Loss, Love, and Science

Sirisha Asuri

Have you heard the old adage “Necessity is the mother of invention”?  My journey so far can be described by this as I have reinvented my role more than once by what life needed from me.

I have a PhD in biochemistry and molecular biology and currently work as a Health Policy Analyst. How did I get here?  

As a child I always imagined I would be treating people as a medical doctor. How I decided on that is not very clear to me; however, as luck would have it, I didn’t make it into medical school! Though very disappointed, I went on to pursue graduate studies in Microbiology and Biochemistry where I subsequently discovered my love for research and I decided to pursue a PhD.   

Sirisha Asuri

 I joined my roommate who was preparing for the Graduate Record Exams (GRE) to apply for PhD programs in the USA. What is interesting is that I actually had not thought about leaving India for higher studies up to that point. So, it was indeed a pleasant surprise for me when I was accepted into the PhD program at Indiana University in Indianapolis with a full scholarship and a monthly stipend. I was thankful that my parents fully supported me in my decision to go study abroad since sending a young woman all by herself to a foreign country was not common in India in the early 2000s. My PhD was like any other with exciting days of cool experiments and days of slogging with no progress. While I worked on signal transduction pathways and cancer signaling mechanisms through my PhD research, I was repeatedly drawn to the research hospital adjacent to my lab where clinical research was conducted. I loved working on projects that had immediate benefits to patients in their treatments and wellbeing. 

I was keen to look for clinical research opportunities after my PhD. Meanwhile, things were going well on the personal front as well. Towards the end of my PhD, I met my now husband. It was a start of my scientific career and my family life. However, as a young woman who was recently married and in the prime child bearing years, I sadly encountered the worrisome look on the faces of many principle investigators whose labs I had applied for my post-doctoral work. Eventually I accepted a post-doctoral position at Chicago with a principal investigator who was a woman with three children of her own and was not deterred by my impending pregnancy. The project I was working on aimed to change the treatment of patients who had suffered heart attacks by using microrods with growth factors directly placed into the tissue near where the cardiac cells were damaged to initiate cell growth. It was my passion to do research that affected clinical care and here was an opportunity to make it a reality.

Everything was going great until I learned that I was soon going to be a mother. As such, the idea of decapitating neonatal mice, which was part of my post-doctoral experiments, suddenly became completely devastating. As a soon to be mother, it was extremely hard for me. I began each experiment sad, distraught, and begging the mother mouse for forgiveness. I felt like I could relate to the pain the mother mouse must feel.

As if the universe heard my plea, my husband was offered a wonderful work opportunity in Canada. We had just had our beautiful daughter and we decided it was the right time to take on a new life opportunity. With a newborn in hand, I was happy to stay home and cherish my time with her. As she got closer to a year, I felt ready to get back into the field. During one of my informational interviews, I met my next post-doctoral advisor. I came in to speak to her to understand the research opportunities in the area when she casually wondered if I would be interested to cover a maternity leave position in her team. I was thrilled to accept the offer.  

Within the year and before the colleague I was covering returned from maternity leave, we secured funding for my own post-doctoral fellowship. I ended up staying in the same team for the next 7 years! I worked on a variety of projects and my analysis directly helped how patients received treatment and care for their conditions. I also worked on understanding some of the socio-economic factors of health, particularly maternal and child health. I researched how policies, programs and interventions can make major changes to the health of women and their children. I wrote reports that would affect such policies and programs. One such report was on the effect of the flu virus H1N1 and pregnancy and young mothers.

I found my work very rewarding and satisfying. At the home front, everything was perfect with a young daughter, a new home, and a happy family. I also came to know I was expecting another child and we were happy to add another little one to our family.

