Health Update: Suspended Attention

After last November and December’s adventures in cancer world, it isn’t surprising that I get a lot of questions about my health and emails wishing me well, often based on incomplete information.  Of course since have incomplete information, that’s no wonder.  So here’s some slightly more complete information.

We’re back to watch and wait.  Ideally, forever. But maybe not.

When I saw my endocrinologist before I left for India on Jan 9th, he read my situation a little differently than the oncologist, as in he thinks I’m in a different class of patient (and was unworried enough to want to talk about teaching evaluations, which I took as a very good sign).

But both of them are singing the same tune in terms of next steps.  In a couple months (give or take) I’ll have a scan that will give us a sense of what’s happened since the “new” baseline set in December, and then we’ll do partial scans throughout the year.  What they are looking for is when the cancer starts “trying to grow” at a considerably faster rate than it is right now.  When that happens, the slow-growing thyroid cancer is trying to start behaving like a more aggressive cancer, so the drugs start.  Once I’m on drugs, I’m probably on drugs forever.  At least with the medicine at where it is at today.  The thing is that “trying to grow” phase could come soon, or it could come in 10 years or even later.  And there are no other experimental treatments to try right now (the lithium/radioactive iodine was their best shot).

So now we pay attention every few months, and otherwise we suspend attention.  “Watchful waiting” it’s called, but I like to think of it as blissful denial punctuated by periods of intense ambiguity.

This is the best possible outcome at this stage, so around here we’re considering me lucky.

Some Suggestions for Improving the Humanities Dissertation and Defence at McGill

…or at least the dissertation in Communication Studies.

How do you improve the dissertation and the defence?  A few weeks back, the faculty members in Communication Studies at McGill met to talk about the graduate curriculum and these topics came up.  But some changes we would like to make would be impossible in the current system.  Right now dissertations and defences at MCGill are governed by a set of regulations imposed by the Graduate and Professional Studies Office at McGill.  In addition to writing to Dean Martin Kreiswirth (who to be completely fair, seems quite open to reform–I don’t want to make it sound like we’re “fighting the man” here), I decided to post these comments publicly in case they would be of use or interest to others either at McGill or at other institutions.

I want to be clear that a) our proposals for the COMS PhD are still in the discussion stage–nothing’s been adopted yet (and some may be impossible to do) and b) the opinions expressed below are solely mine. (I am not speaking for the CS faculty.)

Background for non-McGill people: McGill’s thesis rules are an interesting hybrid of American and European models.  So some of these rules may seem bizarre if you come from one or another system.  But that’s McGill for you — a strange hybrid of American and European bureaucracy.  Within our own universe at one time or another all these procedures made sense.  Some still do, like the pro-dean, and some do not, which is the purpose of my discussion below.  I’ve got full details on some distinctive aspects of the McGill PhD and defence process after my comments below if more background is needed.


1. At our retreat, we discussed restructuring the defence as a public talk.  The student would give a 40-45 minute talk that would be more like a dissertation summary that could be used in a job talk or as the basis for a précis-type article. I  realize not all doctoral students are going on to be academics, but a public lecture would be a more substantial way to honour the expertise they’ve earned, and it would also allow community members (friends or other students) real grounds to participate.  It’s also a good bet they will have to make presentations no matter what they do in life.

The idea would be: the student gives a public talk, committee members each ask a question in turn, then we move onto broader audience discussion.  Perhaps committee members would have to provide at least a short written response as well that the student could digest in good time.  The internal report and external report would stay the same as they are now and students would be able to revise their theses after the defence as per current custom (when needed).  This ventures pretty far from the guidelines sent to pro-deans at the moment (I just read the new ones while pro-deaning in cosmology) and we couldn’t do it unilaterally without pro-deans arriving with proper instructions.

Right now, defences are organized under the illusion that they are tests.  But after something like 60 dissertation defences, I can’t honestly say that I believe testing is their primary function.  They are largely ceremonial, though often they do help guide suggested revisions to the thesis. (Our proposed formal still provides for that.) And often students aren’t in a position to really hear or make use of the feedback they receive in defences. The event itself is an exceptional exercise, unlike other things they will be asked to do in their careers. The proposed idea above makes it more like other kinds of academic work in the humanities, and public work besides.

2. Because of the committee and funding systems we are moving to, GPS needs to get rid of “not close” requirements for committee members or at least relax them.  Right now, McGill requirements are that a majority of the dissertation defence committee members must not have been closely involved with the student or thesis research.


