What if I had 3 months to live?

[I’ll preface this post by saying that I am in excellent health and expect to be rambling on this blog for many more years.]

During the drive back from British Columbia on our vacation this past weekend I got a bit introspective about death. You see, both my grandfather and uncle died from pancreatic cancer (and reportedly my great-grandfather did too) — it’s hereditary. There is no early detection and when you’re diagnosed in the later stages you have, on average, about 3.5 months to live. Treatment options are limited and can extend your life by a few months to a few years (see the 5-year survival rate). Oh, and did I mention it’s extremely painful?

On the plus side, there’s this gem from the American Cancer Society:

Almost all patients [who are diagnosed with pancreatic cancer] are older than 45. About two-thirds are at least 65 years old. The average age at the time of diagnosis is 71.

So as an almost-40-year-old I have a statistically safe 5 years before I need to be at all worried and a couple more decades before the odds start working against me. And it’s perfectly possible that I will never get cancer and live to a ripe old age.

But, what if tomorrow I was told I had 3 months to live… what would I do?

I’m making that list now and seeing which of those things I should start doing sooner rather than later.

 

Promotion: Software Development Manager

Over the past 8 months I’ve gradually taken over responsibility for our Ground & Control segment here at Spaceflight Industries, making sure we’re on-track to support our upcoming launch. Apparently I worked myself into a new role. Today I was promoted to Software Development Manager over Ground & Control.

It’s been insanely exciting watching our next-generation ground systems come online. The team is doing some highly innovative and industry-leading work on automated satellite commanding, whole-constellation planning, ultra-low-latency telemetry propagation, distributed system monitoring & alerting, and more. We learned a ton from our first iteration that is operating Pathfinder-1 and we have significantly improved on it now that we better understand the problem space1.

I’m stoked to be a part of this team as we prepare for Global-1 and beyond!

1 Ba dum bum.

Can we agree that Nazis are bad?

Trump supporters:

I have a hard time finding common ground with you, and common ground is essential in establishing a fruitful conversation about anything.

Can we at least agree that Nazis are bad?

The Nazis that came bearing swastikas.

The Nazis with their goal of an Aryan-only (ie: white-only) world.

The Nazis that hated and killed Jews, gays, the disabled, and anyone else who wasn’t like them.

The Nazis that killed over 11 million people in World War II.

The Nazis that my grandfather fought on the beaches of Normandy on D-Day.

Can we at least agree that Nazis are bad?

Because President Trump can’t:

“I’m not putting anybody on a moral plane. What I’m saying is this — you had a group on one side, and you had a group on the other, and they came at each other with clubs and it was vicious and it was horrible and it was a horrible thing to watch,” Trump said. “But there is another side. There was a group on this side, you can call them the left, you’ve just called them the left, that came, violently attacking the other group. So you can say what you want, but that’s the way it is.”

Trump is claiming a moral equivalency between people who showed up with guns and swastikas chanting “Jews will not replace us” and the protesters who showed up to oppose them.

So I ask you again: can we at least agree that Nazis are bad?

Dear (straight) doctors: advice from a gay patient

Last year my very good friend Dr. Monica Tschirhart was giving a lecture to some medical students in Oklahoma about LGBTQ+ health. She reached out and asked if I had anything to share. After giving it some thought, this was the feedback I gave her based on my own personal experience and stories from friends.

