Resilience

Yale Medicine Magazine, 2014 - Autumn

Features
Resilience
Yes, you can cope
Why our bodies, and brains, bounce back
A bug’s journey
The epigenetics of child abuse
How children rebound from their worst nightmares
Dancing through pain
How two physicians deal with their own illnesses
Can resilience be engineered?
Building strong societies, one dad at a time
The fight to control smoking
Laid-back ‘spokesdog’ on TV
A “decoy” for reversing the effects of stroke
News
People
Dialogue

Recovering from injury to body or mind.

Laura Niklason

Laura Niklason // Biomedical Engineer // “They say that laboratory work is composed of good days and bad months. And I think that having a conviction that you can think your way out of problems and engineer your way to solutions is a big part of resilience in this field. … It took us 18 years to get from the start of the [engineered blood] vessel project to the first implant in man, and that’s actually making pretty good time.“I was trying to finish up some key studies, some key proof-of-principle studies in pigs. This was like 15 years ago. I had nearly a year of culturing and experimental failures for reasons that it took me a very long time to figure out, and I can remember almost quitting then.”

Pranay Sinha

Pranay Sinha // First-Year Resident // “When I’ve made mistakes, I’ve had to sit down and remind myself that this happens to everybody, and crying about it right now or letting it affect the rest of my day isn’t going to make things any better. So the only way I can deal with this is to keep moving and pay more attention to what I’m doing. And this is part of the greatness of medicine. It forces you to become this stronger person who takes his work very seriously but doesn’t take himself that seriously.”

Jorge Galán

Jorge Galán // Microbiologist // “If you don’t have stamina and resilience as a graduate student, you’re not going to graduate, because most experiments do not work. That’s a dirty little secret. Yes, you can learn through the do-not-work part, but the reality is that it’s not that you do a couple of experiments, figure 1, a couple of experiments, figure 2. … Most of the time, things don’t work, so science is all about resilience. If you don’t have that in you, you just couldn’t be a good scientist.”

Anjelica Gonzalez

Anjelica Gonzalez // Biomedical Engineer // “There was a person whom I admired scientifically who told me that I had a poor work ethic and should get out of the field. … Every step of the way I’ve worked very hard, and to tell me that that’s the reason I would fail was demoralizing. I didn’t go to class for two days. … then I thought that if I don’t go, then I’m proving to him that I won’t work. I think that was the hardest time, for me to get up and go to school and go to lab.“Three weeks ago a colleague was at Baylor University for a seminar and this guy was saying how I’m doing great work. … and it was him!”

Chris Zirker

Chris Zirker // Medical Student // “I’m a C6 tetraplegic. I broke my neck snowboarding when I was 20 years old. I had to relearn how to walk. I had to relearn how to eat. … I’m able to walk. I’m able to touch type. My hands are relatively functional but I don’t think I’ll do anything like surgery or things where I need fine motor skills and dexterity. I think I’m going to be a lot more focused on more intellectual fields where you talk to patients and interact with them more that way.”

Peter Jokl

Peter Jokl // Sports Physician // “I went to Yale, was on the track team. I was pretty good; I certainly wasn’t the best. You get injuries and you try to maintain a positive outlook, and during an injury you try to find ways that you can maintain your athletic competence while healing. If someone injures an arm or a leg, I’ll tell them they’ve got three other extremities and their heart and lungs work so you can do other things.”

Ruslan Medzhitov

Ruslan Medzhitov // Immunobiologist // “Because I was growing up in communist Russia, there were all sorts of perturbations on the way to attempting to perform studies and science. I was in graduate school during the economic crisis when the country was breaking apart, when the economy was destroyed, transitioning from a communist economy to a market economy when resources were nonexistent for science. During that period it was almost impossible to perform any kind of science. Even literature was not available to read.“You have to be resilient in that environment in order to maintain interest in science and not go into business or something else.”

Rick Lifton

Rick Lifton // Geneticist // “Resilience is perseverance in the face of adversity. … When I was starting my career, my first NIH application received a score that is no longer obtainable because of the way we triage grants now. On a scale of 1 to 5, my application got a score of 5, which meant that if there were an infinite amount of money and nobody else was applying, my grant should not be considered for funding.”

After a day of sailing, swimming, and jogging at his vacation home on Campobello Island in 1921, 39-year-old Franklin Delano Roosevelt went to bed early and suffered chills throughout the night. By the end of the next day, his legs were paralyzed from polio, and he never walked unaided again. Yet 11 years later he won the first of four presidential elections, and went on to become the longest-serving president of the United States. He reshaped American politics, brought the nation through the Great Depression, implemented the New Deal, and led the Allies to victory in World War II.

How many of us could persevere in the face of a crippling disease, let alone lead a troubled nation and world? Some of us can’t even sleep at night for stressing about our daily lives. Others, however, easily recover from natural disasters, terrorist attacks, and combat. “It’s about the stories people tell,” says psychiatrist Charles A. Morgan III, M.D., FW ’01, “And some people do more storytelling in their heads than others.”

As we set out to explore the theme of resilience for this issue of Yale Medicine, we learned that it comes in all different forms. We look at a woman’s recovery from a stroke and a dancer who overcame a career-ending injury and now cares for other dancers. Microbiologists describe how microbes survive not as individuals, but as populations. Child psychiatrists help children who have confronted violence. And faculty and students describe moments in their lives that led them to dig deep into their own stores of resilience.

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Yes, you can cope