Self-Immolation is Overrated

I drove 4 hours south of home on Monday, back to the office that I used to commute to daily and have since moved away from thanks to my position transitioning to full-time remote. We’re going through an acquisition and their people wanted to understand work that I used to do before my old department was shut down and I transitioned elsewhere in the company. In the several days following my arrival at the office, myself, two engineers I worked closely with, and two PMs (that I hired and trained) poured our knowledge into a flowchart of how we performed our work. A lot of focus was put on how it could’ve been done more efficiently, and a lot of effort was spent on our part explaining the unique challenges that prevent this type of work from ever being streamlined.

These were not easy conversations, and they certainly mirrored how I ended up learning some of the most important lessons about our business.

Smoke Jumper

I was hired in 2019 to join a small, vestigial department of a healthcare company. The department had historically only needed two PMs and two engineers to handle a slow drip of work requests from sales and implementation. This changed when the FDA required the business to drastically reduce the number of running versions of the product currently deployed in a large number of hospitals across the US. Given that we were unknowingly about 5 months from a world-altering pandemic, this turned out to be a pretty smart demand from them.

The department faced a couple of key hurdles in the way of this demand.

First, the product was not designed to be upgraded. And before I’d been hired, the business leapt forward with it’s products’ functionality. Now, the work that this department was being asked to do resembled performing open heart surgery on a bus driver in front of all the 2nd grade passengers sitting, unbuckled, behind us as the bus hauled ass into oncoming highway traffic. Second, there were a lot of versions deployed across the country, at least 30% of which could not be upgraded directly to the new software version. But it doesn’t end there. Third, upgrading almost any software requires downtime – no functionality for your caregivers or patients until we’re done. The 30% that needed to go through an intermediate version would require double that downtime across two go-live events.

The FDA wanted all of our sites on a baseline minimum version, and they wanted it soon. For our business, that meant a big expansion to this esoteric department and an unprecedented push to perform the majority of the upgrades to the newest version which was more complicated to perform than the others. I walked in the door on day one of this effort to see the senior engineer diagramming what he thought the process should look like. I’d been hired into my project management position from a previous career in construction project management, but was very excited to jump in with both feet.

Pyrophyte

The next 2 years took place in 15 minutes. Upgrades took significant effort and I did at least two a week, sometimes as many as five. I stopped going home and started sleeping at the office or in the guest bedroom of my friend’s house across the street at least twice a week. I started drinking a large milkshake, double cheeseburger and fries for lunch each day, but I still lost 120lbs in the first 4 months – partly from stress and partly because I had entered diabetic ketoacidosis, a state where my pancreas was so overwhelmed that I couldn’t use or store the sugar from my diet and my body had turned to cannibalizing my organs and muscles for energy instead.

It was, without question, the greatest time in my professional life. I had never felt half the satisfaction, terror, adrenaline, camaraderie, trepidation, confidence, or drive that I did during that war for progress. 5 months in, COVID shut down the country and our hospital customers reached a new level of desperation for our service. We had never performed this work outside of a scrum-type office where everyone was within arm’s reach to help an upgrade get across the finish line. We lost half our PMs and a couple engineers. The transition to remote work coincided with a doubling of the workload for those of us that remained. The fear and uncertainty of the pandemic were magnified by the urgency and importance of the work we were doing – it wasn’t about satisfying the FDA anymore, it was about keeping caregivers functioning and their patients alive.

So as I showed up at my old office, 3 years on from that first time I walked in, and sat down across from that engineer who had tried to diagram the upgrade process for us that first day, I found myself profoundly nostalgic for the war.

Delenimentality

During the war, I stopped taking my anxiety medication. I didn’t need it anymore – all the things my persistent and intrusive thoughts tried to scare me with paled in comparison to the reality of my situation. I had moved across the country to take a job in a field I didn’t understand in a city I’d never visited, shortly before an era-defining pandemic that would directly spotlight a pool of essential workers that relied on my success to keep our healthcare system from collapsing. I had never been so cozy, so comfortable in my own skin. Finally, there was an external justification for the way my mental illness made me feel. I was Brer Rabbit and fate had thrown me and everyone around me right into the briar patch. Why’s everybody so upset? Just take a left here, a right there, and we can get lunch.

