Category: Career

Posts by Jano Klimas about the academic career and the long and harrowing journeys of academics.

Going home

West coast and East coast of the U.S. are very different, people always told me. West coast was my home for 6 months – spring and summer. At the summer’s end, I took a long trip home to explore the East coast. This blog is about our journey to NYC, Ocean City (NJ), Millstone and back.
On Monday, we went from Portland, Oregon, to New York City. The Portland cab couldn’t find our address and stopped at the bottom of the block, leaving us to carry our heavy luggage alone. This was his second day at work, and his first airport ride – as we discovered later. He played in a heavy metal band for 11 years, since he came to Portland, and he was a vegan. To our great surprise, he knew many towns in our homeland – Bratislava, Prague and Brno – because he played there with his band. His intimate knowledge of those places made us feel closer to him, as we talked about the live in Portland. People who move to Portland are … bums, they are different. What is it about the city that attracts this special breed of humans? We couldn’t find an answer to that question, but agreed that it is the best city in the States. The driver wanted to give us 5$ discount because of the address issues, but we refused recognizing that starting a new job requires learning new skills, which takes time.
NYC was dirty, crowded and noisy. Our red-eye flight drained away all our energy and motivation to explore the city, so our greatest experience there was a long, morning nap in the Central park.
On Tuesday morning, we woke up in the Ocean City, New Jersey. I chose to stay in the Crossings Motor Inn long time ago. Ten years ago, I spent a summer working in its laundry room. It was my liberation summer, when I gained independence and self-reliance, changing my lifestyle forever. I was just a kid when I was here the first time. I didn’t realize it until now; 10 years of independence. As an adult artist-scientist, I am much more self-aware; I’m also very thankful that my research job allowed me to get here after 10 years and to have a great time, and to relax my tired scientific brain.

Crossings changed me; how has the motel changed?

The motel was no longer owned by my Italian friends; staff and housekeepers were different too. Our housekeeper was Kayla – a quiet student from Russia. J1 students, like her, were experiencing increasingly more problems with obtaining visas for this type of work/ region. Sandy damaged the Jersey shore and left its mark on the Crossings too; the lobby was painted and refurnished. Should I have come back last summer – before the Sandy storm – I would still see the ugly pink countertop in the reception. The season ends in Crossings on September 29th, the receptionist stays with her daughter during winter. The handyman hopes to get a job in the construction; he was able to do so during the last 2 winters
On Friday, we went to visit my cousin in the Millstone Township, in the Lakewood area. After dinner, and a short card game with Cassandra, they drove us to the JFK airport. Journey to the airport was never-ending. The traffic was really bad. We needed to pee badly and struggled to find a toiled. So we left the free-way and found a supermarket, where we were the only white customers. The bathroom smelled badly. Half of the toilet desk was missing and so were the bath tissue and soap. Nobody wanted to use the toilet and when I opened the door to get in, a nearby girl told me to save myself. Under these circumstances, there was no discussion about finding another toiled; we did it there. Luckily, we had just enough time to catch our flight back home. Our home away from home – a second home in Ireland.

Saying bye slowly makes parting easier

Last days of my INVEST fellowship

Visiting research scholars make new friends quickly and parting is not always easy for them. I said bye in Portland (OR) five times:

First, I said bye to my writing group. This was my second group in the last 15 weeks. The first, 10-week course of prompt-based writing was a birthday gift from my wife. I enjoyed the first course so much that I decided to go for a second round. The new beginnings were difficult, because we had a new group and group dynamics; dynamics matters most in writing groups. By the 3rd-4thmeeting, the group juice started to flow and we shared more and more feedback on our writings. Parting with the second group wasn’t easy, but much smoother thanks to my experience with the first group; I felt I belong there.

Second, I said bye to the members of the Western States Node from the Clinical Trials Network. The network has 13 nodes funded by the National Institute for Drug Abuse (NIDA) to conduct clinical trials in addiction science. From the very beginning of my fellowship, I have attended weekly meetings of the team – around 20 in total. Marie made delicious cookies and Lynn gave me clock made of bike parts by a Portland artist. This was a well-chosen gift, because I cycled around Portland every day and really enjoyed it.

Third, I said bye to my colleagues from the Department of Public Health at the Oregon Health and Sciences University (OHSU). The lunch invite went to all faculty and staff, but I was worried that no one would come. I was worried that if I left, nobody will care about it. When I came there, I saw many familiar faces. It felt good because it made me feel like I have an impact on people that I managed to make a connection in a short time. We had a BYO lunch on the lawn. The sky didn’t look like 88 Fahrenheit but the sun shone on us eventually. Some of us sat on a white blanket from the ED which used to warm up patients as they came to ED. Many people showed up, including my mentor Dr Dennis McCartywith his wife; Dennis commissioned cookies and Sarah baked them.

