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Make Yourself Accountable

A notebook full of writing with a pen resting on top of it.

I wrote this blog post in longhand before typing it. It's nice to shake things up sometimes. Image by tonyhall via Flickr Creative Commons.

My greatest insecurity as an assistant professor is scientific writing and publishing. My training and abilities were already somewhat strong in teaching and mentoring, as well as planning, conducting and analyzing research. Something about that last step from conference presentation or analysis to paper terrifies me, though. While I can identify the various experiences that led to this, it seemed to me the problem wasn’t going to go away with therapy, but action, because for me action itself is a kind of therapy. I find it useful to freewrite, to use my writing as its own kind of inquiry, and that’s from where my comfort with bad first drafts arises. The point where I get stuck tends to be downstream of when I first put that pen, or cursor, to page.

In this job, I found I could avoid writing very easily. I took on teaching and service obligations that I considered important, yet really had no business doing as a junior faculty member. I started a blog (ahem), thinking writing for a different audience would help me get over writing to my peers (it has and hasn’t, a post for another day). I mentored the crap out of a slew of undergraduates. And somehow each day would pass and the writing wouldn’t get done.

The two things that have worked are mentoring and accountability.

A week ago, my husband and I attended a STEM writing retreat. It was largely unstructured writing time while the kiddo attended a science camp, so we had no choice but to approach the retreat as a team if we were to get anything done. We’d discuss our goals for the day at breakfast, reassess at lunch, and at night once the kiddo was down we’d share our writing, usually just a few paragraphs or pages. We’ve only recently gotten back into reading each other’s work, out of desperation more than anything else. And I have to say, it’s been a real pleasure getting reacquainted with my husband’s work (and I like to think he has enjoyed mine). I think we have both gotten better at writing for a broader audience, which is why this trade is working again.

With dual NSF CAREER deadlines approaching, we are still checking in with each other post-retreat. Yet if we were only reading each other’s work it would be accountability without direction.

Enter the two other means of accountability I have – an NSF writing group, and the vicious pen of the Bastard Colleague from Hell (BCH, and yes, that’s what he prefers to be called). Every week or so I meet with a few other social scientists and one of our illustrious Vice Chancellors for Research, here at the University of Illinois. We discuss our projects and exchange a few pages of writing, then get down to business. I appreciate the candid questions my colleagues pose, as much as I fear every time they find one of the problems I was hoping no reader would catch. Then I patch it up, send my work to the BCH, and he tells me I’m Doing It Wrong. Then I start over yet again.

Where the writing exchange with my husband is more about the accessibility of the writing and how well we convey our ideas, the BCH and writing group criticism is all about the science. Their questions and the way they push me are very challenging. I am glad to have this kind of peer and senior mentoring.

Between my husband, BCH and the writing group, four full years into this job, I finally have most of the accountability and mentoring I need. The skills I need to develop relate to how I promote my science to my peers, and how I pitch my study design. The assistance I’m getting helps me inch my way towards my goals. (Ah, and goal setting. I will have to write a whole other post on that one someday.)

Now you: where do you need help? What can you do to get it? And while we’re at it, what would it take to implement better training for grads, postdocs, and early faculty so we hit the ground running?

On Bad First Drafts

This post first appeared on my old blog on March 16, 2011. I’m writing a post tomorrow relevant to this topic so thought I would re-post it today, to have it fresh in my reader’s minds. And I’ll just tell you the good news if you are a more recent reader: the book I refer is completed, page proofs are in, and it will be out in a few months! So bad first drafts can turn into better revisions, and great chapters.

My blogging mojo has been channeled almost entirely towards a book project I’ve undertaken with Julienne Rutherford of UIC and Katie Hinde of Harvard. The book is called Building Babies: Primate Development in Proximate and Ultimate Perspective and it will be published by Springer in 2012. Each co-editor has a chapter in there, and then we have a number of other rather fancy-pants contributors as well.

The first drafts of the chapters were due yesterday. I did not submit my chapter (er, to myself). I’m running about a week late. I thought I would come clean with this, because there are a number of elements of the writing process that I think remain obscure for students and other junior scholars. And after I share a few thoughts about academic writing, I thought I would show you some of the draft I’m working on.

