May 23, 2017

Considering Pharma? Check out the DIA 2017!

pharma reseracherLast year was a big year for pharma at the Doctor’s Crossing. Four of my clients landed great jobs in pharma and I attended the inspiring world-renowned pharmaceutical conference – The DIA Global (DIA – Drug Information Association).

One of my four clients had no prior pharma experience and she is now working happily as a Drug Safety Officer for a large pharmaceutical company. She is proof that you can get into pharma without having experience in clinical trials or research. 

In my on-going efforts to learn more about pharma, scout for opportunities for clients, and get a better feel for the community, I attended the DIA’s annual conference in Philadelphia last year. I was one of 6,454 participants and I loved every minute. There was an electricity in the air which I attributed to being amongst so many bright individuals who are passionate about improving the health of patients in profound ways. Before I share specifics about the conference, I want to give you an idea of positions open to physicians in pharma.

  1. Drug Safety Officer  (Pharmacovigilance)– involved with reported side effects from drugs, labeling, SAE’s (serious adverse events). Can include involvement in preclinical studies. clinical trials and post-market stages. Public education.
  1. Medical Monitor – advises on clinical trials, planning, and implementation. Monitors patients enrolled in trials for safety, side effects and suitability for study enrollment and completion.
  1. Clinical Trial Researcher – participates in and oversees clinical trial design and implementation. Actively involved in running trials and design.
  1. Medical Affairs Director– bridge between drug development, marketing, and public education. Involved with medical information, communication, launch and post-market strategies.
  1. Medical Science Liaison –a knowledge expert in a therapeutic area, develops relationships with KOL’s (Key Opinion Leaders) externally, resource for physicians in practice; educational and communications role. Frequent travel.
  1. Medical Writer– prepares regulatory documents, slide decks, scientific articles, white papers, covers scientific and medical conferences, etc.
  1. Regulatory Affairs Director – knowledgeable about FDA regulations, prepares and submits regulatory documents, negotiates for market authorization for drugs and devices, keeps informed regarding legislative changes.
  1. Health Economics and Outcomes Researcher (HEOR) – concerned with the cost-effectiveness of drugs and devices, value, as well as the impact of treatments on patients.

 For a more complete description of these positions for physicians, please click HERE. (Note – the job opening links are no longer active).

Click HERE specifically for the Medial Science Liaison.

Sameer Thapar (PharmD), Director of Global Pharmacovigilance for Oracle, and one of the speakers at the DIA, shared a simple way to think about the complex array of jobs in pharma. He said, “There are the Makers, the Sellers, and the Defenders.”  The Medical Affairs and Medical Science Liaison positions help to bridge these three areas (my addition).

When considering a transition to pharma, you may wonder whether or not you would miss patient care and if you’d feel like you were making a difference in a meaningful way.

Dr. Kelly Curtis, my former client who now works remotely as a Medical Director and Medical Monitor for INC Research said this about his transition, “I find non-clinical work very rewarding and feel like I make more of an impact on the future of oncology in this role than when I was in academia.” 

I personally know a pediatrician who works remotely for pharma and he does a few pedi-urgent care shifts a month to keep his clinical connection to patients.  Although maintaining some degree of patient care while working in pharma is not the norm, some doctors find ways to do this through volunteering, medical trips abroad, or attending in a teaching setting.

The satisfaction from helping an individual patient can shift to helping entire populations of patients. Dr. Larry Brilliant, who gave the DIA 2016 Keynote address, recounted his fascinating involvement in eradicating smallpox and his on-going efforts to prevent and treat blindness in millions of individuals in developing countries. You can read about his amazing life’s work intertwined with his spiritual journey in his hard-to-put-down new book, Sometimes Brilliant

Here are some of the Hot Topics on tap for DIA 2017:

  • Data/Big Data/eHealth – informatics, data integration, bioethics
  • Disruptive Innovation – innovative science, technology and therapies: stem cells, regenerative therapies, gene therapies
  • Medical Affairs – MSL (medical science liaison), medical writing, medical affairs roles throughout product lifecycle
  • Patient Engagement – patient-centric practices, advocacy, culture, tools
  • Safety – best practices, post-market safety considerations, monitoring
  • Regulatory – advertising and promotional laws, regulatory writing, document management, compliance
  • Special Populations – Rare diseases, pediatrics, women’s health, aging
  • Preclinical and Clinical Development – discovery, clinical research, recruitment, clinical trial data disclosure, outcomes, statistics
  • Value and Access – drug pricing, reimbursement, access, real world outcomes

For additional information on the Hot Topics for DIA 2017 please click HERE.

