It's not that I'm not happy that my kids can now get their own ice cubes, I really am. We have one of those freezers which sit below the refrigerator, so it's the perfect height for them to open and remove some frozen cubes and enjoy a refreshing cup of ice water. They are very excited about being able to do this, it feels very grown up and ice water has become the hot new thing at our house. I often find them sitting in the Adirondack chairs in the yard, sipping little cups of ice water. Or just sitting around simply munching on ice cubes, enjoying their frozen crunchiness. Better than cookies and candy I guess. They even have ice cube races or do experiments to see how long it takes to melt a cube or two. And the freezer provides a seemingly endless supply of them. So its all good. This morning I opened the fridge to pull some things out to start getting breakfast ready and I notice that I am standing on a little brown puddle of sticky stuff. I think that maybe the dog has been eating a little too much bunny poop in the yard, but no, the puddle is not only sticky, its cold! Someone, in their overzealous urge to enjoy some cubes has left the freezer open overnight and the tub of chocolate ice cream has been knocked over and is dripping on the floor. That leftover lamb stew that has been sitting there since before Thanksgiving is melting too, and oozing onto the ice cream and onto the now thawed piece of that delicious lasagna we had leftover and froze for another day when cooking seems insurmountable, all mixing into a sort of perverse smörgasbord. And it's all dripping onto the floor and the half-melted ice cubes sit there, gleaming in the morning sunlight.
Archive for: July, 2010
Yesterday I had the pleasure of meeting a couple of folks who had started a small, local foundation to support children with epilepsy and their families. This couple had started this memorial foundation in honor of their son. As part of their foundation's mission, they want to advocate epilepsy research, and one way they are doing this is by awarding a couple of summer fellowships that allow undergraduates to perform epilepsy research and to shadow an epilepsy physician during their rounds. One of my undergraduates was fortunate enough to receive one of these fellowships and she has been doing a great job on the project. This student would likely be working on the same project even if she had not received the fellowship, and will continue working on this during her senior year. But what is nice about the fellowship is that she really gets to see that what she is doing in the lab really matters to someone, and is not just a bunch of benchwork. It made me really proud to see her enthusiastically explain her project to the foundation folks yesterday (they even made a little video!) and express how much she appreciated their support and her opportunity to meet patients while she was doing the rounds. She expressed how she's thinking of becoming a neurologist and how she hopes to continue doing basic research after medical school. And you could see that the couple was following everything she was saying, and were really understanding about the importance of basic research which sometimes seems so far removed from producing an actual treatment, and feeling very proud that they were able to provide this opportunity for my student. And this goes to show that even a little fellowship like this, while not a huge amount of money, can have a big impact, can make someone who is smart and enthusiastic feel like her work is important and keep encouraging her to continue to do research, adding one more talented and enthusiastic person to the scientific and medical community. It also gives me some perspective into why I do what I do, and why it matters.
She looked me over and I guess she though I was all right – all right in a sort of a limited way for an off-night. I fucking hate schmoozing. It is one of my least favorite things about being a scientist, but in my job, it is something that everyone has to do sooner or later. It's not that I don't like people, I enjoy talking to my friends and family, and even strangers I find I have something in common with. What I don't like is feeling that I have to be schmoozy with people just because they are supposedly important. For those of you who don't know, schmoozing is the act of chatting up people such as journal editors, program officers from your funding agency, big scientists in the field, with the hopes of having them get to know you and your work, and have them help you promote it. This kind of a thing typically takes place at scientific meetings where you might see a large group of people chatting and drinking with an editor of an important journal, and a whole bunch of others trying to get into the inner clique of big name scientists and journal editors. And what bothers me is that the nature of the mirthful scene is not scientific exchange, but just schmoozing and small talking and buddy-buddying. Me personally, I just don't have much to say to these people in these terms. Often I have nothing in common with them, and while I would like to discuss my and their science, this type of conversation is not part of the mix for the most part. Yet I know, that your chances of getting an article reviewed at a glamour journal are infinitely smaller if you don't personally know the editor. I felt this very strongly when we submitted our first papers from my lab. I felt that the quality of the work and the impact of the results were as good or better as what I did as a postdoc. Yet none of the top journals would even review them, while this was never an issue when I was a postdoc in a big name lab.
