Supporting Women in Science and Medicine with Dr. Michelle Manni

Mothers Leading Science program expands to University of Pittsburgh | University of Minnesota

Current Biologics for Severe Asthma w/Dr. Manni | American Thoracic Society Breathe Easy Podcast

Therapeutic Advancements for Cystic Fibrosis w/Dr. Manni | American Thoracic Society Breathe Easy Podcast

The Association for Women in Science

Women in Science | UNESCO

Supporting and Promoting Women in Science: Actionable Strategies from the NIH

10 Things Everyone Can Do to Support Women Scientists | American Chemical Society Axial

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Voiceover: This podcast is for informational and educational purposes only. It is not medical care or advice. Clinicians should rely on their own medical judgements when advising their patients. Patients in need of medical care should consult their personal care provider. Welcome to "That's Pediatrics", where we sit down with physicians, scientists, and experts to discuss the latest discoveries and innovations in pediatric healthcare.

Dr. Amanda Poholek: From UPMC Children's Hospital of Pittsburgh, welcome to That's Pediatrics. I'm Amanda Poholek, your co-host, assistant professor in pediatrics and immunology.

Dr. Arvind Srinath: And I'm Arvind Srinath, your co-host, associate professor in pediatric gastroenterology.

Dr. Poholek: Our guest today is Dr. Michelle Manni, who's an assistant professor of pharmacology and chemical biology and our topic today is women leaders in the basic science world. Dr. Michelle Manni earned her bachelor's in biochemistry from Allegheny College and completed her graduate work at the University of Pittsburgh under the mentorship of Dr. Tim Ore, where she studied the role of extracellular superoxide dismutase in pulmonary inflammation. After graduating with her PhD in 2011, her post-doctoral work focused on the type 17 immune responses in severe asthma where she worked with Dr. John Alcorn, here at UPMC Children's Hospital. Throughout her training, she's received a number of numerous honors and grants, including a Parker B. Francis Foundation Fellowship and her first RO1 in 2020. She's also a co-investigator on several cross discipline collaborative projects both within and outside the Department of Pediatrics. Welcome to the show.

Dr. Michelle Manni: Thank you so much for having me.

Dr. Poholek: I'd love if we could just start, if you could tell us a little bit about your background, what led you to your current position as an assistant professor in the Department of Pharmacology, and then a little bit about your research interests and how that's shaped what you hope to answer in your lab.

Dr. Manni: Sure, of course. Thank you for that great introduction and kind of walking through the path of my training. I think what led me to my current role is the exciting collaborations that I established in the Department of Pharmacology and those date back to 2016 when I first transitioned to faculty in the Department of Pediatrics. And so a lot of those collaborations helped grow the science in new directions and in new areas and further developed new ideas. So really moving to the department was to foster these collaborations more and to grow more professionally. And I think outside of the laboratory there's also been other things that I've tried to establish doing. I now serve as an ombud for the School of Medicine in the newly formed Office of ombuds. And this is a unique opportunity to kind of give back to the organization that trained me, providing students a voice to a place where they can voice their concerns in a safe and confidential space.

And also to promote a great learning environment for our medical students and our postdoctoral students. So I think professionally that's what my role as a faculty member is here now. I think the second part of your question was about my research interests. So I'm still focused on severe steroid and sensitive asthma, understanding those patients who cannot respond to traditional therapies. And a lot of these patients have very diverse phenotypes so they have comorbidities or they have other things that are preventing them from responding. And I think what really intrigued me the most about asthma research was that even though we've made significant strides over many years of research, there's still a significant portion of patients that aren't helped by our current therapies. And so really understanding why that is and how those patients are different both from a biological and a clinical standpoint will help us develop more targeted and effective therapies.

And I think that's really broadly what my research focuses on from the basic science approach, understanding those molecular mechanisms, having clinical collaborations to allow us to look and see are these pathways relevant in patients and then to help us find ways to target therapies.

