In previous posts, we’ve largely looked at the intrinsic beauty of science. From elegant theories and experiments to the intricate workings of the natural world, the beauty of science has captivated scientists and enthusiasts alike. Here the intrinsic beauty of basic sciences lies in the pursuit of understanding for its own sake. But what about applied science? Can we find beauty in the practical application of scientific insights to solve pressing problems in society? Can it be equally mesmerizing and powerful?
My guest in this podcast episode, Dr. Marcia Otto, thinks so.
Marcia is an Associate Professor at the University of Texas Health Science Center in the Department of Epidemiology, Human Genetics, and Environmental Health. Marcia's research focuses on the effects of different aspects of diet on cardiometabolic health and cognition. Marcia received her postdoctoral training in Nutritional and Cardiovascular Epidemiology at Harvard T.C. Chan School of Public Health.
She holds a Ph.D. in Environmental Health from the University of Texas School of Public Health, an M.S. in Environmental Science from the University of Sao Paulo, and a B.S. in Physics from the University of Rio de Janeiro State. Marcia’s work has been funded by the National Institutes of Health, the American Heart Association, and the Department of Defense. Since 2020, Marcia has been serving as the leading investigator of a multi-site collaboration to inform the response to the COVID-19 pandemic in Harris County, TX.
Marcia began her scientific journey as a theoretical physicist, and discovered that the application of her expertise to solve pressing problems in the real world was a more compelling and exciting way for her to harness her interests and talents. Just as there is beauty in the discovery of new supernovas, there is also immense beauty in discovering new ways in which the fruits of scientific knowledge can help solve real-world problems and contribute to our flourishing.
Yet there are also challenges here especially in fields such as public health. How do we balance, on the one hand, the importance of communicating with confidence what our current scientific knowledge can tell us, while also being cognizant of the provisional nature of scientific knowledge that is always subject to correction? We discuss these themes and more in our interview, which you can watch or listen to below. An unedited transcript follows.
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Brandon: Marcia, thank you so much for taking the time for being with us today. It's such a pleasure to have you.
Marcia: It's my pleasure. Thank you for inviting me.
Brandon: Great. Well, let's start by talking about what drew you to become a scientist in the first place. Did you want to be a scientist when you were a kid?
Marcia: I don't think I had a clear sense that I want it to be at science, but I had a very big curiosity for mathematics. And everything that involved calculations, I really enjoyed. My dream job would be a job when I would be running calculations all day long. That's my early remembrance of my field of interest.
Brandon: So, how did you then pursue a scientific career? Did you have any teachers or professors who were scientists? What actually drew you to then see yourself as pursuing this path?
Marcia: I did have — as I was trying to understand what is it that I was going to study in college, I had to work full time. My first interest was to pursue engineering. I had friends who were engineers, and I was fascinated. I liked the fact that you could use calculations to implement, develop projects, to obtain something concrete. I also liked to be — at that time, there was a big push for engineering in Brazil, so I knew there would be jobs. So, I could do something that I was interested in, and there would be jobs at the end of that tunnel.
And so, I started to look into engineering. But given my family circumstances, I needed to work full time. Engineering classes in Brazil, in public universities — which are the strongest universities — they were offered full time. So, you would have to start in the morning and finish at the end of the day. I said, "Okay. Let me think. What can I do to pursue my interests in mathematics?" And so, I thought about mathematics. Then I understood that physics was a field where you could learn mathematics and apply to understand problems, think about laws, universal laws, understand the world basically. That's how I decided to pursue physics, following this little intuition. I was admitted at the University of Rio de Janeiro, which is my hometown.
Brandon: Okay. And so, from physics, how did you end up in public health and epidemiology?
Marcia: As I began to study physics, I remember being interested in calculus. Mathematics doesn't mean that it's easy, right? As I mentioned, I was working full time from early in the morning until about 3 PM. Then I would go straight to university. My course will be afternoon and evening. I would leave at 10 PM every day. I began to study a lot and study long hours.
By the mid of my midterm, around two or three years into the program, it was clear to me that, in knowing physics, there is two very specific branches. One is the theoretical physics, and the other one is applied physics. Usually, with theoretical physicists, they spend a lot of time understanding problems that are abstract. They spend a lot of time in this world where you think about the fifth dimension, things that are really difficult to study in grasping reality. I saw more and more the potential of physics to really help us understand concrete problems. I found myself more and more interested in applied physics.
