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A Resolution in October.

20 October 2014

I am a goal-driven person. That’s how my ambition manifests. I often think, when imagining taking on some new project, that “I don’t want to die without having done it.” That’s how I felt about writing my symphony, a work still unfinished. I will work on it again one day. I think I’ll finish it. I will probably never publish it (I don’t have the slightest idea how one publishes music). But I’ll finish it. Probably.

Lately, my goals have been professional, and relational, and physical. Professionally, I am achieving the things I set out to achieve. I’m advancing at work. My papers are getting slowly-but-surely published in venues I’m pleased to have them in. I’ve been promoted and my work is well received in my institution. Soon I will have employees who report to me, and my influence will be even more pronounced here. Other people who are moving up the chain of management are invested in my efforts. I’m excited.

My relationship is blossoming. I feel less and less like this is an appropriate venue to discuss it. But I am feeling more closely and more intimately connected in a romantic partnership than I ever have. I feel grateful and fortunate to have someone understanding, supportive, exciting, ambitious, adventurous, and thoughtful to share my life with. It’s more than I deserve. It’s far, far better than I’ve earned.

My physical goals have become prominent for me. Mostly, these revolve around running. This weekend, BB and I ran a total of 12 miles, 5 Saturday and 7 Sunday. We took the pace easy and I was very pleased that both days felt like a nice jog in the park. Other people are no longer expected to be impressed with those sorts of things. I remain gobsmacked that I was an obese alcoholic pack-a-day smoker and now I can run 7 miles and it’s a nice easy jog in the park.

The last goal I set about running was that I would run a half-marathon without walking any of it. I did that. I’ve done that twice now. Lately, I’ve been running faster, and my slow runs have been feeling easier. I’m improving dramatically. Part of the reason is that I’m working harder at running faster, part of the reason is that I’m going to the gym and working with a personal trainer. I’m trying hard to avoid the fate of my father, who never managed his diabetes, and had a debilitating stroke.

So. I’m setting a new goal. I said I wasn’t going to run a marathon, and I still might not. But what I have found is that I really appreciate having organized races to prepare for, because they keep me from slacking off. So I’ve signed up to run the Philadelphia half-marathon just before Thanksgiving, and the Virginia Beach half-marathon in March. But those aren’t my goal. A goal must be bigger than repeating something I’ve already done.

So here’s my goal for 2015: I will run at least 4 competitive (i.e., organized races) half-marathons. If I do decide to run a full marathon, then that will count as two. While I’d love to run one under two hours, or something like that, I’m not going to set specific speed goals. Not here anyway (BB and I are working on running faster, but we haven’t set a specific pace we want to hit. The number “2:10″ has been thrown around for Virginia Beach. If we hit that, I’ll be happy.).

That’s the goal. 52.4 competitive miles in 2015. Which means probably at least 10 times that number in preparation. Right now I’m running about 18-20 miles a week. That’s plenty to stay fit for half marathons, with a brief ramp-up for the weeks before race day. But if I’m going to run a full marathon, I’m going to need to push my weekly mileage out to at least 40 shortly before the race.

So here we go. Run like hell.

Why Spirituality?

14 October 2014

One very important aspect of recovery is the “maintenance of our spiritual condition”. Now, as a person who is not religious and not even particularly spiritual in any traditional sense (though I used to be), I have to consider deeply what that means. Why do we associate sobriety with spirituality? How does that help me recover? The idea that “God strikes us sober” is useful to many people in recovery, and I support that where it is useful to individuals. But it is not a concept that has ever been relevant to my own journey in sobriety.

To me, spirituality is a concept more nebulous and less… supernatural. I find spirituality to be very natural. I think it’s an ordinary aspect of the human condition. Spirituality is one of the natural ways we try to find our place in the world, in society. Spirituality is, to me, about connectedness and awareness of things larger than me. About seeking accordance and harmony between what is inside me, and what it outside. Arranging my mind to be in a state of peace with the things in the world that I cannot change.

I don’t pray. But I see no reason that prayer is incompatible with a deityless nature. I am fond of the aphorism that prayer is not about influencing the thing prayed to, but rather about influencing the thing doing the praying. As such, I see prayer as little different from meditation, or simple mindfulness. When I attempt to find a quiet space in my mind, in my heart, in whatever my soul is, I am doing something like prayer. I am consciously attempting to bring my self into alignment with the world as I understand it.

