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Monthly Archives: October 2014

Belated National Coming Out Day post: Why having words for things matters

Almost exactly a year ago, I came out as asexual on Facebook.

I’m asexual, or possibly some degree of greysexual/demisexual; so far it’s hard to tell. Because I do experience romantic desires, I didn’t know this until fairly recently.

I have it easy because at least I appear heterosexual. And it does look to me like sexual desire is a massive distraction and productivity-drain in other people’s lives, so if someone offered me the chance to add that neural wiring, I’m not sure I’d take it.

The hard part comes with being in a relationship, or wanting to be in one, and having the realization that most other people out there have a totally different conception of what a “relationship” means. The hard part is living with the cultural expectation that, as someone’s girlfriend, you owe them physical and sexual intimacy. The assumption that not wanting sex means that you don’t actually love or desire someone; worse, the idea that you can’t just get into bed with a significant other three times a week, as the tradeoff for getting all the awesome parts of the relationship like hours-long conversations, cooking together, and having kids someday. If you’re not “into it”, it doesn’t count.

So if you’re a guy and you’ve been the recipient of my confusing romantic signals in the past, I apologize. I probably did like you. I could have fallen in love with you, even. But that’s a pretty scary leap when you become an emotional wreck a week into dating anyone and have no idea why.

If you’re one of the people who’s been incredibly kind and understanding about this, and helped me try to sort through my feelings in a way that felt safe, you know who you are, and thank you.

 

I don’t think it took long after this before it became general knowledge to most of my friends in the CFAR/LW community. I don’t remember exactly what was on my mind when I made that post, but I do remember that I didn’t think anyone would care much, and I doubted it would change anything.

A year later, it feels like it’s changed everything.

 

On “baggage”

Miranda!2013 had what my mother would call ‘baggage’ around relationships: a mixture of strong aversions, mistaken intuitions, conflicted feelings, et cetera. It wasn’t like I hadn’t noticed this, either. I knew pretty well that it made no sense how rapidly I could flip from having a crush on someone and being excited about seeing them, to wanting to avoid speaking to them forever. I had been working on it.

In fact, I’d been working on it quite deliberately since 2011, when I made a New Years Eve resolution to have a serious relationship. Yes, really. There were moments that were wonderful. I remember standing in my boyfriend’s kitchen, him behind me with his arms around my waist, rocking from side to side as we cuddled…and how I could remember my mother and father standing in that position, and it felt so adult and right.

But then there was the kissing, the making out, the clothes coming off, and the sleepovers where I lay awake all night…and worst of all, the suffocating feeling of knowing that I was loved by someone who I didn’t and couldn’t love back, not in the way he wanted. I remember being afraid of how much he wanted me, afraid that he would rape me. I thought that quiet voice in my head was being stupid, because obviously my boyfriend wasn’t going to pin me down against my will. He loved me; he was gentle and caring and kind.

But we had sex anyway, six months later. I spent a year and four months throwing all of my ingenuity into making that relationship work, into not letting my ‘baggage’ hold me back.

And every time we had sex, it felt a little bit like rape, even though I was technically consenting, even initiating. The little voice screamed that it was wrong, wrong, wrong, and I pushed that voice down until I barely noticed it–until I could look at our relationship and see a victory, a triumph of self-modification.

In the process, I created an enormous stack of baggage, which made it really fucking difficult to have any kind of relationship at all for the next several years.

Miranda!2011 had the usual inhibitions and insecurities of someone who had grown up nerdy and somewhat of a loner, and a misbehaving vagina, but that was about it. Miranda!2013 had a desperate roller coaster relationship with intimacy of any kind. I wanted to be needed, but I was terrified of being wanted. Sometimes it was too scary even thinking about future relationships, and I would resolve to be celibate forever and go to a sperm bank when I hit 25. Even as I started groping towards the think I thought I might want, I only felt safe in long-distance relationships, or seeing poly people who already had primaries, or preferably long distance relationships with poly people who already had primaries. The amount of travelling I was doing in 2013 made this more feasible.

In May 2013, I turned down sex with someone I really, really liked, who liked me back. It was a tentative step in a direction I didn’t even have a name for yet. At this point I’d managed to convince myself that I didn’t like commitment. Commitment, the thing I’d found most beautiful about my parents’ marriage, but poisoned by association.

In the fall of 2013 I started seeing Alex and Ania, a poly couple. It was one of the most healing experiences I could have had, and I will never be able to thank them enough for respecting my boundaries even when I was completely confused about what that meant. At that point, even getting frequent texts from someone I was dating was scary; it implied interest, which implied desire, which would surely lead to one part of me guilt tripping the rest of me into having sex. Instead of arguing with that, Alex and Ania respected it perfectly. I saw them when I wanted to, and no more.

