Dr. Allison Eddy is a clinician scientist at BC Children's Hospital.
I closed my lab about three years ago after 33 years of conducting research on chronic kidney disease, with a focus on the cellular and molecular mechanisms of kidney fibrosis. I originally intended to be a general pediatrician, but my intellectual curiosity, desire to tackle complex problems, and interest in developing new treatments led to a career that included academic research. It actually took me a long time to decide this and nine years after medical school before I started my first "real job" as a member of the faculty!
I received my medical training in the late 1970s, back when research almost exclusively meant going into the lab and doing experiments. Clinical research or patient-oriented research wasn't really an option then. The head of pediatrics and the head of the kidney program at McGill University were my mentors at the time, and they really encouraged me to take the research route. I was so inspired by their intelligence and their body of work that I finally made the commitment to pursue an academic career. But how I ended up researching kidneys was complete serendipity.
Changing the way we understand kidney disease
I had the opportunity to look at tissues from a certain type of kidney disease and it turned out that there was a type of inflammation occurring that no one knew about yet. From that moment on, my career for the next three decades was focused on trying to understand why injured kidneys are inflamed and how they become inflamed. My research led to the realization that inflammation is not only involved in acute or reversible kidney injury, but plays an important role in the lead-up to long-term, permanent damage to the kidney. I was one of the pioneers to make the connection between inflammation and kidney scarring.
The inflammatory process itself was a real eye-opener. It turns out that any solid organ, not just the kidney, has a shared pathway of tissue destruction. The site of injury tries to repair itself through a process that's meant to be a good thing, but, when allowed to continue, results in permanent damage. The medical term is "fibrosis," which is another word for "scar," and it means that these organs heal by destroying the normal tissue and replacing it with scar tissue. It's like when you have surgery and you have a big scar afterwards — it's a good thing that you have this scar, but if you have too much scarring it can compromise other processes. The really interesting part is thinking about the triggers — what's making this happen and could we intervene with drugs or treatments to get a better outcome.
In the field of fibrosis, I was responsible for some of the early studies that made connections between too much protein in the urine and kidney inflammation, and between inflammation in the space surrounding kidney tubules and scarring. These findings helped to inform past and ongoing studies to find better treatments for chronic kidney disease. (continued below)
Getting more mileage out of kidneys
Nowadays, we know that over 10 per cent of adults have chronic kidney disease. If these patients live long enough, they will all end up needing a kidney transplant. My goal has always been to try to find new ways to treat kidney disease so we can get more mileage out of kidneys. This led to all kinds of new hypotheses that we tested, novel drug candidates, new collaborations, and new opportunities to work with and train interesting people. It's been a really rewarding field to be in.
By definition, if a kidney gets to less than 60 per cent of normal function it's considered chronically damaged. However, that number is a bit arbitrary, because the normal process of aging causes organs like the kidney to scar and begin to lose function. If you were to live to the age of 200 and all the rest of your body were perfect, your kidney would still become a scar. It's just a natural aging process. The important thing is to take care of your kidneys through healthy living — balanced diet, adequate exercise, and so on. In adults, the number one cause of kidney disease is diabetes.
The importance of your work-life balance "recipe"
The question about work-life balance is important for everyone these days. I have several pieces of advice related to this topic, but number one: You cannot do it all. You need to decide what you want to do in your personal life as well as in your professional life, and then decide what you are willing to farm out. You have to be prepared to pay for help at home, for example. I am a grandmother now and I had my son fairly late in life. We had a marvelous nanny who lived with us five days a week. From my perspective, it's about the quality of time with your family and not the quantity of time, and my son and I have an amazing relationship.
That said, the work-life balance "recipe" will be different for each person. When I did pediatric nephrology subspecialty training in the US in the early 1980s, some of my peers decided that they wanted to be educators or clinicians and not include research in the mix, and they were made to feel like failures. This is an unfortunate response, because we all contribute to the world and have important pieces to bring to it. Contributing your best efforts while fulfilling your dreams and passions is what really can make a difference.
You should be allowed to make these life and career decisions when they're right for you and not feel that you've failed yourself or others around you. I've recently had this discussion with an early career faculty member. He loved what he was doing clinically, but it was a pain in the neck for him to worry about getting back to the lab and plan experiments and write grants. I told him, "You don't need to please anybody but yourself at this point. Is being a scientist really what you want to do?" That question helped him decide to change his career pathway and he is much happier now.
Knowing yourself is really important in establishing a sustainable balance for yourself. You've got to love what you do. Your career is not just a job. It's a hobby, it's a passion, and if you don't get joy out of what you do, you're in the wrong field.
The best rewards from being a clinician scientist
I'm a clinician scientist, so I've looked after patients and led clinical programs all my life and I love it all so much. Every day as a clinician you go home feeling like you've helped someone, whereas in science a lot of time can go by between those great feelings. All too often things don't work out, you don't get funded, or your paper gets rejected. But I think when you are successful in science, the highs are so incredible because you've worked so incredibly hard. If you're a competitive person, if you like to work towards certain goals, then science has a lot of rewards. It's certainly not easy, but the wonderful things in life never are.