Hello, my name is Craig Coopersmith, and I am extremely honored to be the recipient of the Distinguished Investigator Award this year from the American College of Critical Care Medicine. Instead of giving the typical, this is what my research is about speech, I'm going to give something slightly different. I'm going to explain to you how I got there. So in other words, an unexpected career as a clinician scientist, lessons learned on the journey. My disclosures are listed here, and none of them are relevant to my talk today. My other disclosure is that I'm not actually going to talk about my research at all during this talk, except for very indirectly. So many people know from an early age, what they're destined to do. They know from an early age that they're going to be a researcher for their entire career. I did not. So here are some lessons learned along the way that led me to where I am today to giving this talk. So back in high school, I looked like this. And if you're wondering which I am, I'm the one who's second to the right. I don't quite look exactly like that, but you could probably still recognize the glasses. Even though that was taken when I was 17 years old, even at that age, I knew I wanted to be a surgeon. So first lessons learned from being a Hawaiian shirt wearing nerd. Having a plan matters. While the plan might change over time, having the vision to chart your own course is important. Whatever you think looks good on you may look ridiculous many years later, and yet you may still see me wearing that Hawaiian shirt again. That's a teaser for you to stay to the end of the talk. At this stage of my life, I'd never heard of critical care, and I had less than zero desire to do research. Many people start doing research in college or even high school. I did not. This is what I did in college. This is me, the Daily Pennsylvanian, which was rated the number one newspaper, college newspaper in the country. I was the editorial page editor. So what are some of the unexpected lessons learned from the Daily Pennsylvanian or the DP part one? I first learned how to work as part of a team and later learned how to actually lead a team. I learned how to write. I learned how to write rapidly at over 150 publications, always with essentially the same day deadline. And I had to learn to write clearly and concisely, even though I would have been totally unable to articulate it then. Every one of those skills became foundational to my future career. This is a list of some of the people I worked with at the Daily Pennsylvanian. Jeff Goldberg is currently the editor in chief of the Atlantic magazine and is a frequent guest at Meet the Press. Gene Sperling was the director of economic policy for both the Clinton Obama White Houses. Ken Rosenthal is the sideline baseball reporter for Fox Major League Baseball. You'll see him in every World Series and the senior writer for The Athletic. If you see him on TV, you'll always see him wearing a bow tie, although in college his nickname was Blade and he never wore a bow tie. These are two people I worked with. This is written by Jeff Goldberg, the editor in chief of the Atlantic, about Gene Sperling, the head of the economic policy for the Obama and Clinton. So if you read it, Jeff is talking about Gene and he says, Gene would turn in columns of 1,500 to 1,800 words. The editorial page editor, that's me. You could see the quote there and I would suggest various edits. You can read the quote there, but ultimately we have unexpected lessons from the DP part two. You have literally no idea who's sitting next to you at any given time and what their destiny might be. The only difference between the most accomplished people in many fields and those who aspire to semi-careers is age. So I'm the same person I was then, I'm just older. And then I went to medical school at the University of Pennsylvania and I looked like that. I'm the guy with the guitar, not the tall one. And when I was asked to take call in my surgery rotation as a medical student, I responded, this is a true story, no thanks, I have a gig. So lessons learned from medical school. Sometimes you can do something unbelievably stupid. It does not help to define you. You should learn from it and help others learn from it. Does anybody here listening to me know how long it should take to get from Philadelphia to St. Louis? It should take a couple of hours by plane. If it takes more than 12 hours, it can actually change your life. So responding to what you cannot control, my grades and my board scores were not good enough to match at Wash U. Remember that I chose to play a gig in the band Go Dog Go rather than take surgery call. I'm convinced 100% to this day that I matched at Wash U because I was up all night and still managed to be somewhat coherent during my interview with the chair. So I missed my connection flight from St. Louis to, I think it