Academic Careers

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Testimonial From a Translational Scientist

Massimo Pandolfo, MD, FAAN
Universite Libre De Bruxelles 

After my residency training I did a lot of basic science with a very focused clinical activity linked to my research. I was a gene hunter, so I spent most of my time in the lab trying to map and clone disease genes and I only saw patients with the diseases I was working on. Then things changed, now I do a mix of basic science in the lab, genetics, cell biology, work with animal models and experimental therapeutics, but also clinical research in the wider sense, including natural history studies, biomarkers, and of course therapeutic trials. Using a fashionable term, I think I became a “translational scientist”. 

Research has inspired my entire career. When I started neurology in 1980 it was very clear to me that this discipline had a lot of important and fascinating questions that were still unanswered. I saw myself from the beginning as someone who would try to contribute to address some of those questions rather than being a full-time practitioner. This was a very personal choice, based on my passion for science, which goes beyond clinical medicine. I have the highest esteem for my “pure” clinical colleagues who critically adopt what comes from research and integrate it with their knowledge and experience to provide the best patient care. I consider it essential to work hand-in-hand with them, but I am not one of them.

Now, as the head of a neurology service in a major university hospital, I am doing my best to help my younger colleagues to develop their careers according to their motivations and passions, some following a path similar to mine, others becoming full time clinicians with a critical understanding and appreciation of what comes from research. 

In Italy we say that sometimes in life one ends up connecting two points not with a straight line but with an arabesque. Getting to my current role was the result of a long trajectory that took me through four different countries (Italy, USA, Canada, and Belgium) and different contexts. I started in Italy with my clinical training, but also with my first contact with basic science. I entirely focused on basic science, genetics, during my two stays in the USA, first at UC Irvine, then at Baylor College of Medicine in Houston. In Montreal I continued doing basic science, but with a more direct link with the clinic and I went back to seeing patients. In Brussels I took the responsibility of directing a neurology service in addition to doing research and teaching neurology, which was a huge stress for me. I had contacts with my current institution when I was still in Canada because of a collaboration in editing a book. When the position was opened it looked a great opportunity to finally do what I always wanted to do, which is now called translational research. I was fortunate enough to find an institution that appreciated my research-oriented profile and took the risk of giving me the responsibility of a clinical service. 

It is definitely not easy to do good research and still be an acceptable clinician. One finds very smart people in both fields, which is a challenge, but also a plus when, as it is the case with most smart people, they are willing to fruitfully interact. Many difficulties of course came, and still come, from the need of finding the resources to do research. Never give grants for granted…. I honestly never had a really hard time in finding support for myself, initially as fellowships then as faculty positions, although some difficulties in moving forward with my career were part of what prompted me to leave Italy. 

In research, challenges are constant even when you succeed to get sufficient means, failures are inevitable and too frequent, technical problems may constitute formidable hurdles, and good ideas do come but not as often and clearly as one would hope. Nevertheless, the joy and excitement of discovery is a great payback that makes it all worth doing-at least for me, and even if it only rarely comes. 

When you want to be in the clinic as well, you must be aware of the challenge of being as good as our patients need. I really felt this challenge when I came to Brussels after many years of research as my exclusive or main activity. And coming with a leading role increased the challenge. I think humility here helps a lot, in particular to recognize the need of constantly improving one's clinical knowledge and not being ashamed of asking the advice of Colleagues. I always considered teaching fun, a real pleasure, and I think I have the gift of expressing myself clearly and effectively. So, I really never experienced major difficulties when I took up teaching responsibilities, although I had to struggle a bit with the French language (I teach in French). 

Finally, the administrative responsibilities that came with my current role have been and still are a challenge for me. However, running a clinical service cost effectively while maintaining the highest standards of care, and at the same time finding ways to support research, are essential activities that require effort and dedication, but also can give great satisfaction. Maybe some additional political skills, which I lack, would have been helpful. I think the best part of my role is how great it is to participate in the creation of new knowledge-which is an enormous satisfaction by itself-and at the same time participate in its translation into better care. And of course, it is even better if this is accompanied by helping smart and motivated young people to find their way. If you are considering a career in research, make sure of your real motivation. Sometimes it is necessary to test it with the difficulties of real life before understanding how solid it is. Do not insist if you don't really feel like it, but if you are one of those who have the right mix, be resilient and persistent. I know how difficult and frustrating it is to deal with the obstacles and temporary failures that are part of the scientific enterprise when one is moved by enthusiasm and passion, but in the end the payback is much greater. You have to believe it if you want to do research. Humility is also essential, but at the same time be confident of your true value, don't put limits to what you may eventually accomplish. Look carefully at all opportunities you may have, when you think something can be good for you go ahead and try, if you don't ask you will not get anything.