Words from Grenoble, words from the past...

 So, I was looking back through some old writings and found this, a piece that I wrote in 2006 when I was living in Grenoble, France.  It was up on the website for the fellowship I was on for a while, but is no longer available there.  It is always odd to look back at writing after years; I know I wrote it, but in ways I am unfamiliar with this ancient version of myself.  Also, this is one of the first things I wrote in which I claimed to be writing non-fiction but was clearly editing and re-writing these emails to weave them into a narrative arc.  

I sat down and tried to write a story.  I tried to write something funny and witty but poignant and moving and something that was entirely representative of my experience so far in France.  The problem was not a lack of stories to tell, I feel like a have a million, but I couldn’t pick one to relate and I found myself absolutely unable to write.  I simply stared at a blank page as the deadline loomed and the idea of distilling my time in France into one narrative became more and more daunting.  With no other ideas, I finally decided, thinking it would also be less work (I was wrong), to share excerpts from emails that I’ve written home to family and friends.  While it is still nowhere near comprehensive, sharing several emails at least allows me to share a progression, an evolution, and a more realistic and intimate vision of my life here in Grenoble.

September 10, 2005

So the apartment hunt.  Ugh.  Imagine looking for an apartment in the states.  Then add in 3 times the confusion as to how to actually go about it.  Then add in 10 times the awkwardness of the phone calls (because, of course, they are all in French and that is not necessarily easy).  Then add the fact that school is starting now and there are about 20,000 students looking for the same places to live.  Cheap, in the center of town, nice enough places.  I really don’t want to live by myself and I really do want to live with a French person; I just think it would be an easy way to get in with a group of friends.  Ready made.  So yeah, a cheap, but nice and well-located apartment in the center of town with a French person.  No Problem, right?

September 27, 2005

I think I finally found  a place to live.  This dude, Pierre, is looking to share a run down but really pretty nice apartment just off the main part of town.  It’s on a small street next to a daily farmer’s market and you can easily walk anywhere in town from the doorstep.  It has beautiful hardwood floors and my room has a (nonfunctional, but romantic nonetheless) fireplace.  The best part however has to be Pierre himself.  No, he doesn’t wear a beret and a horizontally striped white and black shirt.  He doesn’t eat frog’s legs every night.  However, he does smoke, drink his coffee black, and enjoy pâté more than anyone should, ever.  He’s also just a really nice guy and his friends are also great; we went out to a bar last night and everyone was welcoming and interesting.  So moral of the story is that I found a place to live that I like.  With a person that I like.  I’m claiming this as a moral victory.

November 13, 2005

Ok, so last night.... I ate fondu.  Lots of it.  For dinner.  It was a pot of melted cheese, wine, onions, and lardoons (basically bacon) easily the size of my head (including my huge hair) and it was for three of us.  Pierre’s friend, Tatiana, had an American friend come to visit and he wanted a stereotypically French meal.  I guess he got one.  I still feel not quite so well in the stomach.  Along with the traditionally French meal, we played a traditionally French game: if you drop your bread in the fondu pot you had a punishment, a gage, decided upon in advance...  so the first punishment was that you had to sing an entire song a capella out loud at the table in the middle of the crowded restaurant.  And of course, I dropped my bread in the pot about five minutes in to the meal.  In the French spirit of things, I decided to sing Claude François’ French version of “Oh What A Night,” entitled ‘Cette Année Là’ which is deliciously 80s.  It was brilliant and I may or may not have turned a shade of red normally seen only on tomatoes and stop signs.  Also, I can’t sing.  Or speak French.  Ugh.  It’s ok though because later Pierre dropped his bread and he had to stand on his chair and dance the Macarena for 30 seconds.  A highly entertaining evening, full of wine and good conversation, was had by all.  And it felt so French, and the stomachache (and heart disease) that comes from eating at least 3 pounds of melted cheese was well worth it....

November 16, 2005

School is going pretty well, but the very nature of the French education system is a little grating.  At least my program is overtly competitive in a way that I’ve never experienced before.  Professors are constantly reminding students that they’re being graded on a sliding scale.  After the first presentation in my class entitled Biologie Structurale des acides nucleiques et de la transcription des eukaryotes (sounds fun doesn’t it) the professor asked if there were any questions and no one raised their hands.  He then said, ‘You know you should all ask questions because if you ask a really hard one and the group can’t answer it, their grade will go down, and yours, by comparison, will go up.’  Immediately about five hands shot in the air.  I was stunned.  I mean competition in education is unavoidable but I have certainly never seen anything quite that overt.  It just leads to a bit of an odd dynamic between the students.  And I’m really trying not to let myself feed into the competitive nature of the program; I didn’t come to France to sit in my room studying every night.  Otherwise, things are going well; the classes tend to be really interesting and I’ve really enjoyed the time I’ve been able to spend in the lab.  Also, I think I may have contracted mad cow disease.  Seriously. 

