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Sleeplessness.

20 December 2012

Last night I awoke at about 4:30am and couldn’t get back to sleep. I finally got up at 6:30am, and headed in to work. It is vanishingly rare for me to suffer insomnia. My general sleep disturbance is nocturia, but I can go back to sleep in literally moments almost all nights. But for the past four or five nights, I’ve awoken with panic attacks, heart palpitations, headache and rumination. However, my sleep is disturbed for a very good reason.

I was told yesterday by PECMC that if my references are adequate that I would receive a formal offer within 48 hours. They run their references through a web service, and it informs me when they’ve gone through. They told me that they wanted three references, and they have now received three references. I expect to get the phone call from them with an offer today or tomorrow. The human resources woman I spoke to what competent, bright, and excited (or did a good impression of it.). She left no room for confusion. The offer is dependent upon my references, of course, but they are intending to make me an offer.

So did also say that I would have a background check and fingerprint. Which means my DUI will come up. Which means I’ll have to deal with that. I’ll deal with that. I can’t change the past, so I’ll deal with the present, as it happens. I cannot predict how they will react to it. But I can be prepared. It was nearly seven years ago, and I’ve had no issues since then. My sponsor (who is also trained as an addiction counselor) has said he’ll act as a character reference, as has my colleague at ECU, who knew me back when I drank. I can only let things unfold as they unfold.

So I’m afraid and uneasy. I want this job very, very badly. I’m scared of change and of moving and of all kinds of things. Will I sell my house? Rent it out? Let it crumble to ruin? All of these are good options. It’s a blessing to have too many options rather than too few. How will I find a new place? I’ve talked to people who live there and lived there. I’ll figure it out, I know. It’ll be exhausting and frightening and confusing and I’ll do it.

A friend here in AA told me that he has a good friend in the program in ECC, and that he can get me hooked up with good meetings. That’s important. My goal is to take in a lot of meetings for the first few months I’m there, in order to establish myself and get a firm foothold on the recovery scene. These days I go to two meetings a week. After I divorced, I kicked that up to five or six for a couple of months. Then three for a long time. It’ll be important to establish a strong foundation in a new city, to embrace the AA community there and make friends.

But I don’t want to get ahead of myself. I don’t have the official offer yet. I have only a stated intention to make one pending references. Which they now have. So. Wish me luck. Again. Please. Your support has been outstanding.

Not-Quite Twelve Months of Dr. 24Hours.

19 December 2012

Inkeeping with the spirit of the meme, whereby I am supposed to post a link to and the first sentence of each month’s first blog post in 2012, this is my flashback for the year. I’m following on from DrugMonkey

April: My name is Dr24Hours.

May: I was talking with a friend last night about masculinity and – without saying the word – maturity, and how they relate to sobriety.

June: I stayed home today.

July: Last week I was asked to be the speaker at my Sunday morning meeting.

August: It is very difficult for me to see my accomplishments.

September: So, it looks like there are some possibilities on the Canadian-entry front.

October: It’s a good thing that I’ve been applying to new positions for the past month and a half.

November: So, the big news today, as far as I’m concerned, is that I received a decision on a manuscript.

December: My grant is almost done.

Flagging.

18 December 2012

Dear Citizenry of the Internetted Environs,

I write today to express my extreme exhaustion, and deep committment to the accumulation of time spent pruning in the jacuzzi. There are, as they say, too many things. And this at a time when I have no pressing deadlines or encroaching obligations. It is simply the beginning of winter. It is hopefully nearing the endpoint of a job search. Either that or it is just passing the beginning of one. It is waiting, tremulously, for so many things to happen.

Even though I went to Rome recently on a long weekend, I haven’t had an actual vacation since last February. Not one longer than 3 days off work. I’m taking the first week of January off while a friend from out of town is visiting. And if I get the job at PECMC I will be taking a serious vacation of some kind. Unsure what, but there will be a passport involved. Probably a jaunt into the Caribbean.

