Cold Spaghetti

Right after All Things Considered, just moments before the classical hour begins, our local public radio station has the owner of a consulting firm give advice in minute’s time.  They call it “The Louisiana Rebuilds Minute.”  We call it “The WWOZ Minute.”  (A friend coined the term, meaning that this is when he switches the radio to the local music station for that minute).

The idea of the Minute is that the people of Southeast Louisiana are too stupid to realize that it just takes a web search to find the answers to all problems related to an unprecedented rebuilding of an American city.  Since we’re too idiotic to figure it out, The Minute does it for us.  Paul and I have been joking for years that we would make a “Louisiana Rebuilds Minute” Generator — you just add in a common post-Katrina problem, throw in some patronizing ‘pull yerself up from yer bootstraps’ talk, and suggest that one consulting firm’s website has alllll the answers.  Insert those few tidbits, press enter, and BOOM, you’ve got your manufactured minute.

The point that The Minute doesn’t get is that JUST BECAUSE there is one organization out there with funds to build playgrounds, doesn’t mean that every school that needs one and applies will get it.  JUST BECAUSE one bus is available to a few folks who have the magic combination of ills and scripts to qualify for reduced medicines doesn’t mean that everyone who needs meds can get them.  And JUST BECAUSE The Road Home offered funds to some families doesn’t mean they have all that they need to rebuild their homes and lives.  Just because there are programs and grants and applications and dollars out there doesn’t mean that they are thought through, that they are honest, that they actual reach the people that they are meant to reach, and that they make any impact at all in the outcomes of our daily lives.

It is easy to get mislead.

It is easy to think that ideas are either good or bad.

I’m not so sure.  If I have learned anything from being a part of New Orleans’ recovery, it is that EVERYTHING is mired in thick, silty gray.

And in the middle of all that mess sits Charity Hospital.

One of the big discussions flying around Southeast Louisiana surrounds Charity Hospital.  Until Katrina, Charity was the second largest hospital in the country and one of the oldest continuously operating hospitals in the world.  It was the primary source for health care for many of New Orleans’ poor.  Actually, considering that many of Charity’s former patients have not seen a physician since Katrina, technically, Charity is still their source for health care… it’s just not open for them to receive it.

In fall 2007, Jim Aiken, the LSU University Hospital Chief of Emergency Medicine who worked the Emergency Department through Katrina and the aftermath, came to a class I was assistant teaching.  His fascinating lecture included discussion of Charity’s pre-storm emergency plans, his experience of the storm and flood from within Charity, how he helped coordinate emergency care in the extended aftermath, and finally some of the issues involved with long-term planning for health care for the city.  At every step, the issues are overwhelming at best — but what struck me was his passionate and pointed arguments for medicine, good medical care, and services to the community.  He left me convinced that we need to rebuild a top-tier medical facility in this city, one that serves the poor within it, both because it draws good doctors to gain experience within it and because providing care to those who wouldn’t otherwise receive it is as important in this community as drinkable water and drivable streets.

A little over a week ago, the Schweitzer Fellows held our second symposium.  This one was on “The State of Health in Louisiana” and Dr. Larry Hollier, chancellor of LSU health sciences center (encompassing the training programs for all allied health fields at LSU), was one of the speakers.  His presentation was about the new LSU health sciences center — a center which is desperately needed, but is incredibly controversial in how it plays out.

The issue is that Louisiana’s doctors come from LSU graduates… by no small amount.  The physicians practicing in the State are close to retirement age by overwhelming numbers, and the physicians coming out of LSU are not the type to stick around and take their places.  Even before Katrina, LSU was seeing a substantial increase in the numbers of foreign-trained medical students who were ‘matched’ to attend LSU for their residencies — these are students who tend to go back to their home countries after residency.  There were also increases in ‘matches’ with students for whom LSU was not a top choice… indeed, has not been a first choice for many in recent years.  In addition to bringing in students who are not necessarily going to stick around… LSU has not been attracting the best talent, who are going to get picked up by the more desirable residency programs.  Post-Katrina, these enrollment numbers have been even more dire, suggesting that the outlook for Louisiana to have competent, young physicians to support the State’s medical needs into the future is grim.  Dr. Hollier argued that plans for a new science center were in place long before Katrina, and that the need for an expanded, updated center for treatment, training, and research was critical to the survival of health care in Louisiana.

And I believe him.

