Drinking My Education.
Yesterday I wrote about not being good enough to be a professor of systems engineering. But if you’ve read this blog long at all, you know that I’ve wondered if, in different circumstances, I might have been. I don’t know. I’ll never know. I find myself, often, tempted to blame woes in life on my alcoholism. The thinking goes, “If only I weren’t an alcoholic, I’d have…” and then whatever is currently bothering me fills in the ellipsis and is magically solved in the fantasy world where I didn’t spend a decade-plus drunk.
This is seductive thinking. At least, it is for me, and I know it is for many alcoholics. I want to blame any troubles I have on anything but myself. This is a mechanism by which my alcoholism attempts to reclaim me. If I cannot influence my life for the better, if the difficulties I have are the fault of some unconquerable malady, then I get to despair. Despair is wonderful. Despair is someone else’s fault. I’m not responsible. This was done to me, not by me. So it doesn’t matter what I do anyway. It’s hopeless. Let’s drink.
Now, let’s be clear. It is neither my fault nor anyone else’s that I am afflicted with the disease of alcoholism. That’s just a thing that happened by accident of my birth and genes and brain. Seems to happen to a fairly large number of people. There’s no point lamenting it any more than lamenting that I was born with a predisposition toward type II diabetes. It’s my life. We’re all born with good things and bad things, and on the whole, I came into this world spectacularly high up on the privilege scale.
Even drinking or not drinking is not in my own power. When I decide how to live my own life, I make bad choices with respect to alcohol. However, when I am part of a strong social network of people who suffer from the same malady as I do, and have found away to address it and live sober, I am capable of following that path, that program, and living a sober, useful life. I have gained so much through this process. Through descending into alcoholic misery and then being lifted back out of it.
But I also cannot help but wonder what I might have lost. If I hadn’t spent the years from 21 to 33 drinking as much as I could – wholly encompassing graduate school – would I have been able to do the math? Would I have ended up on a different road that might’ve included a professorship in systems engineering? What life would I be living today? but through long and – hopefully – honest self-appraisal, I think I know the answer.
A worse life. I was always pretty darned smart, but I was never very diligent. Because school was easy, I didn’t work very hard at it. I had a B+ average in high school, and a B+ average in college. I went on to have a B+/A- average in graduate school, which is kind of disgraceful. I was allowed to skate through on privilege and potential. And I think my grades would have been almost exactly the same if I had never picked up a drink. Because I got B+’s before I drank, and B+’s after I drank. The fact of the matter is, I am a B+ person. I am willing to work that hard and not much harder.
My alcoholism has taught me to take responsibility for my behavior. I may not be able to control my drinking without help, but it is unequivocally my own responsibility, and no-one else’s, to get the help I need to keep sober. It’s my life. It’s my disease. It’s my charge. I am the one responsible for my life. As much as it is appealing to offload the responsibility for my alcoholism to doctors or parents or circumstances, it’s mine. It simply is. I am the one who has to face the truth of it, recognize my powerlessness, and do the things required to remain in recovery.
My alcoholism taught me to look at myself, give up my need to control all of my life, and other people’s lives. To examine how I contribute to my own problems. To focus inward for the solutions to my discontent, instead of expecting other people to solve my difficult feelings for me. To focus outward for my efforts and interactions, to make my life about being useful to others and contributing instead of expecting the world to cater to me.
But I wish I hadn’t drunk my education. I don’t remember the elegant math I learned. I couldn’t shift gears from my current work in healthcare simulation and go to putting rovers on Mars (or similarly math-intensive engineering work). Not anymore. Probably not ever. I just didn’t retain faculty with nearly as much of my training as I could have or should have. I was capable of it. Never of the truly theoretical work, but I was good enough to solve problems like that.
But I like working in healthcare. I think I’d be working in healthcare engineering no matter if I’d been an alcoholic or not. I simply suffer from grass-is-greener disease sometimes. The truth of my life is, I probably have a better life than I would have if I hadn’t been an alcoholic. I’m almost certainly happier than I would be as a professor even if I had been able to take that path. I don’t work as hard as most professors. And I don’t like to work that hard. My chosen profession uses the training I remember how to do, and compensates me more than adequately.