Today I had my first ever phone interview for a Tenure Track professorship. It’s not a fancy school or a big-name program. But it’s a real honest-to-god tenure track professorship. The kind of job that I never imagined wanting, and then, once I wanted one, I never imagined anyone would consider me qualified for it. Now that at least one school considers me potential tenure-track professorship material (and another for a research professorship), I am overwhelmed with gratitude and astonishment at how my life has changed in the past nearly-five years.

Life can be great for us alcoholics. We just have to stop drinking, clean our houses, and follow direction. Do the next right thing. When I handle the things in front of me, the rest takes care of itself. And here I am.

Connecticut.

17 December 2012

I’m tired of writing about these. I hope to god you’re tired of reading about them. No one yet has crafted words sufficient to address events of December 14th, in Newtown, Connecticut. I won’t be the first. It is simply outside of my ability to comprehend. What I can say is that this one, finally, feels different. In myself, and in my read of the culture after the event. Over the past twenty years, as these events have piled upon one another, child after child after child dying, sometimes at the hands of adults, sometimes at the hands of other children, I have seen the response change, slowly.

We must not simply tell another grieving community that our hearts wail with theirs and then stand back and do nothing again. We must not continue to fill our graveyards with children’s coffins and throw up our hands saying we cannot prevent these massacres. We must not silently consent to sacrifice another schoolyard of innocents to a centuries-old scrawl of ink on parchment, unadorned by the passage of time and circumstance.

Two horrific shooting incidents in 1996, one in Scotland (disturbingly similar in profile to Newtown) and one in Tasmania, led to legislation in the UK and Australia, respectively, essentially banning (though not completely banning) private ownership of firearms. I don’t know if that is the right thing here, even if it could be done. I am not anti-gun ownership in a blanket way. However it is absurd to have fewer restrictions on guns than we do on the right to board an airplane or purchase cough medicine. Perhaps we need a new amendment, to clarify and restrain the second.

And we need better and more comprehensive access to mental health services. As I wrote when I wrote about Jared Laughner, mental illness does not absolve one of responsibility. It does not excuse the killer. And many of the mentally ill can, as I prove myself, lead ordinary productive and positive lives when they engage with treatment. I don’t know for certain if Mr. Lanza was suffering from any mental illness (there has been report of Asperger’s Syndrome). However, as @sciliz said in the immediate aftermath, no one meaningfully sane can commit such an act.

There is an increasing call among mental health and public health workers to see such acts as a public health issue. So many are dying because of the lethal combination of easy access to weaponry and untreated mental health needs.  It is true that we will never be free entirely from disturbed persons who kill. Expecting that is an unreasonable goal that not even the staunchest of firearm-proscription advocates claim. What is reasonable is that we have the ability to make these events both rarer and less deadly.

We do that by expanding our ability to treat all persons with mental health issues early, before they become desperate. While their lives too, can be saved. We cast a wide net, by eliminating the stigma associated with seeking treatment for mental health issues. We do that by reducing the availability of firearms and by carefully screening anyone (and perhaps anyone who lives with anyone) who wants to purchase a gun. We do that by making the penalties for illicit gun ownership very severe.

We grieve, this week, with Newtown, Connecticut. As we should. It is no longer acceptable only to grieve. We must address the specter of violence made manifest in children’s graves.

Career News.

15 December 2012

So much happened in a 10 minute period yesterday. At 1:50 pm, I received an email from a university in the southeastern USA requesting a telephone interview for a tenure track position. At 1:55pm I received a call from my contact at PECMC telling me that they are “definitely proceeding” with the position and want to check my references. More on this in a moment. Then, at 2:00pm, I had my interview with LSMS (Large Southern Medical School) about a non-tenure track assistant professorship. So. To unpack.

