On the misuse of case studies: a case study

Our organization is committed to equality, diversity and inclusiveness. For example, Dr Clara Madeup benefitted from our ‘return to work’ programme that permitted her to come back to work after an extended 2 years maternity break. Clara is now a tenure track associate professor leading in the field of biotechnology.

How many Claras and Johns showcase success stories across our industry? More often than ever, we need to submit case studies during assessment processes, so much so that it is not unlikely to receive negative feedback if we describe our actions and outcomes carefully but without illustrating case studies.

Which is the likelihood that an organization does not have good case studies to showcase? And how likely is it that an organization decided to illustrate a failure in a case study? How representative success stories are of an organization, particularly organizations that are based on high staff turnover and competition? In fact, a few handpicked case studies can conceal otherwise worrisome statistics available within a document right alongside nice case studies.

Of course, the exclusive use of positive case studies in our websites, the brochures we use to describe how great we are, or at least we want to be, is absolutely obvious and legitimate.

I have seen case studies related to negative events within my organization only in two cases. First, introductory courses for health&safety that often provides plenty of examples of incidents with few cases discussed in detail. They are very informative because in the utter boredom of a long H&S course they actually tell you the story of not what can go wrong but what did go wrong in a lab like yours, maybe next door. Second, I had volunteered for a course designed to inform how to help victims of rape and sexual harassment. Instead of dwelling on how good our organization is, we went deep in describing which problems we have to deal with, how problematic communication can be, and how both academic and justice systems can easily fail victims. Very different situations but the illustration of what CAN and what DOES go wrong was absolutely instructive and helped focus on what we should do to prevent incidents.

During management meetings, we usually discuss what we can improve. Obviously, we do not speak about positive things only, quite the contrary. However, we do this often through rather unevocative statistics and get excited when we see progress compared to the past, or we are better than other organizations in the same area. I wished, however, organizations would focus more on the investigation of negative case studies during management meetings, of course, anonymized and taking any necessary precautions or even with the consent of colleagues involved, so that we could understand more deeply the consequences of our failures and identify better strategies to eliminate or mitigate our shortcomings.

I think we should bring a bit of the scientific method we experimentalists are so accustomed to deal with. We often learn a lot from experiments that fail for no apparent reason, and we showcase our failures to colleagues to get help and to teach less experienced how to identify solutions.

I am not really sure about how often ‘negative’ case studies are used in academic management to inform executive decisions in the broader community. In my experience not enough, probably, because the ‘negative’ case studies we should analyze are often just simply buried, swiped under the carpet, a topic for more specialist discussions reserved for those that make issues disappear.

I hope organizations will adopt more the use of ‘negative’ case studies as a tool to improve and fully understand the suffering of those who find themself in challenging situations. And I hope we are asked to produce case studies to illustrate success stories and good practices less frequently during an assessment, reserving these to public brochures.

Managing risk in the lab at the times of coronavirus

In the UK, we are waiting for good news to reopen our laboratories. Well, not ‘waiting’ but getting ready. It might be in two weeks or two months but we have to be ready because if we will be ‘back to normal’, we will have new outbreaks. In science, we are lucky as we are already trained to manage risk. However, most scientists in the UK have a conflictual relationship with health and safety procedures that are often perceived (probably rightly) as overly bureaucratic and can drive people away from good practice. I am lucky as I deal with wonderful people both locally at the Cancer Unit and centrally at University on the regard to safety, at least in those areas I have responsibilities.

In my opinion, this is the moment to restructure how we handle safety. On the one hand, formal risk assessment is very important to identify the source of hazards. It is easy to imagine we can work safely but there are some topics that are very tricky. For example, we are discussing how to deal with fire doors… we can’t keep them wedged open because of fire safety but it would be better to not close them to avoid touching surfaces unnecessarily. There are perhaps solutions that avoid any risk, for example providing hand sanitizers on either side of the door or reverting previous rules and enforce the use of gloves in any area of the labs, or install automatic (fire) doors as soon as possible. What about air conditioning? We need it in a modern building with sensitive equipment but should we do any change? Are they safe? What about cell culture? The other day I joked about infected cell cultures in CL1 laboratories? Wait… it was a joke but then – out of curiosity – I realized that coronaviruses, this included, can propagate in several mammalian cell lines (they express ACE2 and most of them are not killed by the virus). Is this an issue? I assume it is not as it is unlikely we contaminate cultures (we work in aseptic conditions) and cells do not generate aerosols we can breathe. But I wished to mention this just to make a point: it is worth thinking deeply about how work will be when we return in the laboratories to identify possible issues, without paranoia and without panicking, but proactively and scientifically.