I’m an alcoholic. Being an alcoholic has taught me to live. Not just sober, but free. There are living oceans of experience I will never grasp. But I can cup a bowl of water in my hands, and marvel.
Not Good Enough.
Ed Yong is one of the English language’s better science writers. He often weighs in on issues facing academia, in addition to reporting science. One of the biggest issues facing academia right now is the pipeline problem: too many PhDs are graduating compared with the number of professorships that will ever be available for them. This has led to the creation of intermediate steps like “post-doctoral scholar”, and in some places “instructor” or “assistant researcher”, which each have their own bars to hurdle, and their own attrition mechanisms. At each level some people leave. Too often, those who leave are considered, and called, failures by those who advance. Especially those who advanced long ago, before the pipeline narrowed as much as it does today.
This has resulted in people being considered “junior” investigators for nearly half their careers, usually. Because universities and funding agencies are so risk-averse, they expect scientists to be mentored and coached and coddled until “young” can be used only in jest. Or sarcastically. In many ways, it’s degrading and infantilizing to tell a scholar, trained for decades and published many times over, that they must still be buttressed against failure by crouching obsequiously beneath the umbrella of a grey-haired magister. Failure is incredibly useful. A topic for another day.
But on the other side of it, perverse incentives lead to the graduation of so many PhDs. Grant money is scarce. It’s much less expensive to pay a graduate student or a postdoc to do lab work than it is to hire full-time accomplished technicians or full-time researchers to collaborate. So more and more cheap labor is hired. More PhDs are trained. And the wide end of the pipe gets wider. Meanwhile, universities continue to divest themselves of tenure-track and equivalent positions. The narrow end gets narrower. I’ve read (but don’t recall the source – treat as speculative) that fewer than 10% of graduating PhDs can expect to end up in tenure-track positions. There are massive structural reasons that people cannot and do not advance.
And people write about it. Many people, when they leave, describe these structural reasons. Or family reasons. Or any number of reasons that they don’t advance. But something it seems we rarely read is, some people surely must not advance because they just aren’t good enough. Ed Yong put it this way:
Funny how you never see confessional posts from people who left academia because they just weren’t very good.
— Ed Yong (@edyong209) April 12, 2014
Well, I haven’t exactly left academia. But I trained to be a professor of systems engineering. I have a Doctor of Science in Electrical and Systems Engineering from one of those fancy, elite universities. I had good connections and a prominent advisor. But I am not, and I will never be, a professor of systems engineering. And the reason is, I’m not good enough.
Studying systems engineering at the graduate level means doing a lot of theoretical mathematics. I spent five years doing proofs. Mostly, systems engineering revolves around being able to model and control how large numbers of objects interact with one another in complicated ways with respect to time. Usually, this means doing vast systems of nonlinear, time-varying, partial differential equations. Now, a lot is known about this field. In fact, it is provable that most such systems cannot be solved with what we call “closed form solutions”. Meaning, it is impossible to simply solve the equations and use them to calculate how the future state of a system will unfold. We have to manipulate. Approximate. Linearize.
I took an entire class on control systems on free-floating locally-Euclidean manifolds. So, imagine being on the surface of a doughnut, and you want to negotiate a spiral and end up where you started. That kind of thing. Your point-mass vehicle weighs X and has control functions Y and Z. You want to get from A to B in minimum time. What do your controls need to be and for how long? How do you stitch together locally-Euclidean reference frames that allow you to numerically solve the equations of motion for the brief period you’re located in each one? Before the non-linear effects overwhelm the linear approximations. This is the kind of work that put Curiosity on Mars. I got a B+ in that class.
I got a lot of B+’s in graduate school. B+’s are just a step above failing in graduate school. I even got a C in my class on Linear Dynamic Systems. Once we added in stochastic noise that needed to be filtered out, I got very confused. I needed to take the class a second time to understand it. The second time I got an A. And I deserved it. I worked hard for it.