The interview with LSMS was good, I think, and I feel like it went well. There were three professors on the phone and they asked me about my skills and how it would apply to their environment. The position is half supported on an existing grant about oncology medical homes, and half by the dean. I was told it could be converted to a tenure track position in the event that things were “going swimmingly”. Basically, I assume that means that if after three years I have an R01 or two and four or five really good publications, I might be shifted to a tenure track position. It’s reasonably promising and I was told that I would hear if I made the next cut next week.

The other position is a tenure track position in a school of public health, in health policy and management. I think I would be very challenged by such a position, given that I have no background in health management or policy except that which I’ve taught myself. But my simulations are designed to illuminate issues of health policy and management at the level of clinics and the populations they serve. Micro-policy, as it were. So if they’re interested in that, there’s a chance that I could fit in.

But the big news is about PECMC. My contact told me it was “good news”. Obviously it’s not an offer yet, but I was told that “everyone was very impressed” and they are “definitely proceeding with the position”. I was told that I would be contacted by human resources next week to have my references checked. That should be a formality. I have good references. I was also asked to plan a simulation for some kind of pulmonary study they want to do. It’s a little confusing, I have essentially no information. But I’ll be contacted next week with more info. I almost feel like this is a quiz of some kind, like they already know the right answer and want to see what I come up with. But no matter. There are no right answers in these situations and I’m confident that I can come up with something appropriate.

So. If I am offered, officially, a position by PECMC, I’ll take it. I will then suspend any further exploration. Though part of me is tempted to take interviews with other schools in the meantime just for the experience of giving job-talks. Though that’s probably not honest and not appropriate. I’m very, very hopeful. After the interview, I felt like it was about 50/50 that I’d get an offer. Today, I feel it’s about 90/10. But I could be wrong. Is there any way to get Nate Silver on this?

So. Good news. I think it’s very likely that I will be able to find work somewhere by the new academic year. And there’s a really good chance that it’ll be an absolute dream job, in East Coast City, at Prestigious East Coast Medical Center. A glittering fantasy-scape of excitement. I am hopeful today. Which is a glorious luxury in a world otherwise gone irretrievably mad.

Keeping Sanity Through a Divorce.

13 December 2012

At my men’s meeting last night, a man shared that he’s getting divorced. He was also celebrating two years of sobriety. He’s in his mid forties, but has a young child. I also got divorced in my third year of sobriety. I know a few dozen men that got divorced a few years into sobriety. I don’t know if it’s similar for women who get sober or not. I just don’t have the experience, and the mixed meetings that I attend haven’t happened to address the issue much. Though there is a woman, sober 22 years, who is divorcing in my Sunday meeting. Sometimes, sobriety alters a person and a relationship beyond what it can bear. Sometimes, relationships simply don’t survive life.

It’s incredibly difficult to get divorced. There’s a lot of gallows humor that goes around the rooms when it’s happening to someone (You know why divorce is so expensive? Because it’s worth it.). But the truth is, it’s an excoriating, awful, wrenching experience no matter how much the parties know it’s the best decision. There’s just so much about two lives that become interlaced. Emotions and habits and idiosyncracies that are peculiar to the relationship. Things that feel that they’ll be lost forever. Cherished things that must be sundered if the relationship is to dissolve.

I met my divorce with sadness, anger, and a deep dissociation. I had to separate myself from emotions that were too painful to feel in the moment, and process them again later. But I made a few choices that helped me to stay sane through the many months it took to sever our entanglements. I never insulted her. I never even raised my voice at her. Whenever I was too angry to react calmly, I excused myself and went to an AA meeting. I chose not to argue over physical objects. Whatever she wanted from the house, I let her take.

And I remembered some of the wisest words ever given to me about the end of a relationship. No matter what emotional landscape an interaction with my wife brought me to, I simply told her: “I will always remember the wonderful times we had.” True, simple. And they comforted me. Because even though I knew I was making the right decision, there were many wonderful times that I still cherish. I still love all the things I loved about her. And I always will. Maybe that’s why it took me so long to sell the ring. My thoughts on that are here.

