101 Goals, R2

The time has come. (Round 1 is here, don’t laugh.)

I’m a little bit older; not fragile, but not sure-footed either.

Part of that entails feeling aimless. Not for lack of aims, but more of the sense that a huge swath of them might eventually prove frutiful and a paranoia about opting to pursue the wrong ones. That only lasts for so long before you start to feel really useless and guilty about it, and so I guess the big aim of Goals.R2 is to strategically narrow the scope of the adjacent possible: to compress the world of possibility from something rampant and unwieldy to something concrete and manageable and worthwhile, burrowing through the muck toward a clairvoyant surface and engendering habits within myself to keep that burrowing steady and multifaceted.

Career-wise, I’ve got a North Star; I’ve had it, in fact, for a few years – as is perhaps the nature of an aim worthy of the title – and am finally certain enough to be grounded in it though there are like fifty billion paths that might lead that way and it is really anyone’s guess as to which will prove fruitful. So most of these items focus on other things.

Also worth a separate prelude: I would like to include more goals on being kinder, more empathetic, more graceful, a reliable friend in times of crisis – but I can never quite figure out how to phrase them as tangible, checkable goals. And I don’t think I ever ought to, for that matter, so I will be keeping those things in mind as an ever-present thrum that enhances all else.
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101 Goals, R2

Amman: Round Two

I’m headed back to Jordan this summer for thesis research, fieldwork, and (of course) weekend canyoneering. The original plan was Beirut – still angling to make it back & forth a few times. Here are a few things I’m going to work on while gallivanting about the Levant. All advice, criticism, and insight is more than welcome!

1. Gather some hard data on how immunization rates change during Ramadan.

I’ve been tracking patients that miss their immunizations for about seven months now. We started *just* before Ramadan last year, and noticed a pretty substantial increase in the number of missed appointments during that time. This is probably not surprising to anyone, but it’s also completely unstudied. Delaying immunization by a week or two isn’t a huge problem in an area with decent herd immunity, but waiting a full month before maybe forgetting about it, when migrants and streaming in and out from a warzone where hospitals are being bombed, when polio strains are blooming across the border, when we’ve seen unprecedented outbreaks of infectious disease along Syria’s border with Turkey? That’s not a good idea.

My hunch is that general fatigue and a mismatch between maternal waking hours and clinic hours might be the major inhibitors, but I’m open to other ideas (someone just told me some people view vaccination as breaking fast). No moms want to wait in line for hours in the early morning after preparing food all night. Nobody wants to do anything at 3 p.m. after nine hours without food or water. I barely drag myself to 8 am classes on normal days and definitely cannot without scary volumes of espresso, so I feel like these things aren’t unreasonable. One specific goal is to channel these findings into specific policy recommendations on clinic hours, which could be a good work-around.

2. Expand UNRWA’s mobile health capacity. We’ll be issuing immunization prompts to more clinics – hopefully some outside of Jordan, and some catering to Palestinian-Syrian double-refugees! – and gathering some hard data on effectiveness and patient satisfaction. Beyond that? The specifics are still up in the air. One promising suggestion from last summer involved sending reminders on basic aspects of diabetes management to adult patients. I’m not a huge fan of basic mobile health initiatives like this (engineers are technology snobs), but I do think they can be especially useful for patients with limited mobility. Gaza New Camp, in Jerash, provides a good (well, awful) example. The ’67 refugees who live in the camp were not afforded Jordanian citizenship, so they can’t obtain licenses or buy cars; if they bought motorcycles instead, however, they’d be short-changing the Jordanian economy by investing in a cheaper mode of transportation, so they’re also not allowed to buy motorcycles (cue eyeroll). So, if you live there, and your diabetes symptoms progress beyond anything you can manage, good luck getting to your regular dialysis treatments.

Of course, it’s not a problem if for Jordanians who reside in Abdoun mansions – take either of your Porsches down to King Hussein. But that kind of extreme disparity is what allows global health issues in the Middle East to fly under the radar: everything averages out to Middle Income Yellow (new Crayola shade?) and funding is directed elsewhere. Bigger rant on this later.

3. Health care as a bargaining chip. This is an iffy one, perhaps best illustrated by Hezbollah. They provide medical care that drastically undercuts the going rate on Lebanon’s private market, and care is FREE for Hezbollah party members. If you’re poor and sick and on the fence, is that opportunity enough to sway your political stance? There’s rumor of similar models being tested by different extremist groups in Mali, and I’m worried that this might be a growing phenomenon as AQIM spreads southward throughout and across the Sahel to sicker and more impoverished lands.