However, paperwork never protected us. It helps to identify issues and to protect us legally. There is a set of rules that have been gradually abandoned in favour of PPEs and engineering measures to manage risk and I believe we have to retrain people using those rules. It will be impossible to make the world 100% safe from coronavirus, certainly in the short term. We can, however, manage risk by changing behaviours to make it negligible but we need to be prepared and everyone has to comply.

Let me do two examples, not specific to viral work. Even just twenty years ago, for some of us laser safety was just removing any reflecting surfaces from your body and the environment (no rings, badges, other jewellery, no wall mirrors in an optics lab etc) and changing your behaviour: never align your eyes with the likely direction of the laser. This meant, for example, that a researcher would mature the instinct of turning the head always away from the optical table when picking something from the floor. Those were the times when accidents would still happen at a certain frequency because good laboratory practises without PPE relies on a person never do a mistake. PPEs should protect us from our mistakes but once you wear protective gear, once you feel shielded from the hazards, behaviour will change back to normal.

Another example is tissue culture. It is a fair amount of years I do not do TC work in person but, sometimes, when I get a coffee at the Hutch canteen and I pay, I pass on top of my mug and my brain signal me not to do it. Under hood, we avoid to pass over open flasks to minimize the risk of contamination (of the cultures). Again, some of us might have worked perfectly aseptically and safely with no PPE in the past.

I DO NOT advise to drop PPEs or risk assessments, do not misunderstand. The only point I want to make is that changes in behaviour such as social distancing and enhanced hand hygiene will be very important, more important than anything else to come back to work safely. We need to be careful in retraining ourselves. Again, without paranoia or panic. Other than doing ridiculous elbow bumps to replace shaking hands, a smile and a greeting will do. Giving way to people to maintain distance in close environments, planning how to move around cramped laboratories, how to reach instrumentation, when and how to clean hands or use PPE, but also very practical and trivial things such as the use of toilets or where and when to have a lunch or a break, how to reach the workplace might be more challenging. Challenging – not impossible, at least in most cases.

I have been very supportive of lockdowns. Among other things, this period is permitting us to exercise social distancing and train on how to handle materials we buy or we get delivered at home. This is valuable time if and only if you are actually using this opportunity to actively prepare for a life with COVID. We all hope that this virus will burn itself out soon. However, at the moment it seems unlikely and therefore the keyword is one: preparedness.

Do not do the mistakes that several people in leadership have done. They were not prepared to manage this pandemic despite they knew it would happen soon or late. They were not prepared to instruct us for timely societal changes. Are they now really prepared for the next phase, i.e. the management of life with SARS-CoV-2 endemic? I hope in more clarity and transparency. However, to be fair, it would have been difficult not to do mistakes.

If you did not do this already, brainstorm with your team and communicate to your managers what you might want to plan. I also advise having clear and shared rules. As safety will be based quite significantly on behavioural changes, conflicts at the workplace are also likely. Although we are all feeling closer to each other and more helpful, there are always the zealots and the neglectful. Those that are worried about anything and those that are worried about nothing. We need to reassure the former and letting them perhaps working only off the lab (whenever possible) if they cannot handle the situation. We should dialogue with the latter to explain we have to abide by a set of shared rules and, if they do not comply, we should get them off the lab. And in any case, help categories at risk and colleagues that might struggle with mental health.