December 18, 2005

Home is such an interesting thing.  As a side note, one of the linguistic things I don’t like about French is that there is no word for home... there’s house, there’s so and so’s place, but no home in the English sense of the word.  Flying into Seattle over the mountains, seeing Rainer off to the south and then making the same bank every time over lake Washington, the Pugent sound, the university and downtown...  it just feels so amazing.  But in the last couple of years, home has changed a lot, not so much in its actuality, but in my conception of the place.  I’ve always had a critical vue of my little town, of the people and the place, but it has always been home, and a huge part of my identity.  I think that in the last couple of summers living in Seattle, spending most of my time in Minnesota, and now living abroad, my experience has changed enough so that I don’t really identify that as my home, at least not fully, anymore.  Carleton definitely was home, my friends there are like family, but now everyone’s so spread out.  And then there’s Grenoble.  Grenoble is becoming home, and I love it, I love my friends, my apartment, my lab… but living in a foreign country does lead to a feeling of displacement.  I mean, being an American abroad leads to all sorts of privileges, that’s for sure, but I am not French.  Just one look at me, just one word from my mouth and that’s apparent.  I am tired of people talking to me in that slow voice they reserve for foreigners.  I’m tired of being the token American.  I’m tired of people asking me what I think of Bush, of American foreign policy, of American oppression.  Yes, the American government oppresses its citizens (this is, by the way, the correct answer). About the war in the Middle East.  Yes, I’m a pacifist (correct again).  Sometimes, the romantic ideals of living in Europe, in having a foreign experiment, grind directly with the feeling that I have become the Other.  In a country where citizens define themselves first and foremost by nationality, where the solution to racial discrimination is making everyone French, how does the foreigner fit?  The goofy kid with holey jeans, long hair and a funny accent.  As much as Grenoble is becoming my home, it remains a place where I feel somewhat estranged. 

January 5, 2006

Grenoble is buzzing with skiers. It’s interesting and it makes the town pretty exciting.  And on my first night back it snowed like a half a foot, big beautiful snowflakes.  Then the next day I had to take the train then the bus up to the ski station Dévoluy where I was meeting my friends at the Chalet... it started snowing and the road actually got pretty bad.  A bunch of cars stopped in front of the bus to put on chains so the bus had to stop as well.  Then we started to slide.  To the side.  Slide slide slide, wham... long story short, the bus went into the ditch and I almost died.  Ok maybe not almost died, but I had to wait outside the bus in the cold for 2 hours and that wasn’t very much fun. And one of my legs fell asleep, which is kind of like it dying, right?  The bus driver spent well over an hour trying to get the bus out and couldn’t do it, and we were blocking off the road so no cars could pass.  This guy who was behind us in his car knew how to drive a bus, so he decides to come up and get in the drivers seat (what?!) and within 5 minutes the bus was out of the ditch... then as quickly as he came, he disappeared back to his car.  I think he might have been batman. Nevertheless, a one hour bus ride turned into three hours of fun. The good news is that once I got up there, the week was really amazing.  I mean, yes I was really jet lagged and more than a little bit grumpy, but it felt nice to be out in the sun on the slopes just hanging with a bunch of Frenchies, eating traditional French cuisine from the region (raclette is amazing, melted cheese over potatoes and cold meats… yum), and singing Didier Super (amazing).  Plus, on the drive back into Gnobes, on walking back into my apartment and immediately collapsing on my couch, I couldn’t help but breathe that sigh of relief that comes from feeling both exhausted and (at least mostly) at home.   

On Democracy in Health (srsly)...

This article is an adaptation of a talk I gave to undergraduate students in my Biochemistry class at Vassar College.  To integrate several of the topics they had studied so far this semester, and to connect the course to issues of health, advocacy, and social justice, I screened the film “How to Survive a Plague.”  A lecture on the development and mechanism of HIV drugs followed this consideration of the film.  I find the issues discussed here so critically important and so rarely mentioned that I wanted to share them. 

As a preamble I want to just state two simple facts[i] to attempt to demonstrate that this conversation is pertinent, alive, and necessary.

This week, for the first time, doctors claim to have cured an HIV-positive infant by aggressive early treatment. While this discovery is unlikely to impact treatment for adults, it may be a game changer for the treatment of at risk infants.

Long story short, the search for a cure continues. And the drugs used to treat that infant are the very ones we will be discussing today[ii].

Secondly, also this week, we are considering the effects of the sequester on science funding in this country. And it doesn't look great. The nations largest funding agency, which continues to fund ground breaking work on HIV and other infectious diseases, will take a major hit in funding. This will necessarily be passed down to individual researchers. The funding situation has already been dire for a decade. We are nearing the edge of no longer prioritizing the types of health breakthroughs we saw in the film[iii]. Research isn't easy - it takes time and money. But it is necessary - as is made so beautifully clear in "How to Survive a Plague."

I don't think we will like the look of a society that is unable to respond to the next great public health crisis, the next great plague.

I want to start this discussion with a brief but desperate plea about why I think this class is important[iv].  You're taking the class, so one might assume that you think it could be important, too.  But, I don't want to make any assumptions.