To be fair, one could argue that USAID does the same thing, “From the American People” emblems and all – maybe that would make a nice proxy study. I’m not sure exactly of how to pursue this line of investigation, but I think it’s really important and I’m surprised it isn’t getting more attention. Tentatively, I’d like to head up to Zaatari, where UNRWA is trying to deal with lots of pharmaceutical theft & redistribution, to see if there are any grander motivations aside from making a buck on the UN’s dime. Maybe I’ll gather up the gumption for more casual interviews in Beirut. More broadly, if there is any real political shift that comes from this discounted care, I’d like to see it incorporated as a very low-cost national security strategy. The US is good at fighting fire with bigger fires, but fighting knockoff pharmaceuticals and pandering with effective, strategic, and heartfelt health investments seems like a much better deal to me.

Amman: Round Two

101 Goals in (Slightly More Than) 1001 Days

My engineering education imbued me with nothing if not an appreciation for concrete and quantifiable goals. I’ve done a tremendous number of new and ridiculous things over the past year in particular (toured the southwest, left the country for the first time x3, wrote for a national audience, won a business competition, created a (semi)functional medical device, graduated, formed a startup…etc) and after this blur of mostly structured activity, I’ve begun to fear complacency in my murky gap year after undergrad.

While “101 things in 1001 days” lists were a pinteresty craze for a bit, my goal is constructing this one is to provide myself with a more focused narrative for progress over the transition years from undergrad to graduate school and through the early stages of gainful employment. I’ve also extended the time period to three years just for kicks, and hidden just a few for specificity.

In order to qualify, an item must be: 1) concrete or quantifiable 2) not directly dependent on the decision of anyone else 3) reasonable, but require concrete time or effort and 4) make me a better or more interesting person in either a major or minor respect (none of this “withdraw from caffeine for a week” bullshit). Without further ado:

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101 Goals in (Slightly More Than) 1001 Days

Backup Plans

1. Powerpoint consultant. The world needs all of these to be less awful. I am a champion of white-space and pith. It’s meant to be.

2. Join up with the Obama campaign.  Get paid to put off sleep and spend months obsessing over minutia I’ll spend months obsessing over anyway. Find Josh Lyman. Marry him. (This is not really a backup plan.)

3. Breakfast artisan. Saffron tofu scramble? Pistachio-encrusted French toast? Steel-cut oats with caramelized banana? Yes.

4. National Park Ranger. Live on a mountain in the Chisos or in a canyon in Utah. Apologize to that bear I chased that one time.

Backup Plans

Conundrums.

(What follows is a lot of uncertain gallivanting about the post-grad life.)

I want to work in international development because I enjoy doing impossibly challenging things and dislike the fact that the world is not an even playing field. I’ve had the itch to go into public/foreign service for a few years now for a) absurd love of DC b) a firm belief that engineers who can talk and write like real people have an obligation to exercise both of those capabilities and c) outrageous frustration with the status quo of top-down technology implementation.

Here’s the crux of the problem: I like making things.

I like making things a lot – mentally juggling parts of a prototype until they click, outlining program structures to process changes in respiratory wall resistance and log that data in a google doc, transforming complex instrumentation into something elegant and sparsely functional.

I’m not sure if I’m done with that quite yet. I’m terrified that if I jump the gun – take a fellowship abroad for six months or a year or more, to get the basic field experience basic jobs and grad schools require – that I’ll not only miss out on a critically exciting period in the field, but also put my absurd set of technical tools to waste. I drunkenly told someone a few weeks ago that I wanted to be the Steve Jobs of accessible health technologies; that is, to take something bogglingly unwieldy and transform it into a functional market. (But so does everyone. Who’s lived the dream? Design professors with infinite creative labor, obvs.)

In any case, it comes down to this: there is not a paved career path in which I could accomplish those things, nor a relevant industry that hires for my skill set. Not right out of college, certainly. In an ideal world, I think I’d start with senior design: get that up and running, and expand to what comes fluidly – diagnostics are what I’m good at, and what I’ve been best trained in. Work on lots of short-term projects within a grander vision. Add in adventure/shenanigans (low expectations work here – I’m the girl who thinks flying in planes is crazy and I swam across the border for my one trip out of the states, remember). Not picky on location, though the intersection of health and regional stability ignites all the on switches (I swear I’d head to backcountry Afghanistan if I could). Maybe grad school after a break, if it’s useful and helps me do more useful and exciting things.

Anyway, suggestions welcome. I filled out the bioengineering curriculum checklist not terribly long ago, purple pen and all:

 

Rice has given me lots of weapons but not yet taught me how to aim them. Scared I’ll miss.

Conundrums.