Preparing for the Best Future We Can Imagine

Last year we published a blog on my birthday . . .  I love my birthday! As I wrote last year  . . . When you grow up in a family of 10 kids, like I did, your birthday is a very special day. I celebrated my birthday last week and spent time with my dear friend, Viki, and took the opportunity to celebrate my life yet lived. 

At this point in my life, I find myself consumed with the awareness of how precious life is and how short it feels. The pandemic aggravated a sense that people are vulnerable, life is fragile, and there’s not much time. This sensation made me feel rather depressed. I’m not quite sure why as it’s been a busy and productive year. 

Over the past year, NLM accomplished so much by helping the NIH build the data infrastructure for genomic discovery to better respond to the COVID-19 pandemic and prepare for future ones; conducting research on the microbiome; and determining whether we could detect the presence of certain viruses, including SARS-CoV-2, through the analysis of wastewater. We funded new research to make it easier to understand health data and supported more than 300 trainees and fellows through our Extramural Programs Division. We learned how to telework and meet virtually. We kept our highly valued products and services open and operational 24 hours, 7 days a week. We onboarded new staff, said goodbye to coworkers who retired or moved on, and mourned the deaths of several colleagues.

Slowly, as we’ve all been emerging from the pandemic shutdown to discover new ways of being, I find my spirits lifting and my eyes looking towards the future with optimism and joy.

Part of this feeling comes from a deep and respectful pride for NLM’s accomplishments over the year, and the role I’ve played in it. Some of it comes from welcoming new children and spouses into my very large family. A lot of it comes from the sense of purposeful living that helped me transform a sense of isolation to an engagement with others to co-create a new future. What I’ve realized is that we never actually know our future, so preparing for the best future we can imagine is probably the smartest strategy.

This year, as I add another digit to the long lists of digits that I’ve already accumulated, I’m preparing for the best future that I can imagine. I’m exercising more, practicing the piano with greater diligence, and spending meaningful time with friends and family. I’m engaging with NLM leadership and staff to envision the future of work and to enhance the inclusivity and diversity of our work environment.

I’ve somehow managed to shake off the sense of gloom and doom and see a future that appears limitless to me—awaiting what I can be bold enough to envision, create, and accomplish. Please join me in celebrating my birthday and stepping into the future.

Keeping Found Things Found . . .

About 15 to 20 years ago, in the early days of browsers and websites, colleagues from the University of Washington, led by William Jones, launched a research project called “Keeping Found Things Found.” They interviewed many people to explore what we now call personal information management. You know what this is – it’s how you keep track of your medications, your child’s vaccination record, and your family’s health history. People are amazing at devising clever ways to hold on to personally meaningful and important information – you might even have yours stored in kitchen cupboards, file cabinets, calendars, and even family bibles!

If there’s one thing that libraries do well it’s keeping found things found and making them findable to others. NLM excels at this. NLM has more than 3 million books and journals in our physical collection, millions of genomic sequences in our data banks, and we maintain electronic access to almost 13,000 journals. We’ve also been devising new ways to make our print collection accessible during the COVID-19 pandemic, when access to the NLM building is limited, and preserve the pathways to electronic journals.

One thing NLM is NOT good at is personal health information management—this just isn’t our specialty. NLM funds research to better support people’s abilities to create personal health libraries, but we don’t store personal health information. NLM’s hallmark is acquiring, preserving, and making available for public use scientific knowledge for health as represented in books, journal articles, and data banks. Under special circumstances, we will create ways to collect and archive public information that supports personal health actions that stem from events ranging from the AIDS crisis to the COVID-19 pandemic.

Sometimes libraries help create public information from personal stories. NLM is doing just that to capture the experiences of federal volunteers who have been helping support HHS’ Administration for Children and Families Office of Refugee Resettlement Unaccompanied Children Program. By partnering with the Office of NIH History & Stetten Museum, we are compiling and making available the personal stories of NIH staff who volunteered for this important initiative.

My family and I have also benefited from programs supported by federal libraries to keep the stories of individual people found. In 2005, my son and I participated in an initiative supported by a nonprofit organization to record, preserve, and share a wide variety of stories told by people just like you and me. To prepare for our interview, my then 11-year-old son, Conor, scanned the suggested questions (which he wouldn’t tell me about ahead of time) and ventured off to the mobile studio. It was an amazing experience.

Each storyteller gets about 45 minutes to speak while a sound engineer records the interview on high-quality audio, which is eventually preserved. Participants are offered the opportunity to have their story archived at the Library of Congress and have a portion of their story broadcast over NPR (National Public Radio). Conor and I agreed to both, so we became a part of the many personal stories of the United States. You can listen to the segment broadcast on NPR here.

