Archive for the '[LifeTrajectories]' category

Reap What You Sow

Sep 10 2014 Published by under [LifeTrajectories]

While in my fellowship, I became interested in the role of puberty and sex in the progression of kidney disease. I studied this and related sex differences in the renal responses for more than 20 years. Then the NIH would not, could not bring itself to fund my work. My spouse had a new job offer, and the writing on the wall was clear: I closed my lab and moved into full-time clinical medicine.

From this perspective, I can appreciate NPR's series on the state of NIH funding and folks quitting science. At least I knew my clinical skills made me employable, although at times I dream of running a distillery.

Of course, there is the additional irony of the NIH calling for more study of both sexes, even in basic science studies, earlier this year. Gee, exactly what I was doing that was not important enough to merit funding...and now you are issuing special calls for it. Any regrets, NIH?

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Call for Academic Problems

Nov 05 2013 Published by under [LifeTrajectories]

Have you or someone you know had an issue with promotion and tenure?

I'm looking for potential case studies. Time off for maternity leave, nontraditional scholarship, and other such things would be appropriate.

Email to me at {pascalelane} at {gmail, you know}.

Tomorrow I have another travel day from the AAMC (women in medicine and science/faculty development hat) to the ASN (kidney hat) meeting. I'm heading to Atlanta, but I'm not planning to burn it...

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Lessons Learned

Sep 17 2013 Published by under [LifeTrajectories]

Career setbacks happen. Examination of the literature reveals little good advice for dealing with "lemons instead of lemonade." In general, the advice falls into two categories:

  1. If you are not failing, you are not trying. Keep trying and you will eventually succeed.
  2. Analyze what went wrong and learn your lesson(s).
Standard Advice

Standard Advice

I call the first one Cheerleader and the second Sage. Neither tells you how to cope.

Truth be told, I have explored the stages of grief that we all have heard about by now. Shock lasted about a day, with denial covering just a brief moment of that day. Anger and depression tag-teamed with each other, sometimes entering the ring together to hit me with virtual chairs. I never really got the chance to bargain about anything.

The past 2-3 months have included a bunch of introspective navel-gazing. My friends will tell you that this activity is not one of my major skills, but I had to do it. I needed to know what I wanted to do. I had to put in this mental effort to figure out what I wanted my career to be, and how I would move on.

I have now accepted my course. I will no longer have a title, but I plan to continue working in faculty development, on my own campus and others.

I do have some advice for others who find themselves on an unexpected path to a set-back. Stuff that is neither Cheerleader nor Sage.

  1. Dealing will take time. Most advice out there makes you think you should brush yourself off and get right back on the horse. Frankly, you probably have some bruises and cuts that could use some mending. You and the horse could both stand to cool off a bit as well. Don't be afraid to curl up and lick some wounds. Try not to excessively wallow in self-pity. (It's a fine line that friends and family can help you define.)
  2. Be nice to yourself. You will find yourself reliving every interaction that may have influenced your situation. You will likely find things you don't like, that you should have handled differently. And most of this will have no role in whatever happened. Try not to punish yourself; withholding ice cream or pizza or other enjoyments will not change the situation. New shoes can be great therapy (my A2 rejection pumps are still lovely).

The Cheerleader and the Sage are ultimately correct - you will eventually have to take more risks, and you will have the wisdom of this situation to guide your new efforts.

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Book, Paper, Blog

This week a perfect storm descended on me, including a book, a paper, and a blog post:

All of these deal with the ongoing gender bias in our society, but particularly in our workplaces. Yes, men are at fault, but we XX folks are not blameless, either. My full thoughts on the integration of these readings is over at Academic Women for Equality Now. Please read that post, then get the book and peruse the other materials online.

Now think about how we can overcome these subtle, less blatant issues. Comment here or at awenow.org or at Zuska's place. We need to work together instead of against each other!

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Am I Science? Yes, #IamScience

Compared to the other stories posting via this meme, I feel almost traditional.