Now, a real theoretical mathematician will read the above things and say, “that’s not theoretical math”! And they’d be right. It’s not. It’s applied math. Very, very difficult applied math. And I could do it. At least, I could follow along while the professor did the math on the chalkboard. Remember chalkboards? God I miss them. I could do that math well enough to understand the proofs and do most of my homework. But doing that applied math isn’t the real job of a professor of systems engineering. Sure, they do a lot of it, and solve problems and consult for NASA and other such organizations who need people who are really good at applied math.
The real job of a professor of systems engineering is to invent new math. That lets us solve new engineering problems. Or solve problems that we can’t currently solve because they’re too big, or too non-linear, or happen too quickly. A professor of systems engineering, a good one, isn’t so much dedicated to solving problems. They’re dedicated to building tools. That allow us to dream new problems to solve. A professor of systems engineering is a theoretical mathematician.
I am not. I’m not good enough. And I learned that pretty rapidly. Today, I use fairly simple math, and reasonably cool computer science, to solve huge, interesting, and relevant problems. I am a practicing engineer, not a theoretical engineer. I publish. I teach sometimes. I am an adjunct professor in a department of emergency medicine. I am a principal investigator at a hospital. But I’m not really an academic. I’m not a full-time professor. I’m not a full-time researcher. Mostly, I solve the problems my hospital asks me to solve. I’m good at it. And I’m happy at it.
I didn’t fail at academia. And the academy didn’t fail me. I’m a success story. While training to be a professor, I discovered I wasn’t very good at doing the things a professor in my field is expected to do. So, like the engineer I am, I built something. I built a career that didn’t exist when I started: a professional simulator of health care systems. I can’t do the theoretical math of a systems engineer. I can’t do the theoretical computer science of computer scientist. But I can use these tools to solve problems in healthcare delivery that no one has looked at in this way before. And that’s of interest to both the practical world, and to the academy. Just, not the same academy as the one I trained in.
To call what I did a failure, either of me, or of the system, is absurd! I’m doing interesting work, publishing it. I’m employed and my employer is happy with my work. But it is completely fair to say that I am not a professor of systems engineering because I am simply not very good at it. I confess.
Unpaid Work in Academia.
I currently have two interns. They’re undergraduates, and they’re getting ready to move on. I only have money to pay them through April. They knew that going in. Actually, going in, they thought it was only until last December, but I scrounged up a little extra dough. Right now we have a draft of the manuscript. I’m intending on submitting it as soon as we can, with them as co-first authors (a conversation for another day!). Will it be done by the end of April? I don’t know. Probably not. We need to really tighten it up a great deal, and then get edits from collaborators, and then send it off to this enormously famous dude whose clinic we modeled for his comments. That’s a courtesy, but it could have big dividends.
If we can’t submit it by the end of April, what expectations am I, as a PI, allowed to have from these interns? They did a lot of the work. The data collection. The simulation code. The data interpretation. I will certainly need to understand and examine these things to respond to review. Am I entitled to their labor in responding to review, or conducting new experiments, or revising the manuscript after they’ve moved on and I can no longer pay them?
Absolutely not. I have no right to expect them to work for free. Trainees in academia often continue to work long hours for former PIs to get out old papers. And if both parties treat that collegially and believe they have benefits to gain, then that’s wonderful. One of my interns has said she wants to continue the work if she can. One is going off to medical school. I’ll never hear from her again. And that’s fine. I am not entitled to her labor.
That’s the risk a PI takes when they bring on trainees: that they will move on with unfinished work. They have that right. And holding a recommendation hostage, or demanding they produce for free after everyone has agreed they’ve graduated, or after they’ve taken another position is exploitative. And this bizarre arrangement exists only in academia. In any other industry, whenever a person leaves a post, they leave unfinished work, and the people who remain suck it up and move on with their lives and jobs.
“But!”, academics argue, “This work is so important, and we invest so much! It must be completed and published! For the PI, and for the world!” Then pay for it. If you need additional work from a trainee after they leave, set aside some of your budget and pay them hourly as a contractor. I might be able to arrange for my undergraduate to receive credit towards her degree for continuing to work on this manuscript. But there needs to be a tangible, measurable benefit. The unquantifiable “value” of being an author on a paper isn’t enough.
