Translating Science to English
Tad Heitmann
Sam Brown Inc.
Our article today discusses the importance of successful translation for medical communicators and marketers. In a world where it’s so easy to just ‘Google’, Tad Heitmann reminds us that the best way to fully understand a physiological process or method of action is to actually speak to the lead investigator – in the same way a linguist would spend time with native speakers in order to learn a language.
Significant advances in our understanding of the genetic basis and molecular mechanisms of disease have produced a windfall of promising therapeutic targets for drug development and, particularly in cancer, opened a new era of individualized treatment. As our appreciation of the complexity of these underlying processes has grown, so too has the complexity and specialization of the scientific lexicon required to describe them.
Medical communicators and marketers all face the challenge of creating simplicity and clarity (not to mention excitement), for a variety of audiences, from the technical obscurity of biomedical research and product development. Whether you have a background in molecular biology or have to learn the science as you go, successful translation of this knowledge remains one of your principle challenges and most important services. Here are a few things to consider as you move from data to dateline.
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"...nothing can jump start a medical communicator's understanding of a physiological process or mechanism of action more quickly than sitting down with a lead investigator..."
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Making the science simple
Years ago, in my first healthcare agency job (literally at the dawn of the current era of drug discovery), I sought the advice of a retired physician who served as the medical content expert for the firm. After marking up my copy, and patiently explaining how my description of the drug's activity was flawed, he gave me a tip that has been my Rosetta Stone ever since.
The ancient Greeks believed that much of physiology and medicine could be understood in terms of "agony" and "antagony", he explained. You either cause or encourage something to happen (an agonist) or you block it or prevent it from happening (an antagonist). Now reality, of course, is always messier (an inverse agonist is just one example of how this bright distinction is quickly blurred) and you still have to explain how an agent agonizes or antagonizes. Yet this simple dichotomy encouraged me to approach any scientific translation project by applying a model and then asking basic questions to confirm what was happening. Like the scientists whose work I was attempting to describe, I formed a basic "theory of understanding" of my own that I then tested and validated with additional background research and interviews. Once the simple explanation was solid, I knew I could begin to add unfamiliar terminology back into the mix in a way that was both accurate for the scientist and sensible to the non-expert reader.
Learning from "native speakers"
Linguists spend a lot of time with native speakers of the languages they study. In a similar way, nothing can jump start a medical communicator's understanding of a physiological process or mechanism of action more quickly than sitting down with a lead investigator or head scientist. This seems completely obvious, but I've been surprised how often written materials go through multiple drafts before anyone thinks to spend some time with the subject experts. As long as they accept that you are charged with making their scientific insights accessible to non-specialists, they are usually eager to strengthen your grasp of even the most basic elements of their work and patient as you untangle their esoteric jargon.
• How do they describe the process in question?
• What analogies or metaphors do they use?
• Why are they excited about it?
• How do they see this development changing the treatment landscape?
"…it provides early insight into how well these potential spokespeople express themselves…"
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I've found it particularly useful to ask the chief medical officer or research group head to take me through a core clinical presentation, which often includes all of the elements (disease process, treatment algorithm, mechanism of action, clinical trial design / results, etc...) that you'll need. I also start with the experts when it comes to individual scientific abstracts or presentations (or groups of them).
• What's the key take-away here?
• Why is this set of data different than the set you presented at the last meeting?
• Is this important for this investigational agent, the field at large, or both?
In many cases these same scientists or investigators will be involved in reviewing your drafts, so starting with them tends to smooth the subsequent review and revision process. Another side benefit of this interaction, is that it provides early insight into how well these potential spokespeople express themselves and how much work you may have to do down the road in media training. However, even if you decide on the spot that you'd never put them in front of a reporter, it is unlikely you'll find anyone more knowledgeable and more enthusiastic about the subject you are struggling to understand and translate.
The metaphorical basis of understanding – and confusion
So what about using familiar images or phrases to simplify or explain medical-ese? We've all encountered (and are probably guilty of using) well-worn terms such as "lock and key", "guided missile", and "molecular switch". These metaphors have served us well in compressing confusing scientific detail into "ah ha" moments for non-experts. However, by now they have been repeated almost to the point of meaninglessness, so in choosing a recognizable and reasonably accurate metaphor we also have to be careful to describe clearly why this new "lock and key" is different. In helping people to understand, we don't want them to fall into the facile or erroneous association trap - "oh yeah, that's a so-and-so inhibitor, just like all those others...” The choice of metaphors presents a dual challenge – use the familiar to describe the strange, without making it seem like everything else. So this is not just translation but contextualization – we must be aware of how our metaphorical choices link or differentiate our subject to its competitive set. For all of our audiences, understanding where an agent fits relative to others in the pipeline or clinical armamentarium is as important as understanding how it works.
Nesting messages – the path between audiences
Our audiences represent different levels of scientific sophistication, so it is appropriate that our communications should too. Patients and caregivers should be able to get the information they need to make decisions from a top level description. Scientists and clinicians should be able to move quickly from this simple, yet accurate, summary to the level of detail they need to connect your material with the medical literature and / or their own work.
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"...we can easily lose credibility with professional audiences in the clinical, research, and investment communities if we simplify too much."
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Although U.S. regulatory guidelines suggest that patient information materials should be written at a 6th to 8th grade level (and we've always had the "make it understandable" mandate for consumer press materials), we can easily lose credibility with professional audiences in the clinical, research, and investment communities if we simplify too much. We think of this approach as "nesting" messages. Beginning in the lexical thickets of the underlying research, we work our way out through successive layers of simplicity until an intellectual clearing appears that allows us to articulate the fundamental mechanism and value of the discovery at its most basic level. Then we carefully work our way back to ensure that the scientific support for this statement is absolutely rock solid. In this way, we create a reliable and consistent pathway between audiences and levels of sophistication. Here simple tools like glossaries, additional backgrounders, and distinct sets of supplemental materials for patients and professionals can be helpful.
Not missing the forest for the trees
It is the pace of biomedical discovery and the thrill of watching as insights from the laboratory are translated into improvements in human lives that make this industry so appealing and inspire me to keep working on my own translation efforts. Even as ongoing research contributes to the increasing complexity of biomedical language – the trees, as it were – professional communicators have the important role of ensuring that the forests – better clinical outcomes, enhanced quality of life, and the reduction or elimination of the toll of disease on individuals and society – are not obscured.
About the author:
Tad Heitmann is Executive Vice President of Sam Brown, Inc., a leading independent, healthcare communications agency that has been serving the life science industry for more than 13 years. You can find them at www.sambrown.com/ and on Twitter at @SamBrownInc.
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