As it happens, the company that had acquired us provided different insurance, so I’d run out of my meds about a week prior to this meeting in the old office while fighting to get my prescription covered. I sat across a couple old friends to extract value from our collective PTSD for a group of strangers who were, maybe, trying to get the band back together. Our department had been eliminated about a year ago. Most of my peers had transitioned to a related department, but I had been passed over to manage the upgrade team and then immediately asked to be interim manager for the upgrade team, and then we had been acquired by another company, and then the department had been eliminated, so I went to a different branch of the business to cool down.

It worked; while my friends were facing down the uncertainty of a re-org in service, I found a relaxing enablement role to fill for a bunch of sales-adjacent people. I’d gotten my life back in order, started caring about my physical and mental health again, and had been trying to teach myself to enjoy something called ‘work-life balance.’ I’d overseen the penultimate 10% of the FDA effort but they’d crossed the finish line without me, then been called in on occasion to do one-off upgrade series while I’d been left home on the farm like a retired general watching his infantryman march to the next conflict, slipping over the horizon without him. Hopefully they’d come back alive so I could show them the sick-ass pumpkin harvest I’d been working on.

Vasovagal Creativity

After the first day of discussions finished, I headed back to my hotel. The feeling in my stomach was plenty familiar. Suction in my chest, nausea, dizziness, inability to string a sentence together coherently or hold focus on one idea for long. No, not a panic attack – I knew I was going to have to write another long article on DFO.

I was certain of it by the time I hit the bottom of my eighth scotch and the boomer at the end of the bar was sending me a ninth while I played the part of the ‘most interesting millennial’ he’d ever met – a phrase that usually meant he’d never met someone my age willing to let him try to justify his racist and bigoted opinions instead of breaking off contact as soon as he expressed them. This party trick was a surefire way to earn free booze and sometimes even help people change their perspectives by letting them verbalize further than they usually get, and see the reactions of the strangers around them. Good stuff, I’m not a sociopath, I’m a hero.

So much for taking care of my health. This much scotch was going to have me jolting awake in the middle of the night as my blood sugar came screaming down like an over-indulgent blind date cresting the peak of a too-adventurous roller coaster. And so it was, just like that date coming off the ride, I found myself puking my guts out alone in the dark and cursing myself for agreeing to stick around instead of going home where the outside world couldn’t hurt me. As I showered the night sweat off, my mind wandered back to that feeling of nostalgia I’d been soaking in earlier.

Even if we got back together and experienced another influx of work, there wasn’t going to be another pandemic. There wasn’t going to be another mad scramble to define our processes, either. The whole point of these meetings was to anticipate and adequately prepare for the future in order to avoid repeating our mistakes. I was smarter now, too. Instead of reveling in my mental illness, I’d grown to value the tools I’d developed to manage it. And it was the next feeling, here in the shower, that I sat down to write about.

Theseus’ Sexton

I tried, unsuccessfully, to cry the nostalgia out. No tears, my body said. Not sad, my mind said. We’re good. I let the therapist who lives in my head take over my internal monologue. I wanted to feel loss, mourn a period of time that I’d instead therapeutically dissected and determined to be unhealthy, and subsequently grown from. I can no longer feel peace inside a raging inferno, specifically because I don’t have the one within me to match it with. I doused that fire and became a better person, and now it’s useful in a different way.

It felt like wishing to be a child who had just dropped an ice cream cone, but instead I was an adult who doesn’t buy the ice cream to begin with because diabetic maintenance is more important. I couldn’t dramatize for myself an outcome where the glorious sickness of my past could return to brighten my future. There was no recoloring my new life’s pallet with the high-contrast hues of pain and struggle. I chose the safer, sensible tones of off-white and tan that made my mental home much more attractive to a new buyer, but much less interesting to throw a party in. Even if I do go back, get that manager job permanently this time, support upgrades and reunite with my war buddies, we’ll be the hobbits back at the bar in the Shire; awkwardly remembering how we used to get drunk, sing, and dance on the tables instead of falling back into that one-time comfort.

So I dried off, set an alarm and went back to sleep. I got back to the office the next morning and squeezed out from my mind whatever useful information I could, like a lifter wringing sweat out of a towel after a workout. When the time came to assign action items, I didn’t volunteer for everything like I usually would. When I did volunteer, I let others win when they argued that the item didn’t fit my job functions. I got in my car, ate a sensible lunch, drove back home, and got home at a reasonable hour. I got up, attended meetings for my current role, and felt no nausea or rush of anxiety while writing this all down. And I haven’t checked if the manager job has been posted – if they want me, they’ll call.