Academia is an exploitation machine. Grad students, postdocs, undergrads, adjunct professors. All are asked to work for far too little, or for nothing, or for nebulous, vague rewards. And PIs who pressure ex-trainees to continue working, without pay, on projects after they’ve left are participating in the exploitation engine. The risk of taking on temporary workers and trainees is that they don’t finish. That’s the PI’s risk, from the outset. Own it. We can’t demand free labor.
Speaking.
I know that most of my readers read me for the writing on alcoholism, not on science or medicine, or meta-science and meta-medicine. I have a meta-science post brewing about the treatment of trainees after they have graduated/moved on, but this post isn’t about that. In fact, this is barely a post at all. As I wrote a few days ago, I was asked to speak last night at an AA meeting. I recorded my talk (but not, of course, anything anyone else said). It’s here. It’s just my story, told ramblingly and with many bits left out. I get emotional a couple of times, but I won’t apologize for it. It’s 22 and a half minutes. I hope you enjoy it.
Round on Systems.
Behold! Two posts on health care delivery in a row! This morning I was meeting with the leadership of our cardiac surgery center for a project I’m working on. We’re upending the schedules of our surgeons and cardiologists in order to improve our service thresholds, and it looks like there’s going to be a lot of positive impact. I’m excited. That’s what gets me out of bed in the morning as a health care engineer: personal glo… I mean making a difference in the lives of our patients.
While having that discussion, we were also discussing the next phase of our analysis, which will likely be to examine the effects of different types of discharge strategies. Every hospital in the world, I’d wager, struggles with discharge processes. There are a lot of things that have to happen, in a particular order, at particular times. All while ensuring that the patient is well cared-for and doesn’t have status changes during the process. It’s complicated. It can seem like, the night before when discussing which patients should be ready to leave the next day, the actual discharges are totally unrelated to the predicted discharges.
And I had a simple idea, that our leadership liked: round on systems. Just like MDs round on patients, we need to round on the systems. For each of those predicted discharges, the next day, when patients either have or have not been discharged, we should review how the discharge process went: why were they, why weren’t they, which ones went smoothly, which ones didn’t? Who was discharged early in the day, who was discharged late? Don’t just take the data and look for predictors and covariates of discharge. Talk about the systems.
We recently had a briefing in which we discussed how US Navy aircraft carriers operate. They’re about the most complex system in the world: a warship, an airport, a hospital, a nuclear reactor, and a massive living and feeding quarters. They’re operated almost entirely by very young sailors. And they have a stellar safety record, considering they are towing around enough dangerous material to vaporize the Eastern Seaboard. How do they do it? They round on systems. Every carrier landing is given a post-mortem discussion by the pilot, other pilots, and air traffic controllers, flight crew. They talk about what went right, what went wrong. Every person understands the system, and their role in it.
There is no reason that health care delivery can’t do this. We should embed systems thinking into the process of patient care, either by training some of the MDs and RNs in it, or by including systems personnel in the rounding. Talk about the systems. Learn from experience what went right and what went wrong. Share the insights. Every patient admission, discharge, and bed move should be discussed as part of the rounding process. Why did it work, what could have been done better? Until you can land a fighter jet on the ICU. Or some metaphor that makes sense.
We can do better with delivery systems. We have to. Because bad systems engineering (or even worse, no systems engineering) is inimical to the mission of hospitals, providers, and the human endeavor of medicine generally.
Open Access and Saving Lives.
Despite the fact that I write fairly little here about science, I do in fact consider myself at least vaguely a science blogger. And specifically, a blogger with something occasional to say about health care delivery, in that that’s what I do as a matter of my livelihood. For my first year at MECMC, I’ve been building simulations of surgical and inpatient facilities, but for most of my career leading up till now, I was a specialist in emergency medicine delivery. And my academic appointment at ILU is in the department of emergency medicine.
