Monday, July 16, 2012

On excuses

Sometime in my past I learned not to make excuses. I can't remember who taught me this lesson, or in what context, but it stuck. I learned, and learned well, that the bottom line is that nobody cares why something happened, so I should skip talking about it and fix it. I get it. Don't deflect responsibility; it is tiresome. Done. I am a champion tongue biter and a first-class apologizer.

But lately, I feel that I learned this lesson too well. At some point, not making excuses turned into accepting responsibility for things that are not my fault. Or, if they are my fault, they are equally the fault of someone else being unclear in communication or expectations.

I am spending this summer doing an independent research project as a sort of door-propping measure in case the academic career track still appeals to me after my clinical year. Two insane bosses in my scientific research past were not enough to teach me to stay well enough away, so here I am. I don't hate it. My project is interesting. I actually understand it. I like that it is my own project, and that I have the responsibility to troubleshoot it and see it through. I love opening the document containing my research proposal and reading the impressive-sounding title. Most of the other people in the lab are lots of fun. I get to work with cats.

I work for a PI who manages her time as if it were literal money, and woe betide the fool who wastes it. She is small and intense and free with profanity; a characteristic I enjoy, because it is humanizing. Next to her, I am a dim-witted, tongue-tied Amazon. Or so I feel. Which brings me back to excuse-making.

I would like to think that by not making excuses for why something happened, it comes through that I am an upstanding person, a hard worker, and not a snitch. But sometimes, especially when people are looking to vent their own frustrations, a person who is prone to accepting responsibility ends up becoming a scapegoat. By not deflecting blame from myself, ever, I have learned to internalize it. I feel bad about not doing something, even when I would have no way of knowing that I should have done that thing. Nobody told me. It is not intuitively obvious. And yet I torture myself with guilt over not having done it.

My project involves two big sampling time points. One of them was this morning, a Monday. I spent the better part of last week getting ready for today; my reagents ordered, my tubes labeled, my protocol memorized. I spend Friday rehearsing what reagents would go in which tubes at which times. I was determined not to make any blunders. My project involves running an ELISA on samples collected fairly non-invasively from cats. It's not important to understand the details; only that it is complicated to set up, that it takes several hours to complete, and that before I could even start the ELISA, we needed to collect samples.

I was all ready for my 8:00 AM Monday morning start time. As I struggled to fall asleep the night before, I kept rehearsing the protocol, tossing and turning in defiance of my 5:30 AM alarm. 6:30 found me in the lab, adding diluent to my tubes, and wondering why nobody else was around. I needed at least one other person to help me transport the cats from where they are housed to where we would perform the procedure. 7:00 came, and then 7:30. I got panicky. I paced the halls. I swore a lot, since it seemed to work for my PI. I rode the elevator downstairs once, determined to get set up myself, before I realized that I could not transport ten cats all alone. Finally, after 8:00, I ran into one of the undergraduates, a new hire in the lab. I hustled him into the elevator before he could even drop his backpack, encouraging him to keep up with my Amazonian strides. Poor kid.

We arrived at the research facility, scanning our pass cards at door after door. I burst into the women's locker room to change into the generic navy scrubs required by the facility. My PI was already there, stepping out of her small, sensible shoes. This was bad. The usual routine in the lab is that the students get set up and she arrives later, in time to start the procedure. She looked up at me, and I saw that she was wondering what in the world I was doing there. "I couldn't find anyone to help me set up!" I blurted out. "I couldn't do it myself. I was calling everybody, but I didn't know what-"

"You needed to put it on the calendar," she interrupted me. I felt my eyes widen. When chastised, I have two faces I make. One is sulky face. The other is innocent contrite face. In this situation, my subconscious chose the latter. She yanked her green top over her head.

"I . . . guess it didn't occur to me. I-"

"I couldn't do anything while I was out of town," she said, shooting me a look through the neck of the blue scrub top she had halfway on.  "That's why I was sending emails late last night. If you didn't do it, nobody did, and nothing is going to be set up." I felt myself engage stage two of innocent contrite face. My cheeks flushed, my lips parted, and my eyebrows knit together.

"I'm sorry. It's my fault." Numb, I started to change my clothes. I turned my back and replaced my own shirt with the rough cotton one. But she continued, accented words aimed at my back.

"Nobody will probably be in until 9:00 and then we won't even get started until 9:30," she said, cinching the drawstring of the shapeless scrub pants. "It's going to be a long day for you." Her phrases were starting to follow one another less and less. Even in my embarrassment, I recognized somebody who was continuing to talk out of temper. A last-word battle. I recognized it because in other situations, I am a champion in this category.

"I'm sorry. It didn't occur to me," I whispered, laboring over my own drawstring now because I didn't know what else to do. I wished she would stop talking.

