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Greater Than Code

276: Caring Deeply About Humans – Diversify The Medical Community with Jenna Charlton

01:09 - Jenna’s Superpower: Being Super Human: Deeply rooted in what is human in tech

  • The User is Everything

04:30 - Keeping Focus on the User

09:09 - Interviewing Users (Testing)

  • Preparation
  • Identifying Bias
  • Getting Things Wrong
  • Gamifying/Winning (Developer Dogs & Testing Cats)
  • Overtesting

23:15 - Working With ADHD

  • Alerts & Alarms
  • Medication
  • Underdiagnosis / Misdiagnosis
  • Presentation
  • Medical Misogyny and Socialization
  • Masking
  • Finding a Good Clinician

Reflections:

John: Being a super human.

Jacob: Forgetting how to mask.

Jamey: Talking about topics that are Greater Than Code.

Jenna: Talking about what feels stream-of-consciousness. Having human spaces is important. Support your testers!

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Transcript:

JAMEY: Hi, everyone and thanks for tuning in to Episode 276 of Greater Than Code. I’m one of your hosts, Jamey Hampton, and I'm here with my friend, Jacob Stoebel.

JACOB: Hello, like to be here. I'm with my friend, John Sawers.

JOHN: Thanks, Jacob. And I'm here with our guest, Jenna Charlton.

Jenna is a software tester and product owner with over a decade of experience. They've spoken at a number of dev and test conferences and is passionate about risk-based testing, building community within agile teams, developing the next generation of testers, and accessibility. When not testing, Jenna loves to go to punk rock shows and live pro wrestling events with their husband Bob, traveling, and cats. Their favorite of which are the two that share their home, Maka and Excalipurr.

Welcome to the show, Jenna! [chuckles]

JENNA: Hi, everybody! I'm excited to be here with all the J’s.

[laughter]

JAMEY: We're so excited to have you.

JOHN: And we will start with the question we always start with, which is what is your superpower and how did you acquire it?

JENNA: On a less serious note, I have a couple of superpowers. One I discovered when I was a teenager. I can find Legally Blonde on TV [laughter] any kind of day [laughs] somewhere. It's a less valuable superpower than it used to be. But boy, was it a great superpower when you would be scrolling and I'm like, “Legally Blonde, I found it!”

[laughter]

JAMEY: I was going to ask if one of your superpowers was cat naming, because Excalipurr is very good. It's very good. [laughs]

JENNA: I wish I could take credit for that.

[laughter]

Bob is definitely the one responsible.

JAMEY: So it's your husband superpower, cat naming and yours is Legally Blonde. Got it.

JENNA: Mine is Legally Blonde.

[laughter]

I also can find a way to relate anything to pro wrestling.

JAMEY: I've seen that one in action, actually. Yes.

[laughter]

JENNA: But no, my real superpower, or at least as far as tech goes is that I am super human. Not in that I am a supremely powerful human, it's that I am deeply rooted in what is human in tech and that's what matters to me and the user is my everything.

I'm not one of those people who nerds out about the latest advancement. Although, I enjoy talking about it. What I care about, what gets me excited, and gets me out of bed every day in tech is thinking about how I can solve a deeply human problem in a way that is empathetic, centers the user, and what matters to them.

JAMEY: Do you feel like you were always like that naturally, or do you feel like that was a skill that you fostered over your career?

JENNA: I think it's who I am, but I think I had to learn how to harness it to make it useful. I am one of those people who has the negative trait of empathy and when I say negative trait, there's that tipping point on empathy where it goes from being a powerful, positive thing to being something that invades your life.

So I am one of those people who sitting in a conference room, I can feel the temperature change and it makes me wiggle in my seat, feel uncomfortable, get really awkward, and then default to things like people pleasing, which is a terrible, terrible trait [laughs] that I fight every day against. It's actually why remote work has saved me.