Emergency medicine is in real crisis in the United States. The reason for this is that a huge number of people use the emergency room as their basic source of primary care. This is for several reasons. In some cases, it’s because people cannot afford to go to a primary care physician, and so health concerns are left ignored until they become emergencies. Sometimes, it’s because they don’t have insurance, and the emergency room will give everyone at least a basic evaluation regardless of insurance status, including life-saving treatment. And sometimes it’s cultural; many people come from cultures where appointment-based healthcare simply doesn’t exist. A senior MD giving a briefing in my hospital recently talked about how at hospitals in China, people needing to see a doctor never make appointments, and MDs don’t accept them. Everyone queues. That’s the delivery model.
Another critical reason is delays for service. Particularly in large healthcare delivery systems, like the VA, it can sometimes take months to make an appointment to see a physician, including primary care. Resultingly, people with minor ailments well within the wheelhouse of primary care end up coming to the emergency room because it’s the only “clinic” they can get appointments in. This results in EDs being crowded with patients which don’t really need to be there. And overcrowding is known to be associated with increased mortality, and other degradations of care (Bernstein et al, 2009 Acad Emerg Med 16(1):1–10).
I believe (and would love to model) that open access scheduling at primary care (and other primary-type specialist clinics like pediatrics, dermatology, etc.) would address this significantly. Open access scheduling means that many appointments, perhaps 50-75% of them, are not filled until within some time threshold, like 48 hours of the appointment time. The remaining 25-50% are used for planned follow-ups and ordinary scheduled physicals, etc.. The result is that patients are very likely to be able to get an appointment same day, or nearly same day. Planned maintenance care is still available. The trade off is that physicians and clinics cannot be certain of their patient-load in advance.
But, if a clinic is running with a standard 3 month or more waiting list for an appointment, they are very likely to be able to maintain a full load of patients when adopting an open access model. And they will be able to see a large number of patients who might otherwise be forced to seek care at the emergency room. Reduction of these patients crowding the ED will, unequivocally, save lives.
Now, implementing open access scheduling in a primary care clinic is non-trivial. The transition period is difficult and uncertain. Determining the threshold time period to use to limit appointments required examining the rate of requests and doing some mathematics (ahem – I consult). But, open access scheduling models are shown to, theoretically, at least, outperform traditional scheduling in many key metrics. (Robinson & Chen, 2010, Manufacturing & Service Operations Research 12(2): 330-346).
Misuse of the emergency room is crucial to address, because a well-running ED is a fundamental point of care in a system which is, despite its many flaws, one of the best there is in the world at rescue and resuscitation of critically ill patients. This endeavor requires the ED to function smoothly so that those critically ill patients may be fed through to the operating rooms and intensive care units which maintain and treat those patients once they’ve been stabilized in the ED. Crowding, and misuse, thwarts that core mission of the ED. And kills people.
Why We Tell Our Stories.
After my men’s meeting last night, one of the guys asked me if I would speak at a meeting on Tuesday. Of course, I said yes. One of the core elements of the program is passing it on. Not in an evangelistic sense, we don’t go door to door looking for alcoholics to proselytize to. But in the sense that when someone reaches out for help, we need to be there to help them achieve sobriety. When I teach the program, when I help another alcoholic relinquish their active addiction and move forward into a new and better life, my own life improves. My own program improves. My own ability to live and achieve peace and serenity in life is enhanced.
So I’ll go on Tuesday and I’ll tell my story, and I’ll probably record it and post it here as a podcast. When we speak, if there’s not a specific topic, we are generally told to share our “experience, strength, and hope”. We do this by explaining “what it was like, what happened, and what it’s like now“. I never prepare much. Every time I tell my story it’s a little different. My memory changes and the past changes with it. As I get further from my last drink, how I felt when I drank recedes a bit too. Telling my story is a good way to remind myself how it was. Why I mustn’t go back.
In many ways, AA is an altruistic program. We help others. We try to relieve some of the suffering in the world associated with alcoholism. But in a far more relevant way for its members, AA is a very selfish program. I am in AA for precisely one reason: I want to have a good life. And I can’t do that on my own. On my own, I am a lazy, drunken slob. I know because I tried to live on my own terms, and that’s what I did. That’s what I made of myself. In AA, I have the opportunity to be more.
