Cat Scratch Fever

My father never phoned me, so when I got a phone call from him during my last year in graduate school, I knew it must be important.

"Your mother is having a biopsy, and you need to come to the hospital."

I reminded him that my mother had told me that it's only a biopsy, it wasn't serious, and I shouldn't worry.

"It's surgery, and surgery is always serious!" he replied sharply.

When my father was a teenager, his father had died on the operating table from the anesthesic, before the operation. One of his great-aunts broke the news to him by saying, "You're an orphan. Your life will be hard from now on." He never forgot that. One result was that he avoided doctors. (My mother, on the other hand, followed doctors' orders and did everything she was supposed to do. My father lived 10 years longer than she did. Make of that what you will.)

Soon after my father's phone call, K came down with a fever. The fever was accompanied by an enlarged lymph node in his groin (I would call it enormous, but the technical term seems to be "remarkable"). He went to a doctor who told him to get the lymph node biopsied.

Due to the conversation with my father, I freaked out. Surgery is always serious. I would do what I could to help K avoid surgery.

Princeton University doesn't have a medical school or medical library, so I went to the Princeton Public Library and found the Harvard Medical School Health Letter Book. I looked up "lymph node" in the index, and the first thing it led me to was a section on important things to tell your doctor if you have a cat or a dog. It said that young people with an enlarged lymph node and a young cat should know about cat scratch fever.

Toby, a grad student friend who was a year ahead of me, had been having severe backaches. He had decided that perhaps the cure was to get a cat.

Every Christmas, Landau, the Icelandic woolens store on Nassau Street, put adoptable cats in the front display windows. K and I had gone with Toby one evening while he chose a tiny cute black and white kitten who licked his hand (she noticed that Toby had eaten chicken for dinner). During the drive back, the kitten crawled under my coat against my chest to keep warm.

Toby soon decided that the kitten, whom he named Topos, was making his back problems worse --- she snuggled against him under the covers at night to keep warm, and he was afraid to move for fear of rolling over and crushing her.

I couldn't stand the thought of sending her back to Landau's window, so Topos, whom I renamed Ceilidh, became my cat.

When K ate ice cream, Ceilidh would climb up his legs, giving him lots of scratches. As I soon learned, the lymph system drains upwards. The scratches on his legs led up to the lymph node in his groin. Cat scratch fever made a lot of sense.

When I mentioned cat scratch fever to Toby and other friends, they said, "Oh yes. That was a popular song. You must have heard it." I hadn't, but everyone else seemed to have.

We got an appointment with a family friend who was a doctor at a major cancer center in New York. He pressured K to have the lymph node biopsied. I vowed to do what I could to save K's lymph node.

Something Toby had learned in his adventures to cure his bad back was that it's important to be seen by the right specialist. "If you want to be diagnosed with cancer, go to an oncologist. If you want to be diagnosed with an infectious disease, go to an infectious disease specialist," he told me.

So we found an infectious disease specialist in Princeton. 

At that time, not much was known about cat scratch fever. They didn't even know if it was bacterial, viral, or something else, and the specialist didn't know how to test for it. When we told him our theory, he ordered a bunch of tests, including one for toxoplasmosis. We looked up toxoplasmosis in a 70-year-old copy of the Merck Manual (a well-known medical reference book). It gave the memorable warning that you should never eat a rabbit that you can knock over with a stick.

Even though one could get toxoplasmosis from a cat, K didn't have the symptoms for it, so that blood test, like a lot of things K's doctors did, didn't make a lot of sense to us.

I no longer remember how K got the name and phone number of the expert on cat scratch fever (this was long before the Internet or Google). K still remembers the names of the expert and the infectious disease specialist, and he remembers being nervous about phoning the expert.

The expert told K that the Centers for Disease Control (CDC) had an experimental test for Cat Scratch Disease. We found out how to order the test, and K's infectious disease specialist ordered it. It was a simple pin-prick skin test, like the old tuberculosis tests.

I think the reason the infectious disease specialist took us seriously was that both he and K had been undergrads at Princeton, and the Princeton alumni bond is strong. (I was a Princeton grad student, but that doesn't count.)

Sure enough, a lump popped up on K's skin. We measured the diameter as one centimeter, which was the lower end for a positive cat scratch test. The infectious disease specialist  gave a description and the measurement by phone to the expert, who said it should be considered a positive result.

The family-friend oncologist's reaction was, "Even if you have cat scratch disease, you might have cancer too! You should still get a biopsy."

The lymph node eventually returned to normal, with no biopsy or treatment.

The Princeton alum infectious disease specialist was impressed with the way we solved problems, and how thinking like a mathematician led to a faster solution than the problem-solving algorithms in which medical doctors were trained. 

He warned us that, even though our way was better, we would have a lot of trouble with doctors in the future, because we thought like mathematicians. He was right.

Thinking about sex

X and I hadn't seen each other since we were in grad school together. We were standing around with a couple of graduate students during a conference break. Y came bounding up to us, stuck out his hand to X, and gave him an unusually vigorous and ostentatious handshake. Y had been a grad student with us at Princeton, a few years ahead of X and me, and Y knew the two of us equally well.

