Associate Professor, Pediatrics-Allergy/Immunology
University of Colorado Anschutz School of Medicine
Aurora, Colorado, United States
About Elena Hsieh, MD
Career path
1. How did you first get involved in immunology?
I was one of those nerds who chose immunology as an undergraduate major. I got interested in immunology pretty early in my life. I am often asked, “how did you choose to have that major?” I actually grew up in southern Spain. I went all the way through high school there and then I came to the US for university. And in Spain, when you’re in high school, you declare yourself in different branches along the way; “are you humanities or are you sciences?” And basically, by the second year of high school, I knew I was in sciences. And then as you get advanced in the sciences, then you branch into biology, physics, microbiology, immunology, etc. So, in high school, I already had made some declarations and choices. By the time I came to the United States and was an undergrad, I said “I’m interested in immunology.” And it always fascinated me because I like to say that the immune system is very logical. There are immune cells – the soldiers. You need to have enough of those soldiers and they each need to know what to do, to protect you from infection. They have a specific job and that all feels very logical to me. And I like that.
2. Tell us about the research you’re most proud of.
I would say the research I’m the most proud of was a publication we had in the Journal of Experimental Medicine in 2019. This was a story describing a new human, inborn error of immunity, a genetic defect in the IL-2 receptor beta subunit of the IL-2 receptor. The reason why I’m most proud of that, is because I was interested in immunology early on through different clinical and research experiences, I had dreamed that one day I would basically be the person who is a disease discoverer/hunter of some sort, that I would approach patients like detective work. You see a patient, they have a constellation of symptoms, you’re like doctor number 153 that they get to see, and you’re trying to put all the pieces together to explain the clinical picture.
You look at the genes, you find something that seems to be the culprit and then you have to prove that that is indeed the culprit. And to prove it, you have to do a series of immunological assays and assessments and use some intuition and some scientific results to put the picture together. And then you understand the mechanism of disease and you come back to the patient, what I like to call the virtuous cycle of human disease discovery. This was the first time that my lab got to do that, where I felt that I was the director of that orchestra, per se. It also involved the collaboration of multiple investigators, multiple clinical specialties, multiple basic scientists who had different expertise, and then trainees that were clinical trainees, fellows that were graduate students and postdocs. And I really loved that team structure. So that’s what makes it the most proud experience for me.
3. What is the most important trait a researcher should possess and why?
I will boil it down to two. One is perseverance. I think being in research means that you hit a wall many, many times because you don’t get the result you expected, because things go wrong at the times that you don’t think they would happen, because there are logistical delays because, you know, time is not on your side. Persevering through negative results or the sort of results that you didn’t expect is important, as well as curiosity when you get a result that you didn’t expect. Don’t be judgmental, be curious.
4. What is the biggest lesson you’ve learned?
The biggest lesson to remember is that the path to research is actually a marathon, not a sprint. So, you’re kind of in it for the long run. It’s a very patient process. That’s one. I think for those of us who went into medicine first or medicine and research intertwined, a lot about the medical field is the fact that you build a differential diagnosis, but you want to get the right answer because your patient’s destiny hinges on it. And I think what I have learned is that in research, actually, the way to get to the right answer is to get many wrong and that you cannot skip that process. I think my lesson is to enjoy and embrace many wrong answers, because that’s how I will get to the right one.
5. What advice would you give to young researchers just starting out in the field?
I think the advice for a young researcher is to remind them that though a lot of the research process is thinking about details of experiments and thinking about hypotheses; what I actually think is the biggest role that you have as a researcher is you have to like telling stories about your science. It’s about you telling a story of how you arrived at your discovery, your contribution to science, what you think you bring to the table, what’s known now that was not known before. And you actually have to enjoy that process. It can’t just be the doing of the experiment and the planning of the experiment. You have to enjoy talking about the process and telling your story, which means you have to enjoy writing and rewriting. I think young researchers often forget that; they get caught in the “what am I supposed to do at the bench?” And for that to shine, you have to tell your story at the end of it.
6. Describe your average workday.
I’m in the line of work that I am, as a physician scientist, because I like my days to be looking very different from each other, and I think that’s what wearing many hats results in. Usually, my day always starts with waking up very early and doing something active. That could be climbing, that could be hiking, that could be doing a weight workout of some sort. But I start in the morning with getting my body active, to get my mind ready to be active. Then there’s some days where I start my day with some clinical care of patients, and then that switches over to a meeting with a trainee in the lab, that’s switching over to having to help somebody do an experiment, to writing a grant, to then going to pick up my child. And every day’s different from each other and I like it that way.