In the evening, I said bye to the three of my best friends and neighbours plus their dog – Sonic. We stayed up late, talked, ate and listened to great music. Sonic honoured us with two carpet pees which destined him into his kennel for the rest of the night.

Fourth, I said bye to my dentist. Seth was a 3rd year dentistry student at OHSU School of Dentistry and helped me through many long visits. He reminded me about my appointments every Sunday night. Seth called me on Friday evenings and when he didn’t get an answer, he called back on Sunday night. He even called me when he had a cancellation to check if I had time to get some work done. When we parted, he pushed a bag full of toothbrushes and toothpastes into my hand; so that I take care of myself and my teeth. We had a lot in common, especially the taste for adventure. I surprised my wife with a hot balloon ride for her birthday last Thursday and he treated his wife with the same ride for their 3rd anniversary.

Fifth, I said bye to my mentor, Dr Dennis McCarty. When I arrived to the department that morning, it was pretty empty and my heart sank because I haven’t had a chance to say bye to Dennis. But he came later. Dennis helped me to improve and expand my writing. I’ve read four books on writing, borrowed from him, during the my fellowship. I’ve never read so much about writing in my life. Dennis introduced me to science writers, e.g. Atul Gawandeor Carol Cruzan Morton, science writing, e.g. JRF publications, and science writing competition – the Wellcome trust prize. We met at the career crossroads – an emerging science apprentice and a seasoned mentor. He taught me that research project management is unlike any other research skills: you don’t learn these things by reading books or in the classroom, but through the apprenticeship. He was not only my mentor, but at times, acted like my guide, counsellor, teacher, proof reader, father and friend.


My point here – that saying bye slowly makes parting easier – should interest most visiting research scholars. Beyond this limited audience, however, my point should speak to anyone who faces parting with many good friends.

A decade in the addictions field

… or 5 key decisions and accidents that kept me in addiction science

Career in addiction health services research can be daunting. There are moments when people in this career path struggle at work. Have you ever been in that situation yourself? Here’s my story.

1. Needle exchange movie at 16

The internet was still a toddler and I watched the TV rarely. But when I turned on the box on one of such occasions, a summer afternoon, I was brought into the streets of the Slovakian capital, Bratislava, which was a world far far away for me. Young social work students backpacked those streets with bags full with clean needles and distributed them to drug users and sex workers; they talked about what this exciting and controversial pastime meant for them. They worked for a needle exchange project – Odyseus – and I wanted to do it too. I was excited to help drug users in the same way these women did, but I had to wait a couple of years until I grew up.

At that time, they still called it ‘Street work’ which later became ‘Terrain Social Work’. In the following years, I learned from my future boss that the Slovakian public TV screened the film quite often, but mainly as a filler in the downtime hours.

2. Unanswered phone call at 20

After acceptance at the psychology degree, my world changed and the range of my interests expanded. Nevertheless, I never forgot about that documentary. It was in the second year when I saw a poster at our university board, at advertised Needle Exchange as a part time job for students. I picked up a public phone and dialled a number from the poster – following my teenage dream. Nobody picked it up, so I left a message which too remained unanswered, forever. The number on the advert wasn’t for the Needle Exchange which the documentary talked about, but I didn’t know it at that time. By chance, I ended up working for the agency from the documentary movie because they had an email address posted on the internet and were more responsive than the project which advertised on our student board.

3. Student project at 21

Part of my comprehensive exam in the 3rd year of my undergrad was a research project. As most of my friends, I struggled with access to patients. Because of that, almost everyone did a literature review – without having a clue what we were doing. I chose the role of family and drugs as my topic, but it wasn’t an easy choice. At that time, my interest in drugs was drifting away and I felt like researching something else, for example depression or disabilities. I don’t remember how I ended up with drugs again, but my review led to working with Dr Timulak, and eventually, to my MSc and PhD projects.

