Revised Plan.
After a brutal storm blew across the eastern seaboard, temperatures dropped about fifteen degrees. My run yesterday was 6.4 miles at a 9:42 pace and that felt really good. I followed that up with 4.4 miles of bike rides; 2.2 each way to my men’s meeting of Alcoholics Anonymous. It was a good meeting and I needed one. I made a stupid mistake at work yesterday and sent an email that embarrassed myself. I doubt there will be any long-term consequences, but it’s definitely humiliating. But then I go to my meeting and there were two people who’ve lost relationships, another who’s lost a job. My problems are small. And none of us are drinking about it.
After some conversations with BB about the marathon training schedule, we’ve revised it to this:
The yellow “13.1” is a half marathon race we haven’t committed to yet. If we don’t do it, then that weekend will be a normal 13 mile drop-back training run. Distances shouldn’t, I am told, increase linearly. You kind of stair-step the long runs up to the full distance. The drop-back roughly every third week allows some recovery, even in the middle of a long build. All this is leading up to the Marine Corps Marathon in Washington DC on October 25th.
I’m excited about it. It’s going to be a real challenge. The longest I’ve ever run is 14.4 miles. I don’t eclipse that until August 8th. But I’m looking forward to getting into August and September and October and regularly running long runs on Saturday. Really long runs. As we get up to 16-21 miles, I guess I’ll see what I’m made of. I don’t have a time goal, though I’d vaguely like to finish in about four and a half hours. To do that, I’ll have to run at about a 10:10 pace. Right now, in my head, that sounds doable. But I don’t know.
Right now, physically, I’m feeling good. My leg tightness from the spring is eased, and my neuroma is tolerable. I tried on jackets last weekend and I fit a 40R now! I feel fit. I’m doing a decent amount of crosstraining in the gym and on my new bike, which I really enjoy. I’m not losing any weight. I don’t know if I will. but I’m fitter than I’ve been in my whole life, and that feels good.
It’s taken me a lot of time to get to a point where I can feel like I’m accomplishing things. Even though I’ve made some dumb mistakes, I’m getting things done at work. Even though I let myself become obese and nearly diabetic, I’ve made great strides in my health. I don’t drink. I don’t smoke. I run. I ride. It’s hard work, and requires a lot of discipline. But luckily, I’m a person satisfied by repetition and routine, and incremental progress.
So that’s the plan. Run like hell. I think I can do it. And so I’m going to try.
Running in the Heat.
Some people think I’m a little nuts about running these days. But I don’t think that I’m doing anything out of the ordinary, really. Trying to be fit is a good thing, and I’m running generally between 20 and 30 miles a week. I’m about to start training for my marathon, which will require that I do a little more in the way of mileage, but nothing crazy. I’m not going to be running 60 mile weeks. I’ll top out at 40-45. I made a tentative plan for my training schedule, which is still subject to BB’s edits and other marathoners telling me it’s a bad plan:
But I think this is something I can get behind and stick to. A 500 mile plan (including the race) that gets me to where I need to be distance and fitness wise, preserves my crosstraining time, and gets me some rest. And Sunday could also include bike or gym, since it’s a nice easy three mile run day. It’s a very simple plan. No special hill work, no real speed work other than tempo runs. Just about logging miles and getting ready to finish a marathon.
What this means, though, is logging a lot of miles in the heat and humidity after work. That’s going to be a challenge. Yesterday I ran 4.25 miles in 90 degree heat. The amazing thing was my friend from work joining me even though it’s Ramadan. It was 5pm, hot, humid, and he ran while on a total fast – including water! It was a bad idea. Impressive,
So I’m going to be marathon training in the brutal ECC summer. Pray for my soul. And my legs. And my electrolyte balance.
Writing.
I’ve been writing here less lately, but not because I haven’t been writing. I am, as I wrote a month or so ago, doing some writing of the sort that doesn’t get slung up on the internet right away. We’ll see where it goes. But I’m enjoying myself. I have ideas about getting a book published, which would be really exciting. I’d like to try. And so I’m clicking words on a screen and seeing where I get. So far it’s been a lot of fun and I’ve had to do a lot of poorly-thought-through internet research.
So that’s where I’ve been investing my writing efforts lately. Things at work are going well. My boss’s boss – who I think is now just my boss, given that my actual boss moved on and hasn’t been replaced, and might not be – returns from maternity leave next week. We’ll see. The spring has not been an especially productive season for me, but now that it’s summer I think I’ll be moving forward faster. My next project is almost ready for deployment, and I’m looking forward to learning some cool things about our emergency department. We have some major institutional benchmarks we have to hit in the fall and I’m excited to be a part of it.
