Michelle Jack: My journey from ‘the one’ to the many

Michelle Jack

Clinical Associate Professor Michelle Jack was enjoying a successful career in paediatrics and research when a diagnosis changed everything. She loved caring for “the one”, but what if there was a bigger impact?

Early in my career as a laboratory researcher, I’d spend days looking down a microscope. One by one, I’d carefully and methodically sift my way through slides of human pancreas. Like many of my colleagues around the world, I was hoping to find at least one piece in the giant jigsaw puzzle that was the search for a cure for diabetes.

This marked the beginning of what many consider a traditional research career. It taught me the importance of having the support you need to do research successfully and efficiently. I learnt from my failures and, thousands of slides later, was awarded a PhD. I found one little piece of the puzzle, but knew there was plenty of work still to do.

It was at this time I began feeling the pressure of expectations.

I graduated from Medicine with the University Gold Medal, itself an expectation of future success. I was awarded an international fellowship by the Juvenile Diabetes Foundation. Then, early in my career, a well-meaning mentor told me I’d be the next professor of paediatrics, a yardstick I subsequently felt I had to measure up to.

The traditional academic research path was interrupted when a move interstate to accommodate my husband’s career made it necessary to switch gears. I began my career as a paediatric endocrinologist and focused on being a good clinician.

Two great pioneers, Gillian Harris and Dr Martyn Sulway, saw the need for services for children and adolescents with diabetes in the Northern Sydney Health District. I was privileged to work with them and other leaders within the organisation. To be trusted to help establish and grow a new department, which flourished.

I also assisted the development of children’s diabetes services on the Central Coast and in Western Sydney. During many busy years spent building the department, seeing patients, teaching students, I continued my research career as site-investigator for several multi-national clinical trials.

Unwelcome news

Things were going well until health challenges interrupted my career trajectory.

First, I developed laryngitis and lost my voice. The trouble was my voice never returned to normal once the sickness passed. Multiple investigations and multiple surgeries followed.

Initially it looked like cancer, but then they decided it wasn’t. I cut back work hours and a short time passed.

Then strike two. A routine scan had been followed by a biopsy “just in case…” The results were in, and cancer was for real this time.

I distinctly remember the phone call.

The news was all bad, initially. It’s a malignant cancer, the worst type, they said. Surgery, chemo, and more surgeries were needed.

Suddenly my job, which had felt like everything, dropped to the bottom of the priority pile. Family, friends and making the most of the time I had left on this earth – things that were always important – were now urgent.

My treatment and recovery took top priority. I had 12 months off work, I lost my hair and I had time to think about what was important to me.

Long story short, I survived and today I’m grateful for an excellent prognosis.

What next?

Like many who experience this type of life-changing journey, I couldn’t escape the big question: How should I spend my time now?

To gain some clarity, I found an interesting course which included a values exercise. It gave me a moment of clarity that changed the course of my life. I started to question the assumption that I’d just keep being a doctor forever. I found myself reading an article published by UK-based non-profit 80,000 hours which described how people generally become doctors because they want to save lives.

And yet, the author argued, working in medicine has only a modest direct impact.

“A clinician can only treat the patient in front of them. Thus, good clinical practice can’t ‘scale up’ in impact the same way research breakthroughs or policy changes can,” wrote Gregory Lewis.

Then I considered the Inverse Care Law which states resources tend to be concentrated in the areas of least need.

Looking back over my career I could see this at work in many different aspects of medicine and the wider health and social sectors.

A new picture began to clarify the moment I met a refugee from Afghanistan, who I will call Ziya to protect her identity. She’d recently arrived in Australia with her three remaining children. A victim of not one, but two suicide bombing attacks, she had experienced horrors I could only imagine.

Here in Australia, many social services were tasked with helping her, but as I journeyed with her over the next few years, it became clear to me she had well and truly fallen through the cracks of the system.

My health journey, the 80,000 article and Ziya’s story all collided in a kaleidoscope of emotions, inspiration and conviction.

It was time for a change. ‘The one’ always matters in a clinical setting, but how could I make a difference at scale by partnering with many organisations, each of which care for thousands of people like Ziya?

A vision for impact

Fast forward three years and this vision is becoming reality.

As Head of Research at ImpactInstitute, I’m thinking about my research, clinical experiences and higher education in a different light.

These days I’m working in partnership with the passionate founders, NGO leaders and program staff who want to ensure their hard work is making a long-term difference in the lives of people around the world.

In one sense, boardrooms and virtual meetings are a long way from hospitals and clinics. But at the same time, I’ve quickly discovered common ground.

As a paediatrician and researcher, an evidence-based approach was foundational. Organisations are also hungry for evidence-based information that improves decision making and brings vision, purpose statements and individual convictions to life.

Successful clinical management requires well designed, integrated services that involve key stakeholders in co-design processes, adoption of ‘patient-centred approaches’, particularly for patients with complex and chronic health needs.

Evaluation of outcomes and impact is critical to inform excellence in provision of clinical care. Likewise, organisations seeking to have a positive impact, must adopt ‘person-centred approaches’, involving key stakeholders in the design, implementation and evaluation of their service offerings.

It’s early days, of course. But like my early days staring down a microscope lens, the video camera on my computer is taking me into a whole new exciting world of possibilities and discovery.

Ready to increase your impact?

At ImpactInstitute, our highly experienced and qualified research, analysis and data team works in partnership with impact advisors, clients and partners to define the right question, conduct research and unlock data-driven insights. Contact us if you’d like to discuss how your organisation can become impact-driven.

Written by: Michelle Jack.

Clinical Associate Professor Michelle Jack is Head of Research and Senior Advisor at ImpactInstitute. Connect with her on LinkedIn.

For more information visit: Research & Data