A Snail's Space: February 2019

After Blaze died in the summer of 2018, I pretty much spiraled into an abyss of depression. On top of that, the company I worked for was going through reorganizations from top to bottom. There was chaos and uncertainty everywhere. Just like in the movie “Office Space”, many people had to interview for their own jobs. Those who were not chosen to be rehired into their job were placed into a pool of people for “reallocation.” Reallocation basically means that you have a specified amount of time to find a different job within the company or you’re toasty toast. Several people got “toasted.” Needless to say, employee morale across the company was down. My own department went through some huge changes, none of which I cared for.

Reflecting on what mattered to me most, weighing the value of time versus money, asking myself if my identity was still tied to being a scientist, I pondered the possibility of leaving the industry for good. I found myself facing a similar question to that of the character, Tomas, from the novel “The Unbearable Lightness of Being,”: [paraphrased because I can’t find the exact quote online at the moment] What is left of a man once his inborn mission in life is gone? In other words, “Who am I if I am not a scientist (or substitute a specific role within the broader term “scientist”)?” Fortunately, I had to face versions of this question a few times along the way in my career. Each time I found that I acquired a new goal and eventually gained a new self-image, a new expanded identity and I was ultimately still me. I gathered those memories to myself and held them close like a security blanket. My past ability to recreate myself bolstered my courage to take the plunge. In late November of 2018 I told my supervisor I wanted to leave the company at the end of the year. I was grateful to my supervisor that she permitted me to finish out the year, which allowed me to qualify for a bonus (a source of money that would be quite needed in the coming year, given that our household income was about to drop by 55%).

As a good-bye of sorts to my fellow colleagues, I wrote a piece I titled, “Reflections on Firsts” and shared it in the final departmental newsletter of 2018. I’ve shared a copy of that here, dear reader:

Reflections on Firsts

For many of us, this newsletter represents the end of an era. It represents “lasts”, if you will: the last newsletter written by Julie, the last quarter we’re all together as Clin Pharm Sci Com, and, for me, the last year of my career with Lilly. Coming to the end of such a huge part of my life has caused me to pause and reflect on all of the experiences I had while working for Lilly. Among my fondest are memories of my “firsts”.

Lilly was my first real job! At what I thought was an old age of 31, I joined Lilly and was given an assignment of setting up my first laboratory from scratch. Wow. That seemed like a huge responsibility and I had never been allowed to spend money like that – ordering all of the equipment, microscopes, laminar flow hoods, balances, supplies, chemicals, everything. But then, followed an even bigger first. I was asked to turn a large storage closet into a surgical suite for performing in situ rat brain perfusion studies. What a rewarding experience! I worked with construction guys to install ventilation for a downdraft hood, so we could use isoflurane gas anesthesia for the rats, instead of the inferior way they had been anesthetizing them with only phenobarbital injections. We installed surgical tables, dissecting microscopes, perfusion pumps, water baths, gas cylinders, everything necessary to perform surgery. It was one of my proudest moments at Lilly.

After a year of working by myself in the lab, I was allowed to hire my first direct report, James Bacon (yes, there’s a connection J). Together, he and I developed Lilly’s first in vitro blood-brain barrier model. We were nominated for, and won, the President’s Award for that work! (See photo at end of page).

My very first trip outside the United States was on behalf of Lilly. Because of my work, I would eventually travel to England, Scotland, Switzerland, Puerto Rico, and Italy. Those were exciting adventures for which I felt honored to represent Lilly.

After I tired of my time in the lab, I pursued my dream of being a writer and landed my first job as a medical writer at Lilly’s US Affiliate. Little did I know that my role as a medical writer would open a whole new world of firsts for me.

I got to experience what it was like to lead a group of physicians and scientists in writing a clinical manuscript. You all know what that’s like – VERY different from the writing we did as graduate students! When my first clinical manuscript was published, my husband surprised me at work with a huge bouquet of flowers. That seems funny now, so many publications later, but it felt like an incredible feat at the time.

While in the capacity of a medical writer at the US Affiliate, I had the privilege of being involved in a huge variety of assignments. One year, I got to organize and lead my first Ad Hoc Advisory Board Meeting. To accomplish that, I had to execute my first contract with a company called Virtual Meeting Services. I had a budget, I got to choose the venue, I organized the agenda – down to the scheduled bathroom break times – I chose the meals and snacks, and I had to ensure all of the external Thought Leaders were appropriately compensated for their out-of-pocket expenses. It was an amazing experience. A lot of work! I wouldn’t want to do it again, but it was something that I felt really proud of once it was accomplished.

