Series 2 episode 1 - They can only say no: Karen Perkins on detours, comebacks and a career that took the scenic route

For National Pathology Week 2026, Karen talks about the mentors who brought her back to the lab, her pilot of needle-free blood sampling for patients with learning disabilities and needle phobia, and why half a day of work experience is better than none.

Megan Thomas Welcome to this special edition of Life in the Lab, brought to you by BD and the Association for Laboratory Medicine. I'm Megan Thomas, Medical Affairs Manager NW Europe for BD. This series brings you inspiring stories of clinical scientists and medics working in laboratories in the UK and around the world. And to mark National Pathology Week, we're looking at some particularly fascinating career journeys. Karen Perkins is a clinical biochemist whose work brings her into contact with some of the most complex questions in laboratory medicine. But behind the test results and scientific problem-solving is a career that’s taken a few unexpected turns… … and a determination to keep asking how things could be done better. Karen Perkins My day starts with a cup of coffee, definitely. So yeah, I'll come in and everyone knows I'm in 'cause they can smell coffee. And then I crack on like any jobbing biochemist does with sending out patient results that have been produced usually overnight and later in the day before, phoning out anything urgent. And yeah, following up anything weird that happened overnight, getting through, the bulk of the clinical work in the morning is, most of my work. Megan Thomas Karen’s working day might start with a coffee, but her journey into clinical science began much earlier, with a hands-on curiosity about the natural world. The route from there to the NHS wasn’t exactly a straight line. Karen Perkins This is like a Life Scientific on Radio 4, isn't it? I have to talk about my inspirations and stuff. I'm not that famous, but, so I started... I think I could go back to sixth form biology, actually. I have really strong memories of the days when we did A-level biology, and you could actually do proper dissections. So we had rats, we had bulls' eyes, we had cows' lungs, all those kind of dirty, smelly things in the lab that we were allowed to get our hands dirty with and, you know, touch and feel and smell and dissect and look at what's inside, and that fascinated me. I loved that, and I loved chemistry as well. So I knew I wanted a career in science, but I didn't quite know what. I think I went through the whole thing of being a vet, a doctor, a midwife at some point as well. And anything else to do with biological science. And then, I totally messed up my A-levels. I got three Ds and an E. Oh, that's so embarrassing, isn't it? My kids think that's hilarious. My daughter's just started A-levels, and she's just like: "Mum, that's terrible." But, yeah, three Ds and an E, physics, chemistry, biology, and we did something called general studies in those days, which was just like pub quiz kind of stuff, and I couldn't even get more than a D in that. So I went to university through Clearing. I did biological sciences as a degree with biochemistry as a major in that. Absolutely loved it. And my dad, who was chairman of Teesside Magistrates' Court, sat with a chap on the magistrates who ran a private biochemistry laboratory. And dad got me a summer job there just for work experience, and I really loved it. I was like: "This is what I wanna do. This is what I wanna be when I grow up," kind of thing. When I finished university, I phoned up York District Hospital and said, "Could I come for some work experience in their lab there, in their clinical lab. So to see a private lab and an NHS laboratory. And Dr. Ian Holbrook, who was the consultant at the time, he said, "Yep, come for 10 weeks." So he took me on for 10 weeks work experience there, and was possibly the best mentor I think that I've ever had. He really looked after me, showed me absolutely everything. Got me involved in all sorts of different things in and around the hospital. Got to go on ward rounds, got to see what it was like. You know, where did the samples come from? All the technology in the lab at the time. And I really enjoyed that. And I had a copy of Nature and I was looking through, "What am I gonna do next?" You know, I'm only here for 10 weeks, then I'm unemployed. What am I gonna do with my life? And I found an advert for a master's degree in Canada. Oh, that sounds exciting. I love the outdoors. I love adventure. I might have even phoned them up actually on a long distance call from a phone box saying, "What do I need to do? I'd like to apply for this." And then they called me up a few weeks later saying, "Well, we don't actually have funding for a master's. We've only got funding for a PhD. Would you be interested?" And said, "Well, yeah, okay, well, I'll give it a go," bought myself a one-way ticket, much to the disapproval of my parents. And did a PhD in physiology at U of A for about four and a half years, I think. My intention was to do a PhD, come back, and be a clinical scientist. That's what I wanted to do. So, I came back to do a postdoc at the National Heart and Lung Institute at Imperial College in London. I had a great time there. I think, and it was… academia's tough, man. I was like, "Hmm, I'm not sure I'm cut out for this. This is really high pressure." I'm quite academic, but not that academic. And then, one of the people who was also doing a postdoc at the time had just got a job at Unilever in R&D. He was like, "Oh, Karen, you should have a go at this. This is really good fun. It's a great place to work. I'm having a great time." So, I was like, "Yeah, okay, I'll put in an application." I applied for a job there and got it, and I went to work for Unilever R&D for about four years, I think I was there. Megan Thomas A PhD in Canada, research at Imperial College London, and a move into industry: Karen’s early career took her well beyond the hospital lab. But sometimes, exploring different paths helps you understand what you really want to