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A Mayo Clinic podcast for laboratory professionals, physicians, and students, hosted by Justin Kreuter, M.D., assistant professor of laboratory medicine and pathology at Mayo Clinic, featuring educational topics and insightful takeaways to apply in your practice.
(pensive music)
- This is "Lab Medicine Rounds,"
a curated podcast for physicians,
the laboratory
professionals, and students.
I'm your host, Justin Kreuter,
a transfusion medicine pathologist
and assistant professor of
laboratory medicine and pathology
at Mayo Clinic.
Today, we're rounding with
a true pioneer in his field.
He's a professor of neurosurgery,
division chair of neurosurgery
at Mayo Clinic's Jacksonville Campus,
Dr. Alfredo Quinones-Hinojosa.
Dr. Q, as he's known by all
of his students and mentees,
his journey is nothing
short of extraordinary,
from humble beginnings as a migrant worker
to becoming a renowned
neurosurgeon and scientist.
His story is really one of
resilience, determination,
and, of course, a relentless
pursuit of knowledge.
Throughout his career,
he has not only made
groundbreaking contributions
to neuroscience,
but has also inspired
countless individuals
with his compelling narrative.
And I really appreciate you
for joining us today, Dr. Q.
I think our audience is
excited to hear from you.
- Well, my dear Dr. Kreuter,
thank you, my dear Justin,
for allowing me to be here
with you, with your audience,
and hopefully for allowing
me to share some experiences,
and anecdotes, and ways of thinking.
And thank you for that kind introduction.
I don't deserve it.
I remind everybody that
behind people like myself,
there are hundreds, if not
thousands, of unsung heroes
that allows us to do what we do every day
and allows us to care for
patients in advanced science.
And it is a great honor and a privilege,
so I thank you for that kind introduction.
- That's why we're talking with you
is to tap into these insights
and your mentorship for our audience.
Let's kick off with:
What are your thoughts?
I always like to kind of
start with a why question,
and why should listeners invest their time
listening to our conversation today.
Why do you think it's
important for physicians
to play a role in science?
- Well, Justin, I think often about this.
I think that as physicians, as scientists,
as physician scientists,
as clinician scientists,
we are perfectly positioned
because we see human disease
from a different perspective.
We are right there with the patient.
Many times with other
clinicians, with nurses,
doesn't matter in which
discipline you are,
you are somehow either directly
interacting with the patient
or only one or two degrees of
separation with the patient,
and that puts us in an
amazing position already.
Our clinical insight and
our firsthand experience
is second to none.
I would say also that we
are perfectly positioned
to implement not only
new preventive measures
depending on the discipline
for diseases that we care for,
but also we can detect them early on.
Anything that threatens human health,
whether it is one case
or millions of cases,
and of course we're constantly thinking
not only of the patient and the disease,
but also we are thinking:
How can we treat them better?
So we have that connection to the patient
that allows us to
communicate well with them,
and many times we have the ability also
to relay that information
back to the public.
And many times also, across
many other disciplines,
that allows us to be good communicators,
and of course, continue to
move the patient forward.
And I think ultimately, what
makes us really, really special
is the fact that we can
lead multidisciplinary teams
where we get to interact
with basic scientists,
clinicians, clinician scientists, nurses,
but most importantly,
we get to bring the patient
as part of that team as well.
And then we can pivot
and figure out how to make our patients
part of a scientific team,
so we can then, together,
find cures for their diseases
in ways that makes sense to them as well.
So for all these reasons,
I think ultimately, we
can determine policy
and be great advocates for our patients.
- Wow, I really love that answer.
It really, I think,
has hooked all of our different audiences
that we're connecting with.
'Cause I love how you start
with the idea of position, right?
So to not only know what is important,
but as you're saying,
important to the patient.
And I like that your answer also
is opening us up to understand:
What are the ways
that we can actually have
that effect on patients?