I’m still trying to decide where I’m going and what I’m doing for my vacation in August while BB is in Iceland. Recommendations gladly accepted!
A Wonderful Conference.
I just got home from Minneapolis, where I attended the AcademyHealth Annual Research Meeting. I received a small travel award to attend, and was able to meet a lot of truly fascinating people from all over the country. I got to have dinner with the inestimable Hope Jahren and her family, and run all around the city. The running/biking/recreational infrastructure in Minneapolis is stellar. I highly recommend it. I ran about 19 miles while I was there. It was nice to have the cooler, dryer weather compared with ECC.
Most of the conference poster sessions centered around findings from the ACA’s impact over the last four years on access and use of health services in America. Far too much info to process and place here, but there were some very cool results. One of the most interesting I saw was the shift from cheaper, less-reliable forms of birth control to longer-term, more effective methods, and an attendant drop in abortion rates (though small and marginally significant). In general, it seems that access to care is improving slowly, but appropriate access is still somewhat elusive. More care is not always better care, and getting the right patient to the right physician in the right setting remains challenging.
But I had a fabulous time, learned a lot, and met a lot of old friends from my St. Louis days. I made great connections and might have secured a little bit of career-advancing recognition. It’s exciting, and I’m happy to be developing strong connections in the world of health research. Now I just have to get off my ass and get a major simulation finished by July 1. So I’d better kick it into gear.
Six Weeks.
It’s been six weeks since I abandoned my primary twitter account. I keep my professional account, and use it to discuss health care delivery and talk to a few close, personal friends. People I know in real life. But I engage in almost no politics and that sort of thing there. Unless you count arguing over science policy, but I think of that as a professional interest, and not really a political one.
A few things have happened. Traffic on this blog is dramatically down. Without tweeting about posting here, I find I get many fewer visitors. Something between half and a third of what I used to. But I’ve also been writing here less, so that’s not surprising. I’ve gone through a little bit in the way of withdrawal. There have been a few events I can’t talk about because it wouldn’t be appropriate to discuss them from an account I use professionally. But fundamentally, that’s ok too. I don’t need to chime in on everything.
There are things I miss about that account. But there are a lot of things I don’t. I might resurrect it. I might not. But if I were to, I’d need to interact there in a new way. Sometimes I bring the account up on my phone and feel myself itching to engage in ways that I’m trying to resist. As long as I feel that way, I don’t belong there.
There’s a deplorable tendency among humans to want other people to change for our own comfort. For our own agendas. It’s nearly universal, and it’s especially virulent in the online academic community. People insist that everyone adhere to the behavioral strictures that satisfy their own sense of well-being. Those who fail to are ridiculed and ostracized. I don’t enjoy participating in that environment. But it’s an environment with a critical mass of adherents. So it persists.
I cannot change it to suit my own comfort. The only appropriate response is to disengage. I don’t get to make my community operate the way I want it to. Especially when the thing I dislike about it is that it tries to force everyone to operate the way it wants them too. So I’m staying out.
That’s what sobriety has taught me. We say, in AA, that if I am feeling bad, it’s because something is wrong with me. Even when the insult, the injury, is coming from outside of me, I’m the problem. I need to change the things I can. And usually, that’s just me.
The Weekend. Managing Anxiety.
This weekend was lovely. A little hot but little precipitation. My older sister visited me from Seattle and we wandered around ECC and saw museums and did some cooking and generally just chatted about things. It was a nice visit. It was especially nice that my two sisters have now both met BB, and both seem to like her a lot. I went on a long run that didn’t go very well (I had to do walk/run intervals after about mile 7), but it still counts as miles. It’s getting hot and I’m simply going to have to start running slowly and miserably for the summer. That’s the deal. Maybe I’ll bike a little more.
Friday afternoon I had what felt like a good interview with a fancy institution. I am not likely to move or change jobs. But as I wrote before, an offer would be a real feather in my cap, and it felt good to have a professor on a hiring committee in the medical school of one of the world’s most renowned institutions tell me, “Your CV is very impressive.” I don’t feel like my CV is very impressive. I usually feel like I’m making it up as I go along, and barely skating by. But those who evaluate me objectively seem to think I’m doing well, which is a relief for a short while until my anxiety ramps back up.
