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An Interview with a Clinician Scientist: Meet Gabriela (Gabi) Constantinescu

January 22, 2016
Gabi image

Photo credit: Bill Hodgetts

On January 8, 2016, I (Jo Reimer) had the pleasure of sitting down for tea with one of the CSD department clinician scientists, Gabi Constantinescu, a head and neck cancer speech pathologist and PhD candidate at the U of A.

Gabi’s path toward becoming a speech-language pathologist was not a straightforward one. Despite being a successful third-year undergraduate student in genetics, on her way to becoming a basic scientist, Gabi stared into a test tube one day and realized this life simply wasn’t for her—she knew she wanted to be helping people directly, not isolating DNA.  After a visit to a career fair on campus, where there was no mention of speech pathology, Gabi had an impromptu chat with her German professor, who suggested she look into becoming an SLP. A friend suggested Gabi shadow her friend’s aunt around for a day, who turned out to be none other than Dr. Jana Rieger, who now holds a joint appointment between the U of A and the Institute for Reconstructive Sciences in Medicine (iRSM) as a clinician scientist. And an aspiring speech pathologist was born!

Gabi followed the thesis stream, and, attracted by the opportunity to work with state of the art technology, she chose a project under the supervision of Dr. Carol Boliek studying entrainment with children with Autism Spectrum Disorder.  Did you know that neurotypical conversation partners will change their breathing patterns to match that of the other speaker, rather than following their own tidal breathing patterns?  Gabi’s study showed that this was not necessarily the case for children on the spectrum, an interesting preliminary result that really needs more work (hint hint future SLPs).

After her Master’s, Gabi spent a great year with Alberta Health Services, working with kids from grades 1-6, and loved working in the schools, which is small wonder since her reception was generally accompanied by an excited greeting of “Hooray! The speech pathologist is here.  She’ll know what to do!” Although Gabi enjoyed this work, and found it strengthened her confidence, she knew in her heart that she needed to get back to school herself, and enter the world of the clinician scientist.

I told Gabi that one of the competencies our professors are emphasizing is the need to contribute to the field, to accept that no matter how busy one’s clinical practice is, research must be a part of it, and Gabi agreed, stating “clinician scientist should be synonymous with clinician,” adding that you can’t advance the field without critical thinking and research skills.  This is her passion, and, in light of the fact that she specializes in head and neck cancer, research is fundamental to her work.

Gabi credits the immense progress in the work of the iRSM to Dr. Rieger, who took the field from a focus on pure survival for the patients to where it is today.  Initially, a nurse would ask clients how their speech and swallowing was, and that response is all that was reported—there were no objective measures taken, no assessments done to determine how the client was actually doing and if there were any real progress. Dr. Rieger introduced intelligibility ratings and assessments, and, in collaboration with the ENT department, began using an assessment battery for tracking data on her patients so research and care could be informed by objective data. In light of the new emphasis on client-centred care in our field, Dr. Rieger enhanced her protocol to include an assessment of the quality of life of her clients, including their interests, priorities, and participation goals.  Gabi has witnessed firsthand the positive changes inherent in focusing on patient-driven outcomes, and her passion for working with people with head and neck cancer is clear.  In her words, “I love this population.”

So where is she now?  Gabi is completing a PhD at the U of A through the Department of Communication Sciences and Disorders in the Faculty of Rehabilitation Medicine. While working in iRSM, Gabi was bothered by the accessibility issues for their dysphagia clients who were expected to visit the iRSM clinic 2-3 times per week to work on their swallowing. These people need intensive therapy, but the demands of taking time off work, or travelling long distances into the city were problematic, never mind the fact that they only had one machine and could rarely find appointment times to schedule everyone.  Over lunch one day, Gabi shared her frustration with a biomedical engineer, who offered to create a smaller prototype device so that they could have more machines onsite.  This led Gabi and her team to her PhD project, the development of a mobile device that will allow clients to receive the intensive therapy, which is vital to their rehabilitation, in their own homes on an intensive schedule. We have some amazing CSD students who have joined Gabi and Dr. Rieger on this incredible journey as their project for their Master’s.

What’s next for Gabi? I don’t think I have ever met a person with a greater passion for learning, so her next step is likely going to be a post-doc. Although we will be sad to lose her from Edmonton, imagine the knowledge she will be able to bring to her next placement.

I had a few other questions for Gabi that related to the current SLP students.

Me: “The workload in the program is intense and sometimes it is hard to step outside the ‘is this going to be on the test?’ and the ‘worry-about-grades’ mindset.  Do you have any advice for us?”

She laughed and pointed out that it is so hard to get into the program, and we have all been focused on grades for so long that we need to give ourselves time to adjust. As for any vestiges of competiveness, she recommends staying focused on the friendships and camaraderie of the program, as there will inevitably come a time when we are in the field, and your classmates will be your colleagues, perhaps even your boss. Ultimately, she suggests we need to try to permit a shift between the focus on yourself to the focus on the patient or client. Try to think about their needs and less about how people perceive you, and just do your best in the moment.

Me: How can we balance the needs of being a clinician and a researcher in our careers?

She suggested we remember that being a clinician should be synonymous with being a clinician scientist.  In your clinical work, continue to be a critical thinker, ask questions, and build relationships with others around you.

Me: Speaking of relationships with others, what do you think about IntD (our interdisciplinary studies class)?

Gabi stated that it is easy to build great friendships within the department, and sometimes it feels like you are working in a silo. But in the field, you won’t work alone, so embrace it.  Her one regret in her placement at the Glenrose Rehabilitation Hospital is that she didn’t socialize more with people in other fields and become really comfortable with that early on, because it is an essential part of her work today.

Me: Do you have any advice on maintaining a work-life balance?

She replied that obviously balance is important in life, and even if your personality makes you a work-focused person, you still need to step out of that every now and then to bring back that creative focus.

Me: Any final advice?

Gabi: “Find a good mentor.  It’s where I have grown the most and learned the most.”

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