Monday, September 16, 2019

World Childless week - starts today - my comment on IVF

I'm not sure if you've heard about it, but World Childless week starts today - Sep 16 2019.

If you want to take a look at all the things happening go here
And also here on Gateway Women by Jody Day
If you want to read some stories from people who are childless go here at Walk in Our Shoes

As for me, I have a few things I would like to point out. As a childless woman over 40, I've met my fair amount of odd and weird moments in both professional and personal life. Most of them, I think, are based on not knowing reality and why people (both men and women) are childless. Sure, there are a people who are childfree by choice (please note that this would be two various words to described a similar state - i.e. no children present in a person's life - for some it's childfree, and this would imply a choice and these people have chosen to not have children, whereas the childless is more of a general description without a bias implied. Simply put, there are no children by that person. And this person would've liked to have children or at least the option of children.)

I loved finding this site where it was pointed out "Childlessness by Circumstance" is a big number of the childless people.  It was a helpful tool to bring when talking to my friends who are childless and thinking a lot about this in terms of "finding someone" and "maybe I should try and have a baby on my own" and other questions people over 30 who are not in a committed relationship think about. And also it was something to at least bring to the discussion on why it was not as easy as saying "you don't want children" or "if you want children, why don't you have then". Indeed, why don't I, or them?

It was also something I would like my friends and family who have children to consider, that it might be difficult if you don't meet your soul mate when you are 19-25 but later, or never, in life or if you get divorced before conceiving these children. And that it would've been a lovely thing to meet someone and have a relationship with them and then "have sex without protection" and have a child together. But it didn't happen that way.

Since I'm not that interested in talking about myself and why I am in the situation I am in, I'm going to focus on one aspect that I think would benefit from getting some attention. The overpromise of IVF "as a solution of childlessness". Let's get one thing clear, it's not as easy as a 100% guaranteed as "you have IVF and you will get a live baby that looks like you". This is something that people seem to think, and is repeated by the media articles reporting on famous couples having babies into their 40ies among other things.

When you really look at success metrics of IVF, in the US and other clinics (like NHS in the UK or Sweden) the important factor is to remember that the metric is not covering all the couples that go in for an IVF.  Why? For the sake of this post, I'll go into detail.

The success rate of IVF depend on a few factors. First of all, it's only based on the couple (or single woman with a sperm donor) who get at least one viable embryo to implant. If you don't get an embryo, you don't end up in the metrics. (This will make the metrics "better" since only the embryos implanted are counted but people who start a cycle but don't make an embryo aren't counted.)

Secondly, there's a lot of metrics to mention "positive pregnancy test". Let's be clear, that is not the same as getting a successful live baby in the end of the gestation. It's the positive HCG test after implantation, which is after 6 days and followed for a couple of weeks in the pregnancy. This is also called a "chemical positive pregnancy test" and isn't always correlated to a live baby in the end (because there are a lot of pos HCG test that fail and end up in miscarriages and then the woman isn't pregnant after week 12.)

So, in short - not to take up too much time here - the current "general success rate of IVF" is less than 25% when if comes to having a live baby after one cycle of IVF. This is without the people who get a cycle of IVF who doesn't get an embryo to implant. So "the real success rate" is even less than 25%. But you rarely see this mentioned in the media. And they don't really go into the idea of egg and sperm donor leading to a different kind of success rate (usually higher since they are chosen for their good qualities, but that leads into the idea "what is your embryo" and who donated egg or sperm).

The overall success rate of IVF is that after 6 cycles, more than 60% have a live baby. That's still a good amount of people who don't have a baby (3-4/10 couples). And that is after 6 cycles which is a fair amount of time and shots in the world of a relationship. 6 cycles are 2-5 years, depending on how successful you are with getting embryos every cycle, implanting them and then getting a miscarriage, and then waiting for the good time to start again. It's not for the faint hearted, that's very clear. And that's before mentioning that average cycle of IVF in the USA is between $16,000-23,000. It's cheaper in Europe, like in Denmark the charge between $9,000-15,000 for a cycle, still a lot money depending on who pays the medicine/hormone shots.