Don’t get me wrong: my impression of the guy was that we’d have some seriously different views on just about any medical or social issue… but the numbers and his argument was compelling.  More than that, it completed echoed my experience as a student: my peers don’t stay.  Heck, *I* am having trouble figuring out how we’re going to stay.  Even if Paul had gainful employment, the fact is that the research dollars to study health inequalities in our city don’t go to researchers in New Orleans.  If I want to stay involved in research here, it seems like I need to move to Chapel Hill or Ann Arbor or Boston or wherever in order to do it.  (I’ll save this rant for a later date.)

I think that we need a commitment to a new, state-of-the-art facility to attract new talent, house research programs, and rebuild health infrastructure in the city.

Dr. Hollier spoke ONLY of the LSU plans — NOT the combined VA plans.  In the LSU plan, only 33 homesites are impacted over an area that encompasses more empty parking lots than businesses or homes.  (The VA plan, as outlined in a wonderful advocacy website, impacts many more people and historical properities.)  He argued rationally that the Charity hospital building could not be retrofitted to the needs of the new center and any expansion did not include parking or other supportive infrastructure necessary for that sort of facility.  He suggested the renovation of Charity as apartments for residents.

Everything that I know about New Orleans and the way things work make me question people in power — question their motives, question their reasoning, wonder about what they haven’t considered.  (In contrast, it also has shown me that New Orleanians are some of the most change-resistant people on the planet… but possibly for good reason.)  Yet, I am compelled to WANT this new center.  I WANT a place where I can collaborate and build and learn and serve.  I’m EXCITED about the possibility of this center… it makes me want to be here, stay here, work here.

Those first couple of blocks closest to I-10?  The ones that are predominantly occupied by empty parking lots?  I can’t think of a better use than to build a new science center.

But.  The rest?  Well.  I’m uncertain about this.  Because I feel that Dr. Hollier would drive through a community like lower Mid-City and not see a community worth saving.  He wouldn’t necessarily see a pattern of New Orleans rolling over yet another predominantly African-American community for the sake of progress.  Or, maybe he would — maybe he would but he would argue it was necessary for the common good.  And sometimes?  Sometimes I believe in the common good, even if it stomps all over individual rights.  Early public health efforts involved holding people down for immunizations against their will… and that is WHY we were able to control disease.  Sometimes common good is a good answer.

BUT!  Common good should come out of insight and input from the community.  That’s what it’s all about. I’m not convinced that LSU are taking alternative plans seriously.  I don’t understand why the RMJM Hillier plan isn’t feasible and while I am not convinced it is the right place to go, I do think it signals to LSU that it needs to look for compromise.

And I’m worried that this will be locked in years of debate and at the end, the people of New Orleans will continue to suffer for lack of a comprehensive medical center and a generation of medical talent will slip through our fingers.

There is no easy answer here.  And I’m sort of all knotted up inside over it because it involves my field (public health) and my passion (community-level advocating/organizing) — with one tromping on the other in the name of common good.

Got anything good for this one, Louisiana Rebuilds Minute?  What website of yours solves this??

(If anyone still reading has thoughts, comments, insight, or ideas… I’d love to hear them.)

The Celebration of Service for our Schweitzer Fellowship cohort was last Wednesday at New Orleans Yacht Club.

Paul and I got there too late for the boat trip.  So we were stuck enjoying the sunset from the pier.  We weren’t entirely sure what to expect from the night.  We knew some program funders would be there, as well as some from the new group of Fellows.  As part of our fellowship requirements, we prepared posters for viewing during a cocktail hour.

When we sat down to dinner, our program director asked each of us to come up and talk to the crowd about our projects and memories about the Fellowship year.  Impromptu speaking!

Have you ever had one of those moments where you are up in front of a room of people and notice someone unexpected in the audience, maybe someone you’ve been sort of nervous about seeing, and have a total freak out mid-speech?

No?

Oh, well, me neither.

That whole shuttering blinking thing I did last Wednesday when I saw one of my committee members smiling at me in the audience?  Yeah, that wasn’t me losing my train of thought or being distracted by the !!!OMG!!! running through my head.  Not a bit.

That was how Paul met my Committee Member Extraordinaire, whom I could call Dr. Comforting, Dr. Calming, Dr. Confirming, or Dr. Consoling and still not quite capture what this particular person brings to the table.  It had been a LONG TIME since I’d checked in.  My committee chair (the one who is suppose to guide everything I do) had strongly suggested I sort of keep the rest of the committee on the sidelines until I had a pre-defense draft ready for review… an appealing choice, but one that was freaking me out.  What if I alienate another member?  Or, what if I ignore my chair’s advice and get thrown off track by someone else’s comments?  Ack!  The confusion!

