Archive for: January, 2011

The Body Problem: Part Uno

Jan 28 2011 Published by under Dual Career Issues

Those of you looking for advice on hiding the bodies, be disappointed. This post does not feature corpse disposal, nor body image issues. As my husband and I approach our third move in academia, I will explore what has been so lovingly dubbed "the two body problem."

The Book, available on Amazon with a click

Lisa Wolf-Wendel, Susan B. Twombly, and Suzanne Rice even titled their book The Two-Body Problem: Dual career couple hiring practices in higher education.

Their study examines the practices, formal or informal, and resources available to academic couples. It seems men and women seeking advanced degrees often marry each other and may even want to (gasp!) reproduce and live in the SAME HOME. They surveyed institutions across the US, and present their results in a formal, academic way. If you want scientific data, get their book.

In contrast, I plan to ramble in a completely informal manner about our personal experiences over the course of a few blog posts - or at least until I get bored with the topic.

Background

Hubby and I met during our time in the BA/MD program at University of Missouri-Kansas City. Most of the students in this program entered fresh out of high school, and my class, at matriculation, boasted 51 women and 49 men. My eventual spouse entered school a year ahead of me, so he graduated in 1984, approximately 6 months after we got married. He then went off to residency in Chicago, a city with multiple acceptable programs in Pediatrics, my chosen specialty. We believed I would get into one of them the following year, and things worked out that way.

We were still starting and finishing at different times, so he planned a research year in 1987-1988. That way we would start our fellowships together at the University of Minnesota. Our daughter came along in the autumn of 1987, and from then on we planned to live at the same address. Call us old-fashioned, but having both parents in the household felt important.

The fun began the final year of fellowship. My specialty, pediatric nephrology, is pretty much limited to academic medical centers. I hoped to have a funded research lab eventually. My spouse lost interest in basic science during his fellowship. Not in the theoretical sense; no, he still reads relevant cellular and molecular literature to this day. Training with a PI who said (in a manner not tinged with regret) that he really did not remember his children between birth and college graduation may have tainted Jim's opinions. The guy also tended to micromanage; lab meetings were at 5 pm on Fridays. My husband's interests ran to the clinical, patient-oriented spectrum, something his advisors did not necessarily appreciate or advocate.

I began sorting through acceptable available positions for myself. I interviewed in 3 places, only one of which had a job in town for my husband. He ended up in private practice at a large community hospital with its own residency program. He became involved with teaching the housestaff, and he worked on clinical research proposals with faculty at the two academic medical centers in St. Louis. In the meantime, we had our son, I published papers, and eventually the grants got funded.

Time for a Change

In 1997, medicine faced many economic challenges. As my institution developed practice plans, I realized that substantial pay cuts were in my future. To get Medicaid HMO contracts, we were seeing patients for $0.33 for each dollar billed. At that rate I could see kids in clinic 24/7 and never recover my salary and costs. The initial draft for research faculty did not reward one with "at risk" salary until you recovered 110% of your salary on grants and contracts. How did you do that legally?* They also presented no incentive plan for those of us pursuing the "triple threat" career path. My spouse also felt like a move might be in order. He clearly yearned to teach more and to organize clinical studies of his own.

Husker Time!

Once again, I began to check out the open opportunities in pediatric nephrology. The most reasonable place seemed to be the University of Nebraska Medical Center in Omaha. Jim explored a couple of private practice opportunities, but ultimately he convinced the division of endocrinology at the medical center to take him on.

We both thrived. I had great collaborators at UNMC, and the hubby developed skills in clinical research. He also built a diabetes center from the ground up. His team worked hard to improve both comprehensive diabetes care and inpatient blood sugar control for patients not previously diagnosed with diabetes.

Time Flies

Thirteen years have passed since we moved to Omaha. Our daughter now has paying job in another city, and our son will graduate from high school in May. We thought another move might be in the works, and we chatted about looking around in the spring of 2011.

A phone call in 2010 sped up these musings.

Next Post: Tales of the Trailing Spouse

*Someone finally came to their senses, and the final plans worked out fine for those who stayed. I believe they finally got their draconian contracts fixed as well.

