Epigraph Vol. 24 Issue 4, Fall 2022

Career development profile: Dr. Caroline Neuray

Reported by Dr. Alina Ivaniuk Edited and produced by Nancy Volkers

Cite this article: Ivaniuk A. Career development profile: Dr. Caroline Neuray. Epigraph. 2022;24(4):84-92.

Dr. Alina Ivaniuk talks with Dr. Caroline Neuray about her career path from medical school to industry CEO. They discuss the power of peer mentoring, ways to improve medical education, finding the courage to accept change, and how to handle those comments from reviewer #2.

Listen below or download the episode.

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Podcast Transcript

Dr. IvaniukHello everyone and welcome to our episode of the podcast series on career development. I’m Alina from the ILAE’s Young Epilepsy Section, and today I have the very special pleasure of welcoming a very special guest. She’s one of the YES founders and besides that she’s an excellent researcher and an excellent clinician as well. 

Dr. Neuray:  My name is Caroline Neuray, so that’s a German sounding name, people know me as Caroline or Caro, and it’s a great pleasure that you thought of me, Alina, for a career development podcast. You know if you’re being interviewed for these things yourself and in your own life, you always think like this is just my life this is absolutely normal, and you kind of keep forgetting that other people may have a different opinion so yeah I’m honored to be part of this. Curious to hear your questions.

Dr. Ivaniuk: We’re very happy to have you today! Thank you so much for finding the time to speak with me today. So we’re probably going to start from the very, very beginning – tell us a bit about where you are from, what is your background.

Dr. Neuray: So, I was born in Austria, actually in Salzburg, I have Austrian citizenship and German citizenship because my parents were from 2 different countries. I was not raised in Salzburg; I was born in Salzburg pretty much by accident. That was before the EU and my dad was in the midst of graduating from medical school and my mom was still a student, so my parents were very young when they had me. My dad wasn’t allowed to work in Austria, so he lived close to the border because it wasn’t part of the EU at that time. And as my due time arrived, Salzburg was the closest university hospital so that’s where my parents drove, as they were en route, and that’s why I was born there. It’s funny because later on in my career I actually learned a lot in Salzburg which is a funny coincidence in my life.

I moved a lot between Austria and Germany throughout my childhood. I think I was raised fairly normal? As I said I was a child of students and I think I could not envision anything else, I loved that I was just tagging along for everything my parents did with what at the time seemed all these old people, and now that I’m like 35 myself, I’m like, “Oh my god they were so young.” And as a child I always thought oh I have to go be with all these older people on holidays and they were just students in their mid-20s and I thought they were super old.

My dad was a doctor and my mom was a musician, so kind of a bit of creative and scientist combination. My dad also wanted to be a musician first, and also later on in his career changed, so actually a combination of different groups there.

Dr. Ivaniuk: So the medical field itself is pretty understandable, as you mentioned, and you were training in Munich. How did you decide to go into neurology?

Dr. Neuray: Good question and actually I had a similar career path as my dad actually – I wanted to be a musician myself first, and then I didn’t meet my own expectations there and then I said, “Okay, medicine’s a great thing to do.: And my dad always told me, “Ah, but you know it’s a tough job, do you really want to do this, don’t you want to do something creative?” 

But I did decide to go into medicine for various reasons, and I never thought I was going to go into neurology. I had my mind set on becoming a pediatric surgeon and specifically I wanted to work with burn victims. I don’t know; I developed this very niche passion during my uni(versity) time and I loved the manual part of it, and the fact that I ended up in neurology is actually an embarrassing confession.

 I kind of always skipped neurology classes throughout uni, and then the final exam—so in Germany you do one big board exam at the end of your uni, and there’s a catalog of questions, and I looked at the percentage of what are the most relevant topics in medicine and I realized, 30% of the questions were neurology related and only then I realized, maybe I should have paid a bit more attention to that!

And then you can choose in the medical field and university in the last year before you do that exam, you can do several internships. And I knew I was going to do surgery, and I thought internal medicine is important, and then I realized, based on that probability that 30% of the questions were neurology, I thought okay, maybe I should do an internship in neurology to catch up with all the things I missed. 

And actually then I really enjoyed it, and I loved the detective part of it. You can talk to your patient, and the examination and the history is all you need—well obviously not all you need, but I loved that you could spend time and really use your brain to come up with diagnoses and really dig into it, and that you’re fully independent in coming up with that. You don’t need to have somebody who teaches you how to cut into somebody or you don’t need to do a million fancy exams. So that’s when I thought actually neurology is great. 

