Please come read my latest blog post over there at Scientopia!
Reading the Medical Literature: RCTs.
Please head over to Scientopia to read this post!
Guest Blogging.
My first post is up at Scientopia. That’s where you’ll find me for the next two weeks, though I’ll keep posting links here.
Keys to the Kingdom.
Hello everyone! Starting tomorrow, I will be guest blogging over at Scientopia’s Guest Blog for two weeks. For the first week, I’ll be writing about Evidence Based Decision making, and reading the medical literature. The reason I’ve chosen that topic is that I’m taking a short course this week, teaching exactly that. So essentially, I’ll be blogging my homework. I’m excited to take the class, because it will help me understand the physicians and epidemiologists I work with better.
I will also use that space to keep up my semi-didactic, semi-confessional writing about recovery from alcoholism. I think I might write about my experience being an alcoholic specifically in scientific, academic, and pedagogical situations. I’ve had some experiences, mostly pleasant, but usually a bit condescending, which I think might be worth relating. In general, I’m glad to have a forum like that to share. Hopefully, I’ll find an additional audience, that will complement the robust and exciting one I have now.
Sorry I’ve been quiet lately. Lots of unrelatable stuff going on, but nothing that deserves mention here. All is well. I’m in Michigan right now, went to a meeting tonight. Lots of dull crosstalk. But it was good to go. I shared a bit about my job situation. How I know I can’t control the situation. I can only do my best and rely on luck and diligence and karma. Just like I can’t control other people. I can only chose to accept them as they are, or disengage from them. Just as I cannot make anyone accept me as I am. I can only take what they offer, or disengage.
It’s a big strange world out there kids. I’m awfully glad I’m not in charge. See you at Scientopia!
P.S. I finally sold my wedding ring. My thoughts on that matter may be found here.
Toxic Lethargy.
I’m feeling dull and smudgy this morning. I have too much work to do. I don’t really feel like doing it. Repeated rejection is getting me down. Papers, grants, rejection after rejection after rejection. It’s wearying. I would very much like to get a paper into a decent journal on the first try. I would like to have another grant funded at all. I’m feeling troubled by my progress. I would like something to be easy. Or at least seem possible.
My big grant which is still out there is due to be reviewed in October. If it doesn’t hit I am in truly deep trouble, if I want to stay where I am. I am tired of all this academic bullshit. It’s absolute nonsense how difficult it is to do research. Institutions no longer even support their own professors. American universities do not support research. They maintain lab space. You need grants if you want to do research. For providing you with a title and a place to work, the university will demand roughly 30% of any award you receive, and provide you with no staff.
All of which is making the Singapore job, where I’d actually be supported and have hard money and the opportunity to develop my own research program, look better and better. The fact that it looks to pay very well doesn’t hurt either. The truth is, I don’t think I want to live in Singapore for the rest of my life. But three years? Win some grants at a much better funding line? Put out some papers in decent journals? Turn around and come back to the US with a stronger CV and a wad of retirement money? Why shouldn’t I be thinking dreadfully seriously about this?
I’m exhausted and working in a frustrating, stymied environment. On the other hand, if my big grant hits, I’ll be in good shape for a long time. It won’t remove my salary pressure, but it will definitely ease my mind for a long time. Of course, the Singapore position may not allow me to wait to find out about it. I don’t know how big of a douchebag it makes me to accept another position while I’m co-PI of a grant under review. There aren’t a lot of people who do what I do, and so it would be very difficult for my co-PI to replace me if it were funded. Especially because it only covers 50% of my salary. And I still have no idea where the other 50% is going to come from. Well, not no idea, but it’ll take doing.
But. I’m excited about a couple of things. I’m taking a class next week at the University of Michigan. I’m meeting a big name researcher who does some work in my field and talking to her about how to advance my goals and ideas. I’m excited about this meeting even if I’m still not sure what to discuss with her. Maybe I’ll ask about the Singapore job. And my guest stint at Scientopia.org starts Monday, which is awesome. I have no idea what to write about. So I’ll probably write about being back in class, a little bit about sobriety, and my job/grant/publication issues.