But I've had to learn how to take caring about people and turn it into something that's valuable and useful and delivers because we can talk about the user all day and take no action on it. It's one thing to care about the user and to care about people. It's another thing to understand how to translate that care into something useful. When I learned how to do that in testing, my career changed and then when I learned how to translate that to product, things really started to change.

JAMEY: That's amazing.

JENNA: Thank you. [laughs]

JACOB: I feel like so often at work I sit down at 9:00 AM and I'm like, “Okay, what do our users need in this feature, or how could this potentially go wrong and hurt our users?” And then by 9:20, everything's off the rails.

[laughter]

As work happens and here's a million fires to put out and it's all about things in the weeds that if I could just get them to work, then I could go back to thinking about to use it. You know what I mean? How do you keep that focus?

JENNA: So part it is, I don't want to say the luck, but is the benefit of where I landed. I work for a company that does AI/ML driven test automation. I design and build experiences for myself. I'm building for what I, as a tester, needed when I was testing and let's be honest, I still test. I just test more from a UAT perspective. I get to build for myself, which means that I understand the need of my user. If I was building something for devs, I wouldn't even know where to begin because that's not my frame of reference.

I feel like we make a mistake when we are designing things that we take for granted that we know what a user's shoes look like, but I know what my user's shoes look like because I filled them. But I don't know what a dev shoes look like. I don't know what an everyday low-tech user shoes look like. I kind of do because I've worked with those users and I always use my grandmother as an example.

She's my frame of reference. She's fairly highly skilled for being 91 years old, but she is 91 years old. She didn't start using computers until 20 years ago and at that point, she was in her 70s. Very, very different starting point. But I have the benefit that that's where I start so I've got to leg up.

But I think when we start to think about how do I build this for someone else and that someone isn't yourself, the best place to start is by going to them and interviewing them. What do you need? Talk to me about what your barriers are right now. Talk to me about what hurts you today. Talk to me about what really works for you today.

I always tell people that one of the most beneficial things I did when I worked for Progressive was that my users were agents. So I could reach out to them and say like, “Hey, I want to see your workflow.” And I could do that because I was an agent, not a customer. They can show me that and it changed the way I would test because now I could test like them.

So I don't have a great answer other than go bother them. Get a user community and go bug the heck out of them all the time. [laughs] Like, what do you mean? How do you do this today? What are your stumbling blocks? How do I remove them for you? Because they've got the answer; they just don't know it.

JAMEY: That was really gratifying for me to listen to actually.

[laughter]

It's not a show about me. It's a show about you. So I don't want to make it about me, but I have a talk called Walking a Mile In Your Users’ Shoes and basically, the takeaway from it is meet them where they are. So when I heard you say that, I was like, “Yes, I totally agree!” [laughs]

JENNA: But I also learned so much from you on this because I don't remember if it's that talk, or a different one, but you did the talk about a user experience mistake, or a development mistake thinking about greenhouses.

JAMEY: Yes. That's the talk I'm talking about. [laughs]

JENNA: Yeah. So I learned so much from you in that talk and I've actually referenced it a number times. Even things when I talk to testers and talk about misunderstandings around the size of a unit and that that may not necessarily be global information. That that was actually siloed to the users and you guys didn't have that and had to create a frame of reference because it was a mess. So I reference that talk all the time. [laughs]

JAMEY: I'm going to cry. There's nothing better to hear than you helped someone learn something.

[laughter]

So I'm so happy. [chuckles]

JENNA: You're one of my favorite speakers. I'm not going to lie. [chuckles]

JOHN: Aw.

JAMEY: You're one of my favorite speakers too, which is why I invited you to come on the show. [laughs]

JENNA: Oh, thank you.

[laughter]

Big warm hugs. [laughs]

JOHN: I'm actually lacking in the whole user interviewing process. I haven't really done that much because usually there's a product organization that's handling most of that. Although, I think it would be useful for me as a developer, but I can imagine there are pitfalls you can fall into when you're interviewing users that either force your frame of reference onto them and then they don't really know what you're talking about, or you don't actually get the answer from them that shows you what their pain points are. You get what maybe they think you should build, or something else.

