Happy 2020! I realize it’s been a while since I posted anything. I’ve been in dark mode the past month to spend some time with family, recollect, and do some deep reflection.

2019 is a year I will always remember. I finished my PhD, moved out of our condo in Champaign, and decided on a major shift in my career path. My husband and I also celebrated our second anniversary, learned to surf, met many new friends, and lived abroad for nearly three months. All in all, there were lots of wonderful things to celebrate and memories to cherish.

This post is my attempt to be transparent about what I accomplished last year, where I want to direct my energy going forward, and how I want to hold myself accountable for 2020. It’s also a way for me to recall the things that expanded my perspective, new insights that I had, and some of my most memorable moments in 2019. I hope to do this every year going forward and be able to look back on an archive of each year all in one place.

If you read this, I hope you find some of the ideas, insights, or experiences useful to you in some way. As always, I value your input and would love to hear what you’d like to see from my work in 2020. I considered just keeping this as a private journal entry but ultimately decided to publish it as part of my move towards even more authenticity and transparency. I hope to continue to publish more ideas on this blog that are beneficial to personal growth, outside of gut health.

I’d highly encourage all of you to try your own annual review, as I benefited a lot from the structure of this reflection. [Annual review template courtesy of David Perrell.]

1. MY 2019 GOALS (slightly revised in April based on new plans to take a gap year)

Finish Ph.D. & publish last few papers: success! Well, mostly. I unanimously passed my final defense in July and submitted my dissertation in September. I also published a highly cited review paper on exercise and the gut microbiome and an original publication on cohort-dependent behavioral responses to fiber feeding.

I still have a number of papers that are yet to be published from my PhD, but only one of them (our germ-free RNAseq experiment) is at a stage that could possibly have been published as a short communication. I’ll hope to get this one submitted in 2020. The other two are still in the works due to a delay in our collaborators’ metagenomics and metabolomics queue and will likely be published in summer 2020.

Grade: A-

Presenting @ the International Scientific Conference on Probiotics, Prebiotics, Gut Microbiota, & Health in Prague!

Launch AIP study: done! Four years ago, this pilot study was just a far-off dream of mine. After many years of struggling with chronic eczema, it was this diet and lifestyle approach (the autoimmune protocol, or AIP) that allowed me to clear my skin. In early 2019, I was awarded $5k in grant funding from the Division of Nutritional Sciences. With the wonderful support of Angie Alt, Rob Abbott, Mickey Trescott, Jaime Hartman, and the rest of the autoimmune wellness community, we successfully crowdfunded an additional $8.5k, recruited participants remotely from all around the U.S., and walked them through the 10-week intervention, which they finished in December. This was the first remote study I’d ever conducted, and it was definitely not without a few hiccups along the way, but I’m so thankful to everyone who helped make this happen and am excited to dig into our results in 2020!

Grade: A

Become a confident public speaker: of everything that has happened this year, I’m most proud of this. Just a year ago, I was terrified of public speaking, and would shake noticeably through my entire presentation. Thanks in great part to the Champaign Toastmasters club and a great deal of practice, I now feel confident speaking on stage. In June, I even received an award for my oral presentation at the International Scientific Conference on Probiotics, Prebiotics, Gut Microbiota, and Health in Prague.

That doesn’t mean that I don’t still get some nerves at the beginning or that I don’t still have plenty of room for improvement, but I’m now excited for speaking opportunities and received several paid invites for 2020, including the Physicians for Ancestral Health annual retreat and the UCSF IHH Symposium on Nutrition and Functional Medicine!

In 2019, I also appeared on several podcasts, including Revolution Health Radio, Phoenix Helix, and Nourish Balance Thrive, spoke at the Ancestral Health Symposium, and presented some of my research at Experimental Biology.

Grade: A+

10,000 subscribers: I think I underestimated the difficulty of achieving this goal, and also didn’t put enough time and energy into expanding my reach. This is not something that comes easily to me, as I’m not willing to sacrifice my values for the sake of marketing. I also came to the realization in June that my mental health and creativity were suffering from too much focus on social media. Rather than peddle to potential followers by posting daily on Facebook and Instagram, I wanted to serve the smaller group of dedicated readers and followers that I already had, attracting people to my work organically by creating great niche content. Nonetheless, I’ve realized that maybe I need to bring on someone else who can help turn my content into bite-sized pieces to help reach more people through these platforms.

Grade: C

3 new blog posts/month: Wowza. Pretty terrible on this one. To be honest, I had completely forgotten that this was a goal I set last April. I think I underestimated how much of my writing energy I would need to invest into my dissertation, and how busy I would get in the final few months of trying to finish up ongoing projects in the lab. I’d hoped I’d be able to get back to lots of blog writing come August but found that I fell out of my morning writing routine once we were traveling and had to spend mornings doing client calls because of the time zone difference.

