Tony Durkee, doctoral student at NASP

Tony Durkee is the soon-to-be PhD who thought his doctoral studies would be a walk in the park. Instead he got slapped in the face and grew both as a researcher and a person.

Tony is from New Jersey, United States, met his girlfriend, now wife, in Florida and moved with her to Sweden in 1999. As he always wanted to go to college he decided to try it out here in Sweden. He studied hard to become fluent in Swedish. Now he is, but when asked if he wanted to do this interview in Swedish the answer was a polite but firm “Oh God, no!”

Only a year after his arrival to Sweden he started studying at Mid Sweden University, Mittuniversitetet, in Sundsvall in 2000. Three years later he checked out with a double major in English and sociology. After that he took some small courses in public health and this is when he got interested in research-based medicine and he realized that he wanted to help people on a larger scale.

He explored the field and found an interesting International Master’s program in Public Health Sciences at Umeå University. He applied and was admitted. He was also lucky - his wife was willing to move from Sundsvall to Umeå.

Tony describes the years in Umeå as one of the best experiences he ever had. There were over thirty nations represented in the classroom.

“To have all those different perspectives mixed with a very structured programme in public health and epidemiology was really a great learning experience” he says.

Once he graduated, in 2005, it took no time for him to get a job. His first was at the Joslin Diabetes Centre at Harvard Medical School.  He got a two year contract for epidemiologists and extended his skills in handling data, data cleaning and analytical work. He got to go to various sites and they performed different interventions aimed to promote healthier lifestyles among diabetes patients in order to reduce complications associated with the illness. He also administered tests on diabetes patients, assessing hemoglobin A1c, blood pressure, cholesterol and albumin levels using portable medical devises. Results from these tests were compared to the clinical tests among the same group of patients to measure the accuracy of the respective medical devices. This too was a great learning experience, Tony explains.

After two years, he wanted to move back to Sweden. As he really wanted to do his doctorate, but didn’t want to pay $10 000 a year to do it in the US, he moved back to Sundsvall. He started to email all his old contacts as well as new contacts. In 2007, he met Professor Danuta Wasserman. She invited him to come to NASP. In March 2007, he started working on a contract basis that was extended three months at the time. His first assignment was a book that Danuta Wasserman was writing. She gave him the opportunity to publish some chapters in that book. She liked his work and told him to move down to Stockholm and hired him full time as a research assistant. In 2010, he started his PhD 50% of the time, while continuing his work as a research assistant during the other 50%.

What made him want to be a doctoral student?

He always wanted to be the first in his family to become a doctor. He was not sure in which discipline he wanted to work in, but it was always there in the back of his mind, pushing him.

“Yes, when I started off at the bachelor level, I didn’t know what I wanted to study. I mean, I was only twenty years old. Who knows what they want to do at twenty? You need to start experiencing different things before you can decide a profession. As one tests their interests in different fields, you begin to develop and find your own way in life. It is then you realize that OK, I can dedicate myself to this particular field and you become fascinated with that specific subject. But until then, you have to have something that drives you.”

“If you set your mind on something when you are fifteen and just go straight for it, you will likely miss a lot on the way. You might even miss what you were actually meant to do as a profession. I don’t want to miss any opportunities and I want to take full advantage of the opportunities that I got and I want to stay open to everything.”

When he got narrower in his field, he realized that epidemiology and public health sciences were his thing. In his opinion, they are the most helpful for people in the real world.

His doctoral studies and research assistant position go hand in hand. In the research assistant part of his job, he was involved in a project called Saving and Empowering Young Lives in Europe (SEYLE). Tony got to work on two large randomized controlled trials with colleagues from eleven different European countries. In a multinational collaborative effort, they tested different prevention strategies among adolescents with the aim to reduce the risk of psychopathology and suicidal behaviours in this target group.

