12 - Marion Smits on the Collaboration Superpowers podcast

MARION SMITS is an associate professor and neuroradiologist at Erasmus MC in Rotterdam, the Netherlands. She is also an honorary consultant and reader at University College London Hospital NHS Foundation Trust in London, U.K. She recommends paying for good internet on the road and setting boundaries between work and play.



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Marion shares:

I love working while traveling. I love the focus you can get out of a long train ride or plane – especially planes because there’s no Internet and no telephone, so people don’t bother you and you can actually get a lot of work done.

I’m quite a relaxed traveler. I find a quiet spot, get a coffee, and set the alarm for when I know I have to get to the gate so I don’t have to look at my watch. And then I focus on my work.

Podcast production by Podcast Monster

Graphic design by Alfred Boland


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Original transcript

Lisette: Great. And we’re live. Welcome everybody to this Hangout on Air. My name is Lisette Sutherland and I am interviewing people and companies who are doing great things remotely. And today I’m excited because we are going to dive into an area that I know absolutely nothing about. Usually we are talking with software developers or people in software teams. And today we have Marion Smits on the line who is an associate professor and neuroradiologist at Erasmus in Rotterdam and an honorary consultant and reader at the University College London Hospital NHS Foundation Trust in London. So that’s a mouthful.

Marion: It is [laugh].

Lisette: So welcome, Marion. If you have any questions, please send them from now or in the future to #remoteinterview and we’ll get those answered. But Marion, go ahead and let’s have you introduce yourself.

Marion: Thank you. That is a mouthful, isn’t it? [laugh]

Lisette: Yeah it’s a lot of titles and important…

Marion: Yeah. Primarily, my work is in neuroradiology. So that is what I was trained to do, to be a neuroradiologist. What I do clinically as a medical doctor is that I assess brain scans – that’s the easy way of putting it – which is what most neuroradiologists would do full-time. So that would be their job. But I have also an academic position. So about 50 percent of time I spend on clinical work and the other 50 percent on academic work, which means that I do research and that is what the associate professorship title is about. And at the moment I am on what’s called [inaudible – 00:01:44] although I’m actually working quite hard in London at UCL, and that’s the other title, the Honorary Consultant and Reader. So that’s basically the equivalent position I have in Rotterdam and have that here as an honorary position. That’s a very short introduction of what I do and my positions.

Lisette: So do you live then in both Rotterdam and London? Or do you travel back and forth a lot? What’s the situation there?

Marion: At the moment, I live full-time in London. I’m here for six months. I have just moved here, and I do not intend to travel backwards and forwards. It was the original plan when I first came up with it. That’s how I sold it to my boss and the people I work with and my boyfriend who decided to come with me in the end. My Ph.D. students, I have five Ph.D. students in Rotterdam. They were a bit freaked out when I announced that I was going to move to London for six months. At first, I thought, well, I’ll go and see them once every two weeks, travel back for a long weekend and see them on the Friday or the Monday. But in the end, at the moment, I just supervise them remotely.

Lisette: Okay. So from London to Rotterdam is a pretty short flight.

Marion: It is.

Lisette: It’s a pretty quick one, actually it is. An hour and you’re there. You can even bike to the Rotterdam airport. So it’s pretty easy to come back. But you’ve decided to supervise them remotely. And I’m curious like what does that entail and how is it going.

Marion: Yeah. It’s actually going really, really well. We had to get used to it a little bit at first, mostly because we could see each other on Skype and ourselves on the camera all the time and we’re checking our hair all the time. But we got past that. We found, very quickly actually, a way of working remotely. In Rotterdam, I see them once a week anyway. They’re not in an office nearby. They have to walk 15 minutes. The hospital, Erasmus MC, is absolutely huge campus. So they’re in a separate tower. So I didn’t see them on a day-to-day basis anyway. Actually, I see them just as regularly now as I did, but just now over Skype than I saw them in Rotterdam but in person. It’s different, but a lot of them are mostly writing papers and need help with writing. So they send me the paper by email. I send them my comments back just in the Word document. And we discuss it over Skype. We use screen share a lot as well on Skype so that they can point out things that they have questions about or they want to discuss further. The other thing that we started using a lot, but again we already started that in Rotterdam, is that we have shared Dropbox folders quite a lot. So when they have a document or a large data set or something that I need to look at, they would put in the Dropbox folder and I can just look at it in my own time. So that is not that different, actually, from when we were in the same place. So it’s just the personal meetings we had once a week that are now remote. We can still talk, we can still see each other. So it’s actually not that different and it works really well.