All that said, I did write some long-form pieces that I was particularly proud of last year, including the oxygen-gut dysbiosis connection, what the latest research reveals about SIBO, and gluten intolerance or gut dysbiosis?. These articles took much longer to write as they were synthesizing research in a way that had never been done before and generating novel hypotheses and research questions. I’d like to write more articles like this!

Grade: C+

Get our startup ready to launch: Considering all I had going on this year, we did really well in this department. In less than a week’s time, my husband and I pulled together a website for our startup and submitted an application to the startup incubator, Y Combinator. After a brief video interview, we were invited to a final in-person interview in Silicon Valley in early December. While we ultimately did not get funded, we received a lot of great feedback from the partners and got to visit some friends near San Francisco. I was actually relieved that we didn’t get funded because some newfound perspective led me to reconceptualize the company as a citizen science project with a narrower focus and a much greater alignment with my values. I also drafted an Indiegogo campaign and got feedback from a few people. We’re still hoping to make this a reality in 2020!

Grade: A-

2. OTHER THINGS TO CELEBRATE

NextGen Medicine: I’m so humbled by the growth of the NextGen Medicine community over the last year, and how many of you have reached out to share how my work has impacted you. My Patreon account launched just a year ago just hit 24 loyal patrons, meaning that I am now getting some much appreciated monthly income from my research and blogging efforts. A sincere thank you and the deepest gratitude to all of you who continue to read, share, and support my work. I also upgraded my website design and introduced a brand-new logo to celebrate the two-year anniversary of NextGen Medicine, worked through about half of my waitlist for one-on-one consults, and began to develop several online course modules.

Hiking near Twizel, New Zealand

Travel: this was certainly my most adventurous year yet. In the first half of 2020, I traveled to some amazing conferences in Orlando, San Diego, and Prague. In August, my husband Steven and I sold virtually all our furniture and packed the few belongings we had left into storage. With just a backpack and carry-on each, we set off to live the digital nomad life. Wanting some time to regroup in a familiar place, we headed to San Diego, one of our favorite cities, where I onboarded AIP study participants amidst plenty of breaks to enjoy the sunshine and take our first surfing lessons. After a few very zen days in Maui and a week in Waikiki immersed in our YC startup application interspersed with periodic (fairly successful) attempts at surfing, we arrived in Sydney.

Over the next month, we slowly road-tripped up the east coast of Australia to Cairns, working remotely in Airbnbs along the way and enjoying the sunshine, great coffee and “brekkie”, beautiful coastline, cassowaries and koalas. We ended our time down under with an unforgettable full-day scuba dive and snorkel trip to the Great Barrier Reef in late October. A quick flight to Christchurch, New Zealand and we were off on another month-long slow-travel roadtrip exploring the south and north islands. While the weather was certainly much milder and rainier, the scenery in New Zealand was beyond breathtaking. We spent many afternoons hiking and enjoyed meeting some other travelers from Denmark and Germany. Among our favorite towns were Christchurch, Dunedin, and Wellington.

Our eastern hemisphere travels were interrupted briefly for a short week stint in San Francisco for our YC interview and to meet up with friends. Then it was a long flight back to Okinawa, Japan for two weeks to spend with Steven and his brother Paul. Fortunately, I’ve gotten pretty good at sleeping or meditating on long flights!

Navigating the language barrier in Japan was quite a challenge, especially with a peanut allergy, but thanks to a translation that Steven found, I was able to safely try a number of interesting dishes. The Okinawan pork, Wagyu beef, and sushi were particularly amazing, and we loved the assortment of fish, mushrooms, and seaweed you could find at all of the local grocery stores. Perhaps my favorite day of the entire two weeks though was a day trip on a ferry to Zamami Island, a largely uninhabited island with dense forest, crystal blue water, white sand beaches, and amazing overlooks.

Zamami Island, just a short ferry trip from Okinawa

Reading: it’s truly amazing how much reading I get done when I don’t constantly “should” myself into working every waking moment of the day. For the first two thirds of 2019, my “reading” time was largely from audiobooks listened to while running, driving, cooking, or doing other things around the house. Some of my favorites were Can’t Hurt Me, Willpower Doesn’t Work, Daring Greatly, Behave, and Company of One.

Working closer to 25 hours a week over the last few months of 2019 led to a lot more time for pleasure reading, which was wonderful. I got a great deal of joy from finding new or used books at local bookstores. Some of the most influential titles I read in the past three months were The Power of Now, Why Buddhism is True, How to Change your Mind, My Ishmael, Civilized to Death, and Essentialism.

In 2020, I hope to find the balance between getting work done and having enough time and space to read and reflect. I also want to start taking more detailed journal notes for the books I read, and to listen to more audiobooks instead of podcasts.