Dr. Poholek: Well, super, super interesting and important work. And I think what's really intriguing is that you've been able to really build this research program and this interest in asthma while continuing to train all during your time here at Pittsburgh with a variety of different departments, which is really intriguing. So as a woman navigating the world of basic science, what role did other women leaders have for you as you navigated this career trajectory for yourself?

Dr. Manni: So I think that's a really interesting question because as I think about my training, all of my primary mentors have been men. And that doesn't mean to say that women haven't inspired me throughout my career. I can think back to earlier on my interest in math and science really was inspired by women teachers I had in high school. When I went to college, I had a very influential biology teacher and advisor there at Allegheny College, Ann Kleinschmidt. And I think over time I realized that a lot of the inspiration I had to pursue the pathway was driven by women throughout that. So I did a research experience in the summer when I was in Allegheny College at the University of Pittsburgh where I worked with Wendy Mars in the Department of Pathology. And at that point I thought I wanted to be a doctor, I thought I was going to do patient care, go the traditional MD route.

And at that point I realized that I really loved research. So it was really the experience I had that summer in her laboratory that pushed me in the direction of the PhD. And so when I look back on that, I can say that women were the role models and the reason that I pursued the path that I pursued. And if I think about my research now, even though mentored through my training by men, many of the collaborators I have now are influential women in the field. Dr. Anuradha Ray, Sally Wenzel, Stacy Wendell, people who are driving research forward in a very positive way and they're challenging me to think deeper in my own science and also providing meaningful collaborations that are essential to do my research that I want to do. So I think it's with those types of mentors and leaders that we have, you really are able to be successful. Especially for someone like myself who stayed in the area, I think really having close collaborations and people who can help build your science in a team fashion is a really valuable tool.

Dr. Srinath: It's a fascinating path you've had and it's really interesting that you're able to look back and then look to the now and then think about who you're working with as well. Can I dig a little bit deeper in what you mentioned in terms of the characteristics of your female collaborators and looking back at the previous women you worked with. What qualities did they have that really inspired you that let them to really help you get interested in what you wanted to do?

Dr. Manni: I think that's an interesting question. So I think when you are a woman in science and you have a woman mentor, there's a lot of parallels that can be made. And so you really see them as a role model of a tangible, they're doing it so I can do it. And so I think that's really the most simplistic thing that I think about when I work with a lot of women or meet with women leaders is it makes it real that you can do it. I think some of the other characteristics of women leaders, especially more senior women leaders, is that their path has been met with resistance too. And so they're able to talk about experiences that they had of resistance in the academic path or challenges that they had in the academic path and can help you then therefore navigate that as well.

So they're able to share personal stories or ways that they overcome challenges that can be very helpful. So I think a lot of my interactions with women leaders in and out of this university have been really focused on talking about previous experiences and how that shaped them and relating that to my own life. But I think it's inspiring to see women in upper leadership positions and moving through the academic system because again, it makes it tangible for all of us who are more junior hoping to also make it there.

Dr. Srinath: I appreciate you bringing that up and I appreciate you bringing up the challenges you faced. Being in the position of a mentor and a mentee and also being, I'm going to mispronounce this word, I apologize, as an ombudsman as well. What challenges have you seen women facing and how have you seen some being able to overcome those challenges? Very broad question, so feel free to answer as much as you'd like.

Dr. Manni: I was going to say, I think the Covid-19 pandemic brought out the gender inequalities and the disparities that exist, but I think it's important to recognize that those really existed prior to the pandemic too. Women were, I can't remember the exact citation of the article, but it was something in the effect of women were publishing less as first in senior authors. They had less funding overall and women were taking on a lot of duties outside of their primary research responsibilities within institutions, which leaves them less time to focus on primary research, was kind of the gist. And I think that although those challenges have always existed, the goal is to find a way to foster more support for women in science. And I'm probably going to digress off your question a little bit, but I feel like they'll always be elephants in the room and they're going to be different for everyone.

