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What Fitness is For.

26 January 2015

When presented with images of fitness in the media, we generally see images of almost impossibly beautiful people (often actually impossibly beautiful, due to digital effects), who are probably also suffering from severe, chronic caloric deficits. Often, they are also probably using steroids or other hormones to build muscles that ordinary humans who care about their long-term health cannot. They do this to have people want to pay them to take pictures of them, or play lucrative sporting events.

I’ve been working very hard at fitness for a few years now, and I don’t look like those people, and I never will. Don’t get me wrong. I’d love to look like Luke Guldan. But that ship sailed a long time ago for me, and it is never returning to port. My fitness goals can be summed up in very basic terms, but I think that they encompass a larger philosophy, to use too grand a word.

My most basic fitness goal is simple: don’t get diabetes. I’ve written it before and I’m sure I will again. I watched diabetes, unchecked, strip my father of his vitality in terrible ways. I do not want to go that route. And I find it very difficult to control my sugar intake. So I work out and I run, seven to ten hours a week, in order to maintain the physical fitness necessary to help me stave off this killer disease. Which I am genetically prone to, and have personal predisposition towards. And so far, according to my blood work, it’s working.

Next up, of course, is that I would like to to feel healthy and fit in the physical space I occupy, and to be attractive to my partner. I want to feel comfortable on the beach. Having been fifty pounds heavier than I am, and working very hard for several years to lose that weight, I know how it feels to be obese, and how much work it can take to change it. I know that not everyone has that opportunity or physiology, and that weightloss is complex and personal. But I have found what works for me, which is to control my overall diet, and do moderate to high intensity exercise several hours a week.

But yesterday, I was reminded of a practical benefit of fitness that I had forgotten about. As I took the DC metro to the train station, my car stopped a station stop early, and I was late for my train. I needed to find a cab, fast. I sprinted the length of the subway platform, up two long escalators, and found a taxi. The taxi drove me to the Union Station circle, and I leapt from the cab, and sprinted from there to through the terminal and down the length of the track until I found my train, just moments before it pulled away.

In total, I probably ran about a third of a mile, is all. But in docksider shoes and carrying a piece of luggage. Wearing jeans and a winter overcoat. When I finally reached my destination, I sat down, and huffed for about three minutes, and then all was as before. I literally never even broke a sweat. Only a couple of years ago that would have been an extremely difficult thing to do. Six years ago, I’d never have made it. Yesterday, it was a non-event. It’s just something I can do now. Because I’ve trained for it.

That’s what fitness is for me. And I’m sure that such commonplace things are barely worth noticing for normal people who’ve been fit their whole lives. But as a former obese, alcoholic smoker, I find it constantly astonishing to be able to use my body in that way. A way that only a few years ago seemed lost to me forever. And that fills me with gratitude.

AA is Held to a Higher Standard.

22 January 2015

I’m fond, over on twitter, of saying “AA works”. What I mean by that is too complex for the 140 character medium of twitter, but I’ve described it here many times. AA doesn’t “work” as a treatment for alcoholism the way, say, vaccines work for preventing illness or antibiotics work for treating infection. AA isn’t a medical treatment. What it is is a framework for living and being relieved of the obsession and madness of alcoholism, which, when willingly embraced, allows us to relent from our death-grip on addiction and rejoin the world of humanity, productively.

And I often get pushback from scientists when I say that AA works. I get people who say it doesn’t work for atheists because it has a spiritual element. This is, of course, directly contradicted by the fact that many thousands of atheists recover in AA all the time. I’ve known at least dozens, perhaps hundreds, personally.

I’ve been told AA doesn’t work because it isn’t evidence-based. That trials haven’t proven it’s better than placebo. I’ve addressed this here too: investigating AA doesn’t really work, from a scientific perspective, because retrospective cohorts can’t be developed, and because prospective trials require that researchers participate (even minimally) in the treatment, which often derails it (and means that the program that’s being studied isn’t really the AA program anyway). Trying to produce rigorous scientific evidence of AA is doomed from the outset. And like the parachute review, isn’t needed: some things are self-evident. Like millions of recovered alcoholics.

