13:17,130 --> 00:13:20,010 and these kinds of things I've been trying to read about 266 00:13:20,010 --> 00:13:23,400 as well as ethics of animal experimentation, 267 00:13:23,400 --> 00:13:25,590 which is also really interesting, 268 00:13:25,590 --> 00:13:28,680 and I've learned so much that I didn't know before, 269 00:13:28,680 --> 00:13:31,710 but I never would've even gotten into this topic 270 00:13:31,710 --> 00:13:32,820 if it hadn't been 271 00:13:32,820 --> 00:13:35,700 for the American Society of Transplantation 272 00:13:35,700 --> 00:13:39,840 and then these working groups and committees. 273 00:13:39,840 --> 00:13:41,370 - Yeah, I'm really fascinated 274 00:13:41,370 --> 00:13:45,660 about this concept of self-learning, right? 275 00:13:45,660 --> 00:13:49,200 So a lot of times when we think about learning traditionally 276 00:13:49,200 --> 00:13:51,530 in schools and in training programs, 277 00:13:51,530 --> 00:13:55,110 there's some mentor or somebody that's giving you direction 278 00:13:55,110 --> 00:13:57,360 and feedback on here's the assignment, 279 00:13:57,360 --> 00:13:59,850 this is what you need to do next. 280 00:13:59,850 --> 00:14:01,080 You know, you're at a point 281 00:14:01,080 --> 00:14:03,600 where you're really self-assigning and exploring this. 282 00:14:03,600 --> 00:14:05,370 And so I'm kind of curious, 283 00:14:05,370 --> 00:14:08,820 could you kind of elaborate a little bit for our listeners 284 00:14:08,820 --> 00:14:12,720 about how do you go about being a lifelong learner, 285 00:14:12,720 --> 00:14:14,910 really choosing your own curriculum, 286 00:14:14,910 --> 00:14:18,600 like for example, identifying that you're going to read 287 00:14:18,600 --> 00:14:22,230 about arguments and logic 288 00:14:22,230 --> 00:14:25,290 and logical fallacies and such? 289 00:14:25,290 --> 00:14:28,080 - Well, that also, it just, you know, 290 00:14:28,080 --> 00:14:31,020 it was really just based on a hunch of mine. 291 00:14:31,020 --> 00:14:33,870 I just thought, you know, 292 00:14:33,870 --> 00:14:38,820 and what I read, for people who are so sophisticated 293 00:14:38,820 --> 00:14:41,370 in terms of their clinical practice 294 00:14:41,370 --> 00:14:44,193 or in terms of their scientific knowledge, 295 00:14:45,480 --> 00:14:48,660 their ethics arguments just didn't seem to be 296 00:14:48,660 --> 00:14:51,900 at the level of their scientific knowledge. 297 00:14:51,900 --> 00:14:56,610 And if we evaluate a paper for peer review 298 00:14:56,610 --> 00:14:58,950 that someone submits and we're a peer reviewer, 299 00:14:58,950 --> 00:15:01,140 we look through this paper and we try to see, 300 00:15:01,140 --> 00:15:05,910 well do the conclusions in the paper, are those justified 301 00:15:05,910 --> 00:15:10,440 based on their experimental results 302 00:15:10,440 --> 00:15:12,280 and what was the design of the study? 303 00:15:12,280 --> 00:15:14,640 And we have to evaluate that. 304 00:15:14,640 --> 00:15:17,190 But it seemed to me that these, 305 00:15:17,190 --> 00:15:19,740 at least as they were quoted in the lay press 306 00:15:19,740 --> 00:15:21,450 and in interviews and things, 307 00:15:21,450 --> 00:15:25,230 it seemed to me that they weren't really using 308 00:15:25,230 --> 00:15:27,420 their physicians skills, let's say, 309 00:15:27,420 --> 00:15:30,060 or their peer review skills 310 00:15:30,060 --> 00:15:31,860 when they're using those arguments. 311 00:15:31,860 --> 00:15:34,117 You know, they said things like, 312 00:15:34,117 --> 00:15:39,090 "Oh, well we humans consume pigs, 313 00:15:39,090 --> 00:15:40,650 you know, they eat pigs 314 00:15:40,650 --> 00:15:41,970 so there's no ethical issue 315 00:15:41,970 --> 00:15:45,450 with using pig organs for transplantation." 316 00:15:45,450 --> 00:15:48,900 It's really much more complicated than that. (laughing) 317 00:15:48,900 --> 00:15:50,640 That's only one small part 318 00:15:50,640 --> 00:15:54,960 of the ethical implications of xenotransplantation. 319 00:15:54,960 --> 00:15:57,570 But it seemed to me that they really were not able 320 00:15:57,570 --> 00:16:02,570 to justify a lot of these experiments, 321 00:16:02,760 --> 00:16:06,600 especially given some surveys of the public. 