I still remember my second to last semester, I had a teacher. She taught quantum mechanics. She had just come back from a sabbatical, because she was — her grandmother had cancer. She moved to this small town in Brazil where her grandmother was going to be treated. She was a nuclear physicist. She said, "I want to be there with the physicians." Back then, cancer treatment in Brazil was very much. You would receive a very high dose, a lot of side effects. The main goal was really to make sure that you kill all the cells. As a result, many organs at times were affected as well. There was not a lot of very specific, precise estimation — of radiation, for example. She went there. Her grandmother was in her 80's. The doctor said at first that there would be lots of side effects because of her age. They were expecting her grandmother to have a difficult journey. This teacher of mine moved there. She spent the whole six months with the physicians. She said, "I am a nuclear physicist. I can help you calculate the dose for my grandmother for that specific case." Then she did. Her grandmother had minimum side effects. The whole treatment went much better than expected initially. By the end of those six months, her grandmother had ended treatment. She came back to teach.
The first day of class, she was telling us this. She was also telling us how, at the end of her grandmother's treatment, the doctors came to her and say, "Look, we need to work together. There is so much we can do. What you brought — the skill set that you brought was so valuable." She said, "No, sorry. You don't understand. I'm here because of my grandmother. I am a theoretical physicist. I am not interested in anything that is concrete. I like my field and interest. It's to really do theoretical physics." She's telling us in the classroom, with her eyes super satisfied with her answer to the doctors. I looked at her and I said, "Wow, that is not where I want to go. I do not want to be a theoretical physicist if that is what the field entails."
Her whole experience and her excitement in having helped her grandmother helped me clarify that I really wanted to pursue something that was more applicable — a science that could be used to help society, to help individuals and so on. The only intuition that I had at the end of my college was that I wanted to pursue applied physics. I had some research experience on nuclear physics. By the end of college, it was clear to me that working full time and studying full time was too hard. If I wanted to pursue a graduate degree, I wanted to apply for scholarships so that I did not have to work.
And so, I applied to a couple of programs in Brazil. One of them was a program that was evaluating environmental science, which was a big growing field back in the early 2000s. This program would bring professionals from different areas to study the increasing problems of the environment. I applied to that program. I was very fortunate to obtain a full scholarship. I was there being trained in nuclear physics, applied to environmental problems. So, I would come from the physics angle. I will be working with engineers, sociologists, architects, people working with different environmental problems. I would have a strong physics training and then apply that to the problems of the environment.
In that program, I became more and more aware that lead in water was a very big problem, especially in poor communities outside of Sao Paolo City, in which I now reside. My theoretical problem was to derive equations to estimate the intake or absorption of lead in biological samples. That was the project for my master's training. As I was a part of that program, I was studying water pollution. I was studying air pollution. I was involved in large discussions about environmental problems in Brazil. So, I understood in my studies that individuals who were at highest vulnerability to health problems due to lead exposure were children. Their brain is under development. What happens with lead exposure is that it attacks the neurons. Children undergoing neurological development, they were at higher — they were more vulnerable to that exposure early on. And so, I defined it. I studied. I said, okay, I want to study. If I am to quantify, I want to quantify exposure in children in certain regions in Brazil where they are at higher risk of lead exposure.
The second thing that I learned was that bone structure is the place where lead is stored in the body. Because I was interested in children, I also understood that teeth, like milk teeth, would be a great indicator, a great sample to obtain to measure and quantify lead exposure that would occur in childhood, and therefore be more relevant to long-term health consequences. I developed my whole model using teeth as a biological sample. Then I would go to the lab. So, I collected. I went to dental clinics in the outskirts of Sao Paolo City to collect teeth that children would be having removed in those clinics. That, I used in the lab to quantify lead and with the whole estimation of how much they were being exposed. I also went to a different group of children who were less exposed to lead because of the water sources. I compared those two groups.
At the end of my master's training, when I was defending my thesis, I was told that they needed to find an epidemiologist to be part of my evaluating committee. Because the work that I had conducted was a pure epidemiologic study. That was the first time that I heard that word. And so, I became very — it was very clear to me that I wanted to learn those methods. I wanted to pursue that path. That's how I ended up applying for a PhD program in epidemiology here at the University of Texas, and then I moved to United States.