First drafts suck

They really, really do. If you think your first draft is amazing, give it to someone else, and that someone else can’t be a pet, spouse or parent. First drafts suck because we write the most obvious things in them, the most vague. First drafts don’t have enough context. First drafts are where you use cliches because you haven’t figured out how to say what you’re saying in a sophisticated way. They are often under-cited. They are out of order. And, they aren’t that compelling.

This is why so much student writing is bad — but it’s not their fault. Close together deadlines, ones that align with other projects, and little teaching of time management means most students start writing projects just before they are due. So they essentially submit first drafts of papers, with a little copyediting if you’re lucky. Plus, somehow a lot of students have picked up this idea that first drafts are better or more authentic than revisions. This is patently false. They are simply the place our favorite worst stuff goes to die (this is why revision is so often called killing our darlings, to use a term from scio11, though its origin is much older).

But everyone has bad first drafts, so it is absolutely useless to feel bad about them. Give them to your advisor or your colleague if they have said they will read a first draft (otherwise, revise it after consulting with someone else first). They write bad first drafts too. You have to write a first draft in order to get to the revision, and to me, this was a liberating realization. Get it all out now! Don’t worry about using the right word! Just get the words on the page, get about the right content in about the right order, and if something is repetitive, just leave it for now. Because after a little breather away from it, or a look from a trusted colleague or advisor, you will hack it up and remake it into something far better.

Revising only sucks sometimes

Revising sucks when you get your first comments back from a colleague, because it is terrifying to share that vulnerable, bad first draft with another person (ever had that moment after you print it out or hit send when you realize your prized metaphor was a trembling nod to your failed attempt as a fiction writer?). It sucks at those moments when you feel at cross-purposes with the thesis of your paper. And it’s frustrating, also, that revising is the most important yet under-taught skill in academic writing.

But here’s the thing. Revising can be glorious. If you abandon any sense that you own your words, and remember only to own your mind, it allows you to be merciless in cutting out all the badness of that first draft: the cliches, the vague repetition, the jargon. If you return again and again to your outline, or abstract, or data, or whatever materials you keep to help you remember what the paper is about, you will start to see the right shape of the piece. And then you can also build in the context.

The best moments of revision are when you remember why you were writing the piece in the first place. Do you want to produce a fundamental review that will be useful to other practitioners in your field? Do you have an amazing piece of data to share? A well-grounded hypothesis that you want to articulate? What was surprising or compelling about that work when you first set fingers to keyboard?

One last thing I’ll say about revising is that owning your mind is not the same as owning your ideas. You need to be willing to let go of being right, and you need to be willing to change if the evidence is against you. Accepting reality and working with it in an interesting way is the mark of a good scientist, and a good revision.

My first drafts suck

The title of my chapter is: “Inflammatory factors that produce variation in ovarian and endometrial functioning” (eventually, I think, I will need to change the title to better reflect the manuscript). I thought this would be an easy piece for me, since I have been doing a lot of work on C-reactive protein, a biomarker for systemic inflammation, and I have been studying the endometrium and ovaries for many years.

I was wrong. Oh, so wrong.

A few quick searches pulled up an embarrassingly large number of citations for chemokines and cytokines, for toll-like receptors, natural killer cells, and other immunological terms I barely remembered from high school and college. So I re-drafted my outline, set aside a lot of time for reading (as in, several days straight), and then finally set to work.

The problem with the literature on this topic is that it is wholly mechanistic. I can now tell you what interleukins are expressed in the periovulatory phase versus the implantation window, or which ones are suppressed or overexpressed for certain pathologies, but I can’t tell you what that means in a broader sense, or what produces variation in any of these immunological factors in a systemic way that might impact local inflammation in the female reproductive system.

Here is my section on normal endometrial functioning (alas, given the literature, the section on pathology in the endometrium is far, far longer). First draft ahead! Remember, I am sharing this embarrassingly bad prose for the good of SCIENCE.

The endometrium is composed of the functionalis and basalis layers; the functionalis comprises two thirds of the endometrium and is the part that proliferates and sheds each reproductive cycle. The basalis is adjacent to the myometrium, and is the place from which the endometrium regenerates after menses. The proliferative (also known as follicular) phase is when estradiol promotes proliferation of endometrial tissue, where the secretory (also known as luteal) phase is characterized by progesterone control of decidualization and menstruation. The endometrium typically proliferates with narrow, straight glands and a thin surface epithelium, and angiongenesis continues as ovulation nears (King and Critchley 2010). After ovulation and during the secretory phase, the endometrium differentiates: endometrial glands become increasingly secretory, and by the late secretory phase spiral arterioles form. If implantation does not occur, the corpus luteum degrades, progesterone declines, and this triggers a cascade of events to produce menstruation.