4. Dr Peter Halama, PhD and Hungarian trams at 25

Dr Halama, PhD was this new face at the Trnava University, when I wrapped up my comprehensive exam. They were good friends with Dr Timulak and when I asked him about ideas for my MSc research, he said that Dr Halama was doing some interviews with drug users. Two years later, I found myself co-presenting our findings with Peter at a psychotherapeutic conference in Slovakia. Read more about that research here. From there, it was easy to continue in my research with Peter at a doctoral level. I enrolled as a part time student in Social Psychology, which did not convince him that I would finish it. When I announced – after two years of studies – that I’m moving to Hungary for a year, I think Peter had a hard time suppressing his doubts that I would finish my PhD from Hungary. My Hungarian adventure was, however, a real turning point. I had to commute between offices and spent long hours in trams. Being too bored of watching cars and people pass by, I started to read open access articles which I downloaded from internet the previous day. Some were more interesting, others less, but when I found something really relevant to my work, I felt like a gold miner who just dug his jewel out of piles of dirt. My passion grew stronger with every new paper.

5. Irish job hunt at 28

When we arrived to Ireland in early Autumn 2008, all I had was a small EU grant with a budget of 3000 euros and an unclear host organization. We managed to survive for almost a year with a great help of my wife’s EVS stipend and occasional p/t jobs. The work on my PhD and the EU grant took most of my time, leaving only a couple of hours for finding a more stable position. When I eventually ran out of money, it was late winter and the job market had dried up. I submitted my resume to many advertisements, including a research job on men’s sexual health. I must say that research was not on my list of Top 5 jobs, but when this position came up after 8 hopeless months of job hunt it was a true God-send. The pictured ad initially offered a PhD post in drugs research, but at the interview, my current boss – Prof Walter Cullen – told me about a p/t place on the same project. That’s how I came to research drinking among methadone patients in primary care at UCD.

6. Dr Dennis McCarty, PhD at 31

OK, I know I said that there were 5 key decisions earlier, but there has been a lot going on recently. In July 2011, I have been to a summer school on drugs in Amsterdam, Netherlands – no one could imagine a better place for this adventure. Dr McCarty, lectured for several days on different policy models and evidence based treatments. Two years later, I’m sitting in an office down the hall from Dr McCarty’s office, writing my final report about the INVEST fellowship. Visit this post to read more about how I got here. I did not think that the summer school would lead to a fellowship in Portland, OR and I’m most grateful that it did.

With Dennis, I have learned about things I thought did not exist. For example, about researchers who enjoy writing. Writing up research projects is a task that many new researchers fear the most. Dennis is a master writer and his craft is contagious; I’ve discovered a need in me, a strong urge to write a lot and in many different formats. I hope this ‘fire’ will keep on burning for at least another 10 years.

26 weeks investing in Portland

Portland

Welcome to my INVESTing log. INVEST is the International Visiting Scientists & Technical Exchange Program for drug abuse research sponsored by NIDA (National Institute on Drug Abuse). From March-August, 2013, I was an INVEST researcher at the Oregon Health& Science University in Portland and this is a log about my experiences.

Three INVESTing points weekly (from newest to oldest):

Last Week 26 (August 26-31)

Windy and Sandy Jersey shore
Funny looking banknotes in my purse; different scent in my bathroom
With that soulful look on your face

Week 25 (August 19-25)

Here’s the opposite – a lot of professionals and not enough patients
A good bye lunch in the park
We don’t own anything; it’s on loan

Week 24 (August 12-18)

I lost my voice in Santa Rosa
I feel like I’m swimming upstream
Humans make up stories. Most people are better in the abstract

Week 23 (August 5-11)

Please note that your OHSU PC access will expire on 9/2/2013
The goal of writing is to stretch the limits of your thinking
Oregon spirit

Week 22 (July 29 – August 4)

A week of strong decisions
Picnic at Skidmore bluffs
Document the experience

Week 21 (July 22-28)

Swimming in the Frog lake under the Hood mountain
A beautiful place where I have time to think and write
The work ethics in US is different

Week 20 (July 15-21)

2 Free books in 2 days: paradise
Methamorphosis at Marquam hill
‘If the water is dark, the lake must be deep’

Week 19 (July 7-14)

It’s hard to get a credit line
Two writing workshops this week
You are my fountain of knowledge
Great art can emerge from aimless meanderings

Week 18 (July 1-7)

Charts reviews started, best time – 4.06 sec
The department is empty these days, the head brought a cake to appreciate staff
I thought I was here to learn more about research, but I’m actually learning a lot about leadership and group interaction

Week 17 (June 24-30)

73 new emails after a week out of office
A strange proposal will arrive soon
Everything depends on your determination

Week 16 (June 17-23)

at the CPDD conference, visiting San Diego again after 9 years
A complete different time space
Controlled expansion

Week 15 (June 10-16)

First focus group, first night ride through the Terwilliger… feels like on the top of the world
How long have you been using internet for? – 15 years
My first potluck at the OHSU public health

Week 14 (June 3-9)

Release from immediacy
Their number will grow, our number will die
The floor is slippery when wet (Really?)
Sometimes you don’t know what’s possible until you’re forced to do it

Week 13 (May 27 – June 2)

Where is the sun gone?
The atempt here is creating
sometimes, the most powerful and profound changes can be brought about by the most subttle and innocent moments
Journal of Japanese Gardens

Week 12 (May 20 -26)

IRB (Institutional Review Board) approval out now!
Working with other writers is good for me
Quote from a song: “Should I stay or should I go now?
If I stay, there will be trouble – If I go, there will be double.”

