Just do it.

I want another glass of wine.

But I have come to the age that when I have another glass of wine, sometimes it gives me weird dreams, sometimes I can't sleep well, or sometimes I don't sleep at all. When did that happen? And while we're on the subject, when did I get so many grey hairs? Last February, Mike and I were at the Louvre- ON VALENTINES DAY- standing in line, waiting to get in, and he looks at me lovingly and says 'You've got more grey hair now. I just saw a new one.' not in a snarkey way, just in a really lovey, kind way. I laughed. Cause what else do you do in that situation?

I am feeling very... intense about my PhD lately. I have absolutely no perspective on it. Everything about it is life or death. I mean, cognitively, I know it isn't. But whenever I have an advisory meeting, or have to turn in a paper or chapter I have this uncontrollable emotional reaction. I don't really understand where it's coming from. I'll be talking about the design of my next study, and then suddenly be all teary, worrying about whether or not it'll work, and how am I going to write this, and how the eff am I going to defend this in my viva?? I guess that's what this process is about, but I find the constant fear life sucking. The PhD is such an ego-centric exercize. All of it is "how am I going to (fill in the blank)?" not we. Not us. Not team. Just me. ME defending MYSELF and MY IDEAS. I really genuinely don't like that. I don't do well in an environment that is centered on me. I really don't enjoy that attention. I don't want it, and I don't want to be that person. Plus, I don't think that's what life is actually like. I really hope not, anyway. That's for another post, though.

And, really? Really?? This is what I am going to spend my time worrying about? I mean, my life is pretty freakin great. How is it that I spend so much of my mental energy worrying about this?

I was called my dad the other night. I told him I needed a pep talk. I told him that I hate my PhD right now, I am sick of not knowing what I am doing, I really don't understand the minutia of research, and most of all, I DON'T CARE. I just want to help. I just want to be done with this and move on. I want to do something that matters, not format my chapters with 1 inch margins, and headers and footers and my page numbers in the RIGHT corner (cause god forbid they're in the left!).

And you know what he said? He said, Sarah. Get. Over. It. You have to do this. You have to finish. You can't be a swashbuckler until you're a sailor (how awesome is that metaphor??). He said, you just have to tick the boxes and do what you're told. You have to format your papers and you have to get over your hesitations. You will do good, but you have to do this first. Just finish. Head down. Remember why you're doing this. Just finish.

This advice is very interesting, especially coming from my dad. My father is one of the most passionate, go-all-out people that I've ever met. He can't half-ass anything. It's not in his blood. And for him to tell me to just move forward and finish was really eye opening. So, he's not telling me to half-ass this, but he's telling me to get over it and just do it. Stop questioning every little bit. Put the blinders on and keep your head down for the next 10 months. And finish.

I guess I always thought that this process would be one in which the things that I thought and believed would be confirmed and that I could move forward confident in my own ideas and my own well-formed, well-articulated, theoretically-grounded positions.  I don't know how I didn't realize how naive this is... And not just about research. About life, about friendship, about what it is that I actually like to do, about being a grown up.

The thing I've learned, more than anything else during this PhD is exactly how little I do know. 

I've also learned that a little perspective can go a long way. Not that I, in any way, have this mastered. I most certainly do not. But it's like the grey hair. It's coming. And no matter what I do, it'll be there. And I suppose the thing is to accept it, and just move on. With the PhD, it really is just a matter of finishing. The best PhD is a finished PhD. Head down. Just do it. Cause what else do you do in that situation?

Practice makes perfect?

Lately, I have become a bit obsessed with the idea of ‘practice’.  Practice is a repetition or rehearsal of something, an action, activity, work, and so on, in order to become skilled at it. It is both a noun (‘standards and practises’- spelled with an ‘s’ if it’s a noun) and a verb (‘I am practicing violin’- spelled with a ‘c’ if it’s a verb. My mom will laugh at sentence, I hated practicing violin and probably never used this phrase in my life, except when lying to my violin teacher about my upcoming week’s activities). The definition hinges on ‘ACTIVITY’. The DOING of SOMETHING over and OVER in order to become better at it. Sometimes, when you’re really good at your specific activity, you move from the verb to the noun (medical practise or law practise).

I really like this idea that you aren’t ever really done- even if you’re an expert, you still have to practice. In fact, it’s what you do every day.  You go to your job to keep getting better at your job. It’s one of the things that I love about yoga- you’re never perfect at it, you’ve just got to keep working on it.  Even the people that do it every day still strive to attend to their practice and make it stronger.