And that you're also talking about
with prevention specifically,
it's not only the patient in front of us,
but your answer,
you're talking about
highlighting the importance
of connecting with the public.
I think that's a fascinating thing
that probably every one of our listeners
can really kind of key into.
So I'm curious about:
How did you get started
earlier in your career?
I've seen interviews with you before,
and I know that there is
a lot of work and effort,
and certainly not to shortcut anything,
but how did you set up kind
of early in your career,
kind of set yourself up for success?
- Beautiful question, Justin.
I would say that we are
all born scientists.
Our minds are inquisitive.
Since the moment that we are born,
we're trying to bring things to our mouth,
experience with our hands,
trying to get all that information.
Somewhere along the line,
some of us get encouraged
to do a little bit more
science than others.
And some of us get exposed
to the scientific method,
maybe early in our careers
or later in our careers.
But I would like to believe
that we're all scientists at
heart and we're born as such.
But how do you do it
in such a way that is a
little bit more methodical,
in a way that will assure
that you run laboratories,
like the one that we run,
which is federally funded
with tons of grants,
and innovation, and patents,
and leading up to companies
and things like that?
I would say that the first thing
that you have to continue to develop.
Whether it's early in your
life or late in your life,
doesn't matter.
Whenever you sense that there's
something that you wanna do,
you have to continue to
develop an inquisitive mind.
And I would say that
since I was a little boy,
I continued to develop
that inquisitive mind.
By the time I was at UC Berkeley,
what I think I realized is I
needed to join a laboratory
where I was going to learn the basics.
And I gotta tell you,
the first lab that I joined
after leaving the farms,
working as a farm labor
as part of my background,
I joined a community college
and then I went to UC Berkeley,
and I joined a lab that
allowed me to clean dishes.
I always tell people, "You gotta start...
You gotta understand the
nuances of a laboratory,
how it's run.
So that way, when you given
an opportunity to do science,
you can take care of those resources
and exploit those resources even better."
So the next thing that I did
is I found a great mentor,
and a great mentor
doesn't have to be a
great mentor all the time.
He can also cross the line
between a mentor and a tormentor.
And I got to learn a lot from that mentor,
as I found that person who challenged me.
I joined the scientific
team that was open.
He was open to hear from me
labs that allow you to
hear from anybody else
without distinction based
on rank or experience,
but a team that allows you
and treats you like every
member is an incubator.
Every member is a source of
information, of new ideas.
That is the place that I wanted to be,
and I was lucky enough to find that place.
And of course, in science, just
like many other disciplines,
you cannot give up because sometimes,
you gonna do an experiment.
And you're not gonna find an answer.
Or sometimes, you're gonna find
the complete opposite answer
of what you were expecting to find.
And you have to have that kind of mind
that is imaginative and creative
in such a way that when
that moment arises,
it may actually lead to
new discoveries, new ideas,
and new ways of looking
at a scientific answer
that no one else has seen before.
And I would say that those
are the kind of things
that ultimately lead you to
never stop asking questions.
And many times, it is okay
to doubt your own answers
because that leads to
much more precise science
and eventually much better answers
and much better therapies
for our patients.
- Wow, I really appreciate this kind of...
In your answer,
I'm thinking about the
interprofessional nature
of our practice.
The way you're talking
about starting off cleaning
the dishware in the laboratory
as a way to really kind of understand
how that process is done.
And as you work your way up,
you really have a better
understanding how to work
with different colleagues.
That's certainly kind of a microcosm
of clinical medicine these days.
I'm curious, when you talk
about an inquisitive mind,
I'm really kind of curious
to kind of dive into a
little bit for our listeners,
what does that look like for you?
And the reason why I ask this
is because I think for a lot of people,
when they hear that, it resonates.
But to somebody, how do I kind
of develop these practices?
Or what is the habit?
What does that look like for you?