do. Karen Perkins I'm spending more time in airports and in airport hotels traveling around, meeting other scientists and talking about projects than I am actually, you know, living life. So I thought, what did I wanna do originally? Oh, clinical biochemist. So, I started investigating that again and applied for a post, I think one in Manchester and one in Leeds, if I remember. So I thought I'll, I'll slowly start creeping back north, towards hometown and family. I got offered a job both in Manchester and Leeds and thought, well, I'm a Yorkshire lass, so it's gonna have to be Leeds. So yeah, that's how I got my grade A post. Megan Thomas Careers don’t always follow a neat timeline, and time away from work can bring its own challenges. Karen took a 7-year career break to raise her young family. Karen Perkins I think for the first five it was awesome. And then after that, I think I was going slightly mental for two years and thought, "What am I gonna do? The kids are at school now. I'm just waiting for everyone to come home every day. I need to go back." So, my mom was really probably one of the helping driving forces in getting me back to work 'cause her and my dad would come and look after the kids and free me up to do the things I needed to do to find where I needed to be. Steve Goodall, who was a consultant clinical biochemist and the trainee leader at Leeds, and Wayne Bradbury, who was the consultant clinical chemist at Carlisle, both of them encouraged me so much to get my state registration, not to just let this career drift, and to come back to it. And they knew I really enjoyed what I did. And I think because I'd had all those experiences before I got back to clinical biochemistry as a career, you know, I've been around, I've done other things, but this is what I want to do. and that's when I found Martin Myers at Preston, another wonderful clinical scientist in my career pathway. I said, "Can I come for two days a week?" He said, "No, we'll only take you for three days a week." I was like, "Okay. Yep. Okay, I'll do that." And he really supported me. The other clinical chemists there were just absolutely wonderful, and they still support me to this day. We're all in the same pathology network still, and they still cheer me on every day, so we're a very close-knit professional group, I think, in the northwest. So that's been wonderful. Megan Thomas For some patients, something as routine as a blood test can be a real barrier to getting the care they need. Karen’s approach starts with a simple question: what if there were another way? Karen Perkins My colleague Andrew Brown and myself, we get phone calls every now and then from GPs or learning disability nurses saying, "I've got this patient, I really need to get some thyroid profiles done on them. They're on thyroxine medication, but I can't get near them with a needle.” There's one patient that springs to mind. We had a learning disabilities nurse call us. He said, "Look, I've got this patient, it's taken me six months to get trust with this patient just to hold his hand, never mind get near him with a finger prick needle to get a blood spot TSH done." So, we think, "Oh God, this is terrible." And we're getting these calls every now and then. There must be something we can do about this. What else can we offer? So finger prick is the obvious one, but that's still quite painful. And just came across the upper arm transdermal devices, which is like a modern day leech. So it sticks on your upper arm and creates a little vacuum. You don't have many nerve endings on your upper arm, so you can't feel so much. It's not so painful as your fingertips. Just pricks your upper arm and draws a small amount of blood into a small tube. So I called up the company and they came and showed us the device. Oh, this is really good. We had a little play with it, tried it on ourselves, tried it on my husband and my kids, anyone else walking past. Yeah, this is really good. Um, so we did some work in the lab making sure that we would get the same results as compared to a routine sample. So we knew we were giving the right results out. And we developed a whole pilot program looking at providing alternative blood sampling for patients with learning disability and needle phobia. We've got some fantastic patient voices and advocates who are saying, "We need this. We need this." We've got national charities who are excited about it. And we have conversations with NHS England about it, I think I may have got their attention now, so watch this space. Megan Thomas A promising idea is one thing, but making it work across the NHS is another, and Karen has quite a few more hurdles to jump over. But the potential benefits can make that effort worthwhile. Karen Perkins Trying to get something new in place is hard. A routine laboratory anywhere in the country, in the UK, is very standardized, and we're not very flexible with the types of tubes that we can use. It's like steering an oil tanker in the NHS, changing the way that you do things. But slowly and surely, I think we will. There's so much momentum with this now and so many patient voices behind it now. They're demanding it almost. And patient-centric sampling is becoming a real thing, instead of just this rigid structure of this is how we always do it in the NHS. It's always got to be a phlebotomist taking a venipuncture. It's always got to be a standard tube size. No. Though those days are numbered now. I think we need to be more flexible as clinical biochemists and think differently about how we deliver our service. It is a paradigm shift in the way we do things. It's a revolution. So yeah. It'll take a little bit of time, but it's really exciting. Well, I'm hoping in the next five years, the way we deliver blood sciences in the laboratory will be very different. So we'll be more adaptable, we'll be able to take blood that comes in from all different locations by all different methods. I'm hoping we can build a routine laboratory that can cope with all those different things. It needs everybody around the table to say, "This is what we