322 00:16:06,600 --> 00:16:10,800 The public, general public is very uncomfortable 323 00:16:10,800 --> 00:16:12,150 with, xenotransplantation 324 00:16:12,150 --> 00:16:15,150 and uncomfortable taking a pig organ 325 00:16:15,150 --> 00:16:16,740 and putting it into a human 326 00:16:16,740 --> 00:16:19,260 for a variety of different reasons. 327 00:16:19,260 --> 00:16:21,360 - You know, one of the things I'm hearing from you 328 00:16:21,360 --> 00:16:24,270 is it sounds like you have a really developed sense 329 00:16:24,270 --> 00:16:28,590 of where your expertise lies. 330 00:16:28,590 --> 00:16:31,680 That I think I've heard that physicians in particularly 331 00:16:31,680 --> 00:16:34,500 are prey because we may be expert in one thing, 332 00:16:34,500 --> 00:16:38,670 that we just kind of mistakenly broaden 333 00:16:38,670 --> 00:16:41,040 what we think we're expert in, 334 00:16:41,040 --> 00:16:43,845 and as a result we probably make poor financial decisions. 335 00:16:43,845 --> 00:16:45,090 (both laughing) 336 00:16:45,090 --> 00:16:48,180 But it sounds like you have developed a strong sense 337 00:16:48,180 --> 00:16:52,860 of this is where my area of expertise is, 338 00:16:52,860 --> 00:16:54,780 this is what I'm interested in, 339 00:16:54,780 --> 00:16:58,350 and so in order to approach that, 340 00:16:58,350 --> 00:17:01,390 I need to do some work and development. 341 00:17:01,390 --> 00:17:03,240 Is that fair to say? 342 00:17:03,240 --> 00:17:07,590 And if so, how have you developed this honesty 343 00:17:07,590 --> 00:17:08,733 about where you are? 344 00:17:10,140 --> 00:17:13,530 - Maybe my honesty is that I realize 345 00:17:13,530 --> 00:17:17,580 how much I don't know. (laughing) 346 00:17:17,580 --> 00:17:20,430 You know, maybe also it's being 347 00:17:20,430 --> 00:17:22,470 in a really subspecialized field. 348 00:17:22,470 --> 00:17:26,790 I'm a medical kidney pathologist, 349 00:17:26,790 --> 00:17:30,120 so I realize that there is so much in pathology 350 00:17:30,120 --> 00:17:32,760 that I don't know about and so much in medicine, 351 00:17:32,760 --> 00:17:37,671 and then also consequently so much outside of medicine 352 00:17:37,671 --> 00:17:39,540 (chuckles) that I don't know 353 00:17:39,540 --> 00:17:41,880 when you are really specialized in one field. 354 00:17:41,880 --> 00:17:44,970 So I'm trying to learn about those other things. 355 00:17:44,970 --> 00:17:49,200 I think in people who go into medicine 356 00:17:49,200 --> 00:17:50,910 are really interested in learning 357 00:17:50,910 --> 00:17:53,610 and there's always something new to learn 358 00:17:53,610 --> 00:17:55,053 within your field. 359 00:17:56,400 --> 00:17:59,100 Now if I go to a kidney meeting 360 00:17:59,100 --> 00:18:00,450 or a transplant meeting 361 00:18:00,450 --> 00:18:03,090 or I'm watching some meeting online, 362 00:18:03,090 --> 00:18:06,330 at this point in my career when I hear people talk 363 00:18:06,330 --> 00:18:09,390 about something, you know, it's always interesting, 364 00:18:09,390 --> 00:18:12,360 but when it's actually in my field 365 00:18:12,360 --> 00:18:14,310 that I practice every day, 366 00:18:14,310 --> 00:18:18,900 there isn't that much that's new in my actual practice. 367 00:18:18,900 --> 00:18:22,950 So you learn so much more when you try to learn something 368 00:18:22,950 --> 00:18:24,510 that you don't know anything about. 369 00:18:24,510 --> 00:18:27,030 So if you go to a kidney meeting and you go, 370 00:18:27,030 --> 00:18:30,450 just, I don't know, something that's still related 371 00:18:30,450 --> 00:18:33,750 to the kidney but completely outside of your narrow field, 372 00:18:33,750 --> 00:18:36,630 you learn so much more than if you go to the lectures 373 00:18:36,630 --> 00:18:38,850 that are just about what you already know about. 374 00:18:38,850 --> 00:18:41,130 So that's one thing I wanted to say. 375 00:18:41,130 --> 00:18:42,870 - So are there- - It's fun to learn 376 00:18:42,870 --> 00:18:44,340 new things like that. 377 00:18:44,340 --> 00:18:46,650 - Yeah, and so are there a couple of things that are, 378 00:18:46,650 --> 00:18:49,740 what are a couple of the interests that you have developed 379 00:18:49,740 --> 00:18:53,250 kind of in your practice and life? 380 00:18:53,250 --> 00:18:55,170 - I'd like to move to something 381 00:18:55,170 --> 00:18:56,790 a little bit outside of medicine. 