Menstruation is a key inflammatory process of the endometrium. Menstruation is when the functionalis are shed at the end of the human reproductive cycle. The basalis regenerates over the course of the next cycle. The demise of the corpus luteum and the associated withdrawal of progesterone precipitate inflammatory mediators that cause tissue degradation. For instance, progesterone inhibits nuclear factor κ B (NF-κB), which increases the expression of inflammatory cytokines like IL-1 and IL-6 (Maybin et al. 2011). The withdrawal of progesterone is also associated with an increase in endometrial leukocytes and IL-8, which regulate the repair process (Maybin et al. 2011). At this time other inflammatory factors promote MMP production to break down endometrial tissue (Maybin et al. 2011). Further, it is thought that progesterone withdrawal, not an increase in estradiol concentrations, leads to the repair of the endometrium so that it can resume activity for the next cycle (Maybin et al. 2011). Thus, variation in progesterone concentrations may lead to variation in inflammatory activity, degradation, repair and cycling in the endometrium.

First question: why should I care about any of the above? So what if any of this happens? Then, you might not know this, but I do: the only two citations in these two paragraphs are both review papers, and one of the authors overlap between them. Therefore, it’s quite under-cited. To be fair, in this section it is less important that I demonstrate the depth of the literature, but a review that only cites two other reviews isn’t doing its job.

Do I inspire excitement in my field? No. Do I provide an appropriate context for this material in order to situate the reader? Not so much. Right now, these two paragraphs contain the exact information I wanted them to contain, based on what was in my outline. That is, I’ve described the basic functioning of the endometrium, and menstruation. It’s flat because that’s all that I did.

My job in this chapter is to take this vast reproductive immunological literature, pair it with what little we have in anthropology and ecology that helps us understand the way genes and environment might produce this variation, and then describe the necessary context in future work to understand these mechanisms. In some places, a lack of context may help me make my case, because it will demonstrate why anthropologists need to be in the field. But if my whole manuscript looks like the two paragraphs above, it will be an unreadable yawnfest that doesn’t contribute a thing to anthropology.

So, I guess I would expand the “kill your darlings” advice. First, accept your darlings. Accept that you have them like everyone else, and that darlings aren’t just turns of phrase but entire ideas, hypotheses, fields of thought. Then, once you have accepted that your darlings make you just like every other academic writer out there, from the middle schooler to the full professor, kill them. With fire. Finally, make sure you provide what is left with context or else there is no reason to read what you wrote.

And now, I have been sufficiently inspired to go finish my bad first draft.

References

King, A., & Critchley, H. (2010). Oestrogen and progesterone regulation of inflammatory processes in the human endometrium The Journal of Steroid Biochemistry and Molecular Biology, 120 (2-3), 116-126 DOI: 10.1016/j.jsbmb.2010.01.003

Maybin JA, Critchley HO, & Jabbour HN (2011). Inflammatory pathways in endometrial disorders. Molecular and cellular endocrinology, 335 (1), 42-51 PMID: 20723578

What the CDC and WHO Know about Young Girls and Hormonal Contraceptives

Birth control pills via nateOne on Flickr Creative Commons.

Birth control pills via nateOne on Flickr Creative Commons.

I am slowly working on a book chapter on adolescent hormonal contraception, based on this blog post and conference presentation. I wanted to share some findings for your perusal. I’ve intentionally left out much analysis in favor of keeping things open-ended.

I’ve been curious about whether there are general guidelines out there for medical doctors in prescribing hormonal contraception to girls. Do they discuss the consequences of adult concentrations of hormones on girls’ immature hypothalamic-pituitary-ovarian axis? To the fact that hormonal contraception is almost exclusively tested on adult women in their twenties, thirties and forties? Do they discuss discontinuation rates, side effects?

In my first sweep of the literature, not really.

Today I’ll share with you a document by the CDC entitled U.S. Medical Eligibility Criteria for Contraceptive Use, 2010 (this appears to be the most recent version). This is based on the WHO Medical Eligibility Criteria for Contraceptive Use, 4th edition. You can access a copy of this yourself here.