Week 11 (May 13 -19)

weeks started to fly by
I said: I’m an office monkey. They said: We are donkeys.
Work, Play, Love, Read

Week 10 (May 6 -12)

How to spill an oatmeal on the office floor
Two copulating mosquitos sucking blood from my arm
everybody has a different style of working

Week 9 (April 29-May 5)

My first ride to work on the cable car (aerial tram)
My friends at work make their own bread and apple preserves
I’ve been bitten by a writing buy

Week 8 (April 22-28)

First day at work in my 10-year old American sandals – the summer’s comming
Learning about my limits and acknowledging my strengths
“A lot of media advertising is based on things that make people insecure and anxious” (the Missrepresentation movie)

Getting warm welcomes by OHSU Department of Public Health and Preventive Medicine (PHPM) in The Liason Newsletter:

Dr. Jan Klimas joined PHPM as an INVEST Fellow beginning March 1. The National Institute on Drug Abuse supports the INVEST Fellows program to accelerate career development for new investigators who are citizens of a country other than the US. Jan will work in the US for six months assessing the value of screening and brief intervention for alcohol use disorders among opioid dependent patients being treated with an opioid agonist medication (i.e., methadone or buprenorphine). He plans to collaborate with Richmond Clinic and CODA to contrast US agonist treatment services with those in Ireland provided through general practitioners.

Jan and his wife Johanka Macekova are Slovakian. Jan is currently working in Ireland where he studies screening and brief intervention for alcohol use disorders among opioid dependent patients receiving agonist medication. The US provides opportunities for comparative research….
For more info, check the Winter 2013 edition of The Liaison, PHPM’s internal newsletter, is published the first week of the month and highlights news and events that took place the previous month, in addition to listing upcoming events as well.

Week 7 (April 15-21)

New office, new start
What is the American standard?
First stolen bike saddle
Forging new friendships

Week 6 (April 8-14)
car hand brake is actually a foot brake in new US cars
moving to a new desk next week
restrooms and water fountains are so common in Portland
tatoos and piercings are so tolerated… everywhere

Week 5 (April 1-7)

Who uses buses in Portland or US? Discovering Portland Metro area
Really tired
Changed my location on skype/ twitter to PDX

Week 4 (March 22-31)

First fruit of my labour on the INVEST project are here
Beautiful mornings, cycling to work on the hill
Work and life routine, getting used to it

Week 3 (March 15-21)

Conference at Washington DC
Getting to know myself better, my expectations
Everything’s so expensive
A photo from the Spring NIDA CTN 2013 conference: INVEST scholar links with Humphrey scholars:

Week 2 (March 8-14)

Why does it take so long to get used to this, longer than I expected
Too many things to do at work
I miss Ireland – listening to RTE Lyric.fm

Week 1 (March 1-7): starting in Portland

Jet lag, almost all week
My first chai
Everything is so big, different, weird
Arrived safely at OHSU; checking the “Hall of fame” aka Notice board with faculty publications by OHSU Department of Public Health (2011-13):

What happened before my arrival to OHSU in Portland, Oregon:

31/Jan/2013

Jan will speak about his previous and current research in Ireland and plans for future research in Portland, OR at the The Spring 2013 CTN Steering Committee Meeting. It will be held at the Hyatt Regency Bethesda, Bethesda, Maryland, on March 12-15, 2013.
For more info, check the section about International Symposium in the latest issue of the NIDA CTN Bulletin (January 31, 2013, Volume 13 – 02): http://ctndisseminationlibrary.org/ctnbulletin.htm

15/Nov/2012

Jan Klimas, PhD, joins the Western States Node on March 1, 2013, as a NIDA CTN INVEST Fellow.  NIDA is National Institute on Drug Abuse, and INVEST is International Visiting Scientists & Technical Exchange Program for drug abuse research, which combines
“postdoctoral research training in the US with professional development activities and grant-writing guidance to form a unique program for drug abuse scientists”(link).
Oregon Health & Sciences University hosts Dr. Klimas’ six months fellowship during which he will assess the use of Screening and Brief Intervention (SBIRT) for alcohol use disorders among patients receiving agonist medication for opioid use disorders.