I loved this whole experience and treasure the sound of my son’s 11-year-old voice. The variety of questions he asked me was surprising, and it gave us a new chance to document our family history. Yet, figuring out what to do with that CD recording over the ensuing decade has been a challenge to me – it’s moved with me three times and is now lodged between two cookbooks on one of my bookshelves – making me grateful that that I have a library and a URL that is helping keep this important thing found.

There are a lot of good reasons why NLM should NOT be the place where personal information is found – privacy, personal control, and the ever-growing trail of records that characterize health care across the life span. The complex mess of papers, pictures, and small books that most of us use to keep track of personal information aren’t amenable to the services of a library, whose goal is to acquire, preserve and promote access by all to a broad range of information. But there are many stories, records, and other notations about our health that individuals need to keep found across their life span. NLM needs your ideas here – should we fund the development of new apps that manage health information? Should we collaborate with electronic health records system companies to urge them to build personal health information resources for their patients? Is this a place where stimulating the business market could help?

I’m grateful that the Library of Congress committed to storing brief encounters between people telling their life stories, but in order to keep my story found, I had to share it with others.

What can we do to keep things found and accessible only to the individual?

Five Years and Counting!

On August 13, 2016, I became the first woman, nurse, and industrial engineer to serve as director of the National Library of Medicine (NLM). From its beginning in 1836 as a small collection of books in the library of the U.S. Army Surgeon General’s office, NLM has become a global force in accelerating biomedical discovery and fostering evidence-based practices. I am proud to direct this esteemed organization and delighted to guide it towards its third century beginning in 2036. 

This has been an exciting five years for NLM.

We accelerated data-driven discoveries and advanced training in analytics and data science across NIH and around the world. Our genomic resources played a crucial role in supporting NIH and the scientific community’s ability to understand a novel virus and address the COVID-19 pandemic. NLM investigators developed innovative uses of deep learning and artificial intelligence and applied them to a wide range of problems – ranging from interpretation of clinical images to improving search and retrieval of highly relevant citations from NLM’s PubMed biomedical literature database.

NLM pioneered strategies to link data sets to articles through our PubMed Central (PMC) digital archive, and doubled the size of the NLM-supported Network of the National Library of Medicine—reaching almost every congressional district in the United States with the capacity to connect NLM resources to communities in need.

We provided technical expertise to develop a secure single sign-on to a wide range of controlled data resources, and redeployed our research infrastructure to help public health authorities detect foodborne outbreaks and track the emergence of coronavirus variants. We also advanced our use of automated-first indexing to make sure that the published literature is available to our stakeholders as quickly as possible.

With the support and collaboration of other components of NIH, we are building a 21st century digital library that uses our collections to offer literature, data, analytical models, and new approaches to scientific communications that are accessible, sustainable, and available 24 hours a day and 7 days a week.

NLM’s archival collections continue to grow and evolve as the archival records of individuals, organizations, and other communities in health and medicine are increasingly created and communicated electronically or digitally. We expanded the formats and types of records we collect—and make accessible and usable— to include born-digital formats such as websites, social media, and data sets. For example, NLM deployed innovative techniques to prospectively curate and add COVID-19-related information from traditional news, social media, and other sources to our Digital Collections. These collections preserve for future research the ephemeral online record of modern health crises, documenting the work and experiences of health care providers, researchers, government agencies, news agencies, patients, and caregivers.

As a nurse and an industrial engineer specializing in health systems engineering applied to patient self-management, I bring a perspective to NLM that expands its mandate from supporting biomedical researchers and clinical practitioners to one that aggressively supports the health of the nation.

During my tenure, NLM’s footprint has expanded by:

  • Growing our research enterprise in support of data-driven discovery;
  • Supporting key priorities of the NIH in data science, access to secure data repositories, and community engagement;
  • Strengthening the integrity and efficiency of our internal resources to accelerate the acquisition, preservation, and dissemination of biomedical data; and
  • Expanding our commitment to public outreach and engagement.

Two guiding principles have shaped my work:   

One NLM

I initiated the One NLM concept as an organizing framework during my first year as director of NLM. One NLM creates a rallying point, making explicit that all our offices and divisions work in concert and in support of NLM’s mission. As described in my January 2017 blog post entitled, One NLM:


One NLM emphasizes the integration of all our valuable divisions and services under a single mantle and acknowledges the interdependency and engagement across our programs. Certainly, each of our stellar divisions . . . have important, well-refined missions that will continue to serve science and society into the future. The moniker of One NLM weaves the work of each division into a common whole. Our strategic plan will set forth the direction for all of the National Library of Medicine, building on and augmenting the particular contributions of each division.