So far, my way of handling it was to ignore everyone.  A wonderful strategy if my goal is to never finish, or so it seems.

Bottom line is that Committee Member Extraordinaire was INCREDIBLE when we spoke after the speech.  I told her where I was and what I was doing and was honest about the advise from the chair.  “I think that is great,” she offered, “I love it when people can work that independently.”  It knocked the wind right out of me.  Then, she pleaded with me to speak with public health students about Schweitzer, congratulated me about taking over (temporarily) as program director, and just generally made me feel all warm and fuzzy inside.  (Note, this is distinctly different from how committee members usually make one feel.)  Paul turned to me afterward and said, “I love her.  She is fantastic.”

“I know,” I answered.  I forgot how supportive she is.  How could I forget?

Seeing her and getting all of that out in the open took a huge weight off my shoulders and I feel so much more prepared to finish this thing.  I am starting to see that it is something I truly can do…

I finished an abstract today, ahead of schedule, thus completing one of my recently self-assigned dissertation milestones.  It was an incredible achievement on my part, right up there with my self-inflicted embargo of the Twilight series (I may not read until I’ve finished a draft).  My work ethic — it boggles the mind.

All the work work work please don’t talk to me I’m writing work work laundry laundry make dinner work has made it very difficult to procrastinate, which means that I was unable to plan for a last-minute trip out of town.  We were close to picking up and heading out to a tax-deductible, in-support-of-the-company weekend trip to Houston to go to the Ikea (356 miles away) to binge on cheap Scandavian furniture for the office.  When Paul found out that they had BOTH a supervised children’s play area AND cooked ham with mashed potatoes for $6.99, he was ready to take off this afternoon.  Unfortunately, responsibility found out and came knocking and finger-wagging.  Sure, it’d be NICE to have books up off the floor and all, but the next year’s school fees and summer camp deposits are BOTH due at the end of the month.  And the kids need shoes.

In the spirit of looking for creative ways to pay tuition… I’m I too old to sell my unused lady eggs?  They are very effective.

It’s dense, y’all.  So here’s the first dose.

It’s about race and health in public health research.

The U.S. is a multi-racial, multi-ethnic society, so we use race as a variable in all of our research.  We do this partially because of the fact that racial differences persist in virtually every area of health interest, and partially because of convention – we publish statistics stratified by race, we control for race in research models, and we exclude individuals from analysis on the basis of race.  What we (‘we,’ meaning me and my colleagues of health researchers… if I might take that presumptuous leap of status) don’t do is stop to question whether race is really an appropriate construct – what it means, what it really differentiates, and what it ultimately suggests.

This is really important because the use of race in public health research is very problematic.  The idea is that using race categories controls for some sort of undisclosed differences in population genetics… or in fancier talk, the epidemiologic assumption is that there is a genotypic difference that is being controlled.  But in reality, researchers aren’t in the practice of, say, taking gene frequency measures in their participants.  And more to the point: they aren’t even in the practice of defining the criteria for assigning a person in one racial category to another.

Well, if you’re still with me, you might be asking about the standard.  Because, surely, our medical researchers have come up with some hard and fast rule about the biologic concept of race in medicine.

Nope.

And as much as population geneticists will jump up and down screaming about things like ‘continental racial categories’ and the higher incidence of genetically-related disease in certain groups (say, sickle cell) – the bottom line?  All our genome work has us coming back again and again to say that genetically, we’re all pretty much the same.

Richard Cooper (an MD and Epidemiologist at Loyola Med School in Chicago) is sort of the Master and Commander of this discourse and I’d be remiss to try and restate what he says so darn clearly:

Racial differences reflect different social environments, not different genes, even where two groups live side by side, as do blacks and whites in the United States.  Race does not mark in any important way for genetic traits; rather, it demonstrates beyond question the paramount role of the social causes.  We have much more to learn from that paradigm, rather than the one offered by ethnogenetics.

In short, when we’re studying race, we’re really not studying genotypic differences – we’re studying phenotypic differences.  (e.g.: the differences that result in our environments, not our genetics.)
Okay then, but public health uses race all the time and finds all sorts of interesting results.  What does all that mean??

