You can’t change the past. And, even if you could, would you?
Posted on June 30, 2023
If you only have a minute…
In this blog post, I reflect on past decisions and relationships, and wonder if I would change anything if given the chance. I explore different timelines and decisions that led to where I am today, and ultimately conclude that every choice, no matter how insignificant, played a role in shaping my life. While I may occasionally wonder what could have been if I had made different choices, I am content with where I am now and the person I have become.
Have more than a minute? Here you go:
It’s the spring of 2006, and I got a strange email from someone who reads my blog. She tells me she is also interested in public health, and she has been reading my journey through the MPH program at George Washington. I thank her for reading, but I don’t leave it at that. That April, we go to a museum exhibit in Philadelphia, where she is from. “Have you ever been to the Mütter Museum,” she says. ”Haven’t heard of it,” I reply. ”It’s this really cool museum downtown inside an old building from like the 1700s. They have all sorts of medical oddities there.” While the part about the medical oddities does catch my attention, I am more interested in getting to know her better and figuring out how to do so when I live three hours away in Waynesboro. ”We should go sometime,” I say, hoping to see her again.
We end the date in her Jeep, making out to the sound of a local radio station playing R&B. I look at my watch and decide I have to get going. I have to work at eight the following morning, and I still had three hours to drive. It was almost midnight. We agree to go to the Mütter soon, but we don’t. I see her again in person again in May, at a cross-country adventure race for which I foolishly sign up to impress her. We chat at the beginning of the race, and then we don’t talk again for two years. By then, I had already met the love of my life. The “Philly Girl” timeline expired.
It’s July 6, 2000, and dad and I just arrived in Waynesboro, Pennsylvania. We had been driving since Monday, and I was supposed to start a job on July 10 at the local hospital. They had recruited me through an online service where I uploaded my résumé at a time when not many people did that. The recruiter from Harrisburg called me early one morning and asked if I could fly up for an interview the next day. I did, and the lab manager offered me the job right then and there at the end of the interview. “Just like that, huh?” my dad asked. ”Yep. Just like that.”
We drove around Waynesboro to get to know the town. I’d be living there for what I expected would be a while, so we drove to see the parks, the schools, the grocery stores, and the restaurants. One restaurant that caught my attention was “Los Gringos.” It advertised Mexican food, so dad and I had to check it out. We walked in, sat down, and ordered our meals. It was the usual fare for any Mexican-style restaurant far, far from the border: Beans, rice, some sort of protein, a tortilla, and some shredded lettuce with tomatoes. As we were halfway through our meal, the server showed up with a little bowl of corn tortilla chips covered in sugar and cinnamon. “I didn’t order these,” I said. ”They’re complementary,” she answered. “They’re called buñuelos.” ”No, they’re not,” I answered her with a smile. She just turned around and walked away.
A different server took over for the rest of our meal. Dad wondered what happened, why the first server seemed upset. We left a $20 bill for a tip and left.
Six months later, the first server showed up at the emergency room at the hospital. She was in nursing school, and she was doing a clinical rotation there. Someone at the ER was related to her in some way, so they were also testing her to hire her. They usually did not hire new nursing graduates, but I guess a special dispensation was made because of her connections. Not that I’m complaining.
She was easy on the eyes and checked-off most of the attributes I associate with beauty, including brains. So I made an effort to go to the ER as much as possible when working the slow overnight shifts, hanging out and talking to her and the others. One night, I asked her for her number, and she gave it to me.
The next few weeks would be a little convoluted. She told me about recently breaking up with her high school sweetheart, so she was reluctant to date someone else. “Part of me hopes he’ll come to his senses and leave his current girlfriend to return to me,” she told me. Perhaps stupidly, I told her I’d be patient. We went to the movies, to a friend’s music gigs, and for some good conversations at a Waffle House. One night, while leaving a pub in Gettysburg, I reached over and brought her toward me. I kissed her, and she went with it.
On the ride back to her place, she told me she wasn’t a “PDA kind of girl.” When I dropped her off, I kissed her one more time, but she didn’t seem as interested.
She called me the following morning, asking me if I could come over to her apartment. I was over in a flash. We made out on her couch for a while before she suddenly stopped. She started crying. She could not forget about her ex, and she said it wouldn’t be fair to me if she had feelings for him. I agreed, but I was seething on the inside. All those times we went out. All that fun we had. All those conversations. All that was done and over with. It felt like a breakup without it being an actual breakup. “I could have loved you,” I said as I walked out.
The “Sunshine” timeline fizzled shortly thereafter.
It’s 1998, and I’m in college. A girl I chased after in high school has reconnected with me, and we’re hanging out at my apartment. We’re going to a concert that night along with my cousins. “So you want to work in the hospital, but you don’t want to be a doctor?” she asked. ”I mean, maybe I’ll go to medical school, but that’s not the main path,” I tell her. “It’s an alternative.”
”You’d make a good doctor,” she said. “In fact, do you want to play doctor instead of going to the concert?” she asked with a coy smile on her face.
The human brain is a weird thing. On the one hand, it was flooding with oxytocin and many other substances to reward the physical me that I was on a couch with a young and fertile female. Hormones raging, I wanted to tell her that, yes, we should stay in my apartment and do all sorts of things… Some of which were prohibited in the Great State of Texas at that time. But not my brain. My brain wanted me out of El Paso. My brain did the quick math and realized I had no condoms anywhere within walking distance, and that the odds were low that she was on any kind of birth control. My brain reached out and took her hand away from my pants and made me jump up. “So… We ready to go listen to some tunes?” I asked.
We had fun at the concert. We couldn’t keep our hands off each other during and afterward, but I drove her home. We went out on a couple of dates, but nothing at my apartment or her parent’s house. She finally told me she was looking for more, especially since she wanted out of her house. “I can tell you’re not that into me,” she said.
”It’s not that. Don’t get me wrong,” I said. “You’re pretty, and I’ve liked you since high school, but…”
”But?”
”But I don’t want anything serious right now, and I don’t want to be a teenage dad.” Lord knows there were enough of those in my extended family.
We talked on the phone once or twice. And I did see her when I visited El Paso in 2003. But the “High School Crush” timeline went nowhere.
And that’s just the timelines of three of the maybe dozen women I dated before I met my wife. There’s the “Green-eyed Monster” timeline, the “You’re How Old?!” timeline, and the “There’s No Such Thing As A Hypoallergenic Cat” timeline. That last one was a doozy.