Strengthening the NLM Senior Leadership Team

I employ a team model of leadership—engaging the deputy director, four division directors, and four office directors in biweekly meetings. With the support of external consultants, we engaged in a one-year leadership development activity focused on building capacity for joint decision making, improving risk tolerance, and creating an environment that supports trans-NLM collaborative problem solving. I found that continued engagement with individual members and the leadership team established an organizational milieu that led to improved trust in each other. And the team, which held up in good stead during a period of maximum telework in response to COVID-19, ensured the innovative mobilization of NLM resources to help NIH rapidly assume new research programs, respond to public health needs, and most importantly serve as a trusted source of information.

What I’ve Learned

While I remain true to my core values and beliefs, I’m not the same Patti Brennan as I was when I entered the ‘Mezzanine’ floor of NLM’s Building 38 nearly five years ago. I’ve learned to mobilize and reward the talents of the 1,700 people working at NLM to achieve common goals. I figured out how to work with a boss, something few academics ever actually face. I’m better at finding the niche into NIH conversations and policy-setting meetings where the talents of NLM and our deep understanding of data science accelerate NIH’s mission to turn discovery into health. I’ve created space in conversations for the voices of others, particularly the members of my leadership team with whom, I’ve learned, complement my vision and drive with their knowledge and discernment. It’s been a great ride!

How does the you of 2021 compare to the you of 2016?  

Learning from my Irish Heritage

Today is the Christian Feast of Saint Patrick, one of Ireland’s patron saints who lived during the fifth century. Celebrated today around the world as St. Patrick’s Day, this observance has evolved into a celebration of Irish culture and is a day of fun and family for those who are Irish or wish they were! As one of the 70 to 80 million people around the world who claim Irish roots, this celebration offers a chance for me to reflect on my own Irish heritage and what I have learned from it. And as those who have read this blog before know, family is of preeminent importance to me as a source of joy, strength, and comfort — all of which I have drawn on throughout my life.

Ireland is best known for its music and mythology, sports, scholars, and, most relevant to me, deep allegiance to kin groups. I can’t claim any skill on the feadan (tin whistle) or the cláirseach (the 30 string harp), although I enjoy a céilí (a celebration), and I do have some familiarity with the mythology, particularly the Morrígan, the Celtic triple war goddess of old, Queen Maeve, the strong-willed, ambitious, and fearless legend, and the warrior queens of the North. In terms of sports, I’ve learned enough to enjoy a hurling match and can follow Gaelic football. Ireland is known as ‘the land of saints and scholars,’ and my Irish heritage has provided me with a genuine and deep-seated love of learning that has been integral in my life.

Valuing my Irish heritage means also looking clearly at what makes Ireland what it is today.

The response to oppression gave rise to nationalism and a drive to be an independent sovereign state, leading to independence in 1921 (only 100 years ago!) and militance with sometimes tragic results advanced in the name of freedom. The Good Friday Agreement of 1998 brought about the end to one kind of violence. The Good Friday Agreement brought a measure of quietude to the challenges of expressing different views, yet more than twenty years later, differences still persist. And the recent investigations into mother and baby homes engendered an awareness of the need for the apologies to survivors of this awful period in Irish history.

Some believe the “Irish temperament” is a mixture of stubbornness, personal warmth, and a wit that shines through adversity. I certainly hope I have all three of these, perhaps a bit more of the latter two than the first. However, having a bit of stubbornness is important, particularly as the director of NLM, which serves as NIH’s center for biomedical informatics research and the world’s largest biomedical library. Being stubborn, coupled with warmth and wit, has helped me guide the NLM as it approaches its 3rd century in existence. It has helped me serve as an advocate for the technical infrastructure necessary to secure our resources and to make them permanently available around the world. It has provided me with the tenacity needed to hold firm to the values of what libraries mean to society – institutions rooted in collecting and disseminating the literature of the world with integrity and without censorship.

What this means to NLM is that we must continue to hold to our enabling legislation of 1956, to acquire, preserve … materials pertinent to medicine and … make available… materials in the library. As Joyce Backus, our former Associate Director of Library Operations, was fond of saying, “science is self-correcting,” meaning that we don’t need to exclude materials that are no longer aligned with our global perspectives, but we do need to continue to gather and make available the full range of information.  

So, I hope you join in the celebration of all that is Irish on this St Patrick’s Day and remember that history is complex — and the purpose of libraries, including the National Library of Medicine, is to reflect the progress and perspectives across time, rather than a snapshot of a particular point in time.

How can we help you in this celebration?

10 Tips After 10 Months of Video Calls

Like most of the world, staff at NLM has been engaging with others through various technologies – video conferencing, virtual daily work huddles, and conference-inspired meetings that require screen sharing, virtual breakout rooms, chat features and instant messaging. I’ve gone from a 30-minute commute, including a short walk and a metro ride, to a 3-minute walk from my bedroom to my home office. Those lovely, long walks across the NIH campus that formed the bridges between meetings three or four times a day are now replaced by 60-second coffee refills between almost-non-stop video calls between 8 a.m. and 6 p.m. And where before I only had to make sure that I looked professional and polished, I must now make sure that there’s no clutter or distracting pictures or items in the background – the camera sees everything!