  • LGBTQ+ people, particularly those in conservative areas, can be afraid of coming out, even to their healthcare provider. The most important thing you can do for them is make them feel comfortable talking about all aspects of their health, including their sex life. This may mean putting aside your personal beliefs or judgments — doing so will make you a better physician.
  • Don’t assume the person you are interacting with is straight. Doing so by asking about their girlfriend/wife (if they present as male) or boyfriend/husband (if they present as female) already forces them to correct you, making the already stressful “coming out to the doctor” worse.
  • Don’t assume that just because they are married they are straight, regardless if it’s from the intake form or a wedding band.
  • If discussing their sexual practices, don’t use euphemisms – be direct. Like straight folks, “sex” means many things, oral sex, anal sex, etc. If they say they are having “safe sex” it could be they use condoms when having anal sex but are having unprotected oral sex. Also don’t cringe. If you can’t say “do you practice safe anal sex” without cringing, practice in the mirror until you do.
  • Never, ever ask “are you the girl” or “are you the boy” regarding sex. If you’re comfortable with the terms, ask “do you bottom” or “do you top”. If you aren’t comfortable with those terms ask “are you on the receiving end or giving end of anal sex”. Again, practice in the mirror until you can say it without cringing.
  • If asking about their sexual practices, don’t assume they are monogamous if they have a partner. LGBTQ+ folks are often non-monogamous and just because they have a partner/boyfriend/girlfriend/husband/wife doesn’t mean they’re only having sex with that person. And yes, most of the time their significant other is fully aware and OK with it.
  • Don’t inadvertently out your patient. Unless they tell you differently, you should treat how they identify as confidential. LGBTQ+ folks can be fired for being gay, ostracized from their communities of faith, and worse. It’s sad, but there are good reasons why some people are still in the closet — particularly in conservative areas of the country. The moment you out them you’ve violated their trust and potentially their safety.

Daniel added these two very important points to the conversation:

  • Treat your patients as individuals, not stereotypes. If you want to talk about sexual health, start by asking them about their sexual practices (or lack thereof) instead of assuming you know what “people like them” do based on their age, race, sexual orientation, gender identity, or whatever.
  • Give your patients an opportunity to tell you what name and pronoun they want to be addressed by — and always use it, both in conversation with them and in conversation or notes about them.

This doesn’t even touch on PrEP, knowing the risk factors of STI transmission of different types of sex, etc which are all important but I think is somewhat secondary if the LGBTQ+ person won’t open up to begin with.

Dr. Tschirhart said that the students appreciated some of my comments and that it made it more real to them than some general statistics. And that’s just it — we’re people, not statistics or stereotypes.

The above is decidedly cis-gay-male centric based on my own experience. LGBTQ+ folks, what other things would you like doctors to know to provide great care for our community?

PS: The American Medical Association’s LGBTQ physicians resources page is a great springboard for doctors too.

 

Find an LGBTQ+ primary care physician you can trust

Recently I was discussing with a friend how much better medical care I received as a gay man when I started going to a gay primary care physician. It occurred to me that it might not be obvious to other LGBTQ+ individuals how important it is to have a medical provider you can fully trust and open up to so I thought I’d share my experience.

When I first came out in 2000, I was suffering from depression attempting to reconcile my fundamentalist Southern Baptist faith with being gay. During a visit to my doctor I brought up my depression and ultimately came out to him in tears there in the exam room. I got the deer in the headlights look. Instead of compassion, reassurance, or suggestion to talk with a counselor I got a prescription for anti-depressants and told I should be tested for HIV immediately. I changed doctors after that.

I came out to my next doctor in the first meeting wanting to make sure I had found someone who wouldn’t flinch. This doctor was straight but treated me being gay as a total non-issue. As part of the physical he asked about my mental health, any depression, if I was seeing anyone, was I having sex, etc. We discussed safe sex practices and had a discussion about regular STI testing based on my sex practices and risk profile. After I started dating Benjamin, he asked about Benjamin at every visit. He treated me like a human being — that made all the difference.

Fast forward to when I moved to Seattle in 2010. I intentionally sought out not just a gay-friendly doctor but a doctor who was himself gay. Asking around I discovered Dr. Chu and the good folks at Capitol Hill Medical. Hands down this is the best medical care I’ve ever received. I feel totally comfortable chatting about all aspects of my health and sex life with a fellow gay man who understands the LGTBQ+ community. The front desk doesn’t bat an eye when I call in and schedule a regular STI screening and I’ve experienced zero judgement.

Just because you’re gay doesn’t mean you have to have a gay doctor, but I believe it is vitally important that you have a primary care physician that you feel comfortable having open and frank conversations with. If you can’t talk to your doctor about any and all aspects of your health you aren’t getting the best medical care possible. If you’re looking for an LGBT+ health provider, check out the Gay and Lesbian Medical Association’s provider finder.

Regardless of your sexual orientation, race, or gender I strongly encourage you to find a primary care physician you trust. We all deserve the best medical care possible.

