In Search of Lost Time.
In a continuing series on questions solicited over on twitter, I was asked by @katiesci how long it took, after I realized I had a problem until I did something, until I found recovery. I think it’s an important question. Maybe if we knew more about what makes a person seek sobriety, we would know more about how to help more people achieve sobriety. Maybe we could find a way to compress the duration of active, full-blown alcohol dependence and usher more people from dependence to recovery.
Sadly, I think there are a lot of problems there in that paragraph. The very idea of “helping the actively alcohol dependent” is in some ways deeply flawed. Alcoholics are expert at finding ways to turn any kind of aid into a way of sustaining their drinking. The entire concept of medical care for the treatment of alcoholism is, in my own opinion, deeply flawed and badly enacted. Certainly, there is critical need for medical care for alcoholics, don’t get me wrong. But I think we do it very, very badly, and in a way that often prolongs dependence.
My opinion is that the role for medical care for the alcoholic is during the acute phase of very early sobriety. The time when we are at risk for seizure, hallucination, and other types of rapid decompensation. What many of us call “detox”. It’s a little longer than just the detox process, of course. For the first couple of months we are bewildered, disoriented, depressed, and sometimes suicidal. Engagement with medical professionals can address all of these issues.
And I’m not a physician, and alcoholics should not avoid seeing physicians. However, it is my opinion, and it is not an uncommon one among my cohort, that attempting to rely upon physicians or other health professionals to help us achieve sobriety is a fool’s game at best. We will rapidly offload our responsibility to the health care professionals. Then, when we drink again, we have a place to lay the blame: “The doctors failed me!”. Any attempt to treat alcoholism that is not initiated by the alcoholic is very likely to fail. We have to want it.
It took me a long time to want it. And a short time. I began drinking seriously when I was about 21. I found recovery when I was 33. Of course, while I was doing all that drinking, I also got a doctorate from a fairly prestigious university, in systems engineering. So I wasn’t entirely non-functional during the beginning of that. But the years from 2001 to the beginning of 2008 were pretty gruesome. There were all kinds of hints and suggestions that I was on an unsustainable path. Friends like Lawnboy telling me I needed to limit my drinking at his wedding (I didn’t). Like Chicago Joe telling me that I wasn’t invited back to the party in the New Mexico desert. The one where everyone was so drunk it’s amazing no one died; I stood out as a problem drinker.
The truth is, I knew very early on I was an alcoholic. Another friend in grad school, who had introduced me to pot as well (which I gave plenty of opportunities to, but never particularly enjoyed), often just outright said that he was an alcoholic. “I’m an alcoholic, and I drink,” were his exact words. It made sense to me. I felt the same way. I didn’t say it out loud. When people would ask me if I had a problem I would assess their tone. If they seemed like they were joking around, I’d say I was a professional, or something like that. If not, I’d say in serious tones that I enjoyed drinking, but that I had no trouble fulfilling my obligations.
For a long time, probably up until around 2006, I believed that I could be what my then-fiancée called a “functional alcoholic”, which she believed I was, though never quite saying it directly at me. I thought that I could manage my life and be successful while drinking an enormous amount of hard liquor in secret, and reasonable amounts of wine and beer in public. The fact that a beautiful young woman wanted to marry me and let me help her raise a young man helped me believe that I couldn’t be that bad.
I was of course. There’s no point in looking away from how I was as an alcoholic, active in my drinking. I wanted so much to be left alone. I locked myself in the bathroom and drank for hours. I knew how badly I was ruining things. I knew I couldn’t keep living how I was living. But I didn’t know how to stop. I didn’t want to stop. I don’t have any way of conveying the power of the need for a drink to people who don’t need a drink. I was the rag doll in the mouth of the dog.
It was in January of 2008, on a Wednesday, when I finally went to my wife and admitted to her how much I drank. All I could say was: “It’s every day.” It was probably the first purely honest thing I’d said in half a decade. And I’ve never recovered from the wreck of agony I saw in her in that moment.
It took about a month from then before I actually stopped drinking. I talked to my marriage counselor, who told me not to stop until I was under the care of a physician. I went to a rehab for six weeks, where physicians and psychologists cared for me. It was necessary and appropriate. Medical care was crucial, in those early stages, for me. For suicide drunks like I was, drinking about a 750 ml of 80 proof liquor a day, the detoxification process can be fatal if not overseen by medical professionals.
