Category: Writing

Posts on writing by a writer Jano Klimas, primarily on books, poetry, slams and science writing.

Take precautions: improve or improv-ise?

“A ship is safe in harbor, but that’s not what ships are for.” ― William G.T. Shedd

How much uncertainty can you live with? A lot, at least I thought so until I started a new course in improvisation. Improv is a bit like acting without a script. Scary? Here’s how this new experience helped me to lighten up my life.

Uncertainty is the only certainty there is, and knowing how to live with insecurity is the only security.” – J. A. Paulos

Before the improv course, precaution was my modus operandi. I was prepared, over-prepared and hyper-prepared for anything and everything. Like many other people, over-preparation was my way of coping with the uncertainty of life. I learned that careful preparation improved my performance and outcomes. This improvement, however, had limits and I couldn’t do better regardless of how much time I spent with preparation.

Life is what happens to you while you’re busy making other plans” – J Lennon

Figure 1 Neil Curran (R) photo credit: lowerthetone.com
 The Improv course with NeilCurran re-defined perfection for me. Over-preparation can often lead to a stilted impression. As if the spirit of doing things evaporated the moment you get in front of your audience, committee, boss or panel – you replace the addressee. Furthermore, you can only prepare for things you can foresee. But there are always unforeseen events. Improvisation helps you react to those challenges. Like any other art, it gives you the freedom of being here and now and reacting to whatever comes your way. It’s a way of being. An other paradigm. Some critics may say improvisation is lousiness, lack of knowledge or skill, neglect or laziness – something that should be avoided. The opposite is truth; improv skills allow you to respond when you run out of your prepared responses – to transcend yourself.

Improv and medical profession

The role of improv in medical profession is bigger than you might think. Although there are strict procedures and guidelines for most medical procedures, there’s still a lot that we don’t know and therefore – cannot regulate. Clinical intuition is invaluable in unregulated or over-regulated situations. Similar to improv, intuiting is reacting to the situation based on previous knowledge, experience and trust in the process. Atul Gawande, in his book The Checklist Manifesto, advocates using checklist to make sure the basics are done. This creates room for clinical wisdom and intuition to deal with unforeseen events. Instead of making rigid orders to doctors and thereby stripping their responsibility and clinical judgment away, the Checklist helps people make sure they do the basic and essential things, leaving enough space for intuition and … you’ve guessed it – for improvisation.

No Fixed Abode: Movie Screening on Wednesday – 20th August at 10am in Filmbase, Dublin

August 20th, 2014 – South West Inner City Network in Dublin is pleased to invite all to the premiere of No Fixed Abode, a short movie exploring the experience of homeless people in Dublin.
Community Addiction Programme (CAP) launches new website, annual report and ‘Addiction’ play

Pictured above, from left to right, Micheal Murtagh (CAP board member), Elaine Mulvaney (CAP Co-ordinator), Jack Roche (CAP board chairman) and Damien Hughes (FRG/Solid Website Design).

Result of a six-month course for clients in a community addiction programme, the movie tells a real-life story of female homelessness-to-recovery journey.
There were 14 ex-users in the course. The programme was participant led, which means that the movie was created and produced by the participants themselves – from the script, through acting and directing.
As the movie production progressed, the group struggled with the motivation and perseverance with the task. The upcoming screening marks not only a successful completion of a media course, but also celebrates another step forward on the journey of personal development.
Hope to see you there – Wednesday – 20th August at 10am in Filmbase, Temple Bar, Dublin. The screening is FREE and open to all: http://www.swicn.ie/news/
More info on SWICN projects:
Homepage: www.swicn.ie
To stay updated on the movie and media courses, follow @SWICNdublin on Twitter, Facebook or join the event page:
South West Inner City Network (SWICN) is a community organization, providing a wide range of services for adults and young people living in Dublin 8, Ireland.
Community Addiction Programme (CAP) provides a range of services to help problem drug users come off drugs and alcohol, and to restart their lives.
Digital film making course for adults is for people interested in getting an insight into digital film making. It’s an introductory course into digital film making that gives the participants opportunity to learn about script-writing, storyboarding, directing, acting, using camera and sound equipment, editing.

