Bring on the New Year!

Marking the turning of the years is a way to make peace with what is and prepare for what will be. There’s a beautiful night passage that I’ve been drawn to reflect on this week:

It is night after a long day.

What has been done has been done;
what has not been done has not been done;
let it be.
[1]

These words urge us to accept where we are without judgement as we look forward to the new year.

So, what will 2022 look like for me, my family, and NLM? I am looking forward with hopes of more togetherness – at work, with friends, and with society. I am renovating a 110-year-old home in Easton, Maryland to use as a weekend getaway and vacation home. I am looking forward to meeting neighbors and reinvigorating this beautiful, old structure. My family is looking forward to weddings, graduations, retirements, and other milestones across my nine siblings and 37 nieces and nephews. My 92-year-old mom will move to an independent living facility—bringing treasured possessions from the home she shared with my dad along with the anticipation of making new friends.

NLM has big plans for 2022 as well! We anticipate a gradual return to the physical workspace. However, we won’t be returning to work as we knew it almost 2 years ago; we’ve learned a lot about working remotely, and many staff have found joy and satisfaction with this new way of working. We expect that staff will find a balance between working on campus and working elsewhere.

NLM leadership is working with all supervisors and staff to make sure the return to the physical workspace is a safe, positive, and meaningful experience for everyone. We are tasked with discerning what type of work is best done when one is onsite at NLM and what is best accomplished when working remotely. What we don’t want is to bring our valuable workforce back to the physical NLM location only to have them sit in virtual meetings all day!

With less restrictions on travel, I expect to see our staff attending professional meetings and providing informative talks at conferences once again. This will be particularly valuable for our trainees as it helps socialize them into the professional societies that will form their lifelong career support network. I’ve empaneled a “Future of Work” council, not to plan for 2022, but to look into the distant future to envision what work might be like and how NLM can best organize itself to meet the challenges of the future.

In 2022, NLM will continue to work with the rest of NIH to rectify the impact of structural racism on science and the scientific workforce. Under the UNITE Initiative, hundreds of people across NIH are envisioning ways to create a workplace that is free of harassment, inclusive and welcoming to all, and achieves the highest level of scientific impact by engaging a diverse workforce addressing the challenges needed to eliminate health disparities.

We anticipate that the renovation of our building will continue at full speed. All of us will be challenged to call on our sense of flexibility as we move toward a stronger infrastructure that will take us into our third century.

NLM will continue to acquire, preserve, and disseminate scientific literature to make it easier for scientists, clinicians, patients, and the public to acquire information about clinical trials and health concerns, and make our genomic databases more accessible and more useful for society. Our investigators will leverage the new collaborations they forged during the COVID-19 pandemic to augment their longstanding investments in computational biology and clinical health informatics research. We will bring new scientists into our workforce and strengthen our technical and administrative services.

We’ve got a big year ahead – what would you like to see us accomplish? And, more importantly, I’d love to hear your hopes for the coming year!


[1] The Anglican Church in Aotearoa, New Zealand and Polynesia. (1988). A New Zealand Prayer Book. The Office of the General Synod. https://anglicanprayerbook.nz/167.html

Happy Holiday Season!

It’s the holiday season and a time for celebration, reflection, and catching up with family and friends. This year, I am struck by two themes: the celebration of light and darkness, and the time-honored traditions found in special foods and decorations.

For me, a winter aficionado with strong Irish roots, my holidays began with Samhain (pronounced “SAH-win”). Samhain is a Celtic festival that marks the “wintering of the world” – that necessary time of slowing down, becoming quiet, and resting. As I write this blog, millions of people across the globe are celebrating the festival of Diwali. Diwali is a five-day celebration marking the triumph of light over darkness, good over evil, and knowledge over ignorance. Families gather over Diwali in households decorated with vibrant flowers and candles, enjoying sweets in acknowledgement of the year’s bountiful harvest.