On Social Stigma.

11 December 2012

There’s a rather facile article from Salon that has made the rounds on the internet in the past few days, called “Eight Reasons Addiction Carries a Stigma.” They list a bunch of reasons that include the failure of the medical community to properly treat addiction, the discriminatory practices of insurance payments, etc. A lot of their reasons simply beg the question: addicts get sent to jail because of the perception of moral failing. Essentially “there’s a stigma because there’s a stigma.” Tautology rarely, with this case being no exception, provides any new light on a subject. Or: addicts are always under suspicion of relapse, because of the stigma associated with addiction. That’s a consequence, not a cause. So the article isn’t particularly well written, and doesn’t offer any solutions, or suggest alternatives. Of the eight reasons they give, only one seems to be an actual causal reason that addicts face a stigma: we often fail to seek treatment.

Additionally, the writer takes a silly pot-shot at 12 step programs that reveals his deep ignorance of them. He says that patients directed there, and then finding themselves uncured, are reluctant to pursue further treatment. No one who understands 12 step work claims that it cures addiction. It does not. Nothing does that. What 12 step programs do is allow a person committed to recovery to find a path that leads there. Rarely do people “directed” to AA or other such programs recover (though it does happen!). If you have to be directed to a 12 step program, it’s unlikely you’ll arrive in the frame of mind needed to recover. Those who recover arrive of their own desperation willing to do whatever it takes. And those people recover with very high frequency.

The article has entirely left off the two biggest reasons that addiction carries a stigma. The first is that we addicts, we alcoholics, enjoy our drug. Yes, when finally in the deep grips of addiction we no longer take pleasure or joy in drinking or using, but for the most part, we enjoy getting high, we are in denial about the consequences, and we defend our ability to successfully use even in the face of profound, catastrophic evidence to the contrary. And – whether this can be described as a preference in the same way there might be a preference for red vs. blue or not – we prefer to drink and use rather than to engage in life and fulfill our other responsibilities of living. Of course there’s a stigma associated with it. When a person would rather get drunk than raise their children, when the choices they make show a clear preference to drugs and alcohol over human society and basic responsibility, it is utterly natural to see them as failing morally. We abandon our rightful places in the company of effective and useful people, and prefer squalor and misery and inebriation.

The other fundamental aspect of the stigma missing from the article is that we addicts do bad things. We steal. We lie. We sometimes murder. We drive drunk and we kill people in our cars. We neglect children and abandon spouses. We consistently make terrible choices which leave other people in debt, in trouble, or in hospitals and in graves. We do these things, and then we refuse to take moral culpability for them. We hide behind any excuse we can muster, including the disease of addiction, if we think that will get us out of the trouble we’ve caused.

Why is there a stigma associated with addiction and not, as the author suggests, with cancer? Does this question need to be asked? Cancer doesn’t make you lie. It doesn’t make you steal, or prostitute yourself. It doesn’t make you kill. It doesn’t make you abandon those who love you. It is simple and straightforward and obvious why there is a stigma associated with addiction that is not present with other diseases: addicts behave anti-socially.

I’ll go further. It’s not an entirely bad thing that there’s a stigma. When I was in my late stages of active alcoholism, I was unemployed, rootless, and my wife was about to leave me. And she’d have been right to. It’s hard to imagine it being the right thing to do for a spouse to leave a partner with cancer, because of the disease, even if the sick partner refused treatment. But it is absolutely defensible for a spouse to leave a partner with untreated addiction. I’d help one pack today. The stigma associated with our disease can save lives. It can save the spouses and children of an embittered and abusive drunk. And the pain of losing everything can help drive an otherwise hopeless alcoholic or drug addict into recovery.