Brandon: Wow. That's really fascinating. You've stayed with it since then? Have you found it satisfying as your journey has continued in this path?
Marcia: Yes, it's such an adventure, Brandon, when you begin to follow a glimpse of an interest. Very closely, I was reading your work and seeing the videos that you have put together on beauty. I have recognized one by one this theory of understanding has been really very, very striking to me. When I arrived at the University of Texas, there was a large program in the environmental health. The department was being restructured. There was not a lot of scientific projects on heavy metals and effects on health, which was my primary interest.
But then, I was very early on introduced to a professor who was doing work on diet and the effects of diet on heart disease and chronic diseases. I explained to her my work and my passion to understanding especially effects of heavy metals on health outcomes. She said, "I do not have any project on heavy metals, but I do study essential metals. Would that be of interest to you?" And just like that. I said, "Of course, that would be of great interest." Because it's exactly in the absence of good nutrition and in the absence of essential metals, that those heavy metals become even more dangerous. Because the human body is so fascinating that it uses everything it has to do the work. Neurons, in the absence of calcium — which is a very important, essential metal for the brain — the body would use any heavy metal that it will find. And so, that's how I shifted to nutritional epidemiology. The adventure began. Now I have a whole new world to explore, to understand, to really focus on in order to get to a final goal, which was really to help society, to help shift the health of populations.
Brandon: Yeah, that's amazing. Talk to us about the beauty you experience in your work today. What does that look like for you?
Marcia: Yeah, it's a great provocation. Because, as a scientist, it's not that I go to work and I say, "Okay. Today, I'm going to look for beauty." But again, in becoming more familiar with your work, I quickly understood that it is this moment in which we grasp something, in which the whole process of being able to grasp, to understand we human beings, limited beings, how is it possible that we can move from a curiosity or a broad interest in a certain problem, and then refine that research question? Think about which metrics will be needed in order to evaluate that research question, define a method, understand the statistics, or what is it that will take to address that question. All that step by step components, all the way until we actually are able to see something, the whole process of being able to understand, to me, is fascinating.
That's exactly what I teach. There are two super important components. First, I see myself designing a project, evaluating, going to the communities, collecting data, spending the time in front of the data, doing the data analysis, and then seeing something coming out of that process. That allows me to understand in a deeper level. Then at the same time, I am now teaching these methods. I am seeing students undergoing this the very same process, which is coming with an initial interest, being able to walk that path, especially understanding the methods and designing methods that will allow them to explore and address a particular research question. This has been fascinating to see, some of the vibration that I experienced in my research also in front of me in the classroom.
Brandon: What is that? How do you recognize that in the classroom? What does that look like when you're able to see your research interest or the understanding that you find beautiful in science resonating with someone else? How do you glimpse that?
Marcia: This past semester, in the fall, I was teaching an elective course called Nutritional Epidemiology. In that class, I bring my research. I bring other's research. The idea is to just let's look at these studies. Let's understand what has been proposed in terms of research question, what was the methodology that they used, and what they found out. One by one — this is an elective course. It's a small class. Last time, I had about 16 students. It's a new course for me, so I'm still exploring how is it that I present content and provoke students to think about methodology.
I had two. I'll tell you about two specific students. I had student A and student B. Student A is the third semester master student. He comes to the classroom slightly late every day. He sits there, and he's distracted. You can tell that this class starts at 10. He's very distracted. He's still landing and so on. Later, I understood that he's constantly late because he works at night. He works long hours at H-E-B to provide for himself while he's pursuing his degree. Student A is there, sitting there. He's a very curious student. He's very also interested in statistics, so he has studied lots of statistical methods. We are there looking at his research, nutritional research. Day after day, I see student A waking up in front of the screen and starting to ask questions, question after question after question. He's also started to wait for me after class and continue that conversation.
Then one day, he told me, "You know, I've been taking all these different courses. I really love biostatistics, but I never understood how those methods were used to allow us to understand this piece of reality the way that you were explaining. I never saw the need, for example, for how P value could point to a particular path in which that mechanism is now something that we can explore further." The moment I could see him becoming more engaged in the classroom — asking more questions, more excited because he saw a pathway through which his own interests and training could lead to a new direction — I was extremely pleased. Because that's exactly what happened to me. It's contagious when you see that vibration. Okay. First of all, it's possible for me to understand something. Look at how much I can see now. That was phenomenal.