This helps with sobriety because being serene is a crucial tool in abstinence. Many of us drink to quiet raging waters in our spirits, in our consciences. Maintenance of our serenity deprives our addictions of leverage to drive us back toward inebriation. Because alcohol is anesthesia to me. It soothes inflammation of the soul. At least, that’s what my mind tells me. That’s what my addiction wants me to believe.

And so engaging with our concepts of spirituality provides us with an alternative balm for crises of mind and heart. I believe that that is a nearly-universal thing that humans do, and that it is to our credit that we do. Looking to God, to Nature, to spiritual abstracts for solace and comfort is not a sign of weakness or delusion. It is engaging with a natural process within ourselves which – for some of us – demonstrably improves our mood, resilience, and ability to participate in normal society.

Which – for some of us – materially aides our efforts to remain abstinent from artificial intoxicants which plague us and drive us to behave antisocially. We claim spiritual progress. I understand these things differently today than I did before. And differently today than I will in times to come. But today, I believe that spirituality need be nothing supernatural to be real, and tangible, and useful.

Feeling Other.

8 October 2014

One characteristic that is common to most of us in AA is the sense that we feel “other” from the mainstream of society. We don’t belong. We don’t get it. We don’t feel comfortable participating in ordinary social and societal situations. We feel outcast, downcast; belittled and degraded. We seek ways to feel less like this.

Alcohol helps. In the beginning, alcohol helps. We start to find ways to participate. We feel less like peeling off our own skin when we’ve had a drink or two. There’s a reason alcohol is called a “social lubricant”. We feel in dire need of anything to help us feel less like we are stuck, frozen, embarrassed, and out of place.

I think a lot of people who aren’t alcoholics have the same anxieties and discomfiture. And I think alcohol often helps them feel like they fit in too. But for us, we alcoholics, alcohol is a very temporary solution. Because even as it allays our own toxic discomfort, it siphons it off and distributes it to others. People become uncomfortable around us.

We drink too much. We behave unpredictably and inappropriately. Alcohol frees our baser instincts. We act out socially, sexually, physically. We feel powerful when we’re drunk, in the beginning. We feel compelled to drink more. We do. We abandon, or are shunned by, those who do not drink like we do.

And so the drug we took to address our isolation becomes an isolating feature of our lives. We drink more to overcome it. As we do, we are further marginalized. Eventually, loneliness is the dominating landscape of our existence. Alcohol fuels depression and humiliation. It gets worse.

In recovery, this sense of otherness has to be addressed. We need to find communities that adopt us, embrace us. Alcoholics Anonymous is one such community. Where we come together, castaways from the same shipwreck, and understand what we’ve been through. How we debased ourselves and earned condemnation. We dedicate ourselves to moving back towards life, while remembering why and how we lost our purchase on it in the first place.

But we may feel that otherness still, in other environments. I do. I feel useless and isolated an enormous amount of the time. In communities that are supportive and embracing. I try desperately to fit in, only to find myself feeling flung ever further from the center. I fabulate vile scorn from the most innocuous behaviors on the part of those I’d most like to feel accepted by. Invented cordons blocking me from social hierarchies I’d like to ascend.

I find myself despising the things I said I wanted. Succumbing to spirals of relegation. Letting grow derelict gardens I once thought I’d carefully tend. Because I cannot see myself as belonging there. I am not a tiller of that soil, that earth where good things grow and kind people celebrate the flourishing of one another’s labors.

I cannot sit among those whom I would sit among. I am not of them. My desire to contribute opinion and influence in those venues is just gonging on the wrong beats.

I have discovered how not to drink. I have discovered places where I belong. But I have not yet learned to be satisfied contributing in places where I understand the rules. Where I’m part of the bedrock. I reach out to prove I belong part of larger communities and howl to make myself heard when I don’t know what I’m saying. While my thoughts are ill-considered and poorly defined. Undefendable.

I don’t know where I belong. But wherever I am, it seems, the answer is, “Not here.”

Speed.

3 October 2014

I’ve been trying to run faster the past week. When I had a personal trainer in St. Louis, she told me: “If you want to run faster, you have to run faster.” As there often is, there’s complexity in tautology. For a while, I got a little faster just by going out and running at the same effort level. Because I was getting into shape, and I could just sort of improve, without a huge amount of effort being put into speed. Don’t get me wrong, there was a huge amount of effort just put in to moving. But I wasn’t trying to go fast.