So everybody's challenges are going to be different. So the elephant in the room has always been my location and staying in Pittsburgh. And I think that one significant challenge that a lot of women face in academic research or in medicine is an unconscious bias when it comes to your decision to not only focus on your research but also have other factors in your life, like family life. Some view that as not being able to take one seriously over the other. I don't necessarily agree with that, but that's what I think a lot of people think. It's hard to balance two things, it's better to have one. And so I overcame this by continuing to work really, really hard and to prove to myself and probably to others that my location was not necessarily a weakness, but instead was a benefit to my training path. And the reason why I say this is because independent reviewers of grants from the NIH and from societies and other organizations never commented negatively about myself as an investigator or my environment.

And so to me, throughout my training, that showed me that I had what it was necessary to be successful in academics, I had met those academic benchmarks. I was publishing, I had funding coming my way and I was able to learn how to navigate that. And so I think that's what was really important for me is that I was able to learn new techniques, gain new knowledge while still staying at the University of Pittsburgh. So it's important to diversify yourself wherever you are, regardless of if you move institutions or you stay at the same institution. And also, as I mentioned before, the key is really collaboration. So finding people to challenge you, to challenge your work, to help you develop alternate viewpoints that you may not have thought of and really providing insight. And believe me, I think for me this is still a giant work in progress. I overcame this by basically developing confidence in myself to stay true to who I am, which I think is a weird thing to think about. But I'm a mother, I'm a wife, I'm a daughter, I'm a sister, I'm a full-time Pittsburgher and I'm a PhD scientist at a very prestigious institution. And I think it took me a while to realize I value every part of who I am as a person and that everybody who's helped me along the way I value as well.

Dr. Poholek: I really appreciate Arvin's question and your response to those challenges. Cause I think inherently you raised some sort of real key things that I think a lot of women in science and women in medicine have to go through, which is that there is this sort of unspoken requirement that we have to keep picking up and moving. As you change each portion of your career, whether that's from graduate school to your postdoc and then from your postdoc to a faculty position, or whether that's from medical school to your residency and from your residency to your fellowship, and then from your fellowship to an attending position. And this is all happening at a phase in our lives when many people are ready to have a family, settle down, put down roots, purchase a home, and not feel like they have to keep moving from one place to the other.

I think there's been a lot of studies now, and I'm sure you're familiar with them, you talked a little bit about some of them and particularly for women, there is this drain from that graduate school or medical school down to the academic goal, which is faculty. There's like this pinch point where women in particular sort of exit the stream because of these requirements to continually pick up and move, to continually diversify, to continually have to keep changing things. And it can be very hard when you have another part of your life that's not just career all the time, and this belief that you cannot do both. I kind of want to use that to ask a little bit from your perspective as what you see as an ombudsman, what are the things that we, as institutions, need to be doing to support women in science and in medicine so that these kinds of challenges are easier to overcome and that as a system we recognize that these challenges should not inhibit people from being successful in their careers?

Dr. Manni: I think the university's over the time of Covid started to see some of the disparities and make changes. So for instance, some of the things that we've added are changes to tenure clock requirements and childcare additive services. But I think one of the things that we don't still think about again, is how we still have less women in leadership roles. We have less women at the top who are ultimately the people who are making the downstream decisions. And I think what you were speaking about is that leaky pipeline, the spot where people just end up dropping off because they're met with so much resistance, that the easiest route is to recognize what makes your life the most meaningful and important. And sometimes it's not forcing through a brick wall. And so the question is how do we better support our junior faculty, our mid-career faculty who may be at a portion in their lives where they're expanding their families or they have other priorities out, doesn't even need to be family, other priorities outside of the workplace.