Plus I have to say, on a human level, I never connected well with the surgeons; I loved the surgery itself but from an interaction point of view I just thought neurologists were just a cool bunch of people; they were a bit nerdy but had always a funny humor and I thought if I’m going to spend 10 hours a day with people  I need to make sure my colleagues are nice, and I though the neurologists were the nicest people so I thought okay, I’m going to give it a try!

Dr. Ivaniuk: Amazing how you made that turning point very early in your career, and we’re very happy to have you now! 

So you already confirmed that you studied in Munich. How did you end up in Salzburg, the place where you were born?

Dr. Neuray: So when I decided for neurology, it was quite late in my studies. A lot of my co-students, they already knew where they were going to go and used their internships to meet people in that field and they knew where they were going to go after university. Because I’d made this decision fairly late, I had no clue where I was going to goI knew I wanted to have a very basic neurology training because I was fairly new. I thought it was important to see everything and then based on that make a choice where I wanted to go. All the university hospitals in Munich have great teaching programs but they all have their specialty niche. But on the other hand I wanted to go to a center that has primary care, but also the tertiary care facility so that you could really follow a patient – comes to the ER with back pain and in the end it’s something really fancy or really niche and you can have all of that. And I didn’t think any of the hospitals in Munich offered that; they were either super specialized or very basic, and anything that was interesting was sent to a university hospital. And I was contemplating about this and feeling a bit sorry for myself as all my friends were already applying for jobs and I was flipping through a journal like a medical doctor’s association journal and saw a job description for a neurology job in Salzburg and I thought, like, hm. It’s 2 hours from here and it’s somewhere between where I currently live and my parents live, so it kind of made sense, and I went there and I really liked the vibe and the interview and I thought okay, I have all of what I want here – great basic training but all the possibility and subspecializing on site. So I just took it.

Dr. IvaniukYou mentioned you didn’t want to specialize early in your career, you would like to see what was up first. But then you became involved in epilepsy – how did that story evolve and why did you decide to go into epileptology?

Dr. Neuray: I’ve always taken the human approach – I went with my gut for neurology because I liked the people. So I thought okay, who are the people at this center that I can learn the most from. And the most expert person in Salzburg was Professor (Eugen) Trinka, and I thought he’s a world-renowned scientist – It would be absolutely a shame if I didn’t take that opportunity and learn from him. Epilepsy wasn’t really on my list at that time; because from the textbooks I thought it was like super boring, and they have all these medications and all you need to learn was lamotrigine for pregnant people and Keppra for everybody and I just couldn’t make sense of it on a textbook level. But then I thought actually I have a great opportunity – there is a person that I found, the best person to learn from, and I thought it would be a shame not to take that opportunity so I thought okay I’m going to go into epilepsy and learn from him, not really thinking I’m going to make a career of it but I was just thinking that he’s such an interesting person and has so much to teach; I just want to learn.

Dr. Ivaniuk: To hear how other people shape our life pathways, career pathways, that’s amazing, and so he was one of your first mentors. Did you have any other mentors in training?

Dr. Neuray: Yes, so obviously the first mentor I had was Professor Trinka, from day 1, and the next big group of mentors that I’ve had are actually my peers. I always relied very heavily on my colleagues in terms of psycho-hygienic questions like how do you cope with this? Oh, I can’t keep going. And they would have kind words and be understanding because you sit in the same boat, right. You have your peers, they all are tired, you all do night shifts and try to do everything together and that was my biggest mentoring would be peer to peer. 

And for that also ILAE and the YES group has been absolutely fundamental. I think it was super, the best learning I’ve had from the whole group that you kind of connect with people who don’t come from your center but come from different cultures and different backgrounds and you realize that you know the grass looks greener on the other side, but actually everybody is struggling and all have the same questions. 

And with regards to leadership mentors, yeah I think I’ve observed and learned from many people in the ILAE and outside of the ILAE. I know that obviously Helen Cross being a female leader in the ILAE has been somebody, has had an influence on me. I remember she once gave a talk where she was asked the question, “So how did you deal with having children?” And obviously, no man is ever asked about that, you would never ask somebody like Professor Trinka, “Oh how did you deal with having children?”  And the fact that she spoke very openly about some of these questions and doubts that I think we as women have and we have our ambitions and biologically have other questions there, so I think she was instrumental and not a direct mentor but someone I learned a lot from. Also the fact that she was, she had like no problem with sharing this and I respected her more for showing vulnerability than the other way round, so that’s something I learned from her. 