I've kind of heard maybe other people,
maybe that's habits in your personal life,
maybe that's habits with
your research meeting,
but just to kind of give the audience
a little bit of a flavor
for what does that look like for you?
- It's very simple for me, Justin.
I read a lot, I write a lot.
My papers, I always tell people
that by the time I publish a paper,
I probably have gone over 100
different drafts and versions.
I read something, I let
it percolate in my mind,
I let my neurons activate new synapses.
I look at a figure, I dream about it,
I think about it on the weekends
when I am with my family,
I comment, I talk to my fellows,
I allow them to challenge me.
And ultimately, of course, we
have our formal lab meetings,
but we also have a lot
of informal lab meetings,
and the lab meetings
are broken down in different
parts of the lab meetings
where we present the paper,
where we present data, where
we talk about troubleshooting,
and all that creates a chaos
in your brain, in your mind.
'Cause imagine this.
Our brains have over 100 billion neurons.
And right now, I mean,
your brain is over 160 to 600
trillion synapses ongoing.
More synapses going on
in our brains right now
than there are stars in the
Milky Way in our galaxy.
So when you have that kind of chaos,
but in a way that is organized,
in a way that it makes sense for you,
because everybody's a
little bit different,
some people like to wake
up in the morning and read,
some people like to do it at night,
find what is good for you.
What I found for myself
is I am the most creative
early in the morning
when I have my feet up on the table,
when I'm just daydreaming
and thinking about it,
having a cup of coffee,
or when I go for a run
with my fellows, or my lab,
or my colleagues,
and we get to talk about
something that new idea is for.
That's how I sort of structured myself.
- Wow.
I need to join your lab
so I get better about my running habit.
(Justin and Dr. Q laughing)
Something that kind of your
answer there reminds me of,
I remember talking to a colleague
that made a major discovery recently,
and it was one of these things,
when you look back at it,
it kind of was staring in the face, right?
But he was the one that
asked the question.
I remember asking him:
How is he able to recognize this thing
that's right in front
of everybody's faces?
And he kind of answered is like,
it's kind of like they're like
a high-end luxury watchmaker
was his answer to me,
was it's not doing anything
that other people aren't
necessarily doing,
but it is that methodical focus.
and that's what I'm hearing
in your answer, right,
is it's being deliberate about things.
And also, I kind of hear the beauty
of the informal lab meeting
as a way to kind of deepen our curiosity.
- 100%, I always tell people
that every single lab member in my lab
is much smarter than
I am in their subject.
They know a lot more than
I know in their subject.
What I do know
is that I know a little bit
about forming connections.
I hear someone presenting this data,
and I know someone else
has this data in my lab,
and I try to make sure
that I connect the dots,
and then I say, "Why don't we
meet and we talk about this?"
And that's how new ideas are born.
More than anything, my role,
I serve as a matchmaker
more than anything.
So instead of a watchmaker,
I'm a matchmaker.
(Justin and Dr. Q laughing)
- So this is a perfect segue,
and I really wanna explore,
and this is why I really asked
you for this podcast, is:
How do you mentor younger
physician scientists, right?
And this is something I think
that our audience, by large,
can really key into
because we have a number
of physicians in practice
that are maybe early in their career
setting up a laboratory,
trying to figure out
how can they mentor new
trainees authentically.
And of course, we have trainees
and students that are
looking for laboratories
and are trying to figure out
how to navigate that process.
So from your standpoint,
how do you mentor younger
physician scientists?
- Well, this is what I think, Justin.
So from my sense of view,
the first thing that you have to do
is you gotta give them the resources.
You gotta empower them
to change the world.
So how do you give them the resources?
As a PI, as a lead,
you have to get grants,
you have to convince philanthropy,
you have to convince the
government, the foundations,
to give you money.
So you have to come up with some ideas
to establish a laboratory,
to make sure that you have
monies to run a laboratory,
whether it's a startup
package from an institution
or a grant or two grants.
So that's the first thing.