So do you have anything specifically that you do to make sure you find out what's really going on for them?

JENNA: The first thing is preparation. So I have a list of questions and that time with that user isn't over until I’ve answered them. If it turns out that I walked into that room and those questions were wrong, then we stop and time to regenerate questions because I can bias them, they can bias me, we can wind up building something totally different than we set out to do, which is fine if that's the direction we went end up going. But I need to go into that time with them with that particular experience being the goal. So if I got it wrong, we stop and we start over.

Now, not everybody has to do that. Some people can think faster on their feet. Part of being ADHD is I fall into the moment and don't remember like, “Oh, I wrote myself a note, but there's also” – I just read a Twitter thread about this today. I wrote myself a note, but also to remember to go back and read that note. So [laughs] all of those little things, which are why I really hold to, “I got it wrong. We're going to put a pin in this and come. Let's schedule for 2 days from now,” or next week, or whatever the appropriate amount of time is.

There have been times – and I'm really lucky because my boss is so good at interviewing users so I've really gotten to learn from her, but there have been times when she'll interview a user and then it totally turns the other direction and she goes, “Well, yes, we're not building this thing we said we were going to build. I'm going to call you again in six months when I'm ready to build this thing we started talking about.” Because now the roadmap's changed. Now my plan has changed. We're going to put a pin in this because in six months, it may not be the same requirement, or the same need. There might be a new solution, or you may have moved past that this may be a temporary requirement. So when we're ready to do it, we'll talk again. But the biggest thing for me is preparation.

JAMEY: I have a question about something specific you said during that near the beginning. You said, “They can bias me and I can bias them,” and I wonder if you have any advice on identifying when that is happening.

JENNA: When it feels like one of you is being sold?

JAMEY: Mm.

JENNA: So early in my career, before I got into tech, I worked in sales like everybody who doesn't have a college degree and doesn't know what they want to do with their life does. Both of my grandfathers and my father were in sales. I have a long line of salespeople running through my blood. If I realize that I feel like, and I have a specific way that I feel when I'm selling somebody something because I like to win. So you get this kind of adrenal rush and everything when I realize I'm feeling that. That's when I know ooh, I'm going to bias them because I'm selling them on my idea and it's not my job today to sell them on my idea.

I know they're biasing me when I realize that I'm feeling like I'm purchasing something. It's like, oh, okay. So now I'm talking to somebody who's selling me something and while I want to buy their vision, I also want to make sure that it makes sense for the company because I have to balance that. Like I'm all about the user, but there's a bottom line [laughs] and we still have to make sure that's not red.

JOHN: So you're talking about a situation where they maybe have a strong idea about what they want you to build and so, their whole deal is focused on this is the thing, this is the thing, you’ve got to do it this way because this would make my life the most amazing, or whatever.

JENNA: Yeah, exactly. Or their use case is super, super narrow and all they're focused on is making sure that fits their exact use case and they don't have to make any shifts, or changes so that it's more global. Because that's a big one that you run into, especially when you're like building tools. We have to build it for the majority, but the minority oftentimes has a really good use case, but it's really unique to them.

JOHN: What's the most surprising thing you've taken away from a user interview?

JENNA: I wouldn't say it's a surprise, but probably the most jarring thing was when I got it wrong the first time and when I got it wrong, I was really wrong. Like not even the wrong side of the stadium, a different city. [chuckles] Like a different stadium in a different city wrong. [laughs] It caught me off guard because I really thought that what I had read and what I understood about the company that I was working with, the customer that I was working with. I thought I understood their business better. I thought I understood what they did and what their needs would be better. I thought I understood their user better. But I missed all of it, all of it. [laughs]

So I think that was the most surprising, but it was really valuable. It was the most surprising because I was so off base, but it was probably the most valuable because it showed me how much I let my bias influence before I even step into the conversation.

JOHN: Is there a difference between how you think about the user when you have your product hat on versus when you have your tester hat on?

JENNA: Oh, absolutely.

