Infactorium

Managing Alcoholic Friends.

2012-01-27T06:38:00.000-08:00

Short response to the title: you can't. It's that simple. And I'm not in al-anon. So I don't even really know how to help people manage themselves while dealing with alcoholics. For a blog about al-anon from a scientist who really has his shit together, go read Syd's blog. But what I can do is tell you what the experience is like from the perspective of the alcoholic.

I have a dear friend (Let's call her Miss B.) who has a problem with an alcoholic that I don't know, and have never met. Although, the alcoholic in Miss B's life hasn't self-identified as such, so I shouldn't diagnose him site-unseen. However, he does things, and has put himself in situations, that I have only seen alcoholics do.

He is not allowed to drink at home because his children call him out on it. I don't know how old they are. So he goes over to friend's houses, brings small bottles of liquor with him, gets drunk there, and then drives home. His friends are tired of this. They are concerned for him, and for the citizenry. They offer to let him stay over, but he refuses. Miss B asked me for advice about how to handle this situation. How do they stop him from drinking and driving? How can they get him to stay over if he's had too much?

The answer, of course, is that they can't. Supposedly, they've gotten him to agree to stay over if he drinks too much. But only in the beginning, before he's had anything. Once he's drunk, he argues and goes and drives. I did that. Wow, did I do that.

"Are you ok to drive?"

"Totally."

It didn't even register as a real concern. As the statement, rather than question, that it was: "You are not ok to drive."

But there's nothing that can be done. Not really. Not at that point. Because you can't argue with a drunk. The problem has to be addressed earlier, and with unmistakable resolve. There is only one way to handle this situation that does not involve being complicit, being enabling. That is to tell the alcoholic: "You are not welcome to drink in my home." And then, don't invite them over when there will be alcohol served. It's not okay to ask them not to drink while others are drinking. They have to make that choice for themselves, independent from you.

I go to parties where people drink all the time now. It doesn't bother me. But an active alcoholic cannot go to those gatherings and not drink. The only way to help an alcoholic who still drinks is to refuse to participate. If you want them in your life, you have to accept that they will drink, and get drunk, and suffer consequences. If you cannot tolerate that, you have to remove them from your life. You can't change us. We drink. It's what we do. We're alcoholics.

We lie and steal and cheat. We are not your friends. We are using you. We are not the person you once knew. We are the shadow of the bottle. The person you loved, the friend you cherished, the husband, the wife, the parent, the child, they're buried. They may be gone forever. Sometimes, we come back from that oblivion. I have.

Most times, we don't. Most of us who proceed to alcoholic drinking will die that way. If you want to give us the best chance to recover, the best hope, be honest. Be straight. Tell us: "Your drinking has made it impossible to be your friend. I can't associate with you until you quit alcohol. I loved who you used to be, but that person is gone. If you want to get help, I'll be there for you. Otherwise, I don't want to see you."

The only thing that addresses active alcoholism is losing the things we love, the people we love, the life we love, until there is nothing left but us, and the bottle. At that point, sometimes, we choose living over dying.

Second Movement.

2012-01-26T05:31:00.000-08:00

I have finished the second movement of my symphony. It's the slow movement. Despite that, it's very short. Only three and a half minutes. Which is fine. I'm not looking to write a very long piece. If the entire work comes in at 24 minutes or so, I'll be very happy. The first movement is 10:00 minutes. The second is 3:30. The third is about 4:15. I think a six or seven minute finale will be plenty.

The second movement is an aria for oboe, in ABA ternary form. The A sections are in G flat major, and the B section is in C sharp minor. In an acquiescence to modernism, the second A section is not a strict repeat of the first A section (Mozart is spinning, of course, but the Da Capo aria had fallen from favor by 1850 or so. After all, it makes very little dramatic sense in an opera, when there are lyrics.). The second A section increases the accompaniment, adding horns and bassoon to the string choir, which was the sole accompaniment of the first A section.

I will finish this thing. It won't be long now! Another year, two at the most!

Data. Fucking Data.

2012-01-24T08:25:00.000-08:00

Sigh. My data is coming out really ugly. Not really ugly, but ugly. I'll have to either take more data points, or examine it for errors in abstraction, which are certainly possible. Because the results just don't look like we'd expect the real world results to look. And not just from my own hypothesis, but from established literature and basic common sense. Progressive diseases progress in order. You can't, for example, go from mild to severe and back to moderate. It doesn't work that way. And my data, while it doesn't show anything quite that bad, it does show that my 'severe' patients are generally in better health and younger than my 'moderate' patients. Which I'd prefer it didn't.

Now, there are some reasonable reasons for this. 'Moderate' patients have often had interventions, which delay progression. So my 'severe' patients may have missed interventions which could have slowed their progress. As a result, I have older patients who are still 'moderate' and slightly younger patients with a less intense intervention history, and they've progressed faster than the 'moderates'.

But none of that helps me develop the algorithms I need to build. And I can't do a survival analysis because of the crappy nature of my data (which is mostly my own damn fault for devising a lousy abstraction protocol.). GRHSSAKH.

Drinking Dreams.

2012-01-20T05:46:00.000-08:00

I had another drinking dream last night. I won't try to describe it in any detail. It was like many others I've had since about year two of sobriety. I was having a beer. I was enjoying it. I was in a truck, and LawnBoy was driving. He was asking me if I thought I could drink normally. I was saying that I knew I couldn't drink the way I wanted to, but I thought that with willpower, I could have one beer once in a while. I knew I was lying. I was thinking about how I could keep having that one beer once in a while and still tell everyone I had almost four years of sobriety. I was rationalizing that if I didn't get drunk, I still had my sobriety.

I suspect LawnBoy popped up because of the spectator's visit we made to Moderation Management about two weeks ago. In case you didn't read that post, LawnBoy is not suggesting I try to drink moderately (In fact, I doubt I'd be welcome in his home if I announced I was going to try to drink again... and for good reason.). We were just curious about how that program 'works', and he's curious if there's a way to get sober reliably without relying on a higher power. And not because he needs to get sober, but because he's interested in good health care, and an atheist.

Anyway. The dream is telling. Even though I was, in the dream, for that hour, able to drink one beer and not get drunk, I already wasn't drinking 'normally'. I was planning my lies. I was already hurting that I couldn't get drunk. I was preparing my failure. Even in my fantasies, even in dream, where I have limitless potential, I cannot fathom a world where I can drink normally and happily. That world does not exist for me. It hasn't for a very, very long time, if it ever did. And it never will again. And I'm grateful for what I am. Where I am. And that I am free.

Men Leading Men.

2012-01-19T06:45:00.000-08:00

It's no secret that one of the profound gifts that I receive in AA is the leadership by and fellowship with men. Association with effective grown men who know how to face problems head on and successfully meet challenges is critical to me. It shows me how to behave. I know that to many people reading this, that's a confusing statement. It's just something you learned, as a child. I didn't. Not well.

I love my parents dearly. They have many fine qualities. My failures are not their fault. But I was not lead into manhood by wise and temperate models. My father, for understandable reasons, perhaps, did not meet the challenges of life. He didn't teach me to work. To investigate. To fail up. Failing up is the most critical thing, I think, that I missed as a child. I desperately needed my father to tell me: "Yes, you did that wrong. What did you learn by doing it wrong? How will you change it?"

My mother tried to do that. She often said things along the lines of: "You'll do better next time." Which is basically the same thing, if not as interventionalist. And I don't understand the science of gender when it comes to raising children. I can only say that I, personally, missed having a father do that for me.

But today's post isn't about the things I missed as a child. It's about cancer.

Frenchie's wife is dying. Frenchie is a member of my Wednesday night men's meeting. He's early 60s, but looks 45. He's square-jaw handsome, well dressed. Trim, but barrel-chested. He looks like John Hamm will look in fifteen years. Frenchie has been sober for 24 years, I think. He owns a massively successful business, and is worth millions and millions of dollars. He's the sort of man you envy.

None of that can change the fact that Frenchie's wife has about 8 months to live. We all thought she'd beaten it. Her doctors thought that. Then, the MRI showed spots on her liver. It's some kind of aggressive, vicious thing. They're going to Houston, to the best oncologists money can buy. They think it might earn them another three months.

Frenchie didn't cry at the meeting, but he talked about crying earlier. About how this cancer, this thing, is up in his face, and when he turns away from it, it's still there. There's no avoiding this. It's a real thing, and it is going to kill his wife. And there's nothing, it seems, that anyone can do about it.

He talked for about 20 minutes. About how he felt. About what's going on. About God. About how he has to be the strong one out there. That it's not about him. That he thinks there's a reason for all of it. But he can't see what that reason is right now. How it's the worst news of his life. How he'd trade with her in a second. And I believe he would.

And then we all spoke. Offering tattered little rags of support. Commiseration. Love.

We're men. We're alcoholics. And being among men, among my alcoholics, I have learned. And when the great white wave comes, I know now how to face it. Sometimes it washes past. Sometimes it obliterates. And in each case, I am not alone. Yesterday, Frenchie was in the deluge. Today, the rest of us bear him up.

Feedback.

2012-01-18T05:27:00.000-08:00

Well, I got the feedback from my lecture. There were 80 computers attending, which probably means 90-100 people. Of those, 31 chose to fill out a post-lecture response questionnaire. Of those 31, I received 14 "excellent", 12 "very good", 3 "good", 1 "fair" and 1 "poor". Overall, about an A-/B+, I think. Which is what my GPA has been since elementary school.

The principal complaint was that I spent too much time on theory, and not enough on the particular application I was reviewing. Which is a fine complaint to get. I'm an academic. Being able to produce theory is important to me, and I feel strongly that if you can't demonstrate your ability to do the theory, you don't really have any business doing the application. Theory matters.

That said, I didn't actually present any theory. I described the theory. That's all. To present theory would have taken a semester, of course. But I did get specific positive feedback on the background theory as well, and from people who are responsible for major engineering initiatives in my hospital system. So that's exciting. And my boss was proud of me for the outcome.

Lecture Over.

2012-01-17T11:28:00.001-08:00

The lecture went well except that I talked for about 10 minutes too long. Other than that, I think I came off as knowing what I was talking about, which is nice. No idea exactly how big the audience was, but I think it was about 70 different computers tuned in. I'm really glas to have done it. It's a rare honor and I'm excited to have been asked, and to have performed. Hopefully, this will help my institution.

Nerves, Fitness.

2012-01-17T05:50:00.000-08:00

Today I am giving a national web seminar on my work. It's kind of cool, actually, and I'm told it is a big honor to be asked to do this kind of thing. No one in my research department has ever been invited before. It's the kind of thing that goes on the CV as an "invited lecture" and introduces me to various potential collaborators within my hospital system. It's an exciting thing. And I'm nervous as hell. I'm pretty comfortable in front of a classroom. At least, I am when I'm well prepared (and I am well prepared). But this isn't a classroom. I'll be lecturing to a phone and a computer screen. And I feel like I'm about 10 minutes short. I'll just have to slow down and make the time go as I can.

Over the weekend I joined the website Fitocracy. It's free, but I think you need an invitation. I signed up to participate in the beta-launch a long time ago, and I finally got my invite. It's awesome. There was an xkcd about the site a few months ago (warning! dirty! but only stick figures!) (Don't forget the mouseover text.).

Anyway, the cool thing about Fitocracy is that it lets you keep track of all your fitness activities, which is cool for a nerd like me, and awards you points for how strenuous or vigorous each activity is. This way, it converts all your exercise into a single metric of 'points', on the basis of which you gain levels. I'm currently level 5, after three days. Early levels are pretty easy to accrue. But already it's harder. I doubt I'll make level six today, even with a three mile walk and an hour of yoga.

But it's got me doing little things to improve, because I like garnering points. So, like, I did 150 jumping jacks last night, because they're easy and I got a bunch of points for them. I really get a lot of points for running and walking. And dumbell work is surprisingly variable. Bicep curls are worth about nothing, but shoulder presses are worth a lot. As a result, I have very sore arms today. It's really a very cool system. I can feel that it's going to take my fitness to a higher level.

And no, I'm not being paid to say that. It's a very cool website, and this is a free, unremunerated endorsement.

So. I want to give a good lecture because I've already had several people contact me based on seeing the program and ask to discuss potential collaboration. Which is exciting. I'm looking forward to opening up my horizons.

Inkling of an Itinerary.

2012-01-13T08:31:00.000-08:00

I bought a flight from Auckland to Christchurch, one way. It looks like the itinerary will be roughly, two days in Auckland, a flight to Christchurch, and then immediately out of town to Darfield, or another small town in the foothills of the Alps. From there, there is an alpine train across the spine of the island to Greymouth. From Greymouth, I can take a bus trip up the west coast to Picton. From Picton, there's a ferry back to the North Island, to Wellington. From Wellington, I can take trains back to Auckland and fly home.

Eight days in New Zealand. Ahhhh.....

Making Positive Change vs. Taking Control.

2012-01-11T06:00:00.000-08:00

I've been getting a lot of kudos (and let's face it, I've been fishing for them) here about the improvements I've made to my health, my career. How I've become a fairly effective sober man and have weathered some pretty difficult things without turning back to the bottle. And I have. I'm not about to diminish my basic accomplishments. I'm proud of where I am, and I'm pleased with the progress I've made. I have a great deal further to go still, but I'm on the right track and headed in the correct direction on it.

One of the things that I'm good at is making positive change in my life. I know how to work hard, make decisions and follow through on them. I was taught that in part by a mother who led by that example, imperfectly, yes, but tirelessly. And by a father who, while possessed of many wonderful traits, showed me what happens when ambition and diligence are foreign concepts.

It can be tempting to think of these things as bending my life to my will, or somehow mastering my destiny. But that's nonsense. There is so much I can't control. But there is much, that with effort and diligence and strength and courage, I can influence. I can't control my health. But I can make good choices. I can't control my job. But I can work hard.

I am not the master of my destiny. And thank goodness I'm not! I fuck up destiny a lot. But I am, buoyed by forces greater than me, able to move forward, positively, in ways that are meaningful and beneficial to myself and others. And that makes me grateful.

Six Months Later.

2012-01-10T15:58:00.000-08:00

I went to the doctor yesterday, and had some blood work done. My physician didn't see the need to order an A1c, or forgot, so I didn't get one. But I did get a lipid panel and a fasting blood glucose. As everyone knows here, I'm really worried about diabetes. Because it took my father's vitality, and has run rampant in my family and extended family. I really don't want to get it.

I'm amazed I didn't develop it during the years that I drank so heavily. It's kind of amazing that when I was about 50 lbs heavier than I am now, and drinking and smoking, I didn't succumb. I'm very fortunate.

So, six months ago, my LDL was 147 (high, but not extremely high), my blood pressure was 130/82 (high), my fasting glucose was 113 (high, but not diabetic), and my dressed weight on the clinic scale was 205. Yesterday my LDL was 130, my blood pressure was 128/72, and my fasting glucose was 104, and my dressed weight on the scale was 194. Naked, in the morning, I was 187.

So, everything was improved. Many things are still elevated, but nothing is a matter for concern. And I am specifically, demonstrably, not diabetic. Which is a win.

Straightforward Question.

2012-01-09T18:16:00.001-08:00

When do I sell my wedding ring?

Moderation Management.

2012-01-09T06:08:00.000-08:00

On Sunday, I went to a lecture by a group called Moderation Management. I was invited by LawnBoy, who is as normal as they come when it comes to drinking. He's one of those people who doesn't have to think about how much he drinks. Because, when he feels like he's had enough (I already don't get it), he stops (I know, right?). Moderation Management is an organization which doesn't seek to help its members stop drinking entirely unless they want to, and does not rely on any higher power, believing that most of us have the ability to moderate our drinking through individual effort.

LawnBoy has taken an interest in my recovery for a couple of basic reasons (speculation alert), one that we're very close friends and have been for half our lives. Two, that he's a dedicated atheist, and thus is curious about AA's reliance on a higher power. Since he doesn't believe that there is a god to make changes in an alcoholic's life, he's curious as to what the scientific explanation for the success of people who stop drinking, and is curious if that could be harnessed to help people without relying on, as he sees it, a non-existent god.

And I support him in that investigation, such as it is. I have said many times that god, whatever god is, I don't think commits miracles unexplainable by science. And there are so many different and contradictory "gods" and higher powers relied upon by members of AA that we can't all be right. But that's likely where, I think, the atheists have so much trouble with AA's vision of the higher power. We don't much care about being right. And it may well be that honest faith, whether the thing the faith is placed in is real or not, is what makes the difference for many.

But I don't want to get too deeply into atheist-believer divisions here. I want to talk about the people I met at the MM lecture. None of them would have looked out of place at an AA meeting. My sponsor also came, because he's studying addiction treatment right now, and this was an opportunity for him to see another type of practice. There were two short testimonials and then a half-hour long lecture on what MM is and how it works.

The first testimonial was from a woman who described her drinking in a way that I have heard frequently at AA meetings. She drank tequila every day, often more than two gallons a week. She claims that by using the principles of MM she is drinking moderately, though she didn't really describe what that is. She claims to have 'slips' from time to time, which I presume means having more than three drinks in a day or nine in a week, which is what MM calls its "limits". She seemed happy and I have no reason to believe that that program isn't working for her.

The second testimonial, given by the woman who also gave the lecture, was of a different character. It felt much darker and she didn't seem happy at all. Like the first woman, she had tried AA and decided it wasn't for her, claiming that she 'couldn't take step two' (Came to believe that a power greater than ourselves could restore us to sanity.). She described to periodic 30 day periods of abstinence. She also described doing 'planned binges'.

I know that this part is projecting to some extent, and that what is right for others is not necessarily what is right for me, and the converse. But I cannot imagine a sadder, more miserable thing than having occasional planned binges of the type this woman describes. She described needing to bulwark herself, sometimes going out and drinking a lot, but sometimes closing herself up at home, so that she could drink all she wanted and not harm anyone. She was probably 50. She looked tired, and she claimed to be in the middle of a 30 day period of abstinence during January.

The whole concept felt badly awry to me. Surely, if it can help some people, that's a good thing. But it strikes me as far more likely to do great harm. They described MM as not aiming at hard core alcoholics, people like me, for whom complete abstinence is the only approach. I'm glad they admit there are some of us. But rather, for people who are not as far along the curve, that, perhaps there's a period of time prior to full blown alcoholism when moderation can take effect without abstinence being necessary.

Maybe. Most alcoholics I know say they knew almost immediately that they were alcoholic. That there would never be a way to moderate. They fought it for years, but the result was clearly inevitable. That's how it was for me. Other heavy drinkers will naturally moderate without assistance as time goes on, and don't need a program like MM. MM seems aimed at people it either can't help, or who don't need it. Except, perhaps, for a few.

What they didn't recognize was the progressive nature of the disease. In fact they didn't recognize it as a disease, which seems wishful thinking, well contradicted by genetic evidence. I left with the impression that MM is for people who continue to wail against their condition, who recognize that they have a problem, but are in denial about what the solution is. People who, like the lecturer, are incapable of giving up their drunkenness, and want to appear to be making a stab at responsibility.

I'm not saying that AA can help those people. AA, by itself, is just an idea, a book and a bunch of gatherings. It doesn't cure anyone. There's no cure. But following that program offers many of us the last, best hope at living a free and full life. A life where I don't have to bastion myself in a room and drink to insensibility and pretend I'm achieving something by reducing the harm I've done to the world and myself, compared with all the other ways I could be drinking. It struck me as a long, dark road, the way of MM.

Deterioration of Body or Mind.

2012-01-06T06:47:00.000-08:00

We have had some glorious weather here the last week. Over the holiday and for the first few days of the new year it was cold. Well, crisp, really. Low 30s, sunny, even high 20s in the early morning when I went to work. But then the last two days it's been 40s in the morning and 60s in the afternoon. Skies that high pale blue, and a gently gusty wind. Gorgeous. So yesterday after work, I went running.

I've been running a lot less in the colder months. I don't like to try to run bundled up. So I've been walking. And I've been walking a lot. In December, I walked 88.9 miles (for you metric readers, that's about 143km). I walk at about a 3.5 mph pace (5.6 kph). It's a good clip. So, most days I walk for about an hour after work, and I averaged just south of 3 miles per day. It gets my heart rate up, but not a great deal. I get damp, but I don't really sweat. It's a basic light workout.

All the research suggests that a half hour a day or more of brisk walking is strongly associated improved cardiovascular outcomes in diverse types of cohorts[1,2]. And of course, it addresses my primary concern, diabetes[3]. I'm not going to provide a big long list of references, though. At this point, if you don't think exercise is good for people, there's no helping you.

But I hadn't run in more than a month, and in November and October I had only run a little. September was the last month that I put in any real distance. But I've been doing things that I figured were keeping my fitness at least reasonably consistent. I wasn't expecting to improve doing what I was doing, but I figured I'd be holding steady. Hmmm... the evidence is inconclusive.

I ran, and I was able to go a full mile and a half prior to taking a walk break. Which is good, for me. My best is 3.1 miles, but I wasn't aiming for that yesterday, and I wasn't expecting to be able to do that. I put no expectations at all on my performance. I was in fact able to do five miles total in a shade under 56 minutes. I did consecutive 10 minute miles to start, and finished averaging 11:05 minutes/mile. Which is right about how I've been even at my peak, mid September.

But today, I am broken-quality sore. Thighs, back, shoulders, even my abs. But that's wonderful, of course. I need to be sore. That's how I know I'm improving. My question is: was I this sore, regularly, before? I seem to remember feeling pretty sore a lot, but I can't remember if it felt this bad. I can't tell if it is my body, or my memory, or both, which have deteriorated since I was last running regularly.

I'm seeing my physician again on Monday. It's been about six months, and I want to get an update on my lipid panel and A1c. I feel like I've been doing really well. I hope the reality matches my intuition. Since I was last at the doc's I've lost about 17 pounds, and I've been eating healthy and continuing to exercise. I hope I have something to show for it when I get my blood-work.

______________________________
1)Walking Compared with Vigorous Exercise for the Prevention of Cardiovascular Events in Women JoAnn E. Manson, M.D., Dr.P.H., Philip Greenland, M.D., Andrea Z. LaCroix, Ph.D., Marcia L. Stefanick, Ph.D., Charles P. Mouton, M.D., Albert Oberman, M.D., M.P.H., Michael G. Perri, Ph.D., David S. Sheps, M.D., Mary B. Pettinger, M.S., and David S. Siscovick, M.D., M.P.H. N Engl J Med 2002; 347:716-725

2)Evidence Based Physical Activity for School-age Youth William B. Strong MD , Robert M. Malina PhD, Cameron J.R. Blimkie PhD, Stephen R. Daniels MD, PhD, Rodney K. Dishman PhD, Bernard Gutin PhD, Albert C. Hergenroeder MD, Aviva Must PhD, Patricia A. Nixon PhD, James M. Pivarnik PhD, Thomas Rowland MD, Stewart Trost PhD, François Trudeau PhD The Journal of Pediatrics, June 2005, Pages 732-737

3)Intensity and Amount of Physical Activity in Relation to Insulin Sensitivity
The Insulin Resistance Atherosclerosis Study Elizabeth J. Mayer-Davis, PhD; Ralph D'Agostino, Jr, PhD; Andrew J. Karter, PhD; Steven M. Haffner, MD, MPH; Marian J. Rewers, MD, PhD; Mohammed Saad, MD; JAMA. 1998;279(9):669-674

Things I've Lost in Sobriety.