I can be sober, and mostly sane, and employed, and effective. I can be in a relationship and I can participate in things that matter to me. I can attain moderate fitness and health. I can do the things I dreamed of doing and handle things I didn’t know how to even approach when I drank. And to keep these things, I need to help others. I need to give away the same things that I’ve been given in the program.
And here’s why: I believe that the social network in AA is the key to its success. I don’t think there’s anything magic about the steps. They’re a sensible and straightforward path to respectability. And that’s fine and important, and I think sobriety requires having a specific program of accountability and effort to take hold. But they could be in a slightly different order, or say slightly different things, and it’d probably work just the same. I believe (and this is only my own opinion) that it is the social network that makes AA work the way it does.
Humans are social animals, and like-minded people gather to achieve things that individuals can’t. I’m not sure what precisely “like-minded” means in the context of addiction recovery, but I know that you can find us congregating at meetings and at coffee-shops after them. We depend on each other. We share ideas. We owe each other our lives. I work harder at my sobriety knowing that mine is not just mine, it is a knot in a rope in a net that separates active alcoholics from the abyss.
So I go. And I share. And some of the people in the room will connect to what I say, I hope. Because I need a community to be sober. And I need sobriety to be me.
My Problem is My Problem.
Even though I’ve been sober for a few days now (2,237 to be precise), I still can be known to look longingly at a beverage from time to time. Sunday, after hours of driving through torrents of rain, moving in frigid cold, and then walking through sleet and ice for half an hour, I could have used a beer. I didn’t obsess about it. I didn’t crave it. But there was that part of my mind that, in those situations, remembers how good a drink tasted at those times. Like all such ideation, it was transient and mild.
So it didn’t bother me when my partner had a (half) glass of wine with dinner. Well, beyond my standard incredulity that anyone is able to drink a half a glass of wine and not, say, several bottles. I glanced a little longingly at it for a moment, perhaps. And I know for 100% certain that if I had felt funny about it that I could have asked her not to drink it, and she wouldn’t have. But in the context of our relationship, her having that wine was the right thing to do.
Why? Because she felt like having a glass of wine. And my condition shouldn’t impact how she lives her life. My problem is my problem. Not hers, and no one else’s. It’s my responsibility to look after my own condition. I am a member of Alcoholics Anonymous to make sure that my life is not all about alcohol. When I drink, my life becomes consumed by the acquisition and consumption of alcohol. Now that I don’t drink, despite the fact that I do a lot of talking and thinking and writing about my disease, my life is in fact not very much about alcohol at all. Huge swathes of time go by where I don’t think about it. I don’t have to avoid anything I want to do because there might be alcohol there. And I don’t have to try to control the lives of others.
When I drank, I was constantly trying to control others. I tried to get people drunk, so my own drunkenness was less noticeable. It’s a grim and depressing way to live, cloaked in manic insistence on joviality. I tried to manipulate people’s opinion of me in order to make sure that my inebriation didn’t factor. My entire life centered on managing my alcohol and people’s perception of my relationship to it. And I failed, spectacularly. Because the person trying to do the managing was constantly drunk.
I have a number of friends who drink, and who know I’m and alcoholic, and drink around me. And they should; at least they should do whatever they’re comfortable with. My problem is my problem. Others are not bound by my needs. If I am uncomfortable around alcohol, I’m the one that needs to make a change.
Embracing recovery from alcohol is not about moral fortitude, but it does require doing work. Just like there’s no shortcut to cardiovascular health. Those who want to be fit and healthy need to eat well and exercise. Genetics, of course, powerfully influence how effective those efforts are, but fitness requires behavioral interventions. The same is true for addiction and alcoholism. We don’t condemn someone for being an addict. But in order to be in recovery, addicts like me do have to make specific, universal behavioral choices.
Those choices are difficult. And the program of AA makes them less difficult, by focusing on and understanding the root causes of our drinking. Recognizing that our disease and our personality combine to make us powerless over alcohol. Laying out a series of steps which, if taken, will result in freedom from our addictive behaviors. I fully recognize that AA is not for everyone, not even for every addict, I suppose.