When I have my product hat on, I have to play a balancing game because it's about everybody's needs. It's about the user's needs. It's about the business' needs. It's about the shareholders’ need. Well, we don't really have shareholders, but the board's needs, the investors’ needs.

And when I'm testing, I get to just be a tester and think about what do I need when I'm doing this job? What solves my problem and what doesn't? What's interesting about testing and not every tester is like this, but I certainly am. I mentioned that I like to win. Testing feels like winning when you find bugs. So I get to fill that need to win a little bit because I'm like, “Oh, found one. Oh, found another one. Yes, this is awesome!” I get really excited and I don't get to be that way when I'm product person, but when I'm testing person, I get to be all about it. [laughs]

JAMEY: I love that. That's so interesting because to me as a developer, I get a similar feeling when I fix bugs. I feel crappy when I find bugs, [chuckles] but I get that feeling when I fix them. So it's really interesting to hear you talk about that side in that way. I like it.

JENNA: Have I ever shared with you that I think developers are like dogs and testers are like cats?

JAMEY: Elaborate.

JACOB: Let's hear it. [laughs]

JENNA: Okay. So I like dogs and cats. That's not what this is about.

JAMEY: I like dogs and cats, too. So I'm ready to hear it. [laughs]

JENNA: Dogs are very linear. If you teach a dog to do a trick and you reward them in the right way, with the exception of a couple of breeds, for the most part, they'll do that for you on a regular basis. And dogs like to complete their task. If they're a job, because a lot of dogs, they need jobs. They're working animals, it's in their DNA. If their job is to go get you a beer, they're going to go get you a beer because that's their job and they want to finish their job.

Cats, on the other hand, with the exception of their job of catching things that move for the most part, they are not task oriented and really, a cat will let a mouse run past it if it's just not in the mood to chase it. It's got to be in the mood and have a prey drive and they don't all. So a cat, you can teach them a trick and if you reward them the right way, sometimes they'll do it and sometimes they won't. Some breeds of cats are more open to doing this than others. But for the most part, cats are much more excited about experimentation.

So what happens if I knock on that glass of wall water? What happens if I push on that? What happens if I walk up behind you and whack you in the back of the head? They're not doing it because they're mean, they're doing it because the response is exciting. The reaction to their input in some way is exciting to them as opposed to finishing tasks. Because if you've ever had a cat catch a mouse, they're actually sad after they have caught the mouse. The game is over, the chase is done. It's not fun to give me the mouse; it's fun to chase the mouse.

So testers are a lot like that. The chase and the experimentation are a whole lot more fun than the completion. When I find a bug, that's the chase, that's the good part of it. That's like, “Oh yeah, I tracked it down. I figured it out. I found the recreate steps.” After I found the bug, it's not as fun anymore. [chuckles] So I’ve got to find the next one because now I'm back on the hunt and now that's fun again.

Dogs on the other hand, it's like, “Oh, I finished the task. I'm getting my reward. I get to cross this off. My list feels really good” Very different feedback. So I think that's part of it is that devs love to finish things and testers love to experiment with things.

JOHN: Yeah.

JAMEY: I think that's really insightful.

JOHN: Yeah.

[laughter]

JAMEY: I'm like a I put something that I did on my to-do list so that I could cross it off and it feels like I did something kind of person.

[laughter]

JACOB: I think we, at least I was, early in my career kind of trained to have that mindset and trained away from no, we're not here to like experiment with the newest and coolest thing. We're just trying to ship features. We're just trying to fix bugs. We're just trying to finish the task. Please do not be overly experimental just for fun, which is an over simplification because everyone needs to be creative at some point. But I totally agree.

JENNA: Well, and testers do have to balance that, too because there is such a thing as over testing and you hit this tipping point where it becomes wasteful and you move from I've delivered valuable information to now I'm creating scenarios that will never happen. Yes, a user can do pretty incredible things when they want to, but we can only protect from themselves to a point. Eventually, it's like okay, you've reached that tipping point now it's waste.