Reflexively, I stuck out my hand to shake Y's. He looked at my hand, and then put his hands behind his back. It felt, metaphorically, like a slap in the face. The grad students watched the scene unfold, and I felt embarrassed. Eventually it dawned on me that Y's refusal to shake my hand was based on religious grounds.

The affiliation that he had written on his name tag was a U.S. government intelligence agency. So in some sense he was there as a representative of the U.S. government, and his trip was funded by me and other taxpayers.

When I saw Y at a conference break the next day, I pointed out that while I understood, respected, and supported our country's strong commitment to freedom of religion, as a taxpayer I had a reasonable expectation that he behave professionally and fairly in professional settings in which he represented my country. As such, I felt that if he would not shake the hand of a female colleague for religious reasons, he shouldn't shake the hand of a male colleague in a similar professional setting, as a matter of basic fairness and common decency.

I asked what message was being sent to the two (female) grad students who had witnessed his handshake the previous day, about the differences in the way female and male mathematicians are treated by their colleagues and by people representing their government.

He agreed with everything I said, and even agreed that not shaking hands with men in professional settings was a fair and reasonable solution.

We discussed other ways in which he treated his female and male colleagues differently on religious grounds. One example he gave was, if someone were noisily vacuuming the hallway outside his office, he might close his office door when talking with a male colleague, but not with a female one. I pointed out that such actions could give an unfair advantage to one group over another, and suggested that he follow the same protocol as for handshakes: in professional settings, if he wouldn't do it with a female colleague, don't do it with a male colleague.

He explained that the prohibitions he followed were designed to get the practitioner not to think about sex. (And by putting his hands behind his back in response to my outstretched hand, he was reminding himself not to think about sex.)

After we discussed this point for several minutes, I remarked that this conversation was one of the few times I had talked about sex in a professional setting, and wasn't it interesting that his religious practice seemed to lead him to talk with female colleagues about sex, rather than preventing it. He agreed that it was interesting. (I could have pointed out that there are things I would rather discuss with my colleagues than sex or gender. And that I was surprised by how much he seemed to enjoy talking with me about thinking about sex.)

I don't know whether he now treats people equally and fairly in professional settings, irrespective of (his perception of) their gender. But I'm glad we went through the intellectual exercise of discussing it. I hope it gave him more to think about than sex! 

The Interrupter

During a conversation with C in a hallway after lunch, he yelled at me, "Stop interrupting me! You're always interrupting!" 

I didn't think I had interrupted him, but I gave him the benefit of the doubt. I shut up and he continued speaking .... 

... and he kept on talking. His monologue was mostly one long sentence. 

Was I "always interrupting"? Or had he merely thrown a tantrum to get his way, so he could talk and not have to listen to me? I decided to treat it as a scientific experiment, and glanced at my watch to check the time.

When he finally finished his long sentence, which went on for more than 20 minutes, I tried to rejoin the "conversation". He immediately interrupted me, so I shut up again and waited.

C wasn't a close colleague. He worked at the IBM lab where I had a "postdoctoral and junior faculty" fellowship in 1988-89, and we occasionally sat at the same lunch table. I no longer remember what topic he was expounding on, but I remember that it wasn't something about which he knew more than I did.

At an infinitesimal lull, I spoke up to calmly say, "I'm very sorry to interrupt, but I've been politely listening to you for the past half hour. Whenever I think you're done and I try to say something, you start talking again, so I stop. When do I get to speak?"

He berated me angrily for having timed his monologue, before I politely excused myself and walked away.

I mentioned our interaction to a colleague, who reassured me that it was him and not me. He was known for being hard to get along with.

From similar experiments, I've observed that the people who angrily tell me that I'm monopolizing the conversation usually speak for more time than I do.

Alice in Wonderland spent much of her adventures trying to deal calmly and rationally with angry, irrational, unreasonable creatures, mostly older men. Sometimes I feel as if that accurately describes my career.

When I'm tempted to react in anger (in my personal life or at work), I try to remember to take some deep breaths, channel Alice in Wonderland, and say to myself:

"First, self-confidence; then kindness." 

When I succeed, it's the self-confidence that enables me to be kind.

And if I do take the floor for too long, I hope that you'll let me know kindly rather than angrily.

The Affirmative Action We Don't Talk About

I know of a cohort that was chosen (from paper applications without interviews) by a well-intentioned selection committee that tried to put together a racially and ethnically diverse group. The cohort turned out to be more homogeneous than the selection committee assumed. The women with Spanish surnames were non-Hispanic white women who got their last names from their ex-husbands. And the group included whites who were assumed to be black because of their work on African or African American topics.

In the United States, race-based affirmative action was originally supposed to help underprivileged African Americans, Hispanic Americans, and Native Americans who faced a history of discrimination. The way I've seen it implemented in academia is sometimes at odds with those goals. But when some of the problematic aspects are discussed at all, it's often in whispers. Is this too dangerous a topic to talk about openly?

