The Sport that Made Me a Better Leader

Late last month, I dined with the NLM/Association of Academic Health Sciences Libraries (AAHSL) Leadership Fellows on the final day of their program and got more than just lunch. I ended up with an interesting realization about how a sport I enjoy has helped shape how I lead.

The curriculum for the year-long NLM/AAHSL fellowship program includes such topics as power and influence, managing a workforce, and diversity and inclusion. The program inevitably sparks self-reflection for both fellows and their mentors, and though I spent only a short time with the group, it got me thinking, too, about issues related to leadership, personal awareness, and growth. Since then, I’ve been musing over what has helped me be an effective leader at NLM.

Certainly, having a terrific staff and the support of NIH leadership makes the whole process easier. I’m fortunate to have both.

I’ve also received words of wisdom from experienced colleagues, gleaned key insights from books, and recalled valuable lessons from management courses I’ve attended over the years.

But, believe it or not, nothing has prepared me more for senior leadership than squash—the sport, not the food.

For those of you who don’t know the game, Wikipedia explains it this way:

A ball sport played by two or four players in a four-walled court with a small, hollow rubber ball. The players must alternate in striking the ball with their racket and hit the ball onto the playable surfaces of the four walls of the court.

The game’s high speed calls for quick movements and even faster thinking. You have to predict the ball’s angle of return based on the point of contact with the racket and the velocity of the hit. You have to plan your shot based on your opponent’s position and your own. And you have to do all this while avoiding the other player as you both navigate your way around a very small space. (The entire court is about 7 feet by 10 feet.)

The situational awareness and mental agility needed to pull all this off build important skills for management and those high-pressure, think-on-your-feet moments, but I think no skill is more important than timing.

Precision timing—striking the ball at just the right moment—is key to success in squash. Precision timing is also important for leadership.

One must determine how long to let a conversation proceed before weighing in, or how many emails in a chain should pass before making a statement. One must decide if one has entered an argument on its first round or if it is an old engagement rehashed many times. And importantly, one must be prompt with feedback, good and bad, both to reveal one’s values to the organization and to expose one’s preferences and pleasures.

But squash has taught me more than getting the timing right.

Power shots in squash send a 2” ball rocketing through the air. And when that ball hits you unexpectedly, on the arm, leg, or even face, you quickly realize that, even though it is very, very small and you are very, very big, it can really hurt. A lot.

Translating this to management, I’ve seen how a small, seemingly inconsequential statement can serve as the prelude to a major problem, or, on the flip side, how well-timed praise, delivered when the recipient is ready to hear it, can have profound positive impact.

Squash has also taught me to play nice with my partners and observe the rules of engagement on the court. Management situations bring their own rules of engagement, sometimes defined, sometimes not. The unwritten rules can be the trickiest, with rules sometimes changing based on where the engagement occurs. Understanding and respecting protocol, positions at the table, and the tenor of discourse as it varies from office to hall way to conference room are skills worth developing.

I’ve learned through squash that I can tussle with an opponent over controlling the T-zone (the prime spot from which it is easiest to reach most shots) and still enjoy a cool drink and camaraderie afterward. Managerially, this means that conflict is part of the game, and going toe-to-toe over important issues doesn’t—and shouldn’t—stand in the way of collegiality. (Another key take-away: It always helps to share a cool drink afterward!)

And ultimately, in squash as in management, there are always opportunities to improve.

What has influenced your leadership? What makes you a good manager? What makes your manager a good manager?

It Takes a Whole Library to Create a World of Data-powered Health

Data-powered health heralds a revolution in medical research and health care.

Data-powered health relies upon knowing more—more input in the moment, more details across systems, more people (and their data) contributing to the overall picture.

Data-powered health ushers in a new biomedical research paradigm in which patient-generated data complements clinical, observational, and experimental data to create a boundless pool we can explore. New tools based in text mining, deep learning, and artificial intelligence will allow researchers to probe that vast data pool to isolate patterns, determine trends, and predict outcomes, all while preserving patient privacy.

As a result, data-powered health promises personalized health care at a level never before seen. It signals a time when tracking one’s own health data becomes the foundation of personal health management, with sensors—coupled with something like a smartphone—delivering tailored, up-to-the-moment health coaching.

The National Library of Medicine will play an important role in the future of data-powered health. Each of our divisions has something to contribute. NCBI’s identity and access management systems will ensure a solid core for the NIH gateway to data sharing. Researchers in the Lister Hill Center can apply machine learning, computational linguistics, and natural language processing to make sense out of large, diverse data sources, whether that’s the text within medical records or large numbers of X-rays. Library Operations staff will manage the extensive terminologies that support the necessary interoperability. Specialized Information Services’ experience with disaster information management will help us ensure data remains available even with limited or no internet access. And the National Network of Libraries of Medicine will continue to partner with libraries across the country to support the public as they join this strange, new world.

