Nolan Stain

Interviewed by Zehra Azim

Defying all odds, Dr Nolan Stain has emerged as a trailblazer in healthcare. The clinical leader at Barts Health NHS Trust and Vice President of The Society for Cardiac Science and Technology is reshaping healthcare science through innovation and advocacy.

Can you tell me a bit about your background and upbringing?
I was born and raised in South Africa until the age of 23, when I moved to England. I was diagnosed with dyslexia, ADHD, and dyspraxia at a young age. I attended a special needs school for several years before transitioning back into mainstream education with accommodations like having a scribe, extra time, and leniency for grammar / spelling errors. Growing up LGBTIQ+ and neurodiverse in South Africa in the 1980s-90s certainly shaped my perseverant character.

What was your childhood like, and how did it shape your interests and aspirations?

My childhood had challenges, as being neurodiverse and part of the LGBTIQ+ community in South Africa presented some difficulties. However, it led to me to develop a sense of determination and tenacity from a very young age. The only way for me to achieve my goals was to keep trying despite the challenges that came my way. I learned not to give up easily, a quality that has served me well in my career.

How do you balance your personal life with the demands of your research career?

Maintaining a healthy work-life balance has become increasingly challenging as the demands on my time keep growing. Between my main responsibility of leadership, research and innovation collaborations with colleagues, external partnerships, commitments to my professional body, and ongoing awareness efforts, it can be difficult to find equilibrium. I'm grateful to have an incredibly supportive husband who understands the nature of my work. We do, however, make conscious efforts to set boundaries – if I've worked multiple weekends in a row, I make sure to take a break. To unwind and recharge, we travel frequently to Spain and other destinations across the world.

 

Can you walk me through your educational journey?

My educational path has been quite non-traditional. I started with an undergraduate degree in Accounting at Cape Peninsula University of Technology and considered pursuing a law career at one point, but always had an interest in healthcare. After moving to the UK, I started a job as a trainee cardiac technician (now called a cardiac scientist) which involved a 2-year higher certificate qualification. I went on to pursue a master’s degree in Cardiology  at the University of Brighton and later a postgraduate diploma in Management Studies at Birkbeck, University of London. My doctoral studies at the University of Westminster focused on improving patient pathways, help-seeking, and access to care for chest pain.

 

What inspired you to pursue your field of study?

My journey into the cardiac sciences profession was sparked by reading about it in a career book from the library in an era where the internet was not widely accessible. Interestingly, this discovery was preceded by a novel I had read about the pioneering journeys of individuals who were "different" in some way as they pursued careers in medicine and healthcare in the 1960s. As someone who identifies as LGBTIQ+ and neurodiverse, their stories resonated deeply with me and served as a true inspiration. Although I had a keen interest in science subjects like biology and chemistry during school, I was initially reluctant to pursue them due to my dyslexia, opting instead for number-based subjects like accounting where I excelled. However, life's paths ultimately led me back to my passion for science, and I embarked on this rewarding profession.

What inspired you to pursue your field of study?

Absolutely, I had several key mentors who played a pivotal role. One of my teachers, the late Mrs. Madeline Toerien, was instrumental in providing support during my high school years. During my master's program, one of my tutors guided me through the challenges of academic writing as a dyslexic student, boosting my confidence tremendously. Moreover, Professor Julie Sanders, Director of Research at Barts Health NHS Trust has greatly supported me in my research in endeavours. Without such supportive figures, I may not have been able to achieve the level of success I have in my education and career.

Can you explain the focus and significance of your research?

In my primary role as the Head of Cardiorespiratory Physiology, I lead clinical operations and oversee the delivery of healthcare services. Alongside this leadership responsibility, I actively engage in research and innovation projects aimed at advancing professional practices for healthcare scientists, enhancing quality improvement measures, optimising diagnostic services, and improving patient pathways and access to care. A significant area of focus has been the integration of wearable ECG monitoring technology into multidimensional care models that combine in-person and remote care. This approach has demonstrated cost-effectiveness while greatly benefiting patients as well as the healthcare organisation.

What are some of the key contributions or breakthroughs you've made in your area of study?