So that's your duty is,
"I have to figure out
how to convince my peers,
my other scientists,
to also give us resources for our lab,
because that will give them the resources
that would allow them to grow."
And you have to allow them
to do experiments and fail.
And many times, as you empower
them to change the world,
you have to listen to them.
You have to challenge
them when appropriate
and support them above all else,
even when you think they may be wrong.
Why is that?
Because at the end of the day,
it's what is called the scientific method.
As long as they have a rationale,
how they gonna test the hypothesis
that it makes sense to you as well,
then you have to let them experiment.
It may be that you as a mentor are wrong.
So you always have to keep
that open mind overall.
And I would say that as
you are supporting them
and they have this very
rigorous scientific rationale,
you will continue to also grow as a mentor
and as a scientist.
So you have to allow them
to be part of your DNA.
They're almost become those proteins
that allow you to shift your DNA
and produce different ideas.
And I would say that that's
one of the secrets as a mentor
that people don't realize,
or we don't talk too much about it.
The way that you stay young and active
is you surround yourself by younger people
who are also much brighter than you,
and they keep you sharp.
- They also keep the running pace up,
I imagine.
- [Dr. Q] That's true.
(Justin laughing)
- So I'm really fascinated,
I'm really glad you brought up the idea
of that it's okay to fail, right?
The key thing is that you
have a reason and a rationale,
and you're really talking,
at least in your answer,
I hear you're really coaching somebody
to be strong in their thought process.
And I'm curious about:
Do you have thoughts on how to
mentor somebody through that,
maybe their first failure?
As we know, you might have
somebody that's working with you,
they're just getting into this,
you're probably something
of a minor deity to them
in this lab
and they want to come out
with amazing, gorgeous data.
Maybe they saw the postdoc
come out with amazing stuff
and they want to do that,
but then that research failed.
How do you mentor them through that
and how do you help them
achieve that perspective
that this is what science is?
- Beautiful.
You just reminded me my own experience
with one of my early mentors
when I was in medical school.
Ed Kravitz, he is an amazing...
He discovered GABA,
he's a full professor at
Harvard Medical School.
So as a matter of fact,
he still holds being the
most senior faculty member
at any institution
that still has federal
funding from the government.
Now, it reminds me of a quote
that he gave me from Winston Churchill
that said that success is
going from failure to failure
without the loss of enthusiasm.
And you could brought
me back to an experience
where I thought that I had
already discovered a gene
that was manipulating aggressive behavior
in Drosophila melanogaster back in 1994
when I was first young in the
laboratory, in his laboratory.
And I was so excited.
Exactly what you said,
all the book stocks were
producing amazing data.
So I come to him to show him this.
He looked at it carefully,
he had a very kind and gentle voice,
and then made a few adjustments.
He goes, "This is a great start,
I'm so proud of you," he said to me,
"because you're clearly
thinking the right way.
Your interpretation of
the data is incorrect
and you are wrong, but you
are in a great trajectory.
Keep going, and eventually
you will make that discovery."
So he gave me the positive
feedback that I needed
at the same time as my world
was collapsing in front of me.
So I always say that as, and
eventually he's sensitive,
and that's when he gave me
that quote from Winston Churchill,
the success and about failure.
And I have to admit it,
that it's played in my own
life with my own mentees,
is it served me well throughout the years.
- I'm curious about that as
you see your mentees go on,
is there a way
that you're able to kind
of keep in touch with them?
I imagine that just like you're saying,
the gene that you were involved in
probably is from a different
clinical discipline
and maybe you don't interact with them.
How do you keep in touch with your mentees
as they go on in life?
- Beautiful, I always tell them
that they're always connected to me.
Many of them ended up
going into the neuroscience
and some ended up going into radiologist.
Someone goes into industry.
My latest graduate student, she's amazing.
Rawan Al-Kharboosh,
she was a graduate student
here with us at Mayo.
