Monday, December 31, 2007

These I resolve...

To write.
To be.
To greet each day with joy.
To choose love over fear. Always choose love.

Happy New Year. Be the best person you can be...
Peace, Linda

Sunday, December 23, 2007

Into Our Wilds

I wanted movement and not a calm course of existence. I wanted excitement and danger and the chance to sacrifice myself for my love. I felt in myself a superabundance of energy which found no outlet in our quiet life.

The Bus Along the Stampede Trail. Photo by Carol Falcetta

In the wee hours the last Saturday of this year, I turned the final page, and cried. I just finished INTO THE WILD (Jon Krakauer), a mesmerizing true tale about a young man who left behind his affluent East Coast family, possessions, and money and vanished into the West. Two years after his disappearance, a moose hunter found his remains in a derelict bus abandoned in the wilds of Alaska. In his retelling of Chris “Alexander Supertramp” McCandless’ short life, Krakauer follows the boy’s two-year travels as a vagabond and tries to untangle his reasons for leaving “civilized’ life behind.

Of course, there are no final answers. But the story of McCandless and his tragic end moved me. Last night, I slept uneasily, wondering: Why? What compels a few rare people, usually young men, to risk all for some idealistic purpose? To abandon security and satiety, a life understood by all. To lose one’s self in the wilds of nature – and the mind?

This story haunts me. For one, young men fascinate me, their motivations, their thinking when they’re on the cusp between adolescence and manhood. I don’t know why, perhaps because I’m the opposite sex and a writer and my job is to be curious. As a culture, we stereotype this elusive aspect of the human species as an unfeeling and unemotional, motivated by ‘success’ narrowly defined as money, title, and other commercial indicators. But, I believe young men, like all of us, yearn for something greater than daily existence: a truth, a wisdom, a sheer moment of feeling. Of being.

I am too used to my creature comforts: my morning coffee, the warmth of my home, the security of my job, the hugs of my children and husband. Never could I, without a word of warning, disappear into the wilds of America. Yet people tramp into the woods or the desert or winding canyons all the time: John Muir, Gene Rosellini, David Thoreau, Everett Ruess, Chris McCandless. Most return, but others do not. Ostensibly, they leave to find verity in the purity of nature, but I suspect, in the end, they find the truth within themselves, somewhere in their hearts and minds. I admire their courage, the clarity and honesty of their quest.

So in reading, this little tome reveals to me a kernel of epiphany: this is why I write – to find a modicum of courage to peer over the edge of a glaciated peak in hopes, perhaps, of stealing a glimpse of pure blinding white whispering some truth to me.

See you in the New Year. Until then… Peace. Shalom. Pace. Salaam. Peace... Linda

But we little know until tried how much of the uncontrollable there is in us, urging us across glaciers and torrents, and up dangerous heights, let the judgment forbid as it may.


Thursday, December 20, 2007

The Ten Commandments of Services Research

Taking a cue from my friend Sarah Moffett, a lawyer who follows a similar credo...

I. I am the Lord thy God. My name is Validity — Internal and External. Worship both. Thou shall not have any gods before Me. Much of science tends to be preoccupied with internal validity, the strength of the claim that the experimental manipulation causes the outcome. This leads to the desire to control all potentially confounding variables but may reduce external validity. External validity, or the extent to which the study findings generalize to the world beyond the research project, is very important in services research.

II. Do not worship idols. Although you must have comparison conditions, they need not be exact images. Remember that you worship Internal Validity not Perfection. In medication trials we are used to seeing "placebo," which resembles the experimental condition to the fullest extent possible. In services research, although it is important to have control conditions, it is often not possible or desirable for the comparison condition to be a twin of the experimental condition.

III. Do not take the name of "effectiveness" in vain. Remember that you worship External Validity. Many researchers think that they are doing an effectiveness study if they measure outcomes beyond symptoms. That is not what effectiveness means. Effectiveness refers to the impact of a program in the real world, beyond the tightly controlled world of clinical trials.

IV. Remember the Sabbath day and keep it holy. Research assessments should not be scheduled on important religious holidays and on anyone's Sabbath. Services researchers should pay close attention to issues of culture.

V. Honor thy fathers and mothers — and grandparents, foster parents, and families of choice. Services researchers should pay close attention to issues of culture.

VI. Do not murder your data analysis section - or your biostatistician. The quasi-experimental and group cluster designs of services research require complex statistics. The statistician should be a part of the study from the very beginning.

VII. Be faithful to intervention design, and use measures of program fidelity at all times. Given the complexity of many services research studies, which often test psychosocial and organizational interventions, it is essential that strategies are used to ensure that the interventions being tested are true to their descriptions.

VIII. Although thou shalt not steal, thou shalt borrow frequently. To the extent that services research often involves working in unique cultural and system contexts and adapting standard approaches, it is tempting for investigators to assume that they have to reinvent the wheel. It is important for services researchers to borrow heavily from the work of others.

IX. Sins of omission can get you into as much trouble as lying. Don't stick with the psychiatry literature. Remember sociology, anthropology, psychology, economics, marketing, education, political science... Services research draws heavily from a broad range of disciplines for conceptual models and approaches.

X. Do not covet the grants of your psychopharmacology clinical trials friends.

Lisa B. Dixon, M.D., M.P.H.
Dr. Dixon is affiliated with the Veterans Affairs Capitol Health Care Network and with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore.