And I’ll write about health care engineering and systems modeling as a science. I need to plan a primer on systems modeling. It should be cool. I’ll see what I can think up.
Independence Day.
I say this every year. Here in the United States, we celebrate for our independence day not the day we won the battle that secured our independence, nor the signing of the treaty that ended the war. Instead, we celebrate the day we swore to fight. It would be more than a decade from 1776 until we had a constitution (1787), or a president (1789). But we date the founding of our nation to neither of those things. We call ourselves a country from the moment we demanded our freedom, from the moment we said we would rather fight than kneel. I think something of that character remains in us today.
Continuing the Job Search.
After the fiasco at East Coasty University, I was briefly upset about my job prospects. Funding is really hard to get, I’m on soft money, and I’ve had another non-fundable score in my most recent submission. I honestly think my days here are numbered severely. I still have a major grant in the stream. If it is funded (and I’m not too hopeful), it will secure my position for four years. I also have the possibility which is slowly increasing in likelihood at Local Research University. There’s a contract they’re trying to land that will cover my salary (at 25% FTE). They’ve agreed on principle, blah blah blah. It’s probably going to be months still before anyone offers me a position. The department head keeps reiterating how much he wants me there. And I really want to be there. But I can’t operate as if it’s a done-deal.
Thus the job talks out on the East Coast. The first one went really well, but it’s a strange and slightly dysfunctional organization (much like my current post, and much like most of the departments in academia I’ve ever seen or heard of.). I don’t know if they are going to pursue me. They’re traditionally a problem solving organization, and I made it clear I want to be able to continue to do my own research. I don’t mind solving other people’s problems. I’m an engineer. It’s what we do. But I also want to advance my own research agenda.
Which brings me to my most recent potential situation. I received an email from a headhunter in Singapore. There’s an open position for a systems researcher in a medical school there. It’s a prestigious research position, tenure track, with hard money backing. They want someone who does exactly what I do (Though they prefer a physician who does what I do; there aren’t many of them.). It’s a small group, and I have lots of questions.
I’ve been warned that sometimes new departments try to get really prestigious really fast and basically slave drive professors. I’m not interested in that job. I’m not someone who is determined to get professional glory no matter what. I like being recognized for doing good work. But I am never going to put in 80 hours a week and ignore my personal needs for down time and recuperation.
I’m also really not sold on the idea of living in Singapore. It is, apparently, a gorgeous place to live. Truly magnificent. Every amenity, zero crime. It’s a nation-city, almost exactly halfway round the world, and has a huge number of foreign workers. It’s a polyglot metropolis, much like New York, but cleaner, safer, and with better air conditioning. I like living where I am. I am not crazy about the idea of moving at all, much less so far away. But the job is a dream job with respect to the type of work, the funding lines, and the opportunity to do real and lasting good with my engineering skills.
So, I’ve had two conversations with the headhunter, in which I described what I would bring to the department and what I would need from them to work. We talked about living in Singapore and the various aspects of city life there. We talked a little bit about salary. I’m not too worried about that aspect of it. If they were budgeting for a physician, then I am unconcerned that they’d be able to pay me enough to make that part of it worth my while. It’s far more about location than anything else. If this job were in the USA or Canada, I’d be packing right now. Hell, I’d take a pay cut.
So I don’t know if I want it, at any price. There are other opportunities coming. And the most valuable opportunity to me is the grant I have awaiting a score. If it hits, I’m in good shape for a very long time and will be directing my own research program right where I am. I could then cut a little bit of time at my current position, add a little bit of time at LRU, and be very happy. That’s what I want. But this job in Singapore looks at first blush like the perfect position.
So, I’m going to pursue it for now. Supposedly the department head is getting my CV today. Who knows, maybe he’ll just laugh his head off about it, and fire the headhunter for letting me get this far. But I think it’s more likely that they’ll want to interview me over the phone formally. In the event that they want to fly me out for an interview, I’ll probably go. But frankly, one of my big reservations is social and dating. I’m curious as to the opportunity to meet people who share my basic experience and cultural framework. I wonder how many single women live and work in Singapore? I know some cities have highly skewed gender makeups.