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A Very Good Cause and Shameless Self Interest

Jan 27 2011 Published by under Denver the Wondercat, [Medicine&Pharma]

One of my very first blog posts featured Denver the Wondercat*, our pet from 1991-2009. We adopted this gentle giant from the St. Louis County Animal Shelter on my daughter's 4th birthday in 1991. He refused to be an outdoor cat, ignoring all of our plans, and lived a sheltered, pampered life in Kirkwood, MO, and Omaha, NE.

Denver the Wondercat, 1991-2009

In 2008 he became my favorite patient when his vet diagnosed stage III chronic kidney disease. From that day forward he received daily potassium supplements, moist cat food, and subcutaneous fluid boluses several times each week. These treatments won us no immediate love or gratitude from the animal, and they added up to $40 per month; however, he had a good quality of life for another 18 months. The average survival time for a cat with stage III disease is 6 months.

As a pediatric nephrologist, I take care of kids with chronic kidney disease. They, too, have to take yucky medications and uncomfortable shots that win me no love or gratitude. They did enjoy hearing about my cat and his struggles with a special diet and various treatments. I learned the lesson that many before me discovered: children will listen to a talking animal faster than a knowledgeable adult!

After Denver's demise, I decided to write a book for children about his life with chronic kidney disease. Are there a lot of children with this condition? According to the US Renal Data System, approximately 1,300 children are diagnosed with permanent kidney failure in the US each year; an equal or larger number are diagnosed with chronic kidney disease. Approximately 110,000 adults start treatment for kidney failure every year, and at least that many more are diagnosed with chronic kidney disease. These adult patients are likely to have children or grandchildren who would benefit from a kid-friendly discussion of these topics. Finally, according to the Pet Food Institute, over 80,000,000 pet cats live in the US, and kidney disease will be the most common cause of death for these felines. So far no takers on my proposal, but I keep plugging away looking for an agent and publisher**.

If you follow this blog regularly, you also know that my family hails from Missouri and we often attend Missouri Tiger sports events. Big cats, so sleek and powerful, are a favorite venue at the zoo. When I heard about National Geographic's new campaign to raise funds for big cat research, I had to participate!

Little Kitties for Big Cats is a gallery of pet photos. A minimum donation of $5 will get your favorite feline into the gallery where others can tweet it, like it, and donate to it.

Of course, I donated and uploaded Denver the Wondercat. Denver loved to curl up in a lap while we watched Tiger sports, even though he sometimes got dumped out during exciting plays. We know he would want to keep his wild brethren safe and happy as he was for 18 years, even though he didn't choose "the wild outdoor life."

So click here to see Denver in the online gallery. Please tweet it and like it and consider donating; National Geographic wants to raise $10,000 and, so far, they have $2,000. After all, it is in the name of Science!

*Why was he a wondercat? My husband considered himself a "dog person," but our firstborn could not be persuaded to want a puppy. Shortly after Denver's death, my husband missed having a cat so much that we adopted again! Denver turned my spouse into a "cat person," a truly miraculous feat to those who knew him well.

**Of course if you are an agent or publisher with an interest in this manuscript, I would love to chat more with you! Drop me a line at pascalelane at gmail dot com.

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What I Am Reading

Jan 24 2011 Published by under What I'm Reading

Reading is a major joy of air travel. For my short trip last weekend, I started The Autobiography of Mark Twain, a hot new read that sold out its initial printing.


This is not a celebrity bio.

First and foremost, this book is an academic endeavor. Twain started his autobiography over and over, with multiple false starts, leaving a trail of some published works and others locked away for a century. In addition, each dictated session had multiple transcription records, brought together into the final products.

The first 7% of the book consists of academic notes on the process used to construct it, including 140+ footnotes from original sources. Next comes the previously published works; I have not completed my reading here yet. Then comes the bulk of the work, dictated long ago but never published at the author's wish.

Twain felt he would be more honest, about himself and others, if guaranteed a period of time before his thoughts became public. Ultimately, he concluded that this worked for his thoughts on others, but he was still unable to tell the unvarnished truth about himself.

My favorite part so far, from one of the publishers negotiating the agreement:

The agreement would, of course, provide for publication in whatever modes should then be prevalent, that is, by printing as at present, or by use of phonographic cylinders, or by electrical method, or by any other mode which may then be in use, any number of which would doubtless occur to his vivid imagination, and would form an interesting clause in the agreement.

