Probably never. Especially if you are a thoughtful person.

On the other hand, it does get better. It gets easier, and sometimes you even forget.

Things that help:

• Keep that folder/list (hard copy!) of good things that have happened to you.
• When someone says something good to you, write it down, even by hand, and put it in the folder. Date it, timestamp it, draw a fracking picture in the margin. Put it in your memory.
• When you are giving a good presentation, in the middle, if you can, or afterwards, take a step back and remind yourself of what an awesome job you just did.
• Look at a trainee, the undergrad you are supervising right now, whilst in grad school, and think "this person is doing well because of me"
• There's at least one person who believes in you. Think about that person. Smile at them in your mind.
• Listen to whatever up music you need - the scene from The Two Towers when the elves arrive at Helm's Deep, Eye of the Tiger theme from Rocky, the march from Love for Three Oranges by Prokofiev (this was the music background to a record I heard in Kindergarten for a telling of the Trojan War. I was shocked as adult to learn it was Russian, not Greek, music).

Go ahead and add to the list in comments.

Nobody thinks of medical schools as being particularly poor, or in financial trouble. Yet one comment  in an older post, together with a meeting I went to a few weeks ago, got me thinking.

Many people (here, IRL) are outraged that the university would try and make money on postdocs. Although I crashed the meeting to hear about the postdoc stuff, there was another presentation, first, from the chief financial officer. Because this is such a small place, people like the CFO do come talk to the faculty, which was not true of other, larger places. I have found that in MRU, policy, budgets and implementation strategies come down from on high to the plebs. Here, there is at least an effort to share information, although one's ability to actually do anything about it may be just as limited as in the Big Important Universities.

This presentation was based on percentages and compared a number of public medical schools, and some private ones thrown in for contrast. There is an awful lot that can be said about this, stuff that impacts me, the younger faculty I care about, and as a bell weather signal for the future in general. I want to make two points, one data analytic and one substantive about funding. But they're linked.

The statistical point is that he presented percentage data: where the money comes from divided into broad categories. One really needs to see the absolute data as well as the percent data. The broad categories were: tuition, research, state subsidy, and medical income (hospital/professional fees). The biggest difference was the percentages attributable to tuition and state subsidy (large in small schools) vs. research income (large in bigger schools).  The percentages may vary, but the absolute number is close to a constant across schools of all sizes. Tuition and class size are variable. But bigger places tend to have higher tuition and smaller classes, and it works out to a narrow range in the end, certainly the same order of magnitude in dollars. The state subsidy varies, but not greatly. It is a subsidy per student, so while it varies, it will be roughly the same dollar amount. [I want to set clinical income aside for a moment, and just take a look at research. There are many different models, with hospitals separate from med schools, etc etc, and without more information it makes this part of the equation difficult to assess].

So if you look at the percentages, they vary tremendously across Universities, pretty much a function of a size. But I bet that the size of the budgets vary by an order of magnitude. That means if one component is a constant in absolute dollars, that order of magnitude is shifted to the other components. Bad data analysis.

But even looking at the percentages, research is a much smaller part. So the money guys wring their hands and say "the researchers aren't doing enough". But of course, per capita, we are. We are just much fewer in number than at the Big Places. Of course this doesn't translate into policy to either: hire more researchers or provide better support the ones we've got. No, this is part of a justification for developing a two-set faculty: BigDog researchers, who bring in >80% of their salary, and teachers, who teach the equivalent of 18-20 credit hours per term (ie two big med school classes, each term). The model of the teacher/scholar is in danger.

But this is not the end of the analysis. As always, context is important, in this case political context.  States are actively, hostilely, and with total conscious intent, reducing their subsidies to public higher education, including professional schools. It is not a matter of "the states being successful" in reducing contributions. They are being successful at this.

Which actually brings up another point: control of state legislatures is overlooked. But it is critical.  It is critical for being able to call a constitutional convention (and get rid of such pesky things as same sex marriage, birth control, and voting rights). It is critical for support of "extra stuff", like education, clean water, and public prisons. Some of the states, such as Wisconsin, make headlines, when they do headline-making things (like try to get rid of tenure). But as far as I can tell, these trends are pervasive, even in democratic controlled states.

The data for my state, and my tiny medical school are out there with an in your face message: state support has been reduced, consistently, significantly, no matter what percentage or absolute number you look at. If tuition is capped by the states  (which it is here, and in many other states), and the subsidy is being reduced, the difference has to come from somewhere. States, unlike the federal gov't, have bigger problems if they run in the red, and they by and large do not let their univerisities do so. There are many sequellae, many implications, many problems that arise from this. There are people who say that public higher education is not necessary. They say that private schools do a damn good job; let them do it. Private schools have their own issues, which may ultimately translate into the same bottom line issues: the world is changing. We, little ants on the ground, see the part about reduced funding success, NIH grant demographics, extended postdocs. But the issues are greater. As the mother of one of my trainees said at her child's (same-sex) marriage: just because this is possible today, we cannot be complacent.