Lisette: It seems that there are a couple of senses that are missing which are important. You don’t have the sense of the touch or smell, and maybe smell is okay. There are whole senses that are missing when we do it over Skype. However, we still have the sight and we still have the sound, and those are the main ones that are needed. Is there any degradation in the relationship at all because you’re doing it via Skype?

Marion: No, I don’t think so. I really do prefer seeing them. I do want the visual input. As you say, you need the senses. I don’t think I miss much. I don’t think it’s going to be so much easier when I’m back. I’ve joked actually about this because they have to walk, I make them walk to my office in Rotterdam, 15 minutes there and back. I say, well, we can just continue this on Skype when I’m back in Rotterdam. And they were like, yeah, yeah, it’s fine.

Lisette: It’s the commute time, I’m assuming.

Marion: Yeah exactly.

Lisette: 15 minutes is 15 minutes. And on the other hand, they have 15 minutes back. That’s half an hour in a day. It does add up.

Marion: Yeah, exactly. It was a joke but it was for both of us, actually, like yeah, that’s absolutely fine. The other thing I do with them: once every two weeks, I have the whole group together, so my whole research group, them, as well as some other people that are interested in my work, some students, or our work, much as my work. So we have a regular meeting every two weeks. And that is a bit easier when I’m present. But again we still do that over Skype. So they will have me on the iPad and they make sure that I can see the screen or the person that’s talking. And it does actually work surprisingly well. I even have chat meetings like that. The interaction, everybody got used to it quite quickly. It saves me a lot of time because that meeting is always at a distance for me.

Lisette: They’re all in the same room together and you’re on the iPad.

Marion: Yeah. The only thing that is sort of missing is my remote control to control my iPad as it were in a meeting.

Lisette: So the movement that you could have there, the telepresence robot which they have now.

Marion: Yeah, that would be perfect.

Lisette: You mentioned in the beginning when you were first moving that your students were a little bit freaked out by the distance. What was it that they found so… I’m sure they knew about Skype and video. They knew that you would have contact. But what do you think…

Marion: I think we all had to get used to the idea that we wouldn’t be seeing each other face-to-face, although we do actually see each other face-to-face now. But we’ve never used that before. So I think they were just worried that they would lose contact, would lose touch. And I think we’re all quite happy with the situation now. In a way, it’s almost better because we’re better prepared generally. There’s also an early way because you have to be at a certain time online. What happens a lot is that the student, when they come to me, they go and grab a tea or coffee and then wander around a bit. We have that flexibility, which is fine, but we have a much better time management at the moment because the next one is going to be on the line and I can say, well, the next one is on the line. Oh yeah, yeah, hang up. So it’s actually much easier for them as well.

Lisette: And more focused it sounds like.

Marion: It’s more focused, yeah, exactly. I’ve noticed with them as well that some of them share an office with a lot of other people. So they want to work from home sometimes as well. And they’ve started doing this Skype or meetings from home as well. I can see that they’re much more relaxed that they have been having a quiet day at home preparing the meeting, making sure that everything is ready, which is somehow much better than the rushed state we’re usually in when we’re in the office and trying to fit meetings in and people were barging in. Whereas when you’re on Skype, you can say I’m on Skype. You can’t interrupt. So actually, it’s more focused and much easier, I find.

Lisette: Is it because you’re having these remote Skype meetings that they’re actually working from home?

Marion: Sometimes yeah, because for them, there’s no need to come into the office. And that does mean that they can take their time as well at home to prepare the meetings. One of them has just had a baby, so she was pregnant for the last few months and had to work from home because she couldn’t move anymore. It was so easy to just keep in touch with her this way.