There are also all the timelines generated from the decisions I had to make about my professional development. Many people in my life did not expect me to go to college. They expected me to go into any of the many menial jobs people like me were recruited to, not because we could not perform well in college, but because of the color of our skin and our national origin. If I had a dollar for each time, I’ve been asked if I’m for hire at places like Lowe’s or Home Depot.
I wonder if it’s because of my age (and accompanying maturity) that I have less regrets of the decisions I made. Or maybe it is that I am in a good spot in life, so I don’t feel the need to feel regretful. I do know that some decisions I made that felt the most consequential were not done alone. Some of them were done for me, such as when my cousin gave me money to pay the application fee at UTEP when I asked him if I should apply. Or when mom and dad sent me to live with my aunt in El Paso, when they wanted me to have a better education than what I was getting in Mexico.
Reflecting on the different timelines and decisions that led to where I am today, I am struck by the realization that every choice I made, no matter how insignificant it may have seemed at the time, played a role in shaping my life. While I may occasionally wonder what could have been if I had made different choices, I am content with where I am now and the person I have become. In the end, the past cannot be changed, but we can learn from it and use those lessons to shape our future.
Thank you for reading. Please check out more of my thoughts over on my Medium.com blog at: https://medium.com/@epiren
Or listen to my ramblings on the Epidemiological Podcast: https://anchor.fm/rene-najera
Stalk me on LinkedIn: https://www.linkedin.com/in/renenajera/
Or be a total creep and follow me on Facebook: https://facebook.com/rene.f.najera
What’s that? I’ve blocked you? Well… ¯\_(ツ)_/¯
It Was Worth It Just to Learn Some Sleight of Hand
Posted on June 2, 2023
If you only have a minute:
I reflect on my experiences with falling for scams and the importance of learning to resist them. I discuss how con artists prey on loneliness and biases to gain confidence, and emphasize the need to teach people how to discern and resist scams as they grow up.
If you have more than a minute:
I was listening to a podcast episode from “Cautionary Tales” about how smart people can fall for con artists and do some stupid things. The person being profiled in the story is a physicist who thinks a beautiful woman in Belgium wants him to put drugs in a suitcase and take them to her. It was all a scam. The professor ended up doing time in jail in Argentina. While the scam was going on, his friends told him the whole thing was too good to be true. Even as it was explained to the physicist that a supermodel couldn’t possibly be interested in him, and that she couldn’t possibly ask him to take drugs from Bolivia to Argentina, the physicist doubled down. He was too deep on the scam and refused to think it was a scam.
We’ve all been there… without the drugs and Argentinian prison.
When I was ten years old, one of my cousins sold me a plot of land. The land wasn’t his, and it wasn’t so much a “plot” of land, as it was a one-foot by one-foot square out back behind his house. I forget how much I paid for it, but mom had a lot to say when she found out. She talked to my cousin and had him return the money to me. She then explained to me how people could take advantage of me if I wasn’t careful. She asked me to always check with her or my dad when things seemed too good to be true. That by itself wouldn’t stop me from getting swindled a few more times, but at least I did some due diligence.
Figuring out how to counter the swindlers took a toll when I started to recognize the swindler another one of my cousins had become. The dude was relentless when it came to trying to get something out of someone, anyone, and then doubling down on his schemes when they were found out. He could do no wrong, and his parents — who taught him everything they know about manipulation — were all too happy to side with him when he got us all in trouble. I don’t blame them, though. You do that for your kids… except for my mom. Mom was quick to let me know when I was wrong. It was her way of preparing me to be a responsible adult.
Later, when my wife and I were in Italy, a Black man approached us at one of the many tourist spots. He spoke English well, and he told us how he wanted us to have children. For that reason, he said, he was giving us a special bracelet that would help us get pregnant. We turned it down. The scam goes like this: He gives us the bracelet, saying it’s free. We take the bracelet, thank him, and walk away. A few moments later, he would chase us, claiming we had stolen an expensive bracelet. To buy his silence, he would ask for some money, then we would settle on a smaller amount than originally requested. If we didn’t give in, he’d call the police and attempt to accuse us of stealing. Many tourists fall for this, and they decide to pay the twenty dollars to avoid the hassle of dealing with the police. Not us. We gave him back the bracelet, and when he insisted, I did the whole “big chest and broad shoulders” and explained to him that it was going to get loud and bad for him soon. I felt like a jerk, but I’d rather feel like a jerk without being one than feel like a sucker and be one.
The biggest scam I ever fell for was when I sold a phone on Ebay. Someone in Boston bought it and paid with an electronic check. Ebay clearly warned me not to mail anything until the electronic check cleared. I didn’t. I wanted to get it over with and get rid of the phone, so I could buy a new one. The next day, the person sent me an email asking for the tracking number. They said they wanted to make sure they were home when it got there. I gave them the number. A few hours later, I received a notification that the package was redirected elsewhere in Boston. I didn’t think anything of it. I redirect packages all the time when I know I’m not going to be home and don’t want a box sitting out front too long. Hours later, I got a notification from Ebay that the electronic check had been recalled. And that was the end of that… for a couple of days.
Realizing I had been scammed out of a phone, I called the phone company and put a lock on the phone so it could not be activated unless I approved it. Basically, I “bricked” the phone, making it an expensive piece of hardware. Sure, someone might eventually figure out a way to unlock it, but it was locked at the IMEI number level. What happened next was hilarious: The person who “bought” the phone emailed me to ask that I undo the lock. I said I’d do it if they sent me the money, to which they replied they had no money. And then another email a day later begged the lock to be undone, because, according to them, they had sold the phone to “a dangerous dude” unhappy to have been sold a brick.
“Good luck,” I replied. I never heard from them again. I hope they’re okay.
The worst thing is that loneliness is growing in the United States. It has even become the subject of a warning from the US Surgeon General. And it is that loneliness that so many con men pray upon to trick us into doing their will. They tell us we’re alone, that no one understands us. They tell us they understand us like no one else, and they confirm our biases to gain our confidence. (”Con”-fidence, get it?) That’s the shtick of so many out to get theirs at the advantage of others, too. They tell trans kids they are in the minority, so they don’t count. They tell immigrants they are not home, to “go home,” and that they don’t count. They tell bigots that they’re the silent majority, and that they have billions of people behind them to support their bigotry.