Originally appeared in Psychiatric Services (December 2007)

Tuesday, December 11, 2007

Feed Me...

I'm hungry... for time.

Because it's the End Of The Year. Time when everyone wants something yesterday, when everything is due all at once.

When someone knocks gently at my office door (or barges in, the usual approach), I cringe. Please, please, please don’t ask me for anything. Please. I scrunch up my eyes and click my heels thrice, hoping they’ll disappear, leave me alone to continue emptying my two-foot high inbox before The New Year commences.

The ivory tower always is a crazy place at the end of any semester. Tests to correct, papers to read, grades to post, research proposals to submit in hopes of garnering potential sponsors’ ‘left-over’ scraps, and project deliverables must be, well, delivered.

Superimpose the End Of The Elementary School Year projects and parties, music nights, shopping for presents, finding a parking space at the mall, making twelve-dozen biscotti for the cookie exchanges, present wrapping, standing in endless post office lines, tree-trimming and carol singing and you’ve got a set-up for extreme corporeal and spiritual anemia.

Writing? Never taking a back seat (sleep does that), my writing projects swell with bossy importance. Gotta meet those End-Of-Annum goals before posting new ones January 1. So I’m busy critting fellow writers’ manuscripts, penning those last few poems for the last class assignment, revising and editing and polishing and burning BRIGHTER THAN BRIGHT and other works in progress, sending out those dratted queries... and, of course, there’s the blog monster…

Feed me. Feed me. Feed me. FEED ME. Everyone and everything yammers for attention, for sustenance. But despite the zaniness, the nutso schedules, the impossibilities of getting everything on my multiple to-do lists crossed off, I am deliriously happy. The busy-ness feeds me in a way no plate of fresh-baked cookies ever could.

And some things I don’t want to end. Putting a poem to rest is like saying goodbye to a good friend. Finishing Jimmy’s DARK SIDE OF THE SOUL, Steve's PRODIGAL SON, Kim’s TAKING ON WATER, and nearing completion of Chrys' MOONCHILD evokes in me a nostalgic yearning to begin their stories… again...


Good news! There’s a reason for conservatives’ excess happiness – they smoke more pot than their liberal peers. Read about it HEREEat dirt? Join the Donkey Party? Uh, I prefer the new alternative…

Peace, Linda

Sunday, December 02, 2007

Who Are You? Who, who? (And why being conservative might keep you sane(r))

The theme song for CSI is blaring in my darkened living room as I pull this post together. Yes, of course I multi-task. Left brain/right brain – right? The refrain keeps pounding in my head, over and over, such a catchy little mantra. In fact, the tune’s been kicking around my grey matter for the past few days, ever since meeting with my newly-reconvened ‘real’ writing group (as opposed to my ‘virtual’ ones). So last Thursday, I found myself in the middle of a small room, quaking in me wee boots as I read aloud one of my newly-crafted poems. As I finished the third stanza of my first-ever metered, rhyming poem (a rondeau redouble, no less!), the song flashes through my head: Who the heck am I?

It occurs to me I am a forty-something years young woman, mother to two young ‘uns, happily-married wife, and professor with crows feet marching proudly across my upper cheeks. But I didn’t write these verses I'm tripping over. Rather, Ben, the brilliant but bipolar 20 year-old protagonist of my completed (!!!!!) novel BRIGHTER THAN BRIGHT, penned these words. And of course these poems preface sections of the book and, because Ben is a genius (and I am not), they best be damn good poems if they’re ever going to be published. So as I bare my and Ben's souls to my fellow writers, some of who actually deserve the title ‘poet’, half-way through my rather serious poem about child abuse and false paternity, I burst out laughing at the absurdity of it all.

It’s enough to make me crazy. Or at least qualify me for a diagnosis of disordered personalities…

To write about people who only exist in your head means you need to get down into their souls. You live them, breathe them, become them. There were times last year when I would jolt awake in the dark, convinced I was in a psychiatric hospital. Because that's where Ben was at that particular juncture of the story. And when he was shot in the left shoulder, well…. I couldn’t sleep on that side for weeks. It hurt too much.

So now, I am taking a poetry class in character as Ben. My instructor’s great, very tolerant of my eccentricities, and my classmates ask appropriate and probing questions about my life as a young, mentally-ill Harvard undergrad who runs marathons (ha!) and comes from a family of considerable means (double ha!). I’ve learned a lot about writing poems - and being a writer in drag.

Here’s the first stanza of my rondeau redouble…

Newton’s Principia
(Or a Young Boy’s Lesson on Gravity)

He runs free beneath God’s sky-blue brilliance.
On cider-tinged air, quills quiver and twist.
Crimson stains white, the world roars its silence;
bodies of mass fall, clenched into tight fists.


Want better mental health? Go conservative! According to a recent Gallup Poll, Republicans are significantly more likely than Democrats or Independents to rate their mental health as excellent. Fifty-eight percent of Republicans report excellent mental health, compared to 43% of Independents and 38% of Democrats. These distinctions held up after controlling for age, sex, race/ethnicity, education, income, church attendance, marital status, having children, and presidential job approval. What we don’t know is what comes first – the healthy head or the conservative bent.

Thus, in addition to talk therapy and chemistry, there are at least two other ways to attain a healthier and happier mental life: eating dirt and voting Republican. Hmmmm…. Which of the two is most palatable? Peace, Linda