International Women’s Day 2022: Dr Elizabeth Renzoni

To celebrate International Women’s Day this year we interviewed two female colleagues working in research at Royal Brompton & Harefield hospitals.

In this interview, we spoke with Dr Elizabeth Renzoni, a respiratory consultant at Royal Brompton Hospital and an honorary senior lecturer at Imperial College London.

Elizabeth works in the Interstitial Lung Disease Unit at Royal Brompton Hospital which is dedicated solely to patients with ILD.  It is the largest unit of its kind in the UK, and one of the largest in Europe.

Read her interview below:

What inspired you to get into research? What excites you most about working in research?

My father was a researcher in marine biology and he was always very enthusiastic about research. I think it had an impact on me because he would discuss his work with me and so I had an idea of what research was from an early age.

I’ve also always liked thinking about how things work, especially the mechanisms by which the body functions in normal and disease states. When I was 13, we went with my family to the Natural History Museum in London and I remember being fascinated by an exhibition which explained how the body works, it was incredibly well done and got me hooked!

Often research is just tiny little steps that everyone makes and together contribute to greater leaps in our understanding.  It takes patience and can at times be frustrating. But what I like about working in research is that you get to contribute to certain aspects of your field, even only making small changes but still contributing to the larger understanding of diseases and human health. It is exciting to see how much the field of lung fibrosis research has moved on over the last twenty years, with better understanding of disease mechanisms and increasing options for treatment, although there is still a lot of work to do.

Another thing that is great about research is that it’s always carried out as part of a wider team, sometimes including patients.

What are the most challenging aspects of research? Do you mind sharing how you worked to overcome these?

Initially I was worried that I didn’t have all the right skills to do research because I thought I would have to do everything myself and be good at all aspects of research. But over time I gradually realised that wasn’t the case.

Although you need to undertake training and acquire certain skills yourself, you can also reach out to collaborators because research is ultimately a team exercise. For example, I can do statistical analysis but I’m not an expert at the complex statistical models needed for very large data, so I work with collaborators who can advise and help perform these more complex analyses, when needed.

Another challenging aspect of research is finding funding for research. I’ve had both successful and unsuccessful funding applications, and it can be quite demoralising when you work for months at a time to write an application, to put it together and not get the funding. The process for applying for funding can take a lot of time from you and the other people you’re working with. But if you’re unsuccessful you just have to keep trying and stay motivated. And sometimes what can happen is a proposal that initially didn’t work can unexpectedly form the basis for another research call that is successful.

And finally, I do feel that there’s too much bureaucracy involved in research sometimes with all the different approvals that need to happen. I do feel that could be streamlined more to free up the researchers to be able to actually carry out research.

What's been your greatest accomplishment in research so far?

I would have to say it’s probably the AmbOx trial which looked at the use of supplemental oxygen (ambulatory oxygen) in patients with fibrotic ILD whose oxygen saturation dropped during a 6-minute walk test. The study was successful and demonstrated an improvement in quality of life for the patients, which was the primary outcome.

It was a clinician-led study meaning I was involved in the whole design. We had funding from the National Institute for Health Research, and there was a lot of work involved, with a number of challenges. However, thanks to all the various people involved and the sheer determination of everyone, we managed to complete it.

It was a successful study that led to a change in the American Thoracic Society guidelines for ambulatory oxygen in ILD, which now means patients with ILD whose oxygen levels drop during  physical activity can be offered supplemental oxygen during activities, even if their oxygen is normal when they are resting.

So the whole process, from coming up with the idea, designing the protocol, finding the funding, finding the centres to collaborate with and completing the study (despite several setbacks!) was an achievement for me and my team.

Are there any women, either in your field or outside of it, who you admire and why?

One person is Dame Margaret Turner-Warwick, who set up the ILD service at Royal Brompton Hospital. I met her a couple of times over the years, although she had already retired by the time I started working at the hospital. On one occasion she showed me the original x-rays that she still kept on a study she had carried out as a PhD student on new vessel formation in pulmonary fibrosis, and her enthusiasm for research was clear. She was a formidable woman especially considering she entered the field of respiratory medicine in the 1950s, when there were very few women in the field.

She was an outstanding clinical researcher and although I never worked with her directly, I’ve heard from so many colleagues that she was also an exceptional clinician. Without her, the current ILD Unit, renowned over the world for its clinical care and research in interstitial lung diseases, would not exist, and we owe her a huge debt of gratitude. Indeed, the Margaret Turner Warwick centre for fibrosing lung disease at Imperial College was launched in November 2021 in her memory, as the only UK research centre dedicated to the study of lung fibrosis.

The second person would have to be Dr Silvia Quadrelli, a respiratory physician based in Argentina, whom I admire greatly. We met a few years ago when she invited me to do a presentation in Buenos Aires. Since then I’ve got to know her quite well.

Not only is she a brilliant clinician with great humanity and passion for her work in ILD and lung cancer, but she is also an outstanding leader and organiser, and is, among other things, the president of the Argentine Association of Bronchology.

Even more impressively, she is  cofounder of an organisation known as Doctors of the World, which organises international humanitarian and medical support working with several countries. She has personally coordinated and organised humanitarian assistance in countries like Afghanistan, Kosovo and Iraq.

And on top of all that, she’s very passionate about education and supporting junior staff. So I greatly admire her for these various roles, plus she’s incredibly humble!

What advice would you give a junior colleague who is considering research as part of their career?

I would say that it’s important to think about research early on in your career because it’s better to think and plan ahead. Nowadays, there are predoctoral schemes available which allow both clinicians and non-clinicians to dip their toes in the water to see if research is for them.

I would also recommend getting a mentor early on to advise you because it can be difficult to find your way in research and source funding. Over the years, I’ve had two informal mentors myself, to whom I am incredibly grateful, and can see the advantage of finding someone early on.  

And finally, it is important not to get discouraged by setbacks; if you like research it is definitely worth persevering!

Read the interview with Catherine Renwick, consultant paediatric nurse