The epidemiological data derived from the SEYLE project was used for his PhD. As part of his doctoral studies, Tony assessed the association between pathological Internet use (PIU), psychopathology and suicidality. It involved a total of eleven European countries with a sample size of more than 11 000 students age 14-16 years. Results showed significant associations between PIU and depression, anxiety and suicidal behaviours. In fact, findings revealed that those with PIU had a staggering ten-fold higher risk of suicide attempts compared to students with normal Internet use.

“My theory is that when suicidal people are hurting and in despair, they are looking for anything to stop the hurting inside or at least try to find others who share similar experiences. In doing so, the Internet could be utilised to either escape from reality or even find others who have the same desolated feelings”, Tony explains.

He believes that these public health interventions actually are effective. His last study is looking at the effectiveness of mental health actions taken in schools and its effect on mental health. He assessed two specific strategies. The first was mental health education for students and the second was the gatekeeping role of teachers (i.e. teachers approaching students to talk about their mental health). Using the epidemiological database in SEYLE, he found that, in all eleven European countries, both strategies independently reduced risks, but it was the combination of both that proved most effective. Results of this combination of prevention strategies substantially reduced the risk by 50% for PIU. A significant reduction of risks was also noted for depression, anxiety, conduct problems and suicidal behaviours. Tony is very excited about these findings:

“I mean, this is huge! As these findings did not significantly differ between countries, it implies that these results are not culturally biased. This means that these specific prevention strategies are potentially universal and could be used worldwide. However, more research is still needed.”

As the funding of the SEYLE project recently came to an end, Tony is now focused on pushing to finish his thesis. He is due to graduate this year.

When looking back on his doctoral studies, he realizes how much he has grown both as a researcher and as a person. Tony was one of those guys who thought the PhD studies were going to be a walk in the park.

“After all of my experiences on the European level, I thought that I knew everything and that a PhD was going to be a breeze. But reality slapped me in the face quite soon.”

He says that this was good for him. He needed to be shaken up to grasp the challenge. He had to start observing and learning. That helped him to become more aware of himself, his weaknesses and to address them. His supervisors were helpful, as it is sometimes not easy to identify your weaknesses, let alone that you have them.

“But once you do and you work through them and come out on the other side it is strengthening and you are ready for the next challenge”, he says.

In the beginning, Tony was very eager. He was so happy being a doctoral student after having spent years of applying to multiple universities before getting accepted at KI. In the overexcitement, he took on pedagogical courses during his first semester at Uppsala University, so that he could be a lecturer afterwards.

“I had six to eight years left, but I did it anyway, you know. And I took all these medical courses that I wasn’t even prepared for, but fortunately passed them anyway”, he says laughing.

In retrospect, he says it was too much for him in the beginning. He thinks that he should have taken his time and go step by step and not overdo it. A valuable advice from his supervisor, Dr Vladimir Carli, was that you have to feel comfortable and take one step at the time and not run through a PhD, but rather experience it. He followed his advice and that is when he went from being someone who is just trying to get a degree to a person dedicated to his research.

“Now, it’s just experiencing and finding ways to become a better researcher and the whole experience just taught me so much about myself and about my work. It’s such a great process.

Right now Tony is feeling great. He is finalizing these six years of experience and preparing to defend thesis. He is ready to move on to the next phase.

Tony’s advice for those who are considering PhD studies is that it is a very important decision and not one to take lightly. It is definitely a growing experience on a personal and a professional level, but you need to know what you are signing up for.

“I think that if you go through with it, it is something you will never regret.  But one important thing - don’t rush. Take the time and do it right and listen to your supervisors, they know.”

Tony is very grateful of the support he got from his supervisors: Dr Vladimir Carli, Prof Birgitta Floderus and Prof Danuta Wasserman. His main supervisor, Dr Carli, is someone Tony can trust his opinion without being scared of creating a conflict. It is ok to disagree.

“It is extremely important to have a supportive network, with experienced supervisors to share ideas and develop as a researcher, in order to make the most of doing a PhD. But once you have the right combination, doing a PhD can be a life-changing experience.”