The “arm’s length” requirements are based on the idea that only people not involved in a student’s education can be objective enough to judge a thesis.  This is out of step with common practice. Most American and Canadian humanities programs expect that a committee (or  large portion of it) has been engaged seriously with the student at many different times before the defence, and in some cases, consistently throughout the program.  This also appears to be the norm in humanistic Communication Studies programs in the US and Canada.

Right now the “arms length” requirements lead to a situation potentially detrimental to the student.  For example: Communication Studies is moving to a 3-person committee system so the student cultivates relationships with faculty members (this has been happening informally but it is something we aim to formalize).  This is not a “supervisory committee”–we maintain sole supervisors–but simply a supervisor and two other faculty who are charged with “looking after” the student for progress tracking and consultation purposes throughout their program–again, something that is super common in humanities programs in US universities.

While not all students go on to academic jobs, I know of no situation where a student would not benefit from having references from three people who know that student well and are interested in that student’s progress during in-program time.  Under current rules, you have a situation where either letter-writers must not be present at the defence, or you need a 7-person committee.  Neither is a good idea.  Both are bad for the student and bad for the professors.  A 7-person committee leads to too many cooks in the kitchen for the student, and in small programs like ours leads to either a lot of work by core faculty or a lot of calling in favours (or owing them).

Additionally, the conflict of interest guidelines for internal reports are too strict, especially as we are moving to a 4-year funding guarantee.  It is entirely conceivable that in the new committee and funding system, a student might work as a research assistant and even co-publish with two committee members besides the supervisor.  Many of us in Communication Studies are getting more and more likely to credit RAs as co-authors or even actively collaborate with them in writing–more of a science or medicine model for publication (and again good for students).  Suddenly, none of those people can write the internal report because it is a “conflict of interest,” even though the internal report is a great first draft for a letter of recommendation.  Again, we’re in a position of wasting faculty labor and removing people most qualified to comment on the thesis from commenting on it.  I can hear a potential response being “but the student should hear outside opinions.”  Yes, of course, they should, which is why we encourage all of our students to publish and present their work at conferences and almost all of them do.  After over 60 defences, I know for certain that the defence is not the best time or situation for that, and it’s tremendously taxing on faculty resources in a high-achieving department like ours where faculty are working with lots of students and colleagues, traveling all over the world, and in high demand from professional organizations, all while maintaining a significant graduate program.  If this was actually for the purposes of mentorship or education of the student, I could see doing it, but that is simply not the case.

3. Current guidelines about the form of the dissertation are much too strict.  We need more flexibility about format and a strong commitment to fair dealing on the part of the thesis office.  
With multimodal platforms like SCALAR coming into wider use in the humanities, it is entirely conceivable that a student could write a solidly argued, coherent and smart humanities PhD thesis that does not follow a linear, consecutive pagination model, and which actively incorporates audio-visual material other than still images, some produced by the student and some produced by others and marked up under fair dealing.  Although all dissertations at McGill are primarily digital documents at this point, there is no provision for these kinds of things to be in the document, and the GPS guidelines for dissertation format are so structured and limiting that they actually mitigate against multimodal scholarship.  I just taught a digital humanities oriented seminar on sound studies and visual culture and with the existing guidelines in place, I’m left in the position of telling students “this is the direction your work should go if you’re working with multimedia material as a research object or if you produce it as part of your research, except for the dissertation.”

Finally, none of this last paragraph is relevant to the discussions above, but I’d add that there some other working assumptions about the PhD in our unviersity-wide discussions that aren’t true.  For instance, in the recent IPLAI report on the future of the PhD (and note that I would have been at that public discussion had it not been scheduled again a Media@McGill conference I had organized), it is clear that the assumption is that dissertations are not generally completed under some kind of deadline duress.  But most appear to be.  Not all by any measure, but especially with the drastically shortened times to completion we now expect (because of Quebec funding, not pedagogy), more and more theses will be completed under deadline duress. I am also concerned about the abandonment of scholarship recommended by some parts of that document (a teaching portfolio is not a PhD), but that it for another conversation.

[end of edited letter]

Some provisions that might be unfamiliar to people not at McGill (you can skip this part if you work at or attend McGill):

–> we have something called a pro-dean, a person from another faculty who runs the defence.  This separate the event-management from the intellectual dealings, which is great.  Assistant profs don’t have to reign in cranky senior colleagues (yes, I’ve seen this happen at other universities without the pro-dean).  That’s why I ran a defence last week in Cosmology–which was really cool to do and I had some great conversations with scientists afterward.  Yes, we still don’t know what happened before the Big Bang.  Glad I cleared that up.

