Homeostatic Lemonade

It’s been a minute or two (or a semester and a half) since I’ve posted, so let me start by saying hello and welcome back. Happy 2020!

And boy, do we have a lot to talk about!

To make a couple long stories very short, I finished up my first semester of graduate school, am continuing to fight a stalemate battle with autoimmunity, and finally got hired into a position I’ve been working in for over a year. It’s been a long semester and we’re gonna talk about it. Some of it.

The broad, over-arching theme this spring semester 2020: Lemons.

Y’know the kind that life throws at you. Socially, professionally, medically. All these lemons, and very little to do with them. So you make lemonade, right? You advocate for yourself, because at the end of the day who do you have? Yourself.

And we have to be nicer to ourselves. So let’s dive in and talk about the messiness, the difficulty, the exhaustion of advocating for yourself – of making this lemonade. And hopefully we’ll be able to shine a light on why it’s necessary and oftentimes rewarding. Tasty.


Let’s start by taking it back to biology, I mean after all why are we even here?

At the base of your brain almost smack-dab in the middle, there is a small chunk of white matter termed the hypothalamus. Your body temperature, hormone regulation, biological clock, and appetite, among many, many other things, is regulated via this little region of tissue in your brain. Needless to say, it’s vitally important to everyday function and biological equilibrium. For all intents and purposes, the hypothalamus is a key regulator in homeostasis.

Homeostasis, simply, is the ability to maintain internal equilibrium of our physiological processes. It makes sure our set-points are maintained. It’s the reason we’re not running around with fevers at all hours of the night and instead (hopefully) sleep. It makes sure we’re stable.

All of this is, of course, intricate and complicated with different pathways and feedback loops we won’t get into now. But it’s a necessary process designed to keep us alive and, hopefully, well. So why am I bringing it up when I was just talking about metaphorical lemonade? Because your body is always doing the work necessary to keep you up and running (barring any disorder or disease that affects homeostasis). Our environments are always changing, throwing new stimuli at us, and our bodies acclimate and adjust. If our bodies can do that, we can try to make sure we’re getting the best stimuli we can and creating a homeostatic mental environment.

By that, I mean doing the most that you can to ensure you’re being treated how you deserve. Self-advocacy is a tricky business. And every facet of life is going to require its own version. Whether you’re juggling the academic, personal, social, medical or professional lemons, you probably know they can sour easily. Knowing how to advocate for yourself is of the utmost importance.

Academic

Academically, advocating for yourself often has to happen at numerous levels. Individual classes, discipline, department. There are layers to it.

Grades, on tests or papers, are a reflection of what you know and if you know how to present it the way your professors require. Don’t be afraid to ask questions about the material, why something is wrong, how to do better. Oftentimes, professors will consider your rationale and while it may not boost your grade it’ll help in the long run.

Applying is just advocating for yourself. And everyone hates applying. Whether it’s to a conference, a school, or a class it all comes down to knowing who you are and making sure everyone else does too. Personal statements, cover letters, resumes or CVs are just professional ways of doing that. Don’t forget to hype yourself up.

And get to know your professors and chairs. They will be able to help when things get hard and it helps to have people who can advocate on your behalf. Most of the time, they’re very understanding. And if you meet an advisor who isn’t, knowing someone who is can help take the edge off or help you find alternatives.

Also make sure you know what resources your institution has to offer before you need them. It’ll save time when you actually do.

Medical

Advocating for yourself medically can be anything from making sure doctors know you’re in pain, to explaining those pesky invisible symptoms. Why did I mention my autoimmunity earlier? This. Right here.

Going to the doctor is hard enough – between the high insurance rates, long waiting times, and having to take off from work or school. Then, of course, comes actually describing your symptoms.

There’s plenty of disparities in health care. Notably, chronic pain patients, especially those with neuropathies that are hard to diagnose, can struggle to receive proper treatment and often cycle through medications that may have little efficacy for their condition. Like pretty much everything, women are often short-changed in this department. Women are even more likely to have their pain dismissed or misdiagnosed as hysteria mental illness. Of course, there are disparities between women. Women of color are even less likely to be prescribed pain medicine, an inequality Wanda Sykes pointed out in her latest Netflix special. To make matters worse, much of what we know today stems from older research. Much of it done only in men. A problem not limited to clinical research.

With the rise in popularity of the social media platform Tik Tok, there has been a storm of internet backlash responding to “TikTok nurses.” Not all of them, but plenty of videos have circulated of nurses and nursing majors invalidating concerns of patients they’ve seen. The dismissals? Pain and invisible symptoms. It wreaks of ableism, one of the many -isms that permeates the medical profession. Disabilities, invisible or not, have been dismissed by doctors for being too difficult or inconvenient.