One of the major breakthroughs I'm proud of is the successful implementation of wearable ECG technology into patient pathways at Barts Health NHS Trust. This multidimensional model has been recognised nationally and shortlisted for the Advancing Healthcare Science Award in the category of Excellence in Healthcare Science Services. By seamlessly incorporating remote monitoring alongside in-person care, we've been able to provide a cost-effective solution that improves accessibility for patients while streamlining operations for the organisation.

How has your research impacted or advanced the field of medicine/dentistry?

Our team at Barts focuses on demonstrating the viability and efficacy of delivering wearable ECG technology as part of patient care pathways. This model has garnered significant attention, and we've advised other centres on implementing similar digital health solutions. It's a testament to how innovative approaches and collaboration can drive meaningful advancements in improving healthcare delivery and patient experiences.

 

Do you engage in any public outreach efforts?Public outreach and advocacy for LGBTIQ+ and neurodiversity are causes that are very important to me. During LGBTIQ+ History Month, I have worked with colleagues to host information and awareness stands at Barts, encouraging allyship, community building, and open discussions around LGBTIQ+ topics. Similarly, I actively use social media platforms to raise awareness about neurodiversity, having authored blogs and shared my lived experience as part of the Barts Ability Network’s initiatives, especially during Neurodiversity Celebration Week. Representation and visibility are crucial for fostering a sense of belonging and support for hidden disabilities.

 

 

How important is it for researchers to communicate their work to the general public?

In my view, it's absolutely essential for researchers to communicate their findings and work to the general public. Presenting at conferences is important, but leveraging social media makes our research far more accessible and allows us to engage with interested individuals beyond academic circles. Once publication embargoes are lifted, I make a concerted effort to share abstracts and findings on platforms like LinkedIn and Twitter, often sparking interesting dialogues and connections.

 

Have you encountered any challenges or rewarding experiences in making your research accessible to broader audiences?

While I haven't faced too many significant challenges in this regard, there have been some rewarding experiences. People reach out to express interest in my work or seek clarification on findings, which is always gratifying. It validates the importance of making research accessible and promoting open communication further afield. Occasionally, differing viewpoints or perspectives are shared, but I see those as opportunities for constructive dialogue rather than challenges.

 

What does it take to be a successful researcher in your field?

To excel as a researcher and clinical leader in my field, a few key qualities are essential: clarity of vision, tenacity, resilience, and adaptability. You need to have a clear understanding of what you aim to achieve, but also be able to change approach when faced with obstacles or new information that prompts a shift in your direction. It's essential to persevere through failures or setbacks and not become discouraged easily. Remaining inquisitive, curious, and open to exploring new avenues is also paramount.

 

Are there any challenging aspects or obstacles you've had to overcome in your role?

One of the main challenges I've encountered is the lack of awareness and understanding surrounding neurodiversity, including conditions like dyslexia and ADHD. There have been instances where my responses, mannerisms, or interactions may not have aligned with neurotypical expectations, leading to misunderstandings. Raising awareness, sharing my personal journey, and paving the way for future neurodiverse leaders have been a priority in overcoming this obstacle. As a senior leader, I strive to create an environment that draws on the unique strengths of every individual to develop my leadership team.

 

What skills or qualities would you say are essential for being innovative and entrepreneurial in science?

Innovation in science requires a combination of curiosity, inquisitiveness, and business acumen. You need to constantly question how systems work and explore new possibilities. However, it's not always enough to have great ideas – you also need the ability to communicate data-driven insights to a range of  stakeholders, including those without scientific backgrounds. Thus, scientific and clinical data needs to be conveyed in a balanced and succinct manner, alongside costs, benefits, risks, and the potential impact of innovations, to maximise the chance of securing the approvals and resources necessary for the implementation of novel concepts.

 

Has anything surprised you or challenged your preconceptions about your role as a researcher?

I've been pleasantly surprised by the evolution of healthcare sciences into a more cohesive, recognised profession over the past two decades. When I first entered this field, the concept of 'healthcare science' as a unified discipline didn't really exist – it was a collection of disparate roles. Witnessing this transformation has been delightful, although I do believe more work is needed to gain broader recognition for healthcare scientists and our contributions, something I continue to actively campaign for.