For 2018, via the ESO newsletter, we are focusing the spotlight on prominent ESO members under 45. In January we introduced you to Georgios K. Tsivgoulis. For February, we learned more about Else Charlotte Sandset. In March we presented Urs Fischer. In April you met Charlotte Cordonnier, Hopefully you were able to meet some of these people in person during the ESOC in May. From the ESOC, the Young Stroke Physicians and Researchers Committee published daily interviews with Ayse Tanritanir, Stefania Nannoni, and Maren Ranhoff Hov. 

In the June edition of this series, we turned the spotlight around to ask the questions to the woman who is normally the questioner. This month, we interview Marialuisa Zedde, the Chair of ESO`s Public Relations Committee, responsible for the ESO monthly newsletter.

Why did you start your clinical research activity?

Like many physicians working in a public hospital my first approach to the research field was driven by clinical practice. To clarify this point, I think that the so called “routine” management of patients with neurological diseases (and specifically, in my field of interest, cerebrovascolar diseases) very often raises questions about the mechanisms of disease, the global accuracy of the diagnosis, the efficacy of treatments and the prognosis in an individual patient. Surfing across medical literature I found soon that many of these questions had not yet found a strong answer and I tried to discover if there were ongoing projects aiming to answer these questions. At the beginning I was astonished by how many questions were not answered, because even widespread clinical habits were supported only by weak evidence and many of my colleagues were not interested in opening their minds to the best available knowledge to take care of patients.

My personal turning point was when, some years ago, for the umpteenth time, the answer to my solicitations was: “we have always done so and it has always gone well”. I answered back that if this rule had guided our ancestors, probably mankind would have died out.

I started finding answers to my clinical questions and the unsolved questions are constantly growing.

How did you get involved in European Stroke Organization?

Very soon as a resident in Neurology I dedicated myself as a field of primary interest to cerebrovascular disease in its several faces and following the activities of European Stroke Organization was a natural consequence of this interest. From the first approach to ESO, I had the feeling of a lively group, of passionate and competent people and of a farsighted planning covering all aspects of cerebrovascular disease from basic research to practical management and clinical research and finally the attention to social and political issues. I perceived the society as constantly evolving and growing, adding knowledge and applying it to concretely improve the management of stroke patients in all European countries. I appreciated (and, obviously, I’m still appreciating it) the attention given to stroke care in low and medium income countries and the objective to reach a minimum level of care for all European citizens in any country.

I told myself that I wanted to actively participate and work towards achieving these goals. I asked it and now I am here, doing my little part for the common goal.

What does clinical research add to the hospital?

I have always firmly believed that a hospital where research is done is able to provide better care to patients than to a hospital where no research is done. This is true at all levels and in any field of medicine.

Research must certainly answer questions and in a hospital ward the questions concern clinical practice. Therefore, I deal with clinical research, trespassing in the pathophysiological mechanisms of disease though genetics and biomarkers.

Actively engaging in research is the best way to achieve new knowledge and questions generate questions. The doctor who asks questions is more useful to the patient than the one who does not ask himself questions. Following a research protocol in clinical practice has an educational value and allows physicians  to stay smart, curious and young!

How do you manage daily hospital practice and clinical research?

For me this is not a a real issue because my clinical practice is closely linked to clinical research project. Even when the patient I am managing is not part of a research project I study him/her as if it were. It is not uncommon to find into the clinical documentation of inpatients a copy of the main papers about his/her condition I leave for my colleagues, aiming to solicit curiosity and share a knowledge-based management of the patient.

The real question could be how hard it is to do this. My answer is that it is not hard if I can really share this approach with somebody else. So, my suggestion is to work hard to create a group around you, sharing interests, clinical reasoning, research activity. In this way, all people grow and a new generation of stroke physicians can be strengthened.  As Henry Ford said, “coming together is a beginning, keeping together is progress, working together is success”.