For one, it means that the results might be screwy.  The majority of public health research occurs statistically: where a model full of complex and overwhelming Greek letters spell out a variety of things (the independent variables) that predict what happens to an outcome (the dependent variable).  Race is most often used as a dummy, or binary, variable – meaning that you are either black or white – so the lack of conceptual clarity about what in the world each of those categories means leaves a great deal of room for error… if you aren’t controlling for something very clearly within your model, it means that your variable is open to error.  It could be measuring the effects of other things in your model, including things in the error term.  This means it could be “endogenous,” which, in public health research, is a Really. Bad. Thing.  Suggesting that using race as a binary variable presents a problem of endogeneity to statistical models is sort of like saying that that ‘vegetarian’ gravy your Mom has been feeding you for all your 20 years of vegetarianism is actually made from 6 different animals.  It ruins everything you’ve ever done with it and colors your ability to use it in the future.  It’s better to just not know.  Or to ignore the reality.  Or!  To reinvent it!

Like, for example, saying that race doesn’t really mean what we think it means.  Let’s get real, you say, we know that race is all messy!  So when we’re talking about race disparities in health, we’re actually measuring other things… you know, like socioeconomic status, discrimination, cultural factors, stuff like this that we know have a racial component.

That’s all fine and good, I answer, but public health models shouldn’t be proxy for anything not clearly defined.  That’s not good science.  It’s more logic to argue that if race is a proxy for other factors, then we need to find better ways of measuring those other factors.  If we’re going to intervene effectively, we need to clearly understand what is going on.

Let me give an example.  Let’s say that you are a health researcher and you’re studying prenatal care utilization.  You’ve got a great regression model controlling for a variety of factors and your results show a statistically significant coefficient for the race binary variable (that the mean number of visits is higher for whites than for blacks, even when you’re controlling for things like income, age, insurance status, etc.)  You might fall into the trap of reporting (as is embarrassingly common in published research) that “race is a significant determinant of prenatal care utilization.”  Think about that for a minute.  The color of one’s skin has nothing to do with how many times someone sees the doctor.  How the world around someone reacts to them due to the color of their skin (or other individual factors) may very well impact how many times they attend a prenatal visit… but that is not what the model is measuring, nor what the data is suggesting!

Further, if you go along that route, you may filter that finding down to medical and public health practice.  It may be unintentional or even unrealized, but your intervention could be focused on race, trying to address whatever it is about being black that means you go to the doctor less.  You may not even think to see what is going on with the doctor, or the clinic, or the system because you’re so focused on intervening in on that race factor… and you’d be missing the point.

Public health science needs better conceptual precision about the measurement of race, period.  At the very least, the lesson here is that we need to be clear on what we’re measuring and how we’re interpreting it.

Possible reader comment:

“Are you really working on a PhD, because honestly, I read your blog and uh… you’re just totally a Mom with a camera and a sometimes nice way of writing.”

No, really, I am working on a PhD.  And while I don’t necessarily feel like I need to say anything to prove that fact, I am starting to turn a corner with my work.  No, no, I’m way too entrenched in academic aloofness to claim some sort of importance in what I find interesting (we get kicked out of the ivory tower club for that kind of uppity behavior) – but I do feel GOOD about it.  In the sense that there could, maybe, be some sort of usefulness in something, somewhere.  Was that stated aloof enough?  Phew.

Unsure of where to start, I’m just going to start at the beginning.  I figure, too, if I can just talk about this in normal language to explain to a regular person, than I do really ‘get’ the big picture here.  So think of this as an exercise.  Oh, and as something that will come in parts… because these blog posts need to be taken in steps before we reach full stride.  I’m telling you: I get winded easily.

So I study health inequalities.  I’m interested in where the best interventions can be made to improve  lives and health statuses.  In particular, I like health research because of how health reflects on social and political histories: there is a story, a reason, why certain people are healthy and others are not.  War, racism, segregation, climate – these all help paint health.  How this happens and how we should work as a nation and as a global community to mitigate those effects are of endless interest to me.

My current research is with Latin American immigrants to the United States.  Because I am working in New Orleans, the majority of these immigrants are Honduran – not Mexican — which is against the norm in many other areas of the United States that can correctly characterize their Latin American immigrant population as largely Mexican.  In short then, what I am studying encompasses both what it means to be an immigrant from Latin America living in the United States and what it means to be a racial minority within the United States.

So the first place to start is with race and health.  Stay tuned.

(Writ in the style of “The Piggy in the Puddle” — my favorite children’s story to read out loud.)