For the Agenda for the DIA 2017 please click HERE.

I particularly enjoyed a panel presentation on “Big Data” with oncologist Dr. Brad Hirsch, CEO at SignalPath Research. Dr. Hirsch continues to see patients as well as work in pharma in the areas of informatics, innovation and gene-based therapies. You can tell he loves caring for his patients, and also being at the cutting edge of finding cures for the cancers that threaten their lives.

If you’re considering pharma, attending the DIA will give you a deep dive into this area, as well as the chance to make helpful networking connections. And your attendance would be an undeniable indication to any hiring authority of your genuine interest in this career direction. This is just one of a number of ways to increase your chances to land a pharma job.

Even though my time at the DIA was beyond busy, especially since I made a point to network at all of the exhibitor booths (pens anyone?), I left energized and uplifted. Call me pollyanna, but I felt that I was among a large group of people who really care about giving patients the chance for healthier and longer lives.  As physicians, and as individuals with loved ones, we know personally how devastating having an untreatable condition is, or having a poor quality of life due to illness. Pharmaceuticals are, of course, only part of the answer to good health, but when nothing else works, the right drug is truly a miracle.

The DIA 2017 will be in Chicago, June 18 – 22. 

 

 

 

 

 

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2017 Conferences – Could One Lead You to a Happier Career?

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One of the many things I love about my work is getting to attend conferences to explore new career options for my physician clients. I search out both non-clinical directions as well as ways to be happier as a clinician. I always learn a tremendous amount, meet interesting people, and gain a better sense of the opportunities available for doctors.        

And I usually have some fun too! The life insurance conference in Austin was no exception. On the final night, we were treated to a Texas-style party complete with dancing, a live band, BBQ, and something I’ve never seen before – armadillo races! Actually, it was one race. Armadillos, it seems, prefer bug hunting and running in erratic circles to going for the gold!

Attending a conference can help you:

  • Gauge your interest level in a specific area
  • Network with those who have already transitioned
  • Find out about job opportunities and hiring trends
  • See if the attendees feel like your “tribe”
  • Learn more about the pros and cons of a new area
  • Have some fun and get out of dodge for a few days

As doctors, we often don’t really know what’s out there. We may think working for a life insurance company means selling life insurance when the job actually entails using your medical knowledge to evaluate mortality risk. We may dismiss pharma as “going to the dark side” when there are many dedicated physicians working with integrity and high satisfaction in this diverse field. We may still want to practice, but need a new approach to patient care. Below I have listed select conferences for this year. Since it is early in the year, some are just beginning to post their agendas.  Click on the links for conference details.

Medical Writing / Writing

Click here for the 2016 agenda – 2017 not available yet)
American Medical Writers Association Conference
November 1 – 4, 2017  Orlando, Florida

The Life Examined – Exploring the intersection of the arts and medicine
October 12 -14, 2017 Iowa City, Iowa

Non-Clinical Careers
SEAK Nonclinical Careers Conference
October 21 -22, 2017  Chicago, IL

SEAK’s ongoing seminars on expert witness, consulting, IME’s etc

Chart Review/Disability
How to Start, Build and Run a Successful Disability and File Review Practice
February 11 – 12, 2017  Clearwater Beach, FL

Pharma
DIA Global* (largest pharma conference in the US)
June 18 – 22, 2017 Chicago, IL

Life Insurance
Click here for 2016 conference agenda – 2017 not available yet)
American Association of Insurance Medicine
October 15 – 18  2017 Atlanta, Georgia

Physician Advisor
Click here to read a blog about being a physician advisor

Physician Advisor and UR Team Boot Camp
July 19 -21 2017 Bonita Springs, FL

Physician Advisor Summit
March 20 -21, 2017 Orlando, FL

Functional Medicine
Institute for Functional Medicine
March 13 – 17, 2017 Huntington Beach, CA
(others in Washington, DC, Dallas, TX various dates)

