Archive for: February, 2016

It’s hard to watch someone die

Feb 15 2016 Published by under Alzheimer's disease, dementia

My mother is dying. She is dying, surely as the Chicago Cubs will fail to win the World Series, again (apologies to JKR). But she is dying very slowly. At times this is less painful. I can forget she is dying when she seems to be the same week after week. She turned 90 already this year, the first baby born in Passaic, NJ 90 years ago.

But sometimes her dying is much more real and now and present for me. This week, the hospice people called to tell me that she had an “incident”. This, by the way, is her second go round with hospice. She was “on hospice” as they say, about five years ago, but got kicked off because she wasn’t dying fast enough. No one believes she is not going to die, not me, not my sister or brother, or any of her aging friends. But she is taking her time about it.

When they called me, in the middle of the day about the “incident”, I said “do I need to come right now?”. Coming right away is a 20-30 min drive. When I moved to almost-MRU in the heartland of this country, I moved my mother with me, away from the city where she had lived for for over 50 years. No one else cared. My father was gone, and my brother and sister too busy with their lives to think that making sure she was in the same place as one of us was something important.  No, said the nurse, she is doing OK. She perked up and ate something and drank something and we have her on oxygen and that seems to help.

What, I said, is hospice’s view on using oxygen? My sister and I had already agreed on no trips to the hospital, no IV lines, not only nothing heroic, pretty much nothing except that which makes her comfortable, and as happy as she can be. Hospice, the nurse said, thinks oxygen is a family decision. Oh crap, I thought. I do not want to be making decisions. But, the nurse said, oxygen doesn’t extend anyone’s life, it will just keep her comfortable. Until, of course, I thought, she pulls the cannula off her face.

One of our favorite (mine, my sister’s, my father’s, who was alive at the time) stories about my mother and her dementia was a time she was in patient at the Very World Famous MRU hospital, where both of us taught. She was in to get her meds adjusted, as she had bit a nurse in the facility where she was living. I am sure the nurse did something. People with dementia lose executive function, that psychologic construct that keeps us from telling our department chairs that they are a jerkoff asshole to their face. My mother wasn't inherently mean or nasty, but she knew what she did and did not want. She just didn't have a good way of expressing it, and lacked the executive function to understand what would be an acceptable way of expressing it. During this hospital stay, a young phlebotomist tried to take blood from my Mom, without much success. As I watched him try for the fourth time, my Mom grabbed the needle and tried to stab him and said “see how you like this shit”. For the record, when intact, my mother never cursed and objected strongly to my, er, colorful language. “Potnia, darling, academics just don’t talk that way”. It wasn’t about how women talk, but about how scholars talk.

Back to last week. When I did get to my Mom, about an hour later, she was fine. I notice the oxygen tank had run out, but she was alert and chattering in her dementia-talk, and had two bowls of ice cream. Since then I've seen her twice, and she is doing as well as anyone who no longer has either language or speech, but some voice. My sister says she’s got at least 9 lives, I think it’s a near- infinite supply. I go on watching, and waiting. She goes on eating ice cream. And we both know that Alzheimer's is an ugly ugly disease.

8 responses so far

Your Grant in Review: Question for the Masses about Significance and Innovation Sections

Feb 05 2016 Published by under Uncategorized

When the style of grant application changed to include these sections, along with shorter proposals, I remember being told (by grant writing experts) and being successful with these sections being on the order of .5 to .75 pages each (for a total less than 1.5 pages). This was especially true for the 6-pagers (R21s, R03s, research design parts of K-awards). Even though I've written on these sections in the past here and here I did not pontificate on page length for these sections.

In the grants I'm reviewing, people have taken 3-4 pages of a 6 page grant to do Sig & Innov. Is there something I'm missing here? I think they have stinted Research Design (and can make very specific critiques and questions about what I perceive is missing). But... Open I am to mistakes.

I have always thought that if you can't do the significance in a para or three you are belaboring the obvious. If Innovation is that innovative, it can be pointed out in a few sentences.

Please: your thoughts?

 

 

 

7 responses so far

The New NIH Biosketch & Their Do's and Don'ts: Part 2

Feb 05 2016 Published by under Uncategorized

Ok... so part 2 is a little later than I would have hoped (here is part 1). But, shall we plow on? Yes, we shall. The rest of their advice from this page.

Don’t stuff your biosketch with data and information that do not belong there.

Oye. I'm reviewing grants right now, and I can tell you, the temptation to put all sorts of stuff here must be very high, since a full half of the biosketchs I've seen have things that I am just not interested in, not relevant, and irritating. Remember that the very last thing you want to do is irritate the reviewer. I've often said the meta-advice for writing grants is: do not piss off the reviewer. What is irrelevant and does not belong here? Preliminary data. The list of everything you have ever published. More difficult to discern are things that are not in support of your grant or career that explain your delay. You are supposed to put stuff in the Personal Statement such as:

May include a description of factors e.g. family care responsibilities, illness, disability, active duty military service to explain impediments to past productivity

but everyone I've talked to says that you need to be very careful about this. There may be hidden prejudices (against time out for pregnancy or military service). Such may be illegal, and even unethical. That doesn't mean they don't exist. Certainly if your pub record has a hole in it because you were gone, its worth noting here. One example that I think worked was a new colleague hired at a MRU. Everyone there got a lighter teaching load the first year, but the course in which  my friend was hired lost its course director, and they asked her to step in & run the (gulp) enormous first year med school class. They promised (and made good on) a year's break from teaching in her year 3 of employment. It worked brilliantly, to the point, where it could be a strategy for others to consider: she didn't have a lab the first year, and spent it organizing, but in year 3, rather than teaching she had a mini-sabbatical and was massively productive. She put this in the personal statement, and it was positively noted in the reviews.

Next:

Take advantage of the option to provide links to your publications via SciENcv or My lBibliography. 

Only 1 in 3 or 4 bothered to do this. I can see the Old Fartes not doing something new (they didn't seem to read the instructions, either, but that's another story). But why oh why would a young person not do this? Many people have said (on the tweets or in person to me) that they are not going to waste time reading all the nonsense in the new format, they just want to see the pubs. If this is the case, then providing the reviewer with a one-link, one-click place to get that info is going to be very valuable. Putting the list in your biosketch is (allegedly) forbidden. It is also another way to piss of a reviewer who cares about the rules. For my part, I try and ignore rule-breaches, but probably in the way that we all have biases of which we may be unaware, its probably there in the back of my mind.

Relax if you are a new investigator: the new requirement can only help you, since study sections cluster the reviews of new investigator R01 applications.

Hahahahaha. Relax, new investigator, NIH has your back. Tone-unbelievable-deaf.

Update on being a new investigator from DataHound: The NIH Early Career Reviewer Program-Some Key Parameters. I have long advocated doing this. Here are the statistics to support it.

Bottom Line: List only pertinent information in your biosketch, and know your application could be withdrawn if you don’t use the new biosketch format.

Given the number I've seen that have either ignored this part or that, I am not sure this is true. Its one thing if the whole biosketch is in the old format. Someone just didn't care enough, etc etc. But when parts conform (ie the five areas with four pubs, or is it four areas with five pubs? I am sure that after doing this 6 or 7 times, I will have it memorized), and others don't (as in, oh by the way here is a list of my favorite 26 pubs since 1966), its a sure indication someone read the rules, and said screw this.

But, for young investigators, new investigators, and really any of us that want to get funded, following the logistic rules is a small thing. Why give the reviewers any cause for rejecting you, or even just being annoyed?

8 responses so far