In the film that you have hopefully watched by now, one of the characters said something that made me sit up in my chair.  It made me gasp.  It perfectly iterated why I wanted to teach this class in the first place.  It was early in the film, somewhere around 1988 or 1989, when AIDS truly was a death sentence.  In one of the interviews with an ActUP member who was talking about why they formed the data and treatment group said, "I will survive the longest the more I know about what types of drugs I am putting into my body."

I want to repeat that: "I will survive the longest the more I know about what types of drugs I am putting into my body."

This was a man who thought he was doomed to death and who had come to the desperate realization that his understanding of the science and biology of his disease and its potential treatment was literally a matter of life and death.  No one else was going to do this for him.  He had to do it on his own. 

It's 2013 and I would argue that for each and every one of us, understanding the drugs and foods we put in our body is quite literally a matter of life and death.

I am a 30 year old queer[v] man who happens to exists in the world in 2013.  I also happen to have a PhD in molecular biophysics.

This is the level at which drugs work. They generally bind to a protein and inhibit or modulate its activity.  Understanding drugs requires understanding biology and chemistry, at least a little bit.  And without understanding biology and chemistry you will never understand the drugs you put in your body (recreational or otherwise).  And it IS a matter of life and death.

Every time I go to the doctor and get prescribed a medication, before I even fill the prescription, I go home and look up the literature on the drug.  You know where I start?  Wikipedia.  Science articles in Wikipedia actually tend to be pretty good.  But I don't stop there.  I look up actual honest to god research papers on the drug[vi], I understand how it acts, its likely side effects, if there are more cost-effective or better treatments. 

And you know what?  My doctor knows this.  Not only because I have the letters D and R in front of my name on his chart, but because I ask questions when he suggests a medication, and if I look it up and don't want to take it, I call back or go back in and figure out another solution. 

I don't want to trust decisions that are centered on my body to the knowledge of others. My scientific understanding serves to democratize the interaction between me and my doctor.  You want to talk democracy, collective decision-making?  It only works if you are informed.  Otherwise you have to trust. 

And you want to talk about having agency over your own body?  How can you have agency when you don't have the ability to understand if the HPV vaccine is going to do more harm or more good?  How it's going to work?  What strains it is effective against, and not?  Whether or not you still need to be screen via standard methods for cervical cancer?  Whether it is beneficial for a man?  A gay man?

Biomedical knowledge should not be held by a privileged few; it should not be wielded only by doctors but ought to be held near and dear by patients and citizens of the world. 

In this increasingly pharmaceuticalized world, science education ought to be a human right.  No democratic relationship can exist between an individual and his/her doctor, the companies that s/he is trusting to make safe and effective drugs, and the government that is expected to fund and regulate this process without a fundamental understanding of the science. 

Here, scientists have failed.  Here, educators have failed.  Here, doctors, too, have failed, and governments and individuals themselves.  We are all failing to see the importance of doing the difficult work of understanding some critical 'truths' about the biological world.  It is not easy work, but it is necessary. 

And to all of you out there who are hoping to become medical doctors: this is not a class that you should skate through, get your A, and move on to medical school.  Modern drugs are designed using the tools of biochemistry and structural biology.  You can't understand drugs without understanding allostery, and Michaelis-Menten kinetics, and enzyme active sites.  I'm sorry, but you can't.  And if you don't understand drugs, why should I trust you to prescribe them?  Because a drug rep told you to?  Because you survived biochem not once but twice in undergrad and med school?  I need you, if you want to wield a pen and prescription pad, to be able to use the skills from this class to understand the pills you are asking people to put in their bodies.

As we saw in the HIV/AIDS crisis, trusting those in power to sympathize with your plight and act accordingly can be a death sentence.

Now, as then, understanding what types of drugs you are putting into your body is a matter of life and death.  And we should treat it as such, and work to understand those drugs to the best of our ability. 

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[i] I know ‘facts’ are rarely simple, and that I am probably not gaining the trust of the reader by attesting so early on that they are.

[ii] Not here we won’t.  But if anyone out there really wants to talk about small-molecule inhibitors of HIV enzymes, feel free to reach out. 

[iii] If you haven’t seen ‘How to Survive…’, please please do.  Although there’s tea on the street that the film ‘United in Anger’ by Jim Hubbard is also amazing and that ‘How to Survive…’ borrowed a fair amount of the footage from ‘United…’, but having not seen the latter and not knowing the deets, I cannot really comment. 

[iv] This class being Bio272 at Vassar College.  Biochemistry. 

[v] I might have used the word gay when actually speaking to my students. 

[vi] Which are often, but less often than they used to be, behind a paywall.  It can cost 50 or more dollars to access a single research article.  The fact that the research described in the article was likely paid for out of your very own tax dollars, as allocated by the National Institutes of Health, makes exactly zero difference.  Legislation recently changed the law and required that many articles funded with public money are freely available to… the public.  There was an effort to roll back this legislation, which was, happily, defeated after a massive and public outcry by scientists themselves.