Personal
7. Who you most admire and why?
I most admire my mother and that’s because she is, I like to say, a woman ahead of her time. My family is from Taiwan. And during her time, I think some women had education, but not many had the opportunity to make that education shine, and she didn’t have the opportunity. However, throughout my life, she has clearly shown that she has great organizational and leadership skills. She has great financial sense. She is, in a way, the head of the household without really showing other people that she is the head of the household because that’s how women were taught and raised at that time. She has a very good business mind and was really the woman behind the man in our family business. She always knew how to prioritize her time in her day. And I have learned and admire a lot of those traits.
8. What motivates you to work hard?
My patients and my family, honestly. I think, as a physician scientist, I love doing research because I started my enjoyment of interacting with people and trying to see how I can basically have this person be the next version of themselves. And that’s what I see in the clinic. You know, my interaction with them in the clinic is not just to arrive at a diagnosis, but for them to have a better quality of life and for them to arrive at the next better version of themselves. I realized that if I did that strictly in the office, I would have impact on a few lives. But if I actually spent time doing research and I could contribute to the knowledge about specific diseases, I would reach more people and I would hopefully have an impact on helping other people be the next version of themselves on a sort of larger mass. My motivation is always, how can I make this clinically applicable so that my patients can reach the next version of themselves? That, to me, permeates how I want to train my trainees for them to be the next version of themselves, how I want to raise my child to be the next version of herself. And I actually only get to do that if I become the next version of myself, which is taking steps forward in research.
9. Do you have a favorite time management tool?
It’s funny, I’ve been asked that question many times. I don’t use any app specific tools. I think the greatest tool that I have is on my brain. I have this matrix in my mind that is, time wise, what’s urgent, what’s not urgent, but important, right? What’s more important and what’s less important. And I always like to prioritize and get things done that are urgent and important. Something urgent is not always important. But I try to arrive at that metric in my head all the time. And really my best time management tool is understanding how long something takes me, because then I’m in charge, I have 10 minutes now, what can I get done in 10 minutes? And what is the next important and urgent thing that I need to get done that I can do in 10 minutes? So that’s what works for me.
10. Do you have a favorite vacation spot someplace you like to go when you’re not working?
I grew up in Spain and I’ve been in the US for a really long time. And I will still say that my favorite place to go on vacation is to go home, and that’s to go back to southern Spain to the town where I grew up, to feel like I go back to where I belong. And that’s my favorite vacation spot.
11. Do you have a favorite beverage or drink?
Coffee! And good coffee. I’m very picky with my coffee. I care about the bean, I care about the roasting process of the bean. I care about how the coffee is made. So, I’m a coffee snob, I like to say.
12. Can you describe your hobbies, other things you like to do when you’re not working?
I love to do things that are active, so I love to be outside. I think Colorado’s a great place for that. And I was in California before that, so I love the outdoors. I like hiking, I like camping. I like climbing. I just enjoy experiencing my surroundings. I think that’s my best way to put it. And I also love cooking, so I grew up in a kitchen. My family had a restaurant as a family business when we lived in Spain. And being in the kitchen is one of my hobbies. I love it.
Work with FOCIS and FCE's
13. Switching gears, how did you first get involved with FOCIS?
I first learned about FOCIS when I was a clinical fellow. I did a pediatric residency and then I did an allergy immunology fellowship. As I was in fellowship training, I was always interested in clinical immunology as in, how to take care of patients that have immunological problems. In that context, there are many pieces that come into play. One is, what is the clinical laboratory testing that I can do to assess immune function? That’s important. The other part is what is the clinical picture that a patient should exhibit for me to think about them having an immune system problem. And then there’s the research basic science piece that sometimes these patients are quite a mystery, and it takes doing experiments at the bench to be able to understand the root of their problem.
All those pieces came together for me at the meetings of FOCIS, where I went to my first FOCIS meeting when I was a trainee, and I saw people from exactly those backgrounds come together. It was the first meeting where I saw that these are people who work in clinical laboratory, you know, CLIA Certified Labs, standards, clinical assessments designed to understand the immune system. These are physicians and physician scientists who think about immunological problems. And then these are basic science researchers who think about immunological problems. And I think the three pieces of my training came together at a conference, which was an unusual experience for me. That’s how I came to learn about FOCIS.