And I think that one of the things that I've tried to do, which a lot of women do, is attend a lot of these leadership academies and meet people and develop skills to help you as a leader. And I think that's one step and to add more diversity at universities just overall. We have to focus on retention. We have to focus on supporting the women who are there, or underrepresented minority faculty that are there through promotions and also retaining them, finding ways to retain them and to create meaningful relationships to retain them. And so I don't know that I gave a great answer because I don't think there is an answer. But I think overall recognition is the first step and I think we've managed to do that. And I think Covid may have helped us do that a little bit. The recognition, that balance is difficult and balance may never be achieved. But I think moving forward we need to come up with strategies that allow people to not leave and have women being in more decision making positions, I guess I should say.

Dr. Poholek: So what advice then would you give for young women, either in basic science or in medicine who are interested in pursuing these kinds of careers?

Dr. Manni: So I think for students who are interested in pursuing these types of careers, and even postdocs who have completed their training, or fellows that have completed their training and they're thinking about what their next steps are. One of the things that I always tell trainees to think about is do some self-reflection, what's important for you? Doesn't matter what other people desire you to be as a physician, a physician scientist, a PhD scientist, a trainee, tune all that out. What do you want to do? What's truly important to you? And stay true to that. So pick whatever that is and stay true to it. And don't feel like you have to justify or apologize for who you are as a person and who you want to be as a person because that is you, and you are the one who lives that life. And I think if the pandemic taught any of us anything, it's that you should truly enjoy your life and whatever that is.

And if you aren't happy, supported, fulfilled, you should go out and seek whatever opportunities there are to, I don't want to sound cliche, but fill your cup. Whatever you need to find that's important, you should do. And change is hard, but sometimes change is necessary to get you to the next step of wherever that is. And I think in academic medicine and in science, it's not a great field for external validation. You're not going to get a lot of positivity. So when you get those poor reviews from a paper or really negative comments from a grant, you have to realize that it's just a step and turn that into how you can improve. So I think to summarize, or what I'm talking about broadly is don't let people sway you based on what they think you should be doing. You should be doing what you want to be doing. And if that is pursuing academic medicine, go for it. If that is giving up the research side to only see patients because you want to do patient care, then that's pursuing the patient care route.

If that is being a research scientist while balancing a family at home, then that is what looks like for you. But you're always going to have resistance, there's always going to be resistance from time to time. It's just how you move through that and how you decide and it's okay to always reevaluate. So I always tell students to focus on not what's expected of them, because what's expected of you is you signed up to come to school and you're going to go through this training path. But really when you get out, what do you want to do? What do you want to take from that? Because then that's what you should be focusing your time on during training. If you really like teaching, you should be going and getting some teaching experience. If you really want to pursue policy, you should be looking at ways you can get more experience in policy changes.

Dr. Srinath: I so appreciate you bringing up that resistance, the pressures. This is my point here in my long-winded way of saying it, but that it is suffocating to think about all the pressures that are out there and all the obstacles and all the moves and all the responsibilities and the fact that there's very little gratification at all at the end and you have to use your drive to push you through all of that. And that drive can be easily squashed down with just one of the 20,000 pressures that you're on and on top of the pressure you have on yourself. And I suspect, correct me if I'm wrong here, that contributes to the pipeline going down too. And I appreciate you talking about finding that inspiration or that light for helping people see through that, the mud that they're drowning in, for lack of a better analogy. To help them push forward and talking about that growth mindset too. I don't have a question, I'm just making a comment. What I'm getting at is for those who are feeling like they're drowning right now, what can they do?

Dr. Manni: So I think the best thing is to, I don't know the best thing, so I'm going to start with that. I don't think I know the best thing, but I think one of the tools that I use is tackling what is able to be tackled at the time. So if you're at home with your child on Covid quarantine, that's what can be tackled at the time. Also, working for deadlines, that's a tactic that people use. But I think a lot of the time you just need to realize you're not alone in this and that everybody who's in this field has their own struggles, whether or not they show it or not. Because I think a lot of this is always coming across as extremely confident and extremely poised. That's much of science. You are medicine, you're always showing up with your A game. And so I think it's okay to realize that everyone doesn't always have an A game day. It's okay to say I'm going to take a break for a second.