Enjoying the present, getting rid of mental noise, and letting go of ego: I’d read plenty of books related to psychology, and even got a minor in it in college, but had never come across the concept of the ego in such an accessible way until reading The Power of Now.

I’d read Sam Harris’s book Waking Up. I had also tried meditating, many times. It was obvious that experienced meditators had something — some different perspective, an obvious centeredness — that was admirable. And I’d seen much of the science behind meditation. But I found it virtually impossible to sit for more than 10 minutes at a time, and even sitting daily for 10 minutes for a few weeks at a time didn’t feel like it was getting me anywhere.

So when I saw the book at a friend’s place in San Diego, I picked it up and started to read it on the beach one day. I didn’t get very far, but was convinced that it was something I wanted to read, and bought the audiobook that day.

On our flight to Maui a few days later, I sat back, plugged some headphones in, put on the audiobook, and slipped into a sort of unplanned 5-hour long listening meditation. I really feel like only my journal entries from the next day can do it justice: (you’ll have to excuse the abrupt start and sloppy writing)

To be honest, there were definitely some parts of the book that I couldn’t wrap my head around. But nothing I’d read before had ever come close to explaining the “goal” of meditation so clearly and accessibly. Over the next few weeks, I continued to practice this intense presence throughout the day. For the first time, I could take a long walk without constant mental chatter. I didn’t wake up feeling anxious about the things I had to get done. I was much less judgmental and impatient with other people and with myself. Since then, the power of those few weeks has somewhat faded, but in many ways, the shift in my consciousness and the increased quiet in my mind has never left. I’m excited to build on these experiences in 2020 by re-committing to a more regular meditation practice and a 10-day silent retreat. I also want to relisten to books like Waking Up now that I have the first-hand experience to refer back to.

Community: one of my greatest realizations in 2019 was the power of community. I’d always found it difficult to make deep, lasting friendships with more than a handful of people, and as an introvert was not one to seek out social situations. But a few opportune connections and experiences this year led to a great many friendships that I will cherish for a long time, and a feeling of true community that I will never forget. When we can truly be vulnerable and hold each other’s vulnerability with openness and acceptance, so much connection and healing can happen. In 2020, I hope to continue to develop these friendships and sense of community and push myself outside of the isolation box that I so often put myself in.

Roadtripping Okinawa, Japan

Gaining clarity: taking a gap year was one of the best decisions I ever made and gave me the time and space to reconnect with myself. I went off the grid completely at the end of the year to read, journal, and reflect. I was able to reflect on the last three months of travel and experiences, look to the future, and think about what I truly want. And when I did that, it was clear that med school was not the right path for me, and that what I really wanted to do was a postdoc!! More on that below :)

3. THINGS TO IMPROVE

Delegating/bringing on help: I have been saying for far too long that I’d like to bring on an assistant to help manage NextGen Medicine content, oversee some aspects of social media posting, and help answer emails, but have been reluctant to actually do it. Part of this is really feeling like I need to find the right person for the job, but I also have not taken the necessary steps to even test the waters and see if I can find someone who is a good fit. I’d like to make this a priority for 2020.

Maintaining routine when traveling: As I mentioned earlier, I quickly fell out of my routine when we started traveling last fall. I’d like to get back to my regular morning routine of reading, exercising outside, meditation, journaling, and then getting into my writing for the day. Staying in one place, as opposed to moving around every 3-4 days like we did in Australia and New Zealand, will help significantly in this regard. In the evening, I want to take time to read, journal, and stretch before going to bed. This will also mean committing to a more consistent schedule and asking Steven for his support in blocking off this time.

Living the digital nomad life working out of Airbnbs

More time for writing: Writing is the single most important and productive thing I do. Researching and publishing articles allows me to learn new things, expands my reach, and brings amazing people into my life that I would not meet otherwise. Writing first thing in the morning also sets a positive, productive tone for the rest of my day. For 2020, I want to make a goal of writing for 120 minutes per day, seven days per week. This will also allow me to publish more frequent newsletters and connect with my audience on a more regular basis. I’d also like to make more time for editing to be sure my writing is as accessible and understandable by as wide an audience as possible, without sacrificing the quality of the content.

New approach to consulting: Given that I want to make more time for writing and that I have an exciting new career direction (below), I’ll also need to take a new approach to my consulting practice. As much as I love having regular, consistent clientele and prefer a longitudinal model of care with regular follow-ups, I find that managing client expectations and doing regular email support is taking up far too much of my time in this model. I’m also aware that I have many people on my waitlist who could benefit from just a single consultation to get some new insight into their health issues.