OK. I’m scared about my professional life. Opportunities in the world I’ve chosen to work in are hard to come by. This is a potentially good one. I’m going to take it day by day and see where it goes. And yes, I checked. There’s AA in Singapore.
Speaking about Step Three.
Last week I was asked to be the speaker at my Sunday morning meeting. I really enjoy that meeting. It’s a co-ed group, closed (which means that only people with a desire to stop drinking may attend), and friendly and inviting. Normally it’s a meeting where we get outside speakers. But I hadn’t spoken there in about three years, since I was an outside speaker, and so a lot of the group members who have been regulars for that time had never heard my story except in the tiny bits an pieces we all get when we share.
For those unfamiliar, AA doesn’t have any standard meeting type, or rules for how a meeting is run. And I’ve found that different places around the USA, and around the world, have different traditions and habits when it comes to meeting types. But some variations on a few basic themes have sprung up. My Sunday meeting is what’s called a “speaker/step” meeting, which means that there’s generally a single person who speaks for about 20 minutes at the beginning of the meeting on one of the twelve steps, and then for the rest of the meeting members of the group will share for 2-3 minutes each until the hour is up.
Sunday, we were on the third step. Step three states: “We made a decision to turn our will and our lives over to the care of god as we understood him.” (The italics may not be in the original from the book, but the step is generally presented with them in material). Many people struggle with the spirituality in the program of AA. Hell, people who’ve been deeply wounded by religion or by alcoholics will sometimes look at it as a cult*. But the spiritual aspect has never really bothered me.
In the beginning, it didn’t bother me because I had no trouble with the concept of god. I used to be pretty religious. And though I wasn’t religious when I came to AA, I retained my spirituality. In the past four and a half years, even my spirituality has waned. I’ve come to a point where I simply say: I’m hopeful about god. And this is what I said in my Sunday meeting, after telling my story. I’m hopeful about god. I would love for there to be a god. But I can’t sit here and honestly tell you that I am certain I believe in one. And I’m not sure I care. I’m comfortable not knowing.
So what does step three mean to me today, if I don’t know about god? There is a huge system of people, in these rooms. People that I rely on. People that rely on me. People who are stronger as a group than they are as individuals. This social network has enormous power. This is the power greater than myself. Some people call it “the wisdom of the group”, which is fine. Some people simply refer to god as “good, orderly direction”, which I find kind of silly, but surely no more silly than some would find my lattice of social connections.
As I looked around that room, of people whom I knew, and people whom I didn’t; people I’ve watched struggle and triumph, struggle and fail; people who’ve watched me weep and rage; people with whom I’ve laughed about the most horrifying excrescences of the human heart, I said: the third step, to me, means dedicating myself to this.
I think we are all imperfect. Imperfect not as measured against some phantasm’s impossible standard, but imperfect in our own minds, our own lives. In the way we would be if we were always our best selves. The way I would be if I were to do the things the image of me in my head does when I imagine being perfect. And I’m not saying that perfection is even the goal. Progress only, toward a better self, is my goal.
I know that I cannot make that progress unless I have help from something outside of me. Something bigger than me. Something stronger. For some people, that thing is god. And that’s fine. I’m very comfortable with people who are comfortable with god (though, I am often saddened by the conclusions it leads them to). In AA, I have found a place that is truly accepting and open. No matter what a person’s god-concept is, they are welcome in AA, even if that concept is none at all. There are many atheists here. And in AA, there is no proselytizing. I’ve never heard an argument about whose god is the “real god”.
When I dedicate myself to something bigger than me, and recognize myself as a small piece of a big machine, I am better able to understand how I contribute to the advancement of both my goals, and the goals of the thing that I’m a part of. I am a researcher in health care, making a contribution that will hopefully help improve delivery. I am an alcoholic, sharing in a series of rooms, drinking bad coffee and being one of the fibres holding together this lattice of ex-drunks, which has no center, and no edges.
