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Friday, September 02, 2016

Another Upside of Being an Academic: Chronic Illness

I haven't been blogging much lately. That's not unusual: it's been true for the past two or so years. Some of it has to do with exhaustion factors associated with blogging itself. (That gives me an opening to promote this upcoming collection edited by Michael Desch of Notre Dame, Public Intellectuals in the Global Arena: Professors or Pundits?, in which I have a slightly dyspeptic chapter on bloggers as public intellectuals.) The other reason is that I have been generally sick the past two years and had ankle replacement surgery this summer--a pleasant bookend to my last summer, which featured fusion surgery on my other ankle. I will say as a quick side-note that although it's relatively early, both surgeries appear to have gone very well and I'm looking forward to brighter days. 

Chronically-ill-academic pieces are kind of a genre at this point, and I've written here before on living with chronic pain and illness. Given that one of the reasons I'm blogging less is my dislike of repetition, I won't rehash (entirely--in looking back over this post I see I did limp over some well-trodden ground), although the subject, having consumed a big part of my life and energy for the past two years, is of understandable if selfish interest to me. I did want to apologize for being absent here, though, especially given how much of the burden has been shouldered by Howard and our guest bloggers, and felt somewhat compelled to say something about why I was absent. And given that my skill set as a blogger, such as it is, involves saying professionally imprudent things, but at such length that no one notices, I thought I'd add two points--one mildly contrarian, the other mildly "rude"--that I haven't seen made much of in the law professor posts I've seen on the subject of academics and chronic pain or illness. 

The first is that, all things considered, one has to be counted as damned lucky to be an academic if one has to be chronically ill. The usual narrative and counter-narrative about law professors, certainly post-2008 but before then too, involves claims on the one side that law professors, like many other academics, wallow in free time and light duties, and extravagant claims on the other about 80-hour weeks and how much harder one works as a legal academic than one did in private practice. Both are exaggerated and both obscure the single greatest academic privilege concerning the use of one's time: flexibility. With few exceptions, law professors and other academics (although we are probably even better situated) have incredibly few fixed time commitments. Sure, we sometimes work long hours (though not as much or as often as the defenders assert). But for the most part we choose whether and when to do so. And, apart from classes and some service obligations, long pauses between major professional activities are easily--no doubt too easily--available.

And then there is all that is included in the word "summer." No, it is not a vacation--at least not necessarily, although surely some or many law professors use it in that manner and there are a couple of academic summer activities that are not easily distinguishable from vacations. Certainly it shouldn't be one. The fact remains that there are few jobs in which, if you need to plan a major absence from work for medical or other reasons, you can do so as easily as academia. Since I joined the University of Alabama in 2007, I have had two joint replacements, two joint replacement resurfacings, spinal fusion, and ankle fusion. There are other things I (not to mention my long-suffering family) would rather have done with my Christmases, Thanksgivings (and the stretch between the last class in November or December and the beginning of classes in January, if not "summer," is pretty big), and summers. Some of them even involve work! Of course my colleagues and institutional officials have been supportive and my students forgiving, and that helped greatly. But much of it had to do with the seasonal academic schedule itself, and its time flexibility. (And one might note cautiously and sotto voce that the relatively low expectations of the academy itself can help too. I assume everyone is familiar with Dr. Stantz's famous quote on the subject. )

One could and perhaps must add all the usual caveats. It helps to have the "right" kind of chronic illness, I'm sure--physical, painful but not utterly debilitating, and so on. It helps if you can time your chronic illness for after tenure (although I was chronically ill before tenure, if perhaps to a lesser degree, and did not find the tenure hurdle insuperable or even terribly burdensome). It helps if you have a good support system, and if your institution is not blind to your needs or stupid or intolerant. Large universities, like other institutions and workplaces, are not always as good as their word on various things, and sometimes lag far behind decent large private workplaces in developing and implementing best practices for employee care. No doubt many will find things like this report of interest. Complaints there are aplenty and always will be.