"You needed to take care of that. I couldn't do anything while I was out of town," she repeated. She walked toward the door. I struggled to make my fingers turn the combination lock so I could put my street clothes away. I swore out loud at my own stupidity. How could that not have occurred to me? Out loud, but in a whisper. Probably not a quiet-enough whisper though, as I heard my PI pause midway through pulling the door open. Great, now I am incompetent and profane. When I heard the door swing shut, I swore again.

Innocent contrite face has a history of leading to tearful face. But I was not going to let that happen today. I channeled the burning sensation into another string of profanity. In for a penny, in for a pound.

I met my hapless undergrad in matching navy scrubs, and together we schlepped ten cats from one building to the next. When we got the the procedure room, a battalion of people was assembled there. They had the air of people who needed to do something really fast, but had nobody to tell them what that thing was. They looked at me. This was my experiment after all. I had nothing to say.

"Which cats are those?" asked the assistant to my PI.

"Umm, let me check." I fumbled with a list of ear tag numbers cross-referenced to names. Clever that I had thought to stash that in my scrub pocket, I thought.

"You should have labeled the cages," she sighed. "Do that now." She handed me a sharpie and a roll of tape, and turned around to bark orders at the rest of the battalion.

"I'm sorry. It didn't occur to me," I mumbled to my roll of tape.

Before long, a sort of order materialized out of the chaos, but the harried tenor remained, for which I felt responsible. The string of profanities continued in my head. I was so dim.

My PI strode in, shoving a stray hair back under her surgical cap. She gave me a terse string of instructions that sounded even harsher in her her normally ebbing and flowing accent, as though I'd even ruined that by my incompetence. I was glad that I was wearing a surgical mask, because I was pretty sure that I had transitioned into sulky face.

The sampling went fine. Each member of the battalion did his or her job. I did not mix up any tubes. All the cats woke up from anesthesia. I double-triple checked that none of my sample tubes would pop open and spill out my precious sample, before changing back into my street clothes and riding the elevator back to the lab where I would perform the ELISA.

I sat on the high stool at the laboratory bench and started the process of setting up my assay. As I settled into the methodical, repetitive work of pipetting, my blood pressure dropped and my breathing slowed. My mind began to unwind. The string of profanity faded out and was replaced by the more rational monologue that I like to think is my normal.

This is my third week in the lab. In three weeks, I have assisted with experiments to learn how the lab works, and have designed an experiment of my own. I have learned how personnel in this lab prefer to handle cats, biting my tongue and feigning enlightenment when I am instructed to give a cat an injection in a way that is different, but no better or worse, than what I have learned in previous situations. I have learned to perform an assay that nobody else in my lab performs. Most importantly, nobody explained to me how scheduling works. Maybe I should have assumed that the calendar in the student office every Monday does not appear there by magic, but really, expecting a person to assume something is always a shaky proposition. And now here I was. I took the blame in person when confronted by my superiors, and I was still feeling guilty about it now. I'd made no excuses for my mistake. I'd stayed true to the edict of that hazy person from my past. So why didn't I feel satisfied?

I fell into a rhythm, popping open eppendorf tubes, drawing a tiny amount of sample into my pipet, and squirting it into the crystalline microplate well, over and over. I consulted and double checked the diagram I'd drawn of my plate layout. The only words in my mind were the coordinates of each sample well: A2, A3, A4. I covered my masterpiece with adhesive and set it on the rocker to incubate. I took my first normal breath of the morning.

I was all set to end this story by concluding that not making excuses is not okay after all. That it only leads to me feeling bad, and rather than impressing people with my ability to take responsibility for my actions, actually makes me seem more incompetent by not explaining the circumstances that led me to those actions. But what happened that afternoon made it unclear again.

I was walking back to the lab from the section of the medical school library where I go to work and write when the student workroom is too crowded. I ran into J, who works in the lab.

"Hey, I'm really sorry about this morning. I wasn't sure what was going on with the sampling and I totally neglected to put it on the calendar." I brushed off her apology and said something about miscommunication all around.

"Yeah, but G (PI) said that she yelled at you, and I feel bad about that. It was my fault."

When I got back to the lab, my PI was there. She asked me how the experiment was going. She smiled, and chatted, and looked me in the eye. Every trace of this morning's brusqueness was gone. I could tell that this was her way of apologizing to me.

I explained nothing to anybody. I took blame that was not attributable to me. I spent all day developing a new worldview in which nobody would be allowed to vent their frustrations on me ever again. And yet now in the outright apology of J, and the implicit one of my PI, I knew that everyone understood. It was okay. The situation had worked itself out. Nobody thought I was dim or negligent. Okay. But did anyone think more of me for not making excuses? I don't know. Would they have come to this conclusion sooner if I had spoken up, or would I have angered tempers and wasted time with explanations? I no longer have an answer.