What made me seek treatment? Seek sobriety? Pain. The knowledge that I was going to lose everything I had worked for; everyone I loved. Exhaustion. The sense of being totally unable to contemplate another goddamned day dragging myself from bed, trying to remember what I’d said the night before, lying, bargaining, blaming, and eventually finding an excuse or an opportunity to do it again. Shame. That I was failing all of the people who I cared about. Fear. That I would die in my sleep, a vast drunk carcass.
I wish I knew how to help alcoholics seek recovery prior to getting to where I found myself. But I don’t think there is any way. The only thing that I know, and that I’ve ever heard, that treats active alcoholism is pain. For me, it was about three years of fun, five years of knowledge but denial, and four years of exhausting, grim hell.
Several years prior to getting sober, I visited my sister’s in-laws in Oaxaca. My drinking affected that trip very negatively. I don’t need to rehash all the war stories here now. But I remember walking in downtown Oaxaca and seeing a brilliantly colored building with the words “Alcohólicos Anónimos” painted on the side in large block-square and confident white letters. Somehow, the inherent contradiction of plastering the word “anonymous” on a bright building didn’t land with me at the time. I remember thinking: “I’m going to be there one day.”
It took a long time still. But I’m there now. And I’m so grateful. I’m grateful that all that pain can be put to use. Because experience is an incredible tool. I’ve seen how others have been able to benefit from my past. And I’m overwhelmed with the amazing new life I have now. I run in a vast green demesne.
Mantras.
In soliciting blog topics today, I was asked whether I have a mantra. I realized, I’m not even sure what a mantra is, in the true denotative sense. So I looked it up. Originally, it was a Hindu word or syllable, chanted as an invocation or prayer. In the vernacular in English, it is simply a word or phrase, often repeated, often as a truism. In the former sense, of course, I have no mantras that I use, though I suppose I did utter a few during my yoga practice which has fallen by the wayside during the clement weather. But I felt silly about it, and didn’t connect with any mantra in a meaningful way.
In the latter case, though, AA is full of mantras. Little aphorisms which help us focus on the right way to do things throughout the day. “Do the next right thing.” “First things first.” “Easy does it.” We have a lot of these that remind us how we need to think about our condition and our circumstances to avoid putting ourselves in a position where a drink seems like a good idea. Simple, straightforward, daily progress. In fact, one of my favorite of these mantras, which comes from chapter five in the book Alcoholics Anonymous, is, “Progress not perfection.” I will never be perfect. But I can take three steps forward for every two steps back.
One of my other favorites would probably be a little too long to qualify as a mantra, but I use it almost daily: “I got where I am by doing the things I didn’t want to do.” I have a really nice life right now. Sure, my future is uncertain. I wish I had one of those jobs that didn’t depend on luck. Where I could just show up, do my job, and be assured that I would have a job as long as I did it well. But I don’t. But in general, I have a great life. I do science. I do engineering. I have great colleagues. I have a home and a yard and a tiny parrot.
But I couldn’t have those things while I do what I want to do. Because what I want to do, naturally, is to drink every day, from about 2 hours after I get up until I pass out, which will generally by about 14 hours later. That’s not exactly conducive to living a good, useful, healthy, happy life. That’s what I mean when I say I was a suicide drunk. I drink in a way that precludes me from being able to do anything else.
And in general, left to my own devices, I’m lazy. I would rather watch TV than study. I’d rather read in the bathtub than sort through data. I’d rather sit on my sofa than go running. I’d rather drink than live. I keep a slow, quiet, anti-social, inebriated life when I do what I want to do, in the moment. So how did I get this wonderful life that I have? By doing the things that I didn’t want to do.
For a long time in my life, I was good at that. I studied in high school and college. I worked hard at after school jobs. I had a good work ethic for a long time. But after I started drinking, around the time I was 22, I became more complacent. It took several years for my drinking to become truly disruptive to my life. But once it did, it was extremely difficult for me to force myself to do anything productive.
So, the first thing I had to do, which I didn’t want to do, was stop drinking. Don’t get me wrong. I deeply wanted to stop drinking. But I did not want to stop drinking. I wanted to put alcohol into my body. I just didn’t want to suffer any of the consequences I suffer when I do that. Sadly, that’s not an option for me. If alcohol didn’t make me useless, indolent, sick, aggressive, isolating, anti-social, dangerous, self-righteous and indignant, I’d still drink. I like drinking. I like the effects produced by alcohol. Because I’m an alcoholic.
But I don’t have to suffer alcoholic misery. Because I know how to do the things I don’t want to do. And as time goes by, I find myself wanting them more and more. But I’m still lazy. And so I repeat to myself: “I got where I am by doing the things I didn’t want to do.” And that musters the energy to run in the 100 degree heat. Or step up for a session of madwriting. And I go forward. My grants go out. My papers get submitted. Life moves forward.