[laughter]

JOHN: Yeah. I remember some research that came out recently that if you call the cat and it doesn't come, it understands what you're asking for and it's like, “Nah.”

JENNA: Yeah. Maka not so much. But Excalipurr, when she's sleeping, she’ll hear you. That cat is out cold. She has zero interest in what you're saying, or doing. Nothing is going to disturb her well-earned slumber. [chuckles]

JACOB: I'm kind of amazed how like my cat is just easily disrupted by the smallest noise when awake and then when he's sleeping, he's dead to the world just like you said. He clearly can't hear it, or if he is, there's something switched off in his brain when he's sleeping, because he's a total spaz when he is awake.

[laughter]

JENNA: I don't know. I think my vet could explain it better. He actually walked me through what happens in a cat's brain when they were sleeping. I don't remember why. I think we were waiting for a test to come back, or something and he was just killing time with me. But there was this whole neurological thing in their brains that looks for certain inputs and even biochemically, they're wired to certain sounds that are things that they should get awakened by and other things, it's like yeah, that matter.

For some reason, though my cats have weird things that they're really tuned into. If you knock on the door, Excalipurr—we call her Purr—will go bananas. She is furious that someone has knocked on the door. Same thing if something beeps like microwave beep, the sound of if I've got a somebody on speaker phone and their car door opens and it beeps, she is mad. She could be dead asleep and she hears that and she is furious. But otherwise, nothing bothers her. She's out cold. [laughs]

JAMEY: I also hate when people knock on my door so I can relate to that.

JOHN: Yeah.

JENNA: Don't come to my door if I'm not expecting you.

JACOB: Yeah.

JENNA: Also don't call me if I'm not expecting you. [laughs]

JAMEY: I have exactly one person I open the door for. His name is Joe and he's our neighborhood person who comes and collects everyone's bottles and cans. But I recognize the cadence of his knocks so that I can answer the door for him and not other people.

[laughter]

JOHN: So you said earlier that working with ADHD, you had to develop some sort of techniques for how to handle that well in your life. Do you want to talk more about that?

JENNA: I don't know if I would say I handle it well, but I handle it.

[laughter]

Most of the time. Typically, I do you pretty well. So I have lots and lots of alerts for myself. Because as I mentioned, I'll write myself a note, but you still have to have the – somebody said the name of it today and I forgot what it was, but there's a type of memory that tells you to like, “Hey, go look at your notes that you created for yourself,” because you can write the notes, but forget that the notes exist and never go look for them again.

So I have lots of like alerts and alarms that tell me like, “Hey, go do this thing. Take your meds. Check to make sure that you have everything you need on the grocery list.” I have a couple of times a day that I have a reminder to go check my to-do list [chuckles] because otherwise, I just won't remember. I'll put the system into place and forget that the system exists and even with those helps, sometimes it'll just slip by especially I'm busy during those alerts. But I try really hard to use those.

The most effective thing for me, though is definitely my medication. I was chatting about everybody before we started and I mentioned that because of supply delays and all of the rules around how early you can refill and the rules around not being able to transfer your script from one pharmacy to another and all that kind of stuff, I was without my medication for let's see Friday, Saturday, Sunday, Monday, because I didn't get it until midday yesterday and I was sick. So [chuckles] too many factors at one time that I was just not at all functional over the weekend. I forgot steps in what I was cooking. I forgot things on the grocery list. I couldn't stay awake. That was probably more being sick but. So for me, that's probably the most effective thing.

Also, just as a note for those of us assigned female at birth, I that ADHD symptoms get worse [laughs] as we hit 40 and up that all of the hormonal stuff winds up interacting with how our attention is, because I couldn't figure out why my dose had to go up. I was like, “I've been on it forever. Why do we have to raise the dose?” And she's like, “Well, there's some things going on,” and I have a feeling it's all about premenopausal stuff, because for those who don't know, I'll be 40 in June. Not a teenager anymore. [laughs]

So all sorts of things that I need to keep it all in balance and things that I'm learning about being in my age group and having ADHD that nobody talks about because of the assumption that ADHD is something only children have and that ADHD is something that you grow out of. When you don't grow out of it; it just kind of changes. And that it's not just men and people who are assigned male at birth that there's a lot of us out there, varying genders. We’ve got to talk about it more because a lot of us feel like we're wandering the wilderness, trying to figure out what's on in our heads. [laughs]

JOHN: Yeah. I remember hearing recently that ADHD and ADD present differently in AFAB people and so, it goes underdiagnosed because of that. It doesn't show up in the classical symptom lists in the same way.

