Please Join Us in Honoring Milton Corn, MD

This blog post is based on remarks given at the May 17 Milton Corn Memorial Concert.

Yesterday, I was honored to join in a beautiful celebration for the life of Dr. Milton Corn, an amazing man who I regarded as my adviser, colleague, and—most importantly—my friend. I would like to thank his wife Gilan and all of Milt’s friends and family for creating that wonderful moment of togetherness. Many of us knew Milt when he was Dean of the School of Medicine at Georgetown University or in his role with the National Library of Medicine, and I suspect that some even knew him as a bon vivant around town!

While I’m sure many of you can remember the moment you met Milt, I actually can’t—in my mind, it seems like he was an ever-present professional of the big data and scientific technology community! As a newly minted PhD in the late 1980s/early 1990s, I remember Milt as eminent in our field… and that was 30 years ago! I got to know Milt as part of the medical informatics community that was just emerging as a research powerhouse. Milt was a mentor to me; he reached into the visions I had for—and breathed life into—the ways technology could support patient engagement. He was always supportive, but he was also a hard questioner who wanted to know the value of the community’s investment.

Milt brought so many gifts to the field of biomedical informatics. He brought his wisdom as a physician executive to a fledgling field, applying his gentle but direct guidance to inspire research in the domain. Milt also funded my research; I remember a phone call one August afternoon over 20 years ago when Milt said, “Do you still need money for this project? Because we have some end-of-year money for you, and it’s available if you want to use it,” which of course let us advance our original ComputerLink project.

Interestingly enough, I actually know very little about Milt’s role at NLM, although I know a lot about his contributions! He joined our beloved NLM in 1990 during the first decade of applying computer technology to health care, in support of Don Lindberg’s visionary leadership. Milt served as NLM’s ambassador to the broader academic and research community as both their instigator and a supporter of many novel research ideas. Milt was in love with ideas, but he never let that love cloud his judgment or interfere with his expectation that emerging fields needed good science. He was as enchanted with a novel approach to genetic analysis as he was with securing proposals to write important books that detailed the history of medicine.

Milt became a colleague, a trusted advisor, and someone I could talk with about biomedical informatics. We could laugh about the field while enjoying its growth. Later, Milt became my friend. We shared family stories, our love for our children, and the challenges we faced with them. I loved his humor—he had the best sardonic laugh in the world. And then, surprise of all surprises, Milt became my employee, which had nothing to do with his actions, but with my actions! I remember being very mindful of Milt during my first NIH interview, where one of the committee members asked what it was going to be like for me, and I said I’m now going to be the boss of someone who I felt that I have learned from my whole career… it’s going to be fabulous!

Not that it wasn’t daunting; for 25 years, my career success depended on Milt! And he was wise: on my first day on the job, Milt stopped by with a little gift—a bag of peanut M&Ms! What a way to level the playing field. Sometime during those first few weeks, Milt came to my office and said, “Anytime you need my desk for someone else, you just let me know, and I’ll go home.” Every year he would say that sentence, and every year I thought not yet, I need you here. I couldn’t be without Milt, the magic maker.

After working more closely with Milt, I realized his judgment, discernment, and incredibly keen sense of what was a good investment—and, more importantly, what wasn’t—were critical to how NLM functioned. Later in our time at NLM, we needed a single scientific director to unify our intramural programs, and Milt took this responsibility on. Adding the title of Acting Scientific Director to his already stretched ambit, Milt aligned our two very strong intramural research groups: one addressing computational biology, and the other, clinical health informatics. He guided these two very disparate groups of investigators into a single structure… not totally unified, but respectful of each other and clearly willing to meet halfway across the bridge.

I turned to Milt many times as counselor to my position. Navigating the federal waters as director of a venerable institute like the NIH National Library of Medicine was a challenge—even for someone who thought herself quite sophisticated in dealing with complex organizations. Periodically, I’d walk over to Milt’s office, settle into one of his nice leather chairs, and lay out whatever issue I was confronting or a personality that perplexed me. Through a question or a brief comment, he led me to solutions, insights, and confidence, but none more so than the day he said, “Your job is important, and you deserve to have fun—so make sure that you do that!” I am brimming with tears as I remember how his strength made me strong!

In October of 2020, Milt told me that the pandemic was good for him. What an odd statement, I thought. However, he revealed that our maximum telework posture, with everyone working from home, eliminated the need for him to make the long commute from Virginia to Bethesda. Working from home made it possible for him to continue to engage. And engage he did! He remained a mentor all the way up until his very last weeks at the National Library of Medicine. I remember the night he called me and said, “I don’t think I can come back to work anymore,” but he reminded me, “You can call me if you need me.” I took his generous offer to heart and took it up as often as I could.