Integrative Medicine
AIHM Academy of Integrative Health and Medicine
October 22 – 25, 2017 San Diego, CA

Lifestyle Medicine
American College of Lifestyle Medicine
October 22 -24, 2017 La Paloma, Tucson

Nutrition/Diet
Plant-Based Nutrition Healthcare Conference
September 24 – 27, 2017 Garden Grove, CA

Informatics/Electronic Medical Record
HIMMS* (largest informatics/EMR conference)
February 19 -23, 2017 Orlando, Florida

AMIA (smaller informatics/EMR conference)
November 4 – 8, 2017 Washington, DC

Physician Leadership
Amerian Association for Physician Leadership
Ongoing Institutes throughout the year
January, April, July, and November 2017

Coaching – Leadership, Wellness, Health, Lifestyle, Career, etc.
ICF International Coaches Federation Annual Conference
August 24 – 26, 2017 Washington, DC

Harvard Institute  of Coaching in Leadership and Healthcare
October 13 – 14, 2017 Boston, MA

Tips for getting the most out of a conference

  • Read the agenda in advance to assess your interest level
  • Bring business cards with your personal contact info
  • Pump yourself up to network and make connections
  • Join others for lunch and dinner – don’t dine alone or hole up in your hotel room
  • Talk with vendors in the  Exhibitor Hall to find out about opportunities for doctors
  • Take notes on the people you network with & follow-up
  • Have fun!

Suggestions for additions to this list are welcome!

Here’s to a great start to the New Year and a more fulfilling career!

 

 

Using Your Internal GPS for Career Change

Is your internal GPS telling you it’s time to change your career direction? Is it saying “Recalculate! Recalculate!” but leaving you stranded at the crossroads, failing to provide any further instruction?

If so, it can feel overwhelming, daunting, and confusing.

 

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Uncertainty is uncomfortable. It’s natural to wish for some kind of roadmap to guide us through a process of change.

It makes sense that we feel this way. To become a physician, we had every step mapped out for us. Yes, it was quite a climb, but even Everest has a summit and there is one way up. If you don’t give up and make it to the top, you win. There is guaranteed employment, a career with status, and a paycheck.

 

stair-step-cartoon

 

There is a sense of security in such a well-trodden path where the finish line is visible before you even start. However, as our high physician burnout rates reveal, there is no guarantee of happiness. There is no certainty that the rules of engagement won’t change or that expectations will be met.

The shifting sand at the top of the seemingly sturdy staircase has left many considering other options. Instead of using the staircase that guided us, we now have to create our own path.

If we were wired like Lewis and Clark, we wouldn’t have gone into medicine. We’d be bushwhacking with Sacajawea by our side, discovering new lands – not practicing evidence based medicine.

But in spite of our predilections, we may find ourselves staring into a great expanse of non-clinical career terrain, wondering where even to take the first step?

Since we don’t have the prefab staircase outside of traditional practice, we have to use a different approach. Siri had the right idea. We need to use our internal GPS. We need to be able to listen to ourselves and hear our own guidance.

The connections may be a bit rusty if we’ve had to push down that inner voice in service of our career. It may take time to start hearing our true inner voice and what we need and want. When we start to listen, we might be confused by the presence of two voices, one coming from fear-based thinking (The False Self) and the other coming from trust-based thinking (The True Self). Here are some identifying characteristics to distinguish the two:

The False Self – fear-based and self-doubting

  • Sees problems rather than possibility
  • Jumps to the “What if’s” – what could go wrong
  • Is accompanied by anxiety
  • Sells your abilities short
  • Has to see all the steps before starting

The True Self – confident and trusting

  • Focuses on possibilities rather than problems
  • Is able to imagine success
  • Creates a sense of calm internally
  • Does not over or underestimate your abilities
  • Is comfortable taking steps without having all the answers

How do we turn up the volume on the True Self and mute the False self?

1. Start noticing anxious, fear-based thoughts. Write these down and note the frequency.
2. Look at the fears objectively and see if they make rational sense.
3. Take stock of all you have already accomplished and the challenges you have met.
4. Give yourself permission to accept whatever feelings you are having. Get curious about their origin, rather than judging them.
5. Practice mindfulness or meditation techniques to help quiet and train the mind so it is not so reactive.
6. Do things you enjoy and love. This will awaken the heart, which is part of the internal GPS
7. Believe in the value of your individual uniqueness. Embrace your path and don’t worry if it doesn’t look like anyone else’s.