Just the fact that I got in touch with some people that I thought were really scary and then you get to know them and actually you know they’re just human beings as we all are and struggle with the same questions in life, I think that was a great learning opportunity for me throughout the whole involvement, not just with YES but in general just with leaders in the field and you realize okay, I met Sandor Beniczky and I read all his papers and you kind of want to bow to his feet but then you realize he’s such an approachable guy and you just have a normal conversation, and yeah those are things that all kind of shaped my career and my style of leadership, so. 

Dr. Ivaniuk: I find it very interesting and really amazing that you mentioned a peer group as your mentor, because I think that everybody gets something from their peers but you’re the first one to actually feature and mention your peers so thank you for that, that’s important. I wonder how you yourself got into being a leader and you did that pretty early on in your career. How did you combine it with your clinical duties?

Dr. Neuray: First of all I don’t look at myself as a leader; I’ve never done, never did really and I still really don’t and maybe I should do that in my current position as the boss of a group of people! But I think I’ve always just cared about things and work and it was almost like I saw a necessity or a need for change and I thought, “Okay I have an idea to do this, so why shouldn’t I speak up about it?”

For example in my clinical training I was chief resident for 2 ½ years and that came about because I thought okay, we have great training opportunities, but we’re not doing it in an organized manner. And because I cared about my training and everyone else’s training, I kind of then said let’s just make this a thing, and somebody asked me do you want to do like a chief resident position and I said but why, and they said, “Well then you could do these things in a formal way.” 

So I’ve always just tried to fill what I saw as a gap or a need and cared about it, and for that reason I never really took an active decision for any leadership positions rather than organically growing into it, so to speak. And I think therefore it was also not much of a struggle. I understand it was a lot to combine. But because I think especially during my training, and I don’t know if you can relate to that, but I thought my peers in my training, my colleagues, they were my friends and still are, my support group, my mentors, the people I shared hobbies with, tears with and laughter with, and the fact that I managed to combine all of it is because we had a lot of fun.

Dr. Ivaniuk: That is a powerful message– having fun and enjoying what you do. I can relate to that. You mentioned one important thing being research. Did you have any kind of interest while you were in training?

Dr. Neuray: I think I got into genetics of epilepsy because of a patient, and she was transferred from the stroke unit and it was one of these patients that, she had no symptoms, she was waiting to be discharged with like physiotherapy and all the usual general neuro stuff and I was supposed to write her discharge letter. And I looked at it and I thought something’s really off with this case. Nothing was clear and she wanted to go home and so I just gave her like the basics and said I’m going to attempt this later on. 

And then after Christmas I looked back into the case and in the end, yeah she also had symptomatic seizures, or she had seizures and we always thought they were acute symptomatic to the stroke and she kept having them, and they became remote symptomatic because of the stroke lesion but there was no lesion, and it was a very strange case. And I had this feeling, there’s something in there. There’s something in there. And I kept digging and kept digging and kept digging, everybody was like come on it's in your head, there’s nothing there. And in the end she had a mitochondrial disease. And then I started reading about mitochondrial epilepsies and got really into the depth of that and it thought it was so cool. Especially the fact that she was 60 and it was the first manifestation. And then there’s this translational aspect because it’s general neuro reg, you being taught okay general, like, genetic epilepsies are for children only and it’s just like, for pediatric people you don’t need to know. And I thought actually I like the translation aspect, and that’s how I got into genetics because I had this case and got really interested in it and also, I always have been doing very well dealing with teenage, mainly teenage girls, epilepsy patient population? So some of my colleagues always shoved those into my agenda and my outpatient consultation because they were like yeah we don’t know how to talk to these kids, or to these young women actually. Can you do this? They are kind of more compliant when you talk to them. And from that I kind of thought okay I want to know more about genetics and then maybe build a transition clinic or yeah or be part of the transition process of how does a child who has a genetic epilepsy get counseled as an adult and that’s kind of the story of how I developed that interest.

Dr. Ivaniuk: You were one of the founders of the Young Epilepsy Section. What kind of support did you receive from senior leaders?

Dr. Neuray: Yes, so we have had people involved from the beginning, without them we couldn’t have done it because of course there was some sort of skepticism in the beginning from the ILAE because they were like ok, a bunch of young people, they just want to party, why should we do this. But we had Helen Cross who was a super promoter of this, Professor Trinka, Jean Gotman was part of the early conversations, Ed Bertram, there were a lot of these people who were part of the first interactions, and they also gave some ideas and some guidance. We did a workshop before YES or was actually the launch of YES. We did that in London and Ed Bertram was there and Helen Cross was there for like half a day also, to guide us in what does the ILAE need, where can we find our common interests. Like at some point it clicked; it was like we had established what we want to do was not party but actually be part, and kind of also make sure there are new generations coming up and new people going into the task force and it makes sense to include them earlier throughout the process.