See the Mommy.
See her study.
See the Mommy in the middle of her silly little study.
See her cruddy, see her bloody
in the fuddy, duddy, study.
See her muddy, down and ruddy, in the silly little study.

See the Daddy,
chummy-tummy, chummy-tummy, chummy-tummy.
“Don’t you get all crummy, dummy, Mummy, Mummy, Mummy!
You are much to smart and sassy to be in the down and ruddies.
Research is oofy, research is poofy, research is oh-so oofy-poofy!
What you need is lots of HOPE.
But the Mommy answered, “oofy-poofy, oofy-poofy, NOPE!”

See her Babies.
Cutey-tooty, cutey-tooty, cutey-tooty.
“Just stop that writing – lighting, nighting, fighting, miting, citing!
You are much too Mommy Dearest not to be so often near us.
Research is willy, research is nilly, research is oh-so willy-nilly.
What you need is lots of HOPE.”
But the Mommy answered, “willy-nilly, willy-nilly, NOPE.”

Now they all stood by her research,
Right beside the murky research.
And they looked into the ‘search,
What a messy, murky, murch!

There was Mommy, cruddy and bloody,
getting beat up by her study.
She was reading, she was writing,
she was drinking to be wired.
She was listening, she was talking,
she was very very tired.

Said the Daddy,
Mummy-Mommy, you have made me very proud.

Said the Babies,
Mommy-Mummy, you are a sun behind a cloud.

Said the Mommy,
I thank you, but for this I am avowed.

See the Mommy and her study
with her family in a huddy.
They are loving, they are listening,
to the very daunting study.

Said the Mommy,
“Oofy-poofy, willy-nilly, oofy-poofy…
Indeed,” said tired Mommy,
“I think we lack in hope.”

But Daddy and the Babies answered,
“Oofy-poofy — NOPE!”

This post is a Monday Mission, to write a post in the style of a children’s story, as inspired by The Painted Maypole.

I’ve been feeling uninspired lately and needed to remind myself of a few things.

One week into the month of November and how much I have gotten done?

I’ve translated one set of interview notes from Spanish… BUT have not gone back to listen to the original notes to put back in the parts of the notes that are in English. It equates to about 1/7th of the translation I have to complete. *sigh*

This is a wonderful video clip from the fantastic PBS series “Unnatural Causes… is inequality making us sick?” One of the episodes, “Becoming American” was screened last night at the Ashe Cultural Center. I was one of the panelists that took questions about health inequalities at a community forum last night after the screening.

The website for the series is an incredible resource for anyone interested in income, race, immigration, housing, and the myriad of issues that influence our health. In particular, I liked the suggestions to how individuals can make strides in their own communities toward improving health. As a country, we showed we are ready for change… here are some suggestions on how we can start in our own backyards.

Research has shown that health is more than healthcare, behaviors, and genes—that the social
conditions in which we are born, live and work actually get under the skin as surely as germs
and viruses do. What can we do to help reframe the nation’s debate over health and to address
the root causes of our devastating socio-economic and racial health inequities?

Here are a few ideas you can use to get started and encourage others to become
involved in working towards health equity:

• Identify and connect people interested in the root causes of health inequities.
• Organize a “brown bag” screening to discuss how social conditions—where we
are born, live, work and play—impact health.
• Form a committee to identify assets, programs, or initiatives within your
organization where you can use the series to educate, organize or advocate for
health equity.
• Screen and discuss the series with PTAs, book clubs, neighborhood associations,
churches, tenants groups, racial justice groups, and trade unions.
• Identify three existing struggles in your community that can improve health equity,
e.g., land use, a living wage, paid sick leave, affordable housing mandates, toxic
clean-ups, lead paint removal, etc. How can you become a partner?
• Conduct an audit of health threats and health promoters in your neighborhood.
• Identify and build strategic partnerships with community-based organizations and
organizations in other sectors; link health outcomes to housing, education,
employment, political power and other arenas.
• Form a community-wide health equity coalition.
• Ask your public health department to conduct a Health Impact Assessment (HIA)
on proposed development projects and government initiatives and ordinances.
• Provide local media with facts and resources so they can incorporate a health
equity lens in their reporting; help them identify a message point person to provide
quotes, analysis and additional information.
• Broaden the discussion: look for opportunities to submit op ed articles, letters to
the editor, call in to radio talk shows, and form discussion groups.
• Organize a policy forum to brief officials in government agencies about the social
determinants of health inequities.