One of the most unique “firsts” I experienced was standing in for the physician on the team during a market research study. The purpose of the market research was to evaluate the effectiveness of the DURABLE trial manuscript that the physician and I had written together. The physician was sick, so she asked me to take her place. Market research is SOOO different from the types of things we writers normally experience in our day-to-day work. This particular study involved a group of people from Lilly marketing sitting in a darkened room behind a two-way mirror while I went into the observation room and presented an overview of the DURABLE trial to a subject who had previously read the DURABLE manuscript (the subjects were practicing endocrinologists). After my presentation, I left the observation room and went back behind the mirror. A marketing person then entered the observation room and asked the subject questions about the DURABLE trial to see how effective the manuscript (and I) had been at communicating the results. I felt like I was participating in some kind of FBI investigation or something. It was so cool!

Then came my entry into Clinical Pharmacology and my very first New Drug Application submission (baricitinib – Olumiant). O.M.G.! I had no idea what I was getting into. That was a year of my life I’ll never get back! But, no, seriously, I wouldn’t trade that experience. The feeling we had as a team, when we all were working in the wee hours of the morning to carry the submission over the finish line – that was a feeling of camaraderie, teamwork, and togetherness like I’ve never experienced before. That was something really special!

Now, as I come to the end of dreams from the past, I smile with gratitude for all of the firsts I was so blessed to experience. I did it! Most of my dreams were fulfilled and there were others I didn’t even know I wanted that were given to me, as well.

Now, I dream of future firsts: my first published freelance article, my first published photo, my first novel, first interview with a world-renowned scientist, first vet assistant position, first writing assignment requiring travel…. All are dreams. But, I remind myself, so were my dreams of becoming a scientist, of getting a PhD, of working for a pharmaceutical company. I recognize that all longed-for realities begin as a dream. Who knows what lies ahead? Perhaps firsts I haven’t even thought of. Dreams I haven’t yet dreamt. There’s a world of possibility and adventure out there just waiting for me to say, “Yes!”.

I’ll be writing about my next firsts on my blog at: http://ASnailsSpace.blogspot.com

I would be delighted for you to follow me! J

Caption: Here we are, mere youngsters. Little did I know that the man on the left side of Row 1 (James Bacon) would become my beloved husband and best friend. Now, 18 years after we won the President’s Award, Jim and I will celebrate our 15^th wedding anniversary on May 22, 2019.

If you are just joining, my past few blog entries have been an explanation, of sorts, for the 3-year period of time during which I wrote nothing. If you’ve been following and wondering when the heck I was going to continue with my “Series of Unfortunate Events”, I confess that I’ve been stuck. I’ve been avoiding writing this one. In fact, there is something even irritating about having to write it. I don’t know to whom or to what my irritation is directed, but I cannot deny it is there.

Blaze died. There is nothing beautiful I can write about it. It was horrible. He was thirteen. Selfish me for wanting more time.

He had arthritis badly in his left front leg and I could tell he was developing it in other joints, as well. For years we tried to keep him as comfortable as possible with daily doses of anti-inflammatory medication and, when it seemed the pain was particularly acute, we’d give him tramadol. One day last June, I noticed a big bulge on his left front leg. We took him to the vet the next day and were told it was a hemangioma. I had never heard that word before.

Our options were to euthanize him then or euthanize him later. Basically. I don’t mean to blame the vet. We love our vet, but the choices seemed unnecessarily stark. The problem was, we didn’t know yet, what the path forward for a hemangioma entailed. We were mercifully ignorant.

The vet explained that the tumor would eventually rupture and then we would have “a bloody mess on [our] hands.” That didn’t seem so horrible. We’re scientists. We’d seen plenty of blood in our time. The vet explained that most people choose to euthanize their pet at that time, but some choose to go forward with wound management. That didn’t sound so bad. So, we have to clean and bandage his wound, so what? As long as it was not harmful to Blaze, that would be okay, right? The vet warned that the wound could become smelly. Oh, that’s okay. We don’t mind dealing with that. As long as Blaze is comfortable and we aren’t doing him harm, we want to pursue the wound management route. So, we loaded Blaze up in the car and the three of us drove home in silence.

