Dr. Michael Young is an F32 award recipient who is using the funding opportunity to help further develop his career and research on neurotechnologies and neuroethics. The F32 funding opportunity supports the research training of promising postdoctorates early in their postdoctoral training period.
The NIH BRAIN Initiative funding portfolio enables the collaborative and multidisciplinary research necessary to help us understand the brain’s complexities. Physician and researcher Dr. Michael Young received a BRAIN Initiative F32 Individual Postdoctoral Fellowship award to support his research on neurotechnologies that detect consciousness and the ethical considerations surrounding their use. The F32 program rewards promising postdoctorates early in their careers by enhancing their research training in project areas that advance the goals of the NIH BRAIN Initiative. The next deadline to apply for an F32 award is December 9, 2022. This article is the first of a brand-new series highlighting the experiences of NIH BRAIN F32 grantees.
Check out the interview below to learn more about Dr. Young’s background as a physician and his research. He discusses his NIH BRAIN Initiative project and what he hopes to achieve, in addition to challenges, next steps, and what advice he’d give to other early career researchers.
Would you please briefly introduce yourself?
My name is Michael Young, and I am a physician and researcher at Massachusetts General Hospital (MGH) and Harvard Medical School (HMS). After earning my MPhil in Philosophy from the University of Cambridge and M.D. from Harvard Medical School, I completed a neurology residency and neurorecovery subspecialty medical training at Mass General Brigham and Spaulding Rehabilitation Hospital, specializing in longitudinal care of patients recovering from severe brain injuries and disorders of consciousness.
My research closely aligns with my clinical specialty, focusing on fostering responsible development and neurotechnology deployment for people with neurologic disease across the care continuum, specifically for patients with disorders of consciousness following severe brain injury.
The NIH BRAIN Initiative project that I’m leading, “An Ethical Approach to Detecting Covert Consciousness,” aims to clarify how to responsibly translate emerging neurotechnologies to detect and predict recovery of consciousness in patients with severe brain injury. In undertaking this project, I am incredibly grateful for an amazing interdisciplinary mentorship team including Dr. Brian Edlow, my primary mentor, and my co-mentors Dr. Leigh Hochberg, Dr. Yelena Bodien, Dr. Robert Truog, and Dr. Joseph Giacino. My research is based in the Center for Neurotechnology & Neurorecovery (CNTR) within the Department of Neurology at Massachusetts General Hospital.
What led you to research? What continues to drive your ambitions as a scientist?
The field of disorders of consciousness research in which I am immersed stands at the distinctive nexus of clinical neuroscience, neurotechnology, philosophy and neuroethics — interrelated fields of deep personal interest and background. More generally, my ambitions as a physician-investigator are driven by a mission to improve the lives of individuals living with neurological disorders by fostering responsible clinical translation of advances in neuroscience and neurotechnology.
My ambition is underpinned by a conviction that the fruitful conversation between neuroscience, philosophy, and neuroethics is shedding light on shared questions and could fortify the conceptual foundations of these fields. It is also necessary to ensure that researchers and clinicians are equipped to anticipate and responsibly handle downstream implications of advances in neuroscience for the benefit of society.
What major unanswered questions do you hope to address?
Shortcomings of routine bedside examination to reliably detect consciousness in behaviorally unresponsive patients following severe brain injuries generate profound dilemmas for clinicians and families facing decisions about goals of care, neurorehabilitative planning, pain control, prognostication, and resource allocation. Clinical assessments of patients’ levels of consciousness and likelihood of recovery following brain injury commonly form the dominant axis around which critical and often life-or-death decisions are made, yet these defeasible assessments are often riddled with explicit or implicit ambiguity.
During my clinical training in neurology, I was struck by how much diagnostic and prognostic uncertainty often surrounds such assessments and associated medical decision making for this vulnerable patient population, and the vital need to improve goal-concordant care by harnessing recent innovations in neurotechnology.
Novel neuroimaging and electrophysiologic tools such as functional MRI and advanced EEG to improve diagnostic and prognostic accuracy for patients with disorders of consciousness are now under investigation. These tools have recently been endorsed by professional society clinical guidelines, yet little is known about ethical concerns surrounding these tools; the attitudes of clinicians, researchers, patients, and families regarding their implementation; how to appropriately communicate results; and how these innovations should be optimally translated into clinical practice.
Through my research, I hope to address these and other unanswered questions, and to support the development of an evidence-based framework for responsible development and deployment of next-generation neurotechnologies to detect consciousness in settings of diagnostic and prognostic uncertainty.
What are some of the challenges you have encountered in your research and/or career? How have you or how are you working to overcome them?
The inherently interdisciplinary nature of my research interests challenged me to identify and assemble a diverse mentorship team to foster the progression of the different dimensions of my research and career. Having a stellar and devoted primary mentor (in my case, Dr. Brian Edlow) who was also willing to help facilitate connections with co-mentors in allied areas was instrumental in helping me to meet this challenge.
Ensuring protected time for research as a physician-investigator while continuing to build my clinical profile and ensuring that my patients receive the best possible care challenged me to proactively structure my commitments and deliberately plan my schedule to achieve optimal balance. Having a deeply supportive department chair (in my case, Dr. Merit Cudkowicz, Chair of the MGH Department of Neurology) and the NIH BRAIN Initiative F32 award were essential in these regards and in advancing my career as a physician-researcher.
What would be the next step in your research (or professional development)?
I hope to continue to build a funded research portfolio committed to improving lives of patients and systems of care and through the fruitful alliance of translational neuroscience, neurotechnology, and neuroethics. At MGH, I will continue my involvement in building the Emerging Consciousness Program (ECP), a clinical service devoted to ensuring that patients with severe brain injury have access to care driven by ethical implementation of the latest clinical guidelines and neurotechnological breakthroughs, including advanced methods of responsibly diagnosing, predicting, and promoting recovery of consciousness.
What would be your advice to other trainees who want to apply for the F32 program?
Carefully consider the type of impact you would like to have on your field and allow that vision to guide your research and training ambitions.
Are there any specific relevant training and professional development opportunities that you find useful during the fellowship?
A variety of courses, seminars, and other training opportunities offered through the MGH/Massachusetts Institute of Technology (MIT)/HMS Athinoula A. Martinos Center for Biomedical Imaging, the Harvard Medical School Center for Bioethics, the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, and Harvard Catalyst were useful to me during the fellowship. The annual BRAIN Initiative Meeting also provided wonderful opportunities to interface with and learn from other NIH BRAIN Initiative-funded researchers in related fields.
Fill in the blank: When I’m not working on a research project, I am…
Enjoying music, philosophy, or time outdoors.