I know hundreds and hundreds of recovered people. But I don’t know a single one who says: “If only people had been nicer and gentler to me while I was using, maybe I’d have recovered sooner.” There’s a word for being nice and gentle with addicts. Enabling. We will use any crack in someone’s resolve as a toehold to fuel our drug use. We will use people up until they have absolutely nothing left, and then we will discard them as trash. Unless the pain of being a user, the pain of being a drunk, is worse than the fear of recovery.

I came to recovery when I was so sick, when my moral desolation was so complete, that the choice between drinking or recovery or dying was no longer clear. When I was so lost that I had no place to set my next footstep, for fear of the ground collapsing underneath me. And I landed in a soft place: a treatment center that was based in the 12 steps, where they showed me how to follow a path, step by step, day by day, to recovery. By looking hard at my moral failings, at what I drank to suppress. By being honest and brutal about the true nature of what I had become.

It would have made my life far worse, and very possibly ended it, if I had had gentle doctors trying to relieve the stigma of my addiction.

Scientific Conceit.

10 December 2012

I have – usually by my sisters, but certainly not exclusively by them – been called conceited in my life. And it’s true. That’s only one of my many character defects. I can present myself as being absolutely certain of things. Certain that my opinions are facts, that those who would disagree are either stupid or uneducated. It’s a vile attitude, and one which I have come as an adult to choose to battle rather than embrace. There are simply too many variables for my opinion to always be correct. There are too many competing interests for my perspective to be untrammeled. And, most importantly, perhaps, was my realization that I didn’t really like people who acted like I did, but who had different opinions. But I also couldn’t see how they were different from me.

Science has an image problem. My experience is that non-scientists generally have one of two reactions when they discover that I am a researcher and an academic. They either are impressed and think I am probably a genius, or they think I am an arrogant, ivory-tower  egg head. I think most of the public (often distributed along political lines) takes one of these two attitudes. There are additionally a few who assume that scientists are the bought-and-paid-for nefarious operands of the Evil Corporate Overlords. And depending on whether their issue is bio-medical or global climate, they may be on either side of the political spectrum.

And this image problem is largely our own fault. If I may speak in generalities, you will find scientists who say that being a “genius” is not a job requirement, or that people far smarter than they never pursued academics. And those are true. But it is difficult to find a person anywhere who doesn’t enjoy being called smart. And academics have made a life out of being the best at being smart. I don’t bow to the silly stereotype that “so many of us were social outcasts” or “we sucked at sports”, so we now overcompensate by being conceited about our brains. Most of the scientists I know are socially adept and most are even sporty to one extent or another. The “nerd” trope is simply untrue. But we are happy to condescend to the little people who can’t fathom the massive implications of our utterly groundbreaking blah blah blah.

And it’s difficult. I get that it’s difficult not to condescend to people who are simply wrong and yet remain shrill in their promotion of falsehoods. Like Jenny McCarthy and her insane, murderous lies about vaccinations. Children are dying because of her, and her co-religionists. They tell lies on TV, and people who don’t know better believe them, and as a result, children are dying of measles and whooping cough who by rights should be living fat, pink little lives. That’s her conceit: the belief that she must know better than people who’ve dedicated their lives to eradicating disease. But I don’t know that we can fight lies with sneers.

There is also an enormous amount of conceit that we scientists direct at one another. Look at the advertisement for NatureJobs from a recent edition of Nature. (Thank you to @rxnm_ for alerting me.)naturejobs

The very idea that non-professorial jobs are “alternative” is ridiculous. For me, my search for a professorial position is my alternative job. My goal, while studying for my doctorate, was to become an operational engineer in healthcare, perhaps as a business owner. My path to a research position was an unintentional one. My skills as a simulationist in health care have turned out to be in less demand than I imagined – or I’m not so good at pointing out the need for it – and as a result, I have ended up in a soft-money research position. Doing the work I want to do may end up requiring several  years as a researcher until the industry side of healthcare catches up to the research side, and recognizes the value of what I’m doing. Though, of course, I’ve applied for a job doing exactly what I hope to do at PECMC. Hopefully, I won’t have to do too much more obscure academic work, and can set about making a difference in actual patients’ lives.