Dr. Ivaniuk: What are some things that ILAE granted you personally. What are your outtakes? You invested so much in YES; what did YES give back to you?

Dr. Neuray: Oh a lot of things. Mainly I’ve made a huge amount of friends. Friendships that are that strong because we all share concerns, it’s all people who are in the same work domain, who struggle with similar things, have frustrations about reviewer number 2 – “Why the hell didn’t you get the point I made in that paper? Why did you have to comment on that?” So you know like it's people who are very relatable to me. So I think that’s the most important thing that I’ve taken from it. 

I think it’s not just the friendships, that’s part of it, but it’s peer to peer mentoring. I don’t think you necessarily need to be friends with your partners or research collaborators but just to have people to call and be like, can you help me out, or can you help me understand why this didn’t get through, or can you help me read this and challenge my questions, and things like that, it’s just really helpful. People that have your back or talk you into stuff – I remember the first time I got invited to an ILAE conference for the international one, to speak in a main session, I freaked out. I thought I’m nowhere ready, like why am I even there. And I remember that then some of my peers from the YES group, they called me and they were like, “You have to do this! You’ve been telling everybody there’s no such thing as too young; if they’ve invited you, you need to do this.” They gave a pep talk about how like, you’re not chickening out of this, you’re not backing down, you have like a year to prepare for this and you’re going to be good. 

And I think another big part for me personally was the fact that we were being taken serious by the leaders. The fact that there were people who were willing to listen to us gave huge confidence to myself that there is value that I can bring, even when I’m very junior and an inexperienced researcher, that I can bring as a young person to a group and to other people. And that is something that has really strengthened my back for my entire life, not just my career. But just that you can put your feet on the ground and it’s like, I am worth being heard and there is something I have to say, and I can speak up and people hear me. I think that’s a very important lesson in life.

Dr. Ivaniuk: Let’s return back to your career road and see where you get next. The next point in your career was your fellowship in Great Britain, right.

Dr. Neuray: So I think it was a combination of a desire I’ve had since I was a kid to live in London, paired with my interest in genetics and mitochondrial disease and wanting to learn more about this that made [University College London] UCL the right choice for me. It was mainly to clinically learn about genetics and how to counsel patients and also do some research on phenotype-genotype correlation. I knew I was never going to be a basic scientist or a lab researcher, I’ve always preferred clinical research, and in the end also there, my desire there was mainly driven to change education, so I was still in my mind in Salzburg wanting to build a transition clinic there, so I wanted to get real-life, hands-on evidence there, and I also wanted to improve generally on a higher level education in neurology, and I thought what do I need to achieve to be able to get there and I realized okay you have to be a professor to be able to teach or change curricula at a university so for me then, academic research was a means to an end to achieve that. Great timing because it was half a year before COVID hit, so that was an unpredictable turn in that story.

Dr. Ivaniuk: Let’s come to that turn. COVID hit, and how did it hit your fellowship experience and how did you manage to survive though that time, what occurred during that time?

Dr. Neuray: So, regulations in the UK at that time said every lab that wasn’t actively researching on vaccines or anything COVID related had to close down. And then I thought okay what am I going to go with my time, and I had ICU training the past in Salzburg and I just signed up to work clinically again. So I did do that for like a good half-year, I worked at the COVID ward at UCLH, so one of the biggest ICUs, I think we had 60 beds for COVID patients. There was such a strong communal support within the ICU workers, nurses and students, everybody was pulling on the same rope. That was very empowering and that gave you a kick to keep going. I learned so much there, and yeah. I made some friends there in the weirdest times. And then, yeah I had to go back to research and I just had like enough money to finish some of the things I had started, so I managed to at least publish two papers from that time, so I was quite happy to get that out, and then Brexit was a thing, because that time it was already October, 2020? I’m confused about my own time here, yes, October 2020. Brexit was effectuated so it became more tricky to get grants, and COVID wasn’t over yet so I also thought, “Do I really want to sign up for more research in such uncertain times?” It may as well be that every winter they close everything down, so it was a bit of a decision that I had to make there.