Our Internal GPS = an awakened heart + rational, non fear-based thinking

To get started on your career transformation, you don’t need to enter a specific destination into your GPS. You can start with a commitment you make to yourself. It can be a simple statement such as:

“I want to enjoy my work.”

“I want my work to be fulfilling.”

“I want to have quality family time.”

“I want to make a difference in a way that is meaningful.”

“I want to use my creativity.”

“I want to use my brain more and be challenged.”

Your internal GPS will start to work on the initial steps, and as you gain more clarity, keep refining the destination. Staircase or no staircase, it’s OK to “recalculate” so you end up in the right place – for you.

Hot. Getting Hotter. The Physician Advisor Role

physician-handshake-shutterstockAre you stressed by 15 minute patient visits, assembly line medicine and not having a voice? Would you like to use your clinical knowledge but not do direct patient care? If so, you may be interested in the up and coming role of the physician advisor. Before you consider opening a Subway franchise, please read on.

Physician advisors serve as liaisons between the clinical staff and the administration in the hospital. They assist with case management (length of stay, patient status), medical necessity, Medicare regulations, claim denials, and documentation. Jobs can be both hospital-based and in companies offering these services remotely for hospitals. Part and full-time work is available.

In July I attended the 4th National Physician Advisor and UR Team Boot Camp with two of my clients. The conference was an invigorating blend of presentations, breakout sessions, networking, and even a mock ALJ (Administrative Law Judge) hearing for a claims appeal. No boots or camping were required, and the only suffering was braving the triple digit Texas heat to go to dinner.

One of the speakers at the conference, Dr. Phillip Baker, an OB/GYN with 31 years in private practice, described how as a physician advisor he helps other doctors. He gave the example of a surgeon whose care was being denied and the next step was for him to have a peer-to-peer call with the insurance company’s medical director. Dr. Baker said, “I remember being in that situation and I would have mouthed off and said something like, ‘What the heck do you know about caring for patients? You’re not a surgeon!’ Now I can take that burden off that surgeon, make the call myself, and do both him and the hospital a favor. I chitchat with the medical director, take time to ask about the kids and it goes a lot better.”

In the past year, Dr. Baker and his nurse assistant have been able to recoup 11 ½ million dollars for his hospital. Sounds like good job security to me!

I asked Dr. Baker his secret to success with the insurance medical directors. “I come from the perspective that we are both doctors, we both went to medical school. I’m an OB/GYN. I don’t know everything, but I know basic medicine. I take the time to get to know directors and don’t take anything personally. I love what I do.”

As you are probably realizing, to be successful as a physician advisor, emotional intelligence and a tough skin are critical. It’s also helpful to have a good reputation in the hospital system where you want to work.

My client, Dr. Helen Shields, an OB/GYN hospitalist was at the Boot Camp in preparation for a new position as a physician advisor. As of this time, she has started working remotely 20 hours a week for a private company. The Physician Advisor Boot Camp was her first toe-dip in this whole new arena and she shared this feedback, “I felt the Boot Camp provided a good introduction and overview of what a hospital-based physician advisor’s job may entail. I was impressed with the team approach to assist the hospital with legal, regulatory and financial services, and the recurrent theme to do what’s right and best for the patient.”

In the training for her new job, Dr. Shields says she enjoys learning about this other side of medicine and expanding her knowledge base of medicine in general. She adds that she is very happy to have made this transition.

At the end of the Boot Camp, I turned to my other client who was there, Dr. Timothy Owolabi, a Family Practice physician who is a full-time physician advisor, and asked him to describe in one word what he got out of the conference. He thought for a minute and then replied, “Community.” Dr. Owolabi was hired at the beginning of the year to be the physician advisor for his healthcare system. He went on to say, “Conferences such as this one, and the vibrant physician advisor community provide invaluable resources and support.” He added “Becoming a physician advisor had been a continuous exercise in patience, critical thinking, improving negotiation skills and trying to learn rules that are always subject to change. It’s been hard, but rising to the challenge is rewarding.”