And I didn’t really think I wanted to go fast. I had a basic goal of running 10K in under an hour, which requires about 9:40 miles. That’s a good clip, but it isn’t anything too impressive. But it’s a reasonably fast jogging speed for a late 30s dude, which is what I was at the time. And I did that. Last year, in the spring of 2013, I ran ten kilometers in about 59:30, and I was happy, and it felt like a big accomplishment. Then I stopped trying to run any faster, and started trying to run further. I got slower, but that was ok. Because I was running 10, 11, 13 miles at a time, and that was a major accomplishment of its own.

Now, having run two half-marathons with BB, I am torn between two goals. I want to get faster, because faster is fitter and my main goal in all of this is to not get diabetes. For that, I need to stay trim, and I need to have good cardiovascular fitness. But I also am finding myself more and more pulled in by the ambition of completing a full marathon. At least once. I think.

But I’m also compelled by the idea of, say, finishing a half marathon in under two hours, which is a wildly ambitious goal for me. That requires running 13.1 miles in a row faster than 9:10 min/mile. That seems almost impossible. Or at least it did, until yesterday. Yesterday, I ran 10K (6.21 miles) in 55:22. That’s 8:52 min/mile. Which is crazy fast, for me. Tuesday, I ran 5K (3.11 miles) in 25:57, or about 8:18 min/mile. Which is blazing speed for me. Like, beyond what I thought was possible.

But if you want to run faster, you have to run faster. I had to increase my effort level, be prepared to fail, and run like hell. And I did. And I didn’t fail. And maybe, that 2 hour half-marathon is a possibility. Maybe that full marathon is on the horizon. My friend @scicurious tells me that running faster will help me run further too. If for no other reason than that I can go a further distance in the same amount of time.

And then, BB and I can run together, faster, further. And maybe I can stave off the specter of metabolic infirmity until I’m old and tired. I feel good. I’m doing things I didn’t know I could do. Things I didn’t know I wanted to try. But now I’m here. This is kind of amazing to me. And I’m happy. I’m going to get the image below inked on my right calf. Run like hell.

tattoo_run

Contribution to Science!

2 October 2014

Hurrah, haroo! I have had a paper accepted! It felt like it was never going to happen again. This is an exciting one for me because it is the first (and probably only) paper from my little tiny grant that I got shortly after arriving at MECMC. That grant paid for two interns for a year and a trip to London. The work resulted in policy shifts at my hospital, because the client department had quantified evidence to buttress their requests. And it resulted in this paper, where we describe the work as a case study and tell others how to do the work in their own environments.

I consider it a major success, especially because my interns, undergraduates at VFU and UHR respectively (OK, technically one has now graduated), are the co-first authors. I know some people don’t like co-firsts as a concept, and I’m aware of the problems. But they worked very hard, and collaborated constantly. In the “acknowledgements” we state, “Authors [a] and [b] are listed alphabetically.”

The journal is a mid-level medical journal with an audience of MDs, which is exactly what I’m going for, as I’ve written before. I know that it means that my work will not get the publicity that I might get if I were submitting to engineering journals. But I also believe that changing quality improvement practice means exposing medical decision-makers to this work prior to trying to convince them to do it in their own clinics.

It’s exciting to put my science/engineering out there for the world to use. I hope somebody bothers to read it.

Professional Advancement.

30 September 2014

The foundations of my empire at MECMC are beginning to be laid. I have been here now for about 18 months. After two consecutive good performance reviews, I am being promoted. It’s not a major promotion in terms of my job, from an institutional perspective. But it’s a big deal to me. I was asked to write the position description, and I did. And I specifically wrote into it that I will have time to write papers, and represent the institution externally at conferences and symposia, as well as representing my department at hospital-wide events like grand rounds and “Patient Safety Day” etc..

The new position comes with a better title. I picked it, but I’m not super happy with it. I’d like something clean, but there are a few institutional rules about broadcasting levels that require me to pick a particular prefix. And then it’s a matter of distinguishing myself from the IT positions that are engineers, while also hopefully having a title which will signify to grant reviewers and associate editors that I’m academically capable. I settled on a title similar to what I had at my last gig. Of course, now, writing this, I’ve thought of the perfect title and it’s too late.

Nevertheless. I am advancing. This is the first step on my way to having a small “department” of my own. Really a laboratory-sized group of people who will do simulation and quality research and practice at MECMC and disseminate broadly. My manager has said that come spring, we will be looking to hire people that will report to me personally, and I can begin directing larger projects and more comprehensive treatments of our systems.