The Great Chicago Tweetup; the Relentless Monologue.
So, I’m not going to bother rehashing the whole trip out to East Coasty University. There’s still a chance that the department I’m already in there would be interested in having me part-time. Which is alluring for me, still. But it would require a collaboration with East Coasty Healthcare Engineering Institute. Which does seem like a possibility. They were more impressed with me, and also eager to expand their scope from pure problem solving to research. And since my goals include bridging that gap, I feel like it would be a good fit there if I could find a way to make it happen. And I’d be decidedly happy to go there if my prospects here fall apart. Though, Local Research University seems to be finally making a push to get financing for the line for my promised Assistant Professorship. We’ll see. They’ve been saying that for a year.
Anyway. Fuck all that. It’ll happen or it won’t.
After going out to the east coast, I flew into Chicago to meet some friends from twitter. There I got to spend about two full days hanging out with @geeka, @katiesci, @scitrigrrl, and then a day with them and @labroides, and even breakfast with @highlyanne and @allochthonous. I found it was hard to refer to people by their real names, rather than their twitter-handles. I kept slipping. No one else seemed to have that problem.
I got in very late Friday night and met @geeka and @katiesci for dinner. I was deliriously tired after a plane delay of more than three hours, a terrible job talk, and a paper rejection (ed: “very well written but insufficiently novel” me: “no, YOU’RE insufficiently novel!”). I think I had arugula. I know I had pie. I crashed, and then in the morning we met up with Chicago Joe, my friend from undergrad and grad school, for breakfast.
After that, we headed in to the city and met up with @scitrigrrl, who is a newly hired assistant prof at a major research university, and on her way out of Chicago permanently. So she showed us around, and we went to the Art Institute, and Navy Pier, and took an architectural tour of the city. Then we had tapas and later had dessert at a really swank bar called Selby’s or something. There was a lot of glass, and I kept expecting to see people doing blow in the bathroom. Because it was classy (That sounds snarky. It isn’t meant to be. The joint was very classy and had a lot of young, fit, pretty people who looked like they should be doing blow in a Scorsese picture.).
The next morning we met up with @highlyanne and @allochthonous and @labroides, and their children and @labroides’ wife, who has a twitter handle I can’t remember. We had breakfast and then @geeka and @katiesci and @labroides and I went to a White Sox game, which was awesome, and I had a helmet full of ice cream, and Alex Rios stole a home run by going two feet over the wall in right field. Sadly, I had to leave in the 5th inning to go to the airport. I made it home safe and tired and happy.
I really had a wonderful time. It was exciting to meet these people, my sort of natural comrades, and travel around seeing things and having fun and jabbering about science and telling stories, and learning about people’s backgrounds. Putting voices on to tweets.
But my social anxiety was not willing to sit in relief. I never know if I’m fitting in. I think I project the image of someone comfortable with myself and how I fit into a social group, but I am often not. I found myself having to fight not to interrupt people so that I could tell the story about me that was a propos. This led me to making a bunch of abortive syllabic ejaculations that I would then silently berate myself for. I make too many jokes. I don’t know if they’re funny. Hell, I’m not even sure that other people recognize them as jokes half the time.
Whenever I’m in a social situation like that for so long, a couple of days at a time, I end up wondering if people wish I hadn’t come. Did I add to the experience, or detract from it? I’m never sure. I always fear the worst. I’d love to do it again, I really would. But there’s a part of me that’s afraid to even suggest such a thing, because, what if everyone else was thinking that it would have been a lovely time, if only @Dr24hours weren’t there?
I find myself listing all my faults. I’m brash. I don’t hear well, so I’m loud. I wore cargo pants. I’m not as good a scientist as they are. I’m not as comfortable. I sweat. I tend to make suggestions first, and then seek other people’s ideas. Seriously, what was I thinking with the cargo pants?
In AA, we often talk about this as thinking of ourselves as “less than”. I do that a lot. I am always comparing myself to other people, finding myself short. Stupid. Loud. Irritating. It’s relentless. And the thing is, some of it might be true. Some of it is surely false. But I’m not the best judge of it. I can’t see myself from the outside. I have many good friends. That must mean that I’m not as horrible to be around as I fear. Many of my friends will give me counsel about how to be more pleasant to be around. So I’m not completely off base with regard to people finding me to be a lot to take.
