What does it mean to be a “clinical researcher” not “researcher”

A few days ago I got this blog going again after a long break with Realising that I’m a (retired clinical) researcher, not an amateur statistician

I guess it’s healthy behaviour for a hermit to reflect on identity and occupation. So does it matter that I say I’m a “clinical researcher” not simply a “researcher”? It’s an interesting claim as some of what I do can be very geeky, can seem very abstract. I’m interested in, and trying to start doing, research that is pure simulation work. Some of my favourite papers have been very mathematical and some of the statistical methods I use are a bit at the “bleeding edge” (that’s mostly a computing joke about things being at the “cutting edge”) so I get responses like “I can’t say I understand it, but feel reassured by your email 🙂 ” I don’t set out to be unclear or esoteric but some techniques aren’t familiar if they’re not your specialist realm. I’m not very clever, I have always been hopeless at mental arithmetic, I’m useless at chess, I just find a niche with mathematical ways of trying to see and understand meaningful and generalisable patterns in data.

So I’m a researcher. Yes! And it happens that most of my research, all of it really, has been in the general area of clinical work, starting off back in the 80s in medicine and community medicine or public health medicine, and moving into psychiatry, mental health, psychotherapy and counselling.

However, when I say I’m a clinical researcher I am mean that I want my work to have a line from human interactions in which someone, or some group of people want help with something, through the data and back to that situation. I can really enjoy playing around with the abstractions that help us with the data in the middle of that loop from the clinical encounter back to it, but I want to remember that the data isn’t “natural sciences” data, it starts out in humans and human relationships, and it must go back to to that.

For me that means that findings are always approximate, our models are always simplifications, often gross simplifications, their generalisability will always been limited and limited in many ways: to particular social groups, to particular cultures or languages, often to particular periods of time, particular services. That can feel frustrating when we want certainties and control, perhaps deeply frightening when the “clinical” is about pain, suffering, disability and that death will come for all of us. Of course, faced with these things, we want, science, we want medicine, we want psychology, to have answers, hard answers, certainties. Surely if we can make planes fly, get humans into space and on the moon, we can have certainties. Sadly, I am sure the true clinical researcher’s answer to that is “no”, “no, sorry, we really can’t”. Sadly, I think the rewards in our society for pretending otherwise are huge and their effects toxic. I think I had an easier time being my sort of clinical researcher starting out in the 80s than I would have now. The career path I had of combining clinical work and research in roughly 50:50 proportions wasn’t easy but it was there if you went for it. Now it’s pretty much gone at least in the UK and I think, most of the developed world.

On this chilly theme, some more icicles.