Still, apart from "member of the idle rich," which I'm not sure is a job description, being an academic seems to me to be a pretty great job for someone with a chronic illness. Given a choice, I would not be chronically ill. But since that wasn't an option, being an academic was a stroke of luck. And not a blind stroke, either. I'm sure many people's academic vocations are encouraged, not only by whatever forced reading time and isolation accompanied their childhood if they were chronically ill then, but also by the features of the academy that make the lifestyle relatively amenable to and possible for people with chronic illnesses. In this as in much else, I am convinced of the too-often ignored point that biology, or physicality, is destiny. For every FDR, a thousand others seek careers that will not tax them physically, perhaps literally, to death. And many a dynamic and prolific scholar is also, and by no means incidentally, a physically healthy one. 

In any event, others with more expertise can add all the reasons we shouldn't be satisfied with the academy, the legal profession, or the workplace generally on questions of chronic illness. I simply want to add the mildly contrarian counter-note that all things considered, the academic is a pretty great place to be chronically ill. And this, I must say, gives me a certain amount of sympathy--not absolute, but still--with critics of law schools and/or law professors. Anyone who finds the time for six surgeries over nine years without major structural work interruptions has to have at least some sense of being privileged to have this job. Occasionally, someone who knows my situation will compliment me on managing to be so productive despite this or that. (Doubtless others with other situations, not necessarily involving their own illness but things like family commitments or care for aging parents, receive similar compliments from time to time. If not, they should.) I'm always touched by their fondness and kindness, even when I disagree with the assessment. But I surely cannot be the only similarly situated person who thinks that the wonder is not what I manage to get done, but how little some otherwise unfettered (whether by physical illness or other matters) individuals seem to do. I don't mean this churlishly, and of course many people labor under burdens others know nothing about. It is just a general observation about the enormous privilege of having this job, and perhaps about the moral and professional obligation to use all that time flexibility and luxury well and to the best of one's energy and ability. "I would like a good, happy, well-balanced life with time to smell the flowers" is not a sufficient justification for collecting, or continuing to collect, an academic salary. 

I call the second subject "rude" in the sense of something accurate and obvious said at the wrong time or place. That subject is drugs--God bless 'em. I suspect this portion of the monograph is more autobiographical than broadly helpful, except perhaps to those who will experience a shock of recognition about the subject.

I doubt my illness had much to do with it, so much as the simple passage of time, but I have grown much more attached to my students, and to teaching, over the years. I was emphatically never disdainful of teaching or anything going along with it, but a lot of the biggest personal rewards of my job have come from teaching and from being able, over time, to track the development of my students after graduation, in practice and in life. This is a part of the job that, however seriously you take it, can be less visible at first, partly because you know a smaller base of students and especially if, like me, you do enjoy the scholarship and writing side of things. It also takes some time, first to master the "script" you build around your teaching materials, and later to toss out the script and change your teaching every year in response to changing circumstances and interests. The less consuming those start-up aspects of the job are, the more unmediated and rewarding your interactions with students become. And there is one final important aspect of teaching that is perhaps under-emphasized: the sheer fear of failure. It's one thing to disappoint yourself, as far as writing goes. That activity only involves one person alone in a room. It's quite another to face a room full of students, who have paid in time and money and effort to be in that seat and have every right to expect your best. One cannot fail them. 

I think I can say that, with some but relatively few exceptions, I have not, even though the past two-plus years have unfortunately been unusually filled with pain. That's not to say I haven't had bad days, as we all do, when my energy level was lower than I wanted and so on. (I have found that if you are up-front and candid about this, students respond with great generosity. When I have told my students I'm feeling low, apologized, and asked them to supply the extra energy, they always have, to my profound gratitude. Often their energy lifted up my own. And that experience, and debt, certainly has encouraged me to look and listen more carefully for students suffering from burdens of their own, often unrevealed, and doing my best to reach out to them.) Other areas, no doubt, have suffered or required some adaptation. My office hours were more iffy, so I have relied more on setting up scheduled meetings with individual students at times when I know I will be in better shape. My inbox looks like my office: messy. I ask a thousand pardons of those afflicted by delayed or unanswered emails. But the classroom is our one major time-fixed obligation and the one thing we really can't stint on at all.