JENNA: Yeah. So the classic symptom list was developed around pre-pubescent and puberty age boys and in girls, it doesn't tend to present as not being able to sit still. Although, there's still definitely some of that. It presents more in being like a Chatty Cathy as they say like, “Oh, they talk all the time.”

So it presents differently and as we get older and all of the other like stuff starts to factor in, AFAB tend to get identified instead as borderline personality disorder, or bipolar as opposed to ADHD, or even anxiety as opposed to ADHD. Because when you feel like your brain is going a mile a minute, it makes you anxious. So they give you an anti-anxiety medication instead of dealing with the fact that you feel like you can't keep up with your thoughts. There are so many different factors there, but we're learning a lot more about the presentation of ADHD and autism in people who are assigned females at birth.

JOHN: Yeah. I don't know a ton about the history of the diagnosis and everything, but I can assume well, because it’s the society we live in that there's a giant pile of sexism going on in there, both in who is studied and who they cared about succeeding in classical schooling and the work environment and all sorts of biases up and down the hierarchy.

JENNA: Absolutely. There's both, the medical misogyny, but also the socialization because there's an expectation of good girl children and the behavior that girl children should display. So we are socialized to force ourselves to sit even if it means sitting on your hands. You're socialized to doodle instead of wiggling because good girls sit still.

So there's all of that kind of stuff that plays into it, too. Even things like if you develop a special interest, which typically people associate with autism, but certainly has some crossover with ADHD because they're very closely related. You learn to either hide that special interest so you just don't talk about it, or you become that person that has the weird quirky thing because ADHD girls are always quirky, right? [chuckles] They're a quirky girl. There's no neurodivergence there. They're just quirky. They're just different.

I guess, in many ways, I was kind of lucky because my mom taught autistic, intellectually disabled, and other disabled early childhoods. So she identified early, like kindergarten, that I was probably ADHD. I was dealing with it like really early. Also, she had this kind of belief about raising kids without gender, but also not doing it very well. So I wouldn't say it was a successful thing. [laughs]

So let me tell you, we didn't have girl toys and boy toys. We had building blocks and stuff like that. We weren't allowed Barbies. We also weren't allowed Hot Wheels. Very gender in neutral things. But when, as a teenager, I dressed really androgynous, I was told to put on a dress because she is a girl. So I don’t know.

[laughter]

It didn't really work. But I think that a lot of that played into me being identified really early. I'm probably getting off track, but the benefit of is that I learned a lot about it from an early age and I was able to develop systems that work for me from an early age.

Most people who are assigned female at birth don't get the benefit of that. My hope is that our kids, I don't have any kids, but to the people my age that have kids, my hope is that their children are being identified earlier so that they are able to get those systems in place and be more successful in the long term.

JACOB: I'm autistic and sometimes I think about the fact that I think that my white male privilege let me get away with some of the less great behaviors that came naturally to me and did not force me to develop masking skills until much later in my life.

So when you were talking about that, I can sort of relate to that by the opposite that that's making a lot of sense to me, that I could see how all these sort of societal pressures to sit still and behave weren't put on me. I was just encouraged to just be a weird individual and be myself and how that wasn't put on me in places where maybe it probably should have been. So that makes a lot of sense.

JENNA: I have to say, though, I think I've forgotten how to mask COVID has definitely killed masking for me. I have completely forgotten how to make small talk. [laughs]

JACOB: Yeah, me too.