I’ve been told it doesn’t work because someone’s family member tried it and they continued to drink, or, god forbid, died. This is deeply tragic and my heart spasms with grief for those who’ve lost loved ones to this disease. I have too. But AA doesn’t fix us from without. It provides a framework we can use to fix ourselves from within. And even from the perspective of a “medical treatment”, no medical intervention is 100% effective. But we don’t abandon SSRIs simply because not every depression responds.

I don’t know why people are so eager to hold AA to the standard of “It must help every person who engages for any time to recover completely and irreversibly.” That’s an absurd standard to hold any treatment for any disease to. And even though I don’t consider AA to be a medical treatment, that’s the perspective that nearly every scientist and physician I’ve discussed it with has of it.

Like many things, I think the issue is largely one of control. Because AA was invented by drunks, and not scientists (though, of course, one of the founding members was a physician), it can’t be claimed by science as a developed intervention. I think there’s some resentment there. I think there’s also dismissiveness. They don’t know exactly how AA “works”, and we recovered alcoholics can’t ever seem to explain it in a way that makes sense. So it must not work. It must be a fancy placebo.

I’ve largely stopped trying to convince scientists and physicians that AA is a real thing that works for real people. Some few seem to understand. Some accept it despite not understanding. Most are glad to see people recover but deeply skeptical that AA has anything concrete to do with it. A few are openly contemptuous and think AA should be demolished.

And while I prefer the former reactions to the latter, the truth is that it doesn’t matter. When we come to that place where there is no solution left. When medicine has “failed” us, because we’ve failed to do what is required by medicine. When we stand between recovery and death, and cannot decide which path to take. Then AA will be there. As it has been for more than 80 years. And for many of us, those who find the willingness to engage and participate, it will herald recover and freedom and life. As it has for me and millions of others. And we don’t need others to understand it. Our survival is not your evidence.

And most of us, we addicts, we alcoholics, most of us will die. As we always have. And as we always will. Alone, and lost, and silent, and cold, most of us die. I understand why doctors would like to spare us this fate. I understand why scientists want to learn why so many of us prefer that fate to life. I wish them well. Any effort that lifts any of us from that slough is good.

But I know the way out. And Milton was right: Long is the way, and hard, that out of darkness leads up to light. But I know the way. And I can help you find it.

Just Tell Them You Can Do It.

20 January 2015

Saturday night, BB and I went out to dinner with a person I work with and his wife. We went to a cozy little French restaurant and really enjoyed it. I had the venison. It was a good decision. The four of us enjoyed a wide-ranging conversation over three hours.

BB and I both have lots of friends who are academics, and we enjoy them. But it was enlightening to talk to friends who have other ambitions. Both of them trained as artists. He’s a photographer, she’s in textiles. They met at some ultra-fancy art school in Michigan. She is still doing artistic work, but commercially, designing prints. He works as a business manager at MECMC.

We asked how he got into healthcare. He was young and becoming very successful as an artist when the recession hit back in 2008. He decided that the state of the economy was going to require that he had professional training, not just artistic training. So he went back and got an MBA while teaching photography.

Once he had the degree, he talked an administrator at a local hospital into letting him have a short-term internship helping that hospital out of a financial jam. From there, he was able to apply for mid-level administration positions at MECMC and landed one. In his (paraphrased) words, “I had no idea what I was doing. I just said I could do it and figured it out along the way.”

That deeply echoes my own experience and strategy. My doctoral training, the coursework, was totally unrelated to my research, or to what I am doing now. When I have applied to positions, I’ve simply decided that I can learn what I need to know as I go along. Of course, I’m generally bringing some skill set that they want, I’m not making things up from whole cloth, but it’s always stretching.

Right now, BB is writing a series on searching out different paths after academic training (Start here). I find it fascinating how disciplined and systematic her approach was. Our friend and I seem to have taken a far looser path to finding things. But common to both approaches is the reliance on networks, and the willingness to embrace frightening change and take on unknown tasks.