A friend of mine in the program talks about “chemical suppression of feelings”. That’s what alcohol was for. I used it to treat my anxiety. Well, I used it to ignore my anxiety. Managing my anxiety has been one of the more difficult tasks of my sobriety. I’ve had to find a way to operate without alcohol, and without the traditional medicines that are used to treat anxiety. All of those are deeply addictive, and dangerous for me. I can’t take them. So I need alternatives.
My alternatives are simple ones. Exercise really helps. When I am working out hard, my anxiety is generally manageable. It doesn’t fix it. But it does ease it considerably. My program helps. Being consciously mindful that my anxiety is just a feeling. It is rooted in real things, and it is a tool my brain uses to get me to work on the things I need to work on. But it goes overboard. It slips out of my control and takes on a life of its own. Simply recognizing that is the first step, and often the only step I need, to bringing it back into the corral.
I’m looking forward to the July 4th holiday. BB and I are going to do something fun, not entirely sure what yet. But a little trip or time off just for us. It should be lovely. And now I have a lot of work to do before then.
Exciting Morning!
Well. I’ve written hear a great deal about how much I like my job. I love my job. I get to do academics, but I don’t have to depend on grant money. It’s a great deal. And I work for a highly prestigious institution that makes me feel special. Just this morning, the highest-up member of our higher-ups asked me for info so that my work can be presented (along with others) at a fancy-ass conference. One of the most important executives in the American healthcare landscape is going to be talking about my work, on stage, at an international conference. I’m thrilled.
So I love this job, and my institution and I’m building for the future here. So why am I so excited about the interview I found out I got this morning? A few weeks ago, I sent my CV to a health care policy and informatics institute at another very prestigious institution. I did it because it’s much, much closer to where BB lives. Close enough that we could maybe get a place halfway between our workplaces and live together. Though we’d probably need to buy two cars.
The position is a scientist/researcher position with a fancy medical school. So it’s probably a 100% soft-money position. Meaning, grants or die. I’ve been reasonably successful at getting smallish grants in my career, and I believe I could build that into larger ones with mentoring and guidance. But I don’t know that I want to step away from the wonderful thing I have here. In fact, I am certain I don’t want to. But if the position at this new place looks good and looks sustainable, I could see making a move in order to solve my two-body problem. If everything looked great. Though it would probably mean a pay cut and certainly an expensive relocation.
But I don’t want to get ahead of myself. It’s an informational interview, over the phone, next week. I’m going to take it easy. If nothing else, getting interest from a place like this new fancy medical school would make it possible to suggest to MECMC that they speed up their process of building me my own laboratory. We’ll see. Exciting. Confusing. Nebulous.
I need to remember the basics. Today, I’m as good as my sobriety. I’m sober. I’m sane. I’m comfortable. I’m doing well on all my fronts. Life is good. Tomorrow, I run eleven miles with a new friend and my loving partner. Sunday, I think I’m going paddle boating. I don’t have much to complain about.
Staying Happy.
I run in large part to be happy. I run because I like the way it makes my body feel when I’m done. I like the way it regulates my mood. The combination of exercise and sobriety has meant that I have not had to confront depression in any major way for the past several years. A couple of little dips, certainly. But nothing significant or alarming. Even last year when I thought I needed a course of anti-depressants, my doctor didn’t think so, and he was right. I came through it just fine. I wasn’t depressed. I was a little overwhelmed and a little anxious and a little sad. I know how to cope with those things now.
I run to be happy. I run because I feel excited that I can do things now that once were absolutely impossible for me. I run because it makes me feel good to do difficult things that I know not many people attempt. I love that I can run. I love that I’m fit enough to run for two hours or more without stopping. I wish I could do better. I can do better. I will keep running. I will do other things that allow me to run better. I will set goals to run further and faster. I will work harder to achieve those goals.
What I won’t do is incorporate my self-worth into a metric. I won’t decide whether I had a good or a bad race based on who I defeated. Based on hitting a specific time. I run to be happy. And that happiness is not enslaved to arbitrary benchmarks.
Whether I go faster tomorrow or slower, whether I lose by a little or lose by a lot (because winning a race is not in my future, and I don’t much care), I will be happy I could run. I can do things I only dreamed about. And the fact that I’ve worked so hard to do the things I dreamed about has allowed me to discover that I can do things I never even dreamed about. And so running has enlarged my dreams. My ambitions.