Sampling day #2 has come and gone. This time, with the help of a savvy undergraduate, I was set up and ready to go the night before. The room that morning had more of a carnival atmosphere than the panic of two weeks ago. Everybody did their job. No voices were raised, except  that of one notoriously grumpy calico, who was nonplussed with our efforts to induce general anesthesia. My PI chatted comfortably with me the entire procedure, and both innocent contrite face and sulky face took the day off. I like to think that my experience and preparation made all this happen, but I think I'm better off thanking circumstance. 

Friday, March 2, 2012

A view from the other side: Part 1

Last December, I experienced life as a client. That client. You know the one I mean. The crazy one.

It started with a lump. Last September, I noticed a golf ball-sized lump on my rat's flank. Geraldine, whom we purchased for $12.00 from PetSmart almost two years ago, seemed unaware. Horrified, I picked her up and prodded the thing. It was firm, and movable, and seemed to be encapsulated. And then I did nothing. She was an old rat, I rationalized. She's been lucky to make it this far. I didn't want to think about it. But the thing kept growing, and eventually it was just too pitiful watching this otherwise bright-eyed creature drag around a side car that was probably a quarter again of her body mass. I resolved to at least consult with the exotics service by the end of the week.

One Friday at lunch, I saw one of the exotics clinicians walk by where I was eating my lunch and chatting between labs. Clinicians in any discipline are hard to get a hold of, because they have a way of running around the hospital all day. Without a second thought, I set my sandwich down and jumped over several chairs.

"Dr. X!" He turned to look at me, and I became aware of how he easily had a foot in height on me. "Are you on clinics this week?"
"Yes . . ." he answered. By his glance toward the stair case, I could tell he already knew where this conversation was going. I tried to make it quick, squeaking out my words. "I have a rat. She has a mass. Can you look at her?"

Dr. X did not miss a beat. In one breath, in his thick foreign accent, he ran through his top differentials and options for treatment. "Bring her in next Wednesday," he finished.

I am not sure what I was expecting, but all of a sudden I was committed. By interrupting that doctor's lunch break, I'd stepped off the precipice. I was going to seek veterinary care for my $12.00 pet who was pushing the upper edge of average lifespan. I loved her, but the idea of medical treatment for a pet rat was something I'd struggled with, and not without guilt.

Everybody falls in a different place on the spectrum of how much intervention they would seek for their pet. There are those who elect euthanasia rather than pursuing any type of treatment, and those who cart their animal to the veterinary school every day for weeks so that it can undergo the radiation therapy that will buy it eight more months of life. Barring outright cruelty, I believe there is not a wrong place to fall on that spectrum. Look at it this way; it's easy to look down on the individual who elects convenience euthanasia rather than treating a pet with a manageable condition, but is that judgment so easy to make in the case of a person with limited financial resources who elects not to pursue a kidney transplant for a cat in renal failure? I don't think so. My struggle stemmed from the fact that I felt that I should be one of the individuals who advocates state-of-the-art medical treatment for any animal in my care. But from a pragmatic standpoint, I wondered if surgery was a good use of resources- mine and the hospital's- for a pet that was frankly a pretty minimal investment.

But it seemed my conscience had gotten the better of me, because now I was going to do it, if for no other reason than that I had an appointment with the exotics service.

Wednesday rolled around, and I started the day off parading through the reception area with a tank full of shavings and one nonplussed rat. I had class early that morning, so I deposited Geraldine in the exotics ward and rushed to lecture. I was to return later to speak with Dr. X. I was prepared to coolly discuss the necessity of surgery and to really weigh the costs and benefits before committing. I was even prepared to discuss euthanasia, although the thought made me feel a little nauseated. When I returned later to speak with Dr. X, as I expected, he brought up surgery immediately.

"It's most likely a mammary tumor." I nodded. I knew from my previous life working in research laboratories that rats have mammary tissue over much of the body, making mammary tumors a common affliction in rats lucky enough to live that long.

"We should be able to take it out easily, and we would recommend spaying her at the same time to hopefully prevent recurrence."

This is the point where I knew I should stop and consider my decision. I thought about the small amount of money my husband and I had saved from our summer jobs, and the particular use I had in mind for it. I felt my face flush. I inhaled, ready to ask about other options, but no words came.

"Okay," I squeaked. "When?"

Surgery was scheduled for the following day, and I sheepishly sent my husband a text message about transferring some money from our savings account for rat surgery the following day.

As I walked back upstairs for my afternoon classes, I was of two minds. On the one hand, I knew I had been intimidated into electing surgery. Not by Dr. X; he was doing exactly what he would have done with any patient, which is recommending the treatment with the best chance of a positive outcome. I had intimidated myself out of debating a course of action with someone I perceived as an expert. On the other hand, I realized that maybe I really had made the best choice. Maybe this was no less than my due diligence for an animal for whom I had taken responsibility. In any case, I was even more committed than before.

At home that night, I prodded Geraldine's lump again. I watched her haul it around with her as she performed acrobatics, climbing upside-down on the roof of her cage. I started imagining a life for her without the lump. The next morning, I packed her back into her tank of shavings, and drove her off to meet her fate.