Brandon: You said you had a second student.
Marcia: Yes, my second student, I'll call her student X. She is also very, very young. She's actually at her last semester. She's still seeking. Students who come to the School of Public Health, they want to save the world. They don't want to be rich necessarily. They really want to do something that matters for the society. She comes with a general interest in public health because she has a health condition herself. She always wanted to understand if I am to contribute to the prevention of this health condition, I would like that. If public health is a field that I can pursue, that's what I want to do. So, she's finishing her master's degree. She still hasn't really understood what she's come next for her.
She's sitting at my class. Again, I see her starting to ask more and more questions. I see her level of engagement. At a certain point, mid semester, she told me, "Now I understand what I want to do next." I said, "What is it?" She said, "I want to be a scientist. I want to pursue a PhD degree. This was not something that I had initially in mind. But now I see the possibility, the opportunity, the power of these methods that I am learning to really help me pursue this field that I want — which is disease prevention, specifically the prevention of lupus — to help individuals that are highly vulnerable." That possibility of grasping. You grasp something and then you realize and you trust that that's possible. Therefore, I want to spend my energy, my time betting, in that possibility.
Brandon: Could you say a bit about the relationship between grasping this beauty of understanding or having a scientific insight and then the usefulness of science for helping other people? Because certainly, people find the beauty of understanding in theoretical physics. By itself, understanding is highly pleasurable for a lot of people. But it wasn't good enough for you. You needed something more. It seems like there are a lot of students in more applied fields who need something. Is science beautiful because of the value it has for society, or does it have its own intrinsic value? How do you see that?
Marcia: I think I'll start with back to that possibility to know. I first heard that from a friend who is a theoretical physicist. I was, back then, an early-stage graduate student. I was overwhelmed by the complexity of things. The more I studied, the more complex it looked to me. One day, I was just giving him a ride. I was seeing he's very excited living scientific life as an adventure. Not as something very difficult but as something full of possibility.
I remember asking him this question, "How is it for you? Is it that easy? Is it exciting? How is it? How is it that you are not crushed or overwhelmed by the complexity?" He looked at me and said, "I am excited because just the fact that it's possible for us to know, it's almost a miracle. This could remain unviewed. And yet, at times, something happens and you can see through. You can see more. That alone makes me live life full of possibility." That, I think, is the beauty of science. Even before, it's how you apply, which problem you apply, et cetera. It is the possibility to know, which is not a wishful thinking. It's an experience.
Brandon: The usefulness is like an added bonus. I mean, the fact that not only can you know, but then you can use this knowledge to improve things and help people.
Marcia: Beauty is almost like a companion on the road. If I think about myself and my experience, I started with an intuition that I wanted to study anything related to numbers. I loved numbers. I didn't see any use for it, but I love numbers. Then one by one, I was exposed to so many things in college. Then finally, this teacher's experience, that really allowed me to see it more clearly. Okay. I know that I want to do something that is applied, but I don't know exactly what. Look at this possibility here. Look at what she's done. Look at how much more could be done. I understand that within myself I had a desire to use that curiosity to something good. I want to get I think this everyone's —
I see that in my students too. We all want to find our talent and to use it well. So, it was a combination of me trying to find my talent and use it well — with my teacher's experience — and then the enthusiasm that comes when you see a new journey opening up or a possibility of a journey opening up ahead. That's where beauty takes place. Because when you see that that can be a possibility for me, I immediately want to take it. Then that process continues, that seeking, that finding the surprises that come along the way. All of a sudden, I found myself not being so much overwhelmed by the difficulty and the challenges, but excited at the possibility.
Brandon: That's great. What is it like for you right now? You're a tenured professor at a university. A lot of faculties face a lot of pressures, institutional pressures to publish or perish and to get a grant funding, et cetera. We've talked to a lot of scientists in that position who feel like the wonder and beauty that drew them to become scientists in the first place is somehow out of reach, because of all of these pressures, that they overshadow the joy of science. I wonder if you've experienced anything like that, or how you navigate this sort of context?