Above all, Milt was important to me, to the National Library of Medicine, and to the entire scientific and clinical world. Thank you.

Midnight in the Library

Right now, I am reading The Midnight Library by Matt Haig. It’s a fanciful story of a woman in limbo between life and death who finds herself in a magical library, and each book represents one of the lives she could have lived had she made even one tiny different decision. She then finds herself in many of these lives, experiencing what could have been.

This book got me thinking about how NLM helps people experience lives that could be. I see this on two levels:

The first is the scientific pathway: What if . . . ? What if we knew more about the interactions between evolutionary forces and molecular constraints (like the work of Aravind Iyer, PhD), or fully appreciated the potential of proteins for genome engineering (like the discoveries made by Eugene Koonin, PhD), or could envision how and why proteins fold or switch their folds (as explored by Lauren Porter, PhD), or had the power to enable machines to understand human thought (like the research from Dina Demner-Fushman, MD, PhD). In addition to the discoveries by our NLM intramural researchers, our vast literature and data repositories hold answers that could change lives: why some genetic structures lead to human characteristics, or why a certain biochemical compound helps prevent infection. We help scientists discover these pathways and connections by providing them with the tools to uncover what could be.

The second is how NLM helps people see their what if using the amazing richness of the resources that we make available through our collections. Our resources—which encompass clinical insights, medical information, care guidelines, and self-management—help clinicians determine how to care for people with complex diseases or diagnose an illness in a timely manner. Our repository of clinical information available through PubMed ensures that those in need can access well-reasoned, recognized guiding principles for their care, and our MedlinePlus web resource provides patients and their families and friends with reliable, up-to-date health information to support and encourage healthy behavioral changes.

As in The Midnight Library, books alone do not inspire discovery, guide clinical care, or inform self-management. In Haig’s novel, a fictional librarian who knows the collection shows the main character how to select books by carefully listening to her goals and needs. It is the main character’s engagement with the books that helps her explore the lives she could have lived. At NLM, we too have librarians—located in Bethesda, Maryland, and around the country through NLM’s Network of the National Library of Medicine—who organize the library’s collections and guide patrons toward the best choice of resources. Our resources must be findable, accessible, interoperable, reusable, and actionable! And then, the person—scientist, clinician, patient—must actively engage with the material.

As we approach the future of data-powered health, guided by the NLM Strategic Plan (2017-2027), we will fulfill our mission to collect biomedical literature, organize it, preserve it, and make it accessible to the world. As the knowledge of health and biomedicine continues to grow faster than we can process, we will turn our attention to applying emerging tools, including machine learning and artificial intelligence, to make it easier to find our materials and more efficient to examine them. Through our Extramural Programs, we will continue to stimulate new ways of presenting information to scientists, clinicians, patients, and the public so they can explore possible lives to be lived and test out their promise of better health for society. What lives can we help you explore?

Nursing in the Headlines

Every year, we celebrate National Nurses Week between May 6, which is National Nurses Day, and May 12, which happens to be Florence Nightingale’s birthday. If you haven’t picked up a specialty journal or public newspaper in the past few months, you may not know that nursing has made it to the headlines:


Some of us might argue that any press is better than none, and others might say it’s about time that the real story about nurses and nursing become better known. While I believe a little in both perspectives, the real reason I’m glad to see them today is that they depict a much richer, more valid, and more robust story about who and what nurses are and how they serve society.

A recent article in The New York Times stated, “A Shrinking Band of Southern Nurses, Neck Deep in Another Covid Wave.” This news story brings into national view the importance of small, nonprofit safety-net hospitals and the experience of the nurses who work there. Told without romanticizing nurses’ dedication or pointing out their long-suffering compassionate nature, this article tells of the real challenges faced by nurses who want to do good for their communities but are faced with persistent shortages, significant illnesses that could have been avoided, and politically motivated, bureaucratic financial decisions. However, it also tells of the creative problem solving demonstrated by these nurses as they try to meet patient needs and the compassion they provide to their colleagues as they continue, yet another day, to address the needs of many with fewer and fewer resources.

Look at the first three headlines: together, these depict a professional field dedicated to meeting the conditions of its social contract—to provide high-quality patient care—and awash with opportunities for outstanding career growth, and at the same time at risk of losing some of its critical workforce due to unrelenting stress in the workplace. What does this say about nursing? Never has there been such opportunity, but never has the opportunity promised so little.