Lisette: I can imagine. I remember in university I would look into the grad student offices. It’s usually an office with or maybe these are Ph.D. I don’t know, I was just…I was looking in and I would see four or five people in one room trying to do work together. And I always thought… Different people need different things. I need to be totally alone. And so working in that sort of environment would be very hard for me. So it’s interesting now that people are choosing to work from home for the same reason.

Marion: Yeah, I think in a way you need both because I’m very happy that they are in the same room together because then they can talk and they can exchange ideas, but yeah, they have to be focused and that’s why I agreed with them when they said can we work from home for one day a week. So like yeah, of course. I do that one day a week. I need the people around me but also need a bit of peace and quiet to really concentrate sometimes.

Lisette: Is this unusual in the academic setting? Is the working from home unusual? What’s that world…

Marion: In the academic setting, it’s not so unusual. It is unusual for clinicians, for the people that work in the hospitals as doctors because you are supposed to be always there and you’re expected to be there and expected to be available. So then there is no real working from home even though I have the facilities to actually do also my clinical work from home.

Lisette: So this is interesting then. So then the expectation, the culture in the clinical setting is to be there. And I can see it because you think, oh, if you need to be around patients or people then of course you want to be there, but you’re not always around patients.

Marion: Exactly, and especially my work as a radiologist. We do see some patients. We do have some outpatient clinics for ultrasound, which is hands-on, so you have to be there. But a lot of our work is just looking at scans. And in fact we are based in three different locations in the hospital. So it doesn’t matter whether the scan is done in one hospital. I look at it in a different hospital. So we already, in ways, were almost remote working, even though you’re at work but in a different hospital.

Lisette: And one hospital is doing the actual scans and uploading them somewhere. And you’re in a different hospital looking at the scans.

Marion: Exactly, and making my findings available to all of the hospitals, especially to the referring clinician. So in a way we have all the facilities and I could potentially also do that from home.

Lisette: Except that it’s not in the culture.

Marion: Exactly. I can do it when I’m on call, out of office but not during the working day.

Lisette: It’s interesting because in the computer world, it’s very normal. People are with open-source in software development. A lot of people are very used to working from wherever. But it sounds like in the clinical world, this is a new concept. Is it a new concept? Is it something that’s being discussed? Does it come up? Or is it still…

Marion: It does get discussed. I know in our department it did get discussed because we had a problem with understaffing. So at some point, the people working part-time were asked whether they would be interested in the option of starting to work full-time. But they were taken as a part-time day to work from home so that they could still to a certain extent – obviously not with a newborn baby – to just be at home and still work. There was some interest but it never really took off, to be honest. I don’t hear of people doing this regularly. There are some, but that’s not really hospital-based, there are some private diagnostic clinics, like in the Netherlands [inaudible – 00:15:22] center which is just basically a scanning facility where they have radiologists working actually from home. And these are generally people that do this as a little extra, or actually the tired radiologists who keep up their skill by doing this. But those are new concepts that have not really made it to the normal hospital practice. I could conceive it working. It does work. We just need a change of culture.

Lisette: It seems like the impression that I get when I think of hospitals is that doctors work really long hours, and people involved in hospital work… It’s my impression. I don’t know if it’s accurate. But it seems like there are long shifts and long, weird hours and people are away from their families.

Marion: Yeah, we definitely work long hours and weird hours as well. But like I said, working day is still 8:00 to 6:00, Monday to Friday. Anything outside that would be considered on-call time, so evening, nights and weekends. For me, we have junior doctors on who will be in the hospital because obviously there need to be people there. But for me, that is perfectly acceptable that I’m not in the hospital and that I log in remotely when I’m called to look at the scan. It’s never going to be, but I think that’s true for any kind of work. You always need to be in touch with your colleagues somehow, especially in the Erasmus MC is a university hospital where we train a lot of medical specialists, as well students and medical specialists, so residents or registrars. We can do that remotely. We can do that on the phone and look at the scan together, but it is nicer and easier if you’re sitting next to each other and you can point at things and stuff. And the technology we use doesn’t allow for screen sharing, for instance. That does make it easier to just be there. But again, in a way, we have a system where one person will sit in a corner and look at the scans and not be disturbed, whereas another person will be doing resident supervision and talking to the clinicians and answering the phone or whatever. So in a way, we’ve already created that system that somebody doesn’t get disturbed, and that person could easily be at home, of course, which I would really like, to be honest.