And of course I've tried schmoozing, but it is always awkward. I'll go up to a big name at a meeting who's work I've admired and have lots of scientific things to discuss, or try to introduce myself to an editor who's at the meeting who might find my work interesting, and basically I'll say hi, introduce myself, shake hands and then I feel like a complete idiot because I have really nothing to say, and the whole situation feels so phony, and other people doing the same thing feel hollow, and I just say "nice to meet you", linger around awkwardly for a little bit and walk away (I'm starting to sound like Holden Caulfield). But I don't think its me. I do meet lots of interesting people at meetings with whom I have developed long-term friendships and started collaborations, and enjoy seeing them every year. But these are people I have things to say to. The only time I just force myself to schmooze is with program officers. Because once they get to know you, they will provide you with huge amounts of helpful insight the next time you submit your grant, and might be willing to rescue your grant from the dustbin in a pinch. So in these cases I overcome the awkwardness and get right to the business of talking science. It also helps that at bigger meetings you can actually set up appointments to chat with program officers, which removes some of the schmooziness from the whole situation.
Despite my distaste for it, however, schmoozing can get you very far. Often people who become very successful very quickly are excellent and highly articulate schmoozers. They know all the big names and all the editors and every time they submit a paper it gets reviewed and accepted. And its not that these people are not smart. You need to produce top-level, or at least hot and flashy science, to get your work published at a top-tier journal. But there is a lot of really good, top-level science that never makes it into these journals, and I think that one of the reasons is the ability of the investigator to schmooze with the right people. Some people might even get pretty far with schmoozing alone. I've heard of people who have gotten tenure track jobs and prestigious awards without a single publication from their postdoc period, just because they are well-spoken and adept at getting into the right circles and everyone knows them and gives them the benefit of the doubt. To us, non-schmoozers, nobody gives the benefit of the doubt.
And its also not that journal editors, paper reviewers or grant reviewers will consciously reject your paper or grant because you were that guy they had that awkward encounter with at the meeting while they were hanging out with their friends at the poster session. But anyone, no matter what they say, will always look more favorably upon a friend than someone they barely know, and even tiny biases can make a big difference in a highly competitive environment. And that is why, my hesitance to do so, I keep on trying to schmooze and keep on introducing myself and hope that my tics don't scare them away.
I came across this very cool map released by NASA that uses satellite imaging to calculate the height of the various forest canopies around the world (click to enlarge):
One thing that pops out is that the tallest forests in the world are in the Pacific Northwest of North America and in southeast Asia. However, there were two things that struck me as I was looking at this map. First, if you look at southeast Asia you will notice that Thailand –compared to the neighboring countries of Cambodia and Laos– has very little forest land. And the contours of the forests in the area almost exactly match the borders of Thailand. At first I assumed it was some sort of natural feature that demarcated the forest's edge and that was what was used to define the countries borders. But after some in-depth research (five minutes in Wikipedia) I learned that it is actually due to deforestation. Apparently since 1945 and the mid eighties, Thailand lost over half of its forest due to poor government regulation, illegal logging and conversion of land use to large-scale agriculture. I know this happens all over the world, but the contrast with neighboring countries is what struck me. It's a striking example of human impact on the geography of the planet. The second thing that struck me about the map, was that compared to most of the world, the northeast United States has a very respectable amount of forest, despite being one of the more densely populated areas in the country. This wasn't always the case. If you look at the graphic below, you will see that since Europeans first settled here there has been a huge amount of deforestation and loss of old-growth forest (click to enlarge):
Deforestation due to logging and to clearing land for agriculture reached its peak in the 1870's before agricultural production started to move west. According to the Mass Woods Forest Conservation Program, the forest cover in Massachusetts is now over 60%. This is apparently comparable to the level of forest cover around the time of Thoreau. I know that this is not old-growth forest, and that old-growth forests promote biodiversity, but at least its something. It is estimated that most forests in the northeast are about 80 years-old, so in a few generations they will become old-growth forests. It's pretty cool to hike around New England and come across ruins of old colonial stone walls, which delineated farmland a hundred years ago, running aimlessly through the forest (click to enlarge):
So while we can actually destroy forest land, forests can also grow back, and if sustainable conservation efforts are maintained even highly deforested areas can come back. Hopefully this trend will continue. In the meantime, if its nice out this weekend, grab your family and friends and go for a hike!
