The Excitement of Productivity.

I have a lot going on professionally at the moment. I’ve recently completed my first major simulation for MECMC, and it’s really, really pretty if I do say so myself. I’ve already written a draft manuscript and gotten our Assoc. Director of Periop. to serve as senior author. And she’s taking it seriously. No courtesy authorship for her. She’s already dug into my first draft and torn it apart. I’ve integrated her comments and changes. I’ve also included a couple of co-authors from my department. They’re less enthusiastic about it, because they’re not academics and so they receive little benefit from publications. But they’ve contributed and it’s gratifying.

The result is that I think I have a really solid first paper, almost ready for submission. My co-authors want to submit to a high-impact specialty journal. All this is, I think, not shitty for having been here less than four months. I’ve been made a PI, negotiated the research minefields, finished a major simulation, written a manuscript, won a grant, gotten an IRB submission declared exempt, submitted another one for exemption. All of this while being really just alarmingly lazy. I could work so much harder than I do. When I’m focused, I get enormous amounts accomplished. But my focus is so hard to maintain.

Nevertheless, I feel like I’m doing very well. And I’m happy here, which is the most important thing. I feel like I’m contributing in important ways, that my coworkers and colleagues like me, and that the work is going to make a difference in the lives of real world patients. These are the things that make me a happy engineer.

Well, that and prestige. As everyone who has read my writing knows, I’m kind of shallow. I am easily seduced by institutional prestige, for example. MECMC has it dripping from the walls. I feel privileged every day to get up and come to work here. Not simply because they do great work in essentially every arena of medicine and research. But because I really like the response I get when I tell people where I work. I’ve always had a problem with being attracted to things that feed my ego.

I’m also attracted to glamour and prestige in academic success. Because of the kind of work that I do, I’ll almost certainly never have a paper in a truly prestigious medical journal. I’ll never submit to JAMA or NEJM or The Lancet. My work is just not on their radar. And even in the highly regarded specialty journals, I’ve only ever passed desk-review once. Followed by two months of hope and then rejection. I just recently submitted to a big-name journal with little hope of review, much less publication. But I can’t help dreaming about being accepted. It’s like dreaming of winning the lottery.

I know these are ugly things. I think they reveal a fundamental insecurity. I’m not a great scientist. I’m not a great engineer. I might have been good, once, if I hadn’t taken a decade-long detour into substance abuse. My concentration and short-term memory have been decimated. Even more than five years into sobriety, I’ve never regained the deep focus and creative insight I used to have. I’ll never be what I might once have been. I just have to hope that the shreds of my intellect and industry that I’ve retained are enough to make a meaningful contribution.

I am deeply insecure about my abilities, and I have good reason to be. But I am in a place where I somehow get to do the things I am trained to do. The things I enjoy, professionally. Where I have the reflected prestige of a world-class institution. These things make me want to rise to the implied challenge put forth. This is a great place. Great things are expected. They’ve given me a lever and a place to stand. It’s time to move the Earth.