Fake it until you make it: Not a guide for phlebotomy

phlebotomy
flɪˈbɒtəmi
noun
  1. the surgical opening or puncture of a vein in order to withdraw blood, to introduce a fluid, or (historically) when letting blood.

Have you heard the saying ‘fake it until you make it’? Pretty good saying if you ask me. If you’re on a date, and you’re not feeling confident, just fake it until you make it. It’s all about believing in yourself and putting on a front until you gain confidence from experience. If I were Trump, I’d say “Great saying. The best. It is the only saying you need. Believe me.” Personally, I’ve found it applies very well to many aspects of my PhD…except when collecting blood.

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I’m sitting here at my computer and I’m feeling the full psychological effects of a botched blood collection. Let me recall the events for you:

So I’m waiting by the clinical reception for the participant to come in. It’s not mine, but someone else’s, so I’m thinking they’re just going to assume I’m fantastic at blood collection. They arrive. Little do they know that my palms are sweaty, knees weak, arms are heavy, there’s vomit on my sweater already, Mom’s spaghetti. I’m nervous, but on the surface I look calm, ready to collect blood. I usher the participant in using my professional voice (which is exactly the same as my normal voice but with a slight British accent) and sit them down. I ask them how their day was, and if they have a preferred arm to collect from. They’re probably thinking I’m compassionate, caring and professional, but I’m not. I’m stalling. I’m forgetting the basics. Does the needle go in me, or them? Are we born with a limited supply of blood? What is a blood? I’m currently on an express train to Panic Station.

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First needle goes in. Missed the vein. “Oh, you’re a bit dehydrated today,” I lie. “I might try the other arm.”

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Second needle goes in. Success! Found the vein. Fake it until you make it James you cheeky bastard. I look over my shoulder to give my colleague a glance to let her know that I’m in control. I am the captain now. I turn back to my blood tube and to my horror I find the blood flow has stopped. Have I slipped out? Or did the vein decide it’s had enough of my butchering and leave? I’ll never know. Third time’s a charm, I say. If you’re collecting blood and you have to say this, you shouldn’t be collecting blood.

Third needle goes in. No luck. I’m a sweaty mess, I’m embarrassed, and I’m feeling for this poor participant. I’m radiating more heat than the Tele-Tubby Baby Sun. I pull out for the final time and do my best to hide my shame.

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Moral of the story is that as a PhD student, there will be days where you can fake it and the only person who will know you’re faking will be you. There will also be days where you can’t fake it (i.e. today). The embarrassment might take longer to heal than the puncture wounds, but it’s all part of it.

 

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-James

Attrition: the inevitable frustration, and the day I forgot my own name

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Don’t question yourself, yes you read that right. I forgot my own name. There is probably an area of the brain responsible for one’s sense of self, recognition, and identity. Where it is exactly, I’m not sure (is that bad? should I know that?) but wherever it is, it wasn’t working properly. Makes me question if it’s even there. Let me set the scene. Obviously real names will not be used in this reconstruction (except mine, duh).

ACT ONE 

Scene I

James enters his office complex, stage right. The time is 0830, approximately 30 minutes before he is to meet his participant in the building across the street. He sees a person waiting by the office door, eager to get in. James has not has his morning coffee yet. 

Enter JAMES KARANTONIS. Sees ENCOLPROCUS, THE DESTROYER, POLITE, AND SECOND LAST OF HIS NAME waiting by the door.

JAMES: *thinks to self* It is too early for this! Just keep your head down and maybe they won’t see you. This person is definitely not my participant.

ENCOLPROCUS: Morning.

JAMES: grumbles. Morning.

ENCOLPROCUS is clearly waiting to see someone. He peers through the door. Despite his best efforts to not engage, the brief, pre-caffeine human interaction causes James to malfunction.

JAMES: Sorry…are you here to see someone?

ENCOLPROCUS: I’ve got a meeting with James.

James panics internally. He struggles to recall a James in the office. Is James the guy up the very back? Or is James a nickname for the lady who sits across from him, he doesn’t know. James already feels insecure about remembering people’s names after calling Jeffery, Jeremy on multiple occasions. James continues to malfunction, and decides to play it cool.

JAMES: I’m not sure if he’s in today, I’ll just go check for you.

James walks into the office and peers around every corner, at every desk, and attempts to act natural by picking up a piece of paper pretending it was a note left for him because he is super cool and nonchalant about many things. James return to the waiting person.