was Memphis, on over to St. Louis from Philadelphia. And then I was given directions by some medical students who were hosting me and they told me to get on the wrong highway. And so I went two hours out of my way towards Little Rock. Then I came back, then they told me how to get to St. Louis. And once again, they gave me the wrong direction. So it ultimately ended up taking me 12 hours to get there. And then the day that surgery was every other night call, I'm convinced the fact that I was able to talk led me to matching a place that I had no business being at. So what are some lessons learned from a crazy road trip? Life throws unexpected obstacles at you. You can complain, you can give up, you can get angry, or you could take them as an opportunity. I'm literally giving this talk today because they matched at Wash U. I can't even begin to imagine how different my life would have been had that not happened. So serendipity, I started my residency with the clear expectation of being a full-time operative surgical oncologist. I went in the lab basically because it was mandatory. I'd never been in a lab in my life. I told my chair I was interested in cancer and I wanted to work on colon cancer or breast cancer. This is my chair, Sam Wells, serendipity and opportunity. He gave me two choices for a lab, a lab to study basic science, gut stuff, not cancer per se, with a chair in molecular biology and pharmacology. They'd only taken one surgeon before. He thought surgeons were not particularly bright and he mandated a three-year commitment, but he published in science. Or a first-year faculty member trying to get their lab started who'd never trained anyone before with no funding and no independent publications. Since I had no experience, I chose the former. So we have serendipity, opportunity, but then despair. So I went to the lab of Dr. Jeffrey Gordon, shown here, and my first two years I accomplished literally nothing, seriously nothing. My single project was a bust and it took 18 months to recognize the transgenic mice that I thought I had were not what they actually were. Things got so bad that my chair threatened to fire me. But that leads to redemption, or at least hope. Since I was so bad in the first two years of my lab, I was allowed to pick my own project moving forward because my PI had totally lost interest in me. And all of a sudden, everything clicked. I ended up with multiple first author papers and three years after Dr. Wells fired me, I won the inaugural Samuel Wallace Jr. Resident Research Awards and actually ran the competition for many years in the future. So what were lessons learned from my lab time while I was still a resident? Put yourself in a situation that you believe optimizes your chance of success. Work really hard. Even if you do, things often don't go as planned. Turn massive failure into something else. Often others will lose faith in you. Do not lose faith in yourself. And finally, more serendipity. When I became a senior resident, the decision was made to switch into critical care. My mouse model looked at the gut overexpression of BCL2, had no phenotype at all. And the mice I wanted to give cancer never developed cancer. So my mentor was totally uninterested in these animals and was happy to give them to me as a lab resident without any restrictions. Here you go. Have at it. Do research on these totally uninteresting animals. And that leads me to the best mentors ever. On the left is Richard Hotchkiss, on the right, people should know as former SCCM presidents and current CCM and CCE editor-in-chief, Tim Buckman. Still more serendipity. The NIH budget doubled right when I was applying for my first grant, and I was funded for a K-await that I wrote as a fellow, so I started day one as faculty with an NIH grant using the mice that literally had no phenotype for my lab years. That is, they had no phenotype under basal conditions, but they had a total phenotype in sepsis. Within two years, I had an R01, and two years after that, I had a second R01. Lessons learned from my fellowship in the first few years in faculty. Luck does play a role. You should always remember that fact, and be humbled to understand that a series of random events might just happen to fall into place for you. Having said that, your success is actually due to many others taking the time to develop your career. I am incredibly indebted to my mentors and believe essentially that every successful faculty member here should feel the same. Seek out the best mentorship possibly. Choose wisely. It will literally change the arc of your lifetime. Starting a lab. For better or for worse, I've never performed a single experiment in my lab, although I can still look under the microscope. The people I've worked with determine my success every bit as much as my own intellectual input. This is my lab at Wash U. I have three different lab managers there. The