It’s all a con.
Same with the anti-vaccine showmen. They tell worried moms and dads that their worries are real, and that multinational drug companies are out to injure or kill their children. (Because that makes a lot of sense, I guess?) They confirm biases and sell products. They ask for donations and compare themselves to the persecuted classes of the present and the past. And they do it with a big old smile on their face. To them, the “there’s a sucker born every minute” phrase is a mantra, a way of life. And they’ve convinced themselves they are not doing anything wrong. After all, if they’re wrong, why would so many people follow and give to them?
I write all this because learning to discern and resist scams is one of those things that should all be taught one way or another as we grow up. There will always be people out there too lazy to do honest work, and smart enough to get away with scams. Instead of benefiting humanity with their intellect, they think about benefiting themselves. They wake up in the morning and wonder who they’ll scam and how they’ll do it. The rest learn from mistakenly going along with a scam. While most of us will be more annoyed than impacted in a serious way, there will still be enough people badly hurt by the scam.
So I’m left with some ideas on how to teach my kid not to fall for scams and manipulations, but there really isn’t a good curriculum on how to do this effectively. I could let her fall for a harmless scam or two, so she can learn a lesson. Or I could protect her against all scams, and not let her learn valuable life lessons. Of course, I’ll do something in the middle, where she falls for something, learns, and is immune against something worse. All the while, my door is open for her to consult and receive advice on something that seems too good to be true. And I’ll keep her away from that side of the family, which is so manipulative, so scammy… Which is just as well. They’re a bunch of antivaxxers, anyway.
The Fights You’ll Have With Unreasonable People
Posted on May 20, 2023
If you only have a minute:
In this blog post, I talk about my experiences engaging in charged debates, particularly around topics like abortion, LGBTQ+ rights, and gun control. I tell you about my frustration with encountering falsehoods and half-truths, but emphasize the importance of maintaining composure and presenting evidence and accurate information. I believe in the power of education, context, and organized action to create meaningful discussions and advocate for change on a larger scale.
If you have more than a minute:
When I lived in El Paso, one of my aunts used to drag us all to Sunday services at her church. And I mean services, plural. There was one service in the morning and one in the afternoon. The morning one had a “Sunday School” component that included lessons about the Christian Bible and their associated morality tales. After a while, those services became less about worship and more about intrigue. As I grew up, I started seeing how rumors were the currency of the day in that church, and who was dating whom was the game we all played. And I write “we” because I slowly got sucked into that world of intrigue shrouded in religion. But there was one event that slapped me in the face and began my exit from those circles.
At one of the services, a woman stood in front of the room after asking for time to give her “testimony.” Usually, this was a moment when a member of the church stood in the front of the room and related their literal “Come to Jesus” moment. It was done to encourage non-believers in the audience to join the church. Instead of giving her testimony, she read a poem about abortion. Written from the point of view of a fetus, the poem gave a detailed account of what — in her mind — an abortion procedure looked and felt to a fetus. It was graphic, for lack of a better term. And it ended with the soul of the fetus getting to heaven, only to be turned back around to head back to Earth for a second try. (Reincarnation is not a core belief of Christianity, if I’m not mistaken.)
People in the audience went wild over her poem, praising God and praising her for being so brave in writing it and telling it. By the end of the service, a small contingent planned a protest at a local clinic they believed was an abortion clinic. (It was a women’s care clinic that referred people for abortions at another clinic across the city.) Me? I was disgusted. There was something about her description of what she believed was an abortion that did not jive with me. I spent the better part of two days the following week in the library, looking up all the evidence for and against abortion procedures, including ethical considerations. As it turns out, the poem was less than honest… And it made me wonder why someone professing to be so religious would rely on lies? But I gave her the benefit of the doubt and chalked it up to misunderstanding of anatomy and physiology, and biology, neurology, and physics.
Later on, once I was in college, I fancied a girl who invited me to a young adult Bible study group. Once more, the topic of abortion came up, and I was left dumbfounded once more when one of their leaders suggested we lie and tell women that abortions led to higher rates of cancer and depression. (This is a known ploy by anti-abortion activists.) “Does it?” I asked. ”Well, the scientists will tell you it doesn’t,” the dude said. “But you can see how losing a child will cause you to be sad and cause your body to rebel against you.” ”So my aunt, who died from breast and uterine cancer… She had an abortion?” I asked. ”Not necessarily, but she did something to make her body do that to her,” he said. He added a smirk, which almost sent me into a rage. ”Yeah, I can see how genes written when an egg and a sperm fuse together predict how you’ll treat your body,” I said. “Thing is, I’m studying a shit-ton of biology and other sciences, and you’re lying.”
I was never invited back. And just as well. Some people can’t be reasoned with.
Years later, once I had my master of public health degree, I traveled with my wife to Denver for one of her conferences. While she attended her talks, I walked around the downtown area and stumbled across a small group of “college students against abortion.” They were eight or nine men, and one young woman. They had a sign up with statistics on the number of 911 calls from incomplete abortions where medications were used. Their message was that even abortion pills should be banned, because women could have incomplete abortions and require medical care. Oh, I had questions… “What proportion of all women who take abortion pills have to call 911? How does that compare to uninterrupted or planned pregnancies? How does that compare to other reasons for calling 911? How does that compare to needing medical care for painkiller overdoses, car accidents, or drinking too much?” They also had the prerequisite images of products of conception to show the “horror” of an abortion. (You’ll see why this is important in a few seconds…)
Once again, I was trying to reason with people arguing with lies and half truths. This ritual would repeat itself, not just with abortion, but also with other public health and scientific arguments. Lately, the fight is over LGBTQ+ rights. There are people in the county where I live who are convinced that a “liberal” conspiracy is happening at the school system to “indoctrinate” children into “becoming” gay. At a meeting of an advisory committee, a self-identified religious man approached me and told me — among other things — that 20% of people who underwent gender transition “regretted” it. “These young women — girls! — are being told to rip off their breasts and close up their vaginas,” he said. “How can we allow that to happen to children?”