–> Our theses all have to have reports written on them before the defence.  One report comes from an internal examiner who is not the supervisor and one comes from someone at another university.  This insures that theses are defensible before they are defended.  It is a big hassle and a lot of work but I kind of like it anyway, and the student gets substantial written feedback, which is important (and let’s face it, by the time you submit, you know what your advisor/thesis supervisor thinks).

 –> dissertation defences are governed by a strict set of rules.  Committees have be a majority of people not connected with the work leading to the thesis, and dissertation defences must follow a fairly standard protocol, involving a public introduction by the student, followed by two rounds of questions from committee members, followed by (sometimes) audience questions.

–> provincial funding is tied to student enrolment here, which means PhD student have very strict deadlines for completion.  In other words, Quebec gives McGill a certain amount of money for each grad student enrolled, but only for a fixed period of time.  That means that the university has a financial interest in short times to completion.  While I’m not a fan of the 11-year-thesis plan, the administration now considers it aberrant (to the point of kicking the student out) if the thesis takes more than six years from initial enrolment in the PhD.  While students can still finish (and re-enrol to deposit the thesis), this has drastic implications for students’ access to deferments of loans, acquiring additional financial aid, and let’s face it, getting kicked out of school is bad for self-esteem.  The last study I saw said it’s 7 years on average to the PhD across the humanities, and some kinds of PhDs take longer.  Language learning, for instance, is not something that can be “hurried along” and archival research and ethnography take time and money.  I moved through my MA and PhD in six year combined, but I don’t actually expect my PhD students to be the same person I was.  Personally, I really regret not being required to (and fulfilling the requirement to) master another language for scholarship.  My career is poorer for it, though I am good at statistics (we had a quant methods requirement, but I learned most of my stats as an undergrad).

More on Cancer, Luck, and Behavioural causes

A day later, I’ve been pointed to some nice writings but scientists and statisticians. See here:

A few things become clear: 1) the coverage is of the press release, not the actual paper but 2) there are still major problems in the assumptions of the paper.  The “luck” appears to be mostly an artifact of the press release and the abstract, though the analysis remains flawed. The lack of social and environmental analysis is definitely a property of the paper. And of course most of the journalists reporting it are innumerate to boot.

Statsguy has a wonderful critique of the article, but winds up writing about lifestyle as a cause for cancer, and I’m sorry, without environment and social analysis, that’s just bullshit.  Yes, HPV causes cervical cancer and smoking causes cancer, but what causes smoking?  And neither of those things are good explanations for breast or thyroid cancer, whose increasing prevalence appear to result from a combination of changes in diagnostic technology and practice and environmental causes.

So it would be wrong to say cancer in general is “behaviourally” caused. Some cancers are behaviourally caused, though even there, how you could say smoking causes cancer and not also look at policies that promote the tobacco industry around the world, I don’t know. Ditto for the HPV vaccine.  If HPV causes cervical cancer and the HPV vaccine prevents the cancer, then it suggests to me the important behaviour is vaccination, not sexual activity.

There’s a whole layer of moralizing that goes on top of the behaviour talk–which is typical of American (and I’m assuming some other) medical culture. But that will have to be for another post.




Medical Research as Ideology: Cancer is Luck

A new Johns Hopkins study finds “luck” as a major cause of cancer.

This is a great example of how medical research turns social conditions into inevitability and writes ideology (the order of things is given and unchangeable) as if it were science.

While there is talk of personal responsibility as a possible cause for cancer (“behaviours”), there is no talk of social responsibility (which might have something to do with changes in the environment over the last few generations). The only known cause of thyroid cancer is radiation. Other cancers are well known to be environmentally caused. So if, as the article says, we know cancer is caused by a combination of “luck, environment and heredity,” and the luck is more important than we thought (duh), then the logical conclusion is that if we are concerned about the spread of cancer, we ought to be thinking about the environment.

Sure, I’m all for fatalism as an explanation for why I have cancer and the person who experienced the same conditions doesn’t. But since we know certain cancers –including mine–are greatly increasing in the population overall (at least in the US and Canada, I don’t know worldwide statistics), we might actually want to go looking for explanations and solutions.