But having recently read yet another article from a supposed addiction-specialist physician about how AA doesn’t work, I lament the pathetic state of understanding about what AA is, what alcoholism is, and how AA is intended to work. AA is not a medical treatment. AA does not cure alcoholism. AA doesn’t “work”, the way we would like medicine to cure disease. That’s not what we do.
AA lays out a program which, if followed, allows freedom from addictive behaviors, and provides a framework from which we can rebuild our lives. We make no claim that those who follow it are stronger, or better, or smarter. Only that, for those who choose to participate, if they follow the steps, they rarely fail. Not everyone will choose to do so. That’s their right and their privilege. Physicians seek interventions which cure disease. Then claim that AA doesn’t work, because you can’t send someone to AA and trust they’ll get sober, with any kind of reliability.
And you can’t. Persons sent to AA are not particularly likely to get sober, in my experience. The cohort that seem to recover in AA are those who seek us out of their own accord because they can no longer tolerate, in themselves, how they are living as alcoholics and addicts. That is the cohort that AA can work for. Complaining that AA doesn’t work because people who don’t want to stop drinking sometimes go to AA and then don’t stop drinking is like complaining that palliative care doesn’t cure death. It’s not designed to.
AA can’t make anyone want to stop drinking. All we can do it provide the framework that guides those who have exhausted all other options from active addiction into sobriety. And the very first thing, step zero, is deciding that my problem is my problem. No one else’s. Not my partner’s. Not my friends’. And not my physician’s. Mine. No one can cure me. And I cannot recover alone, either. What I can do is walk the road others have walked, sometimes carried, sometimes bearing others on my back. And change. Not who I am, or that I’m an alcoholic. But how I choose to confront the world.
When is it Worth Being Mad?
The following tweet showed up in my timeline, and I was immediately captivated:
How do you know when something is worth being mad about?
— Nikki (@AuroraBirdialis) March 27, 2014
This is a brilliant question, in the first place simply for being asked. So many of us, like me for about the first 30 years of my life, never bother to think about why we get mad. We just react to things. That doesn’t even imply we’re bad at dealing with the anger, necessarily. Simply that emotions are fundamentally primal. They happen to us, it seems, from without. In the first blush, anyway. And from there, we decide how to contextualize them and manage them.
It is a labor of many years duration (at least it was for me) to be able to recognize my emotions rapidly and prevent myself from lashing out with them. And I’m still not fabulous at that, but I don’t generally attack based on fear, anger, or frustration anymore. I can sit back, name my emotion, look at where it’s coming from, and then act when, as I said to Nikki, when I can talk about my emotion, rather than through it. Sometimes this happens in the space of a few seconds. Sometimes it takes me days to sort through everything that was going on.
Anger is an emotion I was always terrified of, both in others and in myself. My mother’s anger was unruly, and vicious. And hair-triggered. My father, very slow to anger, was terrifying when finally provoked. I knew (and know) that I have that kind of cruel, spiteful rage inside of me as well. Rage focused on laying waste to relationships and surroundings. Rage fueled by fear and hate and shame.
Through many years of psychoanalysis and now many years of working the program of Alcoholics Anonymous (which I am told has roots in philosophy not dissimilar from cognitive behavior therapy, though I’m not educated enough to understand all that), I have also come to learn that anger can be a very productive emotion when it is reined in and used effectively. Anger allows us to communicate the unacceptability of a circumstance in a way that ought to be very clear to everyone involved.
Of course, being angry doesn’t necessarily get us what we want. And using anger to demand what we want is bullying. But anger expressed properly about a conflict will almost always result in a change in the circumstance that led us to anger in the first place. In the ongoing saga of my house having many, many problems, I have expressed anger toward my home inspector and the seller. As a result, I’m getting some things fixed, and I know where the line is regarding what I can expect them to handle amicably and what I will have to either swallow or sue for.
