Infactorium

My first week as an employee of MECMC has just about come to an end. This is an incredible and incredibly large organization. I’m utterly lost. There have been a couple of minor disappointments, like the fact that I’m working from a cubicle with no door, but overall, I am happy and confident that I will be able to work effectively here. It’s really setting into perspective the place that I came from. The phrase that keeps rattling around in my head, over and over again, is: everyone here knows how to do their job. That was simply not true where I came from. Many people didn’t even really know what their job was.

I am feeling very overwhelmed. They put a huge simulation model on my desk, and I’m expected to either learn it or replace it. Which is fine, of course, that’s what I do. And I think I’m going to replace it. Frankly, some of the things they did in the first place were bafflingly absurd, mixing real-world and simulated processes to try to mimic a real world output trajectory. That’s not going to work in the best case. And this wasn’t the best case. This was in part because their model was developed by outside consultants trying to use a cookie cutter approach. So I think I’m just going to tear it down to the studs and re-do it the way I think it should have been done in the first place. And I cleared with them that that’s an acceptable practice. They told me they have no emotional attachment to it. Let ‘er burn.

What I need to remember is what I’ve been doing all along. I wrote here a few months ago that I needed to apply my AA program to my move: do today what I can do today. Every day do something. And take it one day at a time. I don’t have the software I need on my work computer to get to work yet. So instead I will simply dig in to other things. I am still meeting a whole group of stakeholders. And soon I will need to take the initiative and start leading my own projects.

When I apply my program, and use it to settle my head, I tend to do well. I can get confused and disoriented rapidly when I try to do too much too fast and don’t stop, settle, and act with circumspection and deliberation. I need to make sure that I do that here. Use the lessons of sobriety, which have served me so well, in my work here. That’s how I’m able to be happy and free. But using my tools. That’s my twelfth step work. These principles have never guided me wrong. As proof, here I am: sober; sane; trying to figure out how to do my best work at my dream job.

This is an astonishing organization. They seem to do just about everything right. In addition to being about the best hospital in America to get medical care, their employee processes are smoothly functioning, elegant, and well-designed. I’ve felt well taken care of at each turn. I have been told exactly what my first project is going to be (It relates to surgical flow, a topic I’ve never investigated before.) and exactly how I’m expected to contribute to the project. The other people working with me are smart, engaged, and eerily attractive.

I was told that I would not be introduced as “Dr.”. The PhDs don’t do that here. I was a little disappointed. If physicians expect me to call them “Dr.”, then I expect the same. The power differential is way too big if medical doctors are allowed to use my first name, but I’m not allowed to use theirs. It allows them to dismiss people they see as uncredentialed. So I had a little trouble sleeping last night, thinking about this. This tells you a bit about my arrogance, and general dissatisfaction with the fact that MDs are allowed to call themselves “doctors” at all.

But, as is usually the case when I worry about something trivial, I found out immediately it doesn’t matter much. In my big Quality Improvement meeting, everyone, MD, PhD, both, or neither, was called by first names. I can obsess about nothing a lot, and it can make me look bad. I don’t want to be that guy, really, I don’t. But a lot of times, I’m that guy.

I also figured out how to make it to my Wednesday night men’s meeting without any difficulty. There’s a bus that goes from about a block from MECMC to about a block from the meeting. I was so exhausted yesterday I thought I was going to fall apart. But I shared at the meeting, and then I walked home. About two miles. I needed it a lot. The day is wrapping up now too. I’m about to take off for home. I’ll be walking.

Life is good. I feel like I’ve successfully navigated the really difficult parts of the transition. I’m living in ECC. I’ve reported to work. I have a new driver’s license, even though I have no car anymore. I’ve found my meetings and I’ve started recognizing people. One of the Information Technology guys from MECMC goes to my men’s meeting. He’s a little older than me, with a little more time in the program. It’s nice to have a guy at work and in the rooms to check in with.

So I’m getting settled. I’m learning new things. I’ve done all the things I had to do. Look at me. Six months ago, I was deeply afraid of unemployment. Three months ago, I needed to find a way to move my whole life from the Midwest to the East Coast. I did a bunch of things. One thing at a time. Until they were all done. And now I’m here. Happy. Exhausted. Sober. And useful.

So the first two days of this week were my new-employee orientation classes at MECMC. It was a well put-together set of lectures and interactive elements teaching us the mandatory requirements for Joint Commission accreditation, something that most American Hospitals go through in order to be compliant with all federal regulations for Medicare, Medicaid, and insurance purposes, among other things. I’ve never been on that side of it before, the administration aspect, so I’m not entirely sure what it’s all about. But I know that it’s important. I paid attention and asked a lot of questions and was generally the snot at the front of the class.

Tomorrow I show up at 0830 and start my real work. I log on and get my shiny new email address. A real one. I complete a couple of training modules. And I meet my work group. I’m excited. I feel confident and ready. And nervous. I have one stupid annoying thing I need to get fixed already. They forgot to put my Doctorate on my ID badge. I’m going to insist on that. It’s not (just) vanity. In order to spar with physicians over data and processes, something that always happens, I need to be obviously in possession of a high-quality credential.

