When is good enough, good enough?

In the lab, we spend a lot of time discussing when to stop innovating. Let me explain. Innovation is the heart and soul of science. We must innovate to move forward, to keep learning. But we want to be a translational lab. Our mission is to bring something to the point where it can go out and help patients. In this context, one must decide, when is good enough, good enough? When can we take what we have and stop tinkering with it and making it better and instead move it forward to the next step. One has to decide this knowing that there will always be something potentially better, safer, more effective or more tolerable to be developed. This then becomes and ethical question. When do the potential benefits to patients outweigh the risks of moving the current technology forward. When does the delay in bringing a badly needed therapy to patients outweigh the potential of future benefits of developing the technology further.

The details matter. The answer to these questions depends in large part on the current state of the field. What are current outcomes for patients? Can the disease be managed? Are there current treatments? If current treatments are good and the disease can be managed, the bar is set much higher. In the disease I study, Huntington’s disease, the bar is relatively low. It disrupts patient’s lives, often in their prime. It slowly and progressively robs them of their independence and eventually of their lives. Particularly because of its hereditary nature, it is devastating for families and there is currently no treatment to delay the onset or alter the course of the disease. In this case you may think a treatment that would be expected to delay the onset or slow the progression of the disease might be good enough.

By nature I am a cautious person. I weigh my options carefully, avoid unnecessary risk. I have perfectionist tendencies. Perhaps more accurately, I consider myself a recovering perfectionist. I can be competitive, but when given a choice between winning and being right, I would likely choose to be right. As a scientist, these qualities can be both bad and good. I tend to overthink things, to talk myself out of experiments, to avoid risk. Once started, I find things hard to complete. There is always more that could be done. I can always do better, be better. In life as in work it is hard to know when good enough is good enough. Perhaps in life, as in work, it is good to see the question as one of risks and rewards. When does the risk of inaction become unacceptable? When does the price for achieving the extra 0.01% improvement become too high? And the answer, as in everything is, it depends.


On competition

In some way, I always wanted to be my father. Perhaps that is how I ended up in science, in the end.

Dhp

My father on a collecting trip sometime before I was born.

DHP-dean

My father when he was the beloved and quirky acting dean of Harvard College (it took me a long time to acknowlege to colleagues and mentors that my college was a successful academic. I was afraid they would either think I was trying to drop names or that they would assume that I was driven by a deep seated psychological need to prove I was better than him.)

I wrote the sentence, "If my father has a competitive side, I never saw it."

As soon as it was on paper, I knew it was false. My father, who always won every game, every argument. Of course he has a competitive side, I just never saw it get nasty. Then again, in my memory, he's always been at the top. He's always had the luxury of being in power. So what I'm saying is, I've never seen him abuse his power. That should not be something that is particularly noteworthy, but perhaps it is noteworthy that it is. 

Thoughts inspired by the discussion of competition among PhD research students here: we need to talk about competition


Bare Hill Triathlon

At 7:02 this morning, my son came down from his room. I was debating whether I should go run a sprint triathlon that started at 8. I had just decided that I would run my 8 miles instead, but somehow when he came down I became undecided again. I asked him what I should do. He (rightfully) looked at me strangely and told me to do whatever. I threw my bike on top of the car and drove to the race. The thing is, I haven't been swimming in months. I'm not sure what possessed me to do this, except that it was convenient and I guess I wanted to? I almost gave up a second time when I lost my timing chip while setting up my bike. It turned out it was lying on the ground nearby, but the thought of having to go and tell the race organizers I didn't have a chip was almost too much for me. 

As expected, the swim was a struggle. Not the worst kind of struggle. I wasn't drowning, or even really very tired. I was just really bad at it. Before I took those couple months off from swimming, the swim coach taught me to pull, I mean really pull. Apparently though, I only do it with one arm. So, like a shopping cart with a squeaky wheel, I pull to the right. I ended up alternating between breastroke and freestyle just to keep going in the right direction and to avoid running into the woman who swam the whole leg beside me. Needless to say, it was slow. When I looked back at the end, I could have sworn there was no one left in the water. Apparently I was wrong, because I was not last in the swim, but DAMN.

This particular triathlon has the longest transition. You run up the hill from the pond about 1/4 of a mile to the transition area. I ran it in flip-flops. I'm actually quite good at running in flip flops. It's a skill you learn from having a daredevil 4 year old daughter. 5:22 on the transition. I figure this was 3-4 minutes of running and  2-3 minutes of actual transition. I had trouble getting my bike shoes on. 

Took off on the bike and started passing people. Being a local tri, I'm used to the hills. I can truly say that I didn't even really push this that much. Maybe a little on some of the longer hills, but not much. I passed people the whole way. Only one person passed me when we had to go down a steep hill with a sharp turn at the bottom. I passed him again on the uphill. At the end, I coasted in. I almost caught a woman in my age group (I later learned) but I decided to let her stay ahead of me in favor of relaxing a little in preparation for the run. I mentioned that I was supposed to do an 8 mile easy run in training today? I wasn't trying to push things. 1:08 on the transition. Uneventful.

The run was probably the best I've ever had in a tri. I started out feeling some soreness in my back, but I just relaxed (not pushing it, again) and ran as if I was doing my 8 miler. It was a nice day, there was shade on much of the route and I was just out to enjoy myself. 


We are here

IMG_20170623_160721

Occasionally, someone will ask me if I ever stayed home with my kids, or a stay at home mom will tell me how she wishes she had a career, but she really feels like she needs to be home for her kids now, or that they can't go out of town because they need to be there when their kid gets off the bus. These are all subtle but real ways that we tell women that it isn't OK to leave their children with others to pursue their own interests. Let me be clear at the outset: if you choose to stay home with your kids because you want to, because you have found that you enjoy it or that it integrates well with the pursuit of your interests, that is excellent and if you have to stay home because you can't afford childcare, that sucks. 

Here is the thing though: there is no one right way to be a mother. There is no one right way to feel. Do I miss my kids when I'm gone? Yes. Am I hearbroken? No. Do I think about them all the time? Honestly, no. I enjoy traveling by myself. I get to do things I don't usually do at home. It is a nice change of pace to set my own schedule, not to have to negotiate for a few days. But I don't rejoice either. I am usually too caught up in the details of what I'm doing to worry much about anything else.

Sometimes it can seem like as mothers we're expectd to feel as if our hearts are breaking when we're away from our children. Sometimes it seems like we're supposed bo be martyrs when we're with them, never getting a moment to ourselves. It can seem like an endless competition: who can be the most selfless and enduring. Time alone then is to be treasured, a luxury for which we should be grateful.

I don't believe any of that. My bond to my family is strong. Time away is good for all of us, but in the end, we don't think much about it at all. The family is simply a constant, steady presence to which we all return. We are here, right where we are meant to be.