2012-01-03T09:09:00.000-08:00

Sobriety is a wonderful, strange, beautiful and seemingly magical thing. People who travel through life sober, never having to confront addiction, are fortunate people indeed. But they may lack the experience of emerging from existential battle. But a strange battle indeed; one that is won by losing. Where victory is surrender.

But when I became a sober person, which happened both one day in February, 2008, and also every day since then through grace, labor, and fellowship, I lost some things as well. Some things I lost right away. Some things I lost over time. Some things I abandoned. These are widely varied and idiosyncratic. Your experience is, and will continue to be, different from mine, I'm sure.

Immediately, I lost my veil. I lost the shroud between me and the world. This was liberating and terrifying. Without alcohol, I was forced to confront the word as it is, I no longer had a way of hiding and withdrawing and pretending that that would let me live in a state where the world didn't impact me. I had to participate. Now, I get to participate. Enormous difference those little verbs.

Immediately, I lost my inebriation. I don't want to minimize this. I like being drunk. The single and most fundamental reason that I am an alcoholic is that I prefer (or at least, for a long while did) the effects produced by alcohol to the state of normal consciousness. I've lost that. Sometimes I still miss it. Being drunk can be fun. But I no longer have the option of being enjoyably drunk. And I no longer have that option whether I'm sober or drinking. I can be enjoyably sober, miserably sober, or miserably drunk. Those are my only choices.

As time passed, I lost my family. I divorced sober. I didn't want to, in the larger sense. I would much have preferred my marriage to survive. And I've told the story, over and again. It's all here in blazing diodes. But I am glad now for the freedom I have, and the opportunity to find a partner who loves herself enough to participate in a marriage.

I have lost my intense passion for sports. I find that I don't really have as much interest in watching baseball, gridiron. I do, and it's not unpleasant. I just don't have the deep, compelling interest. I was thrilled when the Cardinals won the World Series this year. But I do not find my passions ignited the way I used to.

I lost my smoking habit. That sucked. The process, I mean. I like smoking too. I miss my pipe. I miss a cigarette after a great dinner or after sex. There's a reason it's a stereotype. It's because it's wonderful. But it's not worth the price I have to pay. Obviously, my health is vastly improved, but also, rudimentary calculations suggest I have save $4,600 on cigarettes alone. Add that to about $25/day of booze for almost four years, and it's a lot of money.

And I've lost a lot of weight. The improvements are vast and varied. And strange. And wonderful, and perplexing. I've lost a lot, it's true. I've gained so much.

A Minor Accounting of the Year.

2011-12-30T05:37:00.000-08:00

So. 2011 felt short, yeah? Think about this: there's a summer Olympics this year. Remember how like, six minutes ago everyone was blathering about how awesome the Beijing opening ceremonies were? And there were the vaguely racist descriptions of how synchronized and coordinated the drummers were, and the pundits were this close to describing China as a hive of automatons? That was three and a half fucking years ago. I was a brand new sober person still without a job.

This year I spent doing a lot of work. I won a medium sized grant to do my own research and develop my own ideas about how to improve health care delivery. I got an opportunity to work with a close friend and add an ivy league school to my CV. I was offered a wonderful position as an assistant professor. Presumably, sometime in 2012 I will actually take that position.

I traveled, alone, in Europe, and I was afraid before hand. I was afraid that I would really want to drink. After all, I've spent a lot of time backpacking around Europe getting drunk every night, and I had a lot of fun doing it. But it turned out that I had a fine time, if a bit of a lonely one, riding trains and seeing the majestic geography of Scandinavia. I expect I'll have a fine but slightly lonely time in New Zealand as well.

I wrote the first movement of my symphony. I'm very proud of it. It was three months of solid, exhausting work. And then I did nothing on it for the next nine months, essentially. I have about a minute and a half of the slow movement written. I know what it's going to do. I just need to sit down and actually do something about it. But musically, I was successful in other ways this year. I have learned a new Chopin piece, and I'm in the process of learning a new Brahms waltz.

I did a lot of dating this year. It was sometimes good and sometimes not. I met a girl I really, really liked. She seemed to like me a lot too. Then, she didn't. And that was that. I went out on a date last night that was very pleasant. I have another date with a pretty and brilliant professor on Monday. We'll see, I suppose. I don't know how things will turn out. I'm trying to release my expectations.

I lost about 50 lbs in 2011. Some of that was in 2010, of course. But mostly, 2011 was a year in which I worked hard. I went from being a tub of lard to being reasonably fit and only a few pounds overweight. I think in 2012 I can go to being fit, and finally a normal weight. I look good, and I feel good. I'm 185 pounds and have a 32 inch waist. I am approaching the kind of health I am determined to have in my life. At least, the part of my health that I can control.

So. I'm doing pretty well, all things considered. 2011 wasn't so bad. And I'm looking forward to the next one.

On the Management of Chronic Illness.

2011-12-29T06:46:00.000-08:00

Alcoholism is a chronic illness. As I've said before, it is a chronic, progressive, incurable, terminal mental illness. Meaning, it isn't something acute like the flu, that you come down with and then get over. It gets worse as time goes on. There's no way to get rid of it, ever, once you've got it. And it will kill you, for certain, if you don't treat it. As diseases go, it's got a poor prognosis. Remission is rare. Relapse from remission is common.

There are many diseases that have similar profiles, in the sense of being chronic, progressive and incurable. Multiple Sclerosis. Creutzfeldt-Jakob. And of course, diabetes mellitus. That's the one I want to talk about here today, as it relates to alcoholism. And of course, they're frequently co-morbid. But, like alcoholism, diabetes has very effective treatment regimens which can be used to minimize the effects of the disease.

Diet and exercise, those are the fundamental means of controlling diabetes (please note, I'm referring to type II diabetes, generally referred to as 'adult onset', though it is increasingly common in adolescents due to sedentism, obesity, and dietary factors.). Maintaining good diets low in simple carbohydrates, with evenly spaced meals and regular exercise, diabetes can be managed with minimal complications for an entire lifetime, in the great majority of cases. Aggressive glucose control in patients with type II diabetes is shown to dramatically reduce morbidity and mortality over extended time periods[1].

One way you can tell if you are managing your diabetes reasonably well, is through a blood test known as the HgA1c test, or usually just "A1c". If your values are held below 7, you're doing really well. If they're above 8, you're doing pretty badly[2]. This test measures, essentially, your average blood sugar over the previous three months or so. This allows you to determine how well your diabetes is controlled even if you don't have a comprehensive blood sugar log. Keeping the HgA1c low is crucial to good health.

This is one way I've come to think about meetings and working the program of alcoholics anonymous. It is essentially like aggressive glucose control for a diabetic. My spiritual and emotional health is maintained through going to meetings, being diligent and assiduous about my practice of gratitude and the rectification of any harm I do to others. Keeping current with my sponsor, and being willing to work at the things I have to work at to keep my heart and mind straight. And then, it is the sense of well-being and contentedness, the ability to be grateful instead of embittered, that is my A1c.

Because when shocks come to my system - divorce, job changes, illness, anger - it is not my current condition which buttresses me against my natural inclination to drown my emotions in alcohol. It is my longer term condition. It is how many meetings I've been to in the last three or six months. How many other alcoholics I'm friendly with and who rely on me. How well I've been at managing my resentments. And like A1c, those things don't last forever. I can't rely on work I did three years ago to sustain me in a crisis. I must continue my efforts at all times, so that I have a rugged foundation upon which to stand.

In the class of chronic, incurable illnesses which can be managed, diabetes and alcoholism are not so dissimilar. Both are lifestyle diseases with a large behavioral component. They require honesty, discipline, willingness, and acceptance to manage. But there is the possibility of living a life free from the morbidities associated.

___________________________
1) 10-Year Follow-up of Intensive Glucose Control in Type 2 Diabetes Rury R. Holman, F.R.C.P., Sanjoy K. Paul, Ph.D., M. Angelyn Bethel, M.D., David R. Matthews, F.R.C.P., and H. Andrew W. Neil, F.R.C.P. N Engl J Med 2008; 359:1577-1589

2)Measuring Progress Toward Achieving Hemoglobin A1c Goals in Diabetes Care Pass/Fail or Partial Credit Leonard Pogach, MD, MBA; Michael Engelgau, MD, MS; David Aron, MD, MS; JAMA. 2007;297(5):520-523.

Tickets Bought; Musings on Job Security.

2011-12-27T05:35:00.001-08:00

So. I bought my tickets. It's expensive, it turns out, to fly halfway around the world and back. But not prohibitively so. Hopefully, hotels and meals won't be as expensive as in Scandinavia, where food and lodging could easily cost $150 each day, at the medium/low end of things. The plane tickets were about $400 more, so I'm hoping that the accommodations will be about that less.

I have no idea what I'm going to do while I'm there, except for ride the trains, and look for natural beauty. I want, like I did last summer, to do a lot of walking, some writing, and generally have a relaxing time on the other side of the planet. I had vaguely hoped that I would have someone to travel with by the time it came time for another major vacation. Alas. I go alone again. Such is the way of things.

The other reason that it's a decent time to go is that my job is funded for the time being. A year from now, who knows? I have a major grant in, but nothing is ever secure. If I win it, I'll not really have to worry about salary for four years. If I don't, I'm in a world of trouble. I'll have other grants going in imminently, and I'll have other job prospects.

My professorship at SLU (Still not quite official!! URGHM!!) will definitely sustain me in the sense of providing a living wage, even if my current position goes un-funded. But it's a nervous time to be on soft money. It's good news that the NIH is getting a 3.3% bump in budget. But I'm going to need to do a lot more grant writing. But I have a good friend who has an R01 up for renewal, and is interested in including me on that.

It's scary. It shouldn't be. I have a lot of people who are in the position to provide me with wages who are really up on what I do. Which is good. And the AA philosophy, which I am working very hard at, is to trust in today, be grateful, and work hard today on what I can do to make tomorrow work out. I can do that. Fear is just fear. Action will disperse it.

Destination Settled.

2011-12-26T10:17:00.000-08:00

As soon as I confirm with my boss tomorrow that the vacation is acceptable, I am going to buy a ticket to New Zealand. I will spend a full day in transit each way on a 10 day vacation, yes. But realistically, it'll be 20 years before I can arrange to take more than about 10 days in a row off. And I don't want to wait that long. This falls again, like Scandinavia, into the category of "the right time to do it". I'm single, financially stable (may the gods of grant review keep that the case!), and I have no obligations preventing me from a nice whirlwind tripe to the antipodes. So off I go.

Deep, Slow, Tired.

2011-12-23T05:57:00.000-08:00

I have no mind. All in all, things are pretty good. I'm basically happy, and generally satisfied with life. I'm just slow and sleepy and generally ready to go do something that is not work. I haven't worked on my symphony in months. Although I have been playing piano a lot. I need to settle in and write some music. I know what the slow movement is supposed to do. I have it in my head. I just need to get to it.

I need to travel again. Not even a real big long trip. Just a nice jaunt to the Carribean or Europe for about 5 days. I have passed the threshold in my employment where I receive 19.5 vacation days a year. Basically, that's a whole month, once you include weekends. Now, of course I can't take a month off. I can't imagine using all that vacation time. I know I have some European readers, and much of Europe works on the "August-off" model. Huge numbers of workers take an entire month off every summer. I can't fathom that. What the hell would I do with myself?

So I'm thinking about where I should go. And when. I'm giving a cool national web-based lecture for my hospital system in mid January. Unfortunately, it's the week of MLK jr. Day, which I had been hoping to use to travel, since I can get 9 days vacation with only 4 days of leave. Instead, and I'm just deciding this right now as I'm typing, I think I'm going to take off the week of President's Day, in February. Same deal, good timing.

Maybe I'll go to Italy. Maybe I'll go to St. Kitts. But I'll go somewhere. And it'll be nice and vacation-y.

No NSF for Me.

2011-12-22T05:19:00.000-08:00

The NSF grant is not going to happen. I talked to the Program Officer, and he really liked my idea. But there were a few strikes against me:

First, I don't have any graduate students, and even when I do, soon, they won't be the right kind. They're looking for a professor of systems engineering. I'll be a professor of outcomes research, even though I am a systems engineer. So my pedagogy won't be the right kind.

Second, I don't have a history of female or minority co-investigators. This isn't really my fault, as the female investigators in my office are fully funded, or have moved away, or are transitioning back to medical practice rather than research. My female biostatistician, who is the best stats person I've ever encountered, has taken a new job. We just don't have members of the promoted groups to access right now.

Third, as PI, I am not quite the right fit. I have made a career decision to publish in the medical literature. There are two reasons for this: I want to make a difference in the world of health care, and that's the literature that health care professionals read; I'm not much of a hard core math guy anymore, and that's what the engineering journals publish. The PO was saying that they wanted publications in IEEE Transactions, Operations Research, Management Science, etc.. For medical science people reading this blog, that's like saying that they wanted publications in JAMA, and the New England Journal of Medicine, and The Lancet. The best of the best. Those are the kind of journals that a single paper in can vault you to tenure.

And the funding opportunity was only for about $150K/yr for 3 years. To include indirect costs. That's a fine grant for a tenure-track professor who lives on hard money and needs only to publish five papers a year and win one major grant to achieve tenure. As research faculty, and as a soft money investigator, that's almost not worth bothering about if they're expecting a large, multidisciplinary team. It can't possible cover enough of my salary to make the effort of writing the grant meaningful.

In some ways, I'm disappointed in myself that I haven't done work worthy of submitting to those other journals. I used to be that good. Or at least, close to that good. Good enough to give it a shot, to submit something on a whimsy that might have a chance. But I wasn't every really good at theoretical mathematics. I was good enough to understand it, but not good enough to invent it. And the truth is, I drank a lot of my education.

To be good at theoretical mathematics, you need to keep up on it. It's more like weight-lifting than riding a bicycle. If you don't keep at it, it atrophies. At least, that's how it is for me. And I spent a couple of extra years in graduate school drinking a bottle of whiskey a day and not studying. I found computer simulation, which is far, far easier for me than mathematics. And now I don't rate a professorship in a systems engineering department. I'm not good enough.

In the dark moments, I see myself as a terrible investigator. I can be sloppy, thoughtless. Luckily, goldlust and my co-investigators here at work keep me sharp. When something gets published, I suddenly feel more confident. I have good ideas. But I'm not meticulous or thorough the way a good engineer and scientist should be. I need help for that.

In terms of my distribution and visibility, my decision to publish in the medical literature is probably a good one. It will be lucrative, and give me options if it turns out that academia isn't the right place for me. Hospitals and medical systems are constantly looking for ways to improve their efficiency, and I have a track record of doing that. In the engineering literature, I'd be just another voice in a very large crowd, and not a loud voice at that.

But it's time to get to work. I do have a cool idea here, and I want to build it up.

Engineering Away.

2011-12-20T07:09:00.000-08:00

Well, I have a brief pause between now and the next grant submission cycle. I want to get a thing in for the NSF in February. That means I have two months. Which means I need to get on my actual funded project really hard for the next month, so I can justify the time spent writing the grant. Which, I guess, I need to read the administrative gunk for today. I've never submitted to the NSF before, and so I'm not sure of all the procedures. I'm talking to the program officer tomorrow, to figure out how to apply, and ask whether my ideas are even appropriate for the request for proposals.

So I'm continuing to do data chart abstraction for my diabetic retinopathy project. Normally, PIs don't do this kind of work. It's stultifying, doesn't require the kind of skills that I bring to my position, and it's expensive to pay me to do it. But my research office is in such amazing disarray that I can't even get someone to abstract data for me, despite the fact that I have money to pay for the position. Hiring someone is so time-intense that by the time I got someone on, the project would be over. It's absurd.

But, truth be told, I don't mind too terribly much. I think it's important, as a researcher, to be intimately familiar with your data, and its source. A bit like making all engineers study differential equations: lots of engineers don't use them at all in the real world (do you, LawnBoy?), but they're at the fundament of the laws of motion, of thermodynamics, of electricity. It's critical to have basic understanding of these things. It makes the research deeper and more authentic, and it gives a sense of involvement when things inevitably go slightly awry.

So. I'm a happy engineer. I'm excited to be developing my own big idea, and using it to explore interesting hypotheses in the field of medicine where it may be of use in a broad context. Hopefully, others will start doing what I'm doing, applying it even further afield. That's the researchers' dream, I think. That people smarter than themselves will advance their own theories and disseminate the ideas in ways that we couldn't imagine at first.

Because, I can pretty much guarantee that nothing I actually do will be that important. But I think that be being a voice in furtherance of the collaboration between engineers, health services researchers, physicians, and administrators, I have the opportunity to help lay the groundwork for bright people to work together to make health care delivery better for all of us. And that's exciting. It's what gets me out of bed in the morning. Well, that, and the fact that I make lunatic scratch doing it. Seriously. Sometimes I just throw money away because I can't figure out where to put it anymore.

An Amazing Feat. An Unpromising Date.

2011-12-19T07:15:00.000-08:00

I spent a lot of the weekend watching Dr. Peter Henderson (pianist with the Saint Louis Symphony Orchestra, and Asst. Prof. of Music Performance at Maryville University), play Beethoven Piano Sonatas. In what must be the equivalent of an Iron Man triathlon for musicians, Dr. Henderson performed all 32 sonatas in four days. Sadly, there were an average of 20 people at the shows, at St. Louis Community College Forest Park. Dr. Henderson is a skilled musician and a thoughtful interpreter. The task being gargantuan, there were slips. But it was overall an amazing accomplishment.

I saw four of the concerts, including the Appassionata. I missed the Hammerklavier. It was incredible to see how Beethoven changed and aged and introduced new ideas. Given how experimental and avant garde he was becoming, I get the impression that if he'd lived another decade, he'd have finished music, and the rest of us could just go about other business. I mean, he included recitatives and arias interspersed with fugues in the second to last sonata. The last includes minimalism and even jazz-like elements. Beethoven is a genius in a way that transcends his medium, and even art itself, in the way Newton transcended mere physics and mathematics. they are men with a different kind of imagination, as remote from my own as mine is from a dog's.

I went on a date this weekend too. It wasn't promising. We'd had good online communication prior to the date. But her profile was fundamentally dishonest when compared with how she really was. It's too bad. She's a Harvard trained lawyer with a heart. And her misrepresentation of herself is probably sealing herself off from people who would be attracted and available to her. She's looking in the wrong place. Or at least, she found me while looking for someone else.

I am beginning to be very discouraged about dating. I'm a great guy. But interesting, attractive, healthy and engaging women are, mostly, married by now. I came to sound health and mature expression of myself late in life. As a result, my prospects are fewer. And I have significant baggage that makes me unattractive to some, and for perfectly understandable reasons. Such is life. Sigh.

Missing in Action (read: Almost Certainly Drunk).

2011-12-15T08:27:00.000-08:00

So I haven't heard from PhoneMan since last Friday. It's too bad. He's a bright guy, diligent and with a lot to live for. He simply couldn't take step one. He'd flirt with it. He'd tell me he knew he couldn't drink anymore because he couldn't predict when he'd decide to go get crack. Because it wasn't getting him what he wanted in life. That he knew that people without drinking problems don't worry about their drinking.

But then he'd flip back. It was all about the girl. He didn't have a problem with alcohol, just with crack. If he had the girl back, he could drink normally. If he just had a few beers to mourn the girl, he'd be over his substance abuse problems. He could talk himself right back into a drink, telling himself, and me, that it wasn't about the alcohol, so why shouldn't he just go drink?

It would be funny if it weren't so deadly. PhoneMan is ruining his own life on purpose. And he's doing it because he has a debilitating mental illness. And the only way to recover from that illness is to come to a place of deep enough suffering to engender the willingness to do anything at all, even things that are starkly out of character, like honesty and openness, to become unshackled. PhoneMan just hasn't suffered enough.

And some of us have deep reserves. We can suffer through anything for our disease. People who can suffer homelessness, loss of children, loss of spouses, and still cling to the bottle, or the drug. I am just truly grateful that I haven't needed to go through those trials (yet!). I am willing to do what it takes to be a sober man.

A Surprisingly Painful First.

2011-12-14T05:35:00.001-08:00

In the past few weeks, I'd gone out with a young woman that I thought had a lot of potential. She is a physician in training, and very funny, and pretty. She had some issues that might have been challenges, including a fairly controlled case of OCD regarding germs. But it's all moot now because she told me she doesn't want to go out again. It's her reason that is jarring.

She decided thusly because I am in recovery. Usually, when someone breaks up with a person in recovery, because of the recovery, it's because it interferes with their own drinking. That wasn't the case here. This woman drinks only very occasionally. But she didn't feel confident that I (or really, I guess, anyone in recovery) could be assured to her level of need of being able to stay sober.

On our second date, she asked me point blank: "Are you a recovering alcoholic?" Normally I don't tell until the fourth date or so. Even then, I might not go into the whole details, saying responding to questions about why I'm not drinking with pith: "I don't like what it does to me", or "I'm just not very good at it." But when asked straight up, I just responded simply and honestly: "Yes. I hope that's not a deal breaker for you, because it's not something I can change." And I went on to explain a bit about the program and how I'm maintaining my sobriety, in response to her challenge that she'd "like to be sure I can stay sober."

Well, she told me yesterday, two weeks later, that it was a deal breaker after all. She sent a reasonably kind note, saying that except for that, she really liked me. Ah well. It's interesting, and, I suppose, heartening, that this is the first prejudice I've experienced about it. She never asked me additional follow-up questions. I wrote back that I am disappointed, but that acceptance is at the core of recovery, so I can accept her decision. I'm most disappointed that she wasn't interested in finding out more about recovery, if she did like me that much.

So, it's possible that she decided she didn't like me, and the recovery is a good way to make the break final. After all, there's no way I could argue with it. Or that she's been burned by substance abuse in her history, and is not willing to risk it again. Or this or that. Speculating on her motivation does me no good. So. Let's do what I told PhoneMan (who has vanished - more another time) to do.