This year, Hanukkah began at sundown on November 28 and ended December 6. This eight-day Jewish holiday commemorates the rededication of the temple in Jerusalem as a festival of lights remembering the miracle of the oil lamp that burned for eight days. For those who celebrate Christmas, this is both a secular as well as a religious festival including special prayers and church services, household decorations, sparkling trees, and sweet treats. In many places you might find luminarias, small paper sacks filled with sand that support candles creating beautiful lights along streets and up pathways in many neighborhoods inspired by traditions arising from Central and South America. Kwanzaa celebrates African heritage and identity, beginning the day after Christmas lasting for several days. During Kwanzaa people light candles, eat special foods recognizing the “first fruits” of the harvest, and place special symbols around their homes.

Light plays a leading role in many winter celebrations. During this time of year, at least in the northern hemisphere, light is a cherished resource dispelling the darker days and cold weather inspiring vision and hope. Light serves as a symbol of many things to many people, but to me, light symbolizes goodness and knowledge and has special meaning to the National Library of Medicine. NLM brings knowledge to the world 24/7, and I personally take this time to remember the “light” that NLM brings to the world.

NLM has a bit less to do with food and decorations, but we are filled with books, articles, and artifacts about nutrition and symbolism. We can extend the celebration of food and decorations to NLM. In 2016, NLM’s History of Medicine division launched a special exhibition, “Fire and Freedom: Food & Enslavement in Early America.” This exhibit illustrated the important connection between meals and power dynamics – you can visit the online exhibition here. NLM’s digital collection includes pictures of holiday events across time and around the world – you can look here for a poster urging Americans to Buy Christmas Seals, Fight Tuberculosis and here for a September 1917 list of suggestions from the American Red Cross for Christmas packets for our military personnel at home and abroad.

As you experience the lights and marvel at the foods and decorations of this holiday season, in whatever way you celebrate, please take with you the good wishes of the National Library of Medicine!

Please Join Me in Thanking our NLM Veterans

Every year at this time, I take advantage of Musings from the Mezzanine to share with you some of the things for which I am thankful. In my 2020 blog, I reflected on how far we’ve come together since I joined the NLM in 2016. In my 2019 blog, I mused about the people, professionals, and personnel for whom I give thanks. This year, I want to give thanks for all veterans in the United States, but particularly for those NLM staff members who are also veterans.

There’s an official legal definition of a veteran – according to Title 38 United States Code, a veteran is a person who served in the active military, naval, or air service, and who was discharged or released under conditions other than dishonorable. Also included as veterans under certain circumstances are National Guard members and members of the uniformed services such as the Public Health Service.

Left to right: My grandfather, Michael Flatley, and my father, Thomas Michael Flatley.

I come from a strong veteran family – my dad, my uncles Bill and Ed (who were military chaplains in WWII and Vietnam, respectively), my cousin Joey, and my nephew Chris.

At NLM, we are fortunate to count many veterans among our numbers. Some of our staff are not only veterans of active-duty service, but they also continue to serve through the reserves or through membership in the National Guard.

It’s good for NLM to have veterans among our workforce. Veterans bring well-developed skills that can effectively be applied to our operations and research enterprise. While each veteran is unique, and entered uniformed service for very personal reasons, veterans bring a commitment to the country refined through their assignments. And veterans strengthen NLM’s commitment to serve the public through government service.

I think that working at NLM is also good for our veterans. NLM allows them to continue in public service and provides them with a world class enterprise environment that makes effective use of their talents and skills honed through previous service. And working at NLM enjoins the efforts of these veterans with the remaining 1,600 plus people who work every day to bring information to the public, make genomic information safely and securely available for science and public health, and help reach communities across the country with trusted health information.

I am pleased and proud to honor these select members of our outstanding workforce. Thank you for your military service and thank you for your continued service at NLM!