Work-life questions to ask tech recruiters

When I was looking for a job over a year ago I had a list of questions for tech recruiters about the company’s work environment, some of which seemed to catch them off-guard. I continue to refine these questions as I discover what environments I work best in.

These may or may not match things you care about, but perhaps they’ll spark some ideas on what is important to you.

What workstation hardware is provided and is that flexible?
If you’re a Mac aficionado and they stick you with a Windows box, are you going to be happy? If you are use to working with a laptop but they only provide desktops, is that OK? What if you function best with both, is that an option? How many monitors are provided and how big are they? You’re going to be spending hours and hours in front of whatever they give you, so make sure it’s something you want, they’re flexible in getting you want you want, or they’re at least OK with you bringing your own hardware.

Do you provide standing desks?
I’ve used a standing desk for 6 years now and couldn’t go back to sitting down all day. If this is something important to you, ask.

Do you have an open floor plan, cubicles, or offices?
Spaceflight is the first company I’ve ever worked in with an open floor plan and I hate it. It’s loud and disruptive. In the future this is going to be one of the factors I consider when looking for something else.

Can I access my personal email?
Shockingly, some companies block IMAP/POP3/SMTP and/or webmail sites for their employees, preventing them from using their personal email. Yes, you really have to ask this question.

Do you have a man-in-the-middle for HTTPS requests?
This question blew recruiters away. They couldn’t believe that a company would distrust their employees enough to snoop on their secure traffic for banking and other things. Except this is exactly what EMC did to their employees. All corporate-provided systems included an EMC CA. Their snooping appliance used that CA to sign certs provided to your browser every time it made an HTTPS request. For those of us in engineering who installed their Linux OS from scratch on Day 1 and didn’t have it, the web browsers would rightfully complain loudly that the certs were invalid and your traffic was being snooped on. Chrome would go so far as to refuse to connect to Google services when presented with a cert that wasn’t signed by a Google CA.

Can I bring and use my personal devices?
What is the official company policy on bringing and using your personal devices (laptops, tablets, cell phone) while at work? Can you work from the devices?

What is your work-from-home policy?
Are employees allowed to periodically work from home? Does the company provide adequate resources to make that possible?

What is the real vacation policy?
I’m way too old to start a job with just 2 weeks of vacation. Sorry, not going to happen. If the company refuses to budge, ask if they are OK with unpaid leave. On the flip side, if the company policy is “unlimited vacation”, what does this really mean in practice? Because if you give me unlimited vacation I’m likely to take a 4-6 weeks worth of vacation over the course of a year, usually in one or two day increments, while still making sure my work is getting done and my team is taken care of. If that’s not OK I need to know up front.

Where is the office located and are there existing plans to move?
Long commutes do not fit into my work-life balance and I will not work for an employer where I have to waste 2 hours of my day getting to and from work. For instance, I live in Seattle and will not take a job on the east side (that might change when the light rail gets completed, we’ll see). Knowing where the company is located is important to me. Knowing if there are existing plans to move the company is equally important.

 

These are just a small set of the questions to think about (I covered some more in my Dear Recruiter post two years ago) but don’t hesitate to ask them. We spent an exorbitant amount of our lives at work and we need to be happy there too.

DP code release with mysqli goodness

Today we set free the second DP code release this year: R201707. This comes just six months after the last major code release. Both were focused on getting us moved to modern coding practices and middleware.

Today’s release moved the code off the deprecated mysql PHP extension and over to the mysqli PHP extension for connecting to the MySQL database. This will enable the site to run on PHP 7.x in addition to PHP 5.3 and later. This change was essential in enabling the code to run on modern operating systems, such as Ubuntu 16.041.

This release also included the ability to run against phpBB 3.2 allowing pgdp.net and others to upgrade to the latest-and-greatest (and supported) version of phpBB.

Perhaps most importantly to some of our international users, this release includes a full French translation of the DP user interface.

Next up for the DP code is modernizing our HTML and CSS to bring it up-to-date as well as standardizing the look-and-feel across the site. Work is well under way by several volunteers on this front.

Many thanks to all of the volunteers who developed and tested the code in this release!


1 Technically you can run PHP 5.6 on Ubuntu 16.04 as well, but 7.x is clearly the future.