Again, either lies or an incredible misunderstanding of the evidence. The evidence tells us that less than 1% of people who undergo gender transition regret doing so, and many in that 1% regret it because of the societal consequences of doing so. They experience high levels of anger, hate, and marginalization. They express regret because they received some respect when they hid their identities in more “typical” identities. Once they were public with who they really were, the reaction was such that it caused regret. This “man of God” told me something that did not agree with the evidence, and the good side of me (the little angel on my shoulder) tells me that he doesn’t know better.
The bad side of me is not as understanding. It doesn’t stand for baloney.
Then there is the fight about guns. Somewhere along the way, the United States went from having an agreement between people and the government that the people can and would rise against a tyrant… To a murder/suicide pact where gun violence was allowed to be the number one killer of children. Like other cultural controversies, there are lies and misinformation galore, like the easy-to-say but hard-to-prove sayings like “an armed society is a police society” to fallacies like “guns in schools make schools safer.” This is not to say that gun control advocacy doesn’t have an extreme element, but that extreme element has not led to increased risk of death to children with its proposed fallacies. (I could be wrong, though.)
I participated in a meeting of a group working to reduce gun violence, and one suggestion was to publicly show images of what bullets fired from guns by people can do to the bodies of children. One of the proponents mentioned that pictures and depictions of people with cancer have deterred people from smoking. Road safety organizations frequently show crashed cars, or post a marker of where people have died, all in an attempt to persuade/dissuade the public to change their behavior. Well, that’s not for me.
It’s not for me, because it’s playing the same game that the anti-abortion activists play. They show graphic images to elicit the disgust reflex and associate it with the medical procedure. It’s health behavior 101: trigger the disgust reflex to discourage a behavior. This is why you always see people smiling when they’re going for a walk in a commercial about the benefits of exercise for obesity, but they’re dying from cancer in a commercial about the dangers of smoking. In the case of gun violence, most people are likely not to shoot children with military-level weaponry. (Just like the overwhelming majority of people don’t want to have an abortion procedure, but some must because of life circumstances. Or how most people don’t want to die of cancer, but some became dependent on nicotine at an early age.)
There are many other avenues to get politicians to change laws to prevent people at high risk of violence from accessing firearms. Violent imagery will not do the job, in my opinion. What will? People organizing in enough size and intensity that the elected change their mind or face losing an election. And how do we organize people in enough size and intensity? We put the problem in context, inform them of the risk, and work with organizations to mobilize the voters. It has happened before, and it will happen again… I hope.
In the meantime, I’m going to have to figure out how to deal with charged subjects in public without getting too emotional about them. My whole life, I’ve been passionate about subjects near and dear to me, and my reactions have gotten me into trouble for time to time. (Not legal trouble, because there are some lines I won’t cross… As per above.)
Navigating the realm of charged subjects and engaging in debates has been challenging at times. From my early experiences in the church — witnessing the manipulation of emotions through distorted narratives about abortion — to encounters with individuals spreading misinformation on topics like LGBTQ+ rights and gun control, I’ve come to realize that reasoning with those who rely on lies and half-truths is an exercise in futility. It’s disheartening to see how facts and evidence can be twisted or ignored to support personal beliefs or agendas. But I’ve also learned the importance of maintaining composure and finding effective ways to address these issues… Even when it’s hard to do.
Instead of resorting to the same tactics used by those I disagree with, such as presenting graphic imagery or triggering emotional responses, I believe in the power of education, context, and organized action. By presenting the evidence, providing accurate information, and putting problems into perspective, we can create a foundation for meaningful discussions and informed decision-making. Mobilizing voters, working with organizations, and advocating for change on a larger scale can lead to tangible progress.
It is essential for anyone engaging in these debates to temper our emotions and approach the discussions with rationality and empathy. While it can be frustrating to encounter falsehoods or misconceptions, maintaining a level-headed demeanor will allow our arguments to carry more weight and credibility. It’s a challenging balance to strike, but it’s crucial to foster productive conversations that can lead to positive change.
Moving forward, I’m committed to honing my skills in addressing contentious subjects without allowing my emotions to overshadow the facts. By doing so, I hope to contribute to a more informed, respectful, and evidence-based discourse in society. It’s a continuous learning process, but one that I believe is vital for progress and understanding in a world where strong subjects often dominate public discourse.
I’ve Stopped Taking Things Personally, and It Annoys People Trying to Bait Me Into Arguments or Fights
Posted on May 3, 2023 1 Comment
If you only have a minute:
I have learned not to take things personally, which has made me calmer and less reactive. I share personal anecdotes of how I used to lose my temper, and how I have learned to be more mindful and tolerant. I also discuss how my wife and daughter have helped me become calmer and more mindful. I conclude that most things and people are not worth getting upset over, and focus on what matters to me.
If you have more than a minute:
As I’m approaching my mid-forties, I’ve noticed something about myself. I am no longer bothered by things that used to bother me. I used to be a hothead in my youth. Now, I only get riled up by big and important things. Now, it takes work.
When I worked at a hospital, I chased after a young nurse who worked in the emergency department. (You may know this story already.) One day, after she went out on several dates with the guy who would eventually become her husband (and then ex-husband), I asked her why she didn’t talk to me as much as she used to. Sure, I was jealous that she was dating someone, but I still wanted to chat with her. We had good chats. “If you’re asking me if I love him more than I want to be your friend, then I guess I love him more.”
Dear reader, I grabbed a chair and threw it against the ground and stomped my way out of that room. I was so angry that I missed several important things I had to do before I went home that morning. For hours, no one could talk any sense into me. My brain was flooded with thoughts of wanting to call her and tell her that she broke my heart, and that he would break her heart in due time. (He did, but not because I foresaw it… And it took years, too.)
This was not the only instance of me losing my temper. I lost my temper playing soccer all the time. I would let kids who were better than me get into my head and live there rent-free during the game and for some time afterwards. It would take some time before I forgot how someone outplayed me or made me look like a fool.
Then there was school. Even during my doctoral degree, anything less than an A was a cause for panic. When I failed a midterm exam in biostatistics, and when that led to a C grade for the course, I called my wife and told her how I wanted to quit the doctoral program and save me the stress of not understanding biostatistics. I didn’t quit, of course. She talked me off that ledge and talked some sense into me.
And that is where the transition to who I am now began: when I met her.