And brings me to the detail that a few of my friends have talked about in regards to the childlessness and tryin for a baby, especially through IVF.

The strain of doing IVF to your relationship. Not only is it a strain and difficult idea to get around as in "most of our friends just decide to have a baby and they get one or more after having sex",  but for them it's turning into a chore. Sex as something you do at certain times, checking hormones levels and timing, and with expected results. And then with the IVF, there's a lot of shots that need to be taken at specific times and later on in the cycles there are pills at specific times. And some of these shots are needing cold storage, and others are needing help to be able to push them into the part of the "back of the hip" which isn't reachable for a single person.... And then it's the additional emotional toll that they are not worth it as persons but only as parents to their child(ren). To be trying for having a child in your image and knowing that anything less is a failure.... yeah, not the greatest part of being a part of a relationship.

All in all, after hearing a lot of this and wanting to share it - I would be happy if people didn't just say "way don't you do IVF" when realizing you are childless. It's just not that simple.

Wednesday, August 14, 2019

Humpty Dumpty sat by a computer....

Humpty Dumpty sat on a wall,
Humpty Dumpty had a great fall.
Four-score Men and Four-score more,

Could not make Humpty Dumpty where he was before.

This Humpty Dumpty sat by a computer in a new spot and worked hard for an extensive amount of time. A new desk, less thought about position in the new chair, with a strange new mouse and a messed up cord. And then one day the fingers were tingling. Didn't really think about it. Then one day when picking up a carton of milk, the hand couldn't grip and the arm felt like a knife was stabbing it.

At the same time, the other side of the body had cramped up. And the knees had started hurting when jogging, well - not while running but day afterwards. All in all, the parts seemed to get broken one after one. Now, just to hoping that they can be put back together and working well again.

Here's to hope!



(I'm already better in the side, the knees are a work in progress and elbow needs some work.... tennis elbow... what a mess... rehab and boxing, plus using a computer mouse with the other hand for a bit. That'll work on my patience and zen thoughts. And a fair bit of stretching and yoga to make me less stiff as a board. Happy end of summer all!)

Sunday, June 09, 2019

Lessons Learned - not just bad stuff

Lessons Learned is one of the most important parts of a project and is finalized in the closing process. Well, it's one of the things that I think is the most important part of a project (after the deliverables), and something that many people don't want to do since it feels like "wasting time rehashing what didn't work and what did work".

If you look it up in different project management books and sites there will be something about "closing the project allows the organization to record, maintain and reuse lessons learned for future projects". This might be especially helpful if your organization has repetetive projects, say running a same production of compound X in various batches, or performing preclinical PKs with different drugs but the same models.

In my experience this specifics of "lessons learned" is more about "How" you go about capturing the learnt part rather than the "What did you learn". Maybe this is more due to the fast paced environment I move in, with several different teams and the feeling that we are doing "one of a kind experiments that wouldn't benefit from this formal step". Side note, a lot of the processes are the same, just that the people involved in them often think of themselves and the work product as unique and therefore not benefitting of a lessons learned.

There is also a similar connotation of "lessons learned" feeling more like a sit down and repeat what didn't work and let us capture who failed on what. Of course, this is similar to the feeling of people who don't like evaluations or critiques or feedback since the emphasis tends to be on "what didn't work". However, dealing with processes, it's always helpful and important to sort out which processes that did work well, and why. Side note 2, most often these processes get repeated and most people tend to view them as the "norm" since they work, when in fact these processes more often than not are not the norm and can give a huge insight to strengths and built in flows in the organization. It also gives an opportunity to review the successes of the team retrospectively, something that might not happen as often in an academic environment where we have forgotten the project the moment the paper is sent in and accepted rather than when it is actually published.