It's okay to say I'm going to reevaluate. But that's a hard one, I don't think anybody knows the right answer to that because everyone's situation is so different. But I do think it's important to realize that you're not alone. And I think a lot of the leadership programs for women are focused on that. So I'm part of Mother's Leading Science, which is the first year at the University of Pittsburgh. It's a sister site to the University of Minnesota. It's for research intensive faculty that have very young children. And I think one of the things about that program that makes it very unique is you do realize you're not alone in this and that there are other women who are also in similar situations trying to make sure that they can stay on the path and not exit.

Dr. Srinath: Along those lines, I'm sure a lot of those, I don't know how to characterize, pressures can contribute to this feeling that you alluded to earlier of imposter syndrome. What am I doing? Should I even be here? I know there's a lot of literature on imposter syndrome, but given your expertise and where you have gone in your career and the people that you work with and your mentors too, what have you seen has been helpful to help combat that feeling?

Dr. Manni: So combating imposter syndrome, I don't really know how to tackle that. Maybe that's my imposter syndrome.

Dr. Poholek: I can certainly share what's helped for me because I also have a career in basic science, but I think when it comes to feeling like you are not sure what to do next, I generally found that I try to do two things. One is that I actually keep a little file or a little folder or an email list of all the things that have been positive reinforcement. All the emails that you've gotten from people saying congratulations, all the things that you've accomplished, all the awards that you have gotten so that you can refer back to them and say, "Remind yourself, these are the things that I have accomplished. These are the things that got me here. This is why I'm here and this is why I can continue to do the things that I want to do going forward." And the second thing that I think has really helped is to really build a community, which you had talked about earlier on in the conversation, that creating not just a mentorship of the direct mentor above you, but creating a team of mentors.

And I know for myself, I've also created a large team of women mentors that I can look to and go to and rely on and say, "Hey, here's some problems that I'm having, or some things that I'm experiencing that I really could use some of your advice and your experience and your wisdom on." It's really been important to have a community of role models, a community, especially of women, who have experienced all of these challenges and resistances that Michelle referred to previously. So that you kind of, again, see that it is surmountable that these women did it, that they can give you tangible advice for how to move forward and also give you the sense of you're here for a reason and you can continue to be here for a reason because you have the support around you to do so. Really coming back to this idea of you're not alone and creating a community like the Mothers in Science, having that community support to really rely on.

Dr. Manni: Amanda, I love the idea of a win list. Cause that's basically what it is, you're able to celebrate small wins and remember them. I love that.

Dr. Srinath: I so appreciate both of you because the listeners out there, that's something that I think a lot of people are dealing with right now. I'm sorry for making it awkward for a difficult question, but I think it's something that we're all...

Dr. Manni: I think it's super important questions.

Dr. Srinath: Thank you.

Dr. Poholek: So then maybe just to wrap up, can you share with us, given your experience, where you see yourself in the next 10 years?

Dr. Manni: Well, we just talked about how grueling the path is, but I think even with funding being tight and the struggles and the things to overcome, I do see myself still as an independent investigator in 10 years from now. Probably with a little bit larger family and still pursuing understanding molecular mechanisms of severe asthma and probably have diversified my research a little bit to include some of the really cool collaborations I have now. But I think beyond that, we always focus on the 10 year career. But I think as we were talking about imposter syndrome, I hope through this I do have more confidence in myself as a faculty member. I do hope that I'm able to be a role model for other women who are going through training and who are considering the path. I hope that I'm able to emulate some of those things that mentors in the past have shown me in order to show other women that it's also tangible. So I hope that's something I can provide for others in 10 years that people are providing for me right now.

Dr. Poholek: I think I can confidently say that in the next few years you'll be acting as a woman leader in science for those women who are looking ahead. So thank you so much for your time today. We really appreciate it.

Dr. Srinath: I echo Amanda's sentiments. Thank you so much.

Dr. Manni: Thank you. I'm so happy to be here and it's been an honor. Thank you.

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