Curiouser and curiouser… A chat with Dr Sarah Rosen and Eleanor Ingram

As we continue our current blog theme around curiosity, we sat down for a chat with Dr Sarah Rosen, director in the Incite Health team to explore what has caught her eye and intrigued her most recently.??

Joined by senior associate Eleanor Ingram , our Marketing Manager Lucinda Darby led a fascinating conversation which went on a journey from the women’s health research gap, to AI’s ability to detect cancer, to smartphone free childhoods, and Sarah’s unexpected inspiration whilst watching Sister Act…? ?

This is a slightly longer post than usual, so grab a cuppa and maybe a snack, and settle in.?

[The following conversation is edited from the original transcript for clarity].

Mind the gap – the need for more women’s health research?

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Lucinda: So, what's piqued your curiosity recently, Sarah??

Sarah: Coming at this from a broader point of view, I think the thing I'm most curious about, or interested in, is that having worked in pharma for a long time now, there’s sometimes a feeling that everything's exhausted and you're dealing with loads of crowded markets... But actually, it's often not the case with the work we are doing and challenges we are solving.

In some of the therapeutic areas of which we work, we're often dealing with a really underserved audience who desperately need these treatments - and there's a massive paradigm shift that they're going to cause. It's intriguing, and a reality check.?

The same if you look at women's health. You look at menopause, and you think there would be so much opportunity there – seeing as 50% of the world’s population will experience it. I can't remember what the proportion is currently experiencing it now, but it's quite chunky. [Editor’s note: It's estimated that around 13 million people are currently perimenopausal or menopausal, which is about one-third of the entire female population.]? So you would think they would have exhausted all the treatment options for menopausal women, but I feel like they've only scratched the surface.?

Lucinda: Exactly! There's still so much more that needs to be done, so much more research. Like you say, it makes me wonder why there hasn't been more investment, when you consider how many people would benefit from it.?

Sarah: In terms of curiosity, that’s probably one of the topics that I am most interested in and most inherently curious about – not just menopause, but everything women’s health. Whether that's the experience of pain or drug dosage, or things like ADHD, autism etc - having that representation of women and their own experiences and perspectives.?

I was recently listening to this podcast called The Retrievals which is about women going through IVF treatment who weren't given pain medication because the nurse was stealing the fentanyl and swapping it for saline. And the women's excruciating pain wasn't believed. So there's one piece as to ‘how could that happen?’ - that the fentanyl was swapped, but there's another piece - ‘how was that woman's pain accepted?’ How did everyone in the room accept that this amount of pain was okay for a woman to experience?!?

Lucinda: The women’s pain issue is massive. I think there's even a campaign happening from Nurofen around it (https://www.nurofen.co.uk/see-my-pain/) that's sharing all the research and stats around how women and girls aren't believed when they talk about how much pain they're experiencing, especially when it comes to periods and stuff. [See our blog on medical gaslighting].?

Eleanor: I think the book Invisible Women just highlighted so many different data gaps, there is so much to explore – and I personally have a curiosity around the way our world is set up and why it's set up like that. And why it just carries on like that???

With the Olympics, I was watching Keely Hodgkinson being interviewed on a podcast after she won the 800m they were talking about the future of women’s health for athletes. And she said the most important thing for her is the need for more research to be done into the way hormonal contraception and menstrual cycles affect the body and mood, and therefore training and competitions and things like that, because there's nothing right now. ?

Lucinda:? Yeah it’s fascinating. The dips and troughs of the different hormones throughout your cycle, the effects on your body, your energy levels, your mood. We had a similar conversation to this with the US health team recently and it was mentioned how ADHD medication is much less effective during certain points of your cycle due to varying dopamine levels. And I'd never heard this before… I'm on ADHD medication myself and it was never mentioned to me at any point during my diagnosis or when I was given the medication, it was never brought up that effectiveness levels may go up and down. It's crazy that it’s just not more widely known.?

The future of AI and tech in pharma, health and wellbeing?

Lucinda: My next question for you Sarah, was if there are any ideas or innovations or developments in the health and pharma sector that that you're particularly curious or excited about???

Sarah: So there's two interesting things around AI… The first one's around diagnosis, and then the other is around computer aided drug discovery.??

So the diagnosis area is really interesting because you can obviously do scans - be that an MRI or other type of scan - but the human eye can only detect so much. Some studies have shown that AI can detect very small masses and indicate them as tumours better than the human eye can, so it can detect very early and then the prognosis is generally significantly better earlier on, so there’s going to be this move towards earlier diagnosis.??