I've been thinking about this for the past few days. I recently read an interesting article published last week in the journal PLoS One. I am by no means an expert in autism or epidemiology, but here is my take. In this study Durkin and colleagues show that there is a link between socioeconomic status and the prevalence of autism spectrum disorder. The authors took surveillance data from the CDC which evaluates prevalence of autism throughout the country. Overall they evaluated data from over 550,000 eight-year olds in a two-year period and found about 3500 individuals that would qualify as autistic. Using census data they sorted these cases into three groups based on socioeconomic status. Surprisingly they found that there was a very significant correlation between prevalence of autism and socioeconomic levels such that wealthier areas had relatively more cases of autism (see Figure 1). They further show that this gradient is present across all races and ethnicities examined. One possibility is that this effect may be due to the fact that wealthier communities might have better access to health and diagnostic services. In support of this claim the authors state that in fact the gradient is steeper if you only take into account cases where there was a previous diagnosis of autism before the surveillance data was collected. Meaning that children from wealthier families were more likely to receive a diagnosis during early childhood than children from poorer families. This would lead to diagnostic bias and may explain the correlation between wealth and autism. It also means that autism may be underdiagnosed in young children from socially disadvantaged communities, denying them the possibility of early intervention and treatment. Which is another reason for making health care accessible to all.
That being said, the authors then looked at the group of children that had not previously received a diagnosis of autism but were picked up in the surveillance data. In this case any diagnostic bias should disappear. What they found was that even in this group there was a significant correlation between autism prevalence and socioeconomic status. The authors conclude by saying that "factors associated with socioeconomic advantage might be causally associated with the risk for developing autism." Which totally baffles and surprises me. I guess that one possible factor that may lead to this correlation might be maternal age, as socioeconomically advantaged women tend to have children at an older age. Or it could be something to do with differences in the type of prenatal care received that we don't fully understand. However the authors mention in passing something called the "hygiene hypothesis". Now I'm not sure how much actual evidence there is for supporting this hygiene hypothesis, but what it states is basically that the more you are exposed to a variety of diverse pathogens during early childhood, the less likely you are to develop chronic immune disorders such as allergies, asthma or inflammatory bowel disease. Some have used this view to explain higher prevalence of these disorders in developed countries or correlations between socioeconomic status and immune disorders. The reason this is interesting is that there are some well-established correlations between chronic abnormal regulation of immune system function and several neurodevelopmental disorders including autism. Many molecules which are active in the immune system are also known to regulate normal signaling in the brain and this may explain the association between chronic immune disorders and abnormal brain development. This is of particular interest to me since part of my research involves looking at the role of some of these immune molecules during early brain development. It is important to mention that when I say abnormal immune function I am not referring to the immune reactions which result from vaccination. Immune reactions to vaccines are short-term, and it has been very clearly established that there is no link between vaccines and neurodevelopmental disorders, including autism. What I am talking about is long-term alterations in the levels of various immune system molecules including regulators of inflammation and the so-called MHC markers. So wouldn't it be interesting if the link between socioeconomic status and autism prevalence was somehow related to the increased prevalence of immune disorders in economically advantaged groups?
Of course this is just a hypothesis, which has no actual proof. In fact I can find several holes in it. For example there is no evidence that someone from a lower socioeconomic status, living in the United States would be necessarily exposed to more pathogens than someone with a high socioeconomic status. I mean, wealthy kids eat as much dirt as poor kids. If you don't believe me go to a playground in a fancy neighborhood and in a poor neighborhood and observe the kids. They get exposed to all sorts of junk either way. But by making hypotheses scientists are then able come up with ideas for experiments that would either prove or disprove them. What I like about this paper is that it made me think a little outside the box, to come up with ideas and associations that I would not otherwise had come up with. And this is something that is important to do. I have several colleagues who do basic research into the mechanisms of autism and other neurodevelopmental disorders. And everyone is doing very different research, ranging from population-wide human genetic studies, to studying molecules which regulate the communication between brain cells to looking for structural abnormalities using brain scanners. And all of these individuals are doing great science and are very careful with their results and interpretations. Yet despite the fact that they are all studying the same disorder, it's almost as if they live in totally different, internally-consistent worlds. So in essence, they are all "correct" and all their results are "true", but if you look at them together then their theories start to look a little more shaky. At least not so consistent with each other.