We have been married for thirteen years, and have known each other for seventeen. She knows what gets me going and what I could care less about. And she has learned to explain things to me in a way that makes me understand that some things are not worth getting upset over. Someone cut me off on the road? Well, I hope they get home safe. Someone gave me bad service at a restaurant? Well, I hope they get a job that makes them feel better. Some duded talks trash about my ethnicity and tells me to “go home” to my country? Well, joke’s on him because no one is forcing me to return to Texas.
The little girl we have has also had a hand in making me calmer. She is so happy and full of life. She gets sad for ten seconds, then she takes deep breaths and fixes the situation. That is something I’ve practiced with her since she was a toddler. We would take deep breaths when she got upset and ask her why she was crying. It is a way to help her be mindful of the situation and begin putting together a strategy to fix it.
I hope it keeps her out of trouble from emotional outbursts like mine when she is older. As male and female brain chemistry is different on average, I hope she has all my strengths and none of my weaknesses. Because I do have weaknesses, dear reader. I do.
Had I been more mindful of the situation twenty years ago in that hospital, I would have just accepted that the nurse had a boyfriend who told her not to talk to me anymore (for whatever reason, but probably because I intimidated him with my ability to do simple math). I would have moved on faster. I would have focused more on my MPH studies, which would eventually lead me to bigger and better ponds with bigger and better fish.
But I guess this level of tolerance and thinking twice or three times before responding to nonsense takes time to master. It comes with age. Though there are those my age or older who still lose their minds when the smallest thing affects their plans or makes them react. Just the other week, I was playing soccer with some guy a little younger than me, but not much. He was faster than me, so I decided not to chase him around the whole field. I’d be exhausted and worthless before the second half. Instead, I decided to guard the zone where he was and then pull him with me when I had the ball. All the while, I kept pointing out his mistakes or telling him he needed to work on this or that.
Little by little, I crept into his head. Finally, after I kicked the ball from between his legs and shook my finger like Dikembe “Not In My House” Mutombo, he charged at me and shoved me to the ground. His teammates held him back as he went to punch me. Me? I just sat on the ground and smiled. There was no point in fighting. It wasn’t the World Cup. Oh, and my kid was on the sideline. One bad punch, and I’d have to take a trip to the emergency room, or the police station. And who would have taken care of her? Nah… It was worth it to see him lose his cool, get a yellow card, and be useless for the second half of the game, as he shied away from getting that second yellow and making his team lose.
After the game, one of his teammates apologized to me. “He used to play Division One soccer. I’ve never seen him so angry,” he said. ”Yeah, I have that effect on people.”
Of course, there are always things that keep me up at night, like the myriad of public health problems and the seemingly inept ways in which politicians deal with things only to worsen them. I worry about the Republicans who want less government in people’s lives, but they’re quick to pass law after law criminalizing the private interactions between healthcare providers and patients, or between consenting adults who’ve declared their love for each other. I also worry about the Democrats, who can’t seem to control spending. And don’t get me started about the Independents, or the one-issue voters.
But I don’t react (as much) anymore. I look at the attack, analyze it, then determine if it’s worth answering. And, you know what? Most things, and most people, are not worth the bother. My family, my friends, and the people I serve are.
The Parent Ren, Part XIV: Kids, Huh?
Posted on April 29, 2023
If you only have a minute:
I reflect on parenting after hosting my niece and caring for my brother-in-law’s dog. I discuss the different stages of parenting, from speculating about “the child” before conception to teaching and interacting with our daughter. My wife and I have decided to only have one child due to our professional commitments, but have discussed adoption in the future.
If you have more than a minute:
My wife and I hosted my niece for the weekend. We also watched after my brother-in-law’s dog the whole week. The dog has a problem with separation anxiety, so it was a rough first night when he would wake up in the middle of the night and start barking. Little by little, I learned he was just anxious and didn’t like the dark. We live in the suburbs, in a neighborhood where the only outdoor lighting is from other homes. My in-laws live in a neighborhood with streetlights and in close proximity to other homes. So I’m sure the dog was spooked by the quiet and darkness, if such a thing can happen.
We took the girls to the park and watched them as they played. Then we all went for lunch at a local restaurant. The girls proceeded to make a mess, and our food was late. But it was still fun to see them relate and have kid conversations. After that, we went to the grocery store and bought everything we needed for an ice cream party back at the house. We had to herd the two little girls as they attempted to run around the store, grab candy and cookies, and sneak those things into the shopping cart. Then, as expected, the two of them just had to help us with the check-out process.
At the end of the adventure, my wife and I looked at each other and said, “Kids, huh?”
We started talking about children early in our relationship. We referred to the then-yet-to-be-conceived kid as “the child.” And we had many ideas on what this child would be like, and grow up to be. Later on, when we found out an actual child was on the way, “Fetus Ren” became the subject of our speculations. When she was born, “Baby Ren” took up our time like a few other things before.
I distinctly remember sitting in the baby room, trying to read her a bedtime story. But I was not able to read correctly, because we had little to no sleep in the previous day. Foggy mind from lack of sleep is a thing, and I do not recommend it. Once she got into a good sleep schedule, we were lucky to sleep more than six hours at a time. But we got lucky when she started sleeping through the night at around six months of age. Things got better after that, as far as sleeping was concerned.
Of course, the child then got mobile and started getting into trouble. So our time shifted again to keeping her safe. Then it shifted again to teaching her things. And it’s shifting again to showing her how to interact with the world. We traded one set of stressors about parenting for another, and we’ll likely do it again. All the while, we are enjoying being parents, watching this kid grow and adapt to the world around her.
For the time being, we’ve decided to only have one kid. We talked about it before, and one is more than enough because of our professional commitments. With the wife being a physician associate and me an epidemiologist, one of us will always work non-traditional hours. We have discussed adopting a child, and it is something we have discussed for the future… But not yet. We want the current child to grow up a little more.
The AI Revolution Is Here, and I’m All in… Maybe
Posted on April 26, 2023 3 Comments
If you only have a minute:
In this blog post, I talk about the use of AI tools for writing, including grammar and spelling checks, and a program for creating one-minute summaries. I express concern about relying too heavily on AI for communication, and emphasize the importance of human experience and wisdom in conveying complex concepts. Despite my apprehensions, I’ll continue to use AI for tasks such as lecture preparation and inspiration for writing, but will not pass off AI-generated content as my own without editing it. And, when it is all AI-generated, I’ll let you know.