Dr. Ivaniuk: first and foremost, thank you so much for your dedication during this time. Not everybody signed up for that. You did.

I wonder what was the conclusion you made when you got back and somehow transitioned to industry. That’s a question that’s intriguing.

Dr. Neuray: Yes, so many people have approached me about this and were like, “What the hell were you thinking with that move?” So this is a great opportunity to clarify some of those things. It was a gradual decision. I was in that limbo after COVID and it was a very practical issue I was running into. I had formally finished my training, and I was waiting to get from the Austrian medical society chambers, so they need to send you a certificate that you’re done with residency training and formally recognized as a neurologist. And I was waiting for that document, so you had to hand in equivalents, you had to prove that what I did at UCL in terms of research was as good as what I could have done somewhere else, blah blah blah, so I handed in a bunch of documents, and they just didn’t come back to me. And they didn’t come back and I chased them and I was like I can’t apply for a consulting position because I don’t know if you‘re happy with my training. I can’t sign up for any training because I don’t know what needs to be repeated if you have an issue with this. And they were like, “Oh yeah, but you interrupted your training due to COVID and we don’t have a procedure in place” and I was like come on, it was a global pandemic, I’m sure I’m not a single case in this. Oh yeah but you were also abroad, and that means we need to have a meeting but we can’t have meetings right now because of COVID…long story short it took them more than a half a year or longer to decide whether I was done with my training or not and I was in that limbo and it was lockdown and I had nothing to do and I thought this is absurd, also not very productive. 

I had been approached by a company called Epilog and they have a product for ESI, and I was using that product when I was training in Salzburg, and I know the cofounders of the company because I met them actually at a conference once. They had approached me and said we need somebody to start working for us, do you want to consult for us. 

So I was in that time where I had no clue what I was going to do, I was waiting and couldn’t do a career move, so I thought actually I can earn some money there and I can work from London so I can work from home, because it was unclear how that was going to turn out, if I should move back to Austria. 

I’ve always been interested in learning more about algorithms. And again, thinking about education, and let’s remember my goal was to improve education and clinical care. And I always thought like, why are we as neurologists so reluctant to use new tools? Cardiologists do it, oncologists have algorithms and automated analysis, why is there such skepticism in our field and I thought, “Well maybe if I learn more about how these algorithms are being developed, I can mitigate that and go back to the academic field and say you know, not everything a computer does is bad.” Just because we don’t understand it doesn’t mean we shouldn’t use it. You know. And I thought maybe this is a great time, I start on a consulting basis, I learn about how people develop software for clinical care and I can use that in the future to improve the way we educate people and the way we care for people, because I always thought it’s a fundamental flaw to have people look at waves for an entire day, and we give a lot of training for all of that and we give no training about soft skills. And I thought what is the most humane aspect of medicine? Again I’m a people person, I think that’s come out clear--and why are we not making use of that? We’re being trained to be memorizing interactions of medications and learning pharmacokinetics and I’m not saying that’s not right, but I will never rely on interactions that I’ve memorized 10 years ago; I’m going to use an app that calculates it for me, I save time, it’s a certain method, and I have time to speak to my patients, to my relatives, to elaborate on those soft skills that will always remain a human skill. And that’s when I thought okay, I’m going to go into that part of the industry to learn about it and then I can come back and teach about it.

And you’re just, I just got into it and now, just, gotten into it, I’m not ready to leave this yetand then all of a sudden, and then I had to make a choice, to finish the story about the Austrian medical chamber, great story, they did come around after 8 months and they said okay congratulations, you’re a neurologist now! And I then I thought like, Yay. What am I going to do now? I still lived in London. I was actually very frustrated with the health care system in the UK. To be fair, I got to know it during a global pandemic so I think I have a very skewed assumption there. But I felt like the type of medicine and epilepsy care that I would want to provide, I doubt that this is something I can do there. And I wasn’t ready to go back to Salzburg, it felt a bit like a step back into something old, and I was so excited about what I was doing at Epilog, I thought I can always go back there in 2 or 3 years, I’m young enough now, I can do this, I have no family to drag into financial uncertainty, being a consultant and a freelancer, all these practical ramifications, so I thought why shouldn’t I bear it, I’m going to give it a try.

Dr. Ivaniuk: What are your responsibilities now at the company and how is your working day, what is your working day like.