14. How do you think FOCIS has changed your world?
I think it has helped me understand how to link those three pieces, right? When you’re very early in your training, I think it’s very easy to stay in your area of comfort, like if you’re a clinician and that’s what you’re comfortable with and seeing patients, it’s easy to say, I see patients that have immune problems. That could be autoimmune problems, right? You could be a rheumatologist, you could be an infectious disease doctor, who thinks about immune system problems because you get a lot of infections, and you get captured in that area of the world. But, going to FOCIS meetings where you see the three different pockets, like immune diagnostics, clinical care, and basic science research, all revolving around immunology, brought clinical immunology in full circle for me.
15. If your colleague asked you why they should join FOCIS, what would you tell them?
There are many different conferences that showcase research immunology, that have immunology as a centerpiece. For example, there’s the American Association of Immunologists, and mostly it is basic science immunologists who go there. Then you have something like clinical immunological societies, and there you have a mix of physicians, physician scientists, but all kinds involving immune deficiency or inborn errors of immunity. Then you have something like the AAAAI, the American Academy of Allergy, Asthma and Immunology, which has an immunology theme too. But then you have practitioners there. All these meetings have a theme around immunology, but it attracts what I call the one pocket, right? FOCIS is the place where you have the immune diagnostics, the clinical care, and the basic science, all revolving around immunology in one place. And that’s pretty unique to FOCIS. And I think, as a faculty member going to those meetings, that means you get to interact with all those different areas of looking at immunology. I find that is what makes FOCIS unique.
16. We’re going to talk a little bit now about your FCE. Can you tell us about the research that you’re doing?
In my lab, we have two major areas we study. Across everything, we study the immune system. I’m a basic science immunologist and a card-carrying clinical immunologist. I’m a pediatric immunologist, which means that I tend to like to study immune diseases that affect children. There’s two pockets. One is what I call classic autoimmunity. For example, we study Lupus. We have been studying Lupus for many years, particularly in children. Lupus in children has an earlier onset and is more severe. We focus there and we tend to focus on Lupus that affects the kidneys, so Lupus Nephritis. Then in the area of autoimmunity, other than Lupus, we’ve also collaborated with many other labs to study Type One Diabetes, to study multiple sclerosis. Then there’s another section of my lab that studies inborn errors of immunity.
These are disorders that, unlike autoimmunity, tend to be very, very rare. They are genetic mutations that affect specific pathways that then render the patients susceptible to infection or present with autoimmunity, with autoinflammation. And that’s more of a disease discovery, understanding mechanism of disease area, of my lab. We like to use the fancy toys that nowadays constitute the backbone of a lot of the science that we do, where basically you get to single level solution, lots and lots of different dimensions to be able to understand and look at many things at once. And we do that looking at tissue as well as looking at immune cells in the periphery, meaning in circulation.
17. What is the vision/your dream goal of your FCE?
As an FCE director, my goal would be, that we, as a center, are able to actually contribute and make the other centers more successful. I think a big reason why, I mentioned this earlier, is that my goal as a physician is to help the patients be the next version of themselves. My goal as a scientist is to enjoy leading my lab and then, essentially, making forward discoveries in science. But I very much enjoy helping make other people’s science successful. And I think as a University of Colorado Center of Excellence, we have a large repertoire of immunological expertise at clinical translation in basic science as well as a campus with a pediatric and adult hospital and educational opportunities. Whatever we can do to make other FCEs be more successful and to help them get to their next level, that will be my goal as an FCE.
18. What are your biggest challenges?
I think there are challenges. I actually call them language challenges. So, in the same way that I describe FOCIS as a place where we have the immune diagnostic and the clinical practice and the basic science all revolving around immunology coming together, we are all people that, because of those areas of focus, we tend to have expertise and understanding in that particular area. And nowadays, we are all about team science, which means having a multidisciplinary approach to one problem. While that is what makes the science successful, to have people of different backgrounds think about the same problem, it sometimes makes it difficult for us to understand each other and actually leverage each other’s expertise. I think that comes to be very true when we’re trying to have collaborations across institutions and collaborations across people that have different backgrounds looking at the same problem.
19. Why did you apply to be an FCE?
I think a lot about having a better understanding about a problem that you’re trying to solve is to just get a different perspective. This is why we tend to like mentors and tend to like to work in groups and this is why team science is successful, because you can have different perspectives on one problem. I thought that if we, as a university, became an FCE, it would give us the opportunity to network with the other FCEs and have different perspectives on the same problem. I figured that could only enrich our experience.
20. Anything else to add?
No, that’s it. I’ll just close with saying that, as an FCE, I think what I am most excited about is actually contributing to the rest of the theme of FOCIS and continuing to make FOCIS a successful group of immunologists from all walks of life. That’s what I’d like to say.
Those are all the questions for today, thank you for your time.