I’ve had a good time exploring ECC. I have, it turns out, made a couple of friends here from the twitterverse. And the AA community is strong. My Wednesday evening men’s meeting is a great group. Not quite like my old men’s meeting, but nothing would be. And one man there is a co-worker at MECMC. I’m glad for that. It’s good to know that there’s someone in the program at work that I can turn to in the event that things are turning tough and I need to talk the program with someone who understands the work-environment.

And now, I go to work. I find myself waking up in the morning excited, thinking: “Today, I get to go to work at MECMC!!” It’s so beautiful. It’s SO beautiful. I’m thrilled and privileged to be a part of it.

Well, my long vacation is almost over. Having taken five weeks off between jobs, my position at MECMC starts Monday. I’m starting to get a little nervous. But I’m also feeling ready. It’s the kind of nervousness born of anticipation, rather than of fear. Yes it’s a major change. But it’s one I’m trained and prepared for. I’ve had a month here in ECC to prepare myself for living and working in this city. I’ve done that. Today I even got my new driver’s license.

I feel a tiny bit strange. There was a question on the application for the driver’s license that said (paraphrased), “Have you been arrested for an offence that may possibly result in your license being revoked or suspended?” I checked “No”. First of all, the circumstances around my DUI were such that my license could not be revoked. Second, the question was phrased in such a way as to make it sound as though the possible suspension was still pending. Meaning, it was designed to prevent anyone from getting a license in my new state if their old state was in the process of suspending their license. But I also wonder if perhaps they just want to know if I had ever been arrested for any offense for which the penalty could possibly have been a suspended license. There’s certainly wiggle room. But I don’t know if I ought to be looking for room in which to wiggle.

I want to spend tonight and tomorrow working up some of my ideas for how to manage projects so that I have a few things prepared and don’t sound like I’m a goddamned idiot on my first day. I’m excited and nervous and happy and a little manic. I’m vaguely regretting that I didn’t travel internationally during this time, but frankly, it felt like more work to go on an international vacation than to stay here. And I needed to be here and do a bunch of things. And I’ve done all the things now. I’m ready to begin.

I also reached out to a professor at a local Big Fancy University about possibly doing mentored internships or lecturing or something. We’ll see if he responds. It would be exciting to have a contact there. And of course, I’m going to angle, eventually, for an adjunct position. My adjunct professorship at ECU expires in June of 2014, and will almost certainly not be renewed. The project is done. I’d like to maintain some kind of academic affiliation. My position at MECMC is sufficient for my ego, of course, but that university title is definitely compelling.

I gotta say. Life is good. I have ideas that are being supported by a great institution where I can do work I trained for. In a city that I am rapidly coming to love.

My lunch yesterday with my bosses at MECMC was very cool. It was mostly just a friendly meal in the hospital cafeteria (Which is awesome. I had steamed salmon and rice with grilled asparagus for like $8, and it was catered-quality.).  I was given a little more in the way of description of how my workgroup will be organized. Even though I report to someone, they say that it’s all basically a big collaborative process. Which is good for me. I honestly do best when I have people to report to and projects ongoing that I have accountability for. I’m more productive that way, and I do better work when I know people are going to be checking it.

And there were just so many good things that came up. For example, they asked me how my vacation was going. I told them that it was going well, and that I know they wanted me to start earlier but that I really needed the time off. And they said: “Good for you for pushing back on that.” That’s just incredible. Because it means that when it’s time for me to take some time off, a year from now, even if there’s a lot going on, I’ll be able to say that it’s time for me to take a vacation and that it’s important to me, and they’ll respect it.

We talked more about publishing and IRB issues. They’re supportive. They asked me what kind of laptop I want. They’re going to put me in touch with HR so that I can figure out the pension system (What the hell is a “2% paycheck credit”?). My office is just going to be a cube in a room full of cubes. But it’ll be my cube, which is fine. It was a good lunch and I’m excited to start. I’m also nervous. But I think that’s good.

I often feel like I shouldn’t be nervous, or apprehensive. But why shouldn’t I be? Why judge my feelings, thus putting even more pressure on myself for failing to handle these incredible upheavals in my life with anything less than perfect aplomb? I want to assert that I have the right not to be perfect. But moving to a new city and starting a new job without apprehension wouldn’t be perfect; it would be pathological. And that’s just it. I am critical of myself sometimes for not being pathologically unemotional.

I have accomplished a great deal in the past few months. Managing a move, a job search, all while writing an R01 equivalent grant application (Pending, and likely to be turned down even if funded.). And you know what, it’s been emotional. It’s been difficult. I’ve cried a lot. I spent my 5th sober anniversary, a thing that should have been a major event celebrated with close sober friends, alone in a new city unpacking boxes. It was lonely and sad.

But I am emerging. I needed the time off. I love ECC. It’s incredible. I needed this time. I needed it not to burn out and bring the emotional exhaustion from the move and my last job along with me to my new position. I have another week and a half. And then I will begin. I’m excited. I’m happy. I’m ready to move forward.