Lisette: Yeah, it seems that given the weird hours at times and given the long hours at times, and if there are things that can be done in a more comfortable, quiet or whatever it is that’s nice for the person. But in your own setting, that would be very useful. You bring up an interesting concept of understaffing, which comes up a lot in the development world as well, except that people are more looking for specific talent. In a situation where there’s understaffing, this seems like a really interesting opportunity for remote work.

Marion: Yeah, it is, especially for more specialist jobs, as you say, as well. And in a way, that’s not particularly clinical, but I do quite a lot of specialist stuff as well due to my research. I implement that a lot in clinical practice. So when I left for six months, there was no way I could let anybody else do this. I’m the only person in Rotterdam who can do this. So those tasks I still do, even though it’s clinical work. I use remote desktop to do my analysis and I am in direct contact with the clinicians, with surgeons, to tell them my findings. So that’s quite easily done remotely.

Lisette: It seems like you’re showing it in this experiment of moving to London for six months, that you’re showing it this work can actually be done remotely.

Marion: Yeah, at the danger, of course, that they’re not really realizing that I’m gone, not leaving me alone.

Lisette: Yeah but that shows that it’s working.

Marion: Yeah, that’s true.

Lisette: So have there been any real challenges with doing your work since moving? I mean are there communication issues? I mean you’re saying that they don’t really know that you’re gone.

Marion: Almost, yeah. I think that’s the biggest problem, actually. And the biggest challenge is letting them know that I’m not actually available for everybody at all times. It’s so easy. My secretary, at the beginning, would just plan meetings. But you’ve got Skype. Looks like yeah, but the whole point is that I am away. So I’m available for my students and my collaborators, but I’m not available for just about everybody who wants to talk to me. They have to wait until I’m back. That still is a bit of a challenge, to be honest.

Lisette: Because it’s almost like you’re always on.

Marion: Yeah, and that is my challenge, of course, as well. That is the difficulty. I can do almost all of my work anywhere. And it’s very easy then to just always work. And I love my work. So it doesn’t help.

Lisette: What boundaries have you put in place for yourself? Because I have the same thing. I love my work, and sometimes my boyfriend is saying I need some attention [laugh]. Oh right, sorry, sorry. What things have you put in place for yourself for productivity to not always be on 24/7 because this comes up a lot with people who are giving knowledge?

Marion: I have to say I’m not very good at it. I mean at some point it just gets so bad that I tell myself, okay, no email after 8 o’clock or after dinner, whatever. And I keep that up for a bit and then that slips again. I am quite strict at sort of protecting time where I do exercise, and then also just especially for meetings with The States or whatever, what area can you make it for 9 o’clock in the evening as well. No, it’s just not going to happen. My boundaries are quite weak, I have to say.

Lisette: Well, when we love our work, then the work-life blend really comes into play.

Marion: Yeah, exactly. One of the things, I guess, I do – that’s why I am, because I can be quite flexible with work but also with not working then – is that I will say, well, okay, I’ve worked all of the weekend. When I travel, a lot of my meetings are on the weekend. So I tend to always use the travel time for work. So I then, during the week, say, okay well, I’ll take a day off and that’s it. So I do try to compensate a little bit but yeah never enough, of course. There’s always too much work to do.

Lisette: Yeah, finding balance is always a little this way and a little that way. I’ve only found that I found it for a moment and then it’s off again. And then I’m back to finding balance in work. You also mentioned another thing which is traveling a lot.