Whatever I do today is good. Yesterday I mostly rested. I hadn’t rested in a long time. Resting, for me, on this Wednesday, meant my 1.2 mile walk to and from work. And a 2.2 mile bike ride each way to and from my Men’s Meeting of Alcoholics Anonymous. A total of about an hour of very light cardio. No pounding. No heaving. But only a few years ago, a 2.4 mile walk, a 4.4 mile bike ride, would have been exhausting, major challenges. Yesterday, I did both in the same day and it was a rest day. That makes me happy.
I’m obsessive about measuring things. I keep track of all my runs, all my rides. Store them in spreadsheets. I like to accumulate things. Experiences. But I don’t much care if it’s more or less than someone else. I like to do things that few people try, yes. But I also like to encourage others to try them. Come find what I have. I’m an evangelistic runner. I want to share what I’ve found, what I think is a path to greater happiness.
Run like hell. It doesn’t matter how far. It doesn’t matter how fast. I like to work to do better. Sometimes that means faster than before. Sometimes that means further than before. Sometimes it just means that today, I didn’t have much but I gave what I had. And maybe it was a little better than the last time I didn’t have much but I gave what I had. Maybe it was a little worse. But it was what I had, today. And offering that up gives me a sense of accomplishment.
Staying happy is easier these days. I think partly, it’s that I decided I wanted to be happy. I used to be deeply invested in my unhappiness and I imagined that that made me profound and important. It did not. Deciding I preferred happiness to misery was a difficult decision. I know how odd that sounds to people who haven’t ever had to make that decision. But it’s true.
I used to be in the dark. For so long. I chose to be in a small, dark place, alone. Having now emerged into light, sometimes I feel like the whole sun is a spotlight, just for me. I feel special. I feel special to be bathed in all this happiness, all this sunshine.
Addicted to Bullets.
There will never be a cure for alcoholism. I piss off my addiction-science and neuroscience friends every time I write that. But it’s the truth. I’ve never succeeded in explaining the reason for this that any of them will accept. I doubt I ever will. I don’t need to. They keep telling me that I can’t be right, because I’m not informed; I don’t understand how the brain works. Leaving aside the question of whether anyone at all understands how the brain works, I think it’s irrelevant. You don’t need to be able to solve Bernoulli’s equations to know that a plane can’t fly through a mountain.
The real issue is: even if they succeed at what they say they are trying to do, it will not cure alcoholism. A pill that makes me able to drink like a normal person, whatever that is, wouldn’t cure me. A pill that eliminates cravings wouldn’t cure me. A pill that makes drinking alcohol unable to intoxicate me wouldn’t cure me. Because the way I interact with alcohol is bigger than how alcohol affects my brain.
What addiction scientists never seem to understand is that alcohol is not our problem. There’s an interesting phenomenon with bariatric surgery, in which people who lose weight by having a “stomach staple” often become addicted to alcohol or other drugs. This is in part, it is obvious to the alcoholic, because they are effectively deprived of their drug of choice: food. When we cannot indulge to excess in our preferred way, we find another.
My alcoholism is a genetic and mental disorder that does indeed have – as one component – my brain’s peculiar responses to alcohol. But that is the least important part of my disease. The important part of my disease is that I am a person who hates to confront his feelings. I am terrified by my own self. I despise myself. I hate my history. I fear my anger. I fear my shame. I would rather not feel anything negative. I am compelled to wallow in my own negativity. I am depressive. Anxious. Reactive. And I quell these eruptions of the psyche with alcohol. Obliteration. Silence. Peace.
We have pills that treat depression and anxiety and all those things, supposedly. I’ve taken some. For me – other than the occasional SSRI for depression – they’re no better than alcohol, and in many ways a lot worse. (I do not disparage them for those people for whom they truly help. I am not anti-medication for mental health. They can help. Talk to your doctor.) They don’t give me what I need. Or, like Xanax, they give me the same thing alcohol does: a debilitating intoxication I thoroughly enjoy.
The disease is the underlying issue. The ways I confront discomfort. I had to learn to accept feeling bad sometimes. I had to change how I addressed my fears and rages. There is no pill that can do that. And there never will be. Because the act of taking that pill negates its value. If I outsource my emotional management to another substance, another procedure, I’ve simply intoxicated myself a different way.
And as for pills that remove my ability to become intoxicated? Those are worse. Alcohol is not my problem. It’s my solution. And if the alcohol won’t work, I need to find another solution. If nothing else works, then a bullet will. Because I am addicted, at the core, in the end, to not feeling bad. And if I can’t find some way to relieve the isolating rupture in the center of my self, I will end my self.