JENNA: [laughs] I can't do it anymore. I've also forgotten how to fix my face. I was never great at fixing my face. Everything I'm thinking, feeling wears on my face, but I'm even worse at it than I used to be. [laughs]

JAMEY: I also struggle with fixing my face, but I've actually been finding that I love wearing face masks in public because I can interact with someone without having to worry about what my face is doing and it takes a lot of the pressure off me, I feel.

JENNA: I think it does. So I have resting friendly face.

[laughter]

For those of you who've never met me in person, I am 4’ 10”. I'm really short. I'm also kind of wide. I'm fine with it. But little ladies in the grocery store will ask me to help them reach things because I look friendly and approachable.

[laughter]

But I can’t reach them any better than they can!

[laughter]

Sometimes they're taller than me. So face masks have allowed me to blend in more, which is really nice because I get less of random people coming up to talk to me. People will joke that I make a friend everywhere I go because people just start talking to me and I don't really care. I'll talk to them, that's fine. What I really laugh at is since I can't fix my face, I will put on a plastered-on smile and somebody will be like, “You are really mad at me right now, aren't you?” I'm like, “No, everything's fine. I'm super okay with this,” and they're like, “Yeah, you are furious so we're going to stop.” [laughs] Like I can manage an angry smile without meaning.

[laughter]

JAMEY: It's interesting what you said about people talking to you randomly, because I also I tend to be that, the kind of person that people talk to randomly in general. I've been having an interesting experience recently where I've been on testosterone for about a year and a half and I'm like finally hitting the point where the way people perceive me in public is different than it used to be.

That got cut down dramatically immediately and in a way where people's eyes slide off of me in public. I'm not there in a way that never used to happen to me and it was really interesting realization for me to realize how much of that was the socialization that people think they're entitled to a woman's time and attention. It's not exactly what you were talking about, but it made me think of it and I've been thinking about it a lot lately. [laughs]

JENNA: But it's true. It's really true. I think everyone who's perceived as a woman gets it, but gets it in different ways. I tend to get it from people who feel like I'm a safe place to go to. So little old ladies talk to me, little kids talk to me. Now to be fair, bright pink hair, little kids think I'm great.

[laughter]

Especially when my tattoos are showing, too. The parents are usually like, “Okay, okay. Leave them alone.”

[laughter]

But I'm also—no offense to anyone who identifies as male in the room—the person that men don't typically stop and talk to, or even notice. I remember I was taking four boxes of nuts to my coworkers and I think it was Fat Tuesday, or something so I was bringing in these special donuts from my favorite donut place around the corner. I had four boxes of donuts and this guy doesn't grab the door, or anything. Just leaves me to try and push the door open with four boxes of donuts. But then granted, she was gorgeous, beautiful blonde starts walking the other direction. He notices her right away, grabs the door, and opens it for her. It's like oh, okay.

I've had that happen quite a few times and not to sound dramatic here, but that's part of the reality of living in a fat body that you do get overlooked by others. So the little old ladies tend to tend to gravitate towards me and then other women, men gravitate towards them. I think no matter, what women experience this and people who are perceived as women, because I do identify as non-binary. But let's be honest, people in the broader world perceive me as a woman. We all get it. We just get it very differently and in different ways, but I can't think of a single woman who hasn't experienced it in some way.

JAMEY: Definitely.

JOHN: Yeah. I've read so many rants frankly from women who have absolutely loved masking well in public because they don't get told to smile and they don't present as female as normal. So they don't fit into that category as much and so, they don't get that same attention. I look very male so no one ever does that to me, but I can imagine what a relief that must be.

JENNA: I definitely think it is for some women, especially in super public spaces.

JAMEY: I feel like I derailed from ADHD and I want to bring it back.

[laughter]

I did have a question I was going to ask anyway. So I'm bringing it back to that, which is that I feel like these conversations, like the conversation we're having right now about ADHD, is something that I've been seeing happening more, especially about ADHD and adults.