I see conceit over hours worked, and the assumption that a person who doesn’t win a bunch of grants or publish five papers a year is lazy. There’s luck involved. There are personal choices. I’ve seen conceit associated with having children, as if people serious about science (usually they mean, but won’t say, women) wouldn’t waste their productive years having babies. Or vice versa, condescension about children: the childless scientists are required to spend more time in the lab, covering for those who go home to take care of children. As if the time of people without progeny is less valuable to them than the time of a persons’ with children is to them.

We all want to be valued. We want to be seen as important, and making an important contribution. Science is competitive, and that forces us, in many ways, to set up hierarchies. It’s not dissimilar at all from sporting success. Except that we can’t really have head-to-head competitions. So we have all these proxy battles and metrics to separate us and hoard glory. Metrizable prestige. The absurdity of it would be laughable if it weren’t the guiding factor in people’s livelihoods.

The undercurrent of all this conceit and condescension is the fact that all of us, to a person, struggle with Imposter Syndrome. We fear so deeply that we don’t belong. We are ashamed of our best work in the same breath we’re proud of it. We look at others, we measure them, and we find ourselves lacking in comparison. I do. And thanks to our relentless obsession with measuring productivity and impact, I can prove it. I have an h-index lower than anyone else I know on twitter. Fewer citations. Papers in worse journals. I came to the academic side of science late. My first paper was published in 2006, my next in late 2010. I haven’t had a lot of time to accrue citations. Though, obviously, I’ve had time to accrue excuses.

I think the vast majority of us vascillate between feelings of brilliance and excellence, and feelings of shame and fear and outsider-status. And in that respect, I think scientists are very much like everyone else. All of us search for a place we feel welcomed, accepted, and part of the group. All of us fear from time to time that we don’t belong. I feel that way most of the time. And then, when we do find that group, we end up jockeying for position, trying to find exactly where we belong, and then figuring out how to ascend above the next person.

I hope that we can find ways to be mutually supportive that take priority over the ways we are self-interested. The twitter science community does a pretty good job of that. I’ve found more support there than anywhere else, when it comes to learning how to do science, and survive in the cutthroat world of academia. I hope that the public can see scientists as supporting each other, rather than undercutting each other. I hope we scientists and academics can let go of the idea that the only worthy goal of getting a PhD is to become a professor. That choosing another path represents failure in some way. Besides which, why on earth do we despise failure so much? Truthfully, failing is the best way I’ve ever learned.

When I look at myself, I see someone who still struggles with conceit. Yes, I want to be smart. I want people to know it. I want people to be impressed with my work and my efforts. And I want to then be humble about it, so that people are dutifully impressed with that grounding too. But I have abandoned the idea that I am always right. Because when I look at people who think they are always right, I don’t like what I see. So I assume that that’s what people feel when they see me acting like I’m always right.

And maybe this is its own sort of conceit, but when other people insist their opinions are facts, and that those who disagree must be stupid or uneducated, or evil, I assume that their behavior is driven by what mine was: fear; shame; pain. I became engulfed in the fear that I was nothing. The shame that my best efforts were worthless. The pain that I didn’t belong. So I tried to condescend my way out. It didn’t work. I think it can’t work. We cannot elevate ourselves by digging pits for others to fall into.

Waiting.

7 December 2012

In case anyone didn’t know (ha!), I’m waiting to hear about a job. It’s excruciating, waiting for these things. After my interview and talk at PECMC, I was told it would be two to three weeks. It’s now been just more than a week. Which means, unless addition has suddenly stopped working (in which case we all have much, much bigger things to worry about), that I have another week or two before I’m even allowed to have any anxiety about why they haven’t gotten back to me yet. But my brain is not really subject to calendars, so it’s gone ahead and started producing stress hormones ahead of schedule. I’m sure the neuroscientists in my readership could explain that in some detail.

