Matthew L. Cohen, Ph.D. is an assistant professor in the Department of Communication Sciences and Disorders at the University of Delaware and a Moore Foundation patient and family engagement early-career investigator. In this installment of Beyond the Lab, he discusses why his personal relationship to people with cognitive disorders helped drive him to his current work and finding ways to help patients with these disorders live well.
What made you want to become a scientist/researcher?
For most of my life, I have been close to people who have cognitive disorders. These relationships have inherently led me to ask questions about the brain and mind. My parents, who are clinical psychologists, also helped fan the flames of these interests. My early Montessori-style education led me to pursue interesting ideas and gave me the time and space to explore a variety of topics thoroughly and collaboratively. Becoming a scientist also fit my personality, which has always been one of questioning tradition and challenging established ways of thinking.
My academic interests and personal relationships led me to my current work. Our lab is trying to improve the measurement tools and practices that allow clinicians to measure subjective health states such as pain, anxiety and depression. We focus on measuring these conditions for individuals with cognitive and language disorders because they have a unique set of needs. The tools used for people without cognitive disorders might not work for someone with a language or cognitive barrier. For example, about a third of people who have a stroke experience a communication disorder afterwards. These people are often excluded from research or clinical opportunities because of their disorder, for example, if the clinician/researcher is not able to understand the person’s report of their pain or other internal states.
What gets you going every day (besides coffee) and how do you stay motivated?
The fact that my academic pursuits are inspired by real people in my life reminds me of the very real toll cognitive disorders have on individuals, family and society. Through my personal experience, and my background as a clinician, I know that for many people with these disorders, the current state of health care is inadequate and can be demoralizing. My hope is that through research, I can help more people than I was able to as an individual clinician.
Although my work won’t lead to a cure for these disorders, I think there’s a lot that can be done to help people live well with these conditions. Part of living well is speaking the same language as your doctor, and benefiting from clinical research. It’s important for doctors and researchers to know how their patients perceive their health and quality of life.
And, of course, anxiety about tenure is a powerful motivator as well!
What limitations or challenges do you face as a scientist?
I think that scientists face many of the same challenges as other creative professionals. For example, there is a tension between finding time and space for inspiration (e.g., through reading, thinking, and writing); and the necessity of reliably delivering good and creative work. And like some other creative professions, the external product can take a long time to complete. The scientific process often requires months and years of diligent focus with only internal rewards. It requires finding pleasure in the process as well as the results.
Another challenge that I face is needing to balance competing priorities. One thing that I’ve come to accept is that balance may need to be defined over a longer period of time than I would like - not necessarily within one hour or one day or one week. There might be days or weeks that the scale is tipped in one direction.
What do you think the public should understand about science and scientific research?
Carl Sagan wrote, “science is a way of thinking much more than it is a body of knowledge.” I think that we can all think scientifically without being scientists. Thinking scientifically means basing your thinking on evidence (all evidence, not just confirmatory evidence) and being open to being wrong.
Is there someone you look up to, consider a mentor or who inspires you? Why?
Dr. Kenneth Heilman is an internationally-renowned academic behavioral neurologist. As a graduate student, I had the incredible fortune of being a member of his lab and shadowing in his cognitive disorders clinic. I learned many things from him, which I think can be distilled into three main lessons:
First, the power of clinical observation. Dr. Heilman is a very perceptive clinician – through astute observation, interviews, and active listening, he would glean a wealth of data on his patients that most clinicians would miss. Every patient was a case study to him, and his unparalleled command of neurology and psychology empowered him to find neurological anomalies in some of these case studies that inspired more systematic research.
Second, the value of teaching. Teaching and mentoring students of all ages and career stages is a priority and never a distraction for Dr. Heilman. Because he has emphasized this over many decades of his career, there are at least two generations of neurologists and psychologists in the U.S. and abroad that continue his legacy of inspired clinical research and service.
Third, discernment for which aspects of a life and career are important. Although his work is cited often, he was never driven by academic metrics, but rather by which issues he believed were important. I think this ability to suppress “noise” helped him tap into his main fuel supply – intellectual curiosity – to sustain decades of pursuing a fulfilling and productive career. I certainly did not take his mentorship for granted as a graduate student, and he inspires me more even as I grow as an independent scientist leading my own lab.
Where do you see yourself in five years?
My lab strives to improve evidence-based clinical practice for people with cognitive and language disorders. Specifically, we do this by improving how clinicians measure what’s important to these populations – things like quality of life. In five years, I hope to address bigger problems in this area, perhaps by interfacing with and influencing health care policy. For example, health care reimbursement is being increasingly driven by the value of clinical services, rather than the volume. I want to ensure that a patient’s quality of life is considered in determinations of value.
What more do you want people to know about you, your team or your work?
My lab works to solve problems related to quantifying health concepts that are internal and subjective, like pain, anxiety and quality of life. Often, “subjective” health concepts are dismissed by clinicians and researchers as being flawed and imprecise, or perhaps even inscrutable. However, I think if you really get to the heart of most health care relationships and transactions, often what is being treated is something subjective.
Patients with cognitive and psychological challenges are disproportionately dismissed or underserved because their challenges are unseen. Forgive me for quoting a questionably scientific source, but I think some wisdom can be gleaned from Harry Potter and the Deathly Hallows.
“Tell me one last thing," said Harry. "Is this real? Or has this been happening inside my head?"
Dumbledore beamed at him, and his voice sounded loud and strong in Harry's ears…
"Of course it is happening inside your head, Harry, but why on earth should that mean that it is not real?"
Message sent
Thank you for sharing.