Therefore, I plan to try a new model for consulting, where I provide single pay-by-the-hour appointments on one afternoon of each week. On weeks that I am too busy with creative projects or studies, I will block off consulting appointments completely. This will allow me to maximize my creative output, while also providing some income and helping people to get the information they need to get healthy. Any current clients will be able to finish out the packages that they have already paid for but will then be transitioned to single consults.

Email/Patreon growth: email is the best way to expand my reach, and Patreon is the income I need to maintain and grow NextGen Medicine. For a while, I overvalued the importance of social media and undervalued the importance of email. I think part of this was because I built up newsletters to be so complicated and lengthy that they ended up being extremely sporadic, as opposed to sending more consistent weekly emails with one or two new pieces of content. I ultimately want to create the best experience for my readers, and I think sending more consistent weekly emails will help in this regard.

More time for reading literature: in addition to more time researching and writing articles, I also want to make sure I keep up with the latest papers in the microbiome and gut health field. I was great at using Pubmed alerts to accomplish this but fell behind when my defense was approaching and never quite got back in the habit or reviewing these daily alerts. I’d like to block off time each week for reading new articles and write summaries of the most interesting new pieces 1-2 times per month.

4.GOALS FOR 2020

Inevitably, things will happen, new things will come up, and some of these goals may not even be relevant a year from now. I always want to remain open-minded so that I can pivot to some bigger and better opportunity mid-year. But I still think it’s worth setting some goals that align with my values and vision for the future and keep me headed in the right direction.

10,000 subscribers: I realize this is a pretty lofty goal considering it’s more than double than my current email list. In the last year, I have come to recognize that my blog has value regardless of how many people it reaches. However, I do think subscriber list is a good metric of my commitment and time investment to NextGen Medicine. I want this to be organic growth that is reflective of my unique content output, networking efforts, and NOT due to any disingenuous marketing tactics or bribes.

Launch of online courses: In 2019, I started developing a few online courses. I’d like to officially launch my course academy in 2020 with a minimum of three single-lecture courses. This will be a great way to help more people at scale with their gut health, and allow me to get comfortable with using and managing course development software.

A postdoc position! Thanks to a great deal of soul-searching over the last few months and reflection over the holidays, I am super excited to be pursuing a postdoctoral position to further my background in microbiome research and gut health! I have already begun to reach out to potential laboratories and will likely be traveling to several interviews over the next few months. (For more on how I came to this decision, see “Why I’m foregoing med school and starting a postdoc!”)

My ideal position is one that is studying the therapeutic implications of the oxygen-gut dysbiosis connection. My hope is that such a position will allow me to use my extensive microbiome knowledge combined with the new domain expertise I would learn from the lab to direct my own research projects in the context of a supportive and engaging laboratory community. It will also allow me to continue to explore my curiosity in the microbiome and gut health in general, and to publish this blog on the side.

OTHER LESS CONCRETE GOALS

Launch our citizen science project: after some great feedback from Y Combinator last fall, Steven and I have recommitted to seeing our citizen science project launch in 2020. I’ll likely have much more to announce on this very soon!

More community focus: as I mentioned earlier, I want to invest more time in developing and maintaining friendships and a sense of community. I’d like to spend at least three hours each week reaching out to friends and family and make more effort to facilitate time together in-person.

More exercise/play: sports have always been a really big part of my life, but I really missed them during the hectic last few months of my PhD and then our travels towards the end of the year. I’d love to find the occasional soccer, frisbee, or volleyball meetups early in 2020, and seek out more regular competitive outlets once we’re settled down in one place.

More intentional travel: as much as I enjoyed our travel adventures in 2019, I’d like to be more intentional about travel going forward and focus on travel that enriches our sense of community or helps facilitate the goals outlined above. This will likely mean more travel within the United States to visit friends, attend conferences, or connect directly with potential research mentors.

5. MEMORIES

Best Meal: Wagyu beef in Okinawa

Favorite Book: The Power of Now – Eckhart Tolle

Coolest New Experience: Scuba diving and snorkeling the Great Barrier Reef

Favorite Weekend: San Francisco after our YC interview

Favorite Conference: Ancestral Health Symposium in San Diego, CA

Best New Food: Octopus and Enokitake mushrooms

Favorite First Meeting: Jeff Gordon at UIUC

Best Surprise: Finding out a family member is expecting!

Favorite Day: Surfing lessons with Steven in San Diego

Most Intense Week: Finishing my final dissertation draft in Dixon

Favorite New City: Christchurch, New Zealand

Favorite Quiet Place: Beach in Kihei, Maui

Favorite Travel Experience: Ferry day trip to Zemami Island, Japan

Favorite Song: Happy Lil’ Hippie – Cody Simpson

Favorite Artist: Robin og Bugge

Favorite Quote: “To my mind, the greatest reward and luxury of travel is to be able to experience everyday things as if for the first time, to be in a position in which almost nothing is so familiar it is taken for granted.” – Bill Bryson