Marion: Yeah, correct. I travel a lot. Again, this is not typical of a radiologist or a neuroradiologist, but I guess it is quite typical for a person of higher academic rank. I am invited a lot to teach at international courses. I do a lot of European committee work. So I’m in a lot of scientific boards or committees. And a lot of the meetings are actually done over Skype or any kind of software. I still do have to go to a lot of meetings or conferences, often to lecture, to meet people, to network. And I’m on the road a lot. I’m inseparable from my laptop and iPad. And I’m generally online a lot. I love working during travel. I love the focus you can get out of a long train ride or plane – especially planes because there’s no Internet and no telephone, so people don’t bother you and you can actually get a lot of work done. And at airports, I have to say I’m quite a relaxed traveler. I don’t wander around airport or have to do all kinds of stuff. I just usually find a quiet spot or a lounge or whatever and get a coffee. I generally set the alarm for when I know I have to to get to the gate so I don’t even have to look at my watch – and then do my work.

Lisette: Sort of sit in focus.

Marion: Yeah, I don’t have to think about it then. I have almost missed a flight once because I was so focused, waiting at the gate in fact, so that taught me. It’s only because somebody tapped my shoulder and she said “Isn’t that your flight?” Oh, okay, yeah. In hotels I will always have the Wi-Fi option, however stupidly expensive it is. But I just don’t want to think about it anymore. It makes life so much easier. Again, these are the times that I can actually focus because there’s nothing else. I don’t have any other commitments then, and I’m there for work anyway. It’s not like I travel there for fun. I don’t have my friends or my boyfriend with me. So I just take the time to do work.

Lisette: And is it challenging finding Wi-Fi? Or is it just a matter of…

Marion: Hotels are generally okay for the Wi-Fi, especially if you pay for it. If it’s not, I will complain and say, look, I paid so much and I need it for my work. Conferences, generally, have good Wi-Fi. But I had a disastrous conference in May where I had so much to do and there was just no Wi-Fi at the conference center. It was officially there but my hotel was an hour’s travel, so it was meant that I was sitting in my hotel room and not going to the conference center – which is a shame because the whole point is that you do use the time between your meetings or whatever to actually go to the conference and listen to some interesting talks. So that was one example where it was very clear that the lack of Wi-Fi really interfered with me enjoying the conference.

Lisette: Right, that is number one rule of remote working, which is the Wi-Fi has to be great.

Marion: Yeah, you have to be connected.

Lisette: Interesting. That’s a common travel challenge for people when they’re doing work. It’s interesting to bring up the point of being able to focus better while traveling, which is a bonus, not having the Internet or the phone on. I found that also in my travel. And the importance of having good Wi-Fi when you travel. You say that that’s not typical of a neuroradiologist to do all this traveling.

Marion: No, their base of work is the hospital and they would go to one or two conferences a year, a conference or a course to keep up to date. But I do at least once a month, if not more. So I usually have two trips a month, and a lot of that is actually weekend stuff. That is quite typical of the medical profession that our conferences include the weekend which is the busiest time because that means people will go there. They don’t have to take off time of work. I have to say, that is a difficult balance to find where there are a few weekends left for spare time.

Lisette: Right, I bet. The odd hours really can drain energy.

Marion: That is also typical of our profession, is that you are a bit of a wimp if you complain about working out of hours. You shouldn’t have become a doctor if you didn’t like that, whether that’s teaching or doing actual hospital work. Obviously, in a hospital patients getting sick, and people can get sick any time. So you shouldn’t complain about that. But doing your actual education or other stuff is a bit ridiculous and it’s loads of hours as well.

Lisette: So it sounds like if the culture in the hospital is that people need to be there, and you have done now this unusual experiment that you’ve gone somewhere else. You’re not working in the hospital setting. And on top of that, you travel more than most neuroradiologists. And so has there been any kickback from the people that you’ve worked with? Are there people who are not pleased with the situation? Or is everybody generally understanding?