In his book, Outliers, Malcolm Gladwell argues (and has the science to back it up) that there’s a magic number of hours that people need to do something to transition from good to great. When people cross the threashold of 10,000 hours, they somehow move from good at something to very very very good. He uses examples from sports, music, medicine, even art. After working on a certain activity for 10K hours, people reach a state of expertise.

Ok, after reading this part of the book, I think to myself-  “SWEET!!! That’s all I have to do!! Get to 10,000 and I’m home free! I will be Good. At. Something. Important. I wonder how many hours I’ve done so far, probably like 5,000. I feel that I am at about 5,000 hours of expertise.” So of course, I calculate it.  I started as a research assistant when I was a junior in college at the Wright Patterson Air Force Base (3 months, avg 40 hours a week= 480 hrs) then stayed on through my senior year (8 months, avg 20 hours a week=640 hrs), then started my master’s program with about a 3 month break between, for 2 years (21 months- vacation and times when I was goofing off, avg 40 hours a week = 3360), then Mayo for 2.5 years (25 months- wasn’t always doing research and was on vacation, avg 40 hours a week= 4000 hrs), then PhD (22 months- lots of goofing off, avg 40 hrs a week= 3520 hrs). 

HOLD UP A SECOND.

Now I am no statistics genius, but I think that adds up to more than 10,000. Crap. Where’s the magic? I am in fact at a surplus of 2,000 hours! Damn. Damn damn damn.

Perhaps it’s because it’s just not that simple.  Maybe it’s more than an endurance sport. If it were only endurance, this would be a lot simpler. There must be something else to this (please, let there be something else to this). I went back to the book and continued to read. As it turns out, experts are made because an expert works not just on the stuff they’re good at, but also the stuff that they aren’t good at. It’s not just the PRACTICE that’s important. It’s also that you have want to become BETTER at what you’re not good at already. That is significantly trickier.

How do I take this next step? How do I move from endurance to confident, passionate, thoughtful? And significantly for me, how do I do it in the way that I want to? To achieve the things I want to?  To find what’s best not just for me, but for my family? What are the things that I am not good at that I have to practice?

I’ve realized over the last 6 months or so that I struggle with the ‘philosophy’ part of getting a PhD. Seems silly, like I should’ve realized that was part of it before I started… Well, I don’t always read the directions before I attempt to put together the swing set, just ask Mike. I thought this would be a place where I could hone my skills, I could become better at solving practical problems, I could explore new health care and teamwork innovations and apply them within a new domain. As it turns out, yeah, that’s part of it, but it’s not the entire thing.

Philosophy: phi·los·o·phy (n.)

1.    Love and pursuit of wisdom by intellectual means and moral self-discipline.
2.    Investigation of the nature, causes, or principles of reality, knowledge, or values, based on logical reasoning rather than empirical methods.
3.    A system of thought based on or involving such inquiry: the philosophy of Hume.
4.    The critical analysis of fundamental assumptions or beliefs.
5.    The disciplines presented in university curriculums of science and the liberal arts, except medicine, law, and theology.
6.    The discipline comprising logic, ethics, aesthetics, metaphysics, and epistemology.
7.    A set of ideas or beliefs relating to a particular field or activity; an underlying theory: an original philosophy of advertising.
8.    A system of values by which one lives: has an unusual philosophy of life.

Fascinating. The definition of this word is absolutely fascinating. I almost can’t believe it. The problem lies right there in the definition. I mean I love pursuing wisdom by intellectual means and self-discipline. I 100% believe in that. But, one of my biggest problems with getting a PhD is all the thinking about thinking. The lack of actual DOING- ‘rather than empirical methods’ and ‘underlying theory’. I had a fight with my advisor on my first week here because I want to focus on the front line, and how my research will impact what people DO, ie: will impact PRACTISE!!! He said to me, ‘well, Sarah. We’ve also got to think about how you’re going to contribute to the theoretical study of leadership.’ I must’ve made a face or something, because he said ‘what?’ and I almost said, well, I really don’t care about that so much.  Mercifully, my frontal lobe kicked in and I just shrugged.

As I approach my final year of the PhD, I am getting deeper and deeper into the philosophy bit, and I feel that I am losing my touch with reality. I still go back to the OR from time to time to remember why I am doing what I do, but it’s a struggle.  Mike says that this is a good thing because now I know more about what I should and shouldn’t do with my life, and he’s absolutely right. But for now, this is the part of practice where I have to work on the stuff that I’m not good at, and don’t really enjoy. Because maybe I’ve miscalculated, and my 10K is just around the corner.