Hopefully, this will all lead to a body of work that makes a contribution to the field of heathcare quality engineering. And a nice and comfortable career for me in ECC. Or perhaps a stepping stone to a position as a professor of health policy or something. At this point, I’m never taking the Assistant Professor gig on my way to tenure. But I might well work here for 10 more years and then accept a position at the associate level, or something like that. Assuming I can keep up my publication and funding record, which I believe that being at MECMC will help me with*.

So I’m excited. My day-to-day life is not going to change much. I’m getting a new title, a little more autonomy about projects and directions, a small pay bump, and eventually some full-time people to direct on my projects. I’m 40 years old. I have a lot of karmic debt to pay back, that I fucked up my life so badly and yet have managed to land well. I’m happy where I am, and I had better do right by whatever got me here.

___________________

*Go read Proflike Substance’s post on institutional pride.

Obsession in Sobriety.

29 September 2014

Alcoholism is a disease of obsessions. It’s a disease of many things. I guess what I really mean is, “I’m about to talk about obsessions in alcoholism.” Because alcoholism is also a disease of isolation, of depression, etc.. It’s impossible to lay alcoholism at the feet of any one descriptor. But one powerful characteristic that nearly every alcoholic I know shares is obsession. And it may manifest in a million ways.

Some of us (though not me) are diagnosed as obsessive-compulsive. That’s a serious mental illness about which I know little and can offer no insight. I suffer from any number of mental illnesses, but thankfully, that isn’t one of them. However, I am familiar, at least, with the sense of being obsessed with something, to the extent that it dominates my thoughts, and I find myself arranging my life around the object of my obsession.

For a very long time, that was alcohol. But I was obsessive long before I began drinking alcoholically. In seventh grade, I memorized 150 digits of pi. I would become fascinated with various hobbies, and learn everything I could about them. I would be incensed if others didn’t share my interest: it was like a personal rejection for someone to be less interested in a topic than I was. This was especially problematic when, from about age 14 to about age 23, I was obsessed with religion. I was properly insufferable.

And then, of course, I was obsessed with alcohol. Not just with getting and drinking alcohol, but with learning about it. I brewed beer. Good beer! I was good at it. I bought a CO2 tank and a pony keg and a refrigerator and brewed beer and had excellent home-brewed beer on tap on a regular basis. That fell off, of course, as I grew more indolent and decided that purchasing alcohol was far less labor intensive than making it.

My obsession with alcohol increased, until it dominated everything in my life. If you’re reading this, you probably know the story.

In sobriety, my fundamental nature has not changed. I continue to obsess. I find it strangely soothing to discuss the same concepts over and over. I continue to get deeply interested in topics of questionable value and invest time, and effort, and money in learning and studying them. Lately, my obsessions have been men’s fashion and fitness/running. Luckily, these are complementary. As I run more, and lose weight and change shape, I have to buy new clothes.

It’s pretty common for sober alcoholics to be runners. I have known many. Some who ran before quitting. Some like me who began after. Running is deeply satisfying for obsession. It provides endless metrics to consider. Speed, distance, events, equipment, how to train, how to eat, everything. And I think it’s reasonably productive.

Obsession can be a negative even when it’s focused on something positive. Fitness is great, but if working at it causes me to neglect other things in my life, or results in serious injuries, or costs too much money, then it’s not constructive for me. So far, other than annoying people on twitter and at the office with too-long discussions of running, I think I’m still on the “healthy” side of my fitness obsession. I aim to stay there.

I’m grateful that I have the capacity to channel my obsessive nature into things that are positive now. Steps 6 and 7 of the 12 are about recognizing one’s character defects, becoming willing for them to be removed, and asking for that to happen. If you believe in God, then that’s generally what you do. My spiritual concepts are less concrete than “God”. So I find that to accomplish step 7 in a way that’s meaningful for me, I need to make regular efforts at diminishing and releasing my character defects with the help of others.

When it comes to obsessions, that means either recognizing them and trying to accept where I am and how I feel (like about my house), or channeling them into positives (like running). Focusing my obsessions on constructive things, or at least on non-harmful things, it crucial to my continued sobriety. When I fail to do that, I can spin in circles, frustrated and bewildered, until relief from that awful state seems to require anesthesia. And then, drinking might seem like a good idea. By focusing on fitness and health, I think I’m helping to buttress myself against that: I know how bad for me drinking is.

So yes. I know I talk too much about running. I know I’m focusing on it and jabbering and bothering. That’s for me. I’m kind of a nutcase, dear reader. But this is a kind of madness that builds me up, I think, instead of dissolving me away.

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