Everyone, at my little almost-MRU, at other real MRUs, etc, says "Higher Education is in crisis". Yet, in my over 40 years experience, higher education is always in crisis. There is always a fiscal problem. And while everyone says "really, truly, NIH was in trouble now", and there are numbers to back it up right now, there have been other times when NIH is In Trouble. [aside: one of the issues olde fartes, greybeardes, and blue hairs are not inclined to worry, is that this wolf has been called over and over and over. That doesn't make the response "this happened before" right, factually or morally. But it may explain part of that response].

This situation reminded me of when I was a newbie faculty member in a Dental School. Back then, the distant past, before you were born, most likely, Dental Schools were In Crisis. Historically, going back to the 60's, Dental Schools had never gone the "NIH" route as it was called back in the lush days of 30% paylines. And as a result, they were much smaller than med schools, in budget and number of faculty, and, in general, research scope. Medical schools had hospitals, but Dental schools had clinics. As a result, as I pointed out here (part 1), they were much more tuition dependent, especially at private schools with no state subsidy. That is one reason why some dental schools closed in the 80s & 90s. Here is an article about dental school closings, but in the context of the future of Vet Schools. That there were more seats in dental school than total applicants, meant that the classes were being filled with people lower and lower on the admissions list. Whether these people would be "good" or "bad" dentists was not, to my knowledge, ever studied.

Since then, some new dental schools have opened. These are not necessarily scholarly places, but places focused on training people to be dentists. The folks I know who teach in them are teachers, first and foremost. Seed money? Lab space? Not so much.  The ones that closed were more scholarly places, including Emory, Northwestern, Georgetown, Wash U, Loyola, Fairleigh Dickinson. They were private schools, with no state subsidies, and budgets to balance. There was, and still is, lots of talk about demand to be in the profession as a driver of professional school success. Those discussion are informing the future of law schools right now. For medicine, that demand will always be relatively high, and acceptance rates relatively low.

I do not think that the causal root of any crises in medical schools will have the same basis as the historical basis of dental school crises. The problems in medical schools (and likely universities in general) will more likely come from the other parts of the equation that add up to total income. If NIH budgets are being cut, if the state universities are looking at reduced subsidies, those parts of the equation are going to be the problem. Now, there is talk that NIH funding will just be held at previous levels, and thus may or may not translate into problems for med schools. After all, its the same, right? But if that money is sequestered into Olde Fartes, and not supporting younger people, then growth will be absolutely impossible. If more and more young researchers enter the system, as the Big Dog schools feel they must "grow or die", funding at previous levels will be a problem.

There was talk, back in the mid-90s, well after I had left the Dental School where I started, that the closing of some schools had eased the pressure on others. Will some medical school close, too? I have heard scuttlebutt that one of the second tier medical schools in my state is in sufficient fiscal trouble that the State Legislature is considering just that. It won't be from lack of students and demand for the profession. It will be from the other parts of the equation, including, as many of my wonderful readers have pointed out, the expansion of the administration, and the costs associated with that (but you know, I heard the same damn thing in 1986 at the Dental School).

So implications for us ants on the ground? Well, to start with, closing schools means even less jobs. It means more people leaving the system earlier on, and less mouths at the trough in the Asst. Prof. instar. We are back to the argument about where the sorting and selection should occur. Less students? Yes that would likely mean fewer people later on. The argument that everyone should have a shot a being a researcher, a professor, etc, has defensible points. Admit them all and let , who? how? at what point? sort them out? But if the limits aren't imposed at the levels before tenure, they most certainly will get enforced there. And frequently enforced by people who, while they are very sad you didn't get funded and therefore tenure, in the end make decisions based on the fiscal health of the university.

These problems are not new. I got a master's degree in a small, intense program at a good school that invested, in the beginning, in the dream of a faculty senior person. There were 3 faculty, one BigDog emeritus who had been enticed to retire there (from whom I took some of the best seminars of my life), and 10-12 graduate students, many of whom had turned down the big places to go to that program. It was intellectually exciting, and changed how I do science. In fact, I think had I not been in that program, I would have left academia. I was not ready for prime time at that point. But, as these things happen, the program fell apart, one jr prof left, Uni admin changed and declined to replace this person, so the senior person was ripe for recruiting, and left.  I went on to Big Name Place for my PhD, and everyone in that program landed on their feet. I give big props to senior person, who worked hard to make sure every student found a home somewhere (and a very large percentage of those students are still out there being scientists). The program was great, better than great, but without admin support it died.