And it all comes back to shame and fear. I don’t know how to be comfortable with myself, so I don’t know how to assess if others are comfortable with me. I don’t catch social clues when they’re subtle. It often takes people deciding to be very explicit with me before I understand that I’m not behaving appropriately. So I often feel like apologizing for my behavior even when I don’t know if I’ve done anything wrong. Just in case. But that’s weird and anti-social too. I feel trapped and confused a lot.
But my best assessment of the Great Chicago Tweetup was that it went well. I’m taking people at their word. Everyone said they had a nice time. I’ll accept that and trust that I didn’t destroy what could have been a good thing for other people. And I’ll be grateful, knowing that I certainly would have if I’d been drinking. I know, because I have.
There was a brief moment at the bar, Saturday night, when I had about 3 minutes to talk to one of the other attendees about what it was like to be around the rest of them while they had cocktails, one on one. It felt like a tiny little connection, a moment where I got to talk about something real and full and honest and sincere about myself. Where I was comfortable saying: “I feel perfectly comfortable around people drinking. Sometimes I miss it, but what I miss isn’t how it really was.” Because I didn’t have to fear that what I was saying was unwelcome. It was solicited. I didn’t have to worry that my experience wouldn’t mesh with hers. It didn’t need to. I could just describe my experience. Postureless honesty. And that felt really good.
When we left the bar, @katiesci left a nearly full cocktail behind. Apparently it was too gingery. I remain baffled by people who can do this. Sure, I liked some drinks better than others. But abandoning a glass full of alcohol? I can’t fathom it. Except that I did. And now I have. I don’t have to be chained to the last drink, fearful of what will happen when I get on the train to go home, where there’s nothing else to drink.
But I clearly still have a long way to go before I understand how I fit into this big, strange system. This lattice of connections we call a society. But I’m learning. And I’m good at that.
Well, the second job talk was a total fiasco. First, no one showed up. Then I got to go sit down in an office with a senior professor and discuss ideas, mostly his, about how to advance my ideas in systems modeling and public health. But there’s no job. Essentially, they expect people to have their own funding 100% covered before they’ll even given them a title, much less any salary. It’s not even a situation where they’ll cover you for a year or two to establish you. Nope. You need to have in place R01s that they’ll then allow you to bring to them.
So, there’s no real job at East Coasty University. They just want to you to write grants for free until you get funded, whereupon they’ll siphon off the indirects and not support you.
But the cool lining is that I created a hashtag on twitter, #realwomenofscience, in response to a bullshit video about women in science that had highheeled models supposedly as women scientists dancing around a dude in scrubs with a microscope. Totally disgusting. So I created my hashtag to promote the real female scientists on twitter that I follow. It got picked up and is now trending nationwide, and other places too. So that’s pretty exciting. It’s nice to have an idea of mine have legs today.
Talk Number One in the Books.
Very quick update. I gave my first job talk today, at East Coasty Healthcare Engineering Institution. It went really well, and I was quizzed by grad students, post-docs, and professors. It was treated basically like an invited talk. I had fun. And actually, interestingly, the talk was recorded by a camera crew which was filming for a documentary on systems engineering in healthcare. The crew was there working for the National Science Foundation.
After the talk, I sat down with the facility director and talked about what type of position I was looking for, and what I would bring to the facility. They do engineering, not research. Applied, practical stuff. Which I love. But they don’t normally apply for grants, etc. And so they don’t really know how that all works. But I want to keep being able to explore my own research agenda, so I was clear with them that that was something I’d need. And they were cool with that. Especially because it’s a new kind of revenue source for them that they don’t know much about, and I know something, though not a great deal.
So they’re looking at how to partner with East Coasty University, or another university in New England, to put together a joint appointment that would allow me to pursue my own funding to advance my own agenda. All of this is likely to take a lot of months at the inside. But that’s fine. I just want to have options and irons in the fire.
Now I’m exhausted, eating cupcakes, playing scrabble, and getting ready to talk to ECyU tomorrow. Thanks for all the support from everyone. And I’m truly excited that there’s a very high probability that I will be on the cutting room floor of a National Science Foundation documentary.
Post-Publication Review: Optimizing the Pharmacy.
We look today at a paper from Health Care Management Science, a very well-respected journal in the science of the management of health care (Which is, let’s face it, a matter of some concern for the free peoples of middle earth.). The paper concerns the process of filling outpatient prescriptions at two hospital based pharmacies in London. The goal being to build a discrete event simulation which accurately models the process, and then use this to determine the response of the system to changes in demand, workforce, and increased robotic-dispensary utilization. So right there, we’re pretty stoked about this paper from the outset. Computer simulation, drugs, and robots.