I do not remember a time when science was not part of my life. I recall fondly reading and re-reading All About Dinosaurs. I had a tiny kit containing most of the minerals in Moh's scale. Mom refused to complete my set with her jewelry, so I had to imagine the upper levels of hardness. Biology clearly won my heart, though. How things could be alive fascinated me to no end.

Unlike many scientists, I was not the outdoorsy type. I read fashion magazines, did a bit of modeling, and entered some teen-queen pageants. I often joke that a hotel without 24-hour room service is my idea of camping. I love air conditioning and indoor plumbing; I fail to see how doing without these conveniences constitutes "fun." This quirk effectively ruled-out a career in paleontology or biological field work. I do love people. Having a father in academia, and coming of age during the 1970's PhD glut, teachers suggested aiming for an MD which guaranteed employment.

Click for source

Admission to medical school was fiercely competitive in that era, and I aimed my sights on a relatively new program at the University of Missouri - Kansas City. The medical curriculum began on day 1 out of high school and went 11 months each year for 6 years. Getting in meant avoiding the cut-throat competition among pre-med students on many campus. Its goal when pitched to the legislature was producing primary care physicians for under-served areas of Missouri, not academic physician-scientists. My second year there, I got a work-study job as a lab assistant for a fresh-out-of-post-doc carcinogenesis researcher needing cheap labor. This year provided my first experience with real science as I worked with the doctoral student and another lab to set up our efforts. Everyone, including this 19-year-old part-timer, needed to generate data. I learned to do short-term lymphocyte cultures, murine surgery, and a number of assays. The principal investigators of these labs strongly suggested that I figure out a way to pick up a PhD to go with my MD, since I loved the science so much.

The next few years brought more intensive courses and clinical work with overnight call, making meaningful lab time improbable if not impossible. I love science, but another kind of love intervened, along with a big princess wedding. By the time I graduated with my BA and MD, the idea of getting another advanced degree sounded exhausting and unnecessary. I headed off to pediatric residency with the intention of becoming a hematologist-oncologist, building on my background in carcinogenesis. Of course, I met a whole bunch of nephrologists and their patients who convinced me to take my talents elsewhere. After all, urine is golden!

My first 6 months of fellowship were a gray blur. Post-partum depression plus a prolonged period of call without a break left me feeling bleak. January in Minnesota is not exactly rosy, but I entered a lab and felt alive again. More than 100 patients with diabetes of various stages had kidney biopsy material stored for study. I began to ask questions about diabetic kidney disease, learning to do electron microscopy along the way. I published papers, completed my training, and landed a faculty position. National funding followed, along with a better position in Omaha, a great place to live and raise our offspring.

Eventually, my science hit the wall. One project just would not work, no matter what we tried. Another project got shot down by reviewer 3 at the same time the NIH budget tanked. I realized that I could not write a better grant than what I had submitted. The probability of getting the funding expected at my professional level was incredibly close to zero. Even efforts with smaller agencies to get funding for pilot data failed, as these foundations cut back support to established investigators during the recession.

The kids left the nest, and my hubby had an amazing job offer in a warmer town. We moved on last year, and I am turning my problem solving skills back to the clinic and to research in faculty development. I still have a grad student back in Nebraska (who is proving reviewer 3 wrong; take that!), and I love the chance to talk science on a regular basis. I do not miss the grant pressure or knowing that several other people will be out of a job if I fail.

Am I still science? When I see a patient, I gather data through a history and physical exam. I create a hypothesis as to what I believe is wrong, and I test that diagnosis through laboratory studies or treatment. If I am wrong, I go back, readjust my hypothetical diagnosis, and test again. Sounds like the scientific method to me.

I may not have a full-time lab. I may not be a funded PI. I still believe that I am science - with incredible fashion sense, of course.

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More Thoughts on Change: Last One, I Promise

Jun 30 2011 Published by under [LifeTrajectories]

Click for source

For the last time, I post from my office overlooking midtown Omaha. The last box is packed, and I will be leaving this fine academic institution once the few loose ends are tied up.

We came to this midwestern place over 13 years ago. At that time, our lives consisted of our jobs and the tasks and joys surrounding school-aged children.