I'm grateful for the fact that I'm a sober member of Alcoholics Anonymous. I'm grateful that I don't judge whole people based on tatters of their past, or small aspects of their personality. I'm grateful to have spent a few fun evenings getting to know her. I grateful that my sobriety doesn't turn on other people's ideas or suspicions about me. I'm grateful to be up in the morning, looking toward another work day, with productivity on my mind. I'm grateful to have lost 50 lbs. I'm simply grateful to be alive, sober, healthy, and employed. My life, my happiness, is not shackled to other people's vision of me.

Back at Work, with an Unpleasant Twist.

2011-12-13T05:37:00.000-08:00

One of the ways I've treated minor illnesses like cold and flu is to take a very hot bath. I love a bath most of the time, but I have this idea - grounded in sense, but unsupported by evidence that I'm aware of - that essentially creating an artificial fever can help fight the infection. I mean, our bodies jack up the temperature to fight invaders, why shouldn't I give it a little boost, right?

I'll tell you why: because when you're a little sick, and a little over heated, and you get out of the bath and go to the fridge to get some ice water, sometimes you faint. I'm used to being a little lightheaded from heat as I get out of the bath. Yesterday, it was a brand new level. I saw a starfield of yellow tracers, the world went quiet, and down I went. I think I was out for maybe 5 seconds.

I came to confused. I didn't know exactly where I was. My head had landed on the soft mat that I stand on while doing dishes, thankfully. My head cleared extremely rapidly and I realized what had happened. I stood up, surveyed the damage (upended plastic cup, avalanche of ice cubes.), and stumbled over to the sofa to clear my head. That was when I noticed my knee was bleeding.

It's not bad, just about the severity you'd expect if you were to stumble while running on a dirt track, something soft, rather than something grim like asphalt. It stopped bleeding after about two minutes application of a damp paper towel. Then I began to notice my back. Somewhere around the upper abdomen, lower thorax, there is a painful contusion around my spine. It made sleeping uncomfortable, and now, sitting at my desk, I'm thankful my hospital sprang for these truly awesome chairs.

But I'm back at work. I'll be all right. I'll just probably have to skip yoga for a few days. But the good news is, I've hit that last pound, and a bit. 184 lbs this morning. I've now lost more that 50 lbs. It's a whole new world. And I still have miles to go.

A Quick Accounting of Things.

2011-12-11T15:59:00.001-08:00

I am getting sick, I think. I can feel the pressure changing in my Eustachian tubes. I hate that. As a kid, I had many, many ear infections. My eardrums ruptured multiple times. As a result, my hearing isn't great, and my ears pop every time I swallow. When I get sick, and my tubes plug up, it is among the most annoying things in the world. I am used to being able to equalize pressure just by swallowing. When I can't, I'm driven to distraction.

I haven't heard from PhoneMan since Friday morning, and that was just to tell me that he'd gotten some kind of performance recognition at work. Nothing about his condition. I talked to another man who knows him today at my Sunday meeting. We agree he's just not ready to take recovery seriously. He's skipping meetings and continuing to worry about how other people think of him, see him, he's panicking about the future. Doing everything he can to find things to think about and worry about except recovery. Oh well. I'll be here when he's had enough pain.

Sometimes, we need to get arrested before we get sober. Sometimes, we need to lose our jobs or our homes. Sometimes, we need to kill children with our cars. I'm grateful every day that I have never had to do those things (aside from a single DUI in which no one was harmed). I have found sobriety without needing to slide into a total abyss of pain and misery.

I had to cancel my date. The potential adorant works with sick children, and as a result, exposing her to an impending cold/flu would be ungentlemanly at best. We rescheduled for Thursday, by which time I intend to be healthy.

Finally, I'm spending the weekend revising my paper with the fancy journal. They want an appendix, to be published online, which would give additional technical details of the simulation methodology I use. It's a pain in the ass, but I can get why they want it. I'll get it done. Ugh. So clogged.

Grant Away!

2011-12-09T06:22:00.000-08:00

Well, the largest and most detailed and expansive grant application of my career is away. I won't say it's the most important, because I'd be unemployed right now if I hadn't gotten the grant I won last April. But that funding will last me only until November of next year, and I'll need to have new funding in place. If this hits, it covers 5/8ths of my salary for 4 years.

And I feel as good about it as I could. It's a very cool project, it's timely, the work I'm doing on it is novel, and useful. It serves a population desperately in need of attention, and touches several of the granting agency's published priorities. We have the finest dissemination plan I've ever seen, with stated buy-in from national directors of major initiatives, eager to see us succeed. I think there's a very good chance. Insofar as any grant ever has a very good chance that is. Which means about 1 in 5.

I'm so tired and feel so bogged down this morning. I almost stayed home from work. I've got a lot of vacation and sick time saved up. I could certainly do with a few hours off. But I'll save it up for a vacation, whenever I do get a chance to take one. I could have gone now, but I didn't make my plans in time. And truth be told, I'm eager to wait and travel with a girlfriend.

Ah well. I do have a date this weekend. We'll see.

Poop.

2011-12-08T07:31:00.000-08:00

Albert Pujols has been signed by the Angels. But here's how I work my program. He gave us eleven years, three MVP awards, two World Series titles, and is a sure fire first ballot hall of famer wearing a Cardinals cap. I'm grateful for that. I don't have to be bitter that he's going away. I'll miss him. But I'm happy to have gotten what I got. Everything ends.

New Header Art... and Disappointment.

2011-12-08T06:47:00.001-08:00

Blogger has apparently added some kind of lossiness to the header art image processing. I can't get it to look the way it does on my computer anymore. That's a shame. These files are tiny. I can't see the need to compress them. But I'm sure it was a blanket decision. Bleargh. Looks terrible. Maybe I'll have to shop around for a new hosting site for my blog...

It's Wafer Thin...

2011-12-07T07:39:00.000-08:00

The distance between me and 50 lbs. weight loss, that is. At my peak, about two years ago, I was 235. This morning, on my scale, I was 186. I'm so close. I'm tempted, of course, to just dehydrate myself until I hit the mark and call it good. But that's cheating, right? It's not real.

I'm so amazingly pleased with my results. And I'm so disappointed and disturbed by how far I clearly still need to go. My BMI is 26.7. Still almost halfway between the top end of normal and the bottom end of obese. It's astonishing how slender humans are supposed to be, compared with how most of us here in the western world (yes, even Western Europe) actually are. I have a 32 inch waist. And I'm 12 pounds heavier than the top of the normal range. I should, realistically, lose another 20-25 lbs.

Of course, strict weight loss is not my goal. It's just such a good proxy for my goal that I tend to focus on it. My real goal is to avoid diabetes, maintain good cardiovascular health, and look good naked. To that end, I've been eating well, but less, and exercising a lot. Of course, my running over the pring and summer was well documented. But now that late fall and winter have arrived, I've stepped back from that. It's too cold.

So I've taken up yoga, which I've talked about, and instead of running, I've been bundling up and taking 2.5-3 mile very brisk walks after work. It takes about the same amount of time as running, and it keeps my heart rate slightly elevated. It's not the workout running was, and the distances are much smaller (I tended to run 5 miles at a time. That was a very comfortable distance to commit to.). But I walk fast enough that I perspire some, and have to breathe deeply on the uphills.

My physician (holy crap, it's been 6 months, I need to make another appointment!) wants me to do 2.5 hours of physical exercise a week, at a minimum. The yoga classes, which are more strenuous than people who don't do yoga think, are about 2 hours a week. I try to walk for 45 minutes to an hour every day I don't do yoga. Which means I'm getting in about 6 hours a week. But it's not nearly the effort that running those six hours a week was.

But that's ok. My goal for the winter is to maintain, not necessarily improve much. I'd like to find myself in the spring about 180, and ready to start running again. Not to do marathons or even 10K races. Not to do races at all. I want to simply become and stay healthy. And I'm doing that.

Time to go back to the doc and get some blood work done... I'm 37 after all. Being on top of this now will mean a useful, productive and healthy midlife. So many people I see who are incapacitated young, by heart disease, stroke, diabetes, obesity. I don't want to be 50 and living in a chair, or unable to travel the way I want to. Unable to participate meaningful in relationships. That's why I got sober, to have a good life. Why I quit smoking. Time to be fit.

Work, Sponsorship, Etc.

2011-12-06T05:39:00.001-08:00

Last night late I received a 'Revise and Resubmit' letter on my latest paper. Which is a big improvement considering it's been rejected four times. R&R's are where they say, essentially: "We really like this idea, but you did a hash-up of a job describing it. We'd like to see some more analysis, some different math, and oh, don't forget to add this and subtract that." Responding to one is an exercise in longsuffering. But the key is to remember that responses to reviewers are conversations, not arguments. It's a pain in the ass, but a good one. Especially considering this is a well known and well-respected journal. Being published here will represent a real stride forward in my career. It will be the best journal I've ever had a research paper in.

PhoneMan went totally nuts again yesterday, saying that he didn't really think he had a drinking problem, that it was just a girl problem. He keeps saying: "I don't obsess about the drink! I only obsess about the girl! I don't see why I shouldn't go have a six-pack! I'm not even thinking about drinking!" It would be funny if it wasn't going to kill him. He sent me a bunch of texts, saying that drinking wasn't his real problem. We talked on the phone for half an hour, and I told him (again!) that unless he's willing to do the work and look at his addiction, then I have nothing to do for him. That he'd made startlingly honest admissions about his addictions only 24 hours before.

I told him about how we generally have arrested emotional development, and that we stop aging, emotionally, when we start using. Which makes him about 15. He responded by throwing a great big tantrum, whining about the girl again, telling me that he was done writing and that nobody liked him sober, especially not him. And since drinking wasn't his problem, and he doesn't obsess about drinking, he didn't even know why he was talking to me, he should just go drink.

So I told him: "Fine then. Go drink, and quit wasting my time. I can't help you with anything at all until you're willing to look at your addiction. I'll be here for you 100% when you're ready." And he said: "OK."

And I figured that was that. And then, four hours later, he called me up (sober) and apologized for acting like a baby, saying he doesn't know where his head goes or how to deal with it. I took a softer tone, telling him I understand how hard it is. After all, I've done it. I've been there. but that if he wants relief from this madness, he has to start doing what he's told. I'm not hear to listen to him reliving a litany of woes about his ex-girlfriend. He needs to do the damned work. I have told him, over and over again, how to get out of his difficult head-space with useful action. And he refuses, because he likes the pity he feels for himself. And because by obsessing about the girl, he can convince himself he's not a drunk.

Which is what we all do. I'm so grateful to see this up front, face-first again. I was this crazy. I was in that much denial. I needed to suffer through it to get past it, and I never want to do it again.

Total Backslide.

2011-12-05T11:00:00.000-08:00

And we're on about the girl again. Everything PhoneMan learned yesterday is gone. It's all about her again. I told him that I'm done talking about her. I won't listen, I won't respond. I think, sadly, he's just not ready. I told him I'll be here for him when he's serious about dealing with his problems.

Astonishing Progress.

2011-12-05T05:35:00.000-08:00

Just when I had essentially given PhoneMan up for dead - he hadn't called Saturday when I know his best druggie friend and his ex-girlfriend would be at some rockin' party, and he'd recently told me that he thinks he could drink normally if only she'd take him back - he showed up Sunday morning at my sober club having written five pages about powerlessness and unmanageability. I didn't read it (He had asked if I had to read what he wrote, and I said no, but we did have to talk about it, in detail.), but we did sit down after the meeting for about an hour and talk it through.

He's not quite there yet, but his work was much better than I thought it would be. I expected it to be more pissing and moaning about losing the girl. There was only a little of that. In fact, he'd gone back and we talked about how he used to smoke pot in the car before high school. How he risked his career to smoke pot, and later do coke, and crack, knowing he could have a drug test at any time. How he would abandon his responsibilities to go get drunk with a friend, knowing that things he rather do were waiting.

We talked about his father, an alcoholic all his life, and how his dad used to make PhoneMan go in to the take-away restaurant and wait for the food when he was 10-12 years old, while he sat drinking in the car. We talked about how PhoneMan's mom enabled the drinking and couldn't see the madness in her own life, and how she contributed to it. We talked about how PhoneMan surrounded himself with people who drank like he did, his ex-wife and his other ex-wife. How he carried one of them home, after she'd passed out at the bar, and she vomited all over herself, and his thought was: "This is what I want. This is awesome."

It was a good long conversation, and there was emotion and depth to it. I can see his denial cracking a bit. It turns out, he has a cousin who is six or seven years sober, who lost relationships because of alcohol and meth use. PhoneMan is fixated on asking if lives really do get better. He wants to know everything I did and everything I obsessed about and all the pain I had in my life. I tell some. Other bits I tell him we can talk about later, or I tell him are private. But I'm free with my description of how much better my life is now. He needs a beacon to home in on. He needs a lot of them.

What he's slowly starting to learn is that even though he could, often, have just two or three beers and then stop, what he couldn't do is predict when he was going to get loaded and go out hunting for crack. He never knows, when he drinks, what's going to happen. He doesn't know if he's going to end up in jail, or killing someone with his car, or killing himself with a $100 bag of rock. Twice, even three times in a night he'd go out for more.

So, still, no predictions. But I know this: the people how do the first step last longer than the ones who don't. I told him to sit with step one for a few more days. Write down anything else that comes to him. We'll discuss moving on to two soon enough. It's good for me to see the pain of alcohol and drug abuse through his eyes. I never want to go back. It's too hard. I'm so much happier today.

No Predictions.

2011-12-01T06:21:00.000-08:00

It's easy to make predictions about who is going to make it and who isn't when someone tries to get sober. Sometimes, it seems pretty obvious. Someone who has been in and out over and over again, giving it another go. Saying the same things and not doing the work. Those people generally end up drinking again. But not always. People who come in with a court order or because a wife threw them out. Not great success rates. They're generally trying to achieve a particular end that isn't sobriety. When sobriety isn't the goal, it's rarely the result.

When someone comes in like PhoneMan, I generally have higher hopes. He came in because he felt horrible, and hated the fact that he was getting drunk and high, and that it was fucking up his life. Those people tend to have higher success rates. Because their goal is usually to get sober, and they are usually willing to take some direction.

Sadly, PhoneMan isn't taking direction. Over and over he texts or calls to make the same complaints about the girl, to wallow in his remorse about losing the relationship. He's not making any visible progress. He's been going to meetings. He's been talking to other drunks. He's been reading the literature. Those are all good things. But he isn't writing.

Now, there are a lot of fine, sober, happy, healthy ex-drunks who didn't write for their step one. I don't want anyone out there to think that I'm saying that writing down your step one is the only way to do it. It's how I did it, and it's how PhoneMan is going to do it if he's going to work with me. But that's not just abritrary drill-seargent-ism from me. It's an attempt to get him to have to focus his thoughts, to separate himself from his anguish and regret and resentment about the relationship and pay attention to how he drinks and drugs, and why.

The first and most important thing we need to do is give up on our need to control things, to run our own lives. We suck at running our own lives. When I run my own life, I sit in a bathtub and drink vodka. PhoneMan gets drunk and drives around North St. Louis looking for crack. PhoneMan is obsessing about this girl, and he can't see that it's all just an excuse not to do the work. He even admits that the obsession is driving him back to drink.

But he refuses to take direction. He told me that he's not writing because he can't see how it will solve his relationship problems, or make him feel better about them. To which I have said: it won't. It will help you stay sober, and help get you to a place where you can feel relief from this pain. But until you look at yourself, you will suffer and suffer and suffer. And PhoneMan needs to learn to be willing, and take direction, if he's going to accept his disease and move forward.

He just texted me saying he hates his existence. I'm not surprised. I'd hate mine if I were where he is. He says he's out. No peace. He's on about the girl again. Here we go in the circle.

Working with a New Guy.

2011-11-30T06:33:00.000-08:00

PhoneMan is totally fucked up. I say that with love. He's a drunk and a coke-head - a crack-head, really - and he keeps going around and around and around in his head about this girl. He didn't want the girl when he was using. Or rather, he only wanted her to be there when he wanted her, and to put up with it when he went out on drug-fueled binges with his 'buddy', and didn't show up for days at a time.

PhoneMan is exactly what we all are when we come into the program: a liar, a drunk, an addict. Now, as he's sobering up, he's lamenting, pitiably and pathetically, the loss of this 'relationship'. And the potential loss of the friendship with his buddy. Now, as I mentioned in a previous post, the girl seems awfully fucked up to me, deep in debt, children in three different decades of life, and spending four years in and out of a relationship with PhoneMan, who consistently let her down, disappeared to go drink and drug, etc..

When we get sober, if we're going to stay that way, we need to disassociate from the things that drive us to drink. It doesn't mean we can't ever be friends with people we drank with, but it does mean that we have to at least re-frame, and reëstablish the relationships. When a relationship is built around drinking and drugging, it needs to end. PhoneMan is worried about how it will look if he tells his buddy he can't hang out anymore.

I've told him in no uncertain terms, and after consulting with my own sponsor, that he needs to make a clear, clean break with his buddy, and with the girl. They are not helping him, they are hindering him. In two ways: one, they are sources of pain and anxiety and misery that trigger his desire to get high and drunk; two, they are convenient excuses for him to obsess over, so that he doesn't have to do the real work of looking at himself. So far, PhoneMan is happy to wallow in his misery about lost love and lost friends, rather than actually doing the work he needs to do to stay sober.

I let him have it on the phone yesterday. He keeps saying how "Maybe I'm just making it worse by trying to get sober." Meaning the pain he's feeling. We've gone around and around this tree. Every time he brings up the girl, I've started saying: "You want to do this again?" Finally, I got sick of hearing it, and I said: "Look, if you're not sure, if you think maybe things would be better if you went out and got drunk, go for it. Go get drunk. I don't give a shit! But you're just going to end up here, feeling even worse, after fucking things up even worse than they are now."

This is something sponsors regularly have to say to new sponsees, people new to sobriety. They have to understand that we, the sponsors, are not here to 'keep them sober'. That's not our job. We couldn't do it in any case. And truth be told, I don't give a shit if he goes out or not. Not in any existential way. I want him to stay sober, yes. I'd love for him to get it. But if he doesn't, that doesn't impact my sobriety at all. He'll make it or he won't, based on his own efforts, his relationship with his higher power, and his level of willingness.

So far, he's refused to set pen to paper. He is going to meetings, and reading his books, and bitching about a girl. He isn't looking at himself. The reasons he drinks. The reasons he gets high. He's keeping that shrouded in mystery, by focusing on things he can't control. He's keeping himself miserable, on purpose. I mean, I know he's not sitting there thinking: "How can I be miserable today? I know! I'll complain about this woman again! And I'll text her!"

I had to ask him, "How much does this girl need to suffer over your selfish need to keep her in your life? You say you love her, but that doesn't sound like love to me."

To get sober, we have to come face to face with the hard truths about ourselves. I'm going to guess that to my non-addict readers, these things I've said sound horribly and unnecessarily harsh. I'm going to guess that my addict and alcoholic readers who are in recovery have a different opinion.

How to Achieve a Target Heart Rate without Exercise; or, Why I no Longer Resent the $406 Brake Job.

2011-11-28T07:22:00.000-08:00

It started as an ordinary morning. It's ended up that way too, but not for lack of trying. Basic facts: Alarm, grumbling, toothpaste, search for keys. Standard stuff really. Into the car, off to work. 6:57 am. Stop at Starbucks (nonstandard, motivation unclear). Arrival at work, 7:13. Collection of loosely assembled detritus (phone, bag of coffee grounds, car keys, wallet). Exit car, proceed towards office.

At this point, I discover that I've left my badge, which is also my electronic access key, to the office at home. I know precisely where it is (the little glass table in the dining room.). It's missing because I deviated from my ordinary routine. I left my keys on the kitchen island last night, rather than the little glass table, where my wallet and badge were. As a result, I picked up my wallet (neglecting the badge), went to the island, retrieved the keys, and failed to return to the glass table to pick up my badge. Whistled at the bird, and off I went. So, suddenly gloriously happy that I'd wasted $2.16 on coffee this morning, rather than waiting to make it at work, I curse, spin on my heel (not really, though I kind of wish I could to that elegantly), and get back in my car to return home, to gather my badge.

Halfway home, my phone rings. It's PhoneMan, who has asked me to sponsor him. He's been sober for 9 days and is anxious about his first day back at work. But he's feeling better that he was the last few days. His head is clearing. I'm talking him through the process. I really do love working with new guys, despite the high disappointment rate. It's great to see someone's life change. So I'm jabbering with him about the process, how insomnia recedes as time goes on, how speed bumps stop looking like the southern face of the Himalaya. I'm in the right hand lane, going 35, right at the speed limit.

With perhaps 50 feet between us, an aqua blue, late '90s American model (Dodge? Chevy?), lurches from a side street into my lane, realizes his horrible mistake, panics and stomps on his brakes, perfectly obstructing my lane, and frantically attempts to reverse. There isn't time. There could never be time. Physics thwarts his attempts as stolidly as a frontier school marm. The floor obstructs any further excursion of my brake pedal. My little car shudders and vibrates as the anti-lock brakes, brand new and itching to prove themselves, stare into the abyss. The abyss stares back. There isn't room.

Stopping prior to some juxtaposition of vehicles was a brief fantasy, but glorious. Like an illuminated manuscript in a fire. It can't be done. The other driver's eyes saucer. In this perfectly distilled moment in his life, Death drives a Volvo.

But something has happened. Brakes mobilize tires, clawing at the asphalt like talons, threatening the coefficient of static friction. They've cashed a check against the collateral of the laws of motion: they've traded distance for time. Time my brain has spent in an electrical storm of calculations, non-critical operations suspended, conversation abandoned. Derivatives and second derivatives assessed. The car in front of me, the car behind. Flirtations with relativity. I presage the collision, unbidden images of an exploding balloon erupting from the steering column briefly blot out other considerations: how much is this going to hurt?

A deep place in my brain ignites. A trajectory derived. Conscious thought discarded as a superfluous luxury, ancient pathways light up as conduits for action. Muscles are commandeered. The left hand is still (it has, after all, been only a third of a second) holding the phone. The right will have to suffice. Autonomous, it wrenches the wheel counterclockwise. The car is nothing if not nimble. Springs and shocks collapse and expand. I lurch into the left hand lane, just as the other driver's tires find their own purchase, and heave his car backwards the extra inch needed. Our paths diverge in audible silence.

"I'm going to have to put down the phone."

I get my badge. I whistle at the bird. I go back to work. $406 very well spent.

Honesty, and the Love of one Drunk for Another.

2011-11-25T07:08:00.000-08:00

I'm still thinking a lot about PhoneMan. We ended up texting back and forth for several hours yesterday, in addition to having a half-hour long conversation. And I told him some very straightforward, blunt, opinions and perceptions I have about where he is and what he is likely to need. Obviously, I don't know him super well, and I certainly don't know the woman he's fixated on, but I know the situation well enough.