It’s an interesting paper because they perform comparative simulations on the two pharmacies, allowing us to see that different predictions are made based on the different base systems (often called the “plant” in engineering terms). It’s interesting because they find some results that are in line with commonsense predictions, and some that were not predicted and seemed counterintuitive until the model was analyzed more deeply. Though, I have found this to be the rule, rather than the exception: when doing a simulation, you will find something that you didn’t expect. At least, you will if you do it well enough.
So. What did they actually do? First, they identified the setting for their simulation, choosing to focus on outpatient prescriptions, and disregarding inpatient and discharge prescriptions. This was done to focus on the aspect they believed to impact customer satisfaction directly. It’s probably a reasonable restriction, but it wasn’t clear to me how inpatient and discharge orders would complicate the flow, and so if I were to have been a reviewer, I’d have asked for more clarity there. The paper makes it seem as though the outpatient stream can be treated in isolation, which is a pretty big assumption from the outside. It may be perfectly true, but I’d like to see discussion of why it’s true.
Next, they modeled the flow, in a diagram which I assume is printed this way for space, because a few more informative layouts were immediately apparent to me:
Figure 1: DES flow
But that’s not really a criticism. As you can see, the flow is relatively easy to follow. This model was informed with hand drawn data that was gathered by hand over a two month period, resulting in about 2000 observations. This is a solid methodology. Yes, there are problems with hand drawn data, but often they’re the only data available, and there are also problems with other data streams in these circumstances. Computer records are often wildly inaccurate, because they depend too on hand entered data. Interview regarding task duration is also unreliable. Overcoming data acquisition problems in DES is unresolved and to my knowledge, essentially unaddressed. We just state our limitations and plough on.
So this model was informed with two sets of data, in order to allow it to represent two otherwise identically processed prescription dispensary systems. The models are the same, but the staff mixes, times of tasks, and proportions of robot-dispensed prescriptions vary between models. These models were then validated using face validity methods – which are standard, necessary, and insufficient – as well as input-output external validation. Meaning, the model was shown to accurately reproduce aggregate prescription filling times when given real world conditions. This is a minimally sufficient external validation method. Input-output identification is important, but does not capture internal dynamics the way interstitial queue length comparisons would, showing that the model accurately represented the real world at several points along the way, as not merely as a black box.
They proposed several scenarios, including adding additional staff of each type, changing the demand (from -10% to +10% in 1% increments), and increasing by 50% in 5% increments the proportion of prescriptions that could be dispensed by robot. These are solidly interesting scenarios, and well designed. Major changes in combination to systems of this sort are less likely to yield revealing insights. Small changes made in isolation, like these, are likely to have high predictive value.
They then simulated these scenarios 100 times each using terminating, independent instantiations. I’m less confident (but not necessarily non-confident) that that’s the best way. No objection to sample size. Power calculations mean very little in simulation, because we can generate arbitrarily large data sets. I’m more concerned with the terminating independent runs. Are there overnight inpatient and discharge scripts? Can we be certain that these would not influence from day to day? I just don’t know. It seems like a pretty good assumption, but without more information, I can’t be truly certain. I should note that they included a list of assumptions they made and agreed upon, which is a really nice touch.
Figure 2: Staff Perturbation Results
They were surprised that adding an assistant, who has very few competencies that allow for process improvement, made almost as large a difference as any of the other three non-pharmacist staff. Deeper invesitgations revealed two possibilities. Allowing the assistant to do labeling freed more skilled workers to do tasts which did influence throughput, or that the assistant’s main task, assembly, may be a larger bottleneck than had been supposed.
They did make one error in the paper that is unimportant with respect to the results. They stated that the ‘exponential distribution is inappropriate for task durations because it allows a time of zero’. Well, it’s a continuous distribution. The probability it would produce a time of 0 is 0. However, in general, exponential distributions are inappropriate for task durations because they are not likely to model them very well. But the distributions that do model them well are also continuous distributions bounded below by zero, and so share this “limitation” with the exponential distribution. As a reviewer, I’d just have pointed this out and had them leave this comment out of the paper.
The paper shows how we use simulation as a bed for experimentation when it cannot be performed in real life, and allows us to plan for changing circumstances in real life. It’s a good paper, with very few drawbacks. There’s a reason it was published in a good journal.
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M Reynolds, C Vasilakis, M McLeod, N Barber, A Mounsey, S Newton, A Jacklin, BD Franklin, (2011) “Using discrete event simulation to design a more efficient hospital pharmacy for outpatients” Health Care Manag Sci, DOI 10.1007/s10729-011-9151-1
The Long Slow Road.