If you did not do this already, it is time to prepare. Not business as usual but with a new norm as soon as the government will permit us to resume work until this virus will be defeated or at least tamed. For the same reason that most of us are staying at home, helping keyworkers to do their job, we’ll soon be called back to work. Not just for ourselves but again for those amazing people who have kept working in difficult situations in the streets, hospitals, care homes, shops. In fact, it is our duty to share the burden of a society that cannot remain on the shoulders of only a fraction of us. However, we shall do this not in irresponsible ways, but with absolute preparedness. This applies to governments and public institutions but it does apply also to each of us.

Coronavirus – getting ready in a lab

I am publishing here the recommendations I circulated to my colleagues, as this might help others to formulate their strategies or me to receive suggestions on how to improve. At the bottom of the post I also share my opinion about the situation, just to explain why we are taking action. Disclosure: I am no expert in this area, therefore I analysed data just to form my own opinion and to organize our work. Please check institutional guidance and reports.

Dear all,

While we can still hope that no major disruption will occur, it is increasingly likely that the epidemic will not stop any longer. What is concerning, from a logistics point of view, is that this might last for several months as the responses of the public authorities will focus, rightly, in slowing down the epidemics. I would like to invite you to observe some basic rules, but also reflect on issues you might have not considered:

The most important thing is to address the upcoming months with a scientific mind and no panic. Please follow the indications provided by the NHS, WHO, and the University. While I do not doubt that all of us already wash their hands! Please do so also when you come in from outside, something we might usually not do.
I am happy for you to work from home when you can. Most of you will have to carry out experiments, but I am happy for you to cluster reading and to write in specific days and to work from home. Would you need access to your computers from home, just organize this with IT but the Unit will provide appropriate IT arrangements soon.
Some experiments could be rather expensive. Please let me know when this is happening so we could plan them properly. I would like not to delay important work though, so we might take some risks (on funds not on safety) but we could manage these risks proactively. For example ensuring that very expensive steps are executed in the shortest period of time and with sufficient people being aware of the experiment. For example, we have several commercial and in house developed cell lines that have not been archived yet.
I can foresee two situations where we need to help each other. First, the case where a single individual will self isolate and they need help to store, throw materials, or shut down a microscope. I think Slack will suffice, but we should have also a ‘buddy system’. For example, if I started an experiment on a microscope that would last two days, I can inform someone else who would have the expertise to safely terminate the experiment.
The second case is a bit more extreme but not really unlikely as other university campuses around the world have been closed. The Unit will soon provide specific guidance. Please think about which element would be critical, for example we will have to shut lasers down, air compressors to avoid them running out of oil etc.
Do consider if you travel, even just within the UK, you might get stuck somewhere. Please check the University policies that are updated daily. I will not recommend specific actions related to personal trips, except to comply with public health guidelines and to think about the possible consequences to get stuck at home in one or another town.
There is no indication – at the moment – that we will experience disruption to the supply chain. However, this might happen. Have a thought if we will run out of some consumables in a couple of weeks and perhaps order now.
Also, very important. There are people coming from areas that are quarantined. Unless you are sure they are breaching rules, be supportive and do not make too many jokes. Some people are more sensitive than others.

To conclude, please do not allow the situation to make you anxious or too worried. For the general population, the main issue in not health but arranging life around likely restrictions of movement to permit the NHS to cope with the extra workload. For us, provided we will put first safety of ourselves, colleagues and family, we have opportunity to keep reasonably productive even in this situation simply organizing.

Feel free to propose ideas or to have a chat with me in private if you have any specific concern.

My opinion on the situation and on what is happening

I am growing of the opinion that the Italian situation is happening only earlier than in other European countries, not that is a special situation. Spain, France and Germany might be already on that path (10-14 days of delay compared to others). UK is probably an extra week late, meaning that by the beginning of April, or earlier, we will experience similar disruptions we are observing in Italy (hopefully not). Also, I had a look at mortality rates. Once taken into account the demographic and that in Italy we are experiencing a situation similar to Hubei (health systems overwhelmed) and not to the rest of China (managed containment of the disease), the stats of Italy do not seem odd to me any longer.