I fixate about women, as this blog will attest. And I know what it is like to be in a troublesome relationship while sobering up. PhoneMan has a bit of a case of the poor-me's. I reminded him of some basic facts: "Be thankful that you're not also dealing with a DUI, or a possession charge, or are in trouble at work. You're a drunk, and a cokehead, and you've got some woman trouble. I know guys who'd kill to be in your shoes." And he agreed, things could be a lot worse. I introduced him to our "yet" concept. Sure, he's not dealing with a DUI, yet. Or a possession charge, yet. But keep drinking, keep using, he will be.

I had some direct words about the woman issues as well: "Look at it from her perspective, she's in debt and in an on-again-off-again relationship with a coked up drunk. Sounds like she has some issues of her own, dude." And, "I don't know her from Eve, but a girl who puts up with the shit you put her though and doesn't run screaming has some issues that could interfere with your recovery. Complicated, entangled relationships in the first week? I'd recommend against it."

In order to get sober, we frequently need to stay away from the people, places and things that were associated with our drinking. I'm fortunate in that I never did any drugs harder than pot, and I never did pot that much. I don't know what it's like to kick narcotics. But I know that breaking any addiction is made much, much harder by complicated, stressful emotions. Because we're drunks. We drink to avoid emotion, to avoid reality. Those kinds of co-dependant, toxic relationships tear us down, and lead us back. PhoneMan can't see that right now. And obviously, I don't know anything for sure, but in general, the kind of people who are attracted to addicts are not the kind of people we find attractive once we're sober.

But my interaction with PhoneMan has been good for me. Even though I've had to tell him some very uncomfortable things for him to hear, that there's no way to convince anyone else he's changed other than by being different and letting them observe it. How he's not capable of getting sober and fixing a relationship at the same time, and how getting sober might not get him the girl. But that none of that is what matters about getting sober. It's about living the life he is able to live, being effective. Hell, being alive. I told him about my friends who have killed themselves.

But that honesty is part of the love of one drunk for another. I do him no favors by telling him to find some softer way. By telling him it'll all work out for the best. To recover, we need to look carefully and plainly at what we are. I am an alcoholic. A drunk, who prefers anaesthesia to living. Left to my own devices, and ideas, I will find good reasons to get hammered off of my ass. PhoneMan will put a little white rock in a crack pipe and blow out his lungs, after sucking down a twelve pack. It's what we do.

But hearing the unvarnished truth, that this girl might be awfully fucked up too, and that he might not want to join any clubs that would have him as a member, is painful, but good for him. Because we see through cataracts when we're using and drinking, and those aren't removed the day we put down the bottle. It takes time. I've got more than three and a half years now, and I still find myself thinking awfully badly from time to time. I need gut checks and peer review.

I hope PhoneMan makes it. I hope he doesn't "out" me at work. But I'll deal with that if it comes to it. It's not that big a deal. That's the thing about being sober: things like that don't scare me anymore. It'd be unpleasant to be outed at work. But not horrible. And there are a couple of people who know. And I'd move on. And maybe some good would come out of it. I don't know if things happen for reasons or not. But I know that I can find meaning in the things that do happen.

The Men's Meeting.

2011-11-24T18:15:00.000-08:00

Last night I spoke at my men's meeting. It wasn't scheduled, I was asked about 10 minutes before hand. And there was a serious wrinkle. There was a man from work there. I'll call him PhoneMan. I've had some work dealings with him, and found him to be competent and reliable. I always thought he was a little odd, and now that I think about it, it makes sense. He's a raging coke-head. Coke heads, even when not high, have a kind of stereotypical behavior that I didn't identify outside of the context in which I know to look for it. ie., AA. At work, he just seemed a trifle odd, and I don't think he was ever high there.

Anyway, since there were new guys in the room, and I hadn't told my story in a while, I told my story. I started by acknowledging that I was nervous having a guy from work in the room. He commented that he was scared, and that he was 'new at this'. Turns out, he's been clean and sober for about 4 days. But I wanted to show that I wasn't afraid, in a weirdly masculine way, of him being there. I was in my own element. And I wanted him to be welcome there, and know that being sober, I wasn't afraid to tell my story, admit what I am, and claim the benefits of sobriety. That the fear of early sobriety dissolves into confidence as time goes on.

I talked about how my marriage failed, and how it was part my fault and part hers. I talked about how I used to lie and hide things, how I drove drunk and vanished into the bathtub with a bottle of vodka. How I went to rehab, how I discovered how I could move forward. How I did the steps. Today he texted me several times, and we also spoke on the phone. He's obsessing over a girl, which is pretty common when we get in.

He really connected with what I had to say, and he's doing the right things in the beginning; talking about his feelings, confessing that he's screwed up. I'm rooting for him, and I told him I'd go with him to meetings if he needs me to. It's scary to be new to the program, to know that you have to kick the habit, find a way to go without the best friend you think you have. Because the fight isn't against alcohol. It's against the malady of the spirit that consumes us, that makes us think we need anaesthesia.

I'm grateful, today, that that horrible strange time is behind me. And I'm grateful that PhoneMan is reminding me what it's like to be new, when the liquor still has its fists in your gut. I spent today alone, but helping a fellow drunk find his new way. And that's good.

Thanksgiving Alone; Yoga Musings.

2011-11-23T06:50:00.000-08:00

So, I had originally planned to go traveling this four-day weekend, maybe to somewhere in the Caribbean, just to take a little time off and enjoy myself. But when I mentioned that to my co-PI on my current grant submission, he blanched and told me I'd do no such thing. Not with a submission deadline in a week and a half. So I'm home. I often go to Jimmy Legs's place for Thanksgiving, but this year I told him I wouldn't be going due to travel. Then, I realized that I'd need to work on the grant, so I can't go even though I'm not out of the country.

My aunt and uncle will be Tucson with my dad, so I can't have Thanksgiving with them, like I did last year. Although, because they're out of town, they had a mock Thanksgiving dinner last weekend which I attended. So I'll be having my own little holiday by myself. I'll be going into work, probably, and doing grant references. And then eating a peanut butter sandwich, about which I'll be perfectly happy. It's even supposed to be about 65 degrees! Maybe I'll go for a run.

I've really been enjoying my yoga classes. I even talked to a pretty girl last night briefly, before saying, "I guess I'll see you next week.", and heading out the door. We had been partnered up. I have to say that it is really uncomfortable to touch a woman I don't know, even when an instructor is guiding it, and it's just hold ankles for stretching or whatever. It's uncomfortable to touch a man too, but doubly, or trebly, so for a woman.

But it turns out that I'm really good at yoga, for a beginner. I've had three different teachers, and two of them have singled me out for praise. It feels fairly natural even though it is very difficult. My balance is poor, but the postures we've been doing so far don't require a lot, in general. It's been a good decision. I'm sore, but in a good way, and I can tell that I'm using a lot of core muscles that running doesn't target. The pretty girl I mentioned said she assumed I'd been doing yoga for a long time because I was so flexible. But I think flexibility just runs in the family.

So, I've been going on dates again, to decent promise. And I'm moving forward in my professional life. I'm looking forward to my men's meeting tonight. All is well.

Papers, Grants, Ho Hum.

2011-11-21T11:59:00.000-08:00

How long has it been since I was bitching about grant writing? A month and a half? Well, here we are again. I really don't know how I'm supposed to get any actual work done when my whole life is filled with grant writing. Paper-writing does count as actual work. I have two of those in the offing at the moment. And of course, that world of depressing data abstraction.

My paper has been reviewed and is up for editorial decision. Has been for about 5 days now. No idea how long the process takes. This paper has been rejected from several journals already, but it has been entirely re-written and has been reviewed for a very well-respected second tier journal now. A better journal that the last one which rejected it in a different form. I will find a good spot for it. But my last couple of publications have been in decidedly third tier journals, and I want this one to be in a decent one.

I strongly suspect that I'm not ever going to have a paper in a very good journal. I'll never breach JAMA or NEJM or The Lancet. And that's fine. I don't have those grandiloquent desires. I want to make a nice impact, sure, but I'm not so driven as to chase that dragon. My field is almost certainly not going to crack those pages. But I am strongly motivated to get into the high-second tier of discipline-specific journals. I have an idea for a paper which I will be aiming at the American Journal of Epidemiology, which is a fine journal. But it won't be for six months at least until I begin writing it.

I feel like I simply want to do something that will have me remembered as someone who made a difference. That I did something that improved the world, a little, for a lot of people. I want to succeed in a difficult career path. I want to fail less than other people.

On Data Abstraction

2011-11-16T10:48:00.000-08:00

What a sad, horrible task it is. So, for my diabetic retinopathy study, I need to gather data. This is a fact of life. In some sciences, gathering data is really sexy. In physics and chemistry, scientists perform exciting experiments and blow things up and shoot them with lasers. Of course, sometimes you just press a button on an electron microscope and wait, or move a telescope three one-billionths of a degree and wait a month for enough distant light to impact your photosensitive array. Whatever.

In medicine, collecting data often, perhaps usually, involves doing chart reviews. This is done when we need to examine a retrospective cohort. We look at our population of patients, select for a few specific traits, and then examine a random sample of patients with those traits to look at.

In my case, it is patients who were seen in a particular clinic and also have diabetic retinopathy. Then, I look through their chart to determine which relevant covariates they also have, like hypertension, dyslipidemia, etc.. Pretty standard stuff. It's easy to reduce a patient to a small collection of answers to simple questions: "What's the BMI? Is there also diabetic nephropathy?". But my experience is that observing medical records doesn't allow me to do this.

When I look through a medical record, I read the history of a human being. When they were diagnosed, what's happened to them over a period of 20 or 40 years. When examining, as I am, mostly older, diabetic, patients, I end up reading a terrifyingly sad history of a voracious disease. Amputations. Organ failure. Suicide attempts. Alcohol abuse. Impotence. A world of sad and sobering complications.

Diabetes is a monster illness. It ravages almost every system of the body. I'm no physician. I'm an engineer. I can't influence the actual care of the disease. I'm trying to improve outcomes though, by improving access to care, and determining how the epidemiology will change as time goes on under the influence of this policy or that one.

But with diabetes, there is essentially only one way to improve outcomes. Better management of diet and exercise. Weight control is key, but it isn't everything. Fundamentally, one must keep one's blood glucose levels are a healthy value. This means avoiding sweets and refined grains. And it means regular, vigorous exercise. People who do those things have dramatically fewer complications. And the complications they do have are less severe.

As diabetes progresses, diet and exercise will not be enough to maintain healthy blood sugar levels. Medication and eventually insulin supplements are the best ways we currently have to maintain control. I imagine that smart people are working hard now to improve these options, and find new ones.

In many ways, diabetes complications need to be seen as somewhat like smoking complications: avoidable through lifestyle changes. Most people with Type II diabetes do not have to suffer from these if they choose to act in a healthy way. It's a harsh, difficult position to take, and I have family that have made poor choices with regard to diabetes management. But there is an enormous amount of suffering from T2DM that can be averted simply by being a good steward of our intake, and a good steward of our output.

Communication!

2011-11-15T07:41:00.000-08:00

I finally heard from the RHSC last night. I have been texting him about every 10 days, but he hadn't replied since January. I counted, and it was 29 texts I'd sent. Each time simply saying something along the lines of, "Hey kiddo, love you, hope you're doing great!". I figured he's respond when and if he wanted to. When he was ready to.

He finally texted back yesterday. He's doing well, he says. Going to high school. He told me one thing that I told him I wouldn't repeat, so I won't mention it even here (It's nothing that would need to be repeated. I'm not sure why he wants it kept between us, but he does, so I will.), but I can report that ex-wife has apparently made more bad decisions, which makes me sad. She's apparently left the job that she had and loved so much, and was directly in her field, leading her towards a good career. I predicted this. She cannot allow herself to hang on to anything good in her life.

It is quite telling that she was willing to stay with me while I drank, even though she was miserable. It was after I was sober, when I was advancing in my career, able to provide functionally and we had had something like a period of happiness that she decided she had to leave. There is no happiness for her, not contentment. I wish she could find a way to be happy in her life, to be comfortable with her self. But I fear she will never find that.

I told the RHSC a bit about what I've been doing. My trip to Scandinavia and my soon-to-be professorship. Of course, I have in me the horrible strange hope that he'll tell ex-wife about it, and she'll be angry and frustrated and regretful and resentful. That's an ugly sentiment in me; I acknowledge that. But this is a venue where I admit my ugliness, hopefully to transcend it.

I miss the RHSC. But I have this horrible fear, more fully realized with each bit of information I get, that he is being horribly set up for an independent life. He's been moved around and in and out of so many places, schools, environments. When he was expelled last winter, which is a failing of parentage, not him, he was told, apparently, that it was the school's fault. He has been coddled against believing that anything he does can be wrong. As a result, he is growing up entitled, defensive, and self-righteous. It's sad. Because he's a sensitive and good kid. I suppose ex-wife must have been too. But pain is passed from generation to generation. And so is rage.

Collectivised Health Care, Evidence-Based Policy.

2011-11-14T06:48:00.000-08:00

I have said that one of the big problems with winning a grant is that now I have to do all that shit I said. It's a daunting but exciting task, and one which I believe may in fact improve the lives of people seeking ophthalmic care. Ideally, we'll determine just how valuable a change in screening policy is likely to be, and then we can recommend adoption or rejection of the policy based on maximizing the number of sighted years that diabetics are likely to have. Using computer simulation to predict the outcome of policy, and thus engage in providing evidence based performance measures and evidence based access policy.

I suspect that in terms of actually providing high quality health care to persons, evidence-based access is going to be just as important as evidence-based medicine. However, there are very few efforts right now to inform access policy with high quality evidence, because it's very difficult, very slow, and very expensive to do the kind of epidemiological studies necessary to inform access policy. And there are issues of fairness and freedom: if I would like to go to the physician every two weeks, even though I'm healthy, why shouldn't I be able to?

Well, politically, I sympathise with that. And if I'm paying out of pocket and can find a physician willing to see me that often, then by all means, absolutely. But in collectivised systems, where everyone pays a certain amount regardless of use, or at least where payment is in some way disassociated from use, there needs to be sensible distribution of care. I know that I'm sounding like a communist here, but that's the way the world is going.

We have decided, for good or ill, that access to health care is going to be treated as a right, and that payment for access care is going to be compulsory. However, there are serious philosophical and practical complications in behaving that way. I'm going to leave the philosophical aspects out of it for now. My job is to help solve the practical implications of providing a limited resource to a theoretically unlimited cohort.

There are two basic approaches here that will help to achieve this: improve capacity, and reduce demand. These will generally work in concert, but not necessarily. Because human health is a complex system, there can be circumstances in which reducing demand in one area drastically increases demand in another. For example, if we were to cure cancer (all of it!) today, we would actually probably see a massive increase in demand for many services as people lived much longer and a far greater proportion of the population ended up needing, for example, heart transplants.

So, both approaches often cost a lot of money. But reducing demand can also be cost saving. Most of my work at the moment is in diabetes. If we could convince every obese or overweight American who does not yet have diabetes to lose 10 lbs, through diet and exercise, we would reduce incident diabetes dramatically. The result would be in far less demand for health services. Now, this might save a lot of money. Or it might just shift the cost burden to other health conditions that currently have long waiting lists due to current bottlenecks. Increasing capacity is generally thought of as building new hospitals and hiring more health care providers. This is certainly one way to increase capacity.

But there is another way to reduce demand implicitly, which has the effect of increasing capacity (when fewer people show up for service regularly, those unfilled appointments can be used for other things). One way to do this is through evidence-based performance measures. Currently, there are thousands of performance measures for hundreds of health care scenarios, which may or may not be grounded in any medical evidence.

My emergency department wants fewer than 10% of patients to spend greater than 6 hours in the ED, for example. And it is known that as ED wait time increases, so does morbidity and mortality. But what isn't known is how that performance measure is interrelated with the capacity of the system, and the incoming and outgoing streams of patients. Judging an ED by adherence to this measure is inappropriate, as length of stay is strongly influenced by behaviors over which and ED has no control (inpatient beds, radiology, laboratory, etc.). So what is needed is a hospital-wide measure, that takes into account the number of patients and how they are dispositioned.

Another performance measure is to have annual screenings for retinopathy for all patients with diabetes. Now, diabetes is an epidemic, and an accelerating epidemic. As time progresses, this will consume an enormous amount of ophthalmic resources. But some researchers(1) are calling for two year intervals for background retinopathy sufferers. This will likely not worsen sighted years lived, and will open up an enormous number of appointments for other types of ophthalmic patients. Thus, an evidence based policy can improve capacity.

So, what's the evidence? Well, we have some in retrospective studies, like the paper referenced.
What we don't know is, how are these decisions likely to impact the epidemiology going forward? Well, that's what I'm working on. Because in an environment of collectivised health care, there will not be enough to go around. It's a finite resource, and more people want some than there is to distribute. So our goal needs to be to distribute it as intelligently as possible. There are any number of ways to decide how to ration: the sickest get the most, the poorest get the most, the richest get the most, the ones most likely to benefit get the most, those with greatest need of preventive measures get the most, etc..

My goal is to say: before we begin ad hoc rationing, let's see if we can optimize delivery, so that we have efficient distribution. If there are areas in which people are consuming extra health care to no benefit to themselves, let's ration there first. If we can provide most people with what they actually need, adequately, then we can begin to provide more people with exceptional care. Because whether we like the idea of collectivised care, from a philosophical standpoint, or not, it isn't going to go away unless it collapses, and that will destroy care for everyone.

__________________
(1)Misra A, Bachmann MO, Greenwood RH, Jenkins C, Shaw A, Barakat O, Flatman M, Jones CD (2009), Trends in yield and effects of screening intervals during 17 years of a large UK community-based diabetic retinopathy screening programme. Diabet Med, 26, 1040-1047

Lifelong Sobriety.

2011-11-10T07:26:00.000-08:00

Many millions of alcoholics have come to AA, given up drinking, and stayed sober for their entire lives. Through success and failure, victory and defeat, sorrow and joy. Millions of people who, in prior centuries or in other places, would have been condemned to die alcoholic deaths. This is the legacy of AA. Many millions of other people, seeing the success of AA, have discovered that alcoholism need not be a death sentence, and have recovered in other programs or on their own. Through AA, or through reactions against AA, or simply by the knowledge that recovery is possible, which was first demonstrated in a serious way by AA, there are tens of millions of humans who led useful lives and died sober instead of drunk.

But lets not forget the other millions. The many more millions, I think, who have heard of recovery, who came to AA, or to other programs, and died drunk, or are out there drinking. Many simply darken the door, and decide that drinking is better than not. Or could not fathom a life without alcohol, and so they chose a death with it. But also, remember the many men and women, some of whom I know, who came, who sobered up, who worked hard and did all the right things, and drank again. We are alcoholics. We drink. It is what we do.

There is no magic formula for lifelong sobriety. Not even AA's steps. In the end, there is only a single, daily, hourly, minute-by-moment decision that we make, to drink, or not to drink. Last night, I went to my men's meeting and we talked about how few people there are with 6-12 years of sobriety. There are always a great many newcomers, and people like me with 1-5 years sober. And each meeting generally has a few 'oldtimers', with anywhere from 15-40 years sober. The younger guys turn over a lot. The older men tend to persist.

The steps get us right. A drunk, by the time that they are ready to sober up, is a toppled column. In Athens, at the Temple of Zeus, there is one such column. It shows how these columns were constructed of neatly fit disks of marble, and these now all lie in disarray. We are all made of pieces, and if we are alcoholic, we allow them all to fall to ruin. The steps in AA take these disks, and re-stack them, on on another, one after another. It's a slow process of righting what has fallen. Continuing our step work, the tenth, the eleventh, the twelfth, is the maintenance that keeps this foundation stable, the column strong.

But there are no guarantees. In AA meetings, we often fall prey to the No True Scotsman fallacy: that is, deciding afterwards that anyone who goes out an drinks again must not have been doing it right, not working hard enough. You can tell the quality of someone's sobriety by its length. Not everyone feels this way, and there is a lot of discussion of the 'dry drunk' as well, which is generally defined as someone who is not drinking but who is unhappy, and makes those around themselves unhappy as well.

But I've seen no evidence 'dry drunks' go out and drink more than others with what on the outside seems like higher quality sobriety. I'm not saying they do or they don't, just that I have no evidence either way. And the number of people with what appeared to me to be quality sobriety who have gone and drunk again is alarming. As is the number of people with seemingly quality sobriety who have killed themselves, or tried.

I think the truth is this: doing the steps in AA rights the column. Continuing to go to meetings tends to the foundation. Fellowship buttresses it. But earthquakes come. And there's little to predict what stands and what falls when the ground shudders. It's not better people who survive and worse people who perish. There is only us, the relationship to whatever higher power we have, the fellowship of the group, and whatever acid in our veins allows us to stand astride the boiling earth and swear, "Today I will not drink."

Because it is most assuredly not the strong who survive, the weak who drink. Personal fortitude is not the key to success. Having fallen, and been rebuilt, I am already broken. Brokenness is not weakness. It is because I have fallen that I have strength. Because I no longer hold myself up. I stand at the shoulders of others. And today, I will not drink.

Changes with the Seasons.

2011-11-09T11:05:00.000-08:00

I'm not going to be running all winter. I just don't really have it in me. Running served me well for the summer, and I'm glad I did it. I worked very hard, and I got in far, far improved shape. Arguably the best shape I've been in as an adult. But I'm not up for ploughing my way through slush and rain. So I've been thinking about a different way to stay physically active in the colder, inclement months.

I've settled, at least partly, on yoga. I've only been twice, but I've enjoyed it both times. It's challenging. While it's not aerobic, it does make me sweat, and I'm sore afterwards, though not severely. It requires balance and physical strength. The use of the small muscles, core muscles, to maintain posture and balance in precarious positions is undoubtedly effective at enhancing tone and promoting my primary goal of combating glucose intolerance.

I've begun to recover from the sadness associated with the BYP's abrupt decision not to continue our budding romance. I wish I knew more. I have this seeming need to excoriate myself over loss of romantic potential: what did I do? Where did it go wrong? How could I have prevented it? There's this painful sensation of cutting deep grooves into my self, as with a wood gouge, which is mortifying but purifying. Like an unanaesthetised surgery, a black cancer torn from a pink lung.

But life moves on and so do I. I have been conversing with new potential dates. Nothing has materialized yet, but I know something will soon enough. I retain hopes about meeting an interesting woman at yoga, but I don't want to show up with that intent. So I'm keeping to myself. In a few weeks, when I start to recognize people and they me, and I start to make friends, perhaps I'll meet someone worth asking out who's also interested in being asked out. We'll just have to wait and see. In the meantime, it's good exercise.