JAMES: No sorry, doesn’t look like he’s in today. Can I leave a message? What’s your name?

ENCOLPROCUS: My name is Encolprocus, the Destroyer, Polite, and Second Last of his Name.

James hears the slow turning of gears inside his skull. It appears there is electrical activity, albeit minimal.

JAMES: *thinks to self* Huh, that’s the same name as my participant.

James hears a loud clicking noise. It reverberates endlessly against the hollow confines of his head. There is an awkward silence for what seems like an eternity.

JAMES: Oh. Um…I’m James.

END SCENE

So it turns out there was a misunderstanding and my participant met me at my office, instead of where we meet them for testing across the road. They were also half an hour early (which was fantastic, we got an early start) but in the end it didn’t make a difference because there was a fire drill around lunchtime (they happen too often, but safety is no joke). The combination of being early and in the wrong place, and me failing to consume my morning cup of coffee led to a very embarrassing scenario, where the complete lack of recognition of my own name resulted in the participant questioning who was testing who.

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attrition

noun: the gradual reduction of a workforce by employees leaving and not being replaced rather than by redundancy.
Attrition is everywhere. We’ve all experienced it in one way or another. In the context of research, it generally refers to participants dropping out of the study for whatever reason. Life is unpredictable and it’s hard, and as researchers, we understand that things don’t always go to plan. However, this doesn’t stop attrition from being one of the most frustrating and debilitating occurrences in research.
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An example of attrition
There is a saying, that ‘Time is Money’. There is also another saying, less well known, ‘Neuroimaging scans that are cancelled last minute must be paid for regardless’. Ok, so the last one isn’t a saying, but I’ve still heard it plenty of times. When a participant cancels (for whatever reason), it costs the researcher and the project time, money, and sanity, and then some more money on top of that. These are not infinite resources and thus becomes a major source of stress.
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Working with a clinical population has been challenging at the best of times, and so when it comes to dealing with attrition, I’ve had to physically sit myself down and breathe. At the start of my data collection, not having a participant turn up would ruin my day and emotionally challenge me (i.e. that day I got frozen yogurt and drove to Gippsland to find a nice quiet place with ocean views to scream). Now, I understand that this is a unavoidable frustration that comes with testing, and even though I can’t change whether a participant arrives or not, I can change how I deal with it.
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An example of an acceptable reason for not attending the testing session:

“I was stabbed.”
An example of an unacceptable reason for not attending the testing session:
“I think I might be busy that day.”
Both of those quotes are real examples. My advice for those yet to experience the joys of data collection, is don’t take it personally. You’re not alone and what will be, will be. I know this sounds fairly relaxed, but it’s true. Maybe it’s my Greek work ethic, but I try to not stress about it. Things have a way of working out for the best.
Also my good friend Sally has her own blog site! It’s much better than mine, check it out!
-James

The (almost) Great University Fire of 2016

I thought I’d start my first post with my closest near death, PhD experience. You’re probably asking yourself how I had found myself in such a situation. I’m glad you asked, but before I start, I’d like to make it clear that my story telling ability is nowhere near as amazing as that of Sweet Brown, but I will try to do my best. For those who don’t know who Sweet Brown is, here is the original video:

With my study I’ve got two different types of brain scans, MRI (which we’ve all seen on Grey’s Anatomy) and the possibly less well known MEG. This story starts with me down in the basement, wiring my participant up with half a dozen face and head electrodes before their MEG scan. I place the participant in the scanner (imagine a single chair, in a very small room), and I seal the door. Sitting down at the lab computer, I run the first two scanner tasks. So far, so good. I begin chatting with the technician. We engage in quality banter and overemphasise to each other how satisfied we are with life and how optimistic we are about the future, when suddenly a flashing red light appears on a mysterious box on the wall.

“What’s that light for?” I ask.

(Technician begins to look panicked)

“Such a menacing, red light” I say, not aware of the seriousness of this little red light.

“That’s the oxygen atmosphere concentration meter” said the technician. The fire alarm starts blaring, and I’m very suddenly aware of the intense burning plastic smell. I know I’m not having a stroke because the technician can smell it too. We turn to each other and we look like this:

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I can hear Sweet Brown’s voice in my head “Oh lord Jesus it’s a fire“. My every instinct is telling me to run, like Sweet Brown. I grab my Monash City Council Library loan of Pride and Prejudice and Zombies (needed more zombies, 1.5 stars out of 5) and make for the door. I pause. There is one key difference between Sweet Brown and myself that I had almost completely forgotten about. She had a delicious Cool Pop to carry to safety, whereas I had a participant, who was currently wired up in the scanner. With the help of the technician, the participant is safely removed from the scanner and we head for the exit. There was no time to take their face electrodes off, so I’m dragging the poor participant like we’re in some weird sci-fi version of Pinocchio.