At this point, all other European countries will experience the same unless they enact strong preventive measures. To me it seems governments in Europe and USA have preferred to shield economy first rather than people, or they are simply incompetent, to then get caught off-guard and inflicting to the economy the same level of damage they would have got intervening earlier.
We can organize, minimize disruptions and deaths. Not eliminate them but we can do better we are doing. If only politicians would exert leadership, at local and national level, and – of course – people would comply with the indications…

Last word of caution. People might be complacent also thinking they have the best health systems. This is not the issue, the UK system will be as easily overwhelmed as the Italian one. In fact, there are fewer ICU beds in the UK than in most EU countries, including Italy. The point is to slow down the spread of the disease to keep our health system working within certain operational margins.

Bottom line. Am I writing to get your more worried or anxious? NO. The large majority of us will have minor health issues. However, the public health policies that will be necessary to minimize the negative impact on the NHS will cause major disruptions. Therefore, organize not by panic buying, but thinking ahead… how to work, look after family, etc, etc, when restrictions will be imposed.

Last thing. There is a tendency to minimize the situation as people dying is elderly affected by other pathologies. In Germany, it seems that they do not even consider those patients as CoV-related. The large majority of those people could have lived a much longer life, they are not (all) terminal patients. Moreover, with patients piling up in dedicated wards and ICU, everyone risks more because they will not receive adequate treatment, irrespective if they have been infected or not.

So… the apocalypse is not coming, but just the time to work together to get pass this.

The dysfunctional digital office (emails)

January 2018 has been a watershed moment for me for something very simple and important such as… emails. Back from Christmas Holidays after visiting family and friends in sunny Italy, I was confronted with a wall of emails like many other professionals and colleagues. I had experienced this every year for many years, but this time was different. I simply could not cope with it, I avoided responding emails for a while and I became ridiculously inefficient. I gather that this was some type of ‘dysfunctional digital office’ syndrome, that caused to me that extra level of anxiety that made me hopeless.

Most of you will understand the basic elements of what I am describing, but only those of you that have a very strong digital presence (or is famous, but that is not my case), no personal assistant, nor a every good method might have experienced this digital black-out.

I have always rejected advice on how to organize my emails, abhorred the concept of using random passwords (I’ll come to that), inbox rules (I like to see all emails I have to respond in the same place), split my personal and work emails (I have difficulties to separate my personal and work life anyway), etc. etc.

However, now that I have experienced this black-out and I had to invest weeks of work to re-emerge from this mess, I wish to not just give you some practical advice (there are plenty of websites for this), but to explain what others did not explain to me before: without an articulated strategy, if your digital presence is significant, soon or late you will not function. Better investing now, proactively, then later.

SPAM SPAM SPAM

Let me do a step back. The first symptom that something was going wrong is when I’ve lost a PhD student about one year ago. She wrote to me an email, but it went straight to the Junk e-mails folder and I noticed this only a month or so later, when it was too late to confirm my willingness to host her. A few false positives later, I disabled the SPAM filter. Flooded by SPAM, I simply deleted emails as fast as possible and started to complain with our IT Department (sorry guys! you have been great in helping me out). However, this was not the issue. I never had identify the root cause of he problem.

Moving again forward between January and February 2018, I discovered the problem, in the hard way. It was not just SPAM, which was about accounting to a third of my email traffic, but also the various mailing lists I subscribed for work (another third of emails), and various accounts of private use (TV, electricity company etc) making another significant fraction of the rest. Fixing this mess was going to be hard work, but one key element changed: the realization that the issue was not SPAM, but was just, er, … me.

Password management

One issue I faced immediately is that I could not look after all the tens of account I had created over the years. I use strong passwords, but all with a certain meaning to me and pattern. However, each website has different rules and my well-thought system included too many exceptions to remain memorable.

Eventually, I gave up and I really advise you, if you did not do it yet, to surrender. Get a password management system.

Yes, when I login to an account now I am slower than before as I need to open a digital password management system with a very strong password, and copy&paste a completely random and long password to each specific account. Of course, now my digital presence is secure, the time I used to waste resetting passwords is recovered and, very important, I have a constant overview of all accounts. This was a very important step to reorganize all that followed.