And it helps me to maintain my exercise regimen in another way; I obsess about things. I get into something, and I want to push at it for all it's worth, until I exhaust it. I did that with running recently. I'll run again, no question, but after going about 400 miles over the summer, I got a little burned out. Just like I had gotten burned out on doing calisthenics. So now I'll go yoga. I'll get excited about it, I'll go at it really hard and do a lot of it. And then, around the time winter cracks open and spring pushes its way out, I'll be ready for something new, different.

The seasons are important to me. I think they form a kind of rhythm that I haven't been attuned to closely enough in my mind. I want hearty fall foods, tubers and squashes and roots. And I want to settle in for the winter, and tend to my continued growth in a quieter way, less frenzy. More circumspect. When spring comes, I'll be ready to burst forward again.

The Need to Apply Labels, and the Malicious Use of Them.

2011-11-07T10:50:00.000-08:00

Currently, there are two fairly large, sort of grass roots political movements going on the the United States. The older of the two is called the Tea Party. It is a right wing movement, which began shortly after the election of President Obama, as a response to fears that the new Democratic Party majority would enact higher taxes and higher spending. It has since metastasized from that initial impulse into essentially the religious right wing of the GOP. In many ways, it was simply co-opted by people like Sarah Palin and Sean Hannity, who are fundamentalist "religious" conservatives. More about it in a moment.

The other big movement is younger, both in terms of its arrival and its membership. It is generally called the Occupy Wall Street movement, or just OWS. It is a generally left wing movement loosely -or un- organized around protesting the recent malfeasance in the banking industry, which has led to millions of people losing their homes and retirement plans while a few bankers have reaped enormous bonuses and salaries despite, or perhaps because of, gross misconduct. Additionally, the OWS crowd seems to try to highlight the adulterous relationship between large corporations and the federal government.

The punditry on the left and the right have not wasted any time in slapping pejoratives on members of the other camp's group. The Tea Party hadn't existed an hour, it seems, before it was labelled racist, and referred to as 'the tea bagger party'. As usual, people who did not want to confront the activists on the issues chose instead to make ad hominem attacks and insults designed to deflect attention from the political merit of the ideas. Of course, the narrow fiscal mission of the Tea Party was rapidly polluted with evangelical fundamentalism, and there's not really any political merit left there. It's just a mouthpiece for a political agenda based on a particular interpretation of the Bible which, like most interpretations of the Bible, doesn't stand up to any scrutiny, and is vicious and exclusionary.

The punditry on the right was quick to label the OWS crowd 'dirty hippies', 'free loaders', 'pot heads' and 'moochers'. Unable or unwilling to address the issue of corporate wrongdoing and the alarming and problematical widening of the gap between the very wealthy and the middle and working classes, much less the poor, these pundits engage in petty name calling and mockery to discredit any actual ideas that the OWS crowd has, or the legitimate anger they display in the context of class divisions. Of course, the OWS crowd is in the process of it's own takeover and co-option by the Marxist left. People like Michael Moore and Cornell West, faux-anti-capitalists who enrich themselves selling red-meat to the starving dogs.

None of this brings us any closer to solving our real problems. The charlatanism of the left regarding the lack of civil discourse around the Rep. Giffords shootings has been proved just that: cynical rhetoric attempting to capitalize on an assassination attempt to score political points. The right, meanwhile, never paused in its use of violent, hateful rhetoric. Both sides sling accusations and vitriol without regard to the truth.

Are there racists in the Tea Party? Of course! But the movement, as it began, was an attempt and bringing about fiscal discipline, and I saw no evidence then of racism. Since it has been hijacked, I think there has been more. Are there hipster pot-head freeloaders in OWS? Of course! But the movement, as it began, was about a spasm of rage in the face of manifest unfairness. Not mere unfairness that we all have to deal with in life, but criminal unfairness, that threatens to derail our economic system in order that a few might gild their lilies.

Both movements have something right, and something wrong. The Tea Party is right that the government must cut its spending and balance its budgets. And that to do so, major cuts in entitlements need to be made. The OWS movement is right that there is a foul and toxic cancer in the head of the banking industry, and that it is protected by a criminally complicit class of politicians. The Tea Party is wrong that the budget crisis can be solved without tax increases. The cuts that would have to be made to balance the budget without them would hamstring our country for a generation. The OWS movement is wrong that corporations, and corporatism, are evils that need to be dismantled, and that the profit motive is inimical to fairness.

I suspect that the truth is: the system is broken, and we need to let large segments of it fail. This will cause an enormous amount of human misery. But less than constantly rolling the problems uphill: bailing out failing banks with more borrowed money. Paying more and more and more people not to work. Cutting already historically low federal taxes on people who earn unfathomable amounts of money. These 'solutions' lead inexorably to a total failure of government, like we see now on the horizon all across southern Europe. And that will cause human misery on a whole different scale than letting Merril Lynch collapse.

Into Action.

2011-11-07T05:39:00.000-08:00

Friday night I decided to pick up an extra meeting. I was feeling low and isolated, and wanted to get out of my own head. I also, of course, would like to find someone to date. And so I put both those eggs in the basket and went to the "Into Action" meeting. This is affectionately called "get some action" by a number of AAs here in St. Louis. I had never been, but I have a friend who goes, and she seems cool. She's got a month and a half more sobriety than I do, and so being in the same 'cohort', I feel a sort of small connection to her. But neither of us is attracted to the other, don't think this story is going that direction.

So I put on a decent outfit and showed up to the 90 minute meeting. It was a little more like church than I care for. But I saw immediately why it's considered a meat market. A lot of younger people, men outnumbering women about 3-2, were dressed up and had showed up a good half-hour early, by my estimation (I showed up about 15 minutes early, and the place was already packed.).

But I felt out of place and awkward. Even after my friend showed up and said "hi", I didn't feel like I belonged there. The place had, forgive me, a bit of a trashy feel. Redneck-y. There were a lot of faded blue jeans and spackled-on eyeshadows. Even the first speaker, a comely young woman proud to have finished, in sobriety, a master's degree in meteorology, gave off an air like someone whose highest aspiration was to pledge Kappa Kappa Gamma. Obviously, that assessment says far more about me than it does about her. I was clearly not in the right place, either emotionally or location-wise.

Saturday I went to my walking meeting, and then I went to a meeting in the evening over near Wash U, imagining that I might find a more overtly intellectual crowd. But I didn't. In fact, I ran into a woman I'd been sort of vaguely avoiding. She's about 60, and has a weird crush on me, and hugs me, or sneaks up and tickles me, even though I've explicitly told her I don't want her to. She always says things like: "It's too bad you're too young for me, [AnyEdge]!" If the genders were reversed, her behavior would widely be seen as a crime. As it is, it's an annoyance, and I don't feel the need to do anything serious about it. I don't feel threatened, or anything. Just unnerved. I went out for tapas after with a friend.

Sunday I went to my meeting. I clearly needed a lot of meetings this week. I am still torn apart over the BYP. I never did get any explanation other than 'chemistry'. But I never really asked for one either. And it's too late now. For such a short thing, I had an enormous amount of hope. It felt like it was going to happen. Oh well. What a life. I actually did make a date with a new woman for this weekend, but I cancelled it. I just don't feel up to putting that face on again yet.

I feel like I want to do more yoga. I want to get stronger and more limber and generally healthier still. The running has been good for me, but I'm going to do less in the winter. I'm babbling. There is work to be done. Have a good week out there, blogland.

Mixed Motivations.

2011-11-03T10:46:00.000-07:00

So last night I tried a basics yoga class. I have two fundamental goals here. First, I want to find an excersize program that I can adopt through the winter. Running has dropped precipitously lately. October was a bad month for me running-wise, as I had many peculiar obligations involving being out of town or hosting my mother, and the weather was slightly less clement, and I allowed all those things to become excuses not to run. As a result, I think I only ran about 30 miles the whole month.

My fitness goals are going reasonably well though, I am down to 187 lbs, which is freaking amazing, and I look pretty good in the mirror, all things considered. I still obviously have a decent amount of weight to lose, but I'm feeling good about the direction I'm heading. It was around this time last year that I started doing anything at all. And since then, I've lost very nearly 50 lbs. Slow, steady, relentless work.

My second goal, of course, is to meet a pretty girl in a leotard. But I'm not going to be that guy. You know that guy. The guy who goes in and throws a predatory gaze around the room and makes some poor girl uncomfortable by staring at her breasts the whole hour. That guy generally just needs an elbow to the jaw. Sadly, that guy also tends to get all the girls. Don't know why. It is really surprising the number of women, who in all other respects seem perfectly sane and well-adjusted, date men who treat them like meat or chattel.

There were a number of attractive women in the class, but all sporting giant glittering rings. I generally minded my own business, and was able to perform all of the moves. It was much harder than I expected. I had selected a class marked 'basics'. I found out afterwards that 'basic' is not yoga for 'beginner'. But the instructor told me I did well, and I spent $30 to be allowed to go as much as I like for a month. We'll see how it goes.

I think I'm also going to go to a new AA meeting tonight. It has a reputation as a singles hangout. I've never dated anyone in the program, but I've got nothing against it. And it might be good for me to meet someone who is also committed to introspection, improvement, and honesty. Not that I feel like I've met shallow, duplicitous women, far from it. But the program is a particular way of doing those things that I'm aware of and comfortable with.

I need to strike out in a new way. Shuffle up my schedule and see how the world is outside the bounds that I'm currently comfortable with.

Geographic.

2011-11-01T08:49:00.000-07:00

As I often do when I'm feeling down or out of sorts, I find myself dreaming of foreign shores. Where should I go for a winter vacation? I suppose I could put India on my list, but I don't know if I should take 2 weeks to do it. Best bet is to stick to Europe at the furthest, Carribbean or Central America if I want to stay closer.

It may be time to go to Italy. It's been a long time that I've been a world traveler and not been there. I want to see the Vatican and the ancient places in Rome. I'd love to see the Amalfi coast or Sicily. Once again to fly into a foreign city and then ride rail through a strange land.

So I'm taking a poll. Where should I go? High on my list is Italy, of course, but also Sofia, Zagreb, or Costa Rica. I figure that in a week I could see quite a lot again if I went to south-central Europe. But it would also be lovely to spend a whole week in Rome and its environs.

Let me know.

38 Hours Perspective.

2011-10-31T05:47:00.001-07:00

It hurts. Obviously, I'll be fine. But it hurts. I think I was spoiled by my last several date-seeking experiences. Back in 2003 or so I went online, and I met a lovely young woman, a teacher, and we dated for two years. It wasn't always wonderful. But we parted amicably. I've completely lost touch with her now, but I hope she's well.

After that, I waited a while, and then I went online again. I had a bad date. Then I had a good one. That second date I ended up marrying, for three and a half years of tumult and trial. We had wonderful times and terrible ones. I got sober. I quit smoking. Becoming healthy destroyed my marriage; ex wasn't interested in validity from a spouse.

And then, after that, I had a fling almost immediately. I was sad the whole time. It didn't work out when she wanted to get serious and I wasn't ready because I was still married. I waited many months prior to dating again. I worked. I learned to meditate. I went to a lot of AA meetings.

When I started dating again, I've had deeply mixed success. A couple of women who have liked me, but that I couldn't find a way to feel romantically attached to. A couple of women I've been attracted to and really excited about, but who have ended up not attracted to me.

I'm starting to feel unlovable. I knew it was over with the BYP when she told me last Tuesday: "You're the most amazing person I've ever met." I've heard that before. It's always prelude to rejection. I get that I can be intimidating sometimes: I'm smart and I have a lot of talents; I tend to be pretty good at anything I try that isn't sports or involve tools. It drove my ex crazy.

But I'm not handsome, and I'm a little graceless socially. I frequently put my foot in my mouth. I don't hear well, so I often talk too loud. I'm feeling pretty useless, when it comes to women. I'm not giving up, of course. I have a lot to offer, I know. But at the moment, I feel like I'm too much and not enough, at the same time.

The Atheist in AA.

2011-10-30T10:36:00.000-07:00

Today in my Sunday morning meeting, our speaker was an atheist. There aren't a lot of atheists in AA, but there are some, and in some other cities there are whole atheist meetings and groups. The steps talk a lot about god, and so do AA members. I can completely understand how an atheist who is struggling with alcohol might feel like AA isn't the place for them. And I'll freely admit: it might not be. AA doesn't work for everyone.

But there are plenty of atheists who use the AA program to get sober, who are members in good standing of AA, and their personal spiritual choices are as fully accepted as anyone else's. In the beginning, it would not be surprising to hear an oldtimer tell a young struggling atheist that they needed god. And I can imagine that that might turn many off. But the truth is, most alcoholics are looking for reasons to be turned off to recovery: we like to keep drinking. A religious drinker is just as likely to find a reason not to go as an atheist. I'd bet fear of steps 5 and 9 has killed a lot more alcoholics than recalcitrance to some god.

But god is good, in AA, for what god is good for. The real problem so many alcoholics have, which prevents recovery, is ego. Self. Deflating that, and recognizing larger things and more important things than personal indulgence, is crucial to recovery. So long as we are the most important thing to ourselves (and self-hatred is as much a function of self importance as grandiosity), we generally cannot recover. God is a useful thing to put above us, more important, larger.

But the atheist who spoke today had a different construct, and here I'm probably bringing myself to his talk too, than I've heard before from atheists in AA. First of all, he had nothing against religion, he just didn't believe in it. He even gave his fifth step to a priest. He was uninterested in convincing anyone else of his position. That's true of most AA's. You don't hear proselytising of any sort. He didn't talk about a higher power concept. But he did talk about the power of honesty.

This goes a bit to some things that Infactorium's resident atheist, LawnBoy, has said to me too. He has said: "I want to believe in as many true things as possible, and no false ones." (paraphrase - feel free to correct me, LawnBoy). Now, LawnBoy and I may have slightly different perspectives on the meaning of 'truth', but that idea fits very well into the philosophy of AA.

So, here's my idea: why can't honesty, or truth, be the higher power? It's certainly bigger and higher in any metaphysical sense than any of us. We aspire to honesty in AA, as I aspire to truth in science. Find things that are true, and espouse them. Being of service to truth, or to honesty, seems like a perfectly valid construct. There may be some nebulous perfect 'truth' out there, but none of us will ever know precisely what it is. It's a powerful and wonderful thing to be honest, to learn things that are true, and to be a part of honest and true things.

My higher power is, as I've written, nothing like a bearded pater familias. I remember my second AA meeting ever, saying, "I'm so tired of lying.". I suspect one could shepherd an atheist through the steps quite easily using truth and honesty as the higher power.

Ending before the Beginning.

2011-10-29T14:26:00.000-07:00

The BYP decided that there's not the right sort of chemistry for her. Another deep sadness and wrenching excavation of the heart. Like an evisceration that goes a bit wrong, intestines snagged, and they must be regripped and forcibly extracted. Tearing. Blood and offal.

I suppose it can't be helped. Such is the way of things.

At least the baseball went the right way.

Official Capacity.

2011-10-27T07:10:00.000-07:00

Today is my third official function as a member of the SLU faculty. Of course, I remain not a member of the SLU faculty. I have no email address, no badge, no contract, and no paycheck. But I go to the faculty meetings anyhow, and participate. The BYP tells me that for her, the unspoken rule is that junior faculty don't speak in the meetings. For me, it's the exact opposite, I'm expected to participate voluminously and with erudition. That's most likely due to the fact that my field is orthogonal to the thinking processes of most of my new colleagues, so we're working out how to collaborate.

I am really excited to be a faculty member. I just wish it were happening a bit faster. I wish everything were happening a bit faster. I wish I were faculty. I wish the BYP were ready for a serious relationship. I wish I were 15 lbs lighter already. I wish that Am. J. Med. Qual. had published my paper. I wish. I wish.

None of that kind of basic dissatisfaction with my current life and situation is good for me or for my sobriety. It screams of living forward in my head, looking too far into the future, to much about what is coming and not about what is right here. I am selected to join the faculty of a major and prestigious university. I am dating a lovely and talented young woman. I am exercising (though a lot less these last three weeks), and losing weight. I am healthy and happy. I am writing music and advancing work projects. My life is going objectively well.

I went to my men's meeting last night. I needed it and it was good to be there. As I said, I'd missed it three weeks in a row. Not one person called me. They said that they talked about me being missing while I was gone. I had left a message with one member the first time I missed it, but not the last two. I was told that no one called because no one imagined there was anything wrong. And there wasn't. But it would be nice if anyone had checked.

But that's injecting stupid drama into something that doesn't need it. I'm well. I can reach out when and if I need it, and I do. I'm just looking forward to a time of less flux. Meanwhile, to day, in this moment, I have a lot to be grateful for.

A Long Absence.

2011-10-26T05:46:00.000-07:00

I haven't been to my men's meeting for a month. I missed three straight weeks, with baseball, mom, and baseball respectively. And with other travel, I've missed a few other meetings. I did go to one in Providence, of course, but over all, I've not been getting to as many as I feel like I need to for myself. I'm looking forward to seeing the guys, and going to a real-world, honest meeting of men who are working on recovery in a way that really works.

Last night I had a lovely time with the BYP, I made a sage and mushroom risotto, and grilled asparagus, and little appetisers of a whole wheat baguette, basil leaves, and mozarella, rubbed with a crushed sage-garlic mixture and done in the oven for 5 minutes. And I played piano. It was lovely. We are taking this flirtation very slowly. And I'm quite happy to do so.

It was a strange thing, when shopping for dinner supplies, to buy wine. I've done it twice or three times now since I've been sober. Gifts, party supplies, etc.. And of course, the BYP drinks about a half a glass. After she left, I poured the rest of the bottle down the sink. I could probably leave it in the house. I know plenty of alcoholics who have alcohol at home. My sponsor has a fully stocked wet bar. He's been sober for 18 years. His wife is normal, and they have parties where they serve alcohol. It doesn't bother him.

For me, it's been three years and eight months. That's a long time, and it's no time at all. I'm not ready to keep booze in the house, even if I had reason to, which I don't. The BYP suggested freezing the wine so that it could be used for cooking, but I told her I preferred to just dump it out. One day, sure, keeping wine in the house will be fine. If I had a wife who drinks, whatever. But for now, for me, there's neither reason nor wisdom in it.

Over all, things are good. There are clouds with light and dark leading edges both, and I never know which is going to make it here first. At the moment, the better weather seems to be holding ground.

Back to Work.

2011-10-25T06:51:00.000-07:00

Well, I'm back into my job and realizing that I still haven't done anything, really, on my grant that is funded. I have a year, that's all, and I need to get moving. But I don't have a data abstracter, so I need to do it myself. So I need to get moving. It's dull, tedious work. But I'm not "above" it. It's my study. My ideas. I need to go through it. I don't just get to do the sexy parts.

I know I'm talking too much and too stupidly about the BYP, but I am infatuated. She's beyond darling. Sweet. Brilliant. She's coming over tonight and we're cooking and I'll play the piano for her for the first time and we'll probably kiss on the sofa for a while. Which is really all I can ask for from the world right now. The turbulent hours spent wrestling out the wringings of the heart (thanks, Aimee!), it's all so present and painful and thrilling and killing and bursting with strange, sick joy.

Yesterday, the BYP and I had only the briefest of text message exchanges as our entire communication for the day. We had been talking on the phone for half an hour to an hour before bed each night. But when I called, she didn't pick up. I went to bed afraid and sad. I was terrified that she had decided that she didn't want to see anymore and would inform me at some later time that she wasn't coming over tonight. Nightmares gurgled to the surface of my mind.

And of course, as usual, it was nothing. She had gone to bed early, after working hard all evening. Pretty standard stuff for an assistant professor. She texted me this morning that she had a horribly dull day planned, followed by a dramatic improvement in outlook; my heart did a couple of somersaults.

I did get to a meeting in Providence. I needed one. I felt very out of sorts Sunday afternoon. Just sort of beside myself, mixed up. I found a meeting in a church basement about a mile from my friend's house. I walked there, went to the meeting, and walked back. It was a fine meeting, but in Rhode Island, it seems like the standard time for sharing in a meeting is about 5 minutes each, which is too long for me. I think it's too long for most other people too. There was a lot of repeating and blather. Here in St. Louis, people seem to rarely share longer than about 2 minutes or 3. Which feels better to me.

But whatever. It's no big deal. I felt better after the meeting. I always do. Now, I have a bunch more work to do. Got to resubmit that damnable paper again. Got to do some actual work on my funded project. Have a grant to write. And a dragon-lady at work to pacify. And. And. And.

And a lovely dinner with a wonderful, brilliant, exciting, funny, sincere, young woman tonight.

Returning from Providence.

2011-10-24T13:49:00.001-07:00

I'll be home any old minute after a long and productive weekend working on my Rhode Island Hospital project. Tired, ready for a lot of sleep. I see the BYP tomorrow evening. I last saw her a week ago and I'm heartsick for her. But we've spoken everyday. And now I'm just looking forward to nice night tonight and lovely time tomorrow.

Home again soon.

Bye the Bye on Qaddafi.

2011-10-22T12:26:00.001-07:00

I have absolutely no problem if he had been captured and was just shot. War is war, Libya is (was?) in a state of civil war, and Qaddafi was, after all, the leader of the former regime's armed forces. Trials of military commanders is, in my opinion, inappropriate. The civilian leaders, if there are any, sure. But the military is an engine.

Just as soldiers are not murderers for killing the enemy in wartime, so neither is the death of a soldier a matter for courts and forensics. Wartime is when civil laws are suspended while matters which canot be peaceably resolved are settled in battle. Qaddafi was a belligerant. Civil courts are just that: civil. War is uncivil. When the chief of one belligerant in a battle is captured, it would, in fact be ideal of course to capture them, dismantle their apparatus of combat, and then set them free, as a professional soldier. After all, with no more regime to support, a professional soldier is no danger to anyone.

But it is naive to presume that a chief of battle is only a professional soldier. And as war is meant to solve conflicts, killing such men solves one. It is not wrong to kill in war, except insofar as the concept of war is always an atrocity. Killing Qaddafi is not more wrong than trying him. Not while in a state of open warfare. Not even if capture and trial were an option. After all, if it is wrong to kill soldiers that there is the opportunity to capture, then all stealth is a violation. War need not be contested in trenches on open fields to be contested.

And fighting 'fair' is the last thing any army wants to, or should be forced to, do. Demanding that a fight be fair only whittles every army down through attrition. War isn't meant to be fair. It is meant to solve intolerable dissonances through force of arms which cannot be solved by negotiation. Courts are for justice. War is not just. It is only final.

Expanding the Model.

2011-10-22T12:10:00.001-07:00

So I'm now launching into a funded project with Brown University and Rhode Island Hospital. It's a gigantic simulation of the emergency department there, and they're paying me well to build it. I already designed a triage process simulation, which I've discussed at length here, and now we're building the full scale jobber to match it. I believe, based on the literature, that no one, anywhere, has done a simulation of this size and rigor. Conveying that when we publish will be complicated. There is a massive lack of rigor in this field, and it's dismaying.