Marion: Well, they’re mostly understanding. If anything, some people are envious because they just like to travel too and they’d like to be on the road too. The downside for me is especially the clinical work still needs to be done, especially the on-calls will still fall back on… I still have to do as many as anybody else. So I have to work as many weekends. I have to mark as many evenings and because I travel so much. That means I have many that I’m not in Rotterdam. And therefore, the weekends that I am there, I am very often on call because they are concentrated on those weekends. So that is the downside for me, which is fair enough. That’s just a consequence of what I do. The work still needs to be done. I know my colleagues do have to cover for me while I’m away, which does mean that the days I am there, I tend to take on as much as I can. And also, I am quite often available for them if they do have issues. I say you just call me and I’ll log in and I’ll look at the scan with you.

Lisette: So in a way you’re overcompensating.

Marion: Yeah, a little bit, I suppose. I’m trying to compensate.

Lisette: Right, or maybe hypercommunicating, overly communicating and being in touch with people more because you’re away. It sounds like if you’re away and then you have to be on call a certain amount just as much as the other people, that when you come back, there’s no free weekend at all. Either you’re on call or you’re away.

Marion: Yeah, very few. Now that I’m in London, I’m not on call. For these six months, I’m actually experiencing free weekends. I do realize how nice it is, actually. I had forgotten.

Lisette: Stepping up in a new world.

Marion: Yeah, exactly. I suppose it’s going to be tough going back.

Lisette: Do you think the clinical culture will change more to be more remote-focused? It sounds like lots of things are set up in order to be able to work remotely. You’re already working remotely in some ways. You might be in different places in the same building or in different hospitals. But do you see that culture changing?

Marion: Maybe a little bit but I’m not sure. We’ve been thinking it’s going to change a lot. And for radiologists especially, we saw a really big threat of basically outsourcing to cheaper countries because it doesn’t matter where the scan is done and where the patient is as long as there’s a report from somebody who is good enough to read the scan. It could be from anywhere. And this teleradiology has been considered a real threat to radiology, especially in the English-speaking countries where the Indians can quite easily do the work for half the world. And it’s also been seen as an advantage because then you don’t have to do night shifts anymore because there’s always somebody awake somewhere in the world. But somehow that hasn’t really because it’s just been possible for at least a decade. It’s not really taken off that massively. Quite a lot of our work is still personal to be a person in a meeting where you discuss a patient with a surgeon and with whoever is treating the patient. I think it’s still going to be very much work or place-based rather than remote, our work.

Lisette: I just read about this teleradiology. I can’t remember the name of the book, The World is Flat. It was something like the World is Flat and I was just reading. Also in virtual freedom, the author talks about people who are outsourcing this kind of work to cheaper countries, to people who can read these scans somewhere else – like you said that you don’t have to do the night shifts anymore. That’s possible too.

Marion: It seems like there’s still a big element of just trust because it’s just a tough job. It’s just a difficult job and there’s always a level of uncertainty. There’s always a certain element of interpretation rather than just knowing for certain what something is, I mean some things obvious. But the number of scans I get to see that have already been reported by somebody else and then the treating physician says, well, I don’t know this person who’s reported the scan. Could you just have a look at it because I trust you? And that is such a big element. And I get that still while I’m in London. I sometimes still get that question. Could you just log in and see whether you agree because we don’t know this person. And it takes people a while to get used to it. And in a way, that’s good because you want to have the treating physician to do whatever they can to get the right diagnosis. And it’s always good to have several opinions on something that’s difficult. I think that’s why it never really took off because you end up reading the scans anyway, so you’re not really going to outsource and do the work, so pay double, basically.

Lisette: Because you have to do it again anyway after it’s been done. Very interesting because you’re right. It has been around. The capability has been around for over a decade, for sure, and it hasn’t taken off. There are a number of things we’re the same way. I mean remote working in general has been available for at least 25 years, if not more, in a real, very serious way, and hasn’t taken off as quickly as we thought. And it’s interesting that you say that trust is the reason because that is the reason in every other situation that I’ve heard as well. It’s that people don’t trust each other or they don’t trust the results because they don’t know the person or whatever. But trust is the reason. That I find very interesting. So somebody wants to know from you what do you think because they know you and they’ve worked with you and they have a confidence with you.