The other thing is computer aided drug discovery, which is actually what my PhD was in. But that was over 15 years ago, before all this advancement in technology.? It takes a lot of time to design a drug and then synthesise it, test it in a lab and then repeat that work a number of times. It's incredibly time intensive, incredibly expensive, and requires a lot of very clever brains. So I was looking at streamlining that process using computers - people would still help design the drugs, but it would assay or test them using sophisticated algorithms on a computer to come up with the top ten, and then you synthesise those 10 rather than make 100 and test them all in a lab, which would take significantly longer.?

And that's come on leaps and bounds from where I was and the level of sophistication of what a computer was able to model.?

Eleanor: I did something similar for my dissertation - I coded a model of the mean response to a pathogen. So if you know how a cell works, you can predict the immune cascade. Which is how drug developments happen - if you can predict how cells react in certain situations you can predict how they react to certain treatments.?

Lucinda: You guys are so smart...! Sarah, it must have been fascinating to see all of these developments happen in that 15 years since you did your PhD... it must feel like you're living in the future!? I mean, this probably spoken about a lot already in health and pharma circles, but what about wearable tech? Like the ZOE monitor and test…?

Sarah: It's really interesting, and to me it fits in the theme of understanding your health a bit more holistically. Like you go to a doctor when something is wrong, but I have no idea if I'm deficient in certain minerals or vitamins. I have no idea how I could optimise my health - like OK I'm not sick, but what does my body need to be in better health? So I think it's about more personalised health, of which we will hopefully see an uptick in the future.??

Eleanor:?I know loads of my friends have bought Oura rings just for Natural Cycles – so it tracks your temperature but also your sleep and other stuff. My sister was saying it can prewarn you when you're going to get sick, a few days before you actually get sick because the temperature gauge on it is so sophisticated!?

Finding curiosity in the unexpected places?

Lucinda: My last question was how do you exercise your own curiosity??

Sarah: It's a very good question and my obvious answer would be similar to Dan's in the sense of living through the eyes of my kids, who just are inherently more curious, question everything and nothing is assumed.?

But I think aside from that, a few things. One is just getting outside, going for a walk and allowing your mind to freely roam and just go in different directions without a structured agenda of what you're thinking about.? I think my best thoughts, my best client presentations, best strategic advice, best anything - has come from when I'm not purposely thinking about it. It's when I'm going for a walk or even when I'm asleep - so somewhere completely different.

I even remember jotting down notes on my phone when I went to see Sister Act at the theatre - and I was writing down thoughts for my presentation! There's nothing rational to link Sister Act to an incredibly rare disease and the communications behind that…! But I think that's it's just about allowing your mind to disconnect.?

And then with more proactive curiosity, I really enjoy podcasts.??One topic which isn't related to work at all but I’m particularly interested in - and is being spoken about on a lot of podcasts I’ve heard recently - is the concept of the smartphone free childhood. Which is in its infancy, but is really picking up pace.?

It's very interesting to understand the implications of children with smartphones and how it effects their lives – not just in the very obvious ways that a lot of people think about - but in some much more subtle ways as well. For example even with WhatsApp?- so you send a message and you see a tick when it's been received, and then you get second tick when it's been read - and that doesn't happen in a normal conversation. I say something, I can see you've heard it, and you respond - whether with words or your body language.? And so on WhatsApp subconsciously, your brain is going “oh, why haven't they responded?” Sure, you can rationalise it, everyone's busy, but subconsciously there’s concern going on as to why they aren’t responding.? So there's some much more subtle things like that that you wouldn't consider as damaging beyond the very obvious issues like social media and cyber bullying.? ?

Lucinda: Yeah, that's really interesting. I can imagine when I was 13/14, and I had my little Nokia 3210, if I could have seen that the boy I texted had seen my message and ignored me, I would have gone into a spiral...! And it's a really interesting point that you don't think about the level of anxiety that it's creating for kids, just as a consequence of communicating ‘normally’ with their friends.? ?

Sarah: There's one specific podcast episode that resonated in particular. It was Doctor Chatterjee with Jonathan Haidt, who is the author of the book The Anxious Generation – it synthesised it really nicely.?

There’s a lot that’s beginning to happen. For example there's a grassroots movement in the UK called Smartphone Free Childhood where a lot of this began. And Emma Willis and her husband are doing a new TV programme soon where they and a load of school students are going smartphone free.??

So that’s definitely a topic, if not the main topic, on a lot of podcasts I listen to - be they about parenting or otherwise. It certainly feels like for most people I’m hearing from with kids between 4 and 18, it's a key topic of interest.?

Thank you to Sarah and Eleanor for spending 30 minutes sharing their thoughts, opinions and curiosity!?

If you want to read more on the broad topic of curiosity and why it is key to the future of the insights function, check out the previous blogs in this series below:??

The Curious Case of Incurious Qual - 3 ways to look at things differently, inspired by the minds of kids?

The Courage to be Curious – what can we learn from brands who took the leap??

Or if you fancy picking our brains about business challenge, please get in touch!?