Professor Dennis McCarty, Co-PI for the Western States Node, will supervise Dr. Klimas during his fellowship.  The research examines addiction treatment in primary and specialty care settings with respect to implementation of screening and treatment for unhealthy alcohol use among opioid-dependent patients in methadone or buprenorphine maintenance treatment in Ireland and Oregon.  Dr. Klimas’ prior work in Ireland informs the U.S. investigation… read more in the NIDA CTN bulletin, (issue November 15th, 2012): http://ctndisseminationlibrary.org/bulletin/20121115.pdf

Trust: the usual suspect in the addiction story

Believe me, or not, trust is something that has been emphasized in addiction treatment for many years. One can hardly argue that it has become one of the usual suspects in the life stories of most recovering drug users.

In this post, I write about two main findings of my latest research published in the current issue of the Czech academic journal Adiktologie (Addictiology). Although they may not be the key findings, which I discovered, this blog gives me an opportunity to illuminate what I feel people should take away from this paper.

 

 


This comes with no surprise – trust is key for building or restoring relationships of all people. No matter if they have drug problems, or not. In this way, my research confirmed what common sense tells us without any special knowledge of research. Re-prioritisation of relationships during treatment was facilitated by the experience of help, support and restoration of trust in relationships.

Because I was able to look at the pre-recovery years of drug users lives, when they actively used drugs, I could go with the trust issue a little further. Changes in relationship priority during active drug use occurred on the basis of barriers (e.g. the need to obtain drugs, stigma), which restrained active drug users from engaging in and maintaining the social relationships.

 

This research has further deepened my understanding of how problem drug users function and indeed how similar they are to people who don’t have drug problems. Some readers may not like this, but they may be less different to ‘us’ than we thought. The key factors that keep them function in a way that is hardly acceptable  by the main-stream population are drug-related barriers. These barriers prevent them from engaging in the usual social life pleasures, such as keeping in touch with non-drug-using friends, visiting parents etc. My research highlighted that they don’t do these things because they have different priorities, which are not compatible with them (See Figure 1 below).

Saying that they are not bothered with relationships or that they’ve no interest in them is too simplistic, and as suggested by this research, not true. Other research showed that people with drug problems do engage in social relationships, pro-social activities, social relationships, raising children – they just don’t do it in a way that ‘we’ are willing to accept. The question that remains to be answered by future research is what would happen if the barriers of engaging in culturally-acceptable social activities were removed? Would ‘they’ be more like ‘us’? The first signals supporting this question come from the opioid agonist treatment. People maintained on pharmaceutical opioids, substituting their illicit drug use, lead more stable lives, commit less crime and have better chances of being employed than people without these substitutes.


Original abstract:
Background: interpersonal problems among drug users (DU) are frequent, are related to other problems, and improve during the addiction treatment.
Aims: to better understand changes in relationships which occur in the course of drug use and drug treatment, as well as their subjective appraisal by ex-drug users, using retrospective methodology.
Method: semi-structured interviews with DUs in a therapeutic community (TC) were analysed with descriptive-interpretive method. The coding of interview transcripts into categories was performed in two phases using qualitative software NVivo 7. Five interviews were coded in the pilot phase, followed by an audit by an external psychologist and progressive coding of the rest of the transcripts, with data saturation being reached in the second phase.
Participants: nine male and one female client, aged 18-36 years (mean: 25.9), participated in the study and the length of their stay in the TC was 2-35 months (mean: 9.9). The approximate mean age of drug use onset was 15.6 years (12-28).
Results: the analysis provided 21 categories which were divided into three domains based on chronological order. Changes in relationship priority during active drug use occurred on the basis of barriers (such as the need to obtain drugs and stigma), which restrained active DUs from engaging in and maintaining their social relationships. Re-prioritisation of relationships during treatment was facilitated by the experience of help, support and the restoration of trust in relationships.
Conclusions: this study builds on the previous work exploring the broad issue of social consequences of drug use and offers clients’ perspective on this topic.
Cite as: Klimas, J. (2012) Interpersonal relationships during drug use and treatment from the perspective of clients in a therapeutic community. [Interpersonálne vzťahy v priebehu užívania drog a liečby závislosti z pohľadu klientov/iek v terapeutickej komunite.]. Adiktologie (12)1, 36-45
More at: www.adiktologie.cz

Figure 1. Evolution of relationships during drug use, addiction and treatment