I've spent the morning and afternoon laying out the tedious infrastructure of the model, six hours squinting at the screen of my laptop, carefully laying out colored dots to indicate where exam rooms are, how people move from place to place, how many nurses and physicians and residents and midlevel providers and xray technicians, etc.. And I still haven't incorporated the psyche-facility. It's an enormous project.

I'm exhausted and confused now. And I'm tired.

I've been talking daily with the BYP, and texting. I'm totally enraptured. My heart is sick from missing her. It's Saturday. I'll see her Tuesday. I saw her Monday. I have this horrible fear that she is going to decide that she doesn't want to see me anymore, even though all my evidence suggests that she is very much excited to be dating me. Such excitement, riddled through with the horror of imagined loss.

But work is good. Romance is promising if tormenting. And on goes the carousel.

A World Series Morning.

2011-10-19T06:48:00.001-07:00

Last night, I finished watching the BBC special "Planet Earth" on blu-ray. I've never seen anything so amazing in all my life. It's about 8 hours long, probably, and filled with the most stunning and incredible images I've ever seen on screen. Many horrifying beyond comprehension, like a great white shark in ultra-slow-motion leaping out of the surf with a seal in its jaws, becoming fully airborne and more than two body-lengths emerged from the sea, curled into a check-mark of malevolence.

Like those seals, clumsily pursuing an even clumsier penguin across the rock beach of South Africa, a grim struggle across a terrain for which predator and prey are similarly maladapted, the seal seeking food, the penguin desperately trying to deliver its own belly full of food to its young. The seal is a lurching monster to the penguin, but can only attack from behind. The penguins have discovered that fish-spear beaks can also skewer seals' eyes.

Like the arctic wolf, systematically separating a calf from its herd of caribou, and running it down, ruthlessly, for miles, until it drops from exhaustion and succumbs to the howling fang in the permafrost wasteland. There is no rest for anything in nature; the system is hungry. The food chain is a vortex of violence, implacable need, and desperate obligation. Every beast, without exception, is fodder for another, whether by predation or scavenge. And Kingdom Plantae is no innocent victim or bystander.

Up next is the follow up documentary "Life". I got the original BBC version with David Attenborough narrating, not the American version with Oprah. No disrespect to her, but she's not an actor, and narration isn't child's play. I heard her version and I disliked it. Attenborough is a flawless professional.

Tonight I go to the World Series game 1. I have standing room only tickets, which are sub-ideal, but they get me in the stadium. I've never had SRO before. Maybe I'll hate it. We'll see. It's exciting to have tickets to the World Series again. This means that I'll have been to one game each of the three times the Cardinals have won the pennant. I've seen a Game 3 loss, a Game 4 win, and soon a Game 1 something. It's very exciting, even if it means standing in the cold drizzle for four hours.

I am starting to feel less terrified and more justified in my hope about the BYP. I don't get to see her for a week, and we're not using official appellations of relationship status yet, and probably won't be for a month or so. We're going very slowly. Which is good. But it hurts my heart. But we were talking on the phone last night, and I mentioned sending her a postcard from my trip this weekend, and she asked if we'd be talking while I was gone, with a real urgency in her voice, like the prospect of not talking was worrisome and unhappy.

So I am truly and deeply smitten, and she seems to be as well. She gives every indication of being very excited to be with me. She's a very straightforward person. That means she says what she feels, and she doesn't say things she doesn't mean. But she's not blunt. Just, guileless. And she's full of exciting ideas and thrilling ambition. And, like me, she's been forced to become accustomed to a lover treating her badly. So we're slowly extricating ourselves from toxic modalities of the past and building a new thing, a bit like a cottage yet on spindled legs, but we are, both of us, laboring at the foundation.

The vortex churns on. I am flotsam at the margins.

A Quick Reality Check.

2011-10-18T06:15:00.000-07:00

My paper was rejected. This is the 4th rejection for a very good result (the reviewers support this statement) which can mean only one thing: it's not written well. At all. Despite revision and more effort than is reasonable for a short paper on discrete event simulation. BAH!

So, I'm no Midas. I have to buckle my sleeves to the grindstone, or whatever, and work harder. I'm not a bad writer. This paper is just vexing the hell out of me. I'm not trying to get it into a top flight journal. Just a nice, simple journal about quality or emergency medicine. Nothing fancy.

I went over to the BYP's place yesterday evening and made dinner for her. I made a baby spinach and pear salad with pine nuts and blue cheese, and a vinaigrette dressing, and a polenta crust pizza with tomatoes, wild mushrooms, and Parmesan. She said: "I haven't had a boy cook me food with vegetables in the longest time!" It was good, and we had a lovely time. After dinner, we just sat on the sofa and talked for about 4 hours.

I don't get to see her again for a whole week. She's super busy with her work this week, faculty meetings and showing a visiting super-star around town. She'd be available over the weekend, but I'll be in Providence, working with goldlust on the ED project there. But we are slowly but surely advancing in our romantic dedication. It's a slow process, but one which I am comfortable with being slow. I don't want to speed through this, burn it up and watch it flame out. I am crazy about this girl.

So: I think I've given the polenta pizza crust recipe before. If not, too bad. Here's the salad:

One mixing bowl full of baby spinach leaves, washed and dried.
One Bosc Pear.
Two oz aged blue cheese, not too soft, so that it will crumble.
One light handful of pine nuts.
One bottle expensive vinaigrette dressing, preferably raspberry.

Heat a pan over medium heat until hot. Toss the pine nuts in the pan, alone, and toast them until some of the pine nuts have one dark brown side, just shy of blistering. If you blister them, throw them away and start over.

Allow the pine nuts to cool. Add to mixing bowl full of spinach. Slice pear, add to bowl. Crumble blue cheese over salad. dress VERY lightly with dressing, toss, serve.

Please note that this salad is WAY better if served to a brilliant young professor on whom you have a heart stopping crush.

A Lovely Weekend.

2011-10-17T06:02:00.000-07:00

Things are coming up roses for me these days. I couldn't begin to tell you why it seems like so much is happening at the same time that's good, but it is. Work is, of course, fabulous. I discovered some cool rules about my institution and how it deals with joint university appointments, and as a result I am going to be getting a much larger raise that I had thought. The only downside is that I also have to cover more % effort with grants. But I'm doing alright on that for now, and have a bunch more stuff going in.

Speaking of which, my grants are away to the NIH and AHRQ. It was more complicated and more difficult than I thought, as this was a new process for me, dealing with inter-institutional subcontracting agreements. But it got done. If both hit, that's 35% of my time and effort for two years. If either hits, it's a massive feather and the opportunity to demonstrate that I am an effective researcher and grants-manager.

Speaking of which, I need to get to work on my own grant, because I have done precious little, and it started almost three weeks ago. I am daunted by the amount of work I have to do, and I want to make a good showing of it all. I didn't budget nearly enough time for data abstraction, and because of arcane rules regarding payment, I don't have a data abstracter even to get started. It's very frustrating. My research office is going through major revisions. But I believe we'll come out stronger on the other side. But even my boss told me that he expects me to go to SLU full time eventually. He said he just wants me to stay here for 5 more years.

I went out with the BYP again on Saturday. We went to a fundraiser trivia contest and she met my sponsor. We had a lovely time. We were supposed to go out last night, but she fell ill with a severe headache. Of course, I immediately start thinking that that means that she doesn't want to see me, doesn't like me, thinks things are going too fast, something like that. But we spoke on the phone for a half-hour later in the evening, and she reiterated that she is looking forward to having dinner with me tonight. I think we'll cook.

My mother's visit last week was pleasant and enjoyable. She came to my talk for the speaker series at SLU, which I hadn't really wanted. It felt a bit too much like the mixing of domains. Worlds colliding and all that Seinfeld crap. I told her ahead of time that she could only come if she promised not to ask any questions during the Q&A after the talk. She promised, and she kept her word. It was a good talk, all things considered. I stumbled a bit at the beginning, but found my stride and ended up talking for a good 40 minutes, and had questions for another 10. Right about perfect timing. I got good feedback afterwards, though not voluminous, from the faculty in my new department.

Coinciding with my mother's visit, and my newfound romantic relationship, I took almost the entire week off from running. I think I got in about 6 miles of walking and 4 miles of running last week. But yesterday I did 10K, and I felt good about it. I ran the whole first 5K without stopping, the third time I've done that. So I now can say that I can run for a whole half an hour without stopping. That's incredible to me. Since the last week of June, I have traversed 362 miles, the vast majority of it on runs. And that doesn't count all the walking I did in Scandinavia. This morning, I weighed only 189 lbs.

Now, at 189 lbs, my BMI is 27.1. I still have at least 15 lbs to lose to be normal weight. And I can see it. In fact, I'm occasionally disheartened by the way I look still. I'd hoped I would have a better shape already, at this weight. But I have a persistent spare tire, which, if anything, becomes more prominent as I lose weight elsewhere. My shoulders and neck and waist have slimmed down, and I am decidedly more toned. But still I have a belly and love-handles (Where did that term originate? It's repugnant.).

So: I have a burgeoning career. A fresh new romance. A lengthening sobriety. A family that loves me. I don't know what I can complain about. But don't worry. I'm sure I'll think of something.

The Cardinals Win the Pennant!!

2011-10-16T20:45:00.000-07:00

That is all.

The Long Difficult, Wonderful Week.

2011-10-14T06:18:00.000-07:00

Neither of my grants are actually away yet. I'm waiting for subcontract LOI's from a university to finish them. They need to go out today, or I'm in serious trouble. There's nothing I can do right now. I've done everything that can be done. I'm waiting for other people to do their jobs. People I've called, emailed, cajoled, begged and threatened (ok, not threatened.). But these are professional university people. They know how to get things done. I'm reasonably sure it'll be ok. Maybe.

My mother's visit was very nice. She was here for essentially two days and two nights. We did a lot of schmoozing at Wash U. It was really pleasant. I made friends with the Dean there. I saw a cool lecture and had a couple of truly fine dinners. I haven't run in nearly a week and I feel lazy and lethargic. I need to get back on it. I'll do a short run today, and a long one tomorrow.

And now, to the truly wonderful part of the week. [Cue choir of angels] I am beginning a romantic relationship. That's the term we're using. Boyfriend/girlfriend doesn't feel right, so we're not using it. We're initiating it all at a glacial pace, but we are very, very enamoured of one another, and very very happy about it.

Life is good, but frustrating with regard to grants today.

UPDATE: NIH is away. AHRQ pending. Soul filling with dread and grey bile.

Wonderful Feelings, Terrible Dreams.

2011-10-13T05:51:00.001-07:00

I'm feeling better than I have in centuries. I am doing marvellously from a professional perspective. I discovered that because of the nature of the relationship between the various institutions that I am working with, I will actually be making a good deal bit more money next year than last. I thought I'd be getting a raise. In fact, I'll be getting a whopping raise. It whops. You can hear it in the next county.

My nascent relationship with The BYP is flourishing. We're going out tonight. We had a lovely, long, talk on the phone last night, keeping me up too late. She's thrilling and enthralling. Both of our working lives flirt with the periphery of epidemiology, so we have a lot to talk about there. Plus she travels a lot to do field work, and loves to travel, and so we have a lot to share there as well. We have long easy conversations. I'm excited and sick and happy and I'm almost certain there are long, intemperate worms writhing about my gut.

Now, I'm an alcoholic, so I'm good at screwing things up for myself. But I'm also in recovery, and working diligently at that, so I have portcullises and bulwarks cast against those older impulses. Last night I dreamt that I had decided to go out and get drunk, just once. I knew it was stupid, I knew it was dangerous, but I was going to go ahead and get a little drunk because I hadn't in a long time and I really wanted to.

At least my dreams are realistic to the condition: I just decided to do the wrong thing. That's how alcoholism is. When a person in recovery goes back out, it is because the choose, consciously, to do so. And in the dream, I chose to buy two 1.75 liter bottles of wine to drink. I thought that that would get me a little drunk. Well, I wasn't planning on drinking all of it. Just the whole red wine bottle (two normal sized bottles of wine), and part of the white.

Mom was there, and furious and sad and just astonished. I "knew" I'd be fine the next day, but I was drunk. It was, over all, a horrible dream. I was trying to explain, in slurred speech, that I wasn't too terribly drunk, I wasn't falling down or unable to communicate.

The horror of drunk dreams is real and powerful and horrible. The shame and terror of thinking I've drunk and destroyed everything I've worked for is a compelling force in my staying sober. I'm thankful for nightmares. When everything in my life is so manifestly wonderful, new and ripe and polished to mirror-shine, I could ruin it all in a sip. I'm not afraid. But I am cautious and circumspect. Because without my sobriety, I have nothing worth having. Whereas with it, I can do anything.

A Brief Baseball and Dating Update.

2011-10-12T09:37:00.000-07:00

The Cardinals are in the National League Championship Series. LawnBoy and LawnWife (who may be the bigger fan), have generously provided access to tickets to Game 4 of the NLDS (WE WON!) and to the upcoming Game 5 of the NLCS (I HOPE WE WIN!). Albert Pujols had 4 extra base hits in the game on Monday, something that has only happened twice or three times before in baseball history (postseason, of course). I think we have a legitimate shot at the pennant.

I've missed watching the last two post season wins for the Cardinals because I've been out with The BYP. I'm hoping that that continues to flourish. She likes me. I like her. We're going out for the fourth time tomorrow. We text and talk on the phone and email daily. I'm terrified that she'll decide, like the last girl I was into, that she suddenly doesn't like me. Or at least not enough to continue dating. I don't know. It's scary.

Life is good. Life is fluxatious. Fluxatious is probably not a word.

The Great Baffle.

2011-10-11T11:58:00.000-07:00

So many things are going on. I think I have the NIH grant out the door. The AHRQ grant is going to make it too. I think. That'll be two R21's representing 35% of my effort for two years. If I get them. Which, realistically, I won't. There's probably, if we did everything right, about a 25% chance I get either. So if that's true, then there's a roughly 44% chance that I get at least one, and a 56% chance that I get neither, and only a 6% chance I get both. Such is the way of grant efforts.

Both of these will be run through SLU, where I am not even technically employed by them yet. But I got letters of support from my soon-to-be-boss stating that he anticipates a start date of 1 November. Which is awesome, but I believe too optimistic still. I love the way SLU manages grants though, with manageable F&A from which they create a small investigator slush fund that can be used for travel or other minor expenses. I don't know how big it is (not big... something like 2% of indirects.), but it's enough to make tech support costs or travel possible without begging the department for money.

Also, today at 1600, my mother comes into town for two days. She'll be staying with me, and doing some charitable work with Wash U. Tonight we're having dinner with the dean and his wife. Tomorrow I go to some lecture. But I'm looking forward to spending time with mom. I don't see her nearly enough. I feel better about my family visitation though, lately. I've seen every member of my immediate family within the last 2 months. And in the last year, several more than once. That's better.

And I'm sort of seeing a lovely young woman (The BYP). She's brilliant. Seriously, frighteningly, intimidatingly brilliant. She's a physical anthropologist, and a new assistant professor. She's gorgeous, she's sweet, she's funny. And she likes me. We've only been on three dates, and we're taking it slowly, but each of them have lasted four or more hours, and we've walked around and talked and enjoyed each other's company and every time I get a text or an email from her my heart unravels like a ball of string thrown from a mountaintop.

So all is well. I'm exhausted, excited, and moving forward with life. I am the rag doll in the jaws of the beast no more.

Flurry of Granting.

2011-10-07T07:17:00.000-07:00

So, I have to R21 applications going in next week (I think the drop dead date is 15 October.). An R21 is a midsized grant (2 years, and about $275,000 or $300,000 dollars, depending on the agency.). The good thing about an R21 is that you don't need to be a hero to qualify for it. The bad thing is that it only lasts 2 years, so it doesn't even really give you a break from submitting new grants, the way an R01 can for a year or two, if you have enough effort on it.

But I have to complain about AHRQ. AHRQ is a major federal agency, modeled after the NIH, but focused on healthcare research quality. It's right there in the name: Agency for Healthcare Research Quality. It's a good place for me, really, because my work is generally focused on process improvement, analysis of how to improve and implement delivery systems. Here's the problem with AHRQ: their funding levels look good, but they aren't.

Ok, so, every foundation or university or institution has what are called 'indirect costs'. These are the costs of keeping the roof from leaking, the lights on, and the grants manager employed. My institution has extremely low F&A (as it's called: Facilities and Administration.). I can run a grant for 17% indirects. That means that whatever the budget is, you multiply it by 1.17 and then give everything over the budget to the institution for indirect costs. That's absurdly low. No one in academia has indirects like that.

For comparison, the indirects at SLU for the department I'll be joining are 50%. WU med school indirects are 55%. And the institution I'm submitting the AHRQ grant with charges 59% indirects. Now, over at the NIH, this is handled thusly: they publish the grant budgets that are allowed for direct costs, and then your institution tacks on its overheard, and the investigators never even really need to know what it is. Not so at AHRQ. They publish an R21 budget of $300,000. But that has to include the F&A. Now, if I were running it here, that would be a pain, but ok.

But I'm not the PI. I'm just a Co-I/Site PI. So we're losing 59% off the top. Which means that a $300K award is actually topped out at $188K. Which is still a decent amount of money, but not nearly as much as the NIH's for realsies $275K for the same two years for their R21 (one of which I'm also submitting.). I think it's just kind of a BS way of making their grants look bigger than they are. But so what, right? They have the money, and we want it.

So I'm slamming my head against various walls, and beginning to lose my mind. But that's ok. I'm allowed to fuck up budgets a few times prior to getting it right.

Slowdown.

2011-10-05T08:38:00.000-07:00

The last month I have let my running drop off somewhat. I went from averaging more than 25 miles per week to only a touch more than 20. Last week I only did 17.3, for my lowest value since the first week I ran. I'm down to 194 pretty consistently. Some mornings I'm as low as 191. After a light lunch and a 5 mile run, once I was 189.

My right leg has gotten pretty sore. Sometimes I limp. But that's probably not the real reason I'm dropping off. I'm getting lazier again. After four months of running, I think I'm getting tired of it. I've seen remarkable results. I look better, I've had to buy a bunch of new clothes. I've become able to run a full 5K without stopping to walk. I have even run 5K in under 30 minutes four times.

My incremental improvement is likely to be smaller, and then gives me less of an ego boost. And, in order to continue improving rapidly, I have to go further and faster, and that increases the risk of injury. It may be time to cross train. I should bike, or join a gym (I won't join a gym. It's just something I never go to, and end up regretting the money spent.), or something.

At 192 lbs, my BMI is 27.5. Still noticeably overweight. But I'm looking healthy, I have visible surface veins on the backs of my hands. I have a definition line beneath my biceps, even if it isn't a sharp one. It's hard to improve. I'm beginning to reach the asymptotic portion where I need to once again reduce my caloric intake or jack up my exercise. I'm tired and my leg hurts.

But I want to be better. I don't want to develop diabetes. I need to be stronger and fitter. I want to have a healthy, vigorous mid-life. And I'm willing to fight for it. I just need to keep up my motivation. I need to remember my goal: 180 lbs. Only 11-14 more. Then I'll reassess.

First Day as a Funded Investigator.

2011-10-03T05:34:00.000-07:00

And all the horror and terror that brings. My research department is well beyond screwed up. If I still have any PI readership (Dr. Becca, are you out there?!), you'll be astonished at the peculiar inversion that this represents: I have money to pay for a data abstracter and biostatistician. I have a person selected and listed on the grant who does those things. They are an employee of local, famous university (Wash U). And I can't pay them because of byzantine institutional rules. So I'm starting my grant with no one but me to do the work.

OK, that's not entirely fair. I have a 2.5% CI who is an ophthalmologist and is available to me 1 hour a week to answer physician type questions and be a mentor to me when I run into bizarre eye problems. And I've already run into a bizarre eye problem. Here's something exciting that I bet you didn't know (I sure didn't!): humans have two eyes. Seriously. This is a problem for me.

At no time, not when writing the grant, not when consulting with my CI, not when the grant was reviewed, not when it went through the IRB or our internal Research and Development Committee, did anyone think about or ask about the problem of humans having two eyes. The reason that this matters is that the grant is about diabetic retinopathy, and it turns out, and should have been obvious from the beginning, that a person can have two totally different diagnoses: one for each eye. We are going to assume (confirmed after discussion with my ophthalmologist) w.l.o.g.* that the more severe diagnosis is the clinically relevant one. This is a safe assumption because DR is progressive, so we never have to worry about eyes improving autonomously. There are definite issues we'll have to address, like the fact that a patient may require two surgical appointments separated temporally. But I can handle that.

So anyway, it's an exciting day, and I'm excited to be a funded investigator for at least the next year. Even if I have to do all the work myself even though I have the budget to pay someone else to do important aspects of it.

________________________________________
*This is a mathematics term that means 'without loss of generality'. It essentially means that during a proof, there are sometimes situations in which you want to concern yourself with a specific subset of the objects that you're looking at, and prove something about that subset, because you can demonstrate easily that anything that is true for that subset is also true for the whole set. So, when restrict you restrict yourself to that subset, you write "w.l.o.g.", meaning, "Even though I'm only looking at a subset here, this proof is valid for the whole group, and it's either obvious why, or I've already shown you why, or I'm about to show you why, that's so.".

How to be a Douche at an AA Meeting.

2011-09-29T09:14:00.000-07:00

There's a guy, I call him Tan Man, at my Wednesday night men's meeting that I just really don't like. In part, it's because as I was divorcing, he kept talking about how he'd like to date my ex, even after I make trenchant comments about how classless that was. In part, it's because he kept coming to the meeting and participating as if he were sober when he was drinking, lying to us all. He's been sober again (I believe him... his pancreas is sac of ptomaine.) for about 18 months. And in part, it's because he constantly cross talks.

Cross talk is a poorly defined phenomenon which we all know when we hear it. In some meetings it's a little more ok than others, and my men's meeting is one of them. We'll make jokes or small comments when someone is sharing. But they're in the spirit of friendship. I don't mind that sort of cross talk much. I participate in it.

The objectionable (to me, and to most people I know) form of cross talk is advice, and directed commentary. Tan Man does this all the time. Someone will have shared that they're struggling with finding a job, or a kid who's doing heroin, or a wife with cancer, and then, when it's Tan Man's turn to share, he'll discuss each person's prior comments and give them advice, specific direction, or a related story in his own life that shows how he triumphantly overcame the difficulty that the person is having.

It's a bullshit way of trying to be "greater than". I haven't called him on it, because he hasn't done it to me. And it's not my business to call him on it for others. I'm not his sponsor. If other people don't like it, they can discuss it with him or not. Or one of the men with 30 years could pull him to the side after the meeting and tell him to knock it off.