one on the left, the one in the middle with the red shirt, the one on the right wearing a hat. None of them actually wanted to be a lab manager long-term. This is what they're doing now. Paul Stromberg is the clerkship director for emergency medicine at Virginia Tech School of Medicine, and Cheryl and Drew both went back to PA school and became surgical PAs. I work with lots of residents and students at Wash U. Here's pictures of them from a long time ago. These are their first jobs. You'll see three of them went into acute care surgery, but most of them didn't. Pediatric surgery, vascular surgery, GI surgery, pediatric anesthesiology, endocrine surgery. And so what were lessons learned? Work with people who are ambitious. Work with people who work as hard or harder than you. Work with people you actually like, even if they don't want the same career as you. And then in 2009, I came to Emory. I moved to Emory in large part because of the critical care center that I now direct. I was tremendously afraid of what would happen once I lost my side-by-side daily contact with my research mentor turned colleague, Dr. Hoschkis. I needed to work with an immunologist for a simple project, and I asked Alan Kirk, who was then the vice chair of research and is now the chair of surgery at Duke, for a recommendation. And this led me to Mandy Ford, the best collaborator ever. This is a very, very old picture of us, but it's the only one I have. You'll note that I don't have gray hair in this picture. Within a couple of years of meeting each other, Dr. Ford and I had a pilot grant and a co-PIRO1. Lessons learned. Seek out new collaborations. Even if in a sense they don't entirely make sense, Mandy is a transplant immunologist who had literally never heard of sepsis the day that I met her. Be enthusiastic. Keep an open mind as people who are new to your field will see things in ways that you don't because they're new to the field. She never heard of sepsis, so she had zero preconceived notions. It was truly a match made in heaven. And work with people who are smarter than you. There's enough credit to go around, and everyone wins. This is a few lessons I learned from others at the top of the world and then not. I knew in 2011 that I was going to be president of SCCM in 2015. Several SCCM presidents before me left their job after the president. One particular lost their funding, and when they were done with their presidency, they thought they were a researcher, but their chair thought they were a clinician since they had no funding and they had to leave their institution. So my goal when I was president was to have two RO1s, knowing I needed at least one to continue being a researcher. So Mandy and I applied every cycle to the NIH with the hope to have at least one and hopefully two grants. And when I was SCCM president, I was PI or co-PI on five NIH grants. The lessons learned, apply, then apply some more, then apply some more, then apply some more. You never hit the pitch. You don't swing it. The more you apply, the more grants you're going to get. Who does the work? This is variations in my work and my lab at Emory. So what have I learned? Emory surgery residents are awesome. So are our PhD students. There's a lot of international visiting scholars from Japan and China on that list. They're awesome. My lab manager, Zha, is awesome, and the people you work with define your research as well as the culture, the environment, and your enjoyment of a life as a clinician scientist. So to come full circle, the last time SCCM was in Hawaii, I was at the same surgeon as two surgeon scientists, John Alverde and Rob Sawyer, who published in the New England Journal of Medicine and Science. And so since there was no way I could, quote unquote, out-science them, this seemed like an appropriate time, again, we were in Hawaii, to return to my high school attire. This is a picture of me giving the talk. You have Rob Sawyer on the left publishing in the New England Journal, John Alverde publishing in science, and me on the right saying literally wears the same Hawaiian shirt he wore in high school. And if there's any question, you see me at the podium, and then look over here at me, that's in the top right. So lessons learned along the way. Success as a clinician scientist has been a mix of inquisitiveness, serendipity, amazing mentors, opportunities, outstanding collaborators, outstanding residents and scholars in the lab with whom to partner, a willingness to work reasonably hard, and ultimately having fun. Thank you so much to everybody who's done this along the way. I understand that I'm getting this award today, but truly, truly, truly, this takes a village of hundreds of people over the course of the last 22 years. I'm so honored for this award. Thank you very much.

Craig Coopersmith

Distinguished Investigator Award

clinician scientist

lessons learned

mentorship