Crohn’s and the academic job market- a tale

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The abysmal situation of the academic job market has received a lot of coverage in recent years, with not much changing, sadly. You can separate academics into different camps: adjuncts and job seekers, the tenured who have compassion but feel helpless, and those who think that everything is amazing the way it is, and who should just shut the hell up and take it.

Let me backup and explain the types of academic labor:

Tenure-track: This is the unicorn among academic jobs. If you have a tenured position at a university, you’re practically unfireable (unless you really, really mess up). Tenure is usually granted after five years, in which you have to prove yourself to be worthy- i.e. publish a lot, teach well, do service. Right now, only 25% of academic labor is tenure track.

Adjuncts: Adjuncts are non-tenure track, and hired on a course basis. While some states have better labor laws than others, adjuncts are usually paid a fraction of what tenure track professors earn, performing the same labor. Most universities do not even list them under “faculty”.

Visiting Assistant Professor: This one is an in-between. It is usually a temporary, non-tenured position, lasting from one to three years, often renewable. Depending on the university, your salary may even be the same of a tenure track professor.

In the past, VAP’s were usually people who had an appointment somewhere else and came to visit,  but these days, most often these positions are filled by young job-seekers fresh out of grad school. The narrative usually was that you do one of these stints, maybe more, and it will eventually lead to a tenure-track position. And, in fact, I do know people who after several of these positions actually ended up with a tenure track position. The majority however ends up being burnt out, broke from all the moving every few years, and tired of being perpetually in limbo. Again #notallVAPs but, really, most of them.

Every few years, someone dares to talk about the strains of a VAP position, this time, on Easter Weekend. Here is your recap by the wonderful Rebecca Schuman.

I should know better than to get upset by the senior scholar who tried to shut down the junior scholar in question, because that’s what this person usually does (they to camp 3), but  I still did.

Because expecting someone to move across country (mostly on their own dime) is aside from all the other adjectives, ableist af.

When you apply for academic jobs, they tell you not to be picky. You can stick it out anywhere for a year or two. Except, when you have a chronic health situation, you can’t. So whenever I would apply for jobs, I would also check the town’s size, how close a hospital would be, whether there would be a good gastroenterologist close by etc. That already is draining, and it makes you think twice about where to apply.

I actually found a VAP position, and moved across country for it.

Next step was finding a good doctor. I have a long and complicated case of Crohn’s and the fact that most of my past medical records are in German did not make it any easier to find someone to treat me. A lot of factors go into finding a good doctor: Do they know the latest treatment methods, are they ok with an informed and opinionated patient (because I am), do they work well with colleagues (because I can’t have doctors prescribe treatment plans that contradict each other), and do they accept my insurance. To figure all of this out, and know that in a year or two you have to do this again, is less than amazing.

As so often in my life, I was lucky. I made a friend on campus who was suffering from another autoimmune disease, and she recommended a great general practitioner and a great gastroenterologist to me. The not so great part- they were around 25 miles from where I lived, but that was ok.  Then, I only got an appointment after a 4 month waiting period, and by that time, I was in a severe flare. If you have a chronic disease, then constant medical supervision is a necessity, but it’s hard when you don’t even know where you’ll be next year.

Now, the next problem was insurance. I had moved from California to Indiana. My grad student insurance had covered exactly four doses of Cimzia, before I had to enroll in the patient assistance program. I obviously had to disenroll, since I now had insurance and it covered it. That was the easy part. The hard part was the pharmacy my insurance worked with. Not once did they deliver on time. Several times, I had to drive to my doctor and pick up a package of Cimzia that an insurance rep had left me.

While I was glad I had insurance, I didn’t exactly have great insurance. Every specialist visit asked for a $50 copay, and if you have to see your specialist several times a month during your flare, it adds up. They also covered only 75% of most procedures and medications, so the bills kept coming. I roughly spent a quarter of my income on paying medical bills. Mind you, I didn’t have any big surgery during this time, because that would have bankrupted me for certain. So, again, lucky.

Not so lucky- because of the constant fuck ups with the pharmacy,  and another gap in coverage when I moved to Oregon, I missed two doses of Cimzia, and it stopped working. When I met my new gastroenterologist in Oregon (recommended to me by the one in Indiana), he tried all he could to get me out of the severe flare that I was in, but it was too late, and I ended up in the emergency room with a burst bowel.

I am not telling this story to be pitied, on the contrary. I don’t know anyone who has had as much luck in her health journey than I have. I have had caring doctors, supportive friends and family, and fantastic colleagues.

But, not everyone does.

Asking someone to leave their support network every one or two years is hard enough for someone able-bodied, but it is brutal for someone who isn’t. If my partner hadn’t moved with me, I’d probably just gotten on a plane home a long time ago. It’s isolating if you can’t participate in activities and have to explain to people about your health situation. It’s scary if you worry about whether your new colleagues will think less of you or question your aptitude to do your job. If you are following a special diet, finding the right grocery stores can be time and money consuming. If a certain climate can exacerbate your condition, the thought of spending two years there isn’t exactly thrilling.  The thought that you have to do this over and over again, until you finally find your tenure track (or until you’re broke, whichever comes first), is physically, emotionally and mentally draining, so to everyone who says “what’s the big deal?” I want to say, this, my health, and my life is a big deal. I left a job that I (even though I did my fair share of kvetching) loved and grieve over every day.

I can’t say whether my health situation would have worsened had I continued on another VAP, for sure, but something tells me, most likely. So in essence, I had to choose my health or my job. And that is a big deal.


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