I love the Radio 4 programme The Life Scientific, ably
presented by Jim Al-Khalili http://www.bbc.co.uk/programmes/b015sqc7/profiles/jim-al-khalili. Who’d have thought that leading medical imagist
Mark Lythgoe started out in the danceclubs of Madchester, having botched his A
levels? Or that a chance encounter with a chemical engineer led Molly Stevens
to set up her groundbreaking stem cell research laboratory? Or the amazing paradox of the Nobel
prizewinning geneticist Paul Nurse who discovered the truth of his own birth
only recently (his account well worth looking up http://www.nobelprize.org/nobel_prizes/medicine/laureates/2001/nurse-bio.html)?
It’s the non-linear nature of these
intellectual life stories, the serendipity and range of influences – direct and
indirect - which makes it so interesting.
So I was intrigued to stumble across an old (2005) Nuffield
Trust report the other week, edited by Alan Oliver, where twelve eminent health
service researchers were asked to reflect on their academic life journeys and
the people and places that have influenced their work. It’s a good read http://www.nuffieldtrust.org.uk/sites/files/nuffield/publication/personal-histories-in-health-research-aug05.pdf
, although dated in some ways. It seems
another age where, for instance, Rudolf Klein could step into academic posts
after twenty years of journalism (in the words of a colleague, `an eighteenth
century essayist at heart’). He
describes elegantly the ways in which he was shaped by colleagues – and managed
to sidestep much of the academic torpor and in-fighting. It is in many ways a story of hybrids and
`boundary spanners’ at the very highest levels.
Alan Williams flits between setting up pioneering health economics
courses at York and advising Roy Jenkins at the Home Office. Alison Kitson from evaluating new modes of
nursing practice to the top table at the RCN.
Walter Holland from studies of screening in south London to devising the
RAWP formula. Not much clear blue water
between policy and research there.
The influence of individuals as mentors comes over
strongly. That is surely true, although the
career-accelerating effect of chance patronage and interest smells somewhat of
the old boys club. Indeed, one
contributor mourns the passing of a culture of expert closed committees in
favour of more open consultation (not always done well), saying `we have lost a
tradition and not yet found a [new] paradigm’.
Elsewhere, the insecurity of the old system is apparent. It is a tale of hand to mouth six month to
one year contracts (sometimes unrelated to the original field of
interest). A warning against false
nostalgia, perhaps, in this day of NIHR fellowships and career paths for
researchers.
It shows too the broad church of health services research
with its origins in public health and epidemiology. Other disciplines are represented here, from
medical (sic) sociology to health policy.
I remember at a conference someone reflecting on the `epistemic fit’
between different areas of clinical practice and research discipline. General practitioners may be more comfortable
with ethnography and complexity theory than laboratory-based research
scientists. Although this collection
confounds easy generalisations. Sometimes there are direct challenges across
the contributing chapters. Rudolf Klein
and Alan Williams clash swords over whether technical solutions (such as QALYs)
can override difficult political negotiations; in the words of the former,
`implicit rationing – veiling the decision-making criteria and process – [seems]
entirely rational.’ But not acceptable
perhaps to the godfather of health economics.
I liked too the injection of some edgy personal reflection
from Jennie Popay – from the streets of Salford to academic chair, while still
feeling like an outsider.
We need more of this sort of reflection and personal
stock-taking. I think that's why I've enjoyed recent inaugural lectures (for instance of Martin Marshall and Naomi Fulop at UCL) - the chance to look back and make sense of a career midway and the ideas and people who have shaped them. It’s helpful both to
understand what helps to nurture and sustain intellectual work – and individuals
- who will make a difference. And it
satisfies our curiosity. Modern
recruiting practice could learn much from the example of Walter Holland. What singled him out as a researcher for his
first trial spanning many study sites?
He was the only candidate with a car…