It's a little like the movie Rashomon by Japanese director Akira Kurosawa. For those of you who don't know Kurosawa, he is one of my favorite movie directors and you should see all his movies, particularly the Seven Samurai, which is beyond great. But anyway, Rashomon is a murder mystery taking place in medieval Japan. A woman has been raped by a bandit in the woods and her husband, a samurai, has been stabbed and killed. The movie tells the story of the bandit's trial and three witnesses recall the events. The first witness is the bandit, the second is the woman, the third is the dead samurai (channeled through a medium). Although the basic facts are the same –the bandit raped the woman and the samurai was killed with a knife– the three stories differ from each other. At the end of the movie we hear a fourth version, from a woodcutter who witnessed the entire thing as he hid in the woods. For some reason he had chosen not come forward during the trail even though his story would resolve all the inconsistencies between the three other stories. Presumably, his version, as a disinterested party, represents the actual events. However at the very end we become suspicious of even his story since we start to suspect that the reason he did not come forward was because he has actually stolen the murder weapon, a bejeweled knife, after witnessing the events. So even he is not a totally disinterested party.
So what's my point? My point is that even the best hypotheses and ideas in science always have some spin, and that this spin will introduce bias. And it takes a study that makes everyone think outside of the box to bring these various hypotheses together and separate the spin from the facts. Good scientists will gladly let their pet hypotheses evolve or be discarded if evidence shows up to disprove them. Bad scientists will keep looking for specific data supporting their views while ignoring overwhelming amounts of data that don't support their views. As far as this relationship between socioeconomic status, chronic immune disorders and autism, we'll see how that one plays out.
Further reading (some may require subscription or a trip to a university library):
Durkin MS, Maenner MJ, Meaney FJ, Levy SE, DiGuiseppi C, et al. (2010) Socioeconomic Inequality in the Prevalence of Autism Spectrum Disorder: Evidence from a U.S. Cross-Sectional Study. PLoS ONE 5(7): e11551. doi:10.1371/journal.pone.0011551
H. Okada, C. Kuhn, H. Feillet and J.-F. Bach (2010) The 'hygiene hypothesis' for autoimmune and allergic diseases: an update. Clin Exp. Immunol. ;160(1):1-9.
Cohly HH, Panja A. (2005) Immunological findings in autism. Int Rev Neurobiol.;71:317-41. Review. PubMed PMID: 16512356.
There's nothing cuter than kids with puppies. Unless they're my kids. Then its just sheer terror. Recently a neighbor got two little lab puppies and the kids had been begging us to ask if they could go over and play with them. After the neighbor invited us over, I told the kids about one hundred times that they had to be good, that puppies were just like babies, that they had to be gentle with them, that they were not allowed to pick them up unless the neighbor agreed and even then they needed to be sitting before they picked up the puppies in their laps, that they were not stuffed animals. Within seconds of entering the neighbor's yard it was as if someone had given my kids amphetamines. They started running around screaming very loudly and repetitively "PUPPIES, PUPPIES, PUPPIES!!!" I mean very loudly. Insanely so. As I am trying to calm them down I see my son walking around with one of the puppies, squeezing him so hard, like a giant tube of toothpaste. So I had to run over to stop him and as I'm doing this my daughter is crouching under the other puppy yelling, again loudly and repetitively "PUPPY IS A BOY, PUPPY IS A BOY!!!" So as I'm telling my daughter that maybe it is a good idea if she spoke a little more quietly and less excitedly, that both the puppies and the neighbor were getting upset, and that she had to learn to be a good guest, I realize that my son is gone. Soon I hear him banging a drum set in the neighbor's basement yelling "ROCK 'n' ROLL, ROCK 'n' ROLL!" So I finally gathered and scooped up both kids, apologetically thanked the neighbor and put them back in our house, during which time my son is asking "Daddy can we get a dog?" We have a dog. Now my kids can sometimes be a bit loud, but this was ridiculous. And it's not like they were cooped-up all day and they needed to burn some energy. They had just spent the entire day running around and playing, and if I had been doing that I would be exhausted. I don't know where all the extra energy comes from. Maybe they have reservoirs of brown fat, like birds do, which allows them to fly for weeks without stopping. Maybe someone did give them amphetamines…