need, and this is how we're gonna use it. Um, what's the cost benefit?" All those kinds of things need to be talked about. And it's all about making things more accessible to the patient. So if you're a busy, working mum who's working maybe two jobs, and you're looking after elderly relatives, you're looking after children, you often don't have time just to go and get a simple blood test taken. But now you could possibly do it at home and just drop it off at your GP practice or post it in, and there's companies offering that kind of service now in the private sector. So we should be adapting to what's coming in the future. It's not just a blood sample, it's about that interaction with that human as well. And I think to allow that human to be able to give a blood sample wherever they need to and whenever they need to is something that we need to develop in our service going forwards. It's a very old-fashioned service as it is, but it needs an injection of resources for us to make that step change, I think, and hopefully that will come. Megan Thomas Working in science can be absorbing, but finding something completely different to focus on can make all the difference… and for Karen, that means making a little music. Karen Perkins I do have a keen interest in the trumpet. I'm not very good, but… I'm not sure it feeds into my work, but it helps me get out of my work. Often I'm working solo on my own and trying to keep all the plates spinning in the day, so it's really important to get out of work and do something completely different. And when I'm playing with the band, I'm concentrating on that and not on work. So, you know, your brain has to switch off from work then. You have to get away from it. Megan Thomas Karen’s path has taken her through different workplaces, research environments and stages of life. It’s shaped not just the scientist she is, but how she approaches challenges and makes things happen. Karen Perkins It's definitely given me confidence to not be afraid to speak to people in positions of authority. I know sometimes people think, "Oh, I can't just email that person because they're, like, really important." Whereas I’m, like, "Let's just go straight to the top, guys. Come on. Let's not me- let's not mess around." And maybe that's come definitely my days in Unilever when I was working with such eminent scientists and really important people in their fields of research. It gave me the confidence just to approach people. I remember once I had to organize a workshop on healthy aging while I was at Unilever, and I had a really nice budget for it as well, so we hosted it at the British Library, and I had a string quartet and stuff. It was fantastic, and we had all these eminent scientists attend. It was a great day, really inspiring scientific input. And, I went as a guest speaker there, so I think I phoned up Shirley Bassey's agent and said, "Is she available?" And I wrote to Roger Bannister as well and said, "Would you come?" I have a really nice letter from Roger Bannister actually saying he was not that well and he couldn't attend, so that was really nice. So I have that safe in a box 'cause he signed it. And I think, you know, doing stuff like that gives you confidence to speak to people and to communicate, and just don't be afraid. 'Cause they can only say no, right? Megan Thomas Karen’s story is proof that plans can change along the way. For anyone considering this field, it’s a reminder that curiosity and a willingness to try something new can take you further than you might expect. Karen Perkins I think most people that I trained with came from university, or they'd, they'd finished their PhDs, and they kind of knew what they wanted to do and didn't get distracted along the way. So I think, um, yeah, I was pretty distract… not distracted, but redirected. You know, if you see an opportunity, go and grab it. That how I've been brought up. You know, it's better to try something and fail at it than not try it at all, right? So, don't be afraid to give it a go, if it doesn't work out, learn from it and move on. Don't beat yourself up over it. Don't feel bad about it. And, you know, if you screw up your A-levels, you can still become a fellow of the Royal College of Pathologists, right? I hope they don't take that away from me now that I said I failed my A-level. Or I didn't fail it, I just got really rubbish grades, but, you know, I'm sure I'm not the only one out there. Get some experience. So contact your local laboratory and ask if you can come and spend a week there. They might only say, "Uh, we're so busy. I'm sorry, we can only take you for, like, half a day." Half a day is gonna be better than nothing. And if you're already in the early stages of your training post, ask if you can go on ward rounds, go to clinics, go and meet patients, go out into the community, go to a GP practice. Say: "Can I sit in for a day and see how you request tests?" You know, how do you use our service? Go and find out about what's needed for the future, where the problems are. I found just going on ward rounds opens up your eyes to so many problems that people have out there as to how they access our tests, and just getting things to the lab or getting results and that kind of thing that you just have no idea about because you're in the laboratory all the time. So yeah, I've started using hashtag laboratory social science on all my LinkedIn posts because it is social science. It's about what does the patient need? So yeah, if you're a budding clinical scientist and you want to get into this, go and get some experience any way you can, anywhere in a healthcare pathway, 'cause that's gonna stand you in good stead going forwards. Megan Thomas For a transcript of this episode or for more about Karen and her work, visit our website at www.labmed.org.uk/podcasts. This podcast is brought to you by BD and the Association for Laboratory Medicine. Produced and edited by Caroline Bacle, sound mixed by Daniel Fletcher. Special thanks to everyone in the BD and LabMed teams. And we’ll be back next time for more stories of Life in the Lab.