Marcia: Yeah, I, for sure, experienced that too. We all need to be publishing. We need to be teaching. We need to be doing research. We need to be writing grants. All of it is a lot in itself for me to publish. One of the things that I loved most about science is that I can study. I can test possibilities. I can understand and study a particular method that will allow me to, in a very sophisticated way, explore a research question. All of it, at times, is expedited because we need to publish a paper, because we need to rush to meet a grant deadline. That's when the whole joy sometimes can be — we may not enjoy as much. Because what we love the most, what I love the most perhaps, that I do not have enough time to stay in that position.
Recently, I was exploring different research possibilities. There was, as we all know, this huge COVID pandemic. I was asked with other colleagues to join a task force to help guide public health action in the state of Texas, in Harris County, as part of the response to the pandemic. That was a deviation from my field, which I dedicated time very passionately. Because I thought this is my chance to help, provide some little help to this big problem. But then, here's what I understand more and more about the pressure of work. It's in science, and it's everywhere. We are pressured to deliver.
But once we are attracted and moved by something, by beauty, let's say — I am using beauty here, but it's something that I cannot quite quantify. Once that dynamic takes place that I was mentioning before, we do not want to do for less. The question of how many papers. Very often, I find myself longing for those moments of beauty that come when I stay in front of my problem a little longer, when I have more time to brainstorm with my colleagues, and I have more time to brainstorm with my research team, when we are allowing ourselves to explore some possibilities. That longing is there, quite calling me back to a position in which I'm just not only having to publish these other's manuscripts in a year. But I'm here because I've been, in a way, moved. I want to be moved again.
I don't know if I am quite fully getting to the core of your question. But what helps me is to have that experience of being, of grasping a little bit more of reality. When I find myself in a place where I'm not growing, where I am not learning, where I'm not providing my best contribution to my work, to my students, immediately, that sadness comes to place. I have to rediscover within this new world and all this pressure what is really moving me right now. Does that make sense, Brandon? Ask me more questions.
Brandon: Yeah, I think so. Yeah, for me, I'm trying to understand what it is in the face of these challenges. To remain energized, to remain engaged, to not be overwhelmed by the pressure. What is it that you're looking for in this, when you're trying to navigate your way through this? Maybe another way to get at this perhaps is, what advice would you have for colleagues who are struggling to find beauty in their work?
Marcia: I would say, follow. Do not forget your heart, your passion. Do not forget that initial impetus. Like recently, I started talking about a different research path. I started doing a work that was a great contribution but not necessarily my greatest passion. After a while, as my research, I began to explore a project on cancer patients. It's incredible how I have not connected the dots until right now. I'm looking at a new project — evaluating nutritional deficiencies of a certain group of patients, cancer patients. That project is in collaboration with clinicians who are very passionate in helping their patients. They say, "We know that there is a dietary component that is essential here. We don't know how it works, and we would love to work with you."
I'm seeing these clinicians who are seeing these patients. They have a very clear idea of what the critical questions are. We are collaborating on designing this project. I began to be, again, reignited by these key elements. We are all made with the desire to find our talent and to use it well. I found that whole thing reignited in the relationship with these clinicians. Then immediately, at the same time, I have many other pressures. But because I have experienced this excitement before, I said, "Look, I think there is a road here that I want to pursue."
This is perhaps my advice. It's that we are never quiet. Let's never be quiet. There are many times in which we are under a lot of pressure and constantly under pressure. But I am reawakened somehow by this continuous search, this research of what is it that I can contribute the most at this very moment? The more I discover, the more I remember that initial passion, the more I know what's the way for me. That doesn't take away the number of papers. That doesn't take away the pressure that we receive. But as long as I am moved by the sense of the truth of my path, then I can breathe. I can find ways to meet those goals but with my heart centered in the best position, if that makes sense.
Brandon: Yeah, I think I was struck by the desire to contribute that seems to really animate you. I think there's an interesting danger for a lot of people who are seeking fulfillment in their work, who are looking for something. So, you could pursue beauty in a way that you're looking for it as something that you consume. If it's not there, then you feel like, "Well, I need to do something else because I no longer find this fulfillment." But I suppose if you're looking to contribute, and you're trying to see where can I give the most of myself and make the best contribution, I think that orients you in a different way and perhaps opens you up to finding beauty in surprising ways. Perhaps if you were simply saying, "This is what I think of as beauty, and I'm going to look for it," then if you don't find it, you're not fulfilled. That could be a distracting pursuit, I suppose. I don't know if that resonates at all with you.