I've noticed that surprisingly often, the people who benefit from affirmative action are well-off white men from Spain or Latin America who didn't come to the United States until graduate school, or else people who aren't black or Hispanic but are assumed to be. They are usually valuable members of their workplace (who might or might not serve as role models, depending on the situation). But they are not the underprivileged Hispanic Americans or African Americans for whom affirmative action was intended.

If you question such choices, even to point out that more qualified African Americans and women were passed over, you risk being accused of racism for questioning an affirmative action decision.

Many years ago I heard from my father the journalist an anecdote about a radio station that got in trouble for discriminating against minorities. A consequence was that the station had to hire a minority applicant for the next job opening. Of the two finalists, the African American applicant was better. The other one was hired. 

The people who ran the radio station reasoned that one couldn't tell from the black applicant's name or voice that he was black, so they wouldn't "get credit" for hiring a minority member.

The applicant they hired grew up as a white kid in an upper middle class white suburb. He used an Hispanic name when he applied for this job to take advantage of affirmative action. Even though he didn't grow up in an Hispanic culture and didn't know Spanish, the radio audience would think from his name that he was Hispanic, and that's what mattered to the bosses at the radio station.

Implementing only the letter and not the spirit of affirmative action policies is sometimes just laziness. Whatever your views about affirmative action, I hope you agree that we can do better.

The Moving Allowance

While I was an assistant professor, I was asked if I wanted to be considered for a position at Bandersnatch University, and I said OK. I got a job offer from Bandersnatch in the mail two days before Christmas, with a December 31 deadline.

I hadn't interviewed for the position, but the department Chair and I had agreed that it would make sense to visit the campus before I made a decision. When I got the offer letter I tried to phone the Chair to arrange the visit, but the math department office said he had already left for Christmas. I asked about phoning him at home and was told not to since, after all, it's Christmas.

The Chair returned my call in January, and we arranged for me to visit Bandersnatch University later that month.

In January, K also received an unsolicited offer from Bandersnatch. K's offer included a moving allowance, while mine did not. I didn't care so much about the moving allowance, but I did care about fairness.

During my visit I asked the Chair whether they usually give moving allowances. He replied that moving allowances are standard for all offers. When I told him that my offer didn't include one, he said he'd look into it. He said "your husband" K's moving allowance would be higher since K's offer was at a higher rank, but we'd each get one and we could use the sum of the two.

I was disconcerted by the mention of "your husband". While I pondered what to do about it, I asked the Chair how the department would react if I accepted my offer and K rejected his. He replied, "the department would be delighted!" This seemed like an odd reaction to K's turning them down.

I said I was concerned about whether the offers were independent. He said they had to treat it that way, since they know how easily marriages break up.

I reminded him that I had not informed him about my personal life or marital status, and pointed out that he and the university didn't actually know anything about my marital status.

He insisted that he did, since some of his colleagues had told him. I pointed out that his colleagues didn't know either, and whatever he thought he knew was on the level of rumor or gossip.

Changing the subject, I asked about an updated deadline for my offer. The Chair said he knew there were other factors, like my spouse, and surely I would want Bandersnatch to give us the same deadline. He seemed to have learned that I didn't like the word "husband", but he didn't seem to have grasped why.

The Chair phoned me one evening in early February. Among the issues we discussed, he included the news that "the moving allowance has been approved". What that meant was that "since we are also recruiting your spouse," K's moving allowance was a "household" allowance, and I would still be offered nothing.

I protested, and questioned whether this was the usual way to do such things. I asked, "would an assistant professor whose spouse works in industry be offered a moving allowance, whether or not the spouse was getting a moving allowance from their company?" He admitted they would.

The Chair phoned again the next evening, and once again referred to "your husband". Feeling that greater directness was warranted, I said, "You never asked me if I have a husband, and I know what I would have told you had you asked. I would have said it's none of your business."

After discussing other matters, the Chair brought up the moving allowance and admitted that it was wrong not to offer me one. He tried to downplay it by saying it wasn't much money. And he added, "you're welcome here even if your husband goes somewhere else." (This time, he quickly corrected himself and said he meant K.)

I replied, "Yes, I could go there, but not with a moving allowance, since I wasn't offered one." I told him it's not the money, it's the principle. And it sets a precedent for how I'll be treated at Bandersnatch.

The moving allowance (or lack thereof) was not the reason I turned down the offer (and wasn't nearly the worst part of my interactions with that Chair). It was an unnecessarily unwelcoming part of the recruitment process that could so easily have been avoided.

When I showed this story to a friend, his sympathies were with the Chair. He felt that "it's hard for people to forget what they think they know," and I'm asking a lot to expect the Chair to "forget" that I was married.

I'm not asking people to change what they think. But I would like university employees to behave professionally. If someone is entitled to a moving allowance, give them a moving allowance. If you don't know someone's marital status, or don't have a right to know it, don't act as if you do.