You may be wondering, besides FP’s and OB/GYN’s……

Who becomes a physician advisor?

Doctors who enter this area need to be licensed, preferably board certified and have been in practice for a minimum of 3 – 5 years post-residency.

The most common specialties are internal medicine (especially hospitalists) and family practice. However, entrance from OB/GYN, surgery, anesthesiology, pediatrics, emergency medicine, and other areas is possible. It is very helpful to have in-patient experience.

How does one get started as a physician advisor?

  • Shadow the physician advisor at your hospital (if you have one)
  • Serve on committees for peer review, quality, safety, etc.
  • Start doing utilization review, benefits management, and/or appeal work
  • Attend a physician advisor boot camp or conference
  • Join the ACPA (American College of Physician Advisors)
  • Join NAPA (National Association of Physician Advisors)
  • Search on job boards for “physician advisor” positions

I’ll never forget what one veteran physician advisor told me about becoming a physician advisor. He said at first the doctors in the hospital would move to the other side of the hall when they saw him coming. But in time, after seeing that he was their advocate, not their foe, they would be flagging him down for help.

The next National Physician Advisor and Team UR Boot Camp will be July 19th-21st, 2017 in Bonita Springs, Florida. If you want to go, but can’t make the trip, you can join in live via Webcast. It could be the start of a great new career.

Functional Medicine – Could It Be For You?

functional-medicine-tree

 

I didn’t set out looking for a Functional Medicine doctor. I wasn’t sure what such doctors do. But that’s where I ended up. I was suffering from “nonspecific, slowly progressive gym funk.” You might be thinking, JUST WASH YOUR GYM CLOTHES! I wish it had been that simple. Rather, my issue was not having enough energy to work out at the gym. Some days I would put in a respectable effort and break a sweat. But on other days, I’d spend more time sitting on the machines than actually using them. Was I just lazy? Not getting enough sleep? Eating too many chips? I wasn’t sure.  After routine blood work failed to show a reason for my gym funk, I by chance found a Functional Medicine doctor.

Before I go on, let me share a definition of Functional Medicine from the Institute for Functional Medicine (IFM) Website:

“Functional Medicine addresses the underlying causes of disease, using a systems oriented approach and engaging both patient and practitioner in a therapeutic partnership…By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, Functional Medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, Functional Medicine supports the unique expression of health and vitality for each individual.”

Back to my story….

The Functional Medicine doctor took a detailed history, did a lot of blood testing, and found out I had a methylation defect. This was news to me. There were some other issues that showed up which made sense from my history – i.e., a low vitamin D which may have contributed to a prior unexplained stress fracture, and a few other findings. She prescribed methylfolate, vitamin D, multivitamins, and some other supplements. After about 6 – 8 weeks, I noticed more energy and was able to work out much more consistently.

I can’t say for certain if the methylation defect was the culprit (it’s apparently pretty common), but if I stop the methylfolate, doing so adversely impacts my energy. Whatever the truth is, I was able to see a physician who could spend as much time as need with me, addressed my problem, and provided effective treatment.  And she didn’t have to deal with insurance. Sound good?

Hoping this career direction might be an option for some of my war-weary physician clients, I decided to attend the Institute for Functional Medicine’s foundational course – Applying Functional Medicine in Clinical Practice. Even though I was only able to attend the first of five days, I felt I had a good toe-dip into the program.

The first day was packed with presentations, round-table case studies, and time for networking and super delicious, healthy snacks (I’d go back for the food alone). The aim of this course was to provide an in-depth experience of the IFM’s model of assessing and treating patients. Additional training can be taken, leading to a certification in Functional Medicine.

Here is a partial list of topics addressed during the conference:

  • Root Causes and Treatment of GI Dysfunction
  • Immune Dysfunction and Inflammation
  • Food Allergies, Sensitivities, and Intolerances
  • Prescribing an Elimination Diet
  • ABCD’s of Nutritional Evaluation
  • Assessment and Treatment of Adrenal and Thyroid Dysfunction
  • Understanding Sex Hormones
  • Managing a Woman’s Hormones
  • Mitochondria and Energy Dynamics
  • Insight, Intuition, and the Therapeutic Partnership

While at the conference, I ran into a friend of mine, Dr. Julie Reardon. Julie is a Family Practice physician who completed a fellowship in Integrative Medicine and has a busy private practice in Austin. We did a post-conference debriefing. She said she has already been using some of the Functional Medicine approaches with her patients, but that the conference was a fantastic learning experience.