At least for those reachable by useful drug treatments, this is an area where one gives a heartfelt prayer of thanks to Big Pharma. If I may be still ruder, I have been helped immensely in the last few years by opioids and other heavy pain meds. One can go elsewhere for more wholesale condemnation of those drugs, whose increasingly strict and not always sensible regulation has made (law-abiding) doctors afraid to prescribe them and driven (law-abiding) patients through endless hoops to obtain them. But for those for whom they are needed, they are essential and return one to a semblance of life. They certainly saved my ability to function in the classroom in the way students can reasonably expect: with energy, mobility where that is possible, a joy in performance, and an ability to ignore the pain for the 50-90 minutes it takes to teach the class.

They have other problems and side-effects, of course. One of the reasons I've found the last two years so difficult is the almost impossible effort to achieve a workable balance between dealing with pain, on the one hand, and dealing with the effects of pain meds on the other. Both affect one profoundly and invisibly, and their effects have to be observed indirectly and in retrospect rather than being immediately obvious. Too little pain medication and you can't function at all. Too much, or even the right amount, and everything you do is a little more befogged. And your amount of energy and presence is affected either way.

Suffice it to say, the kind of cost in mental acuity that either pain, or pain meds, or the mix of both, imposes wreaks havoc on one's ability to write. And it has other, sometimes less visible, costs. I had a wonderful visiting semester elsewhere last spring, in which I enjoyed meeting many faculty and others, got to know many incredible students, gave a bunch of talks and participated in various activities on and off campus, and otherwise learned and enjoyed a great deal. But it was shadowed the whole time by a mix of pain and pain meds that drastically shortened my productive day by several hours on either end. I enjoyed the experience and think I did "well," in the way we talk about these things. But I wonder how much more I would have enjoyed it had I been in perfect health. Nevertheless, and without exceeding my dosage or anything of the sort, I was comforted to know that even if some of my interactions with faculty were cut short by my inability to be in the building and at my best 14 hours a day, I could time my pain pills just right so that I could give my students everything I had. I might need to collapse after that, but at least it would be on my own time.

In discussions of chronic pain by academics, I see less discussion of drugs, pain pills, and the like--let alone the presence of a dread word like "opioid"--and more general discussions of "living with" chronic pain or illness, although drugs are a key component in living with them. Hence my suspicion that there is something a bit "rude" in talking about them. I don't think it's just that their use is assumed or implicit. One may worry--I do, a little and maybe more than a little--about being typed as too sick, or as bad lateral material, or just about being vaguely associated with whatever stigma accompanies the use of serious pain meds, even when it's necessary and legitimate and helps rather than hurts one's work. I'm as ambitious as the next person, and then some, and would hate to be typed in that fashion. And I will say that one reason I'm so delighted by the latest surgeries is that they have already had an immensely beneficial effect on my general level of well-being. They have ended most of my day-to-day pain and made it possible to cut my pain meds almost to nothing. (I have one more joint on the chopping block, but not soon, I think. I'll cross that bridge when I come to it.) I am very confident that I will return to some of my best natural energy levels and use them in the classroom, on the blog, in shrinking my inbox, and God willing in more academic writing. Still, drugs helped me an immense amount and doubtless have helped many academics and others in similar situations. Yet they are rarely mentioned, possibly for the reasons I've suggested. In my view, however, anything worth carefully-not-mentioning is absolutely worth talking about.

I will close by adding that I consider myself absolutely blessed: by the drugs that helped, by the doctors and surgeons who helped too, by the institutions and students who did so much as well, and by the extreme flexibility of the academic life, which all things considered can be one of the best possible fits for the chronically ill. But not just by those things. I could have been sicker. The illness could have been something worse than chronic. It could have been chronic but of a different sort, and/or impossible to do anything about. Or, like many, I could live in a time and place where no treatment was or is available, or no access to treatment was or is available. There are many such people. No one enjoys being sick, or suffering pain, or having a heap of surgeries. But I nevertheless view the whole thing, not perhaps over but certainly in an excellent state of equilibrium right now, with a sense of having enjoyed remarkable good luck and--and I do think it's the mot juste and am unashamed to use it--blessings.                    

   

Posted by Paul Horwitz on September 2, 2016 at 08:20 AM in Paul Horwitz | Permalink

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