She's now started a company
in Washington, D.C.,
and my role with them is always I am here.
Anytime that you wanna
call about anything,
life, professional,
science, doesn't matter.
I'm here for you.
Of course, I always try
to be thorough with them
and making sure that we finish
our papers or manuscripts,
the things that we needed to do.
But overall,
I think that I touched base
with them from time to time,
try to send them,
they're all in my speed
dial, and my phone,
and my texts, and my WhatsApp.
Doesn't matter where
they are in the world.
I think it is our role as
mentors-slash-tormentors
to continue to make sure
that they know that we are here for them.
And I would say that especially
when things are failing
or not going well,
that's when they need us the most.
And we also need them.
Many times, I go back to them and I say,
"What do you think about this idea?"
That's how I've done it.
I don't have a better way of doing it,
but that's been my modus
operandi for decades.
And I gotta tell you, I'm proud of them.
I'm proud, very proud of all of them
and the things that they're doing
in all different disciplines.
I'm also not in the...
I'm not one of those people
that I believe everybody needs
to be a physician scientist,
or everybody needs to be a neurosurgeon,
or everybody needs to be whatever.
But I am in the philosophy that I am...
My role as a mentor is to
help them find happiness
in whatever field they go to.
- That's wonderful.
I think that's something
that I need to take away.
I'm often trying to...
As I'm kind of known in my area
for trying to share my enthusiasm
and get people to go into
transfusion medicine.
And I think as you highlight, of course,
my wishes for them to find
what makes them happy.
And I really appreciate
how you really kind of set
that sense of home, right?
"I am here," and that's
a wonderful touch point.
Well, I'm really...
I wanna close out our conversation today
by really looking forward into the future.
I think your answers,
the conversation so far,
I think that our audience can
probably feel your enthusiasm.
So what are you most excited for in 2024?
- Well, we have embarked, as you know,
at the Mayo Clinic in the next frontier.
Ball forward, we're
excited about the future.
We continue to invest in
people, space, and technology.
One of these that just
crosses all these disciplines
is the use of artificial
intelligence and machine learning.
We just went through the
process of recruiting Dr. Tao,
Swee Tao, who is coming from Texas
to lead artificial intelligence
research from our site.
As you know, I'm the dean of research here
at the Mayo Clinic in Florida.
I would say the things, the future,
the use of artificial
intelligence, machine learning,
and discovering and using the technology
to allow us to better
discover new therapies,
new ways of treating
cancer, which is my field.
I get excited about it,
but I gotta tell you, also,
the world is evolving.
The latest set of grants
that I put together,
we have really gone out of our way
and engaging the patients
not just as support,
but engaging them in the
conceptualization of science
and the experiments that we are doing
and the therapies that
we're trying to find.
All the way from artificial intelligence
to implantables in the
brain and asking them,
"Does this make sense to you?
Are we communicating our science?"
And I think that that
engagement with our patients,
it really reenergized me.
And I can sense that the world,
the future grants from
the federal government
are going to incorporate
the patient experience
and knowledge much better.
And I'm excited about this in 2024.
- Wow. Awesome way to finish.
Amazing advice.
Closing the loop, really, with Dr. Q
and how to keep that motivation up
through science and research.
We've been rounding with Dr. Q.
Thank you so much for joining us today.
- Well, thank you Justin.
Thanks everybody for
listening to this nonsense,
and I'm really appreciative
and very honored and
humbled by all of you.
- It's wonderful, from
another bow tie wear.
So the next time we have you on Dr. Q,
we'll both be on our bow ties.
- Promise.
(Dr. Q laughs)
- To all of our listeners,
thank you for joining us today.
We invite you to share your thoughts
and suggestions via email
to mcleducation@mayo.edu.
If you've enjoyed this
podcast, please subscribe.
Until our next rounds together,
we encourage you to continue
to connect "Lab Medicine"
in the clinical practice through
educational conversations.
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