Answer to Ethan #38: how to write a science blog

Ethan Siegel posed challenging questions in his post about science blogging. They prompted me to think about my own blog. If you’d ever been thinking about your own blog too, my thoughts might help.
Figure 1 Ethan’s blog. Photo credit scienceblogs.com

1) What is it that you’d like to write about?
I started my blog without careful planning. Shortly after the start, I’ve read someone else’s blog and I realized that I could write about the research I’m doing and about our research group. Blogging was my way of publicising and highlighting my research work. There wasn’t much research to write about at that time. Or, perhaps, as a starting writer, I didn’t see the writing opportunities as I see them now. I started to write about many other topics, including my personal life, hobbies and interests. Sometimes midway my evolution as a blogger, I took stock and divided my topics into three main categories: science, academic and creative. The science and academic categories differed mainly by the language and style of writing. Creative group was everything else. For instance, travel, concerts, poetry, etc.
2) Who is your audience?
Figure 2 William Zinsser, photo credit: npr.org

The first time I have been asked this question was when I talked to Rachel Dresbeck, PhD. I didn’t like that question because I was reading William Zinsser and he said to forget about writing for somebody. “Write for yourself”, I’ve read in his book (On writing well). I told Rachel that I’m writing for academics and psychiatrists who get bored on conferences and who check social media for amusement. She laughed. I laughed too. But there’s a grain of truth in that answer. I write for everybody who likes my posts and who shares my passions. As I grow, my passions develop too. With them, my target audience changes too – from enthusiast researchers and potential researchers to free spirits, artists and life lovers.

3) what are the goals of your writing?
To write a lot.
Some writing leads to more writing. It’s an amazing discovery; one topic leads to another.
To enjoy writing and like its results.
Some topics are easier to write about – on some days, my thoughts flow better. I find it really surprising to read posts that were difficult to write and see that I like them.
To share my ideas and see whether they spark some discussion.
In agreement with my point #1, I don’t write for a particular person or group. Nevertheless, I still want, need, and urge to share my writing with someone. Maybe it’s just the residual momentum from my blogging youth, or a continuing need for highlighting my work/life. Regardless of the motivation, I continue to write a public blog and assume that the silence of commentators = agreement and that “the vast majority of them simplywon’t comment or engage you.

Figure 3 Portland, Oregon guide by Rachel Dresbeck
photo credit abebooks.com

4) what else is Ethan advising to science bloggers?
This is merely a summary of  Ethan’s useful tips, some of which I mentioned above:
  • write often
  • be self-critical and honest about your own writing
  • find your own style
  • share your work with the online community
  • be a real person
  • be prepared for the kind of negativity that only the internet can heap upon you 

Tantalizing exhibition: A night when I was a doctor, an artist and a winning writer

On the night of July 3rd, 2014, I was a doctor, an artist and a winning writer.

An artist

After 30 weeks of laborious drawing and preparing our final show, a group of 16 illustrators and picture book makers exhibited their work in the Culture box, Dublin. We were led by Adrienne Geoghegan. The night before, we hanged our show as illustrated by the photos at the bottom of this post. An illustrator Mr. Clarke opened the night with a story about a British writer who once told him that people talk shite at the openings of exhibitions; it’s such an Irish thing. Wine was pouring, but it was just enough to not make people drunk. The DJ Doolittle played hits from the 60’s.

A Doctor

When Mr. Clarke attended to his keynote duties, he chatted with the artists. I told him that I was one of the people that he mentioned in his opening address. I had great difficulties in fitting the drawing into my day as a scientist. “Are you the doctor, then?” he asked. “Well, I’m a psychologist by background, but I work with doctors.” He wished me well in trying to integrate both careers. Combining Art& Science in one life is like churning 2 things at the same time. And yet, I felt a sense of worth, success at the exhibition. I realized that I have an impact on people, they like me and my work. I’ve never fully realized this until that night. “Are you one of the artists?” Somebody asked me at the end of the night. “Yes,” I replied proudly.