If you have more than a minute:
Congratulations if you’ve noticed that my last couple of blog posts had a one-minute summary at the top. I’ve been creating these summaries with an artificial intelligence (AI) program and then editing the summaries to fit my writing style. I’ve also edited them for accuracy, as there are times when the AI makes mistakes.
The rest of my posts are edited for grammar, with another AI similar to Grammarly. That technology has been around in word processors for a while now. As a non-native English speaker (and writer), I rely on those technologies to ensure that what you read is comprehensible in English… and Spanish. Yes, I also use grammar and spelling checks on my writing in Spanish, because I grew up not writing Spanish.
What can I say? I’m a mutt when it comes to my education. I was in Mexico until fifth grade, when I was ten years old, and then in the US at a primarily Hispanic school district in El Paso, Texas. While I learned the basic rules of grammar in Spanish, I didn’t get to practice them as much. Then, once in the States, the influence of Spanish got in the way of fully practicing the English rules.
Thank God for Mrs. Wilson, though. She was my English teacher in my junior (and last) year in high school. She had a good way to teach the rules of how to write a sentence, and it’s something I’ve carried with me since. I still remember my last day of high school. Part of my check-out process was to take the final exam for her class ahead of time. She asked me to write a 500-word essay about the importance of being clear and concise in writing.
I went slightly over the limit.
I remember her looking at me over her reading glasses and asking me how I could write that essay so easily. “Words just come to me,” I told her. “Sometimes, they come at inopportune moments.” And they did. Once in college, I was diagnosed with hypergraphia, an incontrollable urge to write. Or, rather, an incontrollable urge to be creative, and my creativity comes out in writing.
If you only knew how many draft blog posts exist.
Later in life, I used that love of writing to try and win over the affection of women. It was hit or miss. Not all of them liked the long and drawn-out missives I wrote to them, explaining how wonderful they were and how I wanted to share my life with them. Others, like my wife, appreciated it. She has kept all the love letters I’ve written to her digitally and on paper.
Now that we have these AI tools for writing, I’m wondering if creative writing will go by the wayside. If a machine can write something for us, what’s the point of writing anything at all? It’s like making an actual phone call now. Those with access to the option of texting use it instead of calling. We would rather email or find an online form to ask a question of a business.
My worry as an educator and public health practitioner is that we will rely on AI to communicate complex concepts without the experience. While an AI may have all the knowledge, it will likely never have the wisdom. For example, we know that vaccines are necessary to control many communicable diseases. We know that there are people out there who do not want to get their vaccines, or vaccinate their children. AI can grab all the information from research on how to reach those anti-vaccine or vaccine-hesitant parents, but only our experience of gut-checking discussions with them — our reading of their reactions to us speaking to them — will allow us to filter that knowledge into something actionable.
Then again, it could be that AI is programmed well enough to read human emotion in the future, and I can just walk away from that fight… Only to find some other public health fight.
In the meantime, I’m looking forward to using AI to help me prepare my lectures, correct my writing, and offer inspiration on what to write about next. It can help me create an outline of what my lecture should be about, or offer resources for me to read about an issue and learn more. However, I do have one rule for myself (and my students) that I don’t think I’ll be breaking any time soon… I will not pass off something an AI writes as my own unless it is based on what I wrote (like the summaries) and I edit it to be mine. Doing anything other than that is tantamount to plagiarism in my book.
The Year Since
Posted on April 23, 2023
If you only have a minute:
This blog post reflects on the passing of Andres one year ago, and the impact it has had on me and my family. I also discuss my father’s resilience, my anxiety about receiving bad news, and the difficulty of returning to the ancestral hometown. I also reflect on the prevalence of divorce in my social circle, and the importance of honesty and communication in my own marriage. The post concludes by acknowledging the ongoing pain of Andres’ loss and uncertainty of life.
If you have more than a minute:
It has now been a year since we lost Andres. Time has a funny way of making such big losses easier. It doesn’t mean it doesn’t still hurt, or that I don’t wake up some days wishing it was all a bad dream. It means the loss is less painful and more manageable. A year ago, it seemed like I was also on the verge of losing my dad. He was so heartbroken, and I was worried he’d do what so many men in our culture do when they face great loss.
Dad didn’t. He’s soldiered on, marching into his twilight years with things to do and machines to fix. It also helps that he gets almost daily pictures of his granddaughter, and that we went to see him in August last year. Still, my anxiety moves up a few decibels when I see his name on the phone, as I’m dreading bad news.
I need to re-program my brain to understand that not all calls from him have been bad news, and that not all visits to the ancestral hometown have been bad. Going there was a lot easier when I was a kid, though. There wasn’t a care in the world other than to have fun, catch bullfrogs, play soccer, and eat good food made by either one of my grandmothers or aunts.
In the same year since that nightmare, no less than three couples in our sphere, and two couples I’ve known from previous jobs, have separated or divorced. It was interesting to see how some of them displayed a ton of love and affection on social media, only to air out their grievances and complain of each other’s infidelities, shortcomings, or “changes” since the divorce. I guess what is shared to social media is not always the truth, right?
As I wrote in a previous blog post, I’ve made a deal with my wife that we would be open and honest if it ever got to the point where either of us considered calling it quits. We also agreed to seek help from a marriage counselor, and that we would work hard to fix whatever was going on. This agreement has helped a lot in the almost 13 years we’ve been married, because it has allowed us to be honest about things we need tweaked in the marriage, like me taking care of my anxieties and myself, or her slowing down with the multiple jobs and responsibilities.
And, as always, the little girl we created was priority number one. We owe it to her to be the best parents and role models of what a relationship should be. While we have always been at higher risk of divorce because our parents were divorced, we also used the knowledge of that risk to go to premarital counseling and sort things out before they became an issue. My wife is right when she says we should all be assigned a therapist at birth.
So I keep moving on in the new job and the new challenges presented, all the while still aching over Andres’ death and the lack of fulfillment of all his potential. I still wonder what if this or what if that? And I never get an answer that calms my mind and relieves my guilt of being so far away as a big brother.
Life is crazy like that.
The Update You Deserve
Posted on April 18, 2023
If you only have a minute:
In this blog post, I reflect on my recent experiences in public health and the challenges of working with different personalities. I also discuss upcoming conferences and plans for a summer vacation. I note a trend of divorce among friends and acquaintances, but express gratitude for my own successful relationship and my daughter. The post concludes with a promise to write again soon.