Did someone from the 21st century time-travel and tell them about ebooks? Perhaps that's where Twain got the idea for A Connecticut Yankee in King Arthur's Court!

So far the book has proven to be interesting and entertaining, as one would expect from Twain. I can't wait till I get to the part he felt could not publish while alive!

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We Are Doing It Wrong

Jan 21 2011 Published by under Uncategorized

Image courtesy of PhotoXpress

Although I am not a brain surgeon, I am amazed and delighted at the rapid improvement Representative Gabrielle Giffords shows after suffering a gunshot wound through her head.

Since the start of 2011 only 3 weeks ago, we have also heard about a fatal school shooting here in Omaha and students wounded in Los Angeles after a classmate dropped a backpack with a loaded handgun on their desk.

Yesterday, I caught the end of a rant on the radio by a congressman, thanking some deity for the fact that Giffords got shot in the US of A. He believes that if she had been injured in Britain, with their national health system, she might not have survived the same wounds.

[Note: I can't tell you who the congressman was; I missed the name, and my student has a fellowship application due today. I'm not working that hard on this post.]

He may be right, but not why he thinks he is.

The congressman feels that the quality of care in this country is superior to the United Kingdom. In general, people across the pond have better access to care, providers trained to the same level as the US, and better statistical measures of health than here in the United States. The one thing they don't have? Doctors with lots and lots of experience treating bullet wounds.

According to the UN crime statistics, last compiled in 2000, the rate of homicide by firearm is 3.97 per 100,000 population in the United States. In England and Wales, the rate was only 0.12. The rate appears to have risen over the past decade in the UK, but it may be higher now in the US as well. Emergency and trauma doctors in the US see more gunshot trauma than their European counterparts, and probably have more expertise. Unfortunate, but true.

So have these high profile gun tragedies led to a call for more control, at least on firearms? No! From another article:

many lawmakers believe the right legislative response to fatal shootings like the one in Tucson is to expand, not limit, gun rights. Ensuring broader access to guns for law-abiding citizens, they argue, can help residents defend themselves if an attack or other emergency occurs. In one of its first moves, the GOP majority that took control of the New Hampshire House of Representatives this month voted to allow concealed guns and other weapons in the statehouse and surrounding legislative buildings. Republicans also reversed a 40-year-old chamber policy that banned concealed guns on the House floor itself.

In Arizona sales of the Glock pistol that injured and killed so many people have soared since the shooting. The Arizona GOP has been pushing to allow concealed firearms to be carried on college campuses. The shooting has not dampened firearm enthusiasm one bit out in the wild, wild west.

Guns don't kill people; people kill people.

But killing someone is so much easier with a gun.

So many killings (and suicides) are spontaneous; without a gun nearby, they likely wouldn't happen. But we would have to "deprive" law-abiding citizens of guns to make it possible; our experiment in arming the population does not seem to be reducing gun violence one bit.

I guess this is one more area where many choose to ignore the statistics from countries with strict gun control, just as they ignore the better health and lower care costs of "socialized medicine" in other developed countries.

Why can't data win one now and then?

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Changing Places

Jan 21 2011 Published by under [Etc]

Last summer I left my independent site and joined the crew forming Scientopia. I blogged. About the fork in the road (and even found the artwork for it), but another move was in the works.


My husband had received a wonderful offer from another institution. I had become "the trailing spouse" or the second body in the two-body problem.

After some uncertainty and negotiation, we accepted positions at The Oklahoma University Health Sciences Center. Yup, we are moving to Oklahoma City!


The timing was almost perfect. We just moved our daughter to Kansas City, and our son graduates from high school this summer. The only thing certain about his college choice is that it will not be near us. The problem? They want my spouse there yesterday.

So this weekend we will locate his apartment in OKC. He will start his new job, while I hang out in Omaha, providing adult supervision for our son and selling a house.

More on the new job later. I have to get ready to fly again!

Train tracks courtesy of PhotoXpress.

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What I Am Reading

Jan 20 2011 Published by under What I'm Reading

The title of this post should be in past tense, because I finished Seth Mnookin's wonderful book, The Panic Virus, during my airport adventures. I recently blogged about meningitis in an unvaccinated child, and this book begins with a more serious version of this infection, epiglottitis.