And of course, even if my hopes for PECMC don’t fruit, I now have another interview with a University, and I have a phone call scheduled with a professor at a third place where I’ve applied for a tenure-track post. This professor does systems research, at a place which does a decent bit of systems research. His work is not directly related to mine, nor is anything they’re doing there, from a computer-science perspective. But from a social-systems and healthcare-systems design perspective, there’s a lot of overlap. So I’m excited to talk to him, and then there will be a professor in the department I’m applying to who will have spoken to me personally. Hopefully that will help me get an interview/job talk there. It’s a fabulous school of public health; world-renowned. They’ll definitely have many candidates more accomplished than me. I can only hope they’re looking to develop their systems portfolio.

And I’m continuing to wait to hear from well more than a dozen other universities and institutes I’ve applied to. Some I know I’ll simply never hear from. Most of the ones I do hear from will be rejections, not interview requests. That’s the nature of most job markets, I think. And it’s especially true of professorships. There are so many more applicants than positions. I’ve been told that on average, only about 50% of the applicants for a professorship are remotely qualified. In my case, where I’m applying, a search committee will have to be willing to explore beyond the traditional “professors of public health should have PhDs and post-doctoral work in public health” mindset. I know that I have a lot to contribute to the field of public health. But I also have an enormous amount to learn before I’d be ready to teach even introductory courses.

So it may be idiotic to be pursuing professorships in public health. It’s hard for me to tell. Maybe I shouldn’t be looking at tenure-track positions at all, so that teaching wouldn’t even come into it. But I don’t know. I’ll just have to wait and see what happens all the way around. But I need to remember where I am and what I’m doing. Only two days ago I wept with gratitude about being asked to interview for a non-tenure track professorship. It’s astonishing to me, how far I’ve come, through essentially no doing of my own. I have only walked the paths of persons ahead of me. I have only followed instruction. I’ve worked hard at a program I didn’t invent. One that I couldn’t conceive of prior to hearing about it. But one which has utterly redeemed my life from oblivion.

I hate waiting. But it’s probably meaningful that in Spanish, the word “Wait” also means “Hope”. Because if I’m waiting, it’s because I’m waiting for something. Something good.

 

Non-Tenure Track Phone Interview.

4 December 2012

I just got an email requesting that I have a short phone interview with “The Selection Committee” for a non-tenure track position at a large southern university. It’s a 12 month research professorship, meaning soft money, after the startup is done. Soft money sucks, but let’s face it. Even tenure-track positions are de facto soft money these days. Get grants, or fuck right off. That’s the way academia works. But I’m not particularly worried about that. Why should I be right now? That stuff will either happen or it won’t. In the meantime, it’s an amazing privilege to be considered at all.

For about 12 years, I drank as hard as I could every day. I nearly ruined my life. I nearly ruined other people’s lives. I was a suicide drunk, barely able to drag myself from one blank, miserable day to the next. I was horrible and bankrupt. I hated my life, my self, and my circumstances. I didn’t know what to do, where to go. Everything I looked at was shrouded in fear. I was drinking a bottle of hard liquor a day. Sometimes more. I was cutting myself just to bleed.

Today, I am waiting to hear about my recent interview with one of the world’s fine medical centers, who has given me every indication that they are very seriously considering employing me to serve as a leader in their quality improvement efforts. Today, I was asked to interview for a professorship doing health care delivery research at a major, highly respected southern university. Today, I am considered a capable, productive researcher, with potential to offer value to respected departments.

All I did was join AA. Work the steps. Clean house. Take inventory. And carry the message. Work with a sponsor and try to do the right thing, one day after another. Accept failure. Make progress. And not drink, one day at a time. When people tell you AA doesn’t work, try not to laugh right in their faces.