From horses to humans 1: a journey in the musculoskeletal sciences
I spent my whole childhood wanting to be a vet. In my teenage years I spent a lot of time around horses, so this desire evolved into wanting to become an equine vet (I’m also allergic to cats so a career as a small animal vet had its associated difficulties). During my veterinary degree, I considered intercalating and taking an MSc by research. Sadly, I didn’t pursue it (looking back, it might have made my life easier!) – I was too hell-bent on qualifying and getting out into veterinary practice, doing the job I had always wanted to do.
I graduated from the Royal Veterinary College in 2003 and immediately took up a position as an equine locum in the north of England in a practice where I had seen lots of EMS as a student. The practice was struggling as a senior partner had been injured by a horse. However, although he was incapacitated, he could still ride shotgun in the car to help me navigate the area, easing my transition from vet student to junior vet.
During this time, I applied for, and obtained, an equine internship at the Animal Health Trust in Newmarket, working with Sue Dyson in the Centre for Equine Studies. Needless to say, this was a challenging 12 months, but one I completely relished. It was a steep learning curve, seeing complex lamenesses and working a 1 in 2 rota for 12 months. I loved it though, and the steep learning curve was in fact hugely beneficial. In addition to clinical duties, interns were encouraged to complete a mini clinical research project: mine was on fractured ossified cartilages of the horse’s foot. Sue’s skill, tenacity and expertise in publishing her findings rubbed off on me, inspiring me to publish our findings in the Equine Veterinary Journal. This was my first experience of seeing a research project through from start to finish and I got a taste of presenting our findings at the annual British Equine Veterinary Association conference.
After completing my internship, I was on the lookout for a job in equine practice. My first interview was a disheartening experience. I still vividly remember a senior partner of the practice consecutively firing the forelimbs of several horses with tendon injuries, while simultaneously grilling me on why I would be an asset to the practice. I remember thinking that ‘Surely, in this day in age, we must have better ways to manage tendon injuries?’ After all, they don’t fire tendons in people with these injuries. As it happens, despite the circumstances, this was an important moment – a seed had been subconsciously planted that I would ultimately revisit.
I eventually took a job in equine clinical practice in the north west, where I stayed for three years. It was enjoyable, but I felt my learning trajectory gradually decline in clinical practice and began to feel frustrated by this. The job was logistically challenging, covering a large geographical area, but not mentally stimulating anymore. I saw many horses with musculoskeletal injuries that were difficult to treat effectively and reinjury rates were high. It seemed that there were many treatments available, but little real evidence basis to advocate one treatment over another.
Having never really been interested in basic science research as a veterinary undergrad, as a clinician I started to think more about the biology underpinning common musculoskeletal injuries in horses, particularly tendon injuries, which are career-limiting and sometimes life-threatening. Perhaps the reason we couldn’t treat these injuries successfully was because we didn’t fully understand their pathogenesis. I was transported back to the ‘tendon firing interview’ and began to think I should pursue a new chapter, one where I could really get my teeth into a common disease that interested me, satisfying my curiosity to understand why horses were so susceptible to tendon injuries…and, who knows, perhaps help to find effective new ways to treat tendon injuries in future. Therefore, in 2008, I enrolled for a PhD investigating the role of inflammation in equine tendinopathy at the Royal Veterinary College.
To cut a long story short, after completing my PhD and following a brief return to working in an equine hospital, I elected to advance and translate my research from horses to humans. I was fortunate to be awarded consecutive Research Fellowships and have spent the past seven years at Oxford university researching the mechanisms underpinning chronic inflammation and fibrosis in soft tissue joint diseases – this time affecting the human animal. My research group has a particular focus on tendinopathy and frozen shoulder. I am also Director of a part-time taught MSc course in musculoskeletal sciences at Oxford.
I’m very happy to say that I still feel I’m learning something new every day in my current role. My journey from equine vet to research academic has had its associated challenges, but I’ve learned lots along the way. My experiences as an equine vet ultimately helped me find the research questions that my career is now based upon, something for which I am extremely thankful.