According to its summary statement, the purpose of this document is to “assist health-care providers when they counsel women, men, and couples about contraceptive method choice” (p. 3). They also emphasize later in the document that it is not intended to inform on off-label use, just contraceptive use, of contraceptives. And I do appreciate the existence of this document at all, and the hard work that must have gone into it, from the research that went into the literature, the literature that was reviewed, the experts that made determinations about what constitutes acceptable risk, and the work of putting the whole thing together. I’m glad this exists.

The way this document is organized is that each appendix looks at one type of hormonal contraceptive, and the possible contraindications for taking it if you have a particular characteristic or medical condition. So “age” is a category for some appendices, and sometimes within a characteristic like smoking or condition like migraines, age is a sub-category.

So first, I also want to give the experts on this panel a giant shout-out for the following two statements, in the category “vaginal bleeding patterns:”

On vaginal bleeding patterns: “Irregular menstrual bleeding patterns are common among healthy women.”

On adolescent menstrual cycles: “Menstrual irregularities are common in postmenarche and perimenopause and might complicate the use of [fertility awareness-based] methods.”

Yes, this! This is something many doctors do know, yet somehow it doesn’t always get conveyed to patients… or when it is conveyed to patients, the patients are unsatisfied with the explanation and want a prescription to become “regular.” I would love for all of us to think on what it would take to produce better doctor-patient communication in a way that gets fewer women on hormonal contraception if the only reason they are on it is because they think they need a “regulator.”

Adolescents: We Are More than Our Bone Mineral Density

I read through the “age” sections in each appendix to see what contraindications were expressed, and I put it together in a handy little table for you. Here are the recommendation categories used so that you understand what the table means.

  1. A condition for which there is no restriction for the use of the contraceptive method.
  2. A condition for which the advantages of using the method generally outweigh the theoretical or proven risks.
  3. A condition for which the theoretical or proven risks usually outweigh the advantages of using the method.
  4. A condition that represents an unacceptable health risk if the contraceptive method is used.

I also searched the document for the following words: girls, juvenile, adolescent, and young. Girls turned up a handful of hits, but only in the references, juvenile did not appear at all, adolescent appeared three times in the document, and young only twice. I’ll share the three adolescent and two young findings.

Page 11: Bone mineral density is lower in adolescent girls using combined hormonal contraceptives, but bone mineral density may not predict postmenopausal fracture risk.

Page 34: Bone mineral density and fracture risk is unknown in adolescents using depo medroxyprogesterone acetate, or Depo Provera.

Page 37: Obese adolescents are more likely to gain weight than nonobese adolescents on depo medroxyprogesterone acetate.

Page 54: I will share this quote on the use of intra-uterine devices, because I think the wording is interesting, as well as the lack of a citation: “Concern exists about both the risk for expulsion from nulliparity and for STIs from sexual behavior in younger age groups.”

Page 77: Younger women are more likely to regret sterilization than older women.

So there you have it. Two discussions of bone mineral density, one on weight gain, one uncited concern about IUD expulsion or STIs, and mention of a study that younger women may regret sterilization.

What do you make of this? What other concerns might an adolescent have who is considering hormonal contraception? What research should be done to better understand this age group? And finally, what would it take to produce recommendations that take into account non-contraceptive uses of hormonal contraception (this seems especially important to me to produce more inclusive criteria that looks at off-label use, but also people with different sexual identities)?

Which came first, rewarding outreach or doing it? On chickens, eggs, and overworked scientists

Which came first, the chicken or the egg? You have to break a few eggs to bake a cake... oh, forget it. I'm out of cliches.

Which came first, the chicken or the egg? You have to break a few eggs to make an omelet... oh, forget it. I'm out of cliches. By Public Domain Photos.

Scicurious recently identified exactly where the whole “all scientists need to get off their butts and do outreach” meme sticks in my craw: not only are we overworked, but these behaviors go unrewarded. And in what is so far a very thoughtful comment thread, Katie PhD made the point that this is a chicken and egg problem: we need people to step forward and do outreach, but we also need to make it worth their while… which will only be recognized and understood when more people do outreach. While there are more and more scientists engaging in outreach right now, the majority of the folks doing outreach – at least blog outreach, relevant as this is a blog – are grad students, postdocs, or junior faculty (of course we have some old people grand mentors as well). Danielle Lee suggested that we junior folks are just tired of waiting for the old folks to come around:

“We’re tired of the status quo that can feel unfair, unwelcoming and unappreciative of younger/creative/innovative/inventive talent. Science academia is wanting/expecting each of us to be perfectly adept at doing EVERYTHING perfectly…well everything but having a personal life. And being good Generation X/Y-ers that we are, we’re not buying that crap.