However, life didn’t stay so calm for long. I was given some sad news that my dearest friend was very sick and in the intensive care unit. At the time, she had given birth to twin babies – a boy and a girl – just three days prior. Now, since her lungs were failing, she was intubated to help breathe, and was in a medically induced coma. I heard all this over the phone from a common friend. I was in disbelief, as if someone was playing a cruel joke on me. I didn’t want to believe it. I wanted it to be a nightmare and wake up from it. But her husband confirmed that it was true and explained that he decided to keep the news from me because they knew I was newly pregnant and would be distressed. He had been told that she was infected with H1N1. Her first negative test had been wrong thus it was not pneumonia. Hearing the word “H1N1” made me lose all strength in my legs. Tears rolled down my face as I knew the prognosis of such an infection in a young mother.  The report I had written previously was fresh in my head.

It took several weeks before I could be relatively normal again. After all this, I was more driven than ever.

I logged on my laptop and reviewed all the papers and reports I read on H1N1 and pregnancy. The more I looked for hope, the more I was disappointed to see how bleak the prognosis was if it was not treated within 48 hours of symptom development. I examined many clinical reports and called her husband every single day to see how she was. I played in my head the conversations we had about how she wanted children so much, her struggle to conceive, and how thrilled she was when she got pregnant with her first child.

When her first baby was born via C-section, I was the one who accompanied her in the operation theatre because her husband fainted just watching her get an epidural. I remember sitting by her head, seeing her baby seconds after she was born, and gently whispering in her ear that her beautiful girl was here. We were like sisters born to different mothers. We shared a deep connection. Now, she was fighting for her life. I continued to call her husband with the hope of hearing a glimmer of good news. But it only worsened and finally after a month-long struggle, she was taken off the ventilator. I was not told the exact date of when they were turning the ventilator off but I could almost feel it given our deep connection. I was inconsolable that night. I just knew something was happening. I couldn’t even visit her or hold her hand when all those humming machines were turned off.

My brain was filled with questions – what would have been the outcome if they had treated her with antivirals within 48 hours as all the guidelines recommended? Could she have survived and get a chance to raise her babies? Why were the guidelines not followed? I was so angry to see that there was so much research, 100s of papers on PubMed on the high stakes with H1N1 and pregnancy and the various guidelines that clearly said to promptly treat with antivirals with any fever in high risk patients. I felt like I – along with the whole scientific community – betrayed her. Why? The research was all there but it was not well translated to the clinic. She was just one case. But one was still too many. A family was broken and three children were left motherless. I couldn’t forgive myself and I took the blame on behalf of the whole research and medical community.

During this same time, my own pregnancy resulted in a traumatic miscarriage. It was the lowest point of my life. A week after my miscarriage, I had a high fever and flu symptoms. I went to the emergency department at the local hospital and was told to go home and take some generic medicine. I had to remind the physician regarding the guidelines around fever and pregnancy (which includes new mothers, live birth or miscarriage). Once again, I was shocked to see the important research dropping into the valley of death and never making it to clinical care.

It took several weeks before I could be relatively normal again. After all this, I was more driven than ever. I decided I needed to play an active role in bringing research into policy and guidelines for patient care. It was – and still is – important to fight the valley of knowledge death. I realized that there is a massive need to contribute to how policies are developed and implemented. So, early last year, I accepted my current position as a Health Policy Analyst where I focus on bringing knowledge to health care design, planning and delivery.

I began my career with hopes to uncover the reason for debilitating illness and discover a drug to cure those diseases. But the path I was on to accomplish those goals was not what I imagined it would be. The path was full of surprises and new experiences. The turns I took to receive those experiences has been enriching. The experiences have taught many lessons. Being a mother to my two children has taught me to see the world with wonder and a place filled with possibilities.

Just because you left the lab doesn’t mean you forgo all that you learn in the lab.  The critical thinking, science writing, working tirelessly to accomplish something, thinking beyond the confines of the current knowledge, daring to explore and experiment, not being afraid to fail are all some of the things I learned in the lab that I now use every day. Creating policy is like a scientific experiment. You find the problem, research to understand the current knowledge on it, identify best ways to address the problem and propose solutions. I may not be doing scientific experiments at the bench now but I use all the skills I acquired to create evidence-based health policy that has large impacts on the health and wellness of the society.

Cover Image from Pixabay | CC0 Creative Commons