Entering an augmented reality - early reflections of a new PhD student

By Stephen Hibbs

Stephen Hibbs is a haematologist, a doctor who specializes in blood disorders.  Stephen has just started his doctoral research on sickle cell disease through the HARP doctoral research fellow programme. Here, he reflects on the transition from clinical medicine to starting research in the social sciences.

Let me give some context to start. I have practised as a medical doctor for ten years until I began a PhD within the APOLLO social science team last month. Other than a four-month block in my second year of medical practice, I have not had any designated research time before. I have been pickled in biomedical understandings and discourses for more than sixteen years. I am now traversing two transitions: from biomedicine to social science, and from clinician to student.

Moving from clinical practice into studying the social sciences is to be given augmented reality glasses. I still move through the same world: the APOLLO team office is a short walk from my old haematology office. I worked as a doctor with sickle cell patients, and now I work as a researcher with sickle cell patients. But now I can revisit familiar spaces and situations with new ways of seeing. This is truly exhilarating – what would happen if I applied this theory I’ve just heard about to that clinical encounter, or haematological investigation, or way of speaking about a disease. For example, Rosenberg observed that diagnostic categories can produce a “simulacrum in the bureaucratic space” – served by virtual reviews and board rounds – and often divorced from the patient themselves. When I read this, I gasped at how precisely this describes my own practice. How much of a haematologist’s clinical work is with real patients compared with their “simulacrums”? I have several of these seed thoughts most days. I don’t need to develop most of them. It is enough to hint at the possibilities at the border of haematology and social science.

Some aspects are surprising me. From my previous position as a clinician, I had thought one of the benefits of academia is that you could focus on one way of thinking. This turns out not to be true. I am now juggling several dramatically different ways of thinking. When reading about a particularly important theory or methodology, I am searching for an expansive, connection-building, and reflective way of reading and thinking. But I also need to learn a way of reading to “screen” many resources quickly, to decide which are worth reading deeply. Then there is developing an understanding of project management, academic and regulatory structures, with acronyms like AcoRD and SoECAT. Alongside these, I want to keep a relational focus on the key people involved in my research. Another skill is applying what I read to my own ideas as I develop my research plans and make decisions on design. Finally, I am thinking about my own workflow infrastructure: how do I organise notes in a way that provides any chance of re-discovering them in three years’ time?  How do I write notes that will help me re-experience the same thought that resonates now?

I am grateful for this variety (except the painful governance acronyms). It is a bit like moving from outpatients, to inpatients, to referrals, and to laboratory work in my old job. But it has taken me by surprise, and I want to become agile when moving between each way of thinking, and to avoid neglecting the ways I find harder. It can also be difficult to know what order to do things in. Do I approach a patient organisation with my plans so far? But my plans are so incomplete! Then again, perhaps I need their input at this stage of planning. But once I’ve opened the conversation, there is a new responsibility of maintaining that relationship too. It’s tricky.

I am surprised by how different it is to manage my own time and how much I’ve missed external validation for what I’m doing each day. In my job as a haematologist, I would have many conversations each day about what jobs there were to do and which patients needed seeing. At the end of the day, there’d be a clear sense of what work was done and what needed handing over. And even though it was rare to get a “well done” or other feedback, at least someone knew I’d done something that day. Since starting my PhD, the day feels…different. I create an unrealistic list of vague tasks in the morning and I work through some and get lost in others. At the end of the day I stop and cook dinner for my family, still pondering if I really did what I was meant to.

The borders of work and not-work have also become more porous. The distinction is obvious as a clinician. But as a researcher, it’s hazy. I can be listening to an unrelated podcast one evening and suddenly think of a link with my research. Do I switch back into researcher mode and write it down? And how do I classify academic work that’s unconnected to my core PhD topic? I’ve gathered a few projects and roles in haematology along the way, and I can see that they could distract me from my core PhD project. But they also provide a way to stay in touch with my community of haematologists. I want to stay rooted in the haematology community, as well as making a new home in this land of social science.

It seems like these augmented reality glasses are coming at a fair old cost. The cost, I think, is accepting that I don’t yet know what I’m doing, and that feeling is likely to lurk for some time. So far, with the welcome of this team and the richness of seeing the world in a new way, I reckon it’s going to be worth it.

Stephen’s doctoral research explores the sickle cell crisis and is funded through the HARP doctoral training programme. He writes regular editorials for the Hemasphere journal and created the bloodrhymes youtube channel to explain haematology concepts through rap videos

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