For the point of this blog post though, I had something specific in mind when contemplating the latests of Lessons Learned I am facing to do and capture. One of these closings is my annual review where I will go through a few of the projects I've worked on this year and I see that some of the bullet points from Lessons Learned will fit well into the review format. Why? Well mainly because of the point I made above in regards to a set of experiments that the people viewed as unique and one in a time, whereas I see them as the same process being slightly tweaked with details specific for the project in questions. And I'm involved in these projects on a regular basis.

Interestingly enough (but not surprising), it's a similar Lessons Learned for another project with a different set of people but similar deliverables and time lines. It goes something like this; Communication plan was decided and in the beginning of the project everything worked fine. Emails to the team was sent, in a timely manner before and after meetings, and updates were clear. Everyone got the work done on time. Once the project started lagging behind the time line, the communication plan broke down. This was in hindsight more clear since the person responsible for the communication decided to not be transparent with the delays in production, and at the same time stopped producing meeting minutes and tasks to the team. The team started meeting in smaller groups, which didn't have follow up or minutes, thus making it impossible to gauge where the project was. Finally there was a large group meeting where the project sponsor and the biggest stakeholder were present, this meeting generated a clear list of expectations, deliverables and time line with mile stones. For future projects, clear meeting minutes need to be delivered to the project sponsor and stakeholder for accountability. Communication should not be considered an afterthought. And even an email stating "no news in the project" is an important email if there has been no update meetings in over four weeks since communication indicates "keeping everyone in the project up to date and on the same page".

All of this is obviously easier said than done when working on concurrent projects with several team members in different projects, however - it's even more important for efficient work and avoiding rework and break downs.

There is a lead in from Lessons Learned into more private sphere and how this can be helpful in a career setting (lessons learned from your PhD project for example) but that's another blogpost.


Sunday, May 05, 2019

"you're not a scientist, you don't have a PhD"

Ego getting in the way of making a good team. Ego ruining a good working team.

Everyone who has been in the science field for a certain time know when you meet new people in the field that there is a lot of questions about where everyone fit in and what roles everyone plays in these new teams and collaborations we do.

It's the newly hired person who thinks that "everyone in the labs who is involved with a paper gets on the authorship list". It's the newly minted PhD who know finally (?) feels secure that they have proved themselves explaining "I'm a real scientist now that I have the PhD title". It's the intern who spends three months in the lab washing dishes and cleaning up animal carcasses and studies for their MCAT since they are going into MedSchool and thinks that will give them power. It's the old technician who has seen numerous postdocs crash and burn with the thought that they are the special one who will change P&R while the technician has the ear of the PI.

And then there is that special person who takes it one step further and speaks up and tells people "you are not a real scientist since you don't have PhD" to their face.

And the kicker is that they don't seem to understand why it's offensive and making it impossible to work as a team. Never mind that they are wrong, oh so wrong they are. And that it is such a naive comment to make, and makes you look so small and misinformed. To disregard experience and the work that so many hand and heads in the lab contribute to. That science (STEM and biology is what I'm mainly talking about now since I'm mentioning lab work) is a team effort. That even if there is one PI seeing the bigger picture, writing grants, there is a lot of hands and thoughts and details getting in the way of the ego.... and that scientists come in different shapes, sizes, backgrounds, titles and knowledge areas.

It's similar to an old saying I had told to me in the scout movement and by military leaders in my leadership trainings;  "You're not a leader because you have a title. You're a leader because people follow you since they believe and trust you".

It's also called "if you have to call out in the room "I'm the boss/captain so you have to do what I say", your leadership is on the weakest ground/first step in the staircase of hierarchy and you don't have much in the long run. Authority is the position, that doesn't mean leadership which lies in the character of the person.

It's especially important if you are coming in new to a job, and your title is lab manager or lab supervisor - both titles that vary depending on where the job is, sometimes this requires a PhD, sometimes it doesn't. Whatever the requirements though, I would highly recommend a period of "look, see and gather information about the team" before making any big claims and statements. (Needless to say, I would never state anything as silly as "real scientist needs a PhD".) I would build confidence and trust with the new colleagues and lab members, as much or more as with the PI of the lab. Why?