We leave with an empty nest and the new opportunities that come with that freedom, as well as the challenges of our new career paths.

Of course, most of you reading this message know me at WhizBANG! I will remain at this (virtual) address, as well as my other haunts on the internet. I promise I will get back to my usual content - healthcare, urine, and fashion or lack thereof - after today. But this week has left me a bit melancholy and, frankly, freaked out. I finally feel the change coming.

For those of you who know me in the flesh and blood, I would like to say farewell with the most memorable good-bye performance I can think of:

 

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Virtual Unreality

Jun 30 2011 Published by under [LifeTrajectories]

Today I attended my farewell tea. Having the people I've met over 13 years drop in to say goodbye felt surreal. Even though my office walls are bare, my imminent departure (tomorrow) does not have a sense of urgency.

Perhaps when all the keys and swipe cards get handed over I will feel it. Maybe it will sink in when I scrape the parking permits off the car. Or i may have to wait until I relocate to the new burg for that feeling of closure.

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My Own Farewell

May 25 2011 Published by under [LifeTrajectories]

I sit in my office in a state of some disarray. As I wrote earlier, I am converting my paper files to PDFs, so folders are out. A couple of tubs have been filled, and others await their cargo. Paperwork for my new medical license teeters on top of my to-do stack, awaiting completion.

My radio plays NPR (as always), and callers discuss Oprah's final show. Later today, she will hang up her microphone and move into the next phase of her life.

Today I will treat my lab to lunch. Friday will be the final day that my technicians will be in my employment.

A new job in a new city with a new focus will be exciting, but to get there I must part with people here. I know I want to move into the next phase of my life, but I still feel sad about what must be left behind. Each stage builds us for the next; without the last 13 years in Nebraska, I would not be ready for the next period in Oklahoma.

Before we hit the restaurant, I will leave you with the same song that Oprah has chosen for her final episode (and that featured in the last episode of Glee this season):

"Because I knew you, I have been changed for good."

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Traveling Memory Lane

May 22 2011 Published by under [Information&Communication], [LifeTrajectories]

In 39 days, my stint with my current employer ends. I started packing my offices this weekend.

Click for source

Because I wear several hats at this job, I have two spaces: one in the clinical department, and one in the building that houses my lab. The latter has a better window and view, so it also has my presence most of the time. It is full of stuff, and packing it up will be a painful process.

My clinical digs ended up in 4 plastic tubs, each holding 62 liters. One piece of artwork proved too big to tub, as did a plastic organizer. The most interesting chore this weekend happened in the lab office, where my reprints get filed.

When I started my fellowship, I began collecting articles on a new scale. For you youngsters who never experienced the pre-internet, pre-PDF world, articles used to only come in dead tree form. Looking one up required a trip to the library; keeping a copy in your office, especially one you often wanted to give students to read, made perfect sense. Anything you planned to cite also got filed. Who wants to photocopy something AGAIN, after all. If your library did not subscribe to the journal in question, they used an interlibrary loan system to get papers from someone who had it. This sort of dead tree + US mail process could take 2 or 3 weeks.

At first, my precious papers got classified by topic. While the article might be in my file, this system meant I had to remember what topic I assigned to it, or I had to cross file it in multiple locations. Computers helped, but EndNote revolutionized the process. References could be assigned keywords for searches, and a numbered file rapidly replaced my categorical system. Over time, information from PubMed could be used to directly populate the database, further streamlining the process.

During the last 5 years, my files dwindled. Not because I read less, but because I filed fewer paper copies. Instead, PDFs on a hard drive got linked to their EndNote entries, retrievable whenever desired. This spring I began playing with Mendeley, a free, online reference manager with a collaborative, Web 2.0 vibe as well. It will be used for my next manuscript. Its creators made it easy to import all of my EndNote data, so it all resides in this new place as well.

As I get ready to shift life 500 miles to the southwest, I made a decision to go paperless. Moving 2 lateral file drawers of papers seems silly. I acquired a new scanner with a fast feed and OCR mechanism for the job, and yesterday I went through references 1-700.