Marcia: Absolutely. I think that openness is key — openness to discover what is my curiosity about. What is it that allows one to get out of their mind? I have several ideas. I have so many things going on my mind. My own idea of, for example, how my class would go, how my interaction with the students would go, how clear my lecture would go. Then I go there, and many times it doesn't quite work. But I have been more and more surprised at what is it that allows me to be open to even something that seems not to be working. To me, in my teaching, it's by looking at the faces of my students and then following that. "Okay. Wait a second. I can tell that you have a question. What's your question?"
At times, I shift the entire lecture to address that question and to follow what is it that is triggering that student. The question of openness is really crucial and what allows us, Brandon. Maybe I have this question for you. In your conversations with many scientists, what is your intuition of what allows us to be open to this road ahead, as opposed to me trying to trace or to make my journey and this I'm sticking to it, as opposed to trying to navigate and adjust and adapt and be open to what the road is so in itself?
Brandon: It was a really great question. I don't know if I have a great answer for it. We do see those differences. I think there are some certainly who have that sense of openness. I think, in part, the scientific community, I think seems to cultivate this kind of intellectual humility and openness to surprises in many, many fields. I think that's the case. But I have heard that they're not just individuals but entire sub fields, where they're locked in to a particular — looking for a particular kind of beautiful theory and not really open to things that might unsettle that.
I think sometimes it's an overconfidence, that successes of the past will be repeated in the future. I'm not entirely sure what leads one to be open to those surprises. Maybe impatience might lead people to be open to surprises. Say, look, we're trying this. It's not working. Let's move on. Maybe a lot of patience and perseverance might not be an asset. Because it might keep you locked in and say, no, I'm going to — there are a lot of famous examples, particularly in theoretical physics, of scientists who said, "I'm going to stick to my beautiful equations." Even if experiments today are not supporting those equations you'll see, some of them turned out to be right that the experiments were wrong.
Marcia: That's right.
Brandon: And so that provides a strange kind of historical precedent that, I think, leaves people justified. But I wonder and it feels like there's people's lives at stake. I think maybe there's more of a need to say, "Look, we need to really do something because the problem is really urgent to meet. We have to be open and we have to try different things." I don't know. But that's something for us to explore. I don't think we have a good answer. It's a really great question on science as sort of this is the constant tension between basic and applied sciences. Is science valuable because it's useful to society, because it solves our problems? Or is science valuable because we need to understand reality? Who knows what that understanding will produce in the future? Maybe the problems that seem useless to pursue today, it might lead to breakthrough discoveries 100 or 200 years into the future. How do we invest resources, as a society, into those different kinds of pursuits? Those are tough questions, I think, first of all, to ponder.
Marcia: Very, very tough questions. I'm happy because there are different branches of science that are dealing with these questions in different ways. In public health, I go through textbook after textbook for my classes. I see more and more — now going back to it as a teacher — that there is this push for science that leads to action. Because lives are at stake, right? It's not necessarily one thing or another. But in this branch, we are seeing an increase, a tremendous increase in mortality due to cardiovascular disease. That is one of my students who has seen the huge gap in knowledge in lupus. What are factors that would help prevent? The questions that arise really impact. The questions arise within the context of this practical problem. Then the science helps. Then we make mistakes, and so on and so forth. But that is the first thing that strikes me. It's the size of a certain problem. Some of the physicists started that problem was different. They wanted to understand a universal law that would explain a certain process. That's a beautiful thing to explore, too. Starting with the question. I don't think that there is not one or another. I think there is a big, big value of blind methods that we already know while others will be thinking the unthinkable and helping us move that thought process or the science further.
Brandon: Well, let me ask you one last question that has been troubling a lot of people, which is the question of the public's trust in science and in scientists. Particularly in the United States, since the COVID-19 pandemic, it has been, I think, an interesting case in point. I think there are a lot of people who were troubled by the fact that scientists seemed to say something on one day and change their minds, and say something else the next day, and so forth. It seems as though the public has this picture of science as being able to provide definitive facts, that it's sort of infallible.
