Albert Einstein said, “The definition of insanity is doing the same thing over and over and expecting different results.”
I would say: “How can anyone do the same thing over and over and expect anyone to stay interested?”
This is particularly true for physician researchers when trying to get grants, publish papers, or engage philanthropy. Now, more than ever, things are changing at faster and faster rates. With the acceleration in technology, information processing and worldwide connectivity, what used to take a generation has become 10 years, and this will likely become 5 years, then 2 years. Tomorrow will bring things that do not exist today. To maintain success over the span of decades in the setting of exponential change, one must embrace change.
It seems risky to change and to do something new, but I would say it is more risky not to. It is also just not as much fun. I have developed an automatic answer when someone asks me to do research on a project that someone else is doing. The answer is “no”. While it may be a great idea, it is not challenging or interesting. UCLA is not the place to follow others. UCLA is the place to do things for the first time.
What are some examples of how I have taken risks at UCLA? Years ago, no one cared about the fact that women are more susceptible to multiple sclerosis (MS) and other autoimmune diseases than men. There was no research in the area. So I began research on this, eventually identifying a role for sex hormones and sex chromosomes in sex differences in disease. After decades, this has now become an area of such interest that the National Institutes of Health (NIH) instituted a new policy mandating that all grants in all fields must include the effect of being female or male on disease. Also, I was trained as an immunologist since it was thought that MS would be cured with immune therapies. After the recent two decades of such treatments, it has become clear that immune therapies slow the disease, but do not cure or reverse it.
I began to focus on the brain in MS and not the immune system, and we are leading a new strategy to find neuroprotective (brain-protecting) treatments. Finally, I changed again when it became clear that studying inherited genes from DNA of blood samples was not going to result in new treatment targets in MS and other complex diseases since they were not due to inheritance of a single gene or even a few genes. Although it was challenging, we began studying differences in the level of expression of the same genes in the brain during disease and showed how expression varies by region and differs between females and males. This has relevance to why females and males differ in the incidence and symptom progression of MS, and also Alzheimer’s and Parkinson’s diseases. The common theme in this “risky” strategy of doing things that are new is that the changes I made were not predetermined. They were in response to the most pressing need in the field. Continued funding from NIH and other agencies, high impact papers, and committed philanthropic support all underscore the success of my philosophy of answering unmet needs in the field regardless of how much change it requires or risk it entails.
What will I be doing in 5-10 years? I can’t know yet. What I do know is that I will be addressing the most important issue that I and other physicians observe when we see patients in the clinic. While some might say this is uncertain and risky because it is far easier to just follow the next experiment in the lab, I think it is less risky than not being amenable to change.
Dr. Rhonda Voskuhl is the Jack H. Skirball Chair - Multiple Sclerosis Research, Director of the Multiple Sclerosis Program, Professor of Neurology, and Professor In-Residence in the Semel Institute for Neuroscience and Human Behavior at UCLA.