The Strength of Culture

This American Life, a podcast I listen to religiously, did a piece a couple of weeks ago on Haiti called 'Island Time'.  The show examines life post-earthquake for people on the ground, the people who've lost everything, and how these people, along with NGOs, volunteers, physicians, economic experts, are using their different areas of expertise to try to rebuild or more effectively build a stable Haiti. During the first act (that's what they call segments of the show. I think it's a throw back to the old days of radio as a storytelling medium, rather than an archaic method to get news that only Grandparents and Liberals use) they focus on the story of one woman and her mango trees (not a euphemism). This woman has a couple of mango trees on her farm, which would be extremely profitable, if she could water them regularly, harvest them and get a good crop going. 

Mangos are the top export for Haiti.  This tiny country grows enough mangos to satify all the American demand, but they're not grown on large farms, rather by individual farmers, like the woman, with only a few trees. Therefore, the exporters have to figure out a way to gather all the mangos together before they can be shipped. Americans like their mangos beautiful, pinky and green on the outside and firm to the touch. Haitians don't care if the mangos are bruised, nor what they look like on the outside, just that they're edible. So once each individual farmer picks the mangos, he or she stores them under their beds or in piles outside their homes, because they're so valuable. As you can imagine, this leads to quite a bit of bruising and marking on the skin and overexposure to the sun. Then a middle man comes, buys the mangos, and brings them to a city via donkey and cart for export. This process, developed over centuries, ultimately leaves many mangos unsuitable for export.

Exporters and NGOs have tried to work with people, give them plastic crates to store the mangos in, keep them safe, but people don't understand that this is what the crates are for. The process of picking the mangos, putting them directly into crates, and setting the crates out for exporters to pick up is so non-sensical to the farmers, that they don't do it. They end up using the crates as seats or as shelves, because using them as a vessel for mangos is ridiculous. This seems like an easily solvable problem. Just tell the farmers to use the crates. Tell them that if you do, you'll make more money. Easy.

As the story goes along, you find out that the crates were brought to the woman farming the mangos by some guy she'd never met. He was white, articulate, drove a car, and just handed out the crates. He made no explanation other than, do this, it'll decrease the bruises. But to this woman, who cares about bruises? The mangos taste good. This woman hasn't ever been away from her small village. She can't even imagine an American, much less an American grocery store where young mothers carefully examine every mango, to find the best ones to feed their children (I am not criticizing, I do this. I am extremely picky in terms of how my food looks). It just doesn't make any sense to her. In her culture, having a good mango is good enough. Because she doesn't value these things, she has a hard time conceptualizing why another person would.

I heard a similar story not too long ago at a talk I went to about using science and innovation for development.  During this talk, the speaker told a story about how scientists had engineered a new type of sweet potato which had been infused with beta-carotene for consumption in areas of sub-Saharan Africa. He said that when they first introduced the new potato, it was extremely difficult to get the people in the villages to eat it. The scientists were frustrated. They'd spent all this time and all this money to develop this new, healthier, vitamin fortified sweet potato and now the people won't eat it, even though it's good for them, and will improve their health. As it turned out, finally (FINALLY) the researchers realized that people weren't eating the potatoes because they were a different color than the traditionally grown white potato. People thought there was something wrong with them because they were a different color and tasted funny.  

Another story, not quite as dire, but with a similar theme: When Pele first came to the US to play with the New York Cosmos, after a game he looked at his feet and saw that they were green. He immediately told the manager that he quit, citing green foot fungus that he'd contracted since coming to America. He was in a panic because he said his feet were his livelihood, and since coming to America they'd gotten sick. What had actually happened was, in an effort to make the field look better, the grounds staff had painted the dirt field green, and the paint had come off on the players' feet.

The point I am trying to make, sloppily, is the importance of culture in the evolution of improvement and innovation.  Not just culture, the individuals that are part of that culture. In the first example, the woman needed to be trained on how to use the crates, taught that there are people who value the look of the mangos, not just the taste. The exporters needed to translate the desires of the customer back to the woman in a way that she would understand. She's not stupid, she just doesn't know, or have the capacity to figure it out on her own. In the second example, the scientists didn't take the culture of the villagers eating the potatoes into account. They thought that because the innovation was good, was healthier, that people would automatically be on board. But this isn't the case. People need to understand the WHY, not just that it's better. In the Pele example, again, it's a classic clash of cultures. At one point in his career, Pele played on dirt fields. Lush, green, grassy fields aren't always the norm. But in American sports, the spectacle is really important. Sometimes, it's half the fun (see: Dallas Cowboy Cheerleaders).