Rules, rules, rules

Next, I had identified the main problem (too much email traffic that did not require response) and secured all my accounts. Rather than focusing on getting rid of SPAM, for once, I decided to clear my inbox from emails I did not need for work (but were not unsolicited emails), or that at least did not require immediate response, if at all. I created various rules, one that captures most traffic from our procurement system and deliver the emails to a procurement folder. One that capture all emails from professional mailing lists, one for literature alerts, one for private emails and so on. The trick is to have the fewest possible set of rules and sub-folders. Pay attention, you will need to maintain these folders and rules on a weekly basis, or every day. This reorganization took several days (may be weeks) of full-time work. However, I have now got rid of a large majority of emails that are likely to never require response. Once a day, I check the lists and, in less than a minute, I clear several tens of emails and, occasionally, I respond or archive for follow-up a very few of them. This time-consuming, but trivial trick, saved my sanity (probably).

Private emails

I cannot deal with one InBox, why should I deal with two? It seemed a smart thing to redirect all my emails to my work account. Yes, for many years this worked, but finally it stopped to. With a password management system and with inbox rules, I got to have a clear picture of what could go away. Do I need to keep my electricity bill in my University email InBox? I have reviewed all my forty-something accounts, log in into each of them, reviewed alert (read SPAM) options for each of them, used my gmail account for anything that is private. The decision on most accounts is trivial, some is more challenging. Some of my social media accounts (LinkedIn and Twitter) and my website are private, but I use them for work. However, do a bit of work on your social media accounts to reduce notifications, or even add them into your SPAM filters. After all, Twitter users will contact you by twitter! Now, with the number of private emails minimized, there is even more clarity in front of your computer when you login in the morning. Do I wish to check private emails? Sure, I can do it once a week, not every day.

SPAM, SPAM, SPAM, and SPAM again

Who am I kidding? Of course SPAM is a huge problem, but now I have those few tens of emails that counts in the right place on screen and I need to get rid of the evil SPAM emails only, the rest is secured away. Unfortunately, the SPAM filters are rather ineffective, at least for me. SPAMmers (may they get Norovirus infections on a weekly basis) tend to be smarter than SPAM filters. When SPAM filters are tight, you lose emails as false positives. I am unsure if I got it right, but my strategy was to download an up-to-date list of known SPAM servers. This cuts a significant amount of SPAM, others can be flagged daily as Junk emails. However, these filters are still inefficient and what I do is to update my SPAM rules daily. I have just two. They scan for words in the headers or email addresses. All together, very effective and, after the initial work, time-efficient to maintain.

SPAM, SPAM, SPAM, still SPAM

In my case, at this stage of re-organization, my tens of good emails were the majority of emails in my InBox. Those few false negative are simple to handle. However, some colleagues at University of Cambridge and suppliers decided (you criminals!) to setup legitimate mailing lists utilizing commercial email re-distributions systems. Well, yes, they are SPAMmers and I have a few false positives. What I do is to add exceptions for the very few mailing lists or email addresses I consider important. The rest can get lost and colleagues or suppliers that use third-party services will not be able to reach me, which is the minimum they deserve considering they are giving my email address away. Most importantly, I give a fast check to the Junk email folder every morning, I rescue the now rare false positive and purge the rest straight away.

Professional chats

Now that SPAM is minimized and emails that do not require a response are dealt with, in my mailbox, I have mostly work-related emails that requires a response in my mailbox. However, several of them are brief messages from colleagues asking something, often cc-ed to many. These emails clutter the mailbox. They might be useful to keep for a while, and some contain important files and links that could be useful even after a long time. So, why not re-diverting all this email traffic to a specialized application? For me, Slack was the solution, at least for the team of people I manage. I always thought that Slack was merely a glorified chat. Technically speaking it is true. However, Slack (or similar tools) can really help to avoid missing that very important emails that you really need to reply. Slack might even be a platform useful as a team-building experience, where employees may feel more as part of a team. Just be patient at the beginning. Some people experience insufficient uptake, and this will require proper management. I have experienced madness, with a Giphy storm that made me question the usefulness of Slack at first. However, after the first few days, my team started to use Slack efficiently. The occasional jokes, animated gifs, or ludicrous channels (e.g. SporeTrek), just help enjoying the working day, without accumulating rubbish in the mail inbox.