It's a team sport this game we call science. The PI is the Captain/QB/Skipper/Coach depending on which sport we refer to and the rest of the lab take up various positions and depending on the time of the game, are of various importance at that specific time. An experienced lab technician who has been with the PI for a long time? Yep, crucial to the play. And, like a dishwasher (hello my old job) is key to get tables turned around fast in a restaurant to earn the money for the servers and seaters, someone to keep lab wear clean and sterile, changing animal cages, making regular solutions the same old reliable way are the backbone of repeatable, good and solid science.

And the absolute in the lab it trust. Trust that you know what you are doing at the bench. That you know when to ask for help. And that you realize that certain people in the lab know different things, and that the strength is in those differences and match ups. As long as you can make them all work together, towards a common goal, making al of them feel important and seen in their positions. That's a true leader, and something to strive for.

Sunday, March 24, 2019

being a failure vs having failed at something

There's a motivational quote that goes along the lines of "if you don't try at anything, you can't fail" and "you never fail until you stop trying". I'm not much for motivational quotes. I do however keep some demotivators as my screen saver at work since my humor is dark, and cynism has kept me from falling into the deep pit of despair a lot of times. You can't cry if you are laughing (well, you can but the saying is "laugh or cry")

The thing with the motivational quote in regards to failure is that I do think there is some merit to the saying. If you try something you have never done before there is a chance that you will not be able to do it (aka fail doing it). The problem is not with having failed at something. Learning from what you failed at doing is probably one of the best way to learn how to do something right. Not the only way though, and not always the best, but one of the ways. It is also true (in my humble opinion) that "just because you failed the first time, doesn't mean that you will keep failing".

One of bigger issues is when there is a switch in wording from "I have failed" to "I am a failure". It's a pretty common word play - at least based on the stories I hear at work, and the fears I hear vocalized from people I interact with. That the failure of doing R means that you are defined by R and now you are a failure. And that the failure is in everything, or at least in more things that one thing you initially failed at.

Personally, I have faced this particular piece of thinking a couple of times in my life so far (no surprise here). Maybe that is why I am so good at explaining it to others, yet failing a few key times with myself - no one is perfect...

Most recently I found myself talking to a friend who was walking in a circle around this particular argument. They have failed at something, something that a lot of people do and succeed with, and now they feel that they are a failure. That this something defines them and they keep thinking that success in general would mean no set backs and no failures - ever.

I saw a tweet a few months back in regards to people asking PIs to post their "failure CV" as in stating "applied for and got rejected for 5 R01s", "applied for 48 jobs before landing this one perfect job". While I like the idea, to be able to acknowledge that life isn't a full line of (easy or hard) successes, I can't help but think this is part of the issue that makes it even more difficult to not look at oneself as a failure.

Why? Because there are people who will never succeed with their dreams of getting an R01. They will not have the time to keep trying over and over. Like a lot of us knows, there's a finite time frame for most TT and if you haven't succeeded with an R01 by then, then you are out. Same with people who want to become actresses,  writers, partners, grandparents, truckers or anything else that people dream about. Very select few can keep trying the same thing over and over again to wait for that one time of success. This doesn't mean that everyone who does not succeed with what they set out to do are failures. Not failures as people, nor failures in general. I know that there are people who would say "but you shouldn't shy away from accepting that there is failure in life and that means that you failed". I don't. I shy away from defining it as "they are a failure".

There are a lot of failures in the world, I know. But there is something special to attribute the word "failure" to a person. A ship can be a failure (think Titanic). A plane can be a failure (think 737 Max8). Dinner was a failure (everything burns and is undercooked at the same time). However, Person P isn't a failure if they failed getting into grad school. They failed at getting into grad school.

To me that is a very important difference that bears reminding. We are more than a failure or a success story. We are the sum of all our failures and successes and it's not like math where the pluses and minuses add up since we are not math, we are people. People with experiences to live through, and learn from. And there are so many experiences in a life time.