Consequences

Photo by Valentin Antonucci from Pexels

All told, I was in school or training for 27 years of my life to become a neurologist and a researcher. The most important lessons never came during formal lectures. They came when a patient thanked me for being straight with them, or a family member trusted me with an important secret. They came when I left the hospital furious at how rude, arrogant or careless someone could be on a regular basis and still call themselves a doctor. Sometimes important truths came from the in-between moments—times when a paper or a grant got rejected, a patient died unexpectedly, or the sadness of neurologic illness caught up with me—and one of my friends or mentors would offer me words of kindness.

In my 27th year of training, my last year of research fellowship, I was working on a grant for the National Institutes of Health (NIH) that I thought would be my ticket to academic stardom. The dream of every research fellow is to get an NIH K-award, a five-year grant that magically transforms them from a trainee into an independent investigator. I worked for a good six months on this grant, every day. The week prior to its submission, I stayed at work every evening until 8:00 and then, just before it was due, stayed up 36 hours straight to go over it, line by line, to make sure everything was perfect.

I believe this grant was one of the last to be submitted by mail. I recall going to a print shop and having a dozen copies of this 100-page proposal shipped overnight with insurance. I was ecstatic when they were received by the NIH and celebrated my first weekend in a while with my wife at the time. I had never worked so hard on a single project, nor been so confident of my success. It was a masterpiece.

Six months later, after the grant was reviewed, I logged into the new online system and could not find a score. “ND” was my score, “not discussed.” My stomach dropped. This meant that grant reviewers ranked it in the bottom half of grants submitted and not worthy of further discussion. I called my program officer at the NIH, thinking there must have been some kind of mistake. There was no mistake. It would not be funded.

I quickly moved from shock to anger. I berated the anonymous reviewers for not understanding my ideas, for stifling creativity in the sciences, for not understanding that I was not as inexperienced and unfocused as my publication record led them to believe. Beneath this anger though was a real fear that I was not cut out for the world of research. I hesitantly sent out an email to my mentors to let them know the bad news and see what the next steps should be. I felt like I let them down.

My mentors were nothing but supportive. They ALL shared the numerous grants of theirs that were rejected, some of which went on to get funded when they resubmitted. I got a lot of practical advice about how to use reviewer comments to improve my grants, how to plan for the next grant, and how to make it through academic dry spells.

But the advice that really stuck with me came from Michael Okun; it was not about grants, but about dreams. He told me, “If you have a dream that you really believe in, don’t let go of it. It may take years, but just hold on. The dream will find its way.”

Over the years, I’ve had many set-backs but I always came back to this advice as a mantra.

I am now a professor, an independent NIH-funded researcher, a director of a center, and an NIH reviewer—it’s not an easy job. Out of all the things I learned, my favorite piece of advice to tell my mentees is to hold on to their dreams. This simple act, done with sincerity, faith and curiosity, makes all the difference. Whether you hold on to your dreams or your fears, there are consequences.