My anger did not get me what I want: someone else to fix and pay for all my problems. It did get me a clear delineation of my circumstances and where I stand, so that I can move forward with intention. I sent icily polite emails, in which I made no formal accusations and no official demands, but in which I did indicate I expected to be compensated in some way. And so far, I have been, though not in precisely the way I would like. But at least I understand the boundaries I’m confronting.
When is it worth being angry? I think that’s not quite the right phrasing. We get angry when we are confronted with a situation we find to be unjust, intolerable, unexpectedly disadvantageous. And feeling angry is a perfectly normal and acceptable response to those situations. When we get angry, it’s ok to be angry. To me, the question is, when is it worth it to act angry? To inform others of our discontent and expect some kind of response to our emotional state.
Well, when we’ve sat with our initial reaction and, after the shock of revelation has passed we find ourselves still unable to endure the circumstance we’ve become enmired in. I personally don’t really think it’s ever ok to stomp and rage and tantrum. That’s both childish and bullying. Nor is it appropriate to demand others behave in a specific way. It is perfectly appropriate to inform people of your expectations and needs, without varnish, and to lay out how you will behave in the event that your expectations are not met.
We cannot control others. But we have every right to lay out our expectations, and make others aware that if they are not met, some additional action will be taken. It may be legal action, it may mean changing or ending a relationship, it may mean changing employment or living arrangements. Or it may simply be reframing the fundamental way we consider another person. All of which we have the right to do.
When is it worth being mad? Any time you’re mad. When is it worth sharing that anger, and acting on it? When reflection and consideration, without making assumptions regarding others’ motivations, reveal that a circumstance is not acceptable. When the expression of anger has a potential positive outcome (generally, not only for me, but for others as well). And when I can accept that expressing the anger may result in changes to the circumstances other than what I anticipate, which may be unknowable.
And finally, and most importantly, when I know that if I’m wrong, I can bear to make the amends I’ll owe.
Silence in the Garden.
Shortly after my divorce I began going to a Pragmatic Buddhism meditation group. I only went a few times, but it was very interesting. Pragmatic Buddhism, as it was described to me, means taking the philosophical elements and rituals of Buddhist practice, but it strips away the supernatural things. No gods or magic or prayer (and my understanding of Buddhism is so rudimentary that I couldn’t even begin to describe how those things manifest in ordinary Buddhist practice). I found the meditation useful, and I even bought a zafu and a singing bowl so that I could do it at home. Though, I dropped off the practice and it’s been a couple of years since I did any mindful meditation.
Japan, at least the part I saw, is largely composed of enormous, thriving metropolises. I know that the extraordinary crowding of island nations is a relatively recent phenomenon, but based on my week’s exposure to Japan, it seems as though they’ve been confronted with it for long enough to erect a few crucial and well-designed bulwarks against the madness of inescapable closeness. Even in Tokyo, a glittering, clicking cauldron of 35 million people, oases of solitude may be found in the unlikeliest of places.
Japan was characterized, everywhere we went, by the relentless mastery of horticulture. Temples and shrines, of course. City parks. Even the clumsily named “Park for Persons Who Cannot Go Home Again”, where the homeless pitched camp, was gloriously maintained with putting-green grass and elegant topiary. But not only were religious and public works so maintained. Corporate frontages too were tiny masterpieces of bonsai, persistent illusions of nature cradled in the palm of a concrete monster.
In exploring some of the strangely silent green places in Japan, I was reminded that I seem, these days, to spend a great deal of time around noise and cement. There is nothing green in my home. In St. Louis, I had a yard and a flower bed. In ECC, I have a 14’x10′ slab of aggregated concrete. I need to spend a day in the spring making something green of it. I have no hope, nor real desire, to maintain a garden of any sophistication or transcendent purpose. But I would like a place where I might be quiet in the shade of a living thing.
The adventure I’ve begun here, a career and a life and a love, is exciting and full of hope and promise and the kind of illimitable joy that always seemed both foreign and elusive to me. And somehow, in my rush to embrace the things I never knew I could have before, I’ve allowed myself to become separated from stillness and contemplation. Things I was never great at but always drew great solace from. I need to correct that. To make a place of silence in the garden.
Infactorium 