One of the phrases that stands out for people in the book Alcoholics Anonymous is actually the ending sentence of the text. “…surely you will meet some of us as you trudge the road of happy destiny.” There’s been much discussion of the word ‘trudge’ used in combination with the phrase ‘happy destiny’. It seems that those things conflict. We think of trudging as heavy, difficult work. For me, it ends up arousing the image of soldiers marching home from a terrible, Pyrrhic battle. Bloodied and worn.
In AA, frequently people address this seeming discordance by saying that “To trudge” officially means: “To walk with purpose.” And that that purpose is sobriety. And of course, words mean what the people using the words decide they mean. I’m not going to get all lingual drift up in here, but if enough people decide to use a word in a certain way, then that becomes the meaning. And that’s fine. I don’t mind a little creative reinvention to satisfy a cognitive dissonance.
But I don’t think I need one here. I’m perfectly content with the idea of trudging a road of happy destiny. With trudging meaning what it means in the rest of the English-speaking world. A heavy, laborious, rhythmic slog. I think that that describes almost perfectly the way (especially early) sobriety can be sometimes. Hard work, seemingly endless toil. Slow, arduous translation of mind and body from a state of misery and demoralization to one of content and peace.
That image of soldiers is appropriate for how I think about it. I’ve said before and will again that alcoholism cannot be defeated. But whatever my relationship to alcoholism, I don’t think that describing it as a defeat is quite appropriate either. People who lose the battle to alcoholism die drunk. And of course, no one wins the battle. What I did was give up, stop fighting, and go home. That’s when the trudging begins.
Because it can be incredibly hard, in early sobriety. We’re dealing with shattered lives. Our own, and those of the people we hurt. Egos (the real kind, the integrated sense of self) have been crushed under the weight of selfishness, denial, entitlement, and addiction. Fixing that takes work. Usually our finances are in disarray. We need to do difficult work to secure loans, or bankruptcies, or to find jobs. Doing this requires dealing with administrative systems that seem to suck out our souls. Often the same is true of dealing with medical establishments.
We often must begin dealing with these things while we remain in the fog of detoxification. Our minds stay confused and brittle for a long time. The effect of so much poison, sloshed daily over our brains, is significant and slow to be corrected. But life doesn’t stop just because we’ve begun a new kind of living. The rest of the world is uninterested in our adjustment period, often. And so we have to work.
I was incredibly fortunate when I finally stopped drinking to be unemployed but to have enough money to get by. I didn’t have to worry about keeping a job, fixing things with a boss. Suffering through complicated medical procedures, finding or keeping housing, I didn’t need to confront those things. I was able to spend six straight months worrying about nothing but my sobriety and my relationships. And still, it was an incredibly difficult trudge. I’m utterly impressed with people who have to confront more than that, and do.
And I find trudging is germane to my daily life today too. I have to trudge at work. One of my great shames in life is that I feel incredibly lazy all the time. I don’t work hard enough, or enough hours. I prefer leisure to work. So I have to force myself to engage with my tasks, even when I think they’re really cool tasks. I’m so excited about my research. And I still have to force myself to do it, daily.
But the key for me is that happy destiny. I know that by stomping ahead, though difficult emotions, hard work, unending administrative bullshit, and rejection after rejection after rejection, I move forward in life. Those soldiers, in the opening metaphor? They didn’t win. But they didn’t die, either. And they’re going home. Home to where smiling loved ones and rest await them.
At my meeting yesterday, there was a man, about my age, who had returned and was at his first meeting since his last drink. He had a spectacular black eye, and his eyeball had haemorrhaged to that scarlet-crimson color of old blood. I didn’t know what to say, or how, or even if I should. People don’t talk about injuries like that, out in the real world, I don’t think. Chuck Palahnuik mentioned once that a black eye that no one would talk about was his inspiration for “Fight Club”. But the people in the room with more time than I have led the way. Commented. Made it funny. I learned something about how to interact kindly and openly and honestly yesterday. Though I’m still not sure how to put it into words.
So, he has some trudging to do. To come up with a new way forwards. It’s hard. But I know it can be done. Because I did it. I’m still doing it. Not as well as I should, sometime, perhaps. Not as well as I can. But I’m moving forward. Today. Tomorrow. I’m moving to a place of happiness. Serenity. Peace. Interdependence and autonomy.
I’m looking back at this and thinking it makes sobriety sound like endless toil. It’s not. There are, throughout the process and immediately from the beginning, times of ecstatic joy and freedom and happiness. In fact, it’s so common and widespread that we coined the term “pink cloud” to describe it. Being on a pink cloud means being transported in rapture over being sober and free and alive. And it happens to nearly all of us. It certainly happened, and continues to happen, to me.
