Dear Captain Awkward,

Thanks so much for this blog! I read most of the archives during a recent overnight hospital stay and it really helped keep me entertained. I (she/her pronouns are fine) was a year away from completing my dissertation when my body rebelled. I have two very large liver adenomas, larger than the doctors have seen before. Thankfully my parents live in a city renowned for its hospitals and took me to consults. I had to immediately go on medical leave in September but was hoping to return in the spring. Unfortunately the adenomas are extra stubborn. I’ve had two embolization procedures and I’m in for another two before the surgeon can operate (one of them is in a really risky place and she could hurt me if she tried). With the extra hospital time, she recommended that I extend my leave, so I did.

Everyone congratulated me on how well I’m handling things, but I don’t feel that way. I feel constantly fatigued, I’ve been in a lot of pain, I feel like I’m losing my identity as a scholar and I’ve been living with my parents during the week in case one of these stupid things ruptured. I’ve had to spend a lot of time away from my wife, which has killed both of us. Luckily the surgeon says I should be safe to go home for longer periods now. I’m just wondering how I stay afloat. With a massive surgery looming in May, applying for summer jobs is now unlikely. My father has been helping me financially and I am so grateful. I’m just depressed. I’m done with hospitals, needles and the whole mess. I’m even getting depressed over stupid things like getting denied for a credit card. I feel like I’m a drain on everyone around me and I can’t even contribute academically anymore. I’m writing a 3500 word paper for a big conference in April and even that is a struggle.

My advisor has told me not to worry about the dissertation unless I feel completely up to it, but I would feel better if I could bang out a chapter draft. Therapy would probably help and I was seeing someone before this went down but she wasn’t very effective and then I’ve had to spend so much time in my parents’ city that I haven’t been able to go to appointments anyway. I am also on medication and have been since I was 16. I know that what I need to do is be nice to myself and for the first few months I could do that, but now I’m having trouble. Thanks for everything you do.

Signed

Eeyore’s got a bum liver

Hi Eeyore,

What if I told you that you don’t have to feel positive or stay positive or be positive. Stay alive. Positive can wait. It sucks to be in the hospital, keep getting jabbed with needles, be unable to schedule or plan anything in your life, be unable to do work you love, be unable see your wife, be unable to stay on track with finishing your degree. Let’s just sit with how much all that sucks right now, how awful and scary it is, how much this is not what you planned. You had a great life and then your liver decided to make a bunch of bullshit tumors. Who feels positive about that? Not you! Grieve for the plans you made. Give yourself permission to feel your feelings, even if they are crappy. Feeling less than positive and then beating yourself up for not being positive enough helps nobody.

Yes, put some additional support in place. Revisiting therapy sounds like a good idea, maybe you can ask your medical team for recommendations for therapists who work with people around illness and recovery. You might be able to find someone near your parents’ place, or someone who can work with you online or hybrid between online and in-person visits. Need to talk to some peers who know how much everything sucks and who are unlikely to sugar-coat anything for you? Look into support groups (here’s a link for support groups for people with liver diseases in the United States specifically). You might also want to peek at ChronicBabe, a community targeted toward women with chronic illnesses. Here’s a community for and by academics with disabilities and chronic health conditions. Maybe you build a secret/private Facebook group or Slack channel (or other social media platform, up to you!) for yourself and some friends to make it easy to stay in touch when you’re bouncing between home and hospital.

Fight the idea that being sick is something you’re inflicting on others. You say: “I feel like I’m a drain on everyone around me and I can’t even contribute academically anymore.” This ableist framing is hurting you and other people.

Your worth is not based on how much money you earn, it is not based on how much research or scholarship you do. Academia (and other industries) will tell you this is not true, private health care concerns will generate spreadsheets to tell you that this is not true, cruel politicians run on and vote on platforms that argue that this is not true, but they are wrong. You have been fed messages all your life that tell you that you are only worth what you produce and that to allow yourself to need help and to be helped is a weakness. You were told all your life that people who could not work were burdens on “the rest of us,” you were told all your life that optimizing your health was something you owed not only yourself but your workplace and your whole nation, you were told that disability and illness and poverty were the result of poor personal choices that could have been optimized somewhere along the way and if they weren’t, too bad for those people, those people who are now worth less, those who are now making it harder for everyone because they have imperfect, expensive bodies and it’s Just Too Expensive to take care of everybody.