Over the next few days, his tumor grew from the size of a quarter to about the size of a walnut, and I noticed that it was changing color. It had started as a light pink color (the color of his skin), but now there was a dark purple center to it. One day a little hole formed in the tissue covering the dark center and the center began to squeeze out through the hole. The hole got larger and larger, until the whole tumor was open. It looked like hamburger. By now, it was about the size of a plum.

As soon as the tumor ruptured, we began the wound management process. It was a tedious affair involving cleansing the wound with sterile saline, patting dry with sterile gauze, applying antibiotic ointment, applying sterile gauze pads over the wound, and then wrapping his whole arm in stretchy medical wrap. There was a whole set up and breakdown process for each cleaning. We did this twice daily. About 4 days into the wound management process, we began to notice the odor. The odor was of rotting flesh, because that was literally what was happening. The vet told us we could cut away as much of the dead tissue as possible, and we tried, but I was constantly afraid I was going to hurt Blaze.

Here we are wearing masks against the stench and trying to make the best of the situation.

And, here is Blaze with his bandaged leg.

He was such a good boy through all of this – just like he had been his entire life. So obedient. So gentle. He hated getting his wound cleaned, but he came to the blanket and laid down every time, anyway. Each and every time, we gave him the best treat we could think of – peanut butter or popcorn. Popcorn was his ultimate favorite treat all through his life. He loved sitting at my feet while I ate a bowl of popcorn and I would toss a piece through the air and he made a game of catching it and crunching it up. Oh, how he loved that! Once I would get to the bottom of the bowl, he got to eat the crunchy, partially popped kernels. Heaven on earth for him!

As the days wore on, it took more and more pain medicine to keep Blaze comfortable. One day he stopped eating his food. Jim and I had always said that the day he stopped eating, we would know something was seriously wrong, because he was such a food hound! He wanted to eat constantly and we had to keep him on a strict diet to keep him from getting overweight. During these last days, we observed that if we got his pain under control with enough meds, he would eat. This told us a lot. Now we were asking ourselves what was in Blaze’s best interest.

A few more days passed and Blaze refused popcorn – irrespective of how much pain medicine he had on board. Now we had to face the unimaginable… we made the call to the vet and set the date and the time.

I don’t remember much of anything between that time and the moment we were at the vet clinic. It was July 16 – a hot, sunny day. Blaze, being a Sheltie, hated hot weather. He loved winter and snow. I remember there was a day long ago when it was 5 degrees outside and I took a photo of Blaze asleep in the sunshine on top of a heap of snow on our back porch. Blaze loved being outside. Even if it was sweltering, he would accompany me while tending my gardens. As long as we were with him, he would endure the heat. The technician asked us if we wanted to do it inside or outside. Outside seemed the most appropriate choice. The technicians led us first to a place in the adjacent park that was in the open sunshine. The heat was suffocating. Blaze hated this, I knew. I spotted a large maple tree back across the road on the clinic’s property that was casting a large, inviting shadow. I suggested we walk over there.

Blaze limped across the road to the shade. I felt like a traitor. I felt like we had tricked him. He came over obediently, trusting us. Jim and I were to choose the exact location on which to place one of his favorite blankets. Something inside was rebelling. The bigger part of me made the rebel surrender. I chose a spot. I looked down…and there was a FEATHER lying on the ground. Dear reader, if you don’t know, feathers are my sign from God. The feather did not make everything okay. It did not make it any less difficult to kill my dog, but it confirmed the mercy and the presence of God. I felt God close to my broken heart.

A catheter had already been placed in Blaze’s good arm. He laid down on the blanket just as he was asked to do. He must have wondered what was going on with all these people around him – 5 in all. But, he just looked up at the vet, sort of with a question on his face – I don’t know, I couldn’t see for the tears flooding my eyes. The vet told us what to expect and then asked us if we were ready. I feel sorry for vets that they have to ask people if they are ready for their baby to die. An automaton within me said the word, “Yes.” The vet pushed the plunger on the syringe, then held his hands under Blaze’s chin. Blaze’s chin fell into the vet’s hands and he lowered Blaze’s head to the blanket. A minute passed. Birds called, crickets chirped, cars passed, but I heard nothing. The vet put his stethoscope to Blaze’s chest for a moment and then said, “He’s gone.”