But I work for these things. Also at my meeting yesterday, a friend spoke. His wife had a stroke recently. They’re not old. Perhaps 50. He’s been sober for 14 years. He said that he’d been told that happiness consists of three things: Someone to love. Something to do. Something to look forward to. I think that’s about right. I’ve got a couple of those. And my horizons are inviting.
Inclusiveness and Self-Centeredness.
Gerty-Z over at Balanced Instability is hosting the Diversity in Science Carnival for Pride this year. I hadn’t heard of it before. It is apparently designed to highlight the achievements and improve the climate for non-heteronormative scientists. Which makes it a good thing, in my mind. I think of myself as an ally for gay rights. A proponent of gay marriage. This comes from a couple of places in me.
I went through a period in my life of being very religious, and I believed all the bullshit justifications that religious people use to try to tell themselves that they’re loving people who are simply defending moral rectitude instead of just being hateful bigots. But the truth is, no matter how nicely I tried to frame bigotry, it was still bigotry.
I am grateful to a couple of people specifically who never let me get away with that bullshit. My friend LawnBoy, and my sister Aimee, who nicely, or not nicely, debated me, cajoled me, pointed out the flaws in my ideas and logic, cared for me even when I was being a bigot (demonstrating a kind of tolerance and acceptance that I would still have to learn), and eventually persuaded me to understand some of the simplest ideas that had been so hard for me to get my head around.
Other people are also people.
If I believe that I have the only truth about anything – that my ideas are how everyone should live – I am negating the fundamental personhood of others. Objectifying and degrading them. No matter how nicely I try to do it. And there’s no competing motive, either. Marriage, freedom, is not a zero sum game. I am not less free because someone else has the same rights as I do! My right to marriage is not less valid because someone else has the right to participate in another union which is also a marriage. My liberty is unrestricted by extending it to all. In fact, it is deeply, and greatly, enhanced.
I learned to recognize just how self-centered I am. How easy it is for me to neglect my own privilege, my own advantages. I was given just about every advantage a person can have in life. As a boy, and a young man, I thought I needed to press my advantage, to exclude others from enjoying the privileges I had in order to hoard it. It’s fear. It’s selfishness. I needed to be taught better. Thankfully, I had good people in my life willing to teach. Thankfully, somewhere along the way, I developed into a person who can listen.
LawnBoy once was fond of telling me I was born on third base and thought I hit a triple. Probably not his original phrase, but absolutely correct in its description of me. I was born on third base. Now, it’s the name of my fantasy baseball team. To remind me, if nothing else. And there’s nothing wrong with having advantages, I can’t help them. What’s wrong is kneecapping people who would like to have those same advantages for themselves and their children.
Other people are also people. I’m a better person when I remember that. It reflects badly on me that it took me so long to learn it. It reflects well on those who so patiently (and impatiently) taught me how wrong I was. I try to stay out of matters of politics, for the most part, except with family and close friends. I don’t like to argue on the internet. And I put my foot in my mouth a decent bit when I do participate. And then I need to stop and step back and apologize. But I will speak on these matters.
I’ll speak because I’m ashamed of my former positions. I’ll speak because I like to correct my errors. It keeps me sober. Keeps me sane. I’ll speak because the world I want to live in has freedom for everyone. I’ll speak because I think families are good things. I’ll speak because it’s right. And it’s good to do right things. In AA, we always talk about doing the “next right thing”. We’re trained to look in front of us, and do whatever is right in that moment, to improve our own lives. I’ve emerged from a lot of dark chasms by doing the next right thing.
Full and inclusive rights for all of us; that’s the next right thing. It’s brighter out there.
Constant Development.
So, around this time last year, Local Research University offered me a position as a part-time assistant professor. The only problem was, they didn’t actually have the position available yet. They like me, they want me in their department. I wouldn’t have to give up my current job. It pays well, and I’d be able to be engaged in cool health research and be a PI at a well-known and reasonably prestigious institution of higher learning. I’d get to teach. Seemed like a can’t lose proposition. I was unanimously approved by the faculty to join. I told them I’d sign a contract as soon as they had one for me.
They haven’t had it yet. The new rule at Local Research University is that they have to have an outside funding stream for new hires. This is why I fear that soon, incoming professors are going to be expected to win grants first, get positions later. I don’t write grants on speculation. It’s insane. You want me to write a grant for you? You have to hire me. The same is true of consulting proposals, manuscripts, courses, etc.. I don’t work for free. Nor should anyone.