Together these and other areas of excellence give NLM a solid foundation, but NLM itself must grow and develop to become the NIH hub for data science. We must develop data management skills and knowledge among the Library’s workforce. We must also partner with the other NIH institutes and centers, and with scientists around the country, to complement, not duplicate, data science efforts; to build the technical infrastructure for finding and linking data sets stored in the cloud; to shape best practices for curating data; and to craft policies that support exploration and inquiry while preserving patient privacy.

The ultimate goal is for NLM to do for data what we have already done for the literature—formulating sound, systematic approaches to acquiring and curating data sets, devising the technical platforms to ensure the data’s permanence, and creating human and computer-targeted interfaces that deliver these data sets to those around the world who need them.

We continue to discuss how best to create an organizational home for data science at NLM, and I welcome your ideas. How would you establish a visible, accessible, and stable home for data science at NLM while building upon our expertise and our tradition of collaboration?

One Library, Many Worlds

Back in January, I wrote about One NLM, an idea that acknowledges the particular contributions of each division within the Library while supporting greater engagement across our programs, all aligned toward a common vision.

I wrote that post primarily for NLM staff, but in the intervening nine months, I’ve discovered I need to take the message of One NLM to those outside the Library as much as to those within it.

As I attend conferences and meet members of the many groups NLM serves, I’ve learned the role of the Library is in the eye of the beholder. Librarians see bibliographic resources. Scientists see tools for discovery, clinicians tools for diagnosis and care. Potential post-docs see opportunities for training, and teachers see resources for learning. Even though we are one NLM, we are viewed from those various perspectives more as parts than a whole.

That’s not necessarily a bad thing, but I am working to make our stakeholders aware of both the parts they don’t naturally see and the single purpose that unites those parts.

Our core services are undeniably diverse. We acquire and preserve health and biomedical knowledge across disciplines and across the ages, and then devise platforms and processes to make this knowledge available to clinicians, researchers, and patients. We conduct research to develop more efficient ways to search the literature and to apply computational approaches, such as machine learning and natural language processing, to clinical data and published works to extract specific information. We also take advantage of our own genomic and other sequence data bases to discover the structure and functions of various genes and to create models of functional domains in proteins.

Given that diversity, it makes sense that those who use the Library might focus on one or a few of those services more than others, but for me and for the 1,700 women and men who work here, these services all contribute to one single vision: NLM as a platform for discovery.

Sometimes discovery comes by exploring PubMed’s literature citations to ground a new research program, other times by extracting gene sequences and their respective phenotypes from dbGaP, and yet other times by finding the perfect exercise to supplement a lesson plan.

In the end perhaps the lesson for all of us is that NLM is ultimately both its parts and its whole.

And my role is to help our many audiences better understand their favorite parts while learning more about the totality of who we are and how we serve society.

Words that mean a lot—reflections on swearing in

“I, Patricia Flatley Brennan, do solemnly swear that I will support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; that I take this obligation freely, without any mental reservation or purpose of evasion; and that I will well and faithfully discharge the duties of the office on which I am about to enter. So help me God.”

On September 12, 2016, I placed my left hand on Claude Pepper’s copy of the constitution, raised my right hand, and took this oath to became the 19th director of the National Library of Medicine. These words meant a lot to me then, and they continue to guide me. My oath is to support and defend the Constitution, bearing true faith and allegiance to the same.

Of all the words in the Constitution that I must support and defend, the most meaningful to me are “We, the people”. . . for it is the responsibility of the National Library of Medicine to support biomedical discovery and translate those discoveries into information for the health of people—all the people.

More importantly, as a member of the executive branch of the government, I am responsible for implementing legislation that directs the National Library of Medicine to:

  • acquire and preserve books, periodicals, prints, films, recordings and other library materials pertinent to medicine;
  • organize the materials by appropriate cataloging, indexing, and bibliographical listing;
  • publish catalogs, indexes, and bibliographies;
  • make available through loans, photographic, or other copying procedures materials in the library;
  • provide reference and research assistance;
  • engage in such other activities in furtherance of the purposes of this part as (the Surgeon General) deems appropriate and the library’s resources permit;
  • publicize the availability from the Library of the above products and services; and
  • promote the use of computers and telecommunications.

Thank goodness there are over 1,700 women and men to make sure this happens!