I still spent the rest of that winter convinced that what I really, truly desired in a relationship was to see my partner no more than once a week, and not be expected to even feel like cuddling, and to be free not to talk to them all week if I liked, even then I would have days, or weeks, when I didn’t want to even think about it.

I met Ruby (in person) in February 2014, and things are completely different and a lot better than 2013!Miranda could have imagined–if anything, I am in exactly the relationship I have always wanted–but it took a lot of difficult communication, of digging through baggage and figuring out what the hell it meant.

 

The Moral

It didn’t happen all at once, but the thing that made me feel safe loving someone, and being loved in return, and letting myself want what I really actually wanted and not just what was least scary, was coming out as asexual–more specifically, the community response to my coming out as asexual. People paid attention, and remembered it about me, and brought it up in conversation, and were curious about it, in a way that was incredibly validating. It turned out there were online forums full of people talking about being asexual. Sometime in early 2014, there was a gradual but massive shift where I stopped thinking of myself as a weird broken monkey with missing neural circuitry, and started being okay with asexuality as part of my identity, and then even started being happy about it.

There’s another half to that–one of the foundations of my current relationship is that Ruby knew, before he even met me in person, that I was asexual and what that meant. Starting a new relationship is always going to be confusing and hard, but having a public label took a lot of the ambiguity out–and so far, my being asexual has been a complete non-issue, not even interesting. Ruby is a pretty wonderful person, but it would have been a lot harder for him to find that out a few months in.

I really wish 2011!Miranda could have had that, before she managed to convince herself that she hated commitment and really only wanted casual long distance relationships with people who already had primaries–even though those are nice.

And 2011!Miranda almost had that. I attended my high school’s Gay Straight Alliance, and knew what it looked like to be gay or lesbian or trans. If my college dating experience had consisted of unsatisfactory dates and make-outs with boys, and confusing but thrilling feelings about the girls on swim team with me, or if I’d noticed that I felt wrong in my body and being referred to as ‘she’ made me feel sick, I would have recognized that. (Which wouldn’t make things easy, necessarily–having a word and a name for what you’re feeling doesn’t protect you from discrimination by family, friends, and society.)

But I had no model for “I really like this guy and want to live with him and cook for him and talk about economics until four am and maybe have babies someday, but ohgod if he touches me one more time I am going to run away to the corner and cry.” My mother was supportive and understanding, and her way of being supportive was to buy me chocolate once I managed to have sex.

I’m hopeful, and I’ve got a lot of resources to work on it, but I’m not sure if I’ll ever shed the baggage I amassed in two years of trying really hard to make ‘normal’ relationships work.

That’s why having words for things matters.

 

 

Where Heroic Responsibility Fails

“You could call it heroic responsibility, maybe,” Harry Potter said. “Not like the usual sort. It means that whatever happens, no matter what, it’s always your fault. Even if you tell Professor McGonagall, she’s not responsible for what happens, you are. Following the school rules isn’t an excuse, someone else being in charge isn’t an excuse, even trying your best isn’t an excuse. There just aren’t any excuses, you’ve got to get the job done no matter what.” Harry’s face tightened. “That’s why I say you’re not thinking responsibly, Hermione. Thinking that your job is done when you tell Professor McGonagall—that isn’t heroine thinking. Like Hannah being beat up is okay then, because it isn’t your fault anymore. Being a heroine means your job isn’t finished until you’ve done whatever it takes to protect the other girls, permanently.” In Harry’s voice was a touch of the steel he had acquired since the day Fawkes had been on his shoulder. “You can’t think as if just following the rules means you’ve done your duty.”

-Harry Potter and the Methods of Rationality, Chapter 75

I like this concept. I think it counters a particular, common failure mode, and that it’s an amazingly useful thing for a lot of people to hear. I even think it was a useful thing for me to hear a year ago.

But… I’m not sure about this yet, and my thoughts about it are probably confused, but I think that there’s an opposite failure mode, and that maybe it’s not that easy to avoid.

 

Something Impossible

I dealt with a situation at work a while back–May 2014 according to my journal. I had a patient for five consecutive days, and each day his condition was a little bit worse. Every day, I registered with the staff doctor my feeling that the current treatment was Not Working, and that maybe we ought to try something else. There were lots of complicated medical reasons why his decisions were constrained, and why ‘let’s wait and see’ was maybe the best decision, statistically speaking–that in a majority of possible worlds, waiting it out would lead to better outcomes than one of the potential more aggressive treatments, which came with side effects. And he wasn’t actually ignoring me; he would listen patiently to all my concerns. Nevertheless, he wasn’t the one watching the guy writhe around in bed, uncomfortable and delirious, for eight or twelve hours every day, and I felt ignored, and I was pretty frustrated.

On day three or four, I was listening to Raemon’s Solstice album on my break, and the song ‘Something Impossible’ came up.

Bold attempts aren’t enough, roads can’t be paved with intentions…

You probably don’t even got what it takes,

But you better try anyway, for everyone’s sake

And you won’t find the answer until you escape from the

Labyrinth of your conventions.

