Q: Tell us a little about lessons from your youth and how that impacts your work today?
A: As one of seven children, I received consistent messages about the value of hard work. I actually thought ‘elbow grease’ was a real thing before I understood it was a metaphor for hard work. At home, in school, on the basketball and tennis courts, I learned that working hard consistently over time is what delivers results. I have carried that work ethic throughout my life.
Q. Tell us a bit about BSRI.
A. Although BSRI (about 70 people) conducts a diverse array of research with over 75 currently funded studies, our recognition as the premier blood bank-based institute in the world with respect to transfusion-transmitted infectious diseases is the most important. That identity demands that we be ready to investigate the next emerging infectious agent quickly to determine if it is a threat to blood safety. We are well known for instrumental research on diagnostics, clinical course and treatment of HIV, hepatitis, arboviruses, Chagas disease and more. Our pathogenesis research advances the understanding, diagnostics, predictors of progression and potential therapeutics for HIV and other diseases.
Q. Share three words to describe BSRI.
A. Respected, innovative and productive.
Q. Describe your leadership style.
A. I’m not sure I have a style as much as I have gotten very good at juggling. I am always turning my head to the next thing because we are involved with so many projects. My style is high energy, creative, collaborative and scientifically rigorous. I am proud of our great team in San Francisco and Denver who make ongoing contributions to Transfusion Medicine and in response to broader research questions.
The Operational Excellence (OE) emphasis now at BSI may be relatively new to others, but it is something that we have always done at BSRI — it’s inherent to our work and our success. We ‘huddle’ every day because every day we are driving forward research projects, analyzing data, writing papers, preparing for the next phase, applying for grants or contracts, and continually addressing the questions that arise during these efforts.
Q: How would you describe working at BSRI?
A: We have created an environment for open, honest exchange of ideas and research data. Excellence is the foundation of research and is built into field study design, validation and reproducibility of laboratory assays. We are committed to open exchange within our institute, as well as externally with those in our industry and in academics; that is how science thrives. Collaboration with industry leaders at National Institutes of Health (National Heart, Lung and Blood Institute / National Institute of Allergy and Infectious Diseases), Centers for Disease Control and Prevention, Food and Drug Administration, The World Health Organization, International Society of Blood Transfusion, AABB, and more, as well as our competitors is essential, even as we compete to publish first!
Q. Tell us about a normal day.
A. Again, it’s the juggle! It’s getting up every day about 6 a.m., sifting through hundreds of emails, moving to conference calls which are pre-scheduled starting at 8 a.m., huddling with the team at BSRI and traveling 25 percent of the time to meetings, study groups, presentations, etc., in the U.S. and around the world.
At any given time, I am involved with 30-40 different projects. Some of them are bundled together under an ‘umbrella’ like the Recipient Epidemiology and Donor Evaluation Study (REDS) projects and some are separate entities. We have studies going on today in the U.S., Brazil, South Africa, China and other locations. My team at BSRI is intimately involved in making those studies happen: conceptualizing the studies, developing protocols and operationally delegating work whether it’s clinical, laboratory, or very rigorous statistical analyses.
My non-working time is carved up between spending time with my wife who lives in San Diego (I have become well-adapted to long-distance relationships!) and spending time here in San Francisco with family and colleagues/friends; it’s my home scene. My two daughters live here in San Francisco and we enjoy spending time together. I enjoy playing tennis (on two new knees and one hip), and watching basketball and football and select TV shows as well as reading when I’m not working.
Q: How do you keep track of so many projects?
A: Setting priorities is critical because things can come out of nowhere, e.g., Zika virus. An institute like ours has dozens of studies we are trying to move forward, but when something like Zika comes out of the blue, we essentially repurpose our institute. Zika’s threat to the U.S. and global blood supply and especially the rapid need for donor screening required 25 percent of BSRI to work on it for two years! (It is still a very active project today.) BSRI was instrumental in developing and validating ZIKA tests and in characterizing performance and improving test assays. These sudden detours also mean we focus on government policy and advocacy to quickly get millions of dollars in supplemental funding for this critically important work.
Q: How do you connect the work of BSRI with the work of blood centers?
A: We are involved with the safety of the blood supply, which means identifying pathogens, figuring out if they actually cause disease, how to test for it and how to inactivate it or get rid of it.
We do some relatively basic research (e.g. virus discovery, HIV reservoir testing, etc), but most of what we do is translational research, which is more oriented to developing and applying technologies to understanding and fixing problems. Our primary goal is to generate evidence-based research findings that impact U.S. and global blood banking policies and practices. Although we are most recognized for our studies advancing infectious disease testing and inactivation technologies, we also conduct laboratory research and lead large multicenter studies on relevant non-infectious complications like transfusion-induced alloimmunization (undesired immune response), as well as blood disorders like sickle cell disease.
Q. How often does your team interact directly with blood centers?
A. Quite often. The blood donor pool is a critical resource providing both donor data and blood samples, whether they have an infectious disease or not. In a sense, BSRI is the backbone for the blood safety commitment that we make to our patients and our donors. We also work and communicate very closely with Creative Testing Solutions (CTS), our network of testing centers, related to Zika or other studies.
The willingness of blood donors to participate in research gives us opportunities for developing creative approaches to contribute to broader public health and medical research. Blood donors are a massive population sample for research; at times, allowing us to follow them for decades.
Q. Who have been your mentors and what did you learn from them?
A. There have been many, but working with ‘giants’ in the field like Drs. Herb Perkins (my predecessor), Paul Ness, Harvey Klein and Harvey Alter demonstrated important leadership characteristics like a commitment to rigorous science, collaboration, integrity and humility. I am grateful for their mentorship. Paul Ness’s unwavering vision and leadership at the John Hopkins University Transfusion Medicine research and training program, and Harvey Klein and Harvey Alter’s leadership at NIH were especially influential in my role at BSRI.
My mentors modeled a dedication to sustained and quality research in diverse areas and to the training of future generations of transfusion medicine scientists and clinicians. As we worked together over many years, their leadership, mentorship and friendship set the path for my own leadership journey. We didn’t always agree, but worked through our different viewpoints on controversial projects that ultimately benefited the transfusion medicine community.
Q: You are a prolific author and have been a Transfusion journal associate editor for over 25 years — is that something you enjoy?
A: I’m the longest running associate editor in the history of Transfusion! It’s been a lot of work, but a sincere pleasure and honor. I have great respect for the peer review process necessary for dissemination of high quality scientific findings. Transfusion is a top-tier journal and I am very proud of the progress and quality of the publication.
Q: Have you had any research disappointments?
A: There have been remarkably few and those that occurred were early in my career and because the studies were not published. The way we work is to always design and execute research to be published and contribute to the field. Negative data — when a study doesn’t show the outcomes we thought would be revealed— isn’t an issue because those studies contribute to our understanding. That’s actually a success. Failure for me is to have done work that could have contributed to the body of knowledge, but because it wasn’t published, it didn’t have the impact.
Q. You’ve been at BSRI your entire career – tell us about that.
A. You can’t beat it in terms of a great career! I’ve had the same job for 33 years and it changes every day.
Q: Your advice to new grads?
A: Do what you love and have passion for it. Every day is a new struggle, but persistence and tenacity lead to success.
To view more about Dr. Busch's work, view his profile here.
Contributed by West Division Communications Manager, Vicki Wolfe