During this past year, other words and phrases have influenced and inspired me:

  • Public access

NLM leads the nation and the world in ensuring that everyone, from almost anywhere, can access our resources—from our bibliographic database PubMed to the genetics information in Genbank. Assuring public access means creating vast computer systems and interfaces that allow humans and computers to use our resources. It means helping shape the policies that protect copyright, promote openness, and preserve confidentiality. It means considering the public’s interest as we acquire new resources and design new applications. And, importantly, it means that we provide training and coaching to make our resources accessible, understandable, and actionable.

  • Third century

We date our beginning to books collected by a surgeon in an Army field hospital in 1836. Our first century laid the foundation for purposeful collection of biomedical knowledge, including creating catalogs and devising indexes. Our second century saw the digitization of knowledge and internet communication, delivering our resources at lightning speed around the world. In less than two decades, we begin our third century.

I can only imagine what our third century might bring! What I do know is that it is my job now to put in place a robust human, technical, and policy platform to prepare for our third century.

  • One NLM

It is a common engineering principle that a strong whole depends on strong parts. Indeed, NLM has very strong parts—NCBI with its genomic resources, Library Operations with the power and skill to index the world’s biomedical knowledge, the Lister Hill Center with its machine learning to accelerate the interpretation of images, and more.

During the past year, I have begun to see the crosswalks between our parts—for example, the partnership between our Office of Computer and Communications Systems with Library Operations to serve up vocabularies and the Value Set Authority Center that supports quality care monitoring, and the engagement between Specialized Information Services and the Lister Hill Center to build PubChem and Toxnet services.

We are poised to address the challenges laid out for us in 1956 not by building a single service to address each one, but to knit together the best of several services to efficiently and effectively advance health and biomedical discovery through information.

The ideas of Nina Matheson have helped shape my entire career. As Director of NLM, her words have taken on increased importance to me. In 1982, she talked about librarians as tool builders and system developers and solvers of information problems.

Inspired by these words through my first year, I embrace the idea—and, indeed, the ideal—that the library is the solution engine that will accelerate discovery in support of health for everyone.

Like the Constitution says, it all starts with “We the people.”



Ah, but I was so much older then / I’m younger than that now

I’m just passing the one-year mark in my tenure as Director of the National Library of Medicine. It has been an exciting year for me, filled with many learnings and lessons, and with each week I grow more delighted with this outstanding organization. I have the great good fortune of having taken a leap into an uncertain-but-promising opportunity and finding it to be more rewarding, more delightful, and more engaging than I had anticipated—and I took this position with very high hopes!

I have grown a lot since I arrived here in August 2016, and as the master balladeer Bob Dylan noted, “I was so much older then / I’m younger than that now.” A deep passion for NLM, its mission, its resources, and the people who work here replaces the early hope and excitement that accompanied me on my move to Bethesda. The bravado of vision is supplanted by the realities of working in the federal system. Acronyms and abbreviations now evoke people and processes for me. I have learned to appreciate the rich tapestry of scholarship, service, citations, and collections that make up the NLM. I have met many of our stakeholders and have come to see them as collaborators. And I’ve developed a new appreciation of the Library, not simply as a collection of resources, but also as a dynamic interaction of health and information.

Here are some surprises. I am struck by a sense of patriotism I found resting quietly deep in my soul. As the director of the only federally funded health library, I am responsible for ensuring our resources are expended in support of the public’s health—supporting discovery, knowledge delivery, and personal health management. I am proud of the 1,700 women and men who choose to work here, applying their knowledge and talents in service of society. And I am committed to weaving the tenets of open science through the mantle of government service.

I am amazed at how big the Library is—not just our buildings, with their byzantine hallways and underground spaces, but the human and electronic reach. Because of our 6,500-member National Network of Libraries of Medicine, the NLM has a footprint in almost every single county, and in American Samoa, Guam, Northern Mariana Islands, Puerto Rico, and the Virgin Islands. There is no country in the world that our resources can’t touch. We have 26 million citations in our PubMed bibliographic repositories, and petabytes of data moving in and out of our NCBI resources EVERY DAY!

And I am grateful—to the security guards who help protect our precious holdings, to our scientists who are finding ways to use literature and data to help our nation meet health crises such as the opioid epidemic, to our technical services team who keep our resources available 24 hours a day. I am grateful to the staff who have greeted me with welcome and patiently reminded me of their names. I am making progress, but I’ve still got a lot to learn.

Dylan’s words appeal to me because they characterize the arch of a journey, from initial awareness through growing familiarity to deep realization that the National Library of Medicine is truly a national treasure, and I am both humbled and proud to be guiding it towards its third century of service.

Photo credit (hourglass, top): Scott Schrantz [Flickr (CC BY-NC-SA 2.0)]