A beautiful story in March in The New York Times, “Confronting Grief, With Margaret Atwood, in ‘The Nurse Antigone,’” which talks about regular nurses participating with Margaret Atwood in the reading of the play Antigone, provides me with hope and vision. In this rendition, Atwood will play the blind prophet Theophanes and the nurses will be part of the Greek chorus. This story of Antigone’s determination to bury her brother, who died in battle, despite a law forbidding the burial of traitors mirrors the challenges nurses face by attending to those in need despite enormous challenges in acquiring resources needed to provide care, including sufficient time. An ethicist quoted in the article remarks that Antigone’s triumph over Creon’s prohibitions provides an apt mirror of the moral injury with which nurses cope, neither romanticizing their decision nor despairing at their deplorable conditions.

The final headline in the middle of the pack heralds nurses’ awakening to their economic power. The COVID-19 pandemic didn’t create the traveling nurse sector of our profession, but it certainly accelerated its growth across the country. Individual remuneration soared, leaving many nurses with the dilemma to remain as a loyal worker in a long-served institution or move on for financial gain. Hospitals too faced the challenge of differential staff compensation, with highly paid traveling nurse staff working next to more modestly paid existing staff. Fortunately, the perversity of this economic structure has led to hospitals and clinics improving staff nurse compensation, attending to their work conditions, and stabilizing the staffing complement.

As we celebrate National Nurses Week this year, please join me in recognizing the vibrant, rich picture of our profession. We are not unbuffered by these challenging times, and as a profession, we are responding in a way that serves our patients while preserving our profession. Accepting new models of care, innovative career trajectories, and an expanded understanding of how to create compassionate workplaces promises a future in which all nurses can work to the top of their licenses. Let us know how we can help you do this, too!

Meet the NLM Investigators: L. Aravind Iyer, PhD, Uncovers the Language of Our DNA

NLM is home to a robust research enterprise. Before the COVID-19 pandemic, I introduced you to two researchers from our Intramural Research Program (IRP), Dr. Lauren Porter and Dr. Xiaofang Jiang.

Now I would like you to meet another one of our researchers, L. Aravind Iyer, PhD. A member of the NLM IRP, Dr. Iyer is a Senior Investigator in the Computational Biology Branch of the National Center for Biotechnology Information. His research revolves around uncovering the stories and patterns held within DNA and RNA and is aimed at unraveling the evolutionary forces that shape biochemical functioning and biological form.

Just like any other biological structure, DNA and RNA evolve over time, which can tell a complex story of an organism’s past and illustrate relationships between organisms that aren’t obvious.

See the infographic below to learn more about the exciting research happening in Dr. Iyer’s lab.

Infographic titled: Language of Our DNA and RNA. Listing the featured researcher, L. Aravind Iyer, PhD and his title, Senior Investigator in Computational Biology. 

The first column of the infographic reads: What I'm Working On. The text in the first column lists Dr. Iyer's short term goals to: (1) Decipher evolutionary relationships of organisms (vertical and lateral) and proteins; and (2) Computationally discover biochemical activities of proteins. Next, long term goals are listed as: (1) Create a unified evolutionary theory for biological conflicts; and (2) Understand the contributions of rapid evolution in conflict on other systems.

The second column is titled: How It Works and lists the following text: (1) Reading an evolving story written in DNA/RNA and protein sequences.

(2) Closing gaps in our understanding by applying computational and statistical methods on databases to compare protein sequences and structures.

(3) Determine vertical (ancestral with a picture of an arrow pointing to  descendant) and lateral (one organism with a picture of an arrow pointing to another organism) flow of genetic information.

The third and final column of the infographic is titled: What It Looks Like and has a book in an indecipherable language with a caption that says: Deciphering the language of life written in DNA/RNA and protein sequences.


Now, in his own words, learn more about the man behind the research!

What do you enjoy about working at NLM?
NLM is one of the world’s leading centers (such can be counted on one’s fingers) for deciphering the biochemistry and biology of proteins through computational analysis of sequences and structures. As a national lab, it has an organizational structure and funding framework best suited for the kind of research that I do, which involves an extensive explorative component.

What makes your team unique?
My team embodies a considerable mass of special knowledge regarding protein evolution and function that we accumulated and systematized over a period of several decades. Given that we look at this using various computational methods, my team melds the expertise of people well versed in biology, computer programming, biochemistry, protein structure, and graph-theoretic analysis.

What is your advice for young scientists or people interested in pursuing a career in research?
I think the most interesting discoveries are those that bring together and illuminate disparate areas of inquiry. Hence, spend your early youth acquiring a very diverse knowledge base and technical capacity. Then organize this knowledge into an interconnected network that you can train your intuition on and draw from when confronted with new problems.

When you’re not in the lab, what do you enjoy doing?
Amateur astronomy, reading and writing about history and ancient texts in the original or translations, recreational mathematics, storytelling.

What inspires you?
Lives of past scientists, philosophers, and leaders from around the world. The profound insights found in the works of the ancients.