I’ve had a number of conversations with academics who are finishing a postdoc or approaching a tenure decision and who are terrified about the next step. People who’ve told me that there’s no way they could leave academia because they don’t know how to do anything else. Or that they’re not trained for anything else. Or that they have no experience at anything else. And then that the academic job market is so nebulous and depressing that the only appropriate response is despair.

I don’t believe any of that. I mean, obviously, I accept how people feel, and people always have the right to their own experiences. But I believe that academic training provides us with far more that many academics realize. It provides us with a resourcefulness, a means of investigating the world. And resilience in the face of adversity. Academic training, in any discipline, is hard. Succeeding at it should show us – all of us – that we can take on unknown challenges and risks and prevail.

Academic training in the sciences provides us with specific skills relevant to many different careers. Maybe not jigsaw-piece suited to every different path we could take, but useful and appropriate. We can be more than only professors. Hell: even becoming a professor requires us to take on tasks we’re not trained for. No one teaches us to teach classes or budget grants or manage employees. But professors usually do all those things.

We are more adaptable, more agile, than we think we are. Honestly, I think some of the reason that academics think they can’t do industry is that they’re just hung up on their objections to a commute and a set schedule. Or I hear people talk about how deadening “industry” is because there’s “no intellectual freedom”. These statements are invariably made by people who have never held industry jobs.

So, if you’re an academic who is fearful of finding your place as a professor, know this: there are many places you can land. Your situation is not remarkable in this world. All of us have to make frightening changes, and we do it, and succeed at it, all the time. Your options are not limited to “professor” and “fry cook”.

I really believe that for the great majority of us, if we fail, it is because we decided to fail. Because the difference between failure and success is often simply attitude. I could look at my job and call myself a failure because I have to be at work at 8am and stay until 4pm and work on projects that are not exclusively of my own choosing. Or I can look at my career and see that I’m a success because I’m gainfully employed at something I’m good at, and I contribute.

And you know what? I’d have the same choice of outlooks if I were a fry cook.

Home from Conference.

15 January 2015

I spent the last four days in New Orleans at the International Meeting for Simulation in Healthcare. It was a good meeting, though I am coming around to the feeling that it might not be my meeting. It’s very heavily focused on mannequin simulation, and I do discrete event simulation. There’s a couple of small groups interested in DES, and I presented twice to good receptions.

But overall, I don’t know that this is the right environment for me. Particularly considering there is a very strange person trying to hijack the systems modeling group into some kind of big data/number crunching agenda. He’s a very unpleasant single-mindtrack zealot. I don’t enjoy trying to participate in groups where he’s there, and no one else seems to either.

But it’s not my group, and I’m not calling the shots, and I don’t want to. So this is a case of, “When I’m uncomfortable, there’s a problem with me.” Whatever problems this man has, and however inappropriate his topics are to the group, it’s not really my business, because I’m not the one in charge of the group. So my only decision to make is if I’m going to participate or not. And I haven’t decided.

I probably should have gone to a meeting in New Orleans while I was there, but it honestly didn’t occur to me while I was. I thought about it before the conference. But during I had a lot of work to do and a lot of conference to attend and I simply never gave going to an AA meeting a single thought. That’s a little concerning. I don’t always go to AA meetings when I travel, but I often do, and I think I could have used one this week.

I got about 14 miles worth of runs in on the trip, along the brickwalks around the New Orleans convention center. It was nice to run in a little warmer temperatures. Though it wasn’t especially warm. I got in a 10K in a little under an hour, which always feels like an accomplishment. I won’t be able to run again until Saturday, but I’m planning a 10 miler then.

I’m tired. I was able to use the conference to catch up on a little bit of sleep by napping between sessions, etc., but I am feeling deeply tired. Headachey. The abdominal strain prevented me from doing the kind of workouts I really want to be doing for a couple of months, and now I feel a little slothful. I need to get myself into real shape if I’m going to run a full marathon this fall.

Things are going objectively very well. I’m just a little bleary today from travel. I should shut up. That’s good advice at almost any time.

Satire.