But we don't do that kind of thing much. Because we take what is worth taking and leave the rest. Tan Man doesn't seem to have much that can help me. I don't have a lot of use for a liar and cad with 18 months sobriety who acts like a guy with 20 years and an inflated ego (He has the nerve to say last night, "I've been here for a while now...". No you haven't.). But I also don't need to try to 'set him straight'. It's not my place, not my job, not my business. And it would be exhibiting the same externalization of self that I disparage in him.

If he offers me unsolicited advice in a meeting, I'll tell him to keep it to himself. Beyond that, there's nothing about being in AA that requires me to like him. I hope he stays sober. I hope he gets better. I hope he matures. I feel embarrassed for him, to be a 50 year old man acting like a child, thinking he has the key to making other people's lives better when he's still just learning about his own, struggling to be honest about his problem. But I also need to remember that I am just a kid in sobriety myself. It's better to keep my mouth shut and my eyes open. And not make any comments I'd owe an amends over.

Academic Engineering vs. Academic Medicine.

2011-09-27T18:06:00.000-07:00

Now, obviously, the title up there is way to wide a set of topics for me to comment intelligently on in any kind of comprehensive way. But I can say this much: engineering research is much less hypothesis driven. In general, engineers build models, design things to specifications, test materials, develop new mathematics, etc.. We don't necessarily hypothesize a particular result and then design tests and protocols to determine the validity of that hypothesis.

But that's what's done in medicine. Especially when the questions are clinical or epidemiological. I've never done any basic science, so I don't know about that. But medical questions are all hypothesis driven: we hypothesize that treatment A will outperform placebo by X% according to outcome measure B.

Now, there's not such an enormous gulf between these concepts. In both cases we're trying to find a better way to do something that matters to people. Something that makes their lives better or longer or more economical or whatever. But it's been a major learning curve for me. Since I live in the medical funding world (I'm good, but I'm not NSF good... yet.), I have to learn to frame my grant aims as hypothesis driven. Which is unnatural for me.

I end up having to shoehorn my design ideas into a framework that isn't exactly right for it. So I end up with hypotheses like: "We will be able to design a simulation that accurately represents a population of N's according to relevant covariates M-S." etc.. But others seem to like it, and I had a long conversation yesterday and today with a guy at Wash U who does work very similar to mine, but in a different time domain, and he was very laudatory of my ideas. He's a major, major player in the field I'm trying to break into, so it's gratifying to have him praise me.

It's a strange working world. But I seem to be on a leading edge. And I'm excited to do good work. Science is harder for me than engineering. But I'm learning.

"We Find Ourselves with No Defense..."

2011-09-26T08:46:00.000-07:00

Alcoholics are alcoholic. That's not exactly a tautology. I mean, we are never cured. Some people think that even in sobriety the disease continues to progress, so that if we drink again, we do not pick up where we left off, but even worse along. I have no idea if this is true. Of course, from a strictly physical point of view, in recovery our hearts and kidneys and livers heal, and thus may be in better condition than when we quit drinking, but emotionally, mentally, the pull of alcoholism may well advance while our need to drink is dormant.

The title of the post comes from the big book. It asserts that even in sobriety, we sometimes find ourselves with no defense against the first drink. I've always had trouble with this concept. I know, certainly, that I have no defense against the second drink. And I believe strongly that I am doomed to an alcoholic death if I drink again. But I have always believed, and always felt, that being in the cocoon of AA gives me the defense I need against the first drink. I wrap myself in the steps, in my sponsor's wisdom, in the fellowship of the spirit that I know in my meetings.

I have had all cravings and withdrawals lifted from me. But I certainly have not been relieved of all my memories - real and imaginary - of enjoying drinking. And I have certainly not been cured. I still desire, in a simple vague way, to drink. I'm an alcoholic. It's what I do. I have no need to drink. No craving, no thirst for it. But I have the ache of the alcoholic. I see a fillet of salmon and a glass of Chablis, and I mourn.

And I saw just that this Friday. I went to a building dedication at Wash U, because my old department is moving. I got invited and got to go to a lovely sit-down surf and turf dinner for 500 people. Seriously, they could have outfitted a materials science lab for what it must have cost. I ate and I drank water. Then came the time to toast the woman who had donated the $13,000,000 dollars to name the building after her late husband.

A thought shot my consciousness before I could even process it: "It's just a champagne toast. It doesn't count."

There, my friends, is a stellar example of alcoholic thinking. It doesn't count. Because.... why, exactly? I can't even sort it out in my head now. Because it's only a little bit? Well, I'd not have stopped at one sip. Because it's a special occasion? Well, alcoholism doesn't care what the occasion is. Because no one there knew I was an alcoholic? Why should that matter, and besides it wasn't true; I was sitting next to my former advisor, who does know.

Perhaps this is what the book means by no defense. I wasn't defenseless in the sense that I was compelled irrevocably to drink. I didn't drink. But I had no defense against that impulse, that instinct. It came from nowhere. But I had spoken on the phone to my sponsor only a few hours before. I have done my work. I continue to do it. When the waiter came by with the champagne, I put my had over my glass, and then poured a dram of water from my own glass into it, so I'd have something to hoist. I made the toast. I sipped my water. And I said "thank you" to whatever it is that keeps my focus narrow and my heart from pain.

Because I can go back. I can drink again. I'm not special. I'm not cured. I haven't beaten alcoholism. But I don't know, and in fact I doubt, that I could return again from active drinking to sobriety. And so I stay sober, so that I may stay alive. And I am grateful.

Faculty Meeting.

2011-09-23T12:00:00.000-07:00

I stopped by my first faculty meeting at Saint Louis University. It was exciting. It was a simple brainstorming session for how we should pursue funding, and what sort of research ideas we have that match up with which agency's agendas. It's very cool to have ideas that people, competent, interesting people, think are valuable. It's scary too. I have to back up my talk with results. The real world is so much harder than school.

I also got shown my new office, the one I'll inhabit when I get my new position formalized. It's not a great office, but it's nice. It has a door, a window. No view. But I'm a lowly Assistant Professor, and not on tenure track. Frankly, I'm just happy they didn't give me a bare desk in the elevator.

My main job is having strange upheavals. It may be that I will eventually move entirely to SLU. That would not be a bad thing. But I have at least a year's worth of funding here at my current position, and I'm happy to have it. I like my job here, and I've managed people's expectations very well. I just need to figure out the best way to move forward in life. Right now, I'm firing on all cylinders except the romantic ones.

Ramping Up.

2011-09-21T05:56:00.000-07:00

Finally, after months, the Brown project is about to get under way. I should have a contract within a few days, and be able to begin. It's exciting. It's a large scale project, the likes of which I haven't done since graduate school. In fact, I didn't even do one this sophisticated then. It's a huge, sprawling simulation of a major trauma facility. But it's going to be a good, interesting, useful project that will result in a tool that can be used to improve treatment. Hopefully, we will be able to improve care and access to care for a huge number of people. And they're paying me good money to do it.

My grant starts Oct 1. I'm excited an nervous. The scary part about winning a grant is that now I have to do all that shit I said. This is a really exciting project, and one where I think I have the opportunity to make a meaningful contribution to the fields of systems research in health care and epidemiology. I'm thrilled to have the opportunity.

I'll be starting at SLU as soon as the position there is created. I'm a little nervous, as always, about the background check. I'm sure it will turn up my DUI. I'll have to explain myself. That's fine, I can do that. I have enough time behind me now that normals tend to see me as 'cured'. When you tell someone that you haven't taken a drink in more than three and a half years, they just assume that you've 'beaten' your problem.

And you know what? I think it's fine to let a boss or a casual friend or a date think that. My sobriety isn't their business unless I lose it, unless I drink. So if they want to think of me as cured, or as if I've defeated alcohol, that's fine. My relationship to my sobriety is mine. I'm the one who has to understand. I'm the one who has to know that there's no cure. I'm the one who has to recognize that I didn't beat alcohol, alcohol truly and totally defeated me.

Because keeping that perspective, understanding my situation, is the only way that I can keep this sobriety. As soon as I feel like I've conquered alcohol, I begin my descent. I've seen it so many times. Alcoholics who think, "I can do this! I've not had a drink in X years! I'm in charge. I know how to not drink!", rapidly progress to, "I can control my drinking.". And then they're gone again. We cannot control our drinking. We can choose, one day at a time, with the help of a power greater than ourselves, not to drink. And that's what I've done for a while now. And I see no reason to change it.

A Mildly Rejuvenating Weekend.

2011-09-19T06:36:00.000-07:00

Well, I feel much better this morning after a restful weekend. On Saturday, I broke all my personal records running. It was a cool day, maybe 65. I went running around noon. I was able to surpass two miles prior to my first walk break. I did the first 5K in 28:40. I averaged a 10 minute mile over 5 straight miles. I finished 10K in 1:04:22 Total, I went 7.43 miles in 1:18:56. I can't tell you how proud it makes me to type in those numbers. I've worked so hard to get into better shape over this summer.

Now: I'm still in terrible shape. I'm still overweight. To be fit, I still have a good 20-25 pounds to lose in addition to the 40+ that I've already lost. But certain major goals have been met and surpassed. I'm wearing 32" trousers. I'm wearing a 16/35 trim fit dress shirt. 6 months ago, I was wearing 38" trousers and a 17.5/35 regular fit. None of my clothes really fit, anymore. I've bought some new ones, of course, but an entire new wardrobe is very expensive. I feel much healthier. But I also know that I have a long way to go, and the winter is coming, when it will be more difficult to continue to improve.

And I made a date for Thursday with a lovely young woman to go out for tapas. In fact, we've made two dates. We're going to see Itzhak Perlman play at the Saint Louis Symphony Orchestra on Oct. 1st. She's a nurse, and a former coloratura soprano. I met her online, of course. No idea if we'll actually hit it off. But she seems delightful, and talented, and pretty.

I also bought a new houseplant, and did some work on a grant proposal. And made chili for the first time this year. I went to my Sunday morning meeting, and cried talking about mom and Darren. People were sympathetic.

And it was an AA meeting. So I talked about how none of these troubles are really about me. I'm a spectator. And there are many thousands of people who are like me, alcoholics, by nature self-involved, who nevertheless learn to focus outward (stealing a phrase from AEB), to be humble and kind, and to get through life, with its cancer, and its death, and its pain, with aplomb and dignity and humility. By being of service. By caring about others first. And by being sober. One day after another.

The End of a Lousy Week.

2011-09-16T07:47:00.000-07:00

The news didn't get any better. I've also gotten news that Jimmy Legs's mom, my surrogate mom, has had a relapse of her brain tumor. I despair for her. I don't know nearly enough to make any predictions of treatments or outcomes. Suffice to say, this is the sort of news that was sadly expected, but no lighter to bear for it.

I'm deeply tired of bad news. One of the problems with being in recovery is that your friends kill themselves with alarming frequency. Darren was the first person close to me that I lost, but I've heard of plenty of suicides in my three and a half years in the program, and I know I will have more. We alcoholics frequently have additional comorbid mental illnesses, including me, with my major depression. Sometimes, they overwhelm us.

For all the misery of the last week, the last year, I'm doing quite well. I feel as well as can be expected, under the recent circumstances. I am not depressed. I am sad, but not depressed. I've been continuing my exercise and my good eating habits. I've lost almost 45 lbs now. I'm wearing size 32" waist jeans, and a 16" neck shirt. I ran 1.6 miles before stopping to walk the other day. I am consistantly below 32 minutes for 5K, and I'm running between 4 and 5 hours every week, topping 20 miles for the past 8 weeks in a row. If I make 4.4 more miles this week, I'll do it again.

I'm working a lot this weekend. I'm tired. But I got a nice little performance bonus at work this week. An extra half a paycheck. Straight to the MasterCard corporation. Still, I'm feeling pretty good, all things considered. And I'm having to consider a lot of things. But though the city burns, I'm quietly building my sandcastles.

All My Shit Problems in an Ashtray.

2011-09-13T18:43:00.000-07:00

I don't know why you couldn't go on, Darren. I know you had storms in your mind that swirled up pain I can't imagine. I know you fought battles I will never know. And I know you lost your fight, in a concussion of fire and lead.

I don't know who will interrupt the silence anymore to start my men's group with the serenity prayer. I don't know who will juggle up the metaphors that leave the rest of us baffled, choked with laughter. I don't know who will put his finger on the table and make simple, unguarded, honest statements that show us all the wisdom that can grow under a placid, affable visage.

I'm angry. I'm sad. But I'm sober. And you were part of that, Darren. And I thought you would be, for a long time ahead.

Intense Malaise.

2011-09-13T07:22:00.000-07:00

Well, the story is, if you can believe the story of a person trying to let me down easy, that the hand on the knee thing was no big deal, though she prefers to be the person to initiate contact, she didn't blame me for taking a chance. She likes me, just not enough to work me into her schedule. She wants to be friends. And you know, after I get over my debilitating crush, I think so will I. She's brilliant, after all, and I like smart people in my life. But I'm sad and headachy and I didn't sleep well last night.

I stayed home from work yesterday, prior to hearing that she wasn't interested, because I feel grim and unsettled, especially about the stomach. But I did venture out and buy a new shirt. I had my measurements taken, and I ended up getting a 16/35, slim fit, french cuffed shirt. I could have gone down to a 15.5, but I like my collars a bit loose. I also tried on a 44 slim fit sport jacket, and it was excellent.

I'm feeling a bit hopeless about romance. I'd very much like to be in a relationship. Of course, I did just turn down a girl who was very interested in me, only three weeks ago. So, clearly, I am not so infatuated with it that I'll take whatever is available. But I am definitely looking to be involved. And I am feeling lonely. But it seems that intelligent, attractive women with a lot of options are not particularly interested in me.

I got a really sad note a few days ago on a dating site recently from a woman, who wanted to talk to me, but prefaced her comments with a proviso that she didn't think she was smart enough to be more than "amusing" (her word!) for me. I had no idea how to respond to that, and didn't want to leave it hanging out there, so I wrote back and told her, truthfully, that she seemed very sweet but that I was pursuing an involvement with someone. So it's really difficult for everyone out there.

Bleargh. Well. Work is going well. I'll figure out how to sleep again someday. Probably tonight.

I Was Right.

2011-09-12T18:33:00.000-07:00

She doesn't want to date me.

On Limerence and Torment.

2011-09-09T06:10:00.000-07:00

I have met a girl that I really like. She's a professor and scholar, she's brilliant, she's beautiful. She's new to St. Louis, and working very hard in her early days as an assistant professor. We spent some time exchanging emails and went out on a lovely date last Monday. We went out again last night.

And of course, I feel like I fucked it up. We went to this strange little club in St. Louis, that serves nothing. No food, no drink. There was a jazz trio, and there was supposed to be a guest guitarist, but he wasn't there. They were good, I liked them. We packed a little picnic, and ate veggie burgers and sweet potato chips and drank sparkling water.

When the music started, we switched to the same side of the booth to watch and listen. I put my hand on her knee. She said: "I'm not so much into contact, yet." I put my hand back on the table. I flushed, crimson, in the darkness of the club. I berated myself silently. I waited five minutes and then excused myself to the bathroom, where I stared myself down in the mirror.

"You fucking idiot. She doesn't like you. She couldn't like you. Why would she? She's beautiful and brilliant. You're a stupid, fat, ugly, shit-eating fucking asshole. Keep your fucking mouth shut, be polite, go home, and remember what a fucking idiot you are."

I'm not saying it's a reasonable response. So I returned to the table, and we talked philosophy and other topics. I walked her home (She'd invited me over to her house to begin the date! That felt like a positive sign.). She said we'd "possibly" get together next week. I drove home in a cloudy silence, feeling sad and hopeless. As a final stab from hell's heart at hope, I texted her that I had had a lovely time. I got no reply.

Until this morning. When I got a short email that she had had a really nice time. I'm baffled. But buoyed a bit. I really like her. I know she's busy for a couple of weeks with various things including travel. Maybe I get to see her again. Maybe it's not as bad as it felt in the moment. Maybe the key word was "yet". I don't know. Life is what it is. I'll hear or I won't. She likes me or she doesn't. I'll discover it as time goes on, and it won't happen how I want it to. It never does.

On Incrementalism.

2011-09-07T07:08:00.000-07:00

I crossed a threshold yesterday I didn't know I had the opportunity to cross yet. I ran five kilometers in twenty-nine minutes and fifty-nine seconds. My previous best time had been thirty-one and fifty-five. A near two minute drop is so large an excursion from my previous best, I hadn't thought it possible. My 'ordinary' time is around thirty-four minutes. And I'm not so foolish as to think that I can now regularly run a sub-thirty 5K, but it was a major accomplishment for me. I'd never come close to a third ten-minute mile before, much less 3.1.

Several things conspired to make this happen. I had taken two full days off from running, or even walking. I did get some exercise while I was home (I spent 20 minutes jumping on the trampoline with my nieces, I played a good bit of badminton.), but mostly I was very well rested. And it was a cool day, about 75. And I am feeling happy and successful in my work, in my exercise regimen, and even hopeful about my dating life. As a result, I am feeling hale. My determination is to maintain my health, improve it. And I am doing so by such leaps and bounds as to astonish myself.

All of this is the result of the training I have received in AA. I'm not saying that that's the only way to get it, obviously it isn't. But that's where I needed to get it. It started with such a simple concept. I didn't have to swear off of alcohol forever. I didn't have to say I would never drink again. I've still never said it. I am not going to drink today. I can't imagine drinking tomorrow. Beyond that, I'm not bothering to think about it much. By doing that, I have somehow managed not to drink for more than three and a half years.

Ask anyone how incredible that is. I drank every day, minus one or two a year, for about twelve years. I got drunk every day, minus five or six a year, for twelve years. I hid it. I lied about it. I avoided obligations to drink. I defended it. I secretly hated it. I not so secretly hated myself. I woke up in vomit several times. I would throw up on purpose so that I could drink more. I drove drunk. I was arrested for driving drunk. I very nearly abandoned my doctorate.

And yet, one day, after finally, thoroughly, finishing my self-designed master-work sculpture of squalor, didn't take a drink. And then the next. And then the next. And now, for hundreds and hundreds. But attempting, each day, to make progress. By recognizing, each day, that perfection, while a worthy goal, is unattainable.

Other types of life decisions are the same. Today I do some research. Today I run five miles. Don't worry about tomorrow so much, except as necessary for deadlines. When running, I make weekly goals, but no further out than that. My goal is to not be diabetic. To not suffer a stroke at 60 like my father. To not feel embarrassed by my body. To be able to achieve the things in life that I want to achieve, like maybe one day climbing Mt. Kilimanjaro. Like being able to continue to trek the planet when I'm 70.

Accomplishment is cumulative. Slow progress, slow reward. Inevitable success. Not that I will achieve every goal I set for myself. If I set 'success' to mean 'getting what I want' I am often disappointed. But when I set 'success' to 'being who I want' I am never let down. Because I know how to work to be a better man.

Fear, Excitement, and Anticipation.

2011-09-06T06:18:00.000-07:00

My trip to Seattle was lovely. I had a very nice time seeing my sisters and my brother, and my parents. And of course, 4 nieces and a nephew that I hadn't seen since February of 2009. It was a good length trip for me. Long enough to see everyone, short enough that I never stuck my foot in my mouth, or got into arguments or felt imposed upon or that I was imposing. In fact, I wish I'd had a third day. But as it was I feel very good about it.

Last night after getting home I had a date. I was really very surprisingly nervous about it. I met her online. She's a professor of philosophy with tendrils of interest stretching into psychology and the neurosciences. Things I find really interesting but can't even begin to feign knowledge of in anything other than the most basic pop-science introductions. I've read a few books touching on cognitive science aimed at the layman, and it's very interesting,

We went out to a local rooftop bar. I was a little worried. I had invited her out for coffee, and given the gorgeous weather asked if she felt like just taking a walk. She said: "Ok, that could be, no, you know what, I'm lying. That doesn't sound fun. Let's get a drink. I don't want coffee this time of the evening." Which was actually very refreshing, considering that so many women seem to feel the need to capitulate to the man's first suggestion of a date. Then, later, you find out they don't enjoy that sort of thing at all, and feel like an idiot. I like a woman who is willing to voice her preferences from the outset. It takes a lot of pressure off of me.

But I was nervous too. Because I don't drink. And if she wants to go out for a drink, then maybe she won't accept me for not drinking. My head starts racing. I'm really excited about this girl, she's pretty, she's smart, she has a really interesting job. I'm hopeful. And now I'm just certain that she's going to reject me immediately because I don't drink and that's important to her. I call my sponsor. We agree that if it matters to her on a first date, it will matter to her whenever she finds out. If she won't be interested in a recovering alcoholic, then she won't. I can't control it. And I can't change what I am.

But of course, we go to the bar, she orders a glass of white wine, I order a cappuccino, which they don't serve. Cold drinks only. So I get a club soda with lime. No comment from her, not even a quizzical look. It's cold on the roof. Windy. After our drinks, she suggests we go inside to the bar downstairs. We go. I get my cappuccino. She orders herbal tea. We talk for another hour. She's brilliant and fascinating. The conversation is wide ranging, includes semi-intimate details of family dynamics and history of psychoanalysis.

I'm quite smitten. We're going out again. Eventually, I'll tell her that I'm an alcoholic. I find that if I don't tell by the fourth date or so, I start to feel like I'm lying. We've made tentative plans for Thursday. Jazz. I'm excited. I'm hopeful. Hope is a wonderful thing. The most delightful of all the soul-destroying curses.

I found it.

2011-09-04T22:44:00.000-07:00

I found my lost passport. It's cancelled and useless of course. And I found it in a bag I'd searched many times. Rage rage rage.

Away Away.

2011-09-02T11:45:00.000-07:00

So I will be leaving soon enough to Seattle to spend a few days with my family. I'm coming in for my father's 70th birthday party. I'm looking forward to seeing everyone. There are nieces and nephews and a brother and a sister I've not seen in more than two years. As usual, everyone is squabbling about who I stay with and for how long. I'm not playing. I get tired of it. I've been admonished that if I went home more, there'd be less arguments, but it isn't true. People argued just as much when I used to go home every year. People tried to make me feel guilty for staying not enough here or too much there.

I'm not even complaining. All families are like this to a certain extent. My separation from the day to day squabbles of my family has been by design. The closest school to home that I applied to was 2000 miles away. Within two years of going to school, I stopped coming home for the summer, and stopped coming home for most holidays. I didn't do it out of neglect. I wanted my own life, my separate individuality.

There was a time, not so long ago, when a person leaving for school of fortune never saw their family again, or perhaps once in their life. I am blessed to see my family so frequently. But I also want to have my individual existence. I need a lot of space to breathe, it turns out.