Clockwise from top left:  Dianna Adams (U.S. Army), Alvin Stockdale (U.S. Army), Velvet Abercrumbie (U.S. Navy), Ken Koyle (U.S. Army)
Clockwise from top left: Dianne Babski (U.S. Army), Kevin Gates (U.S. Air Force), Bryant Pegram (U.S. Army)
Left to right: Todd Danielson (U.S. Army) and Peter Seibert (U.S. Army)

A Mother’s Day Message: Time for Action to Improve Maternal Health

Guest post by Diana W. Bianchi, MD, Director, Eunice Kennedy Shriver National Institute of Child Health and Human Development and Janine Clayton, MD, Director, Office of Research on Women’s Health

For many of you, this past weekend likely had its share of greeting cards, flowers, video calls, and, perhaps, even a tasty brunch celebrating the special maternal figure(s) in your life. Maybe it was your mother, grandmother, or another special person who always looked out for you when you were growing up. For others, this past weekend may have been bittersweet—a time to remember a mom or someone special who is no longer with you, but who left an indelible mark on your lives, giving you joy, wisdom, and resilience. Mother’s Day is a wonderful holiday filled with love and appreciation.

Sadly, hundreds of children each year in the United States do not get the chance to celebrate Mother’s Day with their moms because of a growing maternal health crisis. In a wealthy nation like ours, a healthy pregnancy and childbirth should be a given, but it’s not. According to the Centers for Disease Control and Prevention (CDC), nearly 700 women die each year from complications from pregnancy or giving birth. In addition, American Indian/Alaska Native and Black women are 2 to 3 times more likely to die from a pregnancy-related cause than white women. The CDC estimates that two-thirds of maternal deaths are preventable.

Understanding and reducing pregnancy-related deaths and complications—or maternal morbidity and mortality—is a high priority for the National Institutes of Health (NIH). In the past year, with an estimated $223 million in funding, Institutes, Centers and Offices across NIH have worked together, and with their federal and community partners, to support scientific research for this crucial endeavor. In a year dominated by both the COVID-19 pandemic and renewed calls to address health disparities and inequities, NIH is facing these challenges head-on and accelerating efforts to reduce maternal morbidity and mortality.

Engaging the Community to IMPROVE Pregnancy Outcomes

Improving maternal health requires strong partnerships with local communities, particularly with racial and ethnic minority populations that experience stark disparities in access to quality prenatal and postpartum care.

To that end, several NIH Institutes held activities to hear first-hand how patient communities can inform future research and what strategies might enhance local efforts. Workshops and forums included:

A common refrain from these discussions reinforced the importance that research conducted within a community should be developed with and vetted by that community to ensure its success. These exchanges informed the development of NIH’s Implementing a Maternal Health and Pregnancy Outcomes Vision for Everyone (IMPROVE) initiative, which aims to build an evidence base that will enhance maternal care and outcomes from pregnancy through one year postpartum. IMPROVE receives funding support from several NIH Institutes and is co-led by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development, the NIH Office of the Director, and the NIH Office of Research on Women’s Health.

To date, the IMPROVE initiative has awarded more than $7 million in grants in research areas related to maternal heart disease, hemorrhage or bleeding, and infection (the leading causes of U.S. maternal deaths); contributing conditions, such as diabetes, obesity, mental health disorders, and substance use disorders; and structural and healthcare system factors that may contribute to delays or disruptions in maternal care.

Pivoting to Address COVID-19

Like GRAVID, studies funded by NIH and others continue to produce data to help inform medical care for pregnant women during the pandemic. For example, the CDC’s V-safe registry collects data on COVID vaccine side effects from people across the country. Their recently published findings show that so far, the vaccines are safe and effective for pregnant women, which is reassuring news to people who are undecided about getting the vaccine. 

Looking Ahead

Many factors contribute to maternal morbidity and mortality, and NIH will continue to fund projects to develop tailored, evidence-based solutions for pregnant women across the country. This year, IMPROVE will fund new research to understand the effects of SARS-CoV-2 infection and the COVID-19 pandemic on maternal mental health, well-being, functioning, and quality of life. These research awards also seek to address the impact of structural racism and discrimination on maternal health outcomes in the context of COVID-19.