We are the net. We are the soft place to fall.
_________________________
*If AA is a cult, it’s a lousy one. No one is in charge, no one gets rich, and anyone is free to leave at any time. We keep no personal information, have no mandatory dogma, and do not require that anyone do anything. We have a program that has helped a lot of us stop drinking and lead better lives. It’s free to all, and also freely refused.
Euphoric Recall.
Ah what a miserable day. And it’s only 9:43 am. Yesterday I got a non-fundable grant score, though it was scored and not triaged. The score was even halfway decent, but they had some fatal flaws essentially relating to the mechanism. Which we were misled about. We were told that pre-implementation studies would be accepted. The reviewers complained that the study had no implementation aspect, and was a pre-implementation study. Idiots. Then I got a paper desk rejected, after a month again. I respect a desk reject. In fact, this one came with the editorial comment that it was an interesting paper, but framed inappropriately for their journal. But a month? Come on.
Nevermind. I’m going to write about sobriety again. Writing about my sobriety reminds me at these times that if I never publish another paper, if I never win another grant, I’m fine. I don’t need an academic career. I can do other things. I’m a good engineer, health care is burgeoning. There will be jobs of one type or another. And if not, I’ll go sell furniture for a living. I like salesmanship. I can live in this world, and do good in it, no matter where I am.
Today’s twitter question was asked by @celli_bean, which is an awesome name for a cellist. I’m working on writing a piece for cello for her to play, but I’m finding it extraordinarily difficult, because I’ve never really written for stringed instruments before. Not anything requiring complicated understanding of strings and bows, etc.. It’s a great intellectual exercise, and I need to practice what Andrea Kuszewski calls “fetishizing the pain” of new thinking. If I love the difficulty and exhaustion, I can achieve something worthwhile.
@celli_bean asked me, “Is there ever any nostalgia, such as “although I’d never go back, there are things that I miss”?” This is a crucial question as well, and one which deserves a thorough and honest answer. Because dishonest answers to this question get alcoholics in trouble. They put alcoholics in graves. And the first thing to address is the middle part: ‘although I’d never go back’.
I have not promised never to drink again. I have not sworn off alcohol forever. I know that’s probably a strange thing to see for people who aren’t alcoholics in recovery. But it’s an important part of recovery. What I have done is decided, today, this morning when I got out of bed (implicitly, these days, it’s not a conscious effort), that I will not drink today. That’s all. As an alcoholic in recovery, the only thing about my consumption that I have decided is not to drink today. I can’t predict tomorrow.
But I can’t imagine drinking tomorrow. I can’t imagine wanting to drink tomorrow. I can’t imagine struggling about a drink tomorrow. But it would be foolish and dishonest of me to make lifelong sworn statements that I will never drink again. I don’t know. Any alcoholic who says they do is asking for trouble. When I hear someone say they’ll never drink again, big red flags snap warnings in semaphore at me. I haven’t had a drink in 1,595 todays. They were all tomorrow at one point. And day 1,596 is looking pretty good.
As for nostalgia, sure! There’s nostalgia. When I was 22, I drank apple wine and smoked hash on a soccer field at 2 am in Burgundy Brittany (ed – thanks Lawnboy…). It was awesome. There are dozens of memories about drinking that I enjoy. But there are hundreds, thousands, that I despise. That I’m ashamed of. That horrify me. And here’s the big thing: many of my memories of drinking are wonderful and fun, but I found out later that other people thought I was being a disgusting ass, when I thought I was being charming and funny. So, all of my drinking memories are tainted by the idea that when I drink, I don’t remember how it was accurately. I can’t trust my own mind.
In general, yes, alcoholics will often remember fondly our drinking exploits. We have a term for it: “euphoric recall”. In the beginning, it’s really dangerous. Because we don’t remember things as they actually were, often, we are able to deceive ourselves that we weren’t really that bad. That we were the elegant drinker at the upscale party, not the vicious, embarrassing and sloppy drunk whom everyone wanted to avoid.