Marion: Yeah, exactly. And somehow, you only build that confidence by being there as a person. And I’ll have to say, I’ve noticed that now in London where nobody knows me, well the researchers know me but the clinicians don’t. And I don’t do clinical work here. I only do research here. But I still need their input. I still need to include patients in studies. I’ve been introduced to people numerous times. I’ve introduced myself numerous times. They all forget who I am. And they don’t respond to my emails at all even though I’ve been introduced. I’ve introduced myself again. This is a study I’m doing. I need patients with this study. We’ve agreed to do this email and nobody will respond. So you need to build that… They need to know what I do. They don’t believe just my long list of titles. If I read their scans for three months while I was here, I’m sure they would be more than happy to provide me with any… Because that is the working relationship I have in Rotterdam. So I know what it could be like. I now see what I’ve built, which is lacking in that department, to be honest.

Lisette: Interesting. So because of your in-person relationships, then you’re able to ask more.

Marion: Yeah.

Lisette: Yeah, that makes sense.

Marion: Yeah. Of course, that makes sense. So my remote work is all work for Rotterdam, and that’s why I have my relationships. So in a way, obviously, I had to build those relationships first – whereas the other way around, I’m actually here in London and I don’t get my studies going at the moment. I’m sure if I sit in that office for a little while longer, I’ll get there. But it’s taking me a lot of time.

Lisette: So it’s because you haven’t had the in-person relationships in London yet. So it’s funny that you’re actually in London but it’s more remote than what…

Marion: Yeah, in a way it is.

Lisette: Have you had professional virtual relationships where you’ve not met the person before ever and it’s been completely virtual from start to finish?

Marion: I mean not close collaborations, I think. There have been people in meetings that I’ve only spoken to remotely, but never one-on-one, I think. I have to say, if I start working with somebody, I contact them. For instance, I organize a European course once a year and I always try to meet in different hospitals in Europe. And I don’t usually know the person who is locally organizing, yet I’m doing the general organization. So I tend to really just meet up with them somehow at first somewhere at a conference to say are you going to be there or whatever. And then it takes off just fine. I mean I find it important as well. I value it. I’d like to meet somebody face-to-face first.

Lisette: Yeah, I mean it’s always ideal when we can be face-to-face. I’m really looking into the exploration of what if we can’t meet face-to-face. What happens then? If somebody is just on the other side of the world or there’s money issue or whatever the issue is, there are millions of things that get in the way of us meeting. What happens then? So I’m looking closely into professional virtual relationships to see what happens, and you’re right.

Marion: Yeah, although I have to say, when it’s a Skype meeting, I think that makes up for a lot and could actually be just as good or even better because I quite often meet people at conferences. And then it’s so busy. There are always hundreds of other people that know the person that you want to talk to, or vice versa. If I meet somebody at the coffee bar, the conference center, there are so many people that will interrupt because they see me and they want to chat – or they see the other person and want to chat. And it’s like, well, we’re actually in a meeting here. So in a way, Skype is actually more focused and isolated. But what I noticed is that not everybody is as comfortable with it as I am. And that is a big problem that a lot of people I work with, they say, oh, I don’t know about Skype. And Google Hangout is definitely not something people use. And it’s like, oh, can’t we just call? And I hate the telephone. I hate it. I just can’t do that.

Lisette: Interesting. It didn’t occur to me that people would be… My world is that I’m surrounded by these tools and I’m a tool junkie myself. So I don’t think of it like this. But it’s a really good reminder that not a lot of people are very comfortable with some of the most very basic things that people use, like Skype.

Marion: The people that do use it is my generation and younger and a lot of the people I work with are older. I am in a position in which most people are a lot older than me. So they haven’t grown up with it. I’m not saying that my generation uses it a lot work-wise. But a lot of people use it to keep in touch with their kids and whatever and they’re used to it. That’s the only thing that hasn’t worked while I was here, that I’m secretary of the board for the Dutch section of neuroradiology. And I set up Skype meetings. I said, well, I’m not in the Netherlands. We do this remotely over telephone generally. And I said that’s going to be expensive for me And I did Skype and it’s been a total disaster.