OK, maybe I am partly to blame for some of this. My son really likes Rock and Roll. I mean he REALLY likes it. The louder the better. He's always asking me to put some on for him and he turns into a dancing maniac. I find that YouTube is an excellent resource for inculcating your kids with your musical tastes. We often sit around watching music videos and the kids love this. The other day, my son asked me to play some "awesome Rock 'n Roll video, which was loud". So I put on The Who playing "Won't get fooled again" live. This is what I think of when I think of "awesome Rock 'n Roll", complete with Keith Moon going nuts all over the drums, Roger Daltrey belting it out and Pete Townshend doing whirligigs with his right hand and then proceeding to smash his guitar. He liked it. But he wanted more, some song that actually had the words "Rock 'n Roll" in it. So after thinking for a few moments I find Joan Jett singing "I love Rock and Roll". And I realize, that after not having seen this video since the eighties, that it is totally awesome, and that Joan Jett totally kicks butt. My son digs it too, and can now be heard singing out this song as he walks around the house. But…he really wants something that's loud, has the words Rock and Roll in it, and has "explosions and stuff". So I come up with exactly what he is looking for…KISS! Yes KISS. I can't say I'm a fan, nor that it's the most appropriate music for a four-year old - but they have all the elements: they're loud, there's pyrotechnics, they wear makeup and body armor, they have a ridiculously oversized drum set and probably the biggest stage presence of any other band. Soon we're watching a live video of "Rock n Roll all Nite". My son loved it, he loved the song, the shouting, explosions, the idea of going to a party every day, the fact that at some point smoke was coming out of the guitar, the costumes, everything. It was all show and no substance - but isn't that what Rock music is supposed to be about? After it was done, he just looked at me lovingly and proceeded to give me the biggest hug and kiss. Now that's better than the stupid puppies.
I was born in Latin America and moved here when I was 18. That officially makes me "Hispanic or Latino, regardless of race", at least according to the 2000 US census. According to the 2010 census, I would be further characterized as "Mexican American or Chicano". That also means that I am an "underrepresented minority in science". This fact of course was not lost on my university when I was hired, and soon after starting my job I promptly ended up in a list of "faculty of color". In fact, I am the only minority in my department, and one of a handful in my entire division. Now, to me "faculty of color" implies having brown or black skin. The problem is that, being Jewish, although I clearly am Mexican and my name is in Spanish, I don't look Mexican. Which puts me in an awkward situation. Every September I get invited to a luncheon for incoming students of color, and every September I struggle whether to go or not, or whether to sign up to be a mentor for an incoming student of color. On one hand, I can relate as a minority, which I felt much more growing up Jewish in a Catholic country where the antisemitism is real and stereotypes abound. I remember we would occasionally receive pictures of Hitler in the mail, or swastikas would show up on a synagogue or Jewish school wall. Some of my friends would tell me that their parents told them that the Jews killed Jesus. But those were things you got used to and overall I really loved growing up in Mexico. I feel very close to Mexico, and feel very Mexican. My extended family still lives there. I get tingly all over when I hear Mariachis. I eat tortillas. So in that respect I can relate to hispanic students and I've been in the US long enough to feel what is like to live here as a hispanic. Which leads me to think that I could serve as a positive mentor to one of these kids. I am a strong believer in increasing the number of minorities in science and even run a small program for high-school kids over the summer aimed towards this goal. However I'm always nervous of the reaction an incoming minority student will have when she finds out this white dude is her faculty mentor. I would feel like an impostor.