“It’s exhausting and unfair and isn’t getting us/society anywhere. People are still getting left out and excluded from science and new opportunities. It’s not scientists’ fault. We know that; but it is the culture of science’s fault and I sense a culture shift on the horizon.…”

The thinking that I do in this space is incredibly valuable to my development as a scholar, puts me in conversation with anthropologists I may never have otherwise met, and communicates science to a broader audience. Two of my blog posts are in science writing anthologies, a third turned into a manuscript that turned into a journal article that will be out in September, a fourth is being turned into a manuscript over the next few weeks to submit to another peer-reviewed journal. I love the direction my research is going in and the ways in which the mentorship and support I receive among this community bolsters me.

But I’m tired. I share the exhaustion and consternation felt by Sci, Danielle, and others, even while I also share the drive to engage more scientists in outreach. As regular readers may remember, this past year was my third year review for my tenure-track position at the University of Illinois. And it went well. But I do need to, in the words of my committee, “re-budget my time” towards traditional research publications to build the strongest possible case for tenure. I need to write more grants. I need to publish more, and not in the hit-publish-in-Wordpress sort of way.

There was a silver lining. My third year review letter contained language that agreed that my blog constitutes a kind of non-traditional, peer-reviewed writing. The letter applauded my efforts in outreach, over and over again. And so while my next year on the tenure track will surely be focused on my trying to find balance between research, teaching and outreach efforts, I now have written insurance from higher ups at my university that my outreach is considered valuable and aids my path to tenure.

What’s more, in the last year or two the tenure document at the University of Illinois, called Communication Number 9, has been modified to include a public engagement section. This means that our degree of public engagement will be evaluated in the tenure process, alongside our other scholarly efforts. And I think we know that if something counts for tenure, the university values it, and more faculty are going to start doing it.

A critical view of this shift might include the observation that outreach is yet another professional activity for which faculty are not trained, nor are they compensated. This shift did not include an increase in the number of hours in the day, nor a decrease in research or teaching expectations, and so finding time for all of these activities remains a challenge. And at many institutions, an excellent teaching or outreach record will never trump a moderate research record. A critical view of this shift, then, might lead to putting the new tenure requirements through a shredder, or perhaps using it as kindling in one’s wood stove. Of course, I am not saying that I look at these requirements from that particular perspective, oh no. But I am also not saying that these changes particularly ease my own concerns, and we need to push for clearer mentorship and instruction on how to apportion our time and energy rather than accept our job increasing in hours.

It’s still on us, then, to do what we think is right, what fits with our priorities, what makes us happy, and what is most consistent with our view of scholarship. It’s possible that even with the excellent, constructive mentoring I have started to receive from my senior colleagues my “re-budgeting” efforts over the next few years will not be considered substantial enough. I’m not actually worried, yet it’s always possible. But if I haven’t convinced my colleagues by that time that my path is a worthy one, I have made and refined the tools I need to carve out a path somewhere else, and that’s enough for me to keep chipping away at this one right now.

Last year I attended the Purdue Conference for Pre-Tenure Women, and it forced me to acknowledge my impostor syndrome, to confront my fears about radical scholarship, and to take myself seriously enough to have a real plan for tenure (they’ve scheduled next year’s, and yes, you need to go – talk to your department head about at least covering registration if not travel, and tell them I said they are a jerk if they don’t help you out). Go back to that post and read it again. Bring your whole self to your job, have a plan, be a radical. Don’t wait for someone else to carve a path you can follow – you have peer mentors who are carving paths and are just as confused as you are. Take comfort and strength from them. I have also found senior allies by continuing to do my job the way I think it should be done and by being very, very lucky. They provide an added boost when my junior colleagues and I are looking around helplessly for answers.

I take the calls to redefine our work lives from Sci, Danielle, and many others very seriously. Public outreach isn’t about adding more hours to your job. It’s about redefining the hours you have and pushing others to recognize the value you bring to your field – even my own university understands this, perhaps leads on this, given the “re-budgeting” language they used in my third year review. A twenty-first century academic is going to have to cause some discomfort to move twentieth century academia along, and true to our science, I think we can provide empirical evidence of the worth of our paths.

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