The 2014 Aindreas McEntee awarding ceremony: Dr Coughland and Dr Klimas. Photo source: irishmedicalwriters.com

A winning writer

The 2014 Aindreas McEntee prize, is open to members of Irish Medical Writers, a group of doctors and journalists specialising in healthcare. I’ve submitted my entry on the day of the deadline, expecting little more than introducing myself to the arena of Irish medical writing. The third place came as a surprise. The award ceremony was on the same night as the tantalizing illustrations exhibition. Thankfully, they gave me the prize at the beginning and release me to go for the exhibition. At the end of the night, everybody has won and we all got prizes (dodo bird effect).

76th Annual Conference of College on Problems of Drug Dependence: Decide to be fearless& fabulous

Not one, but two conferences in Puerto Rico made my trip fantastic. As usual, the NIDA International forum happened for the 15th time on the weekend before the Conference of the College on Problems of Drug Dependence. The lines below offer some insights from these meetings.

Integration of addiction treatment into primary care: the portals of entry

Is abstinence related with good health? Is decreased drug use related with good health?
Tae Woo Park and Richard Saitz asked these questions in a secondary analysis of data from a clinical trial of 589 patients using cocaine or cannabis with very low dependence proportion among the sample (ASSIST score >27). To answer their questions, they used clinical measures of good health, such as, SIP-D, PHQ-9, and EUROQoL. Health outcomes were associated with decreases in illicit drug use in primary. However, abstinence and decreased use may represent very different magnitudes. Self-reports related dysphoria could also play a role in the differences. It takes a long time to make improvement in those consequences? 6 months of follow up observations may not be enough. Patient-preferred outcomes are paramount: do they want to have a score lower than XY on PHQ-9? What outcomes are important for them?
The TOPCARE (www.mytopcare.org) project implemented guidelines for potential opioid misuse (Jan Liebschutz). Her slides blew up half-way through the presentation but she delivered the talk excellently. Nurse care management was a component of the guideline implementation trial. Academic detailing (45min, with opioid prescribing expert) included principles of prescribing brochure and difficult case discussion. Is academic detailing effective? The Cochranesystematic review of literature found small-to-medium variable effects. The preliminary results of the project show that the nurse manager programme is a no brainer.
Rich Saitz commented on the sad state of affairs in the addiction treatment, where only 10% of people with addiction are in treatment. Integrated care is the best thing since the sliced bread, but where’s the evidence? His research showed no added benefit of integrated versus care as usual. Why? Maybe, addiction is not a one thing, but we treat it like one thing. Dr Tai provoked the audience with a question: “Do our patients with addiction have the capability to participate in the treatment planning and referral?” If they seek medical care for their broken leg and we refer them to an addiction specialist, will they go? most likely not.
But it is the same with hypertension. Referral is a process and not a once-off thing. Although they may not follow our advice at the first visit, a rapport built by a skilled professional over a series of discussions can help them get the most appropriate care.

Does the efficacy of medications for addiction decrease over time?

An old saying among doctors states “One should prescribe a new medication quickly before it loses its efficacy”. Elias Klemperer pooled the data from several Cochrane systematic reviews on addiction medicines, such as, NIRT gum, Acamprosate, or Buproprion. Their effectiveness decreased over time. The changes in methodologies might have caused the decline; also the sponsorship of trials, target populations or publication bias.

Write, wrote, written

Primary author is in the driver’s seat, others are passengers. Primary author pulls the train. Dr Adam Carrico(UCSF) asked us “What are you really passionate about?” Find it and use your passion for those themes to drive your writing habit. Decide to be fearless& fabulous. Develop a writing routine. Put together a queue of writing projects and don’t churn out 2 products at the same time, one of them will suffer. Schedule writing retreats with colleagues. Set Timelines for writing grant and programme time for reviews by trusted people, give people a warning that this is what you’re planning to do. The JAMA June 2014 issue offers useful tips on how to write an editorial.

Dr Knudsen reported on the editorial internship of the Journal of Substance Abuse Treatment – JSAT, which started in 2006, with Dr McGovern (current editor) and Knudsen as the 1stfellows. Success rate of the fellowship applications is 2/30-45, prior involvement is appreciated (peer reviewer, submission). The new 2014 fellows are: Drs Madson and Rash. In the one year of the fellowship, the fellows typically review 12-15 manuscripts, some years, as a managing editor of a special issue. The Drug and Alcohol Dependence journal has a similar scheme.

Check out the http://www.cpddblog.com/