There are also more subtle examples of culture within culture in the world around us. In the work that I do in the hospital, culture is extremely important. There's a surgery culture, a nursing culture, an ICU culture, an ER culture, etc. Some sort of patient safety innovation that works in the OR, might not work in the ER. Not just because the work that they do is different, but because the people, the culture of these areas, is different. What we're talking about here is the idea that another culture might value a particular quality that you, in your culture, find to be ridiculous, or superfluous, etc. The point is that if you want to innovate, make change, and hopefully improve life for someone else, culture is extremely important. If you want to make a lasting change, it's imperative to work with the system that people have established, not criticize it, and to innovate both from a bottom-up and top-down approach.

People are extremely important. In almost every circumstance I've encountered, the people have built a culture for a reason. They do things in a certain way for a reason. To ignore the history and context leads to instability and usually only temporary improvement.

There are two quotes that keep running through my head as I write this.
1) 90% of success is just showing up.
2) People don't care what you know until they know that you care.

Normal Curve

It's been almost 2 months since my last post. I don't know why it's taken me so long to think of something to write, but it has. I've got little scraps of paper all over the house, in my purse, in my backpack, with ideas scribbled on them but nothing has struck me as substantial enough to write about. Not that this is the pinnacle of what I've come up with, but I feel that it is important to write something.

The last 2 months have been interesting. After running the half in Inverness, I basically stopped running. I don't know why. At first, I thought I just needed a break. My body was exhuasted and injured, so I took 2 weeks off deliberately. Then I started swimming and biking to work (not swimming to work. swimming while at work, and biking to work). I was going to do a triathalon in July, so I thought this'd be a good way to start gradually training. I did that for about 2 weeks, but it really wasn't all that fun, so I didn't stick with it regularly. And, I still didn't really want to run. I thought, maybe I need to get back to yoga. Even though the classes that I take aren't very challenging, I find that I can challenge myself with yoga. However, we only have yoga classes available twice a week, and for whatever reason, I didn't regularly sign up or go. What the heck? This is stuff that I like to do... why don't I want to do it?

Also, stuff with school has been in a weird state of suspended movement... like my work is a piece of fruit in the jello salad my grandma used to make. I keep working, keep struggling to make progress, but somehow nothing was happening. I got to work around 8:30 usually, come home between 5 and 6, and still nothing... How is that possible? what do I do all day? I know I fool around on facebook, but honestly (I swear!) it's not what I do all day. I am not depressed by this fact, just incredulous really.

Finally, Mike and I have been blessed in the last 2 months to have his mom and my dad and brother visit. This has been absolutely great. Karen's trip was great, we did some unexpected exploring, thanks to Mount Egiondoarioihallloaiwhefjnlhge in Iceland. It was wonderful to see Karen, she's such a balanced presence, and I admire her so much. Plus, she and Mike are so close, I think they bring out the best in each other. It is a beautiful thing for a wife to watch her husband be so peaceful. 

The week after Karen left, my dad and bro arrived. I thought it was going to be dad and his wife Jen, but everyone (and I mean everyone) except for me knew it wasn't Jen that was coming. Since February, it was going to be Matt. They surprised me at the airport, and I almost passed out from joy. What an awesome gift. We went all over the place exploring... it was amazing to get to know my brother a little bit better. Because we've not spent any substantial time together in ages, I really don't know him as the man he's become. I felt extremely blessed to get this time with him to get to see what he's really like. And I think, aside from being a supreme pud, he's extremely cool.

Soooo... in reflecting about the past couple months, I've realized that what I've been seeking is 'the sweet spot'. In cognition, sports, workload, many things really, there's a sweet spot. The sweet spot is the place between things being too easy that there's a performance decrement and where things are so hard, there's a performance decrement. If you look at a normal curve  you can see that there's a line in the middle- that's the performance sweet spot. By performance I mean the ability to accomplish a goal. This could be anything: learning lines for a new play, writing a thesis chapter, shooting foul shots. The point is, go to either of the extremes, and performance will decline.  Research has shown that people have individual sweet spots. What works for me, probably won't work for someone else. It's entirely personal. Research has also shown that performance can be augmented by short periods of challenge, but that if that challenge is extended for a longer period of time, performance will eventually decline.

I think that that's what's happened over the last couple of months. I've been at the physical, mental, and emotional extremes. My body was tired, my brain was tired, and my soul needed some extra attention. Spending time with family has just made it more and more apparent that in order to be the best person I can be, I need to be around family and friends. I need to allow myself to find my balance and once I've found it, to just sit there and enjoy it, wallow in it, instead of struggle against it. I am going to make an Almost Half Year Resolution: I promise to chill the f out. I promise to try to be more balanced, and to pay attention to important things and let little things go. I promise to forgive myself when I go into my 'hulk moments'.

Nice. ok. here we go.