By Keith Hoots, MD

2009-05-01

Dr. Hoots is Director of the Division of Blood Diseases and Resources at the National Heart, Lung, and Blood Institute.

My first three months as director of the Division of Blood Diseases & Resources (DBDR) at the National Heart, Lung, and Blood Institute (NHLBI) have much in common with my European sabbatical. There are several processes one experiences in a new environment.

First, you should learn the language. (Of course, during my sabbatical I was quite delinquent in this task.) My first few weeks at NIH flew by as I familiarized myself with the federal jargon of grants and studied the primer on NIH acronyms. 

Next, meet the neighbors. I have had the pleasure of meeting with NHLBI research constituencies in hemoglobinopathies and Diamond-Blackfan anemia (DBA). It has been a privilege to work with ASH leadership to chart strategies for future direction and collaboration. Our colleagues who treat coagulopathies in Europe — the European Association of Hemophilia and Allied Disorders — are eager to collaborate on future translational and clinical hemostasis research. DBDR staff has been developing a new avenue for clinical trials in sickle cell disease, which we discussed at the Annual National Sickle Cell Disease Scientific Meeting this past February. The U.S. Department of Defense is enthusiastic about potential collaborative research funding on vascular damage associated with major traumatic injury. I began to feel like the novice downhill skier making his first attempt on the “green” slopes after spending a modest time staying upright on the bunny hill. 

Third, learn your way around. The evolution of NHLBI’s new blood research funding opportunity announcements is an intensely interactive developmental process. Eliciting new, exciting proposals in blood transfusion, stem cell biology, hemostasis and thrombosis, and blood diseases provides continuous and challenging intellectual stimulation. With a bit more practice I hope to graduate to the “blue” slopes and the “black diamonds.” My new job is as exciting and challenging as I had hoped it would be.

Fourth, the first crisis! The winter “storm of the century” arrived with the American Recovery and Reinvestment Act (ARRA) of 2009, which includes NIH as the recipient of $10.4 billion in short-term research resources targeted to investigators nationwide. The new two-year funds have the dual purpose of enabling new and innovative science, while providing new employment opportunities for scientists and technologists — all to be accomplished within 24 months! Suddenly, my skills for controlling the trip “down the mountain” became completely inadequate. Even “expert” colleagues at NIH were challenged; new strategies had to be developed, peer review had to be accomplished in less than half the traditional time, and new systems of tracking and accountability needed to be created. Plans underwent daily — sometimes hourly — revisions. Inter-divisional, intra-divisional, and trans-institute Challenge Grant proposals were drafted, rewritten, and revised. The atmosphere at DBDR, NHLBI, and NIH is palpably vibrant, interactive, and intellectually invigorating. While our regular workload continues and our new ARRA responsibilities demand nearly constant attention, the potential to stimulate growth of new science with this unprecedented opportunity stokes our energies. Excitement is tempered by concerns that infusion of short-term new resources will not sufficiently expand scientific creativity or engender enough sustainable employment.

These three months have affirmed how integral NIH is to biological research — both nationally and globally. The dedication of my exceptional colleagues at DBDR, NHLBI, and across the NIH, as well as the tireless dedication and perspicacity of the NHLBI leadership, has earned my immense respect. I owe a special debt of gratitude to all who have encouraged and challenged me: scientists, patient and advocacy group members, and professional organizations.

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