So what are we to make of the administration? I do not know a single researcher/professor who does not have complicated thoughts and feelings about the administration. Actually, that's not true. I have a wonderful marvelous, now tenured colleague, here at almost-MRU, who would say to me: Potnia, my thoughts are not complicated or conflicted. I hate the fuckers. Ah. Part 3 to come. Soon. Real Soon Now.

This story, obituary, in the NYTimes, about Allen Counter, reminds me that often we do not know, or in this case, for me, forget, about people who have done much to make our world a better place. In short, Counter, a Harvard neurobiologist, did work that took him around the world, to remote places and indigenous people. He was also a POC (although I heard him speak once, and he referred to himself as "black"), and committed to recognizing the histories of POC. In particular, because he did work in Greenland, he was interested in Matthew Henson, who had accompanied Peary on his 1909 North Pole expedition.

As was the case (and yes, there is sexism/imperialism) Henson fathered children in Greenland, and Counter went to find them. He wrote about these children and as the obituary says he then worked at "reclaiming the father's [Henson] reputation".

Long described as Peary’s valet, Henson was actually much more: He was an expert navigator who spoke Inuit, drove sled teams with a skilled hand and knew how to build snow shelters.

In his 1912 memoir, “A Negro Explorer at the North Pole,” Henson recalled Peary explaining to the members of his expedition why Henson would be making the final five-day push to the Pole with him, quoting him as saying: “He must go with me. I cannot make it without him.”

Henson was important and deserves recognition. So does Counter for his work on deafness, his work setting up the "Harvard Foundation for Intercultural and Race Relations" and making sure that Matthew Henson was not lost to history.

Yesterday's post, allegedly about drug abuse amongst professionals, was also about response to stress. There was one more bit from the original NYT article, a bit I took out of the original post, that got to me. It didn't seem to fit. I looked at it again this morning, and realized that it was more hopeful than the rest.

The article talked about how idealism is lost, frequently in the first year of law school. Most people go to law school, or for that matter grad school, because of dreams of helping others or doing Something Good. The article contends that the stuffing gets kicked out of everyone, or nearly everyone, as some people graduate law school and still go work for legal services and things like the Southern Poverty Law Center.

When I stopped to think of this, I thought of my grad school peers. I was in a department of evolutionary biology, but lots of folks doing ecology, systematics, and really, natural history.  Many scientists, particularly the field oriented ones, the paleontologists, ecologists, evolutionary biologists seem to hold on to their idealism a little better than what the article says about lawyers (they lose it in their first year). Yes, the system, both in grad school and following it up,  is still brutal. If you think NIH is hard now, NSF is still an order of magnitude worse, but in money given out and funding success rates.

The alt-career for these guys was doing something in the then sprouting "environmental" industry. Yes, some of the paleo types went to work for oil companies (invert paleo could usually sell that better than vert paleo types). But, in those days, World Wildlife, and Nature Conservancy were hiring scientists. Not so much, these days, but then, there was the feeling you could make a difference in the world that way.

I checked up on a couple of people from those days. Yes, I'm a lousy correspondent, and didn't stay in touch with people. Some are dead, and that was hard to learn. People who were friends have gone, without either of us saying goodbye. But there are some who are professors, teaching ecology and evolution and, yes, natural history in those biology departments that did not give into the late 20th century impulse to be all-molecular all the time. Some are very active in environmental, eciology, and yes, natural history, causes.

A good friend from those days, someone with whom I've stayed in touch, is a good examnple. Liza walked away from an Ivy League tenured job to work at a large midwestern University. She was a dept chair, and is heading up a named institute that you've probably never heard of because it works at the interface of evolution, ecology and sustainable human use of resources. She could have been a BSD, a scientific intellectual property lawyer, but that's not who she is. She has consistently made the choice to do what she thinks is right. And was married. And had a marvelous kid, now launched in the world doing marvelous things. It's not like her life was a fairy-tale. There was lots of hard stuff along the way, and of course, she didn't get rich, only comfortable.

So are folks who are attracted to ecology/environment/evolution inherently more likely to hold onto their dreams? Or do these fields promote and encourage people in that direction? These folks aren't perfect, or even always good. To be sure, there are the self-righteous vegetarians, the I-Won't-Own-A-Car so I must live somewhere, have a job  somewhere that will let me be that way (which is a form of privilege to pick where one lives and works with those criteria). I knew people who would only live in California, or in Boston/New York/San Fran (Seattle and Portland at the time did not have the same cachet). They've got lots of the same little problems that you and I havce.