382 00:18:56,790 --> 00:18:58,650 And another thing I've been working on 383 00:18:58,650 --> 00:19:02,310 for the past year and a half or so 384 00:19:02,310 --> 00:19:05,700 is that we formed a local environmental group 385 00:19:05,700 --> 00:19:08,163 here in Rochester, Minnesota. 386 00:19:09,450 --> 00:19:12,150 About a year and a half ago, 387 00:19:12,150 --> 00:19:15,330 some neighbors had realized 388 00:19:15,330 --> 00:19:20,250 that there was a proposed housing development 389 00:19:20,250 --> 00:19:23,580 on a site of about 130 acres 390 00:19:23,580 --> 00:19:26,940 of mature forest that included 391 00:19:26,940 --> 00:19:29,910 a great blue heron nesting site, 392 00:19:29,910 --> 00:19:31,410 also known as a rookery. 393 00:19:31,410 --> 00:19:35,610 So you may know people who follow me on Instagram 394 00:19:35,610 --> 00:19:38,610 or something and may know that I'm a fan of birds 395 00:19:38,610 --> 00:19:41,100 and I'm very amateur bird watcher 396 00:19:41,100 --> 00:19:43,650 but I do like watching birds. 397 00:19:43,650 --> 00:19:44,970 So of course this had to do 398 00:19:44,970 --> 00:19:48,210 with a great blue heron nesting site. 399 00:19:48,210 --> 00:19:52,050 And it was at that time really the only one known 400 00:19:52,050 --> 00:19:53,716 in our county that supported 401 00:19:53,716 --> 00:19:58,560 the entire great blue heron population in our area. 402 00:19:58,560 --> 00:20:02,640 So we ended up, there was a grassroots, 403 00:20:02,640 --> 00:20:07,530 really truly grassroots development 404 00:20:07,530 --> 00:20:11,010 of this what's now called Save the Rookery. 405 00:20:11,010 --> 00:20:15,240 We ended up incorporating as a non-profit, 406 00:20:15,240 --> 00:20:17,580 and I serve as the board president 407 00:20:17,580 --> 00:20:20,370 for the non-profit Save the Rookery. 408 00:20:20,370 --> 00:20:25,260 But we work to promote awareness 409 00:20:25,260 --> 00:20:28,350 of this threatened great blue heron rookery, 410 00:20:28,350 --> 00:20:30,603 and we're working to try to preserve it. 411 00:20:31,740 --> 00:20:36,210 I learned a lot about the local government processes, 412 00:20:36,210 --> 00:20:38,013 how local government works, 413 00:20:38,970 --> 00:20:41,970 what's the land development, 414 00:20:41,970 --> 00:20:46,740 you know, development process 415 00:20:46,740 --> 00:20:49,140 for different, for land use, 416 00:20:49,140 --> 00:20:50,730 the different steps that are involved. 417 00:20:50,730 --> 00:20:52,950 It's a very complicated process that goes 418 00:20:52,950 --> 00:20:56,760 between both the town where this is happening 419 00:20:56,760 --> 00:20:59,010 and the county level. 420 00:20:59,010 --> 00:21:01,530 - [Justin] Wow. - So we, with this project, 421 00:21:01,530 --> 00:21:05,190 we ended up consulting with experts, 422 00:21:05,190 --> 00:21:08,460 identifying experts from around the state 423 00:21:08,460 --> 00:21:12,090 to submit testimony about the importance of this site, 424 00:21:12,090 --> 00:21:13,590 both for the great blue herons 425 00:21:13,590 --> 00:21:16,980 as well as other reasons 426 00:21:16,980 --> 00:21:20,790 that this is one of the few remaining contiguous forests 427 00:21:20,790 --> 00:21:23,943 in the area and there are reasons to preserve that. 428 00:21:24,960 --> 00:21:28,110 We also, we called ourselves the Rookies 429 00:21:28,110 --> 00:21:30,000 because we really didn't know what we were doing 430 00:21:30,000 --> 00:21:32,490 and we were just learning it. (laughing) 431 00:21:32,490 --> 00:21:34,890 And then there was actually 432 00:21:34,890 --> 00:21:38,940 a few high school youth groups that got involved 433 00:21:38,940 --> 00:21:41,730 and they called themselves the Youth Rookies. 434 00:21:41,730 --> 00:21:43,983 And it's been really encouraging 435 00:21:43,983 --> 00:21:48,983 to work with these young people 436 00:21:49,020 --> 00:21:49,853 in high school. 