“It was like being back in medical school, and drinking from a fire hydrant, but in a good way,” she said. “We delved into a lot of the science and biochemistry (remember the Krebs cycle?). They have excellent tools and resources for us to use in our practice, such as the Functional Medicine Timeline to capture the patient’s medical history in a way that makes it much easier to see connections, correlations and inciting events.”

She was clearly very energized by her experience, summing it up by adding, “My greatest surprise and pleasure out of all it was that the Institute for Functional Medicine embraces uncertainty in practice. They give us the science and tools to work with, but they keep the art of medicine alive by not being so rigid in the approach. They are willing to think outside the box.”

In addition to running into Julie, I had another stroke of luck getting to meet with one of my clients, Dr. Lara Salyer, a family physician from Wisconsin.

We had a chat a few weeks later and she shared some impressions of her experience,

“Initially I thought my career fatigue was due to medicine in general. But in reality, it’s the way our current primary care office visit is structured. As a traditional Family Practice doctor, we aren’t allowed the time or supportive resources to make any substantial impact in mind-body-spirit health as a whole. Learning about Functional Medicine inspired me to reconsider staying in medicine. I am excited to dig deeper into the biochemistry and physiology to help patients live a healthier life, hopefully with less reliance on prescriptions. My favorite part was connecting with other physicians who had already transitioned into their Functional Medicine practices. I understand it takes time and there are challenges, but I am willing to give it a try.”

I asked Lara if she had any advice for other doctors experiencing burnout? She offered these words, “Before you abandon medicine, take a look at this. If you went into medicine because you care about motivating the individual and making real changes socially and humanitarianly, don’t jump ship just yet. Check out Functional Medicine.”

Let’s say you check out Functional Medicine and do the training. What kinds of opportunities exist?

This is where I got a big surprise.

Before I did my research for this blog, I was only familiar with doctors who hung up their own shingle and started a practice from scratch or incorporated Functional Medicine into an existing practice.

Then I stumbled upon this website, Integrated and Functional Connections, where there are actual jobs (I mean real, live, jobs!) for Functional Medicine physicians! Currently, there are postings by the Cleveland Clinic, Baylor Scott and White, and the Sutter Medical Group, to mention a few. Before I could even finish reviewing the jobs, I reached out to Lisa McDonald, founder of Integrated Connections, to learn more. Lisa is truly passionate about her role in connecting her clients with healthcare providers. She is very excited about the significant increase in job opportunities since she started her company 7 years ago. When asked about compensation, Lisa responded, “The salaries have also been increasing, and are now competitive to those a Family Practice or Internal Medicine physician makes in the more traditional positions.”

It was very encouraging to hear that both smaller practices and large healthcare systems are recruiting for Functional Medicine physicians.

Although the specialties Lisa recruits from are predominantly Family Practice and Internal Medicine, physicians from a wide range of specialties have become certified in Functional Medicine.

The most common specialties I noticed on the IFM FIND A PRACTITIONER page are:

Family Medicine, Internal Medicine and (IM subspecialties), Emergency Medicine, Anesthesiology, Neurology, Physical Medicine and Rehab, OB/GYN, and Pediatrics. However, I also saw doctors from these areas as well: Psychiatry, Surgery, Radiology, Dermatology, Radiation Oncology, and Ophthalmology. Some physicians devote their entire practice to Functional Medicine, while others offer the model as a complement to their established practice.

If you are interested in learning more:

IFM offers 2 free online eLearning courses, which provide an overview of Functional Medicine and Functional Nutrition.

You can read here about the IFM certification program. And see a listing of upcoming conferences and courses here.

Functional Medicine uses both traditional and novel approaches to help patients. It may be something you want to consider, or not. The good news is that there are options to explore if you are frustrated by the current practice environment. You get to decide if something could work better for you. At the very least, being able to connect with doctors who are finding their passion again may provide some hope and inspiration for your own journey