Anyway, so I’m giving back-to-back job talks on the East Coast next week. And now it turns out that Local Research University is signing a contract on Tuesday that should include funding for my position. If it does, and they float an assistant professorship for me, I’ll take it. It’ll allow me to stay where I am, do really cool science, work in a field that I’m really interested in, and be well paid to do it. Without having to uproot.
As much as a position out at East Coasty University would be awesome, I’d rather stay here, in my community, with my opportunities and established connections. I’m making new connections, and establishing myself as a reasonably sized fish in a fairly small pond where I am. I like that feeling. I would be very happy building a permanent career where I am. I have the same problems as any aspiring academic. In a world without tenure-track appointments.
What I need to remember is that I’ll be fine no matter what. If I get the best job in the world, or if I’m mopping toilets in a gas station. I can be happy. Because my happiness is based internally. I am happy when I am working hard, doing well, and being of service. I have all of those things in my life right now. I will focus on that. My fears will either come to pass or they wont. And I’ll be sober, sane, and productive no matter what.
When Help Doesn’t Help.
I’ve been talking to a number of people recently about helping people. It’s a difficult issue. So many of us naturally want to help people. And so many people really need help. Why do these things not align themselves better? Why are so many people perpetually needy, and others perpetually giving? Giving, often, to the point of resentment, burn-out, exhaustion, and demoralization. What can be done?
I confess first that I don’t have all the answers. Maybe not even many of the answers. Maybe almost none of them. But I know what has worked for me in my life. And what I have found, in so many cases is that there is a huge difference between being of service, and giving help. It’s kind of a give a fish/teach to fish thing. But it also has an aspect of something a dear friend of mine calls “Emersonian Girding”.
Because, as a member of AA, I believe strongly in being of service to the alcoholic who still suffers, to people in need. Being of service to those people means providing them with real world aid that will actually help them, if possible. But I will not help an alcoholic with money (I’ve given a few people a few dollars here or there, but not more, and not twice.). Nor will I help an alcoholic who is drunk. If someone called me drunk asking for help, I’d say: “Call back when you’re not loaded,” and hang up.
People who are in the grips of crisis asking for help are often asking us to negate their problems for them. But most of people’s problems, in my experience, cannot be solved in any permanent way from the outside. Because we seek external solutions to internal problems. Most problems with debt cannot be permanently solved by giving someone money. They can only be solved by that person changing their relationship to money. Similarly, problems with alcohol cannot be solved except by changing one’s relationship with alcohol.
And the same is true of emotions. When we are in emotional crisis, some of us seek external validation, as a balm against having to look hard at our own natures. We beg people to be kind to us, to tell us that we’re good people. Getting that external validation is like a drug. It allows us to assuage our pain temporarily, and not address the real internal turmoil.
I don’t think we do anyone any favors by placating them that way. Just like I do no favors for an alcoholic by bailing him out of trouble he gets himself into drunk. Being of service, I think, means being willing to be there for a person who needs support while they do the things they need to do for themselves to solve their own problems. And it means showing them the way if I know it and they don’t. When they’re honestly willing to seek guidance.
So, I won’t bail someone out of jail when they’re arrested for drunk driving. But I will lead them through the steps if they’re willing to do the work. I won’t give someone money, but if they don’t know how to write a budget, I’d gladly offer to guide them. And sometimes, the best help we can give someone is Emersonian Girding. Simply saying “no”. Showing them that they’ll have to rely on themselves to get through whatever they’re going through. And that almost all of the time, humans are resilient.
It’s sad when we’re not. Sometimes, our problems are too great. And we don’t have the ability to deal with them. I’ve seen alcoholics die because of that. I’ve had friends kill themselves. I’ve had friends homeless. But there’s nothing I can do for them. Because sometimes, help doesn’t help. And it can drag us down with them. Into misery. Debt. Depression.
I knew an alcoholic, Jim, who worked a great program for alcoholism. He was humble and kind. Sober many years. But Jim couldn’t deal with his gambling problem. He gambled himself out of home and job. He stole the men’s meeting kitty and wagered it away. I haven’t seen him in more than a year. No one knows where he is. I wish I could help him. But he’s lost. In a way I can’t understand. Maybe he’ll come back from that. Maybe he won’t.
To be healthy, sober, and sane, I have to manage my own program first. I can’t do that if I am sacrificing my self to try to save others from themselves. People are on their own journeys. I can be of service when that service will truly aid someone. As long as someone is asking for help, instead of asking what they can do to help themselves, there is no service for me to provide.
But when someone needs what I can offer, I’ll walk through hell to provide it.
Infactorium 