The corridor we’re running through is filled with smoke, hovering around head height. There’s only one exit, and we’re running for it now. I suddenly have an image of the building burning to the ground, and through the fire and flames I emerge with the passed out participant on one shoulder, and the technician on the other. My clothes and skin blackened enough to look like I’ve been through hell. The crowd cheer as I gently place the survivors on the ground, and the Mayor gives me a key to the city and a 6 month extension on my PhD. Even though the danger was very real, I’m starting to enjoy myself. That was, until I inconveniently recall that the MEG scanner is supercooled with hydrogen, and I have a flashback to May 6th, 1937, when the Hindenburg violently reminded everyone that fire and hydrogen don’t mix. If the pressurised stores caught fire, not only would the basement explode, but the whole building would be blown sky high.

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The Hindenburg Disaster, 1937. The German passenger airship caught fire while attempting to dock.

The three of us escape the basement and make a break for outside. Fire Wardens are directing everyone to back away from the building, but they’re a bit too nonchalant for my liking. They’re too calm, I think to myself, They don’t know that this bad boy is going to blow.

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We move down a block, to what I assume was a safe distance. No explosion yet, which was a great sign. My participant is confused, and I think that they thought it was all part of the study, like some sort of pressure test to see how they react under stress. Definitely not the case. The one bit of good fortune of the whole experience was a single sausage sizzle stand, just outside of the danger zone. I bought a sausage for myself and the technician, and the participant bought one too. It’s only as I bite into my highly processed cultural delicacy, that I realise that my testing kit is still down in the basement. The testing laptop, the questionnaires and more importantly, my data, was still down there. I had to go back. I had to summon what courage I had left to go back, through fire and flames, to save what was dearest to me. Cue epic music and slow motion running shots.

Before I could do anything, the fire was extinguished and we were told we could return to the building. Turns out the water cooler for the machinery in the basement had caught fire (the irony is almost too much to handle), and smoke had dispersed into the ventilation system. To my disappointment, we weren’t able to resume testing, and to my frustration, the interrupted brain scan meant that all the data collected for this participant thus far was useless. Any one in academia/research will know the pain of wasting time and money, and it’s safe to say, that if I could have collected my tears that night and used them on the fire, there would have been no emergency.

giphy-3It’s days like these that you can’t prepare for, and you just have to roll with the punches. It was lucky that no one was hurt, and that I didn’t explode.

-James

The relationship between catharsis and sanity: An n=1 study

As I sit here at my desk, I feel myself being violently projected from the early 2000s (which in my mind, it’s still 2004) and into the modern day, as I start my very first blog. Not only do I feel old because I’m a decade behind the trend, but I also feel a little bit vulnerable. I don’t like being the centre of attention nor do I like the sound of my own voice. I’m a reserved introvert who gets embarrassed very easily, and suddenly the contents of my mind are available for all to read.

To summarise what I’m doing at the moment, I’m currently in the data collection phase of my four year stroll through struggle town. This involves finding and screening participants, and then conducting two, four to five hour testing sessions. In writing, it doesn’t seem like much, but in reality it feels like the iconic scene from ‘Titanic’, with a few subtle changes. I’m Jack and I’m holding Rose as she spreads her arms on the bow of the ship, but instead of Rose, its a healthy control or Bipolar participant, and they’re really heavy. Instead of standing on a ship, I’m balancing on the top of a very poorly played game of ‘Uno Stacko’ where each piece represents a fine detail or possible problem that could bring me tumbling. Also the water is lava and there is absolutely no sexual tension between myself and the 60 participants.

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I’ve decided to write a blog about my misfortunes during my PhD candidature. The PhD is a stressful and extremely rewarding process, so I want to document the joy and misery to remind others in similar positions that they are not alone. I want to post it online and have it eternally preserved on a server in America, so that when the post-Trump nuclear fallout settles and the irradiated survivors of the future find the last working computer on the planet, they’ll have a giggle and forget about their own troubles. Same goes for you, reader. Whether you’re on the train or toilet, having a good or bad day, hopefully you can read this and have a good laugh.

-James