Getting more mileage out of kidneys
Nowadays, we know that over 10 per cent of adults have chronic kidney disease. If these patients live long enough, they will all end up needing a kidney transplant. My goal has always been to try to find new ways to treat kidney disease so we can get more mileage out of kidneys. This led to all kinds of new hypotheses that we tested, novel drug candidates, new collaborations, and new opportunities to work with and train interesting people. It's been a really rewarding field to be in.
By definition, if a kidney gets to less than 60 per cent of normal function it's considered chronically damaged. However, that number is a bit arbitrary, because the normal process of aging causes organs like the kidney to scar and begin to lose function. If you were to live to the age of 200 and all the rest of your body were perfect, your kidney would still become a scar. It's just a natural aging process. The important thing is to take care of your kidneys through healthy living — balanced diet, adequate exercise, and so on. In adults, the number one cause of kidney disease is diabetes.
The importance of your work-life balance "recipe"
The question about work-life balance is important for everyone these days. I have several pieces of advice related to this topic, but number one: You cannot do it all. You need to decide what you want to do in your personal life as well as in your professional life, and then decide what you are willing to farm out. You have to be prepared to pay for help at home, for example. I am a grandmother now and I had my son fairly late in life. We had a marvelous nanny who lived with us five days a week. From my perspective, it's about the quality of time with your family and not the quantity of time, and my son and I have an amazing relationship.
That said, the work-life balance "recipe" will be different for each person. When I did pediatric nephrology subspecialty training in the US in the early 1980s, some of my peers decided that they wanted to be educators or clinicians and not include research in the mix, and they were made to feel like failures. This is an unfortunate response, because we all contribute to the world and have important pieces to bring to it. Contributing your best efforts while fulfilling your dreams and passions is what really can make a difference.
You should be allowed to make these life and career decisions when they're right for you and not feel that you've failed yourself or others around you. I've recently had this discussion with an early career faculty member. He loved what he was doing clinically, but it was a pain in the neck for him to worry about getting back to the lab and plan experiments and write grants. I told him, "You don't need to please anybody but yourself at this point. Is being a scientist really what you want to do?" That question helped him decide to change his career pathway and he is much happier now.
Knowing yourself is really important in establishing a sustainable balance for yourself. You've got to love what you do. Your career is not just a job. It's a hobby, it's a passion, and if you don't get joy out of what you do, you're in the wrong field.
The best rewards from being a clinician scientist
I'm a clinician scientist, so I've looked after patients and led clinical programs all my life and I love it all so much. Every day as a clinician you go home feeling like you've helped someone, whereas in science a lot of time can go by between those great feelings. All too often things don't work out, you don't get funded, or your paper gets rejected. But I think when you are successful in science, the highs are so incredible because you've worked so incredibly hard. If you're a competitive person, if you like to work towards certain goals, then science has a lot of rewards. It's certainly not easy, but the wonderful things in life never are.