This tome documents the anti-vaccine movement, from it's early days of cowpox through the present. Much will be familiar to those watching the news. Over the past few weeks, reports of the withdrawal of the Wakefield paper and the Kennedy Salon article detailed the bad science and conflict of interest that drove many parents to withhold their children's shots.

Mnookin weaves the compelling story, and I can do no better here. My observation regards the irony of the situation. The anti-vaccine folks claim that the government and big Pharma run a conspiracy that has duped us ( parents and doctors, I'm both, after all) into endangering our children for their profit. Instead, it would appear that the conspiracy drivers were Wakefield and some trial lawyers willing to put much of society, especially it's weakest members, at risk for profit.

None of this appears to budge the beliefs of the most fervent followers of the movement. I am glad that shoddy tainted science has been withdrawn from the official published record. Perhaps one day fact will triumph over fantasy. As someone who has seen children critically, even fatally, ill with preventable diseases, that is a day of which I dream.

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Time to Stop, Think, Feel

Jan 19 2011 Published by under Uncategorized

Ten hours of sleep finally overcame my "O'Hare Hangover" from Monday's travels. After my online rant, imagine my delight when United gave me 9,000 frequent flyer miles for my inconvenience.

Yup, I can be bought.

So this morning I arrived at the office with a busy agenda; I had things to do and people to see.

Then the email arrived.  A friend and colleague had taken a turn for the worse, after what had seemed to be at least a stalemate with metastatic cancer over the past year. She enters hospice care tomorrow. Her time with us will be measured in days from now until the end.

Suddenly time stopped. All those cool blog posts, simmering in my brain since returning from Science Online, sounded unimportant. Writing out a training plan for my doctoral student looked trivial.

The company for which she worked has kept her email account going, even though she has not clocked in for a while. She wanted emails from anyone who felt like sending one.

What do you say to someone who, almost literally, has one foot in the grave?

Finally, I settled on the truth. Her life mattered to so many of our patients, and I was a better person for knowing her.

When the end comes, I hope someone can say the same of me.

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Open letter to @UnitedAirlines

Jan 17 2011 Published by under Uncategorized

Dear United:

I really do understand that you cannot control the weather. Really. When I saw snow in the. Chicago forecast, I expected delays.

I was pleasantly surprised half an hour before my original flight time when the attendant announced that we would begin boarding as soon as soon as the aircraft came over from the hangar.

3 hours later, we have now finished the average ground delay at the time I arrived in Chicago. I see other planes landing and taking off in 60 to 90 minutes. What give? Is the aircraft delayed in the hangar? Really?

Don't get me wrong. Hanging in the lounge with free wine beats sitting on the tarmac with all electronic devices turned safely off. I just don't get why one express flight just turned around in less than 90 minutes while my plane sits in a hangar.

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Goodbye, Research Triangle

Jan 16 2011 Published by under Uncategorized

The final day of any meeting brings a wide array of emotions, from sad good byes to relief at having enough clean underwear after all. My farewell to Science Online 2011 (#scio11 on twitter) leaves me wondering why I have to wait a full year to do this again.

Never before have I met a group as wired as this one. Never before have I met so many people who love to write about science. Never before have I met so many scientists with such internet presence.

Scientopians were well-represented at the event. Meeting in real life was such a treat, especially those I know only by a pseudonym.

I brought along my devices so I could blog each evening, but real life networking superseded online connections. Sorry, readers.

Next week will bring posts on the meeting, especially the session today on self-marketing. In the meantime, I have to pack a whole bunch of stuff (including the best meeting swag ever) and get ready for a morning flight.

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Off to Science Online and I'm Packin'

Jan 13 2011 Published by under Uncategorized

The big tweet up finally begins! So what did I pack besides my twitter pin and hot shoes?

Electronics! From left to right you see my Livescribe pen and notebook; net book and mouse ( because you can't make Prezis on an iPad); the iPad; my Blackberry in its bling case; and the charger for the camera I used for the shot. My flip cam is MIA, on it's way to California for warrantee work.

Raleigh-Durham, here I come!


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