But back to the question, which way did causality run, or is it just my biased dataset?

Or is it just the article and law school and the people who say things like the research shows that in law school students (all, most, some?) focus on external values, like salary and status?  I think of some of the folks I knew when I was at MRU, particularly folks in public health. They were not the BSD's, running 10 post-doc labs. Lots of these folks had an assistant, part data-manager, part logistics organizer, part-clerical assistant, and that was all. They really believed in what they were doing. Lost dreams? Maybe disillusioned as to how the system worked, maybe disillusioned at how quickly change could come. But still following their dreams? They would say yes.

Maybe the selection and sorting that goes into law school, maybe what happens in law school, pushes people away from their dreams. And maybe lots of the pressures in science and public health, to work long and hard hours, to over-produced are there. And maybe a survey of surgeons will find the same disillusionment that the law school surveys find. Heck, maybe a survey of medical students will too. And maybe drug usage in evolutionary biology is a the same level as in law, because there is a genetic predisposition, to people under pressure, from work, from life, from circumstances pushes people in that direction. But I hope there are more people like my friend Liz, people holding onto their dreams and fighting for their dreams of a better world. They just don't make the news.

Ah, in today's edition of good things do come to good people:

THE PROVOST REVERSED HIS DECISION AND IS RECOMMENDING ME FOR TENURE

— Dr Becca, PhD (@doc_becca) July 17, 2017

I once lived in Australia for two years. It changed my life. The beauty of the desert changed my life. The friends I made changed my life. It was over 20 years ago, and I spend a non-trivial amount of money going back every 2-3 years.

I love Aboriginal art. When I was there, one of the emerti professors had a wife who was a sometimes artist and a longtime supporter of the museums and art communities. Tippy and Sam and I became friends and Tippy introduced me to a dealer and gallery owner who, while white, was committed to supporting the Aboriginal artists. I began to save money, and every trip bought some art. Art with known provenance and art, that to the best of my knowledge, supported the artists. It's been more than 20 years, so I've acquired quite a bit (for a scientist as opposed to a Collector). It surrounds me in my life and gives me great joy. It is one the few things I enjoy having. Here are two (rather bad, taken with my phone) pictures of a sculpture of one of my statues. I have many birds.

One thing that became clear to me as I lived with this art, and became friends with the woman who owns the gallery (which also became a studio for artists who did not have resources), is that while there was much information on the artists, I didn't really want it. And that is true of other art forms: I don't want to know about the actors or musicians or writers whose work means so much to me. (Although, I do admit to enjoying the Museum of Music in Vienna, which taught me a lot about Haydn, Mozart, Beethoven, etc).

This is an ongoing  argument I have with my partner, who is a historian of jazz and wants to know about the life and the forces that shaped the music and the people who make it. I just want to listen. Or watch. Or read.

So why Temple Grandin? She has famously said she doesn't get music. I had read her work on animals, for my work, especially on animal emotions. I started doing research in the days before IACUC's and AAALAC inspections and in general, rule about doing animal research. I was frustrated because I wanted to know more about the animals, and when the rules and regs started, including the Animal Welfare Act, I felt I really needed to know more to think about animal distress. In those days, there was nothing easily available, hence Temple Grandin's work.

One of the things Temple Grandin did, could and probably still does, is design things in her head. Enormous things, like 10K sq ft meat processing facilities. I cannot do that. I start at the beginning and work my way through. I realized that there are people who learn to do art in the same way. I was visiting a good friend, giving a talk at his Uni. We didn't talk science, even though we have collaborated in the past, and moved in different, but very interesting directions from that common point. We talked about the Goldberg Variations and how Glenn Gould played them. We talked about how each of us learned music. We talked about all the ways in which people, creative people who are learning to do things, learn how to do them. My friend is not Temple Grandin either. He was struggling, in his words, to master one part of the Variations. I love music, but lacked the precision, the physical knowledge, that is the first necessary step to creating music.  He never gave up.

So, I will never be an artist. But I have realized, at this point in my life, that it is ok to surround oneself with art, with things that make one happy. There is always music in my office (yes, I'm lucky to have my own). There is art on the walls, home and work. And this makes me a better scientist. Even if I'm not Temple Grandin.

I know lots of people get weird publication requests from sketchy journals. But the subject line of this one was the best in a long time:

From: Gastroenterlogy & Hepatology: Open Access [mailto:gh@medcraveonline.org] Sent: Thursday, July 06, 2017 8:12 AM To: Potnia Theron

Subject: Expectant submission