Given the time costs of retrieving articles pre-internet, any article with a sliver of potential future use got filed. I knew that there were important background references in these files, but a lot of crap remained as well. The first few folders contained many pieces that were presented at journal clubs, and a number of reviews of clinical problems I faced in those years of fellowship training. Then I hit the section when my laboratory work began. Several book chapters on stereology got scanned, as did other technical references that I cite to this day. Some historical references, like Kimmelstiel and Wilson's initial description of diabetic kidney disease, went through the scanner; not too many journals have digitized their entire archives. Something that old (1936) might not be readily retrievable yet.

Click for source

As I went through the files in chronological order, it proved to be a journey through my career and interests. Sudden clusters of articles on a given topic signaled my foray into kidney size and hypertension, or the burden of kidney disease in African Americans. Projects that never reached their potential are now remembered again, alongside the ones that bore academic fruit.

Tomorrow I begin to address the remaining 1100 or so articles that remain in my files. Initially, I dreaded this chore, but it has been a fond trip through my past at work. As I begin a new direction in my career, it is sort of nice to see where I came from. And to rid myself of a load of paper.

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Back But Tired

Apr 02 2011 Published by under [LifeTrajectories]

So I landed back in Omaha last night and plopped into my own bed, complete with husband, after midnight.

Today, I am awaiting a patient so I can then rush to catch the last part of my offspring's baseball game, and then celebrate my spouse's April Fools Day birth a day late.

From Harvard Business Review April 2011

Since I only have a few minutes, I will point you to another excellent piece in the current Harvard Business Review on failure. Really, this issue is important reading for any of us trying to accomplish anything. You should go buy it now (available through Zinio, so how hard could this task be for my wired and wiley readers?).

David Silverman wrote Constructive Confessions. I have shamelessly quoted the intro here:

History, it’s often said, is written by the victors. And so it is in business. Scan the shelves of Barnes & Noble’s business section, and you can find plenty of books about Bill Gates, Donald Trump, Larry Ellison, Warren Buffett, and their ilk.

However, while it’s perfectly fine to hear about the fabulously successful, it’s ultimately just an exercise in self flagellation for us, the hoi polloi. There’s very little to learn from comparing a successful person’s crêpe suzette with one’s own humble boiled egg.

No, the most important lesson for most of us is to learn from our failures and use the new knowledge to try again:

When you’ve been knocked down time and again, you learn how to deal with setbacks, which ultimately come to every one of us. You don’t figure out how to stop making mistakes; you figure out how to recover from them quickly.

Silverman's bio describes "ten careers so far" including one in typesetting that included spectacular failure, the basis for his book, Typo:

What any aspiring business leader really wants is first-person accounts from people who did it wrong—who ran the proverbial train into the abyss and, as a result, can explain how to bring it back. These, it turns out, are hard to come by. I myself am the author of one such story—Typo: The Last American Typesetter or How I Made and Lost 4 Million Dollars (Soft Skull Press, 2007). In that book I describe how I ruined a 50-year-old typesetting company in Iowa with 200 employees and $12 million in revenue. And in the efforts of trying to publish it, I learned why most people don’t write books like this: Industry buyers think nobody wants to read them. As my publisher, Richard Nash, explained, “All the evidence suggests that business books are not in fact about learning, but about escapism, just like a romance novel. The business book is about imagining yourself a success, not making yourself a success through learning from failure.”

He goes on to discuss other books of business failure (not a lot - see the last quote), including a blog post from Robert Strauss:

Or there’s the post in Robert Strauss’s blog, Ahead of My Time, which recounts the graphic moment when the would-be inventor realizes, several weeks and thousands of dollars too late, that condoms in air cargo holds depressurize and leak unwashable goo onto everything around them. That’s pretty much all you need to know about what can go wrong as a start-up.

Maybe times are shifting, though. In this era it seems anyone can "write" a book after any media event. Even if you lost the election or woke up drunk in a ditch, if you have name recognition, someone will publish "your" book.

The dead tree book shops better get a new shelf ready in the business section!

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