8 January 2015

I have written before that offensive humor is the edge on the blade of liberty. Giving offense has a long and critical tradition. Without the right to offend, we do not have the right to breathe. Because someone, somewhere, right now, is offended by our breath.

Offending Muslims with caricatures of Muhammed isn’t nice. Nor is it nice to place crucifixes in jars of urine. Nor is it nice to picket fallen servicemen’s funerals with vile screeds that god loves dead Marines, as the Westboro Baptist Church did at my cousin’s graveside. These things are unkind. They are offensive.

But it is the right of every person to offend. It is the right of every person to assert their own truth, even if it is demonstrably absurd. No one is obliged to listen. No one is obliged to adopt someone else’s positions. But each of us has the right to shout them.

Even hate speech. Even lies. Unless the vocalizations create a substantial, direct, and immediate threat to human life, all speech must be protected.

Because someone thinks that your opinions are hateful. Someone thinks that your speech is harmful. Someone thinks that you should be silenced. Someone thinks that you’re not toeing the right line. And when enough of those people congregate in the same place, and assume power, you will find yourself oppressed.

I see this happening right now in my own community. There are opinions that it is simply not acceptable to voice in liberal academia. If you are pro-life. If you have laissez-faire economic ideas. If you challenge the academic conclusions of sexuality or gender. You will find yourself isolated, marginalized, and shunned.

No, you will not find yourself shot. And no, freedom of speech is not freedom from consequences. But there is no tolerance for thoughtful dissent in academia with regard to politics, because there is no admission that thoughtful dissent can exist. Therefore, attempting to dissent brands a person immediately as a reprobate. Frequently I’ve seen absurd contests to see who can be the most orthodox. Academia is becoming like a caricature of a small town church: piety and judgement and enforcement.

We all have the right, of course, to disassociate from people who hold objectionable beliefs. But when we as a community hold the keys to a kingdom – as we do in academia (publishing, grant money, positions, titles, advancement of knowledge) – it becomes exceptionally egregious to demand uniformity of thought. As academia makes impressive, long-overdue strides with regard to diversity of race, gender, sex, and origin, it is simultaneously exterminating diversity of opinion and politic.

Satire finds a soft belly and slashes it open. It exposes our absurdities. Giving offense challenges ossified ideas. We are all proud to offend those we think need offending. But when someone comes along and offends our own sensibilities, my community is as bad as any at stamping the nonconformist down.

The proper reaction to being offended is to shrug off the offense and, if desired, engage the offender in a discussion. Ostracism and gunfire cross a line.

Gratitude for a Good Year.

30 December 2014

This year has presented me with many significant challenges. And I’m going to lift them up out of my heart and set them aside today. Because in all objectivity, this has been about the best year of my life. The number of wonderful things I have going on dwarfs the difficulties and trials, and it’s high time I accounted for them in a meaningful way. I have a good life. A far better life than I deserve, or have earned. And I say that while feeling like I’ve earned a good bit, as well.

One of the fundamental aspects of sobriety, at least as practiced in AA, is to keep careful track of the things we’re grateful for. If we don’t do that, it is easy to fall into the traps of self-pity and resentment, which all too frequently feel like they will respond to inebriation. Relapses happen when we don’t focus on our gratitude. On what we have, rather than on what we want. So. Here’s what I’m grateful for about 2014:

  • I didn’t drink this year. This marks the sixth complete year that I have not had a drink. And if I don’t drink again before mid-February, it will be seven years since I have had a drink.
  • I didn’t smoke this year. It’s been more than five years now since I had any tobacco. I ought to be nearly approaching the health profile of a never-smoker.
  • I have an incredible love in my life, fulfilling and exciting and thrilling and generous. I am feeling a sense of partnership I always longed for, and finally have.
  • I have a great job that I’m good at. I enjoy my work – most of the time – and I like the people I work with. I believe in the mission of my institution and I’m pleased to be a part of it.
  • I’ve seen more of my family in the past year than in most years, and I’m grateful to have been able to see my nieces and nephew growing up bright and strong.
  • I am in the best physical condition of my adult life. I have run hundreds of miles and three half-marathons. I’m working on strength and fitness and gearing up to do more.
  • My hernia scare turned out to be nothing more than a muscle strain, and it is nearly healed. No surgery for me in 2014!
  • Despite all the vexing and expensive troubles, I have a pretty good home in a pretty good place to live, close to work and with access to everything I really need.
  • I had two wonderful vacations with my partner, including a two-week trip to the far east which was magnificently rewarding. I learned and experienced some of the most amazing things of my life.
  • I published three papers this year and have another accepted and coming out soon in the new year. I’m contributing to my field in a way that will have impact.
  • I helped mentor a student into medical school.
  • I was promoted at work, and may be getting an academic position at a local university from which to do some research and increase my academic presence at my own institution.
  • I have a long list of close friends that I see and interact with regularly, and I have chosen to embrace my online experience in a new way, accentuating its positive impact.