This is not to say all doctors are bad – there are plenty fighting for equality, better research, and above all, their patients. Dr. Jen Gunter, a gynecologist made famous by her twitter threads and book, The Vagina Bible, detailing women’s health and the lies that get told about it, is one such doctor. And the nature of medicine is changing every day, with medical programs including courses to teach previously ignored aspects of medicine like bedside manner. But this isn’t going to change overnight.

So, let’s make one thing painlessly clear: your pain is valid. Your concerns and conditions are valid. You are valid, M.D. or not.

It’s important to find a doctor who listens to your concerns, and if they don’t, leave. Realistically, though, leaving a particular doctor or practice isn’t always an option. It’s important to stand up for yourself. This in and of itself can be difficult, as doctors can be intimidating. Plenty of Google searches ask, “how to make your doctor listen.”

WebMD even has a page dedicated to it.

The key takeaways?

Bring notes so you have a list of what to talk about.

Tell your condition, disease, or injury like a story instead of just the ailment. Even doctors love stories. How and when did it happen? What does it feel like? How has it progressed?

Be direct.

And be honest.

Professional

When you can’t even convince your doctor that something is wrong, it can be even harder to convince your employer. Add on your professional experience, pay, opportunities, and bad coworkers, and work gets even worse.

Toxic work environments can be even more draining than what work you do. Men who don’t know how to talk to women or talk to them too much; bosses that make impossible demands, those that aren’t engaged at all with the work you’re doing or, conversely, micromanage; coworkers who challenge your every move. Toxic work environments can exist anywhere, unfortunately. And if HR doesn’t work or your administration doesn’t care, it even more unfortunately falls on the individual to demand respect. While conflict, especially in places you spend 8+ hours every day, is difficult, sometimes it’s necessary. Tell your coworker to stop questioning you, to use different language, to stop looking at you like that. Defend your work to the people who think they get it when they really don’t. Ask for a raise if you think you deserve it.

If you’re going to spend half your life doing it, make sure you feel safe there.

Social

And even when you don’t, build your support system. Friends, family, significant others play an integral role in our mental health and wellbeing. They’re the people to turn to when things go really well or really poorly. And they’ll do the same to you. The key is asking for your time or space when you need it without isolating yourself.

Self

And sometimes, you have to advocate for yourself to yourself. Your mind can be a messy, dark place and it’s easy to lose yourself in it. Mental health matters just as much as your physical health, and it’s harder to work out. This stuff is exhausting and messy (like the homeostatic pathway) and that’s okay.

It’s about growth, learning to say no, learning to go easier on yourself, learning that it’s okay to ask for help. We’re our own biggest critics because we’re stuck alone with ourselves all the time, but that doesn’t mean we have to do it alone. Appreciate your accomplishments. Hype yourself up in the mirror. Pick a personal mantra and remind yourself that you’re good enough, you’re valid.

It is not an overnight process, let alone a linear one. The learning curve can be astronomical, but it gets easier with practice. It’s a lot and easy to get overwhelmed, so take it easy as you learn and practice and grow your confidence.

I fell deep into imposter syndrome when I spent over a year getting hired into a position I’ve held for just as long. It led to financial difficulty which led to debilitating stress and a flare-up of my autoimmunity which fed in to compromised academics and plenty of self-hate. Everything feeds into everything else and untangling it can be like untangling a pair of corded headphones. The past eight months were one hit after another, and this week is when it all of it started to settle down. My stress level was way off it’s setpoint and is only now returning to normal. It’s a process. And sometimes it’s just about surviving the day.


It’s important to point out that I am able to speak from a place of privilege. I’m a white, middle-class academic, and while the fact that I’m a woman comes up far more than I’d like, I’m still privileged in a system entrenched in racism, homophobia, ableism, sexism, etc., etc. I’ve been lucky to have mentors who understand the difficult nuances of navigating these aspects of life, bosses who will go to bat for me, and sanctuary from (most kinds of) harassment. Each of these institutions – professional, medical, academic – have a long way to go before we can see equality and understanding, making advocating for yourself that much more important. Maybe you’re told you’re too sweet, too sour, too watered down, too strong. So be it. If you’ve struck your homeostasis, keep your balance.

As my PI told me, sometimes life gives you more than enough lemons to make lemonade.

You just gotta make sure you have enough sugar.

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