Lisette: Because you get the video component which is so useful to have…

Marion: Yeah, that’s even, I didn’t even try. We couldn’t even connect. They wouldn’t find. They had to find somebody to help them install it on their computer. I gave up. I thought I’ll just use telephone. It’s difficult because I’m thinking why do you need somebody to install it? You don’t need tech support to install Skype. And then they’d be like, oh yeah, I guess we don’t have good Internet here. It’s like, well, you do have a laptop. Find somewhere with good Internet. You know that this is important. That realization is just, well, this doesn’t work – just like your phone wouldn’t work if you don’t have a connection.

Lisette: Right. What’s surprising to me is that these are not dumb people. These are all highly educated, highly technically savvy in a different way, people. It’s really an eye-opener and a good reminder, I think, that the technology is really a barrier.

Marion: Yeah, it is. It surprises me, to be honest, because as you say, these are smart people. I mean radiology, we are the technical crowd in a hospital which is not technical. We’re supposed to be at least a little better.

Lisette: You have to deal with complex equipment, I’m assuming. Not a lot of regular people can use it.

Marion: And it’s not that they can’t do it, because of course they can. It’s just resistance. I’m the one who uses social media. Skype is not social media.

Lisette: Well, the generational gap is really important one for most industries and actually really inspires me to look further than the industries that I’ve been looking into other places as well because I think that this is an issue. Not only is culture an issue but also this generational gap that really is a serious issue.

Marion: Yeah, and people, especially if they’re not used to it a lot… I do a lot of online meetings and stuff like that. But there are lots of people who don’t and they don’t have the etiquette. They will not mute themselves on a meeting or don’t have the equipment. So they won’t have a sign on the door that they can’t be disturbed. You hear their beepers on the phone or whatever and they usually take the phone call as well while they’re on the meeting, not on mute. I can sort of understand that if you’re not aware and you don’t use it a lot, then it’s actually not obvious. There is a lot of education required as well sometimes.

Lisette: Yeah, there are rookie mistakes. We’ve all been there at one point, but usually it’s been a long time ago. When I interviewed NASA even – that was an interesting interview – but they do a lot of hand holding for all their researchers all over the world. They really take people and they set them up with the right equipment and they have particular lists of things that they must have if you want to work together. But they really do one-on-one sessions with many, many people to get them all being able to collaborate remotely.

Marion: That’s interesting. But I think that really, really helps because as I said, I do stumble my way around a little bit. And hopefully, you see somebody else make the mistake before you do it and realize that you shouldn’t do that. But yeah, it’s so much easier if somebody actually tells you how to do it.

Lisette: Right, and it’s a different culture. I mean we have NASA who have to work remotely. It’s the extreme remote working, really, if you think about intergalactic working and exploration. I think it would have to become more a part of the academic culture and the clinical culture for that kind of hands-on education to happen. So we’re nearing the end of our time. This has been great. I knew I’d learn something new today. Good reminders. Only one final question, which is if people want to learn more about you and what you do, what’s the best place to find you?

Marion: I do have a website which I don’t update. That’s marionsmits.net. And I have a LinkedIn profile which just shows who I am and what I do. And they can always email me.

Lisette: And a Twitter profile as well.

Marion: Yes. So I’m @marionsmits.

Lisette: Great. So marionsmits.net and @marionsmits on Twitter. And of course I’ll post these in the show liner notes for everybody. Is there anything else that I haven’t covered that you had in your notes?

Marion: No. My notes have gone to sleep. Let me see. I think we’ve done most of it.

Lisette: I just want to make sure because sometimes there’s a new subject or a new topic like neuroradiology which I know nothing about. Sometimes I don’t know which questions are the right questions to ask.

Marion: Yeah, neuroradiology always talk about loads anyway. I think I don’t have anything else.

Lisette: Great. If I have any follow-up questions, I’ll be sure to email you.

Marion: Great.

Lisette: Thanks so much for your time today. I really appreciate it.

Marion: You’re welcome.

Lisette: And until next time, everybody, be powerful.


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