Every maternal death is one too many.

We encourage pregnant women to get care as early as possible in pregnancy, and to discuss their health and lifestyle habits with their health care providers. In turn, health care providers (including non-obstetricians) should take a health history that includes recent pregnancies and listen to women, especially if they have health factors that increase the risk of complications.

NIH will continue to advance research to help ensure healthy pregnancies and reduce maternal morbidity and mortality. For researchers, whether you’re studying fundamental science, leading clinical studies, conducting population or social/behavioral research, or developing new technologies, an important opportunity exists to improve maternal health and help families across the country.

What opportunities do you see to improve maternal health in your community?

Dr. Bianchi is a co-lead of the NIH’s IMPROVE Initiative. As director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Dr. Bianchi oversees NICHD’s research on pediatric health and development, maternal health, reproductive health, intellectual and developmental disabilities, and rehabilitation medicine, among other areas.

Dr. Clayton is a co-lead of the NIH’s IMPROVE Initiative. As director of the NIH Office of Research on Women’s Health (ORWH), Dr. Clayton has strengthened NIH support for research on diseases, disorders, and conditions that affect women.

Holiday Greetings from the NLM Director!

I consider myself an upbeat person and am most upbeat during the winter holiday season. I’ve always been drawn to this time of year – it’s cold, often snowy, and brings many traditions I love, including spiritual customs, family gatherings, fabulous food, and gift-giving. It also brings about an annual pause in the lives of many people, and an opportunity to celebrate the many holiday observances that take place across various cultures in the world.

This year I’m struck by the importance of light as a symbol across many religions and cultures, such as the Festival of Lights celebrated by Hindus, Jains, and Sikhs known as Diwali; the Jewish Festival of Lights known as Hanukkah, or Chanukah; the Christian tradition of Christmas; or the celebration of African and African American culture, known as Kwanzaa.

Light is almost a universal symbol.

Light represents hope, transcendence over darkness, and knowledge. We experience light through lamps, candles, in the flames of a fire, through the brilliance of the sun, and the twinkles of color that appear on holiday decorations. In some religious traditions, light represents spiritual power or guidance. In common parlance, light reflects joy and invites engagement. Light stands in a positive contrast to the short days and long nights of winter experienced in the Northern Hemisphere, where I’ve spent most of my life.

Light also serves as an indication of illumination – the increased clarity, insight and awareness about situations and ideas. NLM serves as an illuminating force in the world – bringing knowledge to bear to increase enlightenment and awareness about complex biomedical situations and ideas. I’ll bet you haven’t often connected the idea of holiday lights and NLM resources — bear with me — it really works!

Information alone – unread and unused – is not enough, just as the benefits of light are limited when the light is obstructed or not in view. This idea holds true for NLM resources too.  

As a leader in biomedical and health data science research and the world’s largest biomedical library, NLM’s research and information services are most valuable when they are readily available to those who need it. Thanks to our NLM team, we continue to be able to provide free and unencumbered access to information to people from around the world.

Individuals perceive light through a complex physiological and psychological process and their reaction to light builds on history and prior experiences. When NLM users discover new articles or preprints through our search process and read them, they do so against the backdrop of their own life experiences and knowledge – adding even more value to research, both new and old! Finally, one of the greatest things I love about light is that it can be experienced and perceived by many without being diminished. So too for our NLM resources that serve many without ever being exhausted!

This year, I am observing and celebrating the Christmas holiday and want to share the light of this holiday season with all of you, and particularly with my son, who is far away from me in Seattle. This season, many of us will be connecting with loved ones near and far through the light of a computer screen!

Certainly, the challenges of 2020 have made it ever so much more important to enjoy the spark that friends and family near and far provide. Please share your special views on light with each other and with the readers of this blog.

Happy holidays from ours to yours!

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