It's not the best way to be. I often don't know how to be individual without being lonely. I would love to be able to feel like a self-actuated individual and be around my family more. I don't really know how. It ends up being about conflict. I have to assert boundaries that make other people feel like I'm rejecting them. I had to tell my mother not long ago that I would not ever discuss sex with her and that I would immediately end any conversation that strayed to that territory. I've been redirecting and trying to be polite about it for a decade without success. Finally, I said it baldly. But I know she felt rejected and blindsided. It wasn't my intention, but subtlety was ignored.

But I have to do what is right for my own frame of mind, or I will end up wanting to isolate myself from everyone completely. And I've done that before and can do it again. Instead, I go, I assert my boundaries, and I accept that that makes my family mad at me sometimes. Some of my boundaries might not be fully fair to everyone. I don't know. I just know that they are what they are, and maintaining them is what allows me to function.

I'm so very tired today. FedEx screwed me. Work is too long. Soon I will be going home. Huzzah.

Strange Reaction to Success.

2011-09-01T06:06:00.001-07:00

I always have it. I feel inflated, proud. Brilliant. Then foolish, vainglorious. Ashamed. Imposterish. I think that this impostor syndrome is simply something I'm going to have to learn to live with. Battling it drives me to do better work.

I have a fascinating negotiation with the people at SLU, in which I ended up being offered about 15% more than I was planning on asking for. Considering it's a part time gig, that's not a huge amount of extra money, but it is significant enough to make me feel good. They clearly want me and are not going to quibble over pennies to get me.

So, while I get excited in the moment, my excitement tempers rapidly and I start to feel embarrassed and ashamed pretty rapidly. Now I'm just looking for a way to return to mid-keel. But that's ok. Mid-keel is the right place for a drunk like me. I don't need to find myself at precarious heights. Because, I know how to fall, but not to fly.

How my Higher Power Behaves.

2011-08-30T05:38:00.000-07:00

I have taken to saying in meetings, when it comes up, that "I do not understand the god of my understanding." And both of us seem happier that way. The more I try to fathom whatever god is, the less connected I feel, the less relevant god seems. I don't believe in miracles, not the kind where a prophet is assumed into heaven in a whirlwind. I don't think that god reaches down and mucks about with the laws of physics. I do not believe that god consciously and willfully struck me sober and left other good men and women alone to an alcoholic hell.

My higher power is more like the emergent behaviour in the system. The way a trillion neurons, each just a single unit analog to digital converter, can combine to form a thinking identity. The way a community of termites, each feeble and frail, can combine to slay a forest, and create a cohesive and elaborate society.

I sense that I am somehow connected to this thing. And I believe that that connection allows me to muster strength that I might not otherwise have access to. It is my place in a universal community, my responsibility as a member of an astonishing hive, that entrenches my resolve and lifts me out of the monstrous fate I had otherwise planned for myself. I am connected to an enormous system, I am a member of it. Which has tendrils beyond anything I can imagine. Not a simple hive of humanity, but a hive of life. A termite mound of creation.

Now, I know people can, upon examining this description, begin to formulate hypotheses that may demonstrate that I'm wrong about god is this or that particular way. And that's fine. Everywhere god finds a hypothesis, it seems to shrink from it. My conclusion is not that that means there is no god, but rather that hypothesis making is a small and human endeavor. I do not believe we can see the full thing of it, the stuff that makes us all. Much like we can see neurons, but not consciousness.

Now. This is all very unscientific, and probably wrong. But when it comes to god, I really, really don't need to be right. In fact, trying to be right makes me feel immediately and fully disconnected from whatever the higher power is, if it is. I know only that I am not the thing that has made it possible for me to quit drinking. When I seek strength, I have a community which buoys me, in AA. And I sense a connection to a larger thing. A thing that will not work miracles for me, but whose presence is the miracle.

On Sensible Goals.

2011-08-29T11:55:00.000-07:00

I set a goal last week of running 30 miles. I did it. I will almost always achieve the goals I set for myself. But it is clear that this goal was too much to be repeated. For now, anyway, averaging 5 miles a day, six days a week is too much. So my goal this week is more sensible. 22 miles. Significantly reduced, but still a long ways. And well thought through.

Gratitude-in-Mundania.

2011-08-28T13:57:00.000-07:00

Today I went to the supermarket. I bought peaches and bananas and raspberries and skim milk and carrot juice. I went to the checkout lane to pay for my groceries. The checkout woman was slow and under-supported. I was waiting behind a man stretching the imagination of the 20-items-or-less regulation (which, to be fair, is agrammatical, and therefore possibly a moot proscription.). I had left my phone at home, and so had to find some alternative means of staying entertained for the 300 seconds it took to scan and package this man's shopping list.

Naturally, I chose to spend the time annoyed, gathering in frustration. He should have been in a different line. The checkout lady could work faster. They should have a bag-boy. Now, at this point in the story, I should point out that I had a grand total of nothing to do this glorious Sunday afternoon. Lotioning my new tattoo is the sum-total of pressing concerns I have to attend to today. So, beginning to simmer in the savory au jus of my own irritation, I turned away from the scene to roll my eyes.

Whereupon I was confronted by my own alternative future. There was a man behind me. Paunched, heavily pockmarked. Face spider-webbed with rosacia. He was wearing sweatpants, and a t-shirt that looked recycled beyond its wear-by date. He was perhaps 55, but a weary, haggard 55. And he was purchasing a 1.75 liter plastic bottle of caramel coloured liquor and two boxes of Budget Gourmet cheese stuffed bread sticks.

Now, I don't know this man. I don't know his situation. I am not diagnosing him. But he resembled greatly the thing I used to be, and the future I used to have, at least in my imagination. I was reminded of how I drank and ate as if I didn't matter to myself. How I dressed as though I had nothing to present myself for. How I didn't care enough about my own life to tend to it.

So I am grateful. Because I am liberated.

Gratifying News, Astonishing Sobriety.

2011-08-26T06:14:00.000-07:00

So, the guy at SLU who has wanted to hire me told me yesterday that my candidacy has cleared a major hurdle. I have been unanimously approved by the relevant faculty to be offered the position of Assistant Professor. There's paperwork and lawyerly stuff to handle. I'll be keeping my current position at part time, and adding SLU at part time. It's considered one job with two employers. This makes it easier for me to pursue several different pots of grant money. It has some drawbacks too, complicated funding arrangement issues. So be it. I will be a professor at a fine university.

Presumably. Live today, not tomorrow. Things can fall through. I just have to sit and reflect about where I was not long ago. Where I am now. I'm a person who has regularly skipped prerequisites. I never had a training grant. Never did a post-doc. I just leapt from graduate student to weird research-assistant-in-a-borderline-legal-position-to-a-big-awesome-PI to a PI myself. And now I've had almost a quarter million dollars in funding.

I was talking to my sister Penelope, and she mentioned how major a transition is has been. When we talked about the strange path I've taken, she said: "Well, most researchers don't spend a dozen years drunk off their asses." And I said: "You'd be surprised." But she's right of course, my alcoholism and recovery have charted a different course for me. But it's a course that I am excited to pursue. I am well. I am sober. I am happy, and I am productive.

Now if I can just get this sense of not belonging off of my shoulders... It's inevitable. But I do belong. I need only to step assuredly, one foot then another. One day and then the next. One loop of the park is 1.2 miles. I'm running now. And I'm running forward.

Glorious Sunshine.

2011-08-25T10:59:00.000-07:00

It is fabulously beautiful outside today. I didn't run yesterday, so I'm rested up. It should be a perfect day to put up a good time. But I don't know if I can even really try. I'm going to run, certainly. I have only three days to complete my attempt at 30 miles this week, and I'm not about to give up on that goal. I have 13.6 miles left. I'm planning on doing slightly more than 6 miles today, and then I'll only have 7 and change to do in the last two days, which is good because Saturday I have my walking meeting, which will add 2.7 miles of walking that don't count towards my goal, and then at 5 pm I'm getting a tattoo. So I'll have only a short time to get my run in (between noon and 5 pm) and still bathe and be presentable for my inking.

I'm excited and nervous about my tattoo. This will cover a decent amount of ground. And it will require dedication to upkeep. Suppose I go to Costa Rica this Thanksgiving? I'll need to schedule a touch up. And each new country thereafter, for the rest of my life. So, when I'm 90, and finally make that excursion to New Corpocracy of North Korea, I'll have to iron my wrinkles out and get cut. But now that my body is more of a, you know, human male body, and less of a sack of garbage, tattoos look pretty good on me.

So that's where I am today. I stopped seeing that lovely young woman, and we've talked through it a bit. I feel bad, but I know it wouldn't work out. So I believe it's best to be kind but honest, and let her find someone who will appreciate her better. Such is life. Sad, but hopeful.

Passport Arrival, and Gifts for Lost Persons.

2011-08-24T07:04:00.000-07:00

Well, sad as it is to have lost my passport, at least I only lost 3 stamps along with it. But what three stamps! Taiwan, Bahamas, and Denmark. But, now that I am single and finally, nearly, out of debt from the divorce, I will be traveling as much as I can. I am determined to make use of this time in my life. I will see things I could not have at other times.

The RHSC's birthday is coming up. I haven't received any communication from him since the 8th of January. Nevertheless, I text him faithfully, telling him I care about him and I hope he's well, about once a week. I never hear any reply. But I will be sending him a birthday present. He's to be 15. I don't know what to get him. I will send it to his grandparent's home. I don't want to trouble my ex-wife at her home. And frankly, I'm not certain she still lives where she did the last time I knew where she lived. Which is just as well.

I hope that someday, the RHSC will see that I did the best I knew how. Maybe he will, maybe he won't. I have regrets of course, that I didn't do better. But I feel no remorse for lack of efforts made. I worked. There is a deep sadness there. But it is a solemn sadness, and not a totally unwelcome one, in a strange way. Because I think, if he tries, eventually, to see, he will see that I showed him that people do not have to sit still for abuse, but can forge their own paths. But that is a difficult and horrible lesson for a teenager to process, and he hasn't.

I hope he's well. I hope they are both well. But I fear for them, sometimes. Because they do not make wise decisions, nor seek counsel from those who could advise them. But it's not my business anymore. I shall lighten my heart of it.

Machado; I am Found.

2011-08-23T19:20:00.000-07:00

I may have to write a book of these. This is Antonio Machado again, "To an old elm"

Al olmo viejo, hendido por el rayo
y en su mitad podrido,
con las lluvias de abril y el sol de mayo
algunas hojas verdes le han salido.

¡El olmo centenario en la colina
que lame el Duero! Un musgo amarillento
le mancha la corteza blanquecina
al tronco carcomido y polvoriento.

No será, cual los álamos cantores
que guardan el camino y la ribera,
habitado de pardos ruiseñores.

Ejército de hormigas en hilera
va trepando por él, y en sus entrañas
urden sus telas grises las arañas.

Antes que te derribe, olmo del Duero,
con su hacha el leñador, y el carpintero
te convierta en melena de campana,
lanza de carro o yugo de carreta;
antes que rojo en el hogar, mañana,
ardas en alguna mísera caseta,
al borde de un camino;
antes que te descuaje un torbellino
y tronche el soplo de las sierras blancas;
antes que el río hasta la mar te empuje
por valles y barrancas,
olmo, quiero anotar en mi cartera
la gracia de tu rama verdecida.
Mi corazón espera
también, hacia la luz y hacia la vida,
otro milagro de la primavera.

***********************************

To the old Elm, cleft by lightning,
Half rotten,
With the April rains and May sun
Having sprouted just a few green leaves.

The hundred year elm on the hill
lapped by the Duero! A pale saffron moss
That stains the hoary bark
Of the dusty, chewed trunk.

It will never be, as the choir of poplars
Which guard the shoreline road,
Inhabited by russet songbirds.

An army of ants in a row
Marches through, and in its roots,
spiders plot their grey webs.

Before you are felled, elm of the Duero,
by woodcutter’s axe, and the carpenter
makes of you a bell yoke,
an axle, or the hitch of a wagon;
before, red in the hearth, morning,
you burn in some miserable cottage
at the side of the road;
before you are uprooted in a whirlwind
and snap in the breath of the white mountains;
before the river pushes you to the sea,
through valleys and canyons,
elm, I must enscribe on my page
the grace of your verdant branch.
My heart hopes
as well, hopes to light and to life,
for another miracle of the spring.

Wellness and Malaise.

2011-08-23T07:58:00.000-07:00

I feel like I am simultaneously achieving and stagnating. Work is going strangely. I've been spending the whole summer preparing grants, none near ready to submit yet. Luckily, I have time. My own funded project starts 1 October, but I feel like it's been so long since I've done anything with it I'm going to have to rethink the entire project. So many things are all happening at once. It's confusing. In addition to the big federally funded study I am the PI of, I have at least one major grant going in in December, hopefully two. I have the study I've been awarded at Rhode Island Hospital, separate from my day job. And I have something going on with SLU that I don't fully understand. And I have this nomad of a paper I really want to get published, but which seems to be floundering amidst the various journal scopes.

Healthwise I am doing quite well. I was 196 lbs this morning. That's a BMI of 28.1. Still significantly overweight (and my belly confirms this). I used to dismiss the utility of BMI as a measure. It seemed to me like it underestimated how heavy I should be to be "normal". But now that I have lost almost 40 lbs, I realize that BMI is about dead on for me. I wasn't seeing myself the way I really was.

I was fat. The consequence of years of being sedentary and filling myself with booze and cheese and smoke. In only 10 months, I have made such dramatic changes to my body and health. And they have shown me just how far I have to go. I am revealing just how terribly I had allowed my health to lapse.

As of 18 August, it has been two years since I have had a cigarette. It has been 3 and a half years since I had a drink. I have been running almost daily for nearly three months. Prior to that, I was walking, and doing push-ups and sit-ups and squat-thrusts. My shape has changed. My endurance.

And yet, I still cannot reliably run a mile without stopping to walk. I have run consecutive ten minute miles only once. My best time to run 5K is 31:55. These are numbers that a reasonably fit man twice my age should be able to achieve. I'm not complaining. My transformation has been remarkable to me. But it is far, far from complete.

In order to be, by BMI, at the top end of normal weight, I need to lose another 22 lbs. I don't know if that's my goal or not. My real goal is to not get diabetes. To be able to take my shirt off at a beach and not feel a knifing shame. Right now, my BMI is 28.1. Solidly overweight. And I am. I have a belly. There are no surface veins visible on my forearms. The line beneath my biceps is faint and shallow.

Progress, not perfection. I didn't accumulate 3.5 years sober by leaping ahead. Each day, for 1,283 days, I didn't drink. Each day, for the last 735 days, I have not smoked. And now, nearly every day (perfect attendance is less necessary for exercise) for the last 10 months, I have done something physical to improve my health. It shows. I'm excited to see my family next week (over the holiday weekend), and have them notice how I look. Vanity. Sheer vanity. And yet, there it is. I have a bit of Narcissus' blood in me, doubtless.

What a Week.

2011-08-22T06:00:00.000-07:00

Well. I'm feeling fairly low at the moment. Not like, crushed or miserable. Just low. The lovely young woman I'd been seeing for about a month and I have decided not to continue. There were some fundamental compatibility issues, and it's really more my decision than hers. But I'm sad about it. She is sweet and fun, but I wasn't feeling like I could be myself around her. I didn't feel free and open.

I just got a bizarre rejection letter from a medical journal. I was told that my paper couldn't be considered for publication because they only publish papers about computers in health care delivery. My paper is about computer simulation used to improve healthcare delivery. I'm wondering what the hell went wrong. It didn't even go out for peer review, so it isn't that they read the paper and didn't like it, it's that they thought it was the wrong place to submit. I suspect that someone skimmed the abstract, saw that it involved emergency medicine, and said: "This is all wrong and I'm old and bored!" I mean, this is a paper about computers in healthcare delivery. It's in their wheelhouse.

I saw Mom S. this weekend with Jimmy Legs. We drove out to Cincy and spent the weekend with Mom and Dad and Jimmy Legs's brothers and nieces and nephews. Mom is doing great. I'm very happy. Considering it's been about 16 or 17 months since she was diagnosed with a Glioblastoma Multiforme, and she's up and around and seemingly undamaged except for a scar where they went in for the surgery and a cut on the left side of her vision, she's doing better than anyone could have predicted. Except Jimmy Legs, who's been right all along.

I did get 23.6 miles in last week. I'm aiming for 30 miles this week, with no time goal. I don't need to do it fast. I just want to get in 30 miles of my intervals. That's an ambitious goal. 5 miles on each of 6 days. I'll try to get in a couple of 10K's so that I can take a day or two easy.

So I'm a little bummed. But that's ok. I'm sober and sane and overall, life is good. I've got a lot of grantwriting to do. See you soon.

Brief Update.

2011-08-17T09:32:00.000-07:00

All is well. I simply haven't had anything that I felt was pressing to write about. I've slowed down a bit on my running. Last week I did 22.3 miles, and this week I've done only 11.3 miles so far this week. I took a half sick day yesterday for fatigue, a mild headache, and the desire not to be at work. The paper that I've been working on does not seem to garner enthusiasm from anyone but me, which is too bad, because I think it's pretty good work. It'll get published. Goldlust is making it better with his criticism and insight.

The project for Brown is going forward. They made an offer that is a little below what we asked for, but go figure, that's always the way. Nevertheless, they offered me a non-competitive funding award to continue my work, which is worth a significant amount of money to me personally. I'm excited about it.

And I've been dating a lovely young woman, a teacher, for the last month or so. We've hit it off very well, and things are moving forward. I don't know where it's going, but it's definitely making me happy for the time being, and that's a good thing. She obviously likes me as well. Life moves forward and is what it is. I'm going along with it.

Fruit of Labor.

2011-08-14T12:57:00.000-07:00

Today I broke every record I keep. I ran two consecutive 10 minute miles. I did 5K in 31:55. I did 10K in 69:15. I totaled 6.29 miles. And I'm down to (after the run but before re-hydrating) 194 lbs. Every day a bit more, a bit stronger. I will not achieve records every time of course: I don't try to. But I do get better and better and I'm quite pleased. Isn't sobriety grand?

Inches and Pebbles.

2011-08-12T07:01:00.000-07:00

Great castles are built by inches and pebbles. I am slowly but surely advancing my career. 2010 was a good year for papers, having had about 6 accepted to various publications. 2011 saw me become a funded Principal Investigator for the first time (I managed to get my funding start delayed until October, giving me more time to write and submit before it runs out next year.). I also did my first consulting work this year, which is likely to lead to a part time official position at the medical foundation which provides physicians to RIH for Brown University. It's a complicated structure, as everything in academia is. Essentially, it's the mechanism by which I will be paid and allowed to submit grants to the NIH in my capacity as an Adj. Asst. Prof. of Emergency Medicine at Brown.

I have also received infuriatingly oblique news about my position at Saint Louis University. My boss there has now listed me as an Assistant Professor in official communication, but of course I haven't signed anything or been formally offered any position. I don't know exactly what they want from me, or how I'll be engaged. But I'm prepared to do what it takes. It's a wonderful position to find myself in, being wanted like this. But it's taking a very strange path.

I don't mind that. I took a strange path in everything I did. I learned very late about grants and papers. I have only seven papers to my name. I have only one official grant, and one other financial award. I'm 37. I never did a post-doc. I've been advanced up ladders normally reserved for more accomplished persons than myself. But I am landing in a spot that is very good for me. And I have a history of success at skipping pre-requisites.

I'm nervous, excited, and anticipatory about how I'm going to make everything work in my career. I started late. I should have finished my doctorate at 26 and been an associate professor by now, like several of my friends. But I didn't. And now I have different aims and opportunities. But I like my work. And I like my life. And I'm hopeful.

Program Benefits.

2011-08-11T06:42:00.001-07:00

Joe goes to my Wednesday night men's meeting. Six years ago, Joe sat in his room peeking out the windows, drinking Popov vodka and smoking crack cocaine. Mickey is my sponsor. Eighteen years ago, Mickey lived in a tiny basement apartment and was seriously contemplating suicide, drunk and stoned every day. Newt chairs my men's meeting. Thirty years ago, Newt laid out a dozen bowls of cat food so that his cat would live until someone found his body. Then he drank until he hoped he'd die. Megan goes to my Sunday group sometimes, and I go to a Tuesday group she regularly attends once in a while. Four years ago, she got thrown out of a crash pad of drunks for being too much of a drunk.

Sue. John. Mary. Mike. Bill. Debbie. Danny. Rick. Mike. Kenny. Linda. Kathy. Chap. Jim. Vance. Pam. I could name dozens, hundreds more. People who were at death's door. People who were living in hell. People like me. Soaked in alcohol. Many also steeped in drugs. Homeless. Hopeless. Jobless. Friendless. Today, every one of those people are sober, sane, at least reasonably financially secure.

I have been sober for roughly three and a half years. Before I was depressed, angry, miserable. Drinking nearly a bottle of whisky or vodka a day. Trying to hide it (ha!). Married to a woman who hated me. Unemployed. Wretched. Now I am sober, sane, have a good job and will soon have a few others. I am well and happy and capable of reaching out and relating to others. I have sloughed off my toxic marriage. I am a sober member of AA.

Alcohol will, if you are like me, take everything you have, demoralize and humiliate you, and then kill you. But you don't have to let it. Give up. Alcohol will always win. It will defeat you in every battle. Withstand any assault. Give up. Find the other people who have lost their ability to control their drinking. Who have been rendered powerless over alcohol. They will help you. They will teach you to live without it. They're not hard to find. They're at your local AA meetings. They're right here.

General Contentedness.

2011-08-09T08:47:00.000-07:00

As I watch my life savings spiraling down the drain of an intransigent market, and my beloved country trying to pretend that it's made inroads on the debt problem which is going to bankrupt us all, I find myself happy. I mean, the so-called greatest generation, and their spoiled-rotten children the baby-boomers, decided to steal a fine standard of living from the next several generations. My generation appears to be trying as hard as it can to figure out how to do the same thing to the next.

The debt is corrupt. I think we could be morally justified in declaring it odious, defaulting, and letting the entire baby-boom generation starve. They have stolen our labor to finance their avarice, and they ought to rot for it. But that is not what we'll do, because we are better than that. Even debt-criminals don't deserve that kind of justice.

Nevertheless. I am well. I need not worry too much about the future: the future will take care of itself. Eventually, the entire debt-system we've created will crash, the western world will fall into ruin, and we'll say, "What the hell! It was a good thousand years.". And when it does, if I'm still here, I'll manage. Because people are strong, even when they're poor.

I am strong, I am healthy, I am sober. I am seeing a delightful young lady, and I think it's going someplace positive. I am gainfully employed, and able to prepare for my own future. My life is a good one. Whatever happens to the economic system. Because I am willing to work to make my life better. Willingness. That is all I need to be happy.