A new dawn at the office

I know, most of you, well, those two people that arrived to read my post until here, will consider what I have written an exaggeration. However, if you are a professional with a digital presence, I really advise you to take action before it is too late. Now, I come in the morning to the office and I do not dread opening Outlook. I feel like a ‘winner’, despite the occasional setbacks, and I spend a couple of minutes checking the self-archiving folders I have created, purge them and flag the rare email I wish to follow up. Then I move to the main mailbox, archive everything not important but worth archiving, delete what does not need to be remembered and immediately reply (and archive) everything that is simple (‘thank you for your assistance’, ‘we’ll meet later at 10’, etc etc). After that I have only a very few emails that requires significant amount of time to respond.

It is a few weeks that I have my main InBox with fewer than ten emails at the end of the working day. Now, I can keep track of what is important, I have still an archive of everything else, but – most important then everything else – I feel in control.

A lot of work is still ahead. I am a techie, but so low tech when comes to management. Now that my digital communications are sorted (mostly), with my public digital presence already looked after, I would have to roll-out digital project management solutions and digital laboratory notebooks. Lots to do, but after the madness I had experienced with something as simple as emails, I want to find the time, and invite you to if you still did not, to identify appropriate solutions to your digital problems. Otherwise, when your business will grow, you will experience outages of some sort and you will be surprised to find out that the main issue was, well, … you.

The ‘no asshole’ rule

Do you know when you are at the airport with some time to kill, and you go to a bookstore? Do you know that revolving shelf with business-oriented books suggesting how you will have a great career if you read them, yes, the one just near the other shelf with books on mindfulness, homoeopathy and wonder diets? Well, bear with me a moment, and I tell you about when I dared to buy one of those books (no, not on diets, silly!).

In these days, we are recruiting students, and I had the occasion to host several candidates in the labs for a non-formal chat. Unplanned but unavoidably, I find myself discussing how I have a culture of team-work and how I would not tolerate any behaviour that would undermine a good work environment, team-oriented. As rewards in academic biomedical research are rather individualistic (no one is rewarded for being a good team player, sadly), I also have to reassure people that when papers are published, I prefer to have few good papers with several people sharing authorships rather than having one person with a paper and around them… devastation. I try to discourage self-centred disruptive personalities, however bright, to work with me.

Why do I do that? I do that because the cost of handling the consequences of working with ‘assholes’ (yes, coming to that…) is far superior to the advantage of hiring sociopathic alpha females and males even when they fully deliver on the set goals, perhaps seemingly faster and effectively.

I do have witnessed the effect of various sort of bullying in the work environment, most times as a bystander. Not frequently, but I had the opportunity to see how dramatic can be the fall-out of such events on the psychology of those involved and how these behaviours can undermine efficiency and productivity of individuals, and their future careers*.

So, back to the airport. A couple of times, before a long trip and having exhausted all other possibilities, I dwelled in front of business books. A scientist can learn important things from business, but choosing a book that is not the equivalent of drinking-urine-cures-all-diseases or a specialist treaty on the economy is not trivial. I think I eventually landed on ‘the no asshole rule’ by Robert Sutton (I promise I’ll review this bit at the earliest convenience) and I try to adhere to this rule as much as I can!

First of all, I do agree with the ‘asshole’ definition, because broader than that of a ‘bully’. Sometimes people may not be recognised as a bully, but they are clearly disruptive assholes. Other times, people may seem bullies, but they are actually good people trying to foster discussion. The no asshole rules should be institutionalized so to make sure that disruptive behaviour is not rewarded, but first discouraged and eventually punished.

In the absence of a consensus on the ‘no asshole rule’, I invite you to adhere to this principle, or any other more or less colourful flagship rule, aimed to create and support good, efficient and productive work environments.

* I am rather happy about the team I lead, the group within which I work and the Department where I work. Now and then, here or elsewhere, however, I did see wrong behaviours. But, most importantly, even when we create good environments, we are constantly interacting with others (peers, journals, founders, etcetera). There are far too many that do consider science a tough business and therefore accept various shades of bullying as the acceptable norm. I’ll speak about this on other occasions, but here I wished to say just something about recruiting.