And maybe I am agonizing over nothing. Maybe my perceived lack of "minority cred" is just in my head, and any student "of color" would be happy to have a dedicated faculty mentor that would look after them, take the time to listen to their concerns, encourage them and advocate for them, regardless of what this mentor looks like. I certainly have experienced that with my high-school kids, so why would this be any different? If so, why am still so uncertain about doing this? Does it have to do with my own prejudice of what a minority in this country should be like? I don't know, these are not easy questions to answer... Maybe these guys can provide some insight:
I have been at my academic job for about six years, and this year I'm coming up for tenure. That is, I'm about to reach the end of the tenure track and am barreling along at full-steam towards the station (see video at end of post). I was actually supposed to do this last year, but although I had major grants from governmental and private funding agencies, a decent set of publications, and sufficient funds to keep my lab going at a nice clip, I did not have funding from the NIH - the gold standard for tenure. My department chair did tell me that NIH funding was not a requirement for tenure, as long as my lab was funded, and that tenure rates at my university were high. However recent incidents where people were denied tenure even with NIH funding made me panic a bit and I took advantage of a retroactive parental leave policy to extend my tenure clock for a year. Which I guess was good, since NIH funding finally came through, we published a handful of papers and submitted another handful. So now I'm just worried, not terrified.
For those of you not in academia, or pondering jobs in academia, tenure is something that is awarded to faculty after 7-10 years, depending on the university, which essentially means you have indefinite, guaranteed employment. My guess is that initially tenure was awarded to guarantee freedom of scholarship. That is, faculty would be free to research unconventional topics or hold controversial opinions without fear of losing their jobs. In practice though, even if you are tenured, you still need to fund your research, and a two-year wild goose chase with no positive outcome will result in no publications and make it harder and harder to renew your funding. So any advantages tenure gives you are counteracted by the need to stay funded. However, I think the main reason for tenure still existing is to convince the brightest people to stay in academia. Working in academia is hard, stressful and pays comparatively little to other fields which require similar or even less amount of training. So the promise of lifetime employment is a nice bonus.
So as I was saying, I'm 'up for tenure' this year. The process varies from institution to institution, but in general you are supposed to be evaluated for three things: scholarship, teaching and service. In reality though, scholarship is what mostly counts, at least at a major research university like mine. It's good to have decent student reviews (which I guess can help you find a teaching job if you are denied tenure), and service, which means serving in departmental and university communities as well as benefiting society in general, counts for very little other than for generating good will among you colleagues, hopefully convincing them that they want you to stick around indefinitely. But scholarship, assessed by your publication and funding records and your reputation among colleagues, counts the most. In my institution the tenure process is as follows – after completing five years, a departmental tenure committee is formed and you are asked to provide them with a list of suggested letter writers, colleagues outside your university that can evaluate your work. These can't really be your PhD or postdoctoral advisors since their letters will be perceived as biased in your favor. I mean, they can write letters for you, but they won't count for much. Your committee then meets, picks five letter writers from your list and suggests another five and shows you the final list. Then you have to assemble your dossier. This consists of your incredibly detailed CV (listing publications, funding, committees you were in, talks you gave, meetings you presented in, students you advised, etc.), summary of your teaching evaluations, copies of papers published, etc. This gets sent out to the letter writers in the fall and all the letters are compiled and added to your dossier. Around this time you are supposed to give a talk, open to the public, about your research and future plans. In late fall, your department meets and votes whether to recommend you for tenure. If they do, this recommendation goes to the dean and once approved, your department chair goes before the university tenure committee to present your case. This committee has faculty from all disciplines, including things like Archeology or Media Studies. So it is your department chair's job to not only make the case for you, but to explain why it is OK for someone in your field to have 1-2 publications per year, while the guy from engineering that they just reviewed has something like 7-8 publications a year. The committee then votes, and their recommendation is sent to the Provost. You are also informed of the outcome of the vote. This is sometime during early spring semester. The provost then makes the ultimate decision for all practical purposes. While usually the provost's recommendation goes the way of the university tenure committee, he or she can overturn the decision either way. The provost can recommend tenure in a case where it was voted down, or recommend against tenure in a case where it was voted in favor. At this point you are informed of the decision, typically late spring, and if you are awarded tenure it becomes official once the board of trustees approves of the provost's decision and if you are not you basically have a year before you have to get the hell out of dodge and find a new job.