437 00:21:49,853 --> 00:21:52,770 It's been really refreshing to work with them. 438 00:21:52,770 --> 00:21:56,250 And it's been a real bright point in this project 439 00:21:56,250 --> 00:21:59,724 to realize how engaged young people are 440 00:21:59,724 --> 00:22:04,440 in the future and in environmental causes like this. 441 00:22:04,440 --> 00:22:05,580 - Wow, that's awesome. 442 00:22:05,580 --> 00:22:09,060 This really thread of a efficacy 443 00:22:09,060 --> 00:22:13,260 I really hear in your stories that you're sharing 444 00:22:13,260 --> 00:22:17,520 and how your experiences as a pathologist 445 00:22:17,520 --> 00:22:19,680 has set you up to kind of look at things 446 00:22:19,680 --> 00:22:22,320 in perhaps a slightly different way. 447 00:22:22,320 --> 00:22:25,530 And how not only can we kind of make effects 448 00:22:25,530 --> 00:22:29,670 in our communities and in our professional environments, 449 00:22:29,670 --> 00:22:33,107 but also this concept of mentorship, right, 450 00:22:33,107 --> 00:22:34,980 of the younger group 451 00:22:34,980 --> 00:22:39,980 of what is it like to learn up, 452 00:22:40,050 --> 00:22:42,690 you know, how are things done in local government? 453 00:22:42,690 --> 00:22:46,170 How can we affect changes in our communities? 454 00:22:46,170 --> 00:22:48,150 This is really fascinating. 455 00:22:48,150 --> 00:22:52,770 I'm curious, so this has been a lot of really big projects 456 00:22:52,770 --> 00:22:53,670 you've been sharing with us. 457 00:22:53,670 --> 00:22:56,193 What's your next project, Dr. Cornell? 458 00:22:57,120 --> 00:23:00,780 - To be honest, my next project is finishing up 459 00:23:00,780 --> 00:23:03,236 all the previous projects that I've started. 460 00:23:03,236 --> 00:23:04,740 (both laughing) 461 00:23:04,740 --> 00:23:08,040 It's so easy to be excited about the next new thing 462 00:23:08,040 --> 00:23:08,940 that you want to work on, 463 00:23:08,940 --> 00:23:10,980 but it's really important 464 00:23:10,980 --> 00:23:15,450 to finish your previous projects. 465 00:23:15,450 --> 00:23:17,550 And here at Mayo, we have 466 00:23:17,550 --> 00:23:20,130 a renal pathology fellowship program 467 00:23:20,130 --> 00:23:23,850 and we have residents who are doing projects 468 00:23:23,850 --> 00:23:25,800 in renal pathology. 469 00:23:25,800 --> 00:23:30,120 So of course we have all these projects with the trainees 470 00:23:30,120 --> 00:23:33,990 and especially important for them I think to follow up 471 00:23:33,990 --> 00:23:34,950 on those projects. 472 00:23:34,950 --> 00:23:37,803 So I'm working on finishing up those projects 473 00:23:37,803 --> 00:23:39,036 with the trainees. 474 00:23:39,036 --> 00:23:40,680 - (chuckles) Brilliant. 475 00:23:40,680 --> 00:23:42,540 We've been rounding with Dr. Cornell. 476 00:23:42,540 --> 00:23:44,220 Thank you for taking the time to talk 477 00:23:44,220 --> 00:23:45,810 about lifelong learning with us, 478 00:23:45,810 --> 00:23:49,740 not just sharing with us your enthusiasm and experience, 479 00:23:49,740 --> 00:23:54,090 identifying how we can all be better lifelong learners, 480 00:23:54,090 --> 00:23:56,820 but also the importance of being finishers 481 00:23:56,820 --> 00:23:58,473 in these projects as well. 482 00:23:59,580 --> 00:24:01,197 - Thank you so much. (lively music) 483 00:24:01,197 --> 00:24:02,460 - And to all of our listeners, 484 00:24:02,460 --> 00:24:03,990 thank you for joining us today. 485 00:24:03,990 --> 00:24:04,830 We invite you to share 486 00:24:04,830 --> 00:24:07,140 your thoughts and suggestions via email. 487 00:24:07,140 --> 00:24:08,760 Please direct any suggestions 488 00:24:08,760 --> 00:24:12,390 to mcleducation@mayo.edu 489 00:24:12,390 --> 00:24:14,160 and reference this podcast. 490 00:24:14,160 --> 00:24:14,993 If you've enjoyed 491 00:24:14,993 --> 00:24:18,180 Lab Medicine Rounds podcast, please subscribe. 492 00:24:18,180 --> 00:24:19,860 And until our next rounds together, 493 00:24:19,860 --> 00:24:22,980 we encourage you to continue to connect lab medicine 494 00:24:22,980 --> 00:24:26,793 and the clinical practice through insightful conversations.