The beauty of fact is actually what, for a lot of people, draws them to say, "I believe in science, though it's this religion of sorts." It seems to have a dogma where it pronounces some truths, and then people have to believe it. A lot of scientists don't really like that kind of image of science that has been communicated. I think, in particular, in fields like public health, it's really critical to figure out how do you — once you know something to the best of your knowledge, and there's some degree of consensus, how do you communicate that in ways that still allow you to continue investigating? Then perhaps you could realize, "Gosh. Okay. Everything we prescribed is wrong. We really need to redo things." How do you do that? How do you navigate that kind of field and interface with the public? Or what is it that maybe you want the public to understand about your work as a scientist and then the beauty of that kind of scientific work?
Marcia: Yeah, well, as much as I think, in certain branches, especially in public health, we are urged to respond to an urgent need. If I think about my recent interactions with public health practitioners, who needed to know at this moment what are the communities at higher risk of infections that we should go and send testing units to and later on prioritize for vaccination, there is a question that is today. We are making a plan for tomorrow. What's the best way to use the data that we have to guide our units, to guide our action? This is really a part of practical public health in action scenario.
But what I tell my students — I study a lot of chronic disease. What are the risk factors for chronic disease, how certain risk factors will impact development of cognitive decline, heart disease, diabetes — the road to that understanding is a long road. We began by exploring a particular mechanism. We began by exploring this size of a problem. But very often, the way that those findings are communicated, they are communicated in a way that, number one, expand too much of the conclusions from that particular study. It's not only the scientists that may communicate in that way. But many times, it's reported in that way because everybody's looking for answers. But the road is long, and we need several studies to allow us to become more confident. Perhaps, at times, we are not confident at all. We need to develop new methods. We need to develop new metrics. We need to wait more and see.
Having that caution and having to put the findings in perspective is an extremely important thing. Because science, for sure, brings a lot of value. But science is not defined well, especially for complex problems. We need to be able to — not one scientific finding, not one particular study. Very much at times, findings from one study are communicated as if this is fine, or we now know how saturated fat affects the heart disease risk in adult populations. I would avoid. I would certainly stay away from definitive answers. We move by becoming more certain based on replication, based on understanding. Okay. If I find the same answer in a different population, with a different composition, with a different type of diet, so I am moving to become more confident. And yet there are so many limitations, right?
Brandon: Yeah, and I suppose it's the challenge. It's how to preserve this confidence and trust in science in the face of the fact that we are so limited, that our knowledge is always provisional. That, I think, is really the daunting task for a lot of people.
Marcia: Yeah. I always tell my students, we, epidemiologists, I say, we are never afraid of limitations. But we take a lot of time to understand what we are doing, what are the limitations of what we are doing, and reporting and discussing it very carefully, being very clear as to what is it that we can see a little bit ahead based on these findings. What is all of it, all of the questions that are opening up as part of this process? Being very clear and transparent as to what we can say and what we cannot — this is what I encourage my students a lot. This is what I try to practice when reporting my science.
Brandon: Right. Yeah, we had Adam, one of my recent guests, also a Brazilian scientist who I interviewed recently who talked about how the limits of science or the limits of our knowledge are not really a bad thing. Because we'll never really arrive at fully knowing. That's a beautiful thing, that there's always going to be more to know and more to understand. Our knowledge is always improving. We should see that as liberating as opposed to burdensome, which I thought was really, really quite beautiful.
Marcia: I fully agree. What I observed with my students, especially coming out of the COVID era, was that they arrive in the classroom, and they are reading those papers and studying the science. At the end, they would say, "But we will never know." Because these studies are so biased. So, the coin had flipped to the point that instead of there is a possibility to know, now we will never know. That it's biased, and there are not enough individuals from certain groups. There are all these criticisms to the studies that left them with a sense that no study could help us understand anything, because we have all these sources of bias. And yet we can't. There is the possibility of learning. Not learning at all, we will not be going to solve the entire equation. But the possibility of knowing is also extremely liberating. As long as we understand the limitations, we study very well, we design this post possible strong study, and then we report it clearly, honestly. Especially, what is it that we do not know?
Brandon: Yeah. Great. Well, Marcia, thank you so much. This has been such a rich conversation. I'm so delighted that you were able to join us. Where can we direct our viewers and listeners to your work? Where can they learn more about what you do?
Marcia: Yes. So, we have a site in construction. But if you go to UT Health, www.uthealth.tmc.edu, you will find my page there and my research interests and projects.
Brandon: Perfect. Well, we will link all those in the show notes. Thank you, Marcia. It's such a pleasure.
Marcia: Thank you. It's my pleasure, Brandon.
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