Those are the highlights. Every day I wake up grateful not to be hungover and hacking up brown phlegm. Every day I wake up grateful for the people I love in my life and the wonderful ways they enrich me. Every day I wake up grateful for the opportunities I have to contribute to the world and make my environment a little bit better place to be, for myself and for others.

I am profoundly grateful for the privileges and good fortunes I have that have allowed me to flourish here. I am proud of the hard work I have done which has taken advantage of both those fortunes and new opportunities. I am moving upwards and forwards. And I am learning more each year that perhaps my greatest privilege is to be an alcoholic. Because it has provided me with a framework for my life that encourages me to work hard, and recognize all the wonderful things I have.

This has been a good year. This has been a great year. My biggest challenge is staying focused on all my manifest blessings, rather than on the small things that irritate and frustrate me. And the fact that my biggest challenge relates to my perspective, rather than my health or my relationships or my economic stability, is by itself a matter of extraordinary gratitude.

I hope you’ve had a good year. I hope you’ve had your best year. And I hope that the blessings in your life are as profound and encompassing as mine have been. May 2015 reveal in all of us a lightness and meaning that we can celebrate together.

What a Difference a Day Makes.

26 December 2014

So, relieved of my anxiety about having a hernia (see previous post – I don’t after all), I am treating my lower abs issue like a muscle strain. The relief of knowing it’s not a hernia is palpable, and the pressure/tightness/whatever has subsided a lot. Probably in part because I’m not poking at it constantly. I got the news Tuesday, and did light workouts that afternoon and Wednesday, and yesterday I ran an easily-paced 10K.

It was nice to get out on Christmas and go for a run. The last couple of miles, the strain was barking at me a little bit, but not painful. Today it’s still there, but diminished. I’m taking some NSAIDs to hopefully bring down any lingering inflammation. But basically, I’m going to treat it like the nagging injury it is, take things light but not sedentary, and let it heal on its own.

Considering it’s been bothering me for about six weeks now, I’m frustrated, but I believe it will get better with time. That’s not necessarily a safe assumption. I hurt my shoulder about two years ago, and it’s as bad as it’s ever been. I think I damaged a ligament or two. But I’m not going to do anything about it, because it doesn’t impinge my normal range of motion, or diminish my strength. There’re just some awkward type movements that hurt.

So. I hate running in the cold and I hate running in the dark. But the sky will be lightening rapidly now, though it will probably be getting colder. Damn seasonal phase-lag. But I have a half-marathon to run in March, and I intend to be fit for it. Which means I’m going to have to get my miles in during the winter. I’m not going to try to stay in peak condition at all times. I’m going to try to keep up 10-12 miles a week and work out at the gym a couple days a week too.

Fitness is a lot like sobriety. Regular practice. A commitment that feels vaguely spiritual in nature, at least to me. Running and fitness make me feel like I’m using my body, and maintaining my body, the way it’s “supposed” to work, whatever that means. Whether we were designed or we were simply optimized for a particular ecological niche over millions of years of essentially random evolution is not particularly important to me. I’m here. And I’d like my body to work the way bodies are supposed to work.

That requires effort, time, and good fortune. I’ve always had good fortune. I’ve arranged my life to have time. So I need to put in the effort. I’ve found that willingness, in my life, in the past few years. I’m grateful for that.

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