You’ve read his words, but now you can hear them for yourself. Follow along on the NLM YouTube page for more exciting content from the NLM staff that makes it all possible. If you’d like to learn more about our IRP program, view job opportunities, and explore research highlights, I invite you to explore the newly redesigned NLM IRP webpage.

YouTube: Dr. Aravind Iyer and the Protein Universe

Video transcript

[Iyer] Early in my life, I wanted to be a paleontologist. And that’s what actually led me to molecular biology. At one level, I could say that I wish to understand the whole protein universe. Proteins can be divided into evolutionary units. There’s a part of a protein that’s preserved over evolution because natural selection is maintaining that part for some reason. And one realization, which dawned on us starting around the early nineties—and this was a very profound realization for all of biology—is that there is a relatively small number of these evolutionary units of proteins, which we term domains, which constitutes the entire protein universe of all organisms across the tree of life.

If we can understand the functions of these units, then that goes a long way towards understanding what organisms do. And given there are many gaps in our understanding of what organisms do, one way to get at it is to first, find all these domains. The second aspect of it is predicting functions for them. The first phase of my research, we captured most of the low-hanging fruit, which were the big families conserved across all organisms.

Now we are moving on to the more difficult terrain, but the difficult terrain also holds a lot of promise because many un-understood functions are hiding within that difficult terrain, and it gives these offshoots in the form of biotechnological reagents. There are things like restriction enzymes, the CRISPR systems, and DNA modification systems. All of these have become very popular reagents.

NLM is a world leader in the analysis of protein sequences, protein structures, and inferring evolution from these bits of information. And this has been a very long-standing interest of mine so, this is the place to be.

You Can’t Be What You Can’t See

Every year, International Women’s Day is celebrated across the globe to recognize women’s rights and gender equality. This year’s observance encouraged all people to #BreakTheBias and envision a world that values and celebrates diversity.

Bias results from the complex interplay of experience, cognition, learning, and stigmatization. It shapes the way people make decisions and influences one’s appraisal of what constitutes good and bad. Bias can sometimes be helpful as it provides a quick way to motivate social discourse. However, bias often leads to unfair or discriminatory treatment. The most insidious aspect of bias is that it frequently happens outside of one’s conscious awareness. The only effective way to disrupt the dangerous influence of bias is to persistently raise awareness, challenge assumptions, and enrich the visual cues around the world that highlight the unique and powerful differences between people. Placing oneself in groups and teams with others who are different from ourselves is one starting point.

I’ve been inspired by a phrase I’ve heard several times recently: You can’t be what you can’t see. This phrase is often used to identify the multiplicative impact of creating a diverse workforce. This is pretty inspirational to me! I have often experienced efforts to bring women into leadership positions or to open scientific opportunities to people of color as a strategy that served the individual person — which in itself has many benefits. For the individual, expanded career opportunities provide meaningful work and the opportunity, not only to use one’s talents to advance an enterprise mission, but also gain financial rewards. The teams surrounding these individuals benefits too. Making sure that leadership teams are comprised of people of different genders and who have different life experiences improves our collective thought and creativity. It is important to recognize that these benefits do not arise solely because teams are made up of people who look different or sound different from each other but requires the intentional application of managerial actions that celebrate differences and help individuals build bridges between ways of knowing.

The Secretary of the Smithsonian Institution, Lonnie G. Bunch III, attributed this quote to Sally Ride in an article he wrote about the opening of the Sally Ride exhibit for a Smithsonian Magazine article titled How the Smithsonian Is Honoring Remarkable American Women. In his words, the presence of women in the space force not only benefited Dr. Ride and her crew but also served as a visible symbol to everyone, particularly girls and young women, that there were people who looked like them enjoying fulfilling careers in space.

True appreciation of the diversity of people requires that we look beyond their physical characteristics to see their real uniqueness. One’s culture, family customs, language, and upbringing imbue individuals with mannerisms, mental models, and motivations, few of which have any physical manifestation. So, if we want to enrich our work groups with colleagues with differences in the cadence of speech or adherence to traditions, we will have to find a way to make those aspects visible, and in turn, engaging for all.

Jeff Reznick and Ken Koyle, respectively the Chief and Deputy Chief of NLM’s History of Medicine Division, published a free visual history of NLM and its beautiful buildings. In a brief video featuring some of the pictures from their book, you can take a tour of NLM’s nearly 200-year history. What’s important to pay attention to as you view these amazing images is the early and persistent commitment to creating a diverse workforce evidenced though the pictures of people present throughout the modern history of NLM.

As NLM prepares its plan to join with the rest of the NIH to dismantle structural racism and make the NIH a welcoming workplace for people of all racial identities and ethnic heritages, looking back helps us understand that what we could see in our history allowed us to be in our future — may we continue to grow as a welcoming workplace serving scientists and society.

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