2014 in Review

It’s been a really complicated year–some major highs and lows. We’ve spent the last couple days on unfinished business: seeing Laura Poitras’ gripping CITIZEN FOUR (highly recommended), doing our donations for the year, and it looks like I am actually going to get an article revised that I thought I might not be able to do.

2014’s highs included a semester at Microsoft Research and a month at Folger Shakespeare library, new friends and reconnecting with old ones, lots of opportunities to do original research of both the archival and ethnographic kinds, a really amazing graduate seminar and conference, five PhD students finishing, lots of great trips and talks and meeting new colleagues at distant places, and especially our first trip to Sweden. Also 2014 was the year I performed solo electronic music for the first two times (thank you Boston!), came out as a member of a country band, discovered the joys of modular synthesis, and bought an electric guitar and took a few lessons (I’m terrible but it was fun).  The kittens have been a constant happy obsession since they arrived in August.

Lows included being apart from Carrie for weeks at a time, including when our 19-year old cat Ya-Ya died, and later when, her grandmother passed. My own medical adventures have been a bit of an emotional roller coaster and I’m still digesting it all.  Carrie’s dad’s hospital visit was a bit of a scare and yesterday, I just learned of the passing of one of my best friends from graduate school, Greg Dimitriadis. Mortality is all around.

If I had the energy, I’d write a longer blog post (especially about Greg), but this will do for now.  It’s okay by me if 2015 is a little less eventful.


I got what I wanted, sort of

So after having three (yes 3) of my doctoral students defend their dissertations Monday and Tuesday, my reward was to spend yesterday and today getting tests and doctoring.  The good news is that they have decided to go back to watchful waiting for now.  I will have another full body scan in three months (this time including brain) and after that, they will probably break it up into various different kinds of scans for different body parts. But I have to say meetings with a medical oncologist are nothing if not sobering.  Right now the disease isn’t doing much of anything.  It might continue to not do much of anything, but once it starts “trying to grow” it can move very fast and go from a slow-growing don’t worry about it cancer, to the standard aggressive, take over your body, lights out kind of cancer.  And I’m now fully in their system, which is quite functional and efficient, but I’d definitely not be at the place I’m obviously at in triage. It means they think it’s serious.

Now more of the good news.  The oncologist said “I’m not impressed by your tumour.”   Music to my ears.  The CT scan report shows my lung nodules are more or less unchanged since July.  The big one was measured a little smaller, but within the realm of human error, so I don’t think the radioactive iodine had any effect.  My thyroglobulin is down (that’s the tumour marker in my blood), which is very good.

They also assigned me a primary care doctor (oh the irony, I now have two and many people in Quebec have none), who specializes in young adult cancer patients.  Because that’s my category.

Thanksgiving update

It’s American thanksgiving!  I’m thankful for my wonderful family and friends (some of whom I will see tonight at a potluck), KITTENS and CARRIE, great colleagues and students, as well as for the kindness of strangers. Since I last posted, I got a little information on but the ThyCa people managed to manually add me to the advanced thyroid cancer listserv, where I got much more good information (including help with a list of questions for the doctor today).  I am also grateful for socialized medicine and the fact that I like in a place where there are people who do research on thyroid cancer (and that the cancer wings of the Jewish are better funded and more functional than some others).

So, onto that.

I went to the medical oncologist today.  The discussion was serious but inconclusive.  There is another CT scan in my future and I’ll be talking with him again in a couple weeks while he gathers more information.  Here’s what we know: My thyroglobulin (that’s a tumour marker in the blood) is down from 57.5 to 40.2 after the radioactive iodine.  The CT scan report is woefully vague–it says there is no visible update but does not describe the size of the lesions in my lungs.  So there will be another CT scan.  Also, there is some confusion about prior RAI uptake in my lungs in 2010.  So he will talk with my endocrinologist, we meet again in two weeks, and the CT scan happens thereafter at which point we come up with a program for treatment or non-treatment.

The options are:

1.  Exploratory lung surgery to get an absolutely firm diagnosis.  This isn’t likely to be necessary as everyone is pretty certain it’s thyroid cancer.  If it weren’t thyroid cancer, there would be a whole other set of questions.

2.  More watchful waiting, which means regular CT scans and followups.

3.  Medical oncology treatment with tyrosine-kinase inhibitors, which can slow or stop the growth of metastatic thyroid cancer but do not reverse it.

I’ll know more in two weeks, but even then, it will probably be a bit longer before we’re certain how this particular episode will shake out.