Paul came with me to the event last night (he was impressed that I managed to only use the phrase ‘epidemiologic assumption’ once) and regretted not having a video camera there. That can only mean that at some point in the evening, I picked my nose or something.

In lieu of my comments from last night, I’m listing a few of my thoughts based on the screening, the questions panelists were asked, and my comments…

— We should be very concerned about the mental health of the Latino youth in New Orleans. Statistically, their risks of mental illness far outweighs any other group in the city — and the risk factors we know to trigger illness in this group exist for them here in spades.

— What can we do, as a community, to create public, multiracial spaces?

— How can we advocate for better city transportation?

— What can be done to attract health researchers back to New Orleans?

All of these things are on the radars of the many community activists and organizations that are working to rebuild a better community here… but as anyone who works in community organizing and nonprofits understands, the strides made are more likely baby steps.  Can massive overhauling really occur?

Here is one community project that I think is great example of a fantastic step: The Hollygrove Market.  We have not been able to pick up the weekend box, but just knowing it is there for us and available in a neighborhood where food markets are scarce, makes me feel that maybe it is possible to create a healthy city in the midst of poverty and destruction?

The clip being shown, as I understand it, is on immigration and the health of immigrants. I’m speaking here tonight about my research if anyone has an unnatural interest.

unnatural-causes-flyer

SCREENING OF THE PBS SERIES
UNNATURAL CAUSES
AND COMMUNITY DISCUSSION
WEDNESDAY, NOVEMBER 5, 2008
6 PM – 9 PM
ASHE CULTURAL ARTS CENTER
(1712 ORETHA CASTLE HALEY BOULEVARD)
Light refreshments will be served
UNNATURAL CAUSES is a documentary series that explores the
root causes of health and illness including economic and racial
inequality, the wages and benefits we’re paid, the neighborhoods
we live in, the schools we attend and the social conditions in
which we are born, live and work.
Please join us for a 30 minute screening followed by
a community discussion

A few days before we left for last week’s Pittsburgh trip, when I was feeling totally overwhelmed with home and Mommy and wife-y duties and starting to beat myself up about ‘what is the next step with this dissertation…. hmmmmm??‘, I decided to join NaBloPoMo, or National Blog Posting Month.  This is an agreement to blog each day for the whole month of November.  I rationalized that I could publicly track my progress daily.  Either it would be a motivation for me to do better each day (sort of the ‘Weight Watchers’ idea of accountability), or, be so publicly humiliating that I am shamed into progress in December**.

I look back at this and think, “WOW. I thought all of that and I wasn’t even on the crazy pills yet!”

Part of the treatment for my bronchitis/cold/can’t breathe mess is a short course of steroids (“I want to pump… you up!”)  Thankfully, this is a quick in-and-out treatment where you start to taper at the first dose, not the several month taper I endured for almost half a year in 2001.  If you knew me during that time, you remember that I was one big hunk of crazy on steroids.  Couldn’t sit still, couldn’t listen, couldn’t sleep, always hungry, and way emotionally raw… in short, completely manic.  That is pretty much how I feel now.

I’m not sure what I can get done, if anything, until I’m tapered off these drugs and better recovered.  But what I can do is make some plans.  This is what I want for the month of November.  Here are my goals:

— To review the transcripts

— Translate relevant parts

— Decide if more interviews need to be done

— Complete any additional interviews (okay, this one involves many forces outside my control, but there it is)

— Send them to Angela and Monica (in Peru) for transcription

— Announce that I am done with interviews, and BE DONE WITH THEM.   (This could be the hardest step of all!)

There is one potentially fatal flaw in the plan, and that is I did not include a ‘meet with committee for input’ part.  This is somewhat strategic… getting feedback from a committee member is a hopeless process that takes months, is wrought with conflicting information, and typically leaves me feeling lost.  In other words, I could do all of this work and then have it all shot down.  But I’m going for the ‘forgiveness not permission’ route here.  And hoping that what I do have is strong enough to build on.

So that’s my goal.  The second goal is to post progress here.  Just how much work can one woman complete on her dissertation in the midst of illness, election day school closures, home renovations, a husband who works three jobs, her Schweitzer Fellowship retreat and project obligations, school committee meetings, Board responsibilities, her first child’s 5th birthday, Thanksgiving holiday, and general holiday preparation?

May the force be with me.

** Hey… I was not the only one to feel this way!