All these imaginary cures that scientists and physicians think they can provide are vapor. And they are worse than my disease. If I were cured the way they say will one day be possible, I’d be dead. The only answer is recovery. Is finding how to manage what I can manage and accept what I cannot. To sit with the thing I am and breathe it through. Relent from my need to obliterate my feelings. To intoxicate. No human power can relieve it. The very act of relying on someone to cure me derails the recovery.
Recovery is about abandoning myself to acceptance of the emotional disregulation I cannot manage. And learning to live unanesthetized in the storms. I don’t need your pills. That medicine could never fix me. It could never restore me to the life I have, in recovery. Open. Unadorned. Liberated.
Progress, not Perfection.
One of the guiding principles of recovery in AA is “progress, not perfection”. The phrase comes from chapter 5 of the book Alcoholics Anonymous, where it actually says, “We claim spiritual progress, not spiritual perfection.” As I’ve said many times, even though the book and the program of AA refers a lot to “God as we understand him”, there’s no need to be religious to be a part of AA, or to believe in anything spiritual/supernatural. Recovery doesn’t depend on that.
But I think recovery can hinge on our ability to look outside ourselves for strength, and to consider ourselves as a small piece of a big whole. For me, I think of systems. Networks of recovering people who form, together, a far stronger fabric than I could be as a single thread. I haven’t given up on the idea of God. I’m hopeful about God. But my “spirituality” doesn’t require there to be one. And I am constantly evolving in a spiritual sense, and I am uninterested in being right, or being perfect. I am moving forward, and that’s what matters.
For example, AA is a program of honesty and self-reflection. But Sunday night I lied, on purpose, to get something I wanted. It was just after 10 pm, and a neighbor a few houses down was blasting bass-heavy music. And I mean blasting. It was a good 6 houses away, and my windows would rattle on the deeper notes. I went over there and said, smiling, and polite, “Hi! Some of us have to work in the morning, and I was just wondering how late you were planning to go?” They were polite, and said, “It’s a holiday tomorrow, but we can turn it down a bit.” And they did. And I went to bed.
I feel a tiny bit bad about it the lie. But not really. They were disturbing the whole neighborhood, and it was after 10 pm. But, it was self-serving dishonesty. That’s outside the program I’m trying to work. And I probably didn’t need to lie. I probably could simply have said, “I’m trying to get to bed,” or something. But I lied, I got what I wanted, and I feel pretty justified about it. Is that ugly? Did I commit an offense? I don’t know. I don’t feel like I harmed them. They just turned their music down from “earthquake” to “hearing damage”. But, if it weighs on my conscience, I’ll make amends.
But progress, rather than perfection, is a guiding principle of my life these days. And I’m applying it to my fitness as well as my program. This weekend, with BB in town and three days to work with, we really turned it up. Saturday morning we went out for 10.36 miles, and hit a 9:07 pace. That’s on a pace to (just) break two hours in a half-marathon. 9:08 is the pace you have to run, if you do exactly 13.1 miles. But usually, half-marathons end up being 13.4 or so, because you have to weave a bit, etc.. So to get to a sub-2, the pace you have to run is probably closer to 9 minutes per mile, flat. Nevertheless, this was the fastest I’ve ever gone on a long run.
Sunday we went to the gym. Monday, we did something insane. We did hill sprints. This was BB’s idea. We jogged to the art museum, which is on a hill, and then sprinted up the hill, and jogged back down it, fourteen times. The hill is about 100 meters. We added in some recovery jogs around a big circle, and then jogged back home. Like so (top of the hill is on the lower right):
The total distance was 6.2 miles. I was so drenched in sweat that the bootcamp group at the top of the hill made fun of me. After about our tenth ascent, I gasped at them, “Tell her she’s crazy!” while pointing at BB. They shouted, “YOU’RE CRAZY.” It was fun.
So, fitness-wise, I’m making progress. Perfection is impossible. What I think of as “perfect” is far beyond my reach. Beyond anyone’s reach, really, who doesn’t have specific genetics and the opportunity to spend hours a day with a trainer and nutritionist and chef, etc., managing their body. Which I wouldn’t want anyway, even if I had the money and time to do it.
But today, I’m sore. I’m tired. I’m behind at work and need to pick it up. But I’m happy. Because I’m making progress. And progress is good.
Infactorium 