From Childhood Dream to Research: Dr. Silvia Marchesi's Mission to Transform Pain Care

3 days ago

6 min read

AdvanSci’s medical writing grant application, clinical trial consultant, and scientific advice services helped Dr. Silvia Marchesi refine her study design and protocol and win two major grants from the Swedish “Avtal om Läkarutbildning och Forskning” (ALF—an agreement on physician education and clinical research) and the Swedish Research Council (Vetenskapsrådet) to a total of 2.2 million SEK plus 50% of her salary for four years. — Dr. Silvia Marchesi is a postdoctoral researcher, anesthesiologist, and intensive care practitioner at Skåne University Hospital, Malmö.

The morning light filtered through the windows as Dr. Silvia Marchesi adjusted her schedule one more time. As a postdoctoral researcher, anesthesiologist, and intensive care practitioner at Skåne University Hospital, Malmö, she had strategically chosen this time for our videocall —early enough to minimize the risk of being called away to an emergency. It's a careful balance that defines her daily reality: pursuing research while never losing sight of her primary calling—caring for patients.

I decided to become a doctor when I was just 8 years old. My parents thought I was dreaming, as any young child would. But the older I grew, the more certain I became. I like science as well as people. The medical field sits right at the intersection where I can unite both passions. —Dr. Silvia Marchesi

What her parents couldn't have predicted was how that childhood dream would evolve into a mission to address one of medicine's most overlooked challenges. Today, Silvia focuses on perioperative care, advancing how surgical patients are assessed, anesthetized, and supported through pain. She gives special attention to two categories of patients who face pain and suffering both in general and related to surgery: inflammatory bowel disease and endometriosis.

The Forgotten Patients: Women with Endometriosis

During her clinical practice, Silvia developed an interest in a patient population that would change the trajectory of her research career: women with endometriosis. Endometriosis represents one of the most challenging conditions in gynecological medicine. This disorder affects approximately 10%-15% of women of reproductive age and is identified in roughly 70% of patients presenting with chronic pelvic pain. In these patients, endometriotic implants—painful uterine-lining-like tissue growths— grow outside of the uterus in locations such as the ovaries, pelvic peritoneum, and various other anatomical sites.

The underlying pathophysiological mechanisms of endometriosis and its associated pain remain unelucidated; gynecologists primarily attribute inflammation as a principal factor in disease-related symptoms. Although surgical intervention can achieve complete resolution in some patients, the majority experience symptomatic recurrence over time (1). For too long, this condition has been relegated to the shadows of medical research, compounded by systemic sex bias in pain management that leads to womens' pain being stereotypically judged as less intense than males', leaving endometriosis patients struggling with inadequate pain management options (2).

My colleagues at the hospital raised a concern. These patients were dealing with enormous pain after surgery, and we simply weren't able to help them effectively. —Dr. Silvia Marchesi

The problem runs deeper than individual cases. Current post-operative pain protocols address wound and incision pain but fail to tackle the visceral pain that endometriosis patients experience—a gap that has persisted for generations. As Silvia discovered through her research, the field has not had new pharmaceutical developments in decades.

Pain care has seen no new molecule for more than 100 years. —Dr. Silvia Marchesi

But sometimes breakthrough solutions hide in plain sight.

A Simple Solution with Potential

While working in the operating theater, the anesthesia team at kvinnokliniken (the gynecology/obstetrics department) made a crucial observation: several studies have shown that ketamine is highly effective for managing postoperative pain and can reduce the need for opioids. Perioperative administration of ketamine or its S-enantiomer, esketamine (ketamine being a racemic mixture), has been employed across various clinical contexts to diminish postoperative acute pain and reduce opioid requirements, with a systematic review confirming its efficacy (3) (4). Furthermore, ketamine has shown efficacy in preventing the transition from acute to chronic pain in certain clinical scenarios (5). In addition, it can be given in liquid form to patients post-operatively, making it easy to administer. In spite of its simplicity and known efficacy, no one had tested its effectiveness specifically for endometriosis patients' unique pain profile.

This realization sparked what would become her second major research initiative. However, securing funding for innovative research presents its own challenges, especially for early-career researchers navigating the complex grant landscape without institutional support systems.

When you're doing a PhD, you have supervisors and established systems. But when you start your career as a researcher, there's nothing like that. You need to build systems for yourself while simultaneously securing funding for the future. —Dr. Silvia Marchesi

Grant Writing Presents Unique Challenges

Research funding applications are notoriously demanding. For early-career clinician-researchers like Silvia, who must balance patient care with research pursuits, this investment represents a significant challenge.

The stakes are particularly high for early-career researchers, who have an average grant win rate of below 8% (3). Without the safety net of established research groups or dedicated grant-writing support, they must master not only the science but also the art of persuasive proposal writing—skills rarely taught in medical training.

When a professor from Lund University recommended AdvanSci, Silvia recognized an opportunity to level the playing field.

The Power of Expert Perspective

AdvanSci's approach to medical writing for grant applications goes beyond simple editing. The team, led by experienced medical research consultants Jane Fisher and Susanne Larsson Faria, provides what Silvia describes as "peer review from a funding institution perspective"—offering insights into what grant committees actually seek in successful applications.

After Jane and Susanne reviewed my grant application, I realized how many mistakes I had made in previous submissions. Of course, I can write applications myself, draft after draft. But I would be left alone to navigate the process when what's most important is being confident in your research and knowing your protocol is flawless. —Dr. Silvia Marchesi

The collaboration proved transformative in unexpected ways.

Beyond Professional Medical Writing Services: Building Confidence and Community

What distinguished AdvanSci's approach wasn't just technical expertise; it was their understanding of the human element in research.

Compared to others, Jane and Susanne were much more human and flexible with their approach. They were open to discussing what type of service I really needed, and as a result, I'm satisfied with what they delivered. —Dr. Silvia Marchesi

The impact extended beyond the grant application itself.

Now I feel much more confident with my research, even when pitching it. —Dr. Silvia Marchesi

This confidence boost is crucial for early-career researchers who often struggle with multiple challenges while establishing their research identity. By providing both expertise and strategic guidance, AdvanSci helped Silvia transition from having feelings of uncertainty to being a confident researcher ready to tackle complex funding landscapes. This newfound confidence has already translated into funding success: AdvanSci’s scientific advice service helped her refine her study design and protocol and win two major grants from the Swedish “Avtal om Läkarutbildning och Forskning” (ALF—an agreement on physician education and clinical research) and the Swedish Research Council (Vetenskapsrådet) to a total of 2.2 million SEK plus 50% of her salary for four years.

Looking Forward: A Research Career Built on Passion

Today, Silvia's research interest continues to focus on improving pain management for endometriosis patients—a population that has waited too long for targeted solutions. Her work represents more than academic achievement; it's the fulfillment of that 8-year-old's dream to help people through science.

"Taking care of people always motivated me," she reflects. And now, armed with both clinical expertise and grant-writing confidence, she's positioned to make that care more effective for countless women.

Her advice to fellow early-career researchers echoes her own journey: "Research is amazing. Enjoy what you are doing. It makes us more resilient and patient. And most importantly, try to believe that you can do it. Start the process."

As our conversation wraps up, Silvia's phone remains silent, indicating that, at least for the moment, there are no emergencies that require her attention—a small victory in the daily balance between patient care and research pursuits. Her mission remains constant: transforming scientific knowledge into better patient outcomes, one breakthrough at a time.