It’s time to just shut up, and do the impossible.

Can’t walk away…

Gotta break off those shackles, and shake off those chains

Gotta make something impossible happen today…

It hit me like a load of bricks–this whole thing was stupid and rationalists should win. So I spent my entire break talking on Gchat with one of my CFAR friends, trying to see if he could help me come up with a suggestion that the doctor would agree was good. This wasn’t something either of us were trained in, and the one creative solution I came up with was worse than the status quo for several obvious reasons.

I went home on day four feeling totally drained and having asked to please have a different patient in the morning. I came in to find that the patient had nearly died in the middle of the night. (He was now intubated and sedated, which wasn’t great for him but made my life a hell of a lot easier.) We eventually transferred him to another hospital, and I spent a while feeling like I’d personally failed.

I’m not sure whether or not this was a no-win scenario even in theory. I do think that I was a perfectly good nurse, who fulfilled my responsibilities to my patient. Nurses have a lot of responsibilities to their patients, well specified in my years of schooling and in various documents published by the College of Nurses of Ontario. Nurses also have responsibility to the abstract higher authority of “the nursing profession”; we are expected to hold ourselves accountable for our mistakes, to improve continuously, to propagate certain virtues. But nurses aren’t expected or supposed to take heroic responsibility for these things, and it doesn’t make things better when they do.

And, when I consider it, I don’t actually think that’s a problem. In fact, it seems like a better situation than the converse.

 

The Well-Functioning Gear

I feel like maybe the hospital is an emergent system that has the property of patient-healing, but I’d be surprised if any one part of it does.

Suppose I see an unusual result on my patient. I don’t know what it means, so I mention it to a specialist. The specialist, who doesn’t know anything about the patient beyond what I’ve told him, says to order a technetium scan. He has no idea what a technetium scan is or how it is performed, except that it’s the proper thing to do in this situation. A nurse is called to bring the patient to the scanner, but has no idea why. The scanning technician, who has only a vague idea why the scan is being done, does the scan and spits out a number, which ends up with me. I bring it to the specialist, who gives me a diagnosis and tells me to ask another specialist what the right medicine for that is. I ask the other specialist – who has only the sketchiest idea of the events leading up to the diagnosis – about the correct medicine, and she gives me a name and tells me to ask the pharmacist how to dose it. The pharmacist – who has only the vague outline of an idea who the patient is, what test he got, or what the diagnosis is – doses the medication. Then a nurse, who has no idea about any of this, gives the medication to the patient. Somehow, the system works and the patient improves.

Part of being an intern is adjusting to all of this, losing some of your delusions of heroism, getting used to the fact that you’re not going to be Dr. House, that you are at best going to be a very well-functioning gear in a vast machine that does often tedious but always valuable work.

Scott Alexander, Slate Star Codex

The medical system doesn’t run on exceptional people–it runs on average people, with predictably average levels of skill, slots in working memory, ability to notice things, etc. And it doesn’t run under optimal conditions; it runs under average conditions. Which means tired staff working at four in the morning.

Sure, there are problems with the machine. The machine is inefficient. The machine doesn’t have all the correct incentives lined up. The machine does need fixing–but I would argue that from within the machine, as one of its parts, taking heroic responsibility for your own sphere of control isn’t the way to go about fixing the system.

Taking heroic responsibility for your patient would mean…well, optimizing for them. In the most extreme case, it might mean killing the itinerant stranger to obtain a compatible kidney. In the less extreme case, you spend all your time giving your patient great care, instead of helping the nurse in the room over, whose patient is much sicker. And then sometimes your patient will die, and there will be literally nothing you can do about it, their death was causally set in stone twenty-four hours before they came to the hospital.

 

Conclusion

Someone’s going to be the Minister of Health for Canada, and they’re likely to be in a position where taking heroic responsibility for the Canadian health care system makes things better. They’ll be able to look at the machine, and say “this part isn’t working well” or “this process is inefficient,” and bring in experts, and do whatever it takes to win. And probably the current Minister of Health isn’t being strategic, isn’t taking the level of responsibility that they could, and the concept of heroic responsibility would be the best thing for them to encounter.

I think that many people in the rationalist community imagine themselves in a similar position the the Minister of Health. And some of them are. And maybe a lot more of them ought to be. It might, in fact, be a morally right action for me to leave nursing and choose something higher-impact, somewhere where my heroic responsibility will matter.

But not everyone is going to be the Minister of Health, and I kind of predict that the results of installing heroic responsibility as a virtue, among average humans under average conditions, would be a) everyone stepping on everyone else’s toes, and b) 99% of them quitting a year later.

And I suspect that many people who read Less Wrong and HPMOR are working as parts in a huge machine that does “tedious but always valuable” work, and maybe, like I did, feeling terrible that they couldn’t “win”, and that seems wrong.