I've often thought that a university and an academic health center are more than just places where talented faculty, healthcare professionals and biomedical scientists do their work – this is also the place where these professions reinvent themselves to stay relevant and to best accomplish the work that improves lives and transforms health. That is why I so enjoyed having UC Davis alumnus Wilson To PhD, the head of Worldwide Healthcare Business Development for Amazon Web Services (AWS), as our 2019 Highman Lecturer last month. Wilson gave us a thought-provoking view of digitally-enhanced data-driven healthcare that AWS and others are fostering. It was an opportunity for everyone — regardless of specialty, discipline, or role — to think about transforming what we do through the amazing new tools available, as well as how we all need to reinvent ourselves to fully realize our potential and the potential of these new technologies to benefit patients and communities.

Wilson To shared many wonderful and creative examples of innovation in healthcare delivery during his talk, but one of my favorite insights came during an informal lunch discussion. Wilson was commenting on his formative experience as an undergraduate in our department's Edmondson Summer Research Internship program during which he worked on intravital microscopy in the laboratory of professor emeritus Tony Cheung, work that Wilson later continued as a post-doctoral fellow in our department. Wilson noted that one of the most valuable lessons from his experiences here was that he learned “the art of the possible”. As I mentioned during my introduction to Wilson's lecture, this was a beautiful way to describe the awakening of young minds that we all hope to achieve in our roles as educators and mentors.

But what really is the “art of the possible”?

Otto von Bismarck, the first Chancellor of Germany, coined this phrase when speaking about politics: “Politics is the art of the possible, the attainable — the art of the next best.” The “art of the possible” has commonly come to reflect pragmatism, and that perfection is the enemy of good enough (one of my favorite phrases) since seeking the perfect solution or path can often prevent progress.

Needless to say, science can be very different from politics. As blogger Tom Cheesewright notes (https://tomcheesewright.com/the-art-of-the-probable-the-possible-and-the-desirable/): For me, science is a much more optimistic 'art' of the possible than politics. It explores the boundaries of what the laws of physics permit us to achieve, pushing back those boundaries with knowledge all the time.”

Michelle Nyman, Executive Director of National Council for Science and the Environment (https://www.ncseglobal.org/ncse-essays/climate-science-and-art-possible) also reflected on the art of the possible in science: Science serves the public good and can lead society toward solutions…. Science brings substance to policy deliberations through evidence-based research and analysis. Science serves as the foundation to the solutions…. Science offers hope and continually informs the art of the possible.

I believe that our job in academic pathology is to push against boundaries to find possibilities in the seemingly impossible – and ideally to put these newly discovered possibilities to use to bring hope, as Michelle Nyman had emphasized. The influence of diet and gut microbiota on cognitive disorders such as Alzheimer's disease was previously considered to be an impossibility – but our Vice Chair of Research Dr. Yvonne Wan and her colleagues have created a body of work to demonstrate that this is the case and just received a new $2.7M grant from the California Department of Public Health to bring hope by continuing this work. A computer that could predict which patient will develop acute kidney injury as well or better than a human was considered an impossibility — but our Vice Chair of Graduate Medical Education Dr. Hooman Rashidi along with Clinical Chemistry and Point of Care Director Dr. Nam Tran have proven this possible in their soon-to-be published paper in the journal Burns. And who would have thought that we could improve the throughput in a very busy emergency room with a single lab test, like our new cardiac troponin test has done, or that we could reduce the time to a positive blood culture by almost two days, a previous impossibility that brings treatment to patients faster, thanks to the new Biofire instrument and the recent validation and implementation by our laboratory team. These are just a few of the impossibilities we make possible in our every day work at an academic health center.

We want – and need — to do more. To paraphrase Christopher Vollmer in Forbes (https://www.forbes.com/sites/strategyand/2014/10/28/the-art-of-the-possible/#2443918e7257), pathology, lab medicine and biomedical science “need to take a leader mentality and imagine the art of the possible.” He notes that we need to ask ourselves: “ 'What can we do now that we couldn't do before, thanks to changes in technology and user behavior?' That's how great organization drive toward leadership in times of disruption.”

Stepping up as a leader may seem like yet another impossible task, but the opportunity to creatively address important challenges is why so many of us choose to work at an academic health center. Last month, we celebrated César Chávez Day, a holiday for the University of California. As César Chávez famously said, “Sí, se puede” — “Yes, we can”.