So it looks like a I have a stressful year ahead of me. As I said, I am nervous but not quivering in a corner, based on what I've been told of my case. I will update you as things progress and provide my progress and insights into the process. For now, I have to go generate a list of potential letter writers and go finish a manuscript. Here's my favorite train scene, ever:
Wet/dry shop-vacs are in principle a good idea except when you need to switch them from dry to wet mode, and have to remove the dusty filter and empty out the container which has some disgusting remnants from who knows when, then put it back together and take it into your basement which got wet because water streamed in under the old bulkhead door during this afternoon's downpour and directed it down the basement stairs making huge puddles in your basement, so then you go down there and have to maneuver this large shop vac through the clutter of old baby paraphernalia which is all over the basement, and as you are vacuuming up the water you realize you are only wearing your socks and they are wet and the extension cord for the vacuum is sitting in a puddle, and you realize you have not thought this through before starting because you are exhausted after putting the kids to bed who were acting like they had eight espressos, and so you vacuum the water anyway and when you are done you open up the vacuum to find a few gallons of brown liquid which you proceed to dump down the basement sink and leave some sticky residue behind which you then have to wash off as you stand there in your cold wet feet.
I guess should mention that I have Tourrette syndrome. It's not too bad, and in general you wouldn't necessarily notice unless you hung out with me for a while. As I hope that you all probably know, Tourrette is not primarily characterized by uncontrolled swearing, despite what this idiot, who is clearly faking it, may do or say. Coprolalia – literally 'shit speech' – is extremely rare. People with Tourrette express a collection of motor and sometimes verbal tics which wax and wane with intensity and change in character over time. I mean, I do curse, but that's just your regular swearing. In any case, I rarely if ever talk about my Tourrette since I don't usually think of it as something that defines my personality, it's more like a limp that occasionally gets worse when the weather is bad. It hasn't prevented me from getting a faculty position, from doing my research, from teaching or from raising a family (more on that later). For the most part, I just have several tics, mostly facial, and clear my throat a lot. Occasionally I let out little grunts or repeat words, but that's when I'm stressed out. Some of the tics are mental - meaning a specific thought or sequence is repeated in my head, forcing me to, for example, turn the light on and off twice. I can imagine that if that is taken to an extreme it would be similar to obsessive compulsive disorder. I also tend to abuse computer keyboards.
Most people don't ask me about it, even close friends and colleagues I've known for years. I'm pretty good at hiding it when I teach or give talks, and if I'm focused on what I'm doing (like giving a lecture or dissecting a brain) then they mostly go away. I don't usually book meetings right after class though, because sometimes after suppressing the tics for an extended period of time they get quite bad for a while, at which point I just hide in my office. People in my lab don't ask about it either – I guess that would be weird for them, sort of like asking your PhD advisor about that lump in his neck. When people do ask, if its a friend who genuinely wants to know what's up with the faces, then I tell them. If its some stranger in the street, I tell them to fuck off. I don't ask them about their hemorroids, do I? Then why is it their business? But for the most part, I don't make this something that is front and center in my life, it is just part of who I am, and part of my body language. That is why I've never tried to take medication to suppress it, and basically know how to manage when my tics act up, and know how to, for the most part, avoid situation which would lead to my tics getting worse. Unless the tics were unbearable and making me non-functional, I wouldn't want to take drugs to correct some slight weirdnesses in my behavior. Alcohol in small quantities does sometimes suppress them too. Coffee has no effect wither way.
As a neuroscientist, I've been asked why I don't work on Tourrette syndrome. After reading the available literature, I realize that we understand very little about the etiology of the disorder (maybe I'll write about this another time) and maybe because of my intuitive insight into it, I feel like it is very unlikely that any research I can contribute would actually get closer to generating a sane treatment for the disorder. I mean, I know about the side effects of most psychiatric drugs and would certainly not risk surgery to have a deep-brain stimulator implanted in my brainstem. That's just fucking nuts, just for a bunch of tics? Again, if tics were rendering me non-functional it might be a different story. So the short answer is that I don't think I would have anything significant to contribute to this field.
So that's it for now – hopefully you have gained a little insight about what Tourrette's is like. Most of us lead normal lives, have families and jobs and generally function well within society. The New York times recently had a nice profile of several people with Tourrette. It's worth watching. I do worry about my kids a bit, the prevalence in offspring of parents with Tourrette is ridiculously high. I do notice little tics in my kids and worry, but then again after visiting their preschool class I realize that most kids of that age are ultra twitchy and laden with tics too, so hopefully they will correct themselves. If they do develop Tourrette's then hopefully I can serve as a role model of how to cope with being quirky and a bit different.