Fortunately for me, I regard meetings as a high art. For the past 15 years, meetings have been one of the main mechanisms through which I work. Early on I learned two great tips from a great biomedical informatics guru, John Glaser

Never walk out of a meeting with more to do than you came in with, and never close a meeting without knowing who is taking the next steps on every item.

This comes in handy when your days are lived on camera! I can’t match the wisdom of John, but I can share some ideas that are proving helpful to me as I (virtually) meet with NIH colleagues, the NLM leadership team, individuals with whom I’m collaborating, and NLM staff through “brown bag” lunch sessions.

I’d like to share a few of my own tips garnered from my years of in-person and virtual meetings.

Call people by name, often.

This is particularly helpful if you are leading a meeting, for it acknowledges people and engages them in the moment. It is also important when you are a participant. Using names helps compensate for the lack of communication cues in video calls, such as eye contact and head nodding, and fosters engagement and stimulates participation.

Start on time and end on time.

I know I’m not the only one whose days are lived through conference calls and video chat. By starting and ending on time, you demonstrate respect for everyone on the call, as well as those in the prior and subsequent calls. In addition, it saves you from having to start every next call with the “sorry I was finishing up a previous call” apology.

Allow for pauses.

This is important for the leader of the meeting and is also equally relevant for participants. It can be difficult to pick up on visual and audio cues, gestures, and conversational threads, such as someone leaning back, leaning in, shifting their gaze, or changing their tone of voice. So, it becomes particularly important to let pauses stand an extra second or two to allow someone to come off mute or organize their thoughts.

Keep your camera on when possible.

Keeping your camera on provides visual evidence that you are present and attentive during the conversation and meeting discourse. It’s courteous to others, and yes, it does mean that you have to attend to the image being displayed, but it allows your colleagues to see that you’re not reading email or distracted by other issues. It also reinforces the connection between the speaker and the audience and enhances a sense of group engagement. Although some may worry about excessive bandwidth consumption, the social value is worth it!

Keep your microphone off unless speaking!

Visual cues are important; auditory cues are distracting. Until technology advances, microphones (mics) often create distortion, pick up background noise, contribute to audio feedback, and generally degrade the conversational experience. Remaining on mute signals respect for the speaker and gives them a non-competitive platform for discussion. It helps to learn the steps of muting and un-muting to keep up with the rhythm of the conversation.

Check your mic often and use a headset with a good mic.

Get to know your mic, how it works, and the indicators that it’s live. Poor audio quality can affect the experience of the video call for everyone. Many of us forget that the mic is on our laptop and the further away we are from the mic, the poorer the audio. I’ve found that using a headset helps because it puts the mic close to your mouth and will help minimize background noise. It is key to your personal happiness and professional survival that you make sure you know how to troubleshoot basic mic issues, particularly knowing when your mic is on, when it’s NOT on, and to stay alert so it’s never on when you don’t realize it! 

Use chat features judiciously.

Most video conferencing software has some type of text support, usually called “chat.” I find this feature to be very useful when I’m NOT the speaker and very annoying when I am. Sometimes, in a big and exciting meeting, sidebar conversations held through the chat feature can provide clarification and enhance the shared experience. However, every thought appears on the screen and it can be distracting to the speaker. If you really want to chat your way through a video call, consider setting up a parallel channel in a different platform for that purpose or consult with your speaker beforehand. Your speakers will thank you!

Watch your backgrounds!

Video conferences introduce us to the private lives of our colleagues in ways never before anticipated, often by having the opportunity to look over the shoulder of your colleague and into their background. Some video conferencing platforms allow you to customize the image projected on your screen – a blessing and a bane. Remember that some backgrounds may best be left for personal calls with friends or family, and professional engagements do best with a more subdued background where the interest can focus on the person, not the background.

Take notes.

Many of the mental mechanisms we use in human discourse add meaning and interpretation to the words that are exchanged. We remember how a colleague smiled when bringing up a new idea, or the worried look when your words weren’t well understood. Note taking (I use a fountain pen and write in long hand) helps keep me focused during video calls, aids me in organizing thoughts, and often provides a reminder for the next meeting or conversation.

Take a break!

This tip is for you; not about using the technology. Technology is unrelenting and always demanding. The immediacy of work, the pull of people waiting for a meeting to begin, and our tendency to overschedule can lead to very packed days. As an industrial engineer with human factors training, I know that performance degrades over time and short breaks help! Schedule breaks – at least every two hours – even if only for five minutes. Take a walk, hug your child or someone you love, or start a load of laundry. The goal is to refocus and refresh!

What have you learned from 10 months of video conferencing? Please share your tips and ideas here – we are all in this together.