If you have more than two minutes:
I know… I know… It’s been a while since I’ve written something on the blog. It’s not for lack of trying. I’ve written plenty of drafts, but I haven’t finished my thoughts. If I don’t finish my thoughts, I don’t hit the publish button… And you don’t get to read what I wrote. Not that you would want to read what I write.
National Public Health Week was the first week of April, and I hosted a “Cafecito Hour” on LinkedIn where I talked to people who wanted to chat about getting into public health, finding work, and how to move up in the world of public health. It was a little sobering to see and talk to so many people struggling to get into school, struggling with school, or struggling to get that all-important first job after graduating. Then there are those who’ve been working in public health during the pandemic, and they are exhausted.
Me? I’m not as exhausted as I was last year, when I was still working at the health department. The long commute in and the different personalities who were micromanaging my work made it impossible to get any enjoyment out of working there. I loved the people I worked with, though. They made the whole damned thing tolerable, and I miss working with them.
Now, I’m doing this public health gig with the non-profit, and it’s actually kind of fun. It’s also challenging in its own way, since I have to herd cats, as it were. There are also different types of people with different personalities. From academics, to public health practitioners, to physicians… Everyone contributes a different view, and everyone has an opinion on what we should be doing to improve the lives of the people we serve.
I just wish we could actually do more, instead of just meeting after meeting to talk about what we could do. But all these things take time, and I have my own projects on the side to work on. There are chats/interviews to schedule, multimedia to produce, and conferences to attend. In July, my wife will attend a conference in Denver, and I hope to go with her. In June, I hope to go to Puerto Rico for a few days for a quick conference on — of all things — the law. Later in June, it’s off to Salt Lake City for a gathering of epidemiologists. Then there is the American Public Health Association conference in Atlanta.
I’m also planning to take my wife and daughter on a short vacation this summer, somewhere nearby that we can drive to. We’re holding off on a big, international vacation until next year. This year is just too busy. I’ll be lucky if I can get away and see my parents. (Easier said than done, since they live in such separated places.)
Speaking of divorce, one trend that my wife and I have noticed is how many of our friends and acquaintances are getting divorced, especially those who married before we did. It must be that time when couples fall out of love or find they have nothing else to share. Kids or no kids, they just call it quits and go their own way. Not us. We’ve managed to talk through our issues and find ways to solve our disagreements. We find time to be with each other and away, balancing the needs and wants of the relationship so we’re both happy.
Then again, we have this little kid to look after and make sure she grows up to not burn down the world…
Anyway, that is all I have for now. I’ll write soon again, I promise.
Maybe.
The War on LGBTQ+ Kids Is Getting Out of Hand
Posted on October 22, 2022
I don’t remember exactly when I learned that there are people who are sexually attracted to the same sex. Growing up in machismo-rich northern Mexico, I was taught that people (most often men) who were gay were not to be trusted. They were to be shunned, laughed at, and excluded in every way possible. Even at a young age, this attitude confused me because the very same people who were teaching me that behavior would go to church on Sundays and claim to be children of an all-loving God. I started thinking that their love only lasted the time they were in church, or — even worse — that love mean hating people for their behavior even when that behavior affected no one.
The more I learned about biology and science, the better I understood that sexual preference was not a choice. I learned that people who are not “straight” did not choose who they were attracted to any more than I chose who I was attracted to. As I explained to a cousin of mine, “I like petite women with 0.7 waist-to-hip ratios, blue or green eyes, light skin, and long hair. You like more robust women with brown eyes and shorter hair. He [a mutual friend] likes dudes with bulging muscles and a good sense of humor. It’s all a spectrum, my dude.”
When I was in high school, one of my good friends who I had known in middle school was open about his sexuality. He made no effort to hide that he was gay, and even tried out for a position in a cheerleading team that was 100% female. Still, I took offense on his behalf when someone called him gay (or some homophobic slur). “You’re just trying to offend someone who’s clearly bested you,” I said to a girl once. She had called my friend a homophobic slur to me, complaining that my friend had gotten a better test score than she did. “So, if he were straight, you’d be okay with him being smarter than you?” I asked. I didn’t talk to her after that. She was the kind of person who was angry at the world for some reason, and her hate spilled over into hate toward my friend.
Weeks later, I found out she had started a rumor that my friend and I were a couple. I was very angry, and I talked to my mother about it. “Well,” mom asked, “do you feel attracted to him?”
“No,” I said. “You know I like girls,” I emphasized.
“So it’s just another rumor like any other rumor. If there’s no truth to it, there is no need to even address it.”
Shortly after that, we found out that one of my dear cousins was gay. Everyone held him in such high esteem that no one really shunned him… Not to his face, anyway. There was plenty of pearl-clutching from aunts and grandmothers. “Oh, I pray for him every night before I go to sleep, so that he changes his ways before he ends up in eternal suffering,” they would say. Me, having understood the mechanics of the universe and the math intertwined therein, reasoned my cousin had nothing to worry about if — as my personal evidence showed — the universe liked to balance equations. He was not hurting anyone, so no universal harm should come to him.
Of course, we know that non-universal harms do come to LGBTQ+ people. There are plenty of angry and sad people who would like nothing more than to pass on their hurt to people they see as less-than-holy or ungodly. They hide their homophobia in statements like “hate the sin, love the sinner” or “I just want you to not go to hell.” They mean they can’t fathom someone who is not like them, and they would rather the “other” be like them instead of continuing to be themselves.
This particular kind of hatred has now spilled over into the public discourse in the United States. The moral panic of this electoral season is transgender kids and the medical interventions and social protections they need. We know that gender-affirming care is necessary for the mental health of teens with gender dysphoria. Without a support structure that accepts them for who they are, these kids are more likely to turn to drugs and other risky behavior. Worse yet, they are more likely to die from suicide… Or from someone hurting them, as there is nothing worse than a group of people scared to death of something they do not understand.
Now, on top of everything else public health workers have to worry about in this country and around the world, we have to worry about the health and safety of LGBTQ+ people (especially children) because today’s moral panic has pegged them as today’s folk devil. We in public health will probably never know if and when the pandemic ends since we’ll be so busy fighting off the next wave of lies and misinformation.
Sigh.
Thank you for reading.