Dr. Neuray: (laughs) So I have become the CEO of the whole Epilog unit. I started as a clinical, head of clinical affairs. So now my responsibilities have shifted a bit. We have a clinical product on the market which does electrical source imaging for presurgical evaluation, and we are developing this further. So a lot of what I do is give input from a clinical point of view. I’m the only clinician and only medical doctor in our company. So I work with a bunch of engineers. You can tell them, “I’d like to have that” and they say, “Yeah, I can just write two lines of code” and you think, “Oh my god, that is so cool.” So what I do is I give a lot of input on, we can do it but is it useful to the clinician? Like does it make sense that if we have ESI (electrical source imaging) that we can export that as a DICOM to our customers – is that something people need, is that something you would use in a clinical product, would it make more sense to have an MRI viewer integrated with ESI and PET scans, what is really useful, what do you need as a clinician. 

The second part is that we are involved in a lot of clinical trials and a lot of these trials look into disease-modifying drugs. So that is where my expertise of genetics and EEG has found its niche, because what we currently do is we provide optimized EEG analysis as endpoints for disease-modifying effects of compounds in trials. People ask what kind of EEG things should we look at, how often do we need to measure an EEG, how long should the EEG be, it’s very difficult questions where I would love for people to come up with guidelines for. And I give input on that, I talk to the pharma companies, I learn about the pharmacokinetic and dynamic characteristics of the compounds they are trialing, and then we roll out the clinical trial, we train centers on how to record EEGs that have sufficient quality, and then obviously I interpret all the results. So somebody, you have a bunch of EEG results and somebody needs to make sense of that and report back to the trialists.

So I’ve found a niche where the background of genetics and EEG analysis and the passion of optimizing workflows and being efficient all come together, so I supervise a lot of that and now I need to manage a team. Which is a new responsibility, but I really enjoy it. It’s like running a family somehow. 

Dr. Ivaniuk: Coming to your skill set that you have to apply, did you feel that you lacked something for this position given your clinical background and clinical training, or was everything all right and you could jump in right away.

Dr. Neuray: I mean, I lack a lot of things and I oscillate in my enthusiasm between “Oh my god this is great!” and “Oh my god what am I doing here.” I’ve had fully clinical training; I have no idea about running a business. I had to learn that not everything that’s a great idea is a business case.Wouldn’t it be cool to do THIS, and I have these ideas and then our business developer’s like, “Great, and how are we going to make money with that?” The regulatory questions – oh my god, how oblivious am I as a clinician about how many steps need to happen for something to become a medical device. Regulatory questions in clinical trials, like how does a drug get approved by the FDA? All things I’ve had to learn. And then obviously finance. I have no clue about running a business financially. Like how do you make a budget, how do you calculate growth for the next 2 years of a business – those are things about which I’ve had no clue.

I’ve learned a lot, I’ve done a crash course, like a three month MBA quick course, I’ve read books on financing and budgeting, I’ve learned so much from my colleagues, from our engineers, our business developers, regulatory—I’ve learned a lot and there’s a long way to go. 

Dr. Ivaniuk: To wrap up our conversation, could you give some advice to our peers, do some peer mentoring, and suggest something to all young epileptologists and people involved in epilepsy care, research, education out there—some practical or maybe ideological advice, whatever comes to your mind.

Dr. Neuray: I think the biggest advice would be to rely on your peers. To not be shy, to open up about your issues and your struggles. I know every human being struggles and we all are fundamentally flawed and there is no shame in that at all. I think that makes us who we are, and I think relying on friends and peers to give you support and involve them in your life and your career is I think the best advice I can give from my life. 

I think it’s important to be curious. I think it’s really important to keep an open mindset and sometimes as an early-career person, for me it was sometimes very scary to think, “Oh my god, if I open the door toward epilepsy I’m going to close the door toward all of the specialties in neurology.” But the curiosity and the faith that something will come once you cross that door, that there will be 100 new doors that open after that in that corridor is great, and have that confidence and that curiosity that there is something out there even if you’re scared about indecision—that’s okay. 

And what I had to learn is that you need to accept the fact that a personal vision can change over time. Maybe we set out to do something and we realize actually that’s not the vision that I have for my life anymore, and actually the good thing to do then is applaud that. Applaud the fact and accept the fact that visions change – it shows you’re curious, you’re open to self-reflection and you’re not going to chase something that is not real anymore. Accept that they change, applaud that they do, and don’t grieve that maybe you didn’t reach the goal you set out to do, but you’ve achieved something else along the way and accept and applaud that change in vision that you had.

Dr. Ivaniuk: Those are some great pieces of advice. Thanks so much for sharing your wisdom and all of those great career pathway twists, thank you so much for finding time to speak with me today.