The Daily Dose • Saturday, April 28

Advice through Anecdote: How Experience and Mentorship Shape the Career of a Young Anesthesia Scholar

By Dr. Michael D. McDonald, from the IARS 2018 Annual Meeting*

Dr. Max Kelz kicked off the Scholars’ Program by using his experiences to share how to get started as a young anesthesiology scholar. Dr. Kelz used a series of anecdotes from his training and career experience to achieve his three objectives: first, to describe how early experiences, including adverse ones, have the potential to positively impact and shape a career as an anesthesia scholar; second, to argue the importance of seeking to think critically and disprove your own hypotheses, and how to channel failure into growth; and third, to emphasize the role of a mentor who is invested in helping a young anesthesia scholar grow.

Dr. Kelz did not always know he was destined for a career as a physician scientist, and first contemplated a career in astrophysics. It was not until he found his first mentor that he discovered his passion for academic medicine. Dr. Kelz emphasized the role of serendipity in his career path, encouraging young anesthesia scholars to embrace chance encounters. Dr. Kelz met his first mentor, Dr. Eric Nestler, at Yale where he learned career-long lessons.

While his work with Dr. Nestler eventually turned into his PhD thesis and led to advances in mechanistic biology within the field of addiction medicine, it was the broader lesson of critically evaluating and incorporating modern scientific methodology that has helped him succeed as Dr. Kelz advanced through his career to answer big questions in his field of neurobiology.

Dr. Kelz emphasized the importance of leveraging your own clinical expertise to find a niche in answering critical questions in advancing medicine. His own adverse experience as a first year anesthesia resident allowed him to do just this. Dr. Kelz recalled caring for a patient with a traumatic femur fracture. The patient had a history of narcolepsy, and while he followed proper administration of general anesthesia, it took the patient ten hours to awake following the removal of all anesthetic administration. Humbled in front of his attending, the program director at the time, Dr. Kelz used this experience to critically think about the need for a better understanding of sleep and wakefulness. Reflecting back, Dr. Kelz again highlighted the importance of using clinical experience to find a passion.

Using a mouse model for narcolepsy, Dr. Kelz formulated his first hypothesis: the state of general anesthesia necessarily arises by impairing orexin signaling, and orexin deficient mice will be hypersensitive to anesthetic induction and exhibit delayed emergence. As Dr. Kelz overcame obstacles to make this project happen, he felt betrayed by his data when the results demonstrated both controls and knockout mice had the same sensitivities to general anesthesia.

To further emphasize the role of mentors in his development, Dr. Kelz shared how his mentor at the time helped him rethink his question and identify that it may not have been the data that failed him, but his hypothesis. Dr. Kelz came up with a new hypothesis with the understanding the phenotype he witnessed in his patient was not hypersensitivity in anesthetic induction, but in delayed emergence. Dr. Kelz applied this new thought process to his work and the data supported this notion. Dr. Kelz developed the insight that induction and emergence are not a mirror image, but path independent processes, coining the term neural inertia. His work in the field continues in humans, with the support of R-01 funding, and has encouraged him to do one of the things he is most proud of: serve as a mentor to young anesthesia scholars.

As parting thoughts, Dr. Kelz credits his current career position to the unique experiences he had during his training and early career, as well as the invaluable support from his mentors over the years. Dr. Kelz encouraged young anesthesia scholars to leverage their own unique clinical experience to fuel and drive their careers. He shared his own failures to show how to reevaluate one’s own work to grow from failure. Dr. Kelz demonstrated how his mentors were invaluable and emphasized the importance of finding good mentors early in a career path.

*Coverage of SCHOLAR-02: Moving from Insight to Research Program and What This is All About