You probably rejected most of these messages as silly and unfair along the way, but it doesn’t mean that they didn’t affect you, that they didn’t crawl inside and wait for you to be sick, and sad, and un-moored from your achievements and no longer earning a steady income, to crawl back out and whisper powerlessness in your ear, to accuse you of being undeserving of care. Tell those messages to fuck off. You, me, all of us need to counter those messages wherever and whenever we find them. It’s expensive to be a human being. We must invest in each other without counting the cost. We must stop acting like it’s possible to un-deserve financial help or medical care when we’re sick, we must build communities and political entities that are not based on rote acceptance of scarcity when it comes to human needs and well-being. Start building that place in yourself.

One step in that direction: Accept the gifts that come your way. Good medical care, financial support from your family, an advisor who wants you to take your time to heal, the ability to take some leave, a supportive wife, interesting studies and projects to go back to. Accept the gifts, you’re not a drain on anybody, you’re not failing at anything, you’re just sick right now, there are people who love you and value you who are rooting for you to get better and who will gladly take up the work of helping you do that if it means they get more “you” in the world, not just You, The Great Scholar, With So Much Potential but the present Januaryish you who is in a shitty mood, feeling pessimistic about credit scores and summer jobs. Let the people in your life give you what they can, stop telling yourself you don’t deserve it. When you can, you will pay it forward. Right now, eat the love sandwich.

Another step: Practice turning “I’m sorry” into “Thank you” as much as you can. “I’m so sorry I’m behind on this conference paper draft” => “Thank you for reading my draft.” “I’m so sorry this is costing you a fortune” => “Thank you for the help.” “I’m so sorry I’m falling behind in my dissertation” => “Thank you for giving me permission to take the time to heal.”

I know I said you don’t have to be productive, and I still think that. You don’t. But if you are like me, that won’t really penetrate all the way, because you like your work and you want to be working on stuff, so let’s make a plan for sustainable engagement with your studies while you’re laid low.

As for the April conference, it’s only January 13. If you need to back out of the conference and the paper, do it. Annual conferences happen every year, this isn’t the only one. If you want to stay involved, I believe in your ability to crank out 3500 words about your topic before April. Your rebellious liver did not destroy your subject matter expertise, and nobody makes it this far in graduate school without having had to crank out a few pages of well-crafted bullshit for a deadline. Plus, lots of academic conference talks, panels, etc. come together pretty last minute. I do not know your field, of course, but please do not think that everyone else at these things is some kind of badass unstoppable work robot. Others are not often going to be able to tell the difference between your half-assed effort and someone’s whole-assed effort.

As for your dissertation? Maybe you don’t write a single page right now. You’re not going to stop being interested in your subject area and collecting knowledge like a magpie, so what if you called this The Year Of Reading Widely instead of The Year I Fell Tragically Behind. Can we find a middle ground between “You’re way too sick to do any work on your dissertation” and “If you stop working on this now maybe you won’t ever be able to again”? I don’t know about you, but I do better the more I convert anxiety into action. A possible process:

Make two lists.

DISSERTATION READING FUN READING

Put some things on the lists.

Evaluate and categorize the things you put on the lists and assign time and focus estimates to them. Group items on the lists according to how interesting you find whatever it is as well as the time/focus investments required to engage. Fun counts on both lists, for example, if you were studying your research topic strictly for pleasure and not as a job or as a method to fashion and insert your particular arguments about it into the Great Discourse, what would you want to read or know about?

When you start feeling anxious about your dissertation and like you’re falling behind, pick one of the dissertation-adjacent readings with a low-focus and low-time commitment and knock it out, 30 minutes here, 1 hour there, one more entry in your bibliography. When you need a break, but still want distraction, grab something from the fun list. You’ll know you’re onto something interesting when you want to engage more. You’ll know you’re feeling better when you dig for longer/more complicated things. You’ll know you need to slow down when nothing on the list seems interesting or possible.

The brain needs breaks, and I really do think that if you can let your interests and your capacity to engage guide you for the next little while while you heal, you will end 2019 with more progress on your dissertation than if you went at it full-force while your health is still so fragile or neglected it entirely and let it grow like a giant guilt-Balrog, flaming at you from the darkness and telling you where you can and can’t go.

If you start using these lists as more reasons to beat yourself up, burn the lists.

Down the road: When you do get through this crisis and back to your full strength, be an advocate for others. If you teach, be aware of how disability and illness affects your students, be a professor who thinks about accommodations and lets students know you are here to help them do their work and succeed. Push back on the pressure for constant productivity in your grad cohort and your department when you find it, and thank/raise the profile for your advisor for supporting you when you were sick (not everyone’s advisor would do this). I linked this at the top of the post, just want to remind people again that there are a ton of disabled and ill scholars doing amazing and important work inside the academy. You can amplify their work as you move forward in your career and be one of the people who changes things.

Wishing you a speedy resolution and recovery and a return to the things that make you happy very soon.