Check out more of my thoughts over on my Medium.com blog at: https://medium.com/@epiren
Or listen to my ramblings on the Epidemiological Podcast: https://anchor.fm/rene-najera
Stalk me on LinkedIn: https://www.linkedin.com/in/renenajera/
Or be a total creep and follow me on Facebook: https://facebook.com/rene.f.najera
What’s that? I’ve blocked you? Well… ¯\_(ツ)_/¯
Another Circle Is Now Complete
Posted on October 14, 2022 6 Comments
The first week I started working at the Maryland Department of Health in 2007, we faced an interesting situation when a person who worked at a government office building came down with legionellosis. Legionellosis is a pulmonary disease caused by the Legionella species of bacteria. It is usually associated with exposures to fine water mists, and can present as a flu-like illness or full-blown pneumonia. There are many sporadic cases of legionellosis, and some are not diagnosed. People are usually just diagnosed with a “community acquired pneumonia,” given an antibiotic, and sent on their way. (Though it can be deadly if comorbidities make fighting off the infection difficult.)
Legionella were first discovered in the 1970s after a big outbreak in Philadelphia. That outbreak happened during the bicentennial celebrations, when a group of American Legion members came down with a respiratory disease of unknown origin. There were almost 200 sick and about 30 deaths during the outbreak. The local, state, and federal public health agencies who responded to the outbreak went through the hotel with a fine tooth comb. They tested everything for everything. They kept coming up empty.
It wasn’t until a group of scientists discovered Legionella as a new species of bacteria, and it was difficult to grow it in the laboratory. (We call these bacteria fastidious.) Once they had the culprit, everything else in the puzzle fell into place. Scientists were able to sample the hotel again and grow Legionella from water sources. The winning theory was that the bacteria were “seeded” in the cooling towers of the hotel building and were released as aerosols in the ventilation system or even outside into the nearby environment. People would breathe in the bacteria and get pneumonia.
When I started working at the lab in Waynesboro, PA, one of the lab techs told me how her father was one of the original victims of the outbreak in Philadelphia. I heard about Legionella from my medical technologies studies, and I heard about the outbreak. But it was always a far-away thing for me. (Being so dry, the climate systems in El Paso didn’t generally lend themselves to cooling towers. That, or I didn’t notice outbreaks of legionellosis when I was there.) When I started studying epidemiology, knowing her story made it more real. When I had the chance, I drove to Philadelphia to see the site. The hotel is still there.
Anyway, back to the case at the government building. As it turns out, the woman who had legionellosis knew about the original outbreak. (Her father or uncle were there. I don’t remember the details correctly.) She told her coworkers about legionellosis and how deadly it could be. Not understanding that legionellosis is not spread person-to-person, or believing she caught it at the building, most employees got up and out of their office spaces and walked out. It was a bit of a crisis, though no Legionella were recovered from the building, and no other people were sick.
That experience taught me much about how a state health department managed things. There were many political considerations. On the one hand, we epidemiologists knew that the odds of the woman catching the disease in the building were low. She had not spent the necessary amount of time in the building for the building to be the sole culprit of her disease. Had she been there the whole incubation period, it would have been another story… More on that later. But the authorities wanted to be seen as doing something, so we were off conducting surveys, looking for more cases of the disease associated with the building, and sampling the water systems of the building.
Of course, that would not be my last time dealing with legionellosis outbreaks or situations. There was a very public outbreak at a building housing elderly residents. That one became interesting because the relative of a well-connected political player in Baltimore lived there. Again, the authorities needed to be seen as doing something or risk backlash. Somewhere out there, there is a clip of people driving up to the building to move their relatives out while the water systems were cleaned and disinfected.
There was also an outbreak associated with a hotel in Ocean City, Maryland. That one got weird because an overzealous “fan” of the hotel threatened violence against us if we shut down the hotel. As it turns out, he was married at the hotel, and he was going to travel there soon to celebrate his anniversary. He even told us he had the hotel tattooed on his chest. I can only imagine what his Yelp reviews were like.
The saddest outbreak was one that occurred at a nursing home. There was a person there who developed legionellosis without leaving the facility. Because of this, the facility had to shut down their water and air conditioning. It was during the summer, in Baltimore. The elderly residents had a hard time staying cool, and they could only drink bottled water. Because of concerns about inhaling the bacteria, there were no showers and no running faucets until the water was tested, and all the lines were cleaned, disinfected, and flushed.
It was sad because so many of those folks had no clue what was going on, and the facility seemed overcrowded. Granted, it could have been the unbearable, humid heat, but everyone seemed so sick. They were so vulnerable, and their lack of understanding made it hard to explain why we were there. There was no panic — or they did not show it — and no one drove up to get them out of the building, like they did in the apartment complex I mentioned before. By the time everything was said and done, the index case died, and a few more cases were detected. The water was eventually clean, and everyone could go back to using water after a few days.
By 2013, I left the health department to work on the doctoral degree. You all know that story. I tried to have my dissertation be based on a novel surveillance and testing system to prevent outbreaks of legionellosis, like the ones I had seen in Maryland, or the big ones that happened in New York City. But the eggheads at Hopkins didn’t see it as something useful. So I did it on a different subject altogether.
You all know the story of what happened from 2013 to 2018. You know what I did after 2018 and how I became the editor of the History of Vaccines project by the College of Physicians of Philadelphia. You know that I worked occasionally on History of Vaccines from 2018 to 2022. You know that I worked full-time for the Fairfax County Health Department from 2019 to 2022. And now, I’ve taken another step in my career. But first, another story of another epidemiologist…
Back in 1976, the head of disease control for the Philadelphia Department of Public Health was Dr. Robert Sharrar. He and his team led the investigation and worked with state and federal public health to identify the cause and contain it. Today, Dr. Sharrar is still involved in public health. He is currently a Fellow of the College of Physicians of Philadelphia, and is the current chair of the Section on Public Health and Preventive Medicine.
Now back to me.
As of October 3, 2022, I am the director of public health for the College. (I’m still the director of History of Vaccines, too.) I’ve left my job at the Fairfax County Health Department. As challenging and rewarding as that job was, I am ready for a new adventure, new challenges. And now, in this new position, I work with Dr. Sharrar and the rest of the section members to bring together bright people to tackle some of Philadelphia’s public health problems.
From first learning about Legionella in my clinical microbiology class at UTEP, to now working with one of the epidemiologists who worked on the original outbreak. Another circle is now complete.
EpidemioLogical 