But as time in sobriety goes on, that euphoric recall subsides. And I can see my drinking for what it was: the exhibition of the symptoms of a progressive, terminal, mental illness. The further I get from my active drinking, the more clearly I see what I was: a self-centered, self-righteous, angry, depressed alcoholic in a state of pure and criminal denial. There’s not much euphoria to be found when I look at myself honestly. Yes, I love the taste of a Pomerol with a steak. But that was about 0.5% of my drinking. And it never stopped there.
Nostalgia is fine. But we would all do better, I think, to recognize that memory isn’t perfect. I can’t reclaim the past. Attempts to do so are foolish and often destructive. And my present is so much better. My future looks bright. Even on days when I get poor grant scores and rejected manuscripts.
We alcoholics can predict the future, at least in some circumstances. I can safely predict that the day I drink is the day I lose everything I’ve worked for. I can predict that my world would contract back to a bathroom and a bottle of vodka. I can predict I would be unemployed and unemployable. But that day isn’t today. And I doubt it’ll be tomorrow. And as long as I keep my mind and heart centered, focused on my sobriety first, I needn’t fear those days returning. It is because alcohol is so terrifying to me that I am comfortable and confident without it.
I don’t understand how consciousness and time interact. I know that I exist in a perpetual present. The memories I have of everything are fallible and often confused and inaccurate. So I’ve learned to appreciate them as memories. And I don’t need to try to relive them. The person I was when I accrued those experiences no longer exists. The person I am is incapable of experiencing those things again. Memory is valuable to me in how it allows me to move forward and interact with my present more effectively. And for now, today, I feel like I’m doing that reasonably well.
Difficulties of Sobriety.
The next question from twitter I’m going to address is @scitrigrrl’s question: What’s the most difficult thing about sobriety, (or staying sober)? This is a very interesting question, because I think it highlights a couple of phenomena about sobriety the way I’ve been taught to practice it which normal people (that is, non-addicts), have no framework to understand. So, I’m not sure my answer will be elucidating, because in some ways, I think the recovered alcoholic is an entirely different animal from the unrecovered, and the ordinary person.
To a normal person, I suspect that the parenthetical question is meant to restate or clarify the first clause. But difficulties about sobriety and difficulty staying sober are different things. Difficulty in sobriety, to me, sounds like having difficulty doing step-work, difficulty being fully honest (generally with myself) or doing service work. Difficulty knowing how to apply the lessons of my program of sobriety to life, so that I remain planted firmly where I need to be. Difficulty in staying sober sounds to me like having trouble struggling with the desire to drink.
I have no difficulty staying sober. I haven’t had any difficulty with cravings or struggling not to drink since day twelve. Drinking is just not part of my life anymore. I don’t really miss it. I miss the pretend way that I prefer to remember it. I miss how it was in the beginning, sometimes. But those things are remote from me in both time and capacity. I no longer have the option of drinking the carefree way I did in the beginning. My only choices are freedom and life and abstinence, or alcohol and toxic, lethal misery.
Working the program, on the other hand, is often difficult. Honesty can suck. I am required to look very hard and very closely at myself, seek out the defects in my character which prevent me from being useful to others, and root them out. I am, like most of the alcoholics I know, often obsessively self-centered. It is difficult to set that aside sometimes. It is challenging for me to think of other people first and myself second. But the rewards for doing so are manifest in my life. Good things happen to me when I am, as a dear friend taught me to say, focused outward.
But the real answer to the question is that nothing about sobriety is truly difficult. What was difficult was hiding my liquor. Finding ways to drink that I didn’t get attacked for. Trying to live while totally inebriated most of my waking (and sleeping!) hours. Going from that to where I am now? I am astonished daily by how easy my life is.
Once we get past the ugly part of early sobriety, our lives become much more straightforward. Because we have tools for living. We learn to rely on things other than ourselves. We move forward by following the footprints of those who’ve gone before, and then finding our own new way. In that way, it’s much like science.
Infactorium 