I think it's just something that people have been talking about more the past few years in a way that's positive. I know a lot of people who were like, “Oh, I got diagnosed recently as an adult. I started on medication and I never realized this was what was making my life so hard and my life is so much easier now.” I have several friends that are like really thriving on that currently.

So I guess, my question for you is that as someone this whole story you told about being aware of this much younger and being able to make all these coping mechanisms and things like this. What would your advice be to someone who's now, as an adult, realizing this about themselves and then coming to grapple with it?

JENNA: Let me preface with this. I'm not one of those people who says medication is the only way; there are lots and lots of ways to manage ADHD symptoms. But I feel like the most beneficial thing you can do for your is to find a clinician that listens to you, that believes you, that doesn't dismiss your experiences because there are as many different presentations of ADHD as there are people who are ADHD. If you've met one ADHD person, you've met one ADHD person; we all have different traits.

So finding somebody who is willing to hear you, listen to you, and partner with you, as opposed to try and dictate to you how to manage, how to cope is critical. Part of that is arming yourself with all the information that you can. But the other part of it is being a really, really good self-advocate and if you aren't comfortable with that kind of self-advocacy, finding somebody that's willing to partner with you to help be your advocate.

I know a lot of people in the fat community who have personal advocates for medical appointments, because they feel like they're not heard when they go to the doctor. Same thing for us as people who are neurodivergent. We don't get heard all the time and if you feel like your clinician isn't hearing you and because there is a real barrier to getting a new one many times—oftentimes we're stuck with someone. Finding that person that's willing to walk with you is huge.

It is really easy to find yourself in a situation where you lose control of your decision-making to a provider who makes the decisions for you, but is clever enough to convince you you're making the decision yourself. That's my biggest advice is don't fall into that trap. If something feels wrong, it's wrong. If a medication doesn't work for you, it doesn't work for you. There are multiple different types of medications, classifications of them, and different brands for a reason is because we all need something different.

Like I went through Ritalin, Adderall, finally to Vyvanse because Ritalin and Adderall weren't working for me. Adderall worked, but it raised my heart rate. Ritalin made me feel manic. My provider listened to me when I said I feel manic. I feel out of control, and she's like, “If on the lowest dose you feel out of control, this is not a way to go.”

I have a friend who has been pushed off of taking stimulants because she has a history of addiction. She has a history of addiction because she's ADHD and she was self-medicating. It took four different providers to finally get to somebody who said, “Yeah, the stimulants are what worked for you.” The non-stimulant options weren't working, but she had to go and demand and demand and demand and it was the only way to get heard.

So I probably got on a tangent there, but self-advocacy, finding someone who will work with you, and getting an advocate if you don't get hurt.

JAMEY: I think that advice will be really helpful for people. So thanks.

JOHN: Yeah.

JENNA: I'm always very worried that I'm going to cross a line and upset somebody, but it just is, right?

JACOB: I don't know what line that would be. I feel like everything you said was just really empowering and I wish someone said that to me 10 years ago, honestly.

JENNA: I hope it's helpful, but I've had people who haven't realized that even though they're an adult, because they're neurodivergent that they are forever a child.

JACOB: Yeah, I know.

JENNA: So their opinion, their experience doesn't matter, it's invalid, and those are the folks that sometimes get really upset when I talk about self-advocacy. That's a big personal journey to realize that hey, you are a grown up. You make these decisions. [laughs] You are allowed to be an adult now. In fact, you need to be an adult now.

JAMEY: That's also very insightful, I think.

JOHN: Yeah, and interestingly, it ties in with – so my company had an event for Black History Month. We're a healthcare company, we have a lot of clinicians of color and they put together a panel discussion about Blackness in a healthcare context and literally one of the panelists was talking about how do you cope with there's still prejudice, there's still people joining medical school right now that believe that Black people don't experience pain as strongly as other people. How do you deal with that?

They said almost literally the same thing. You take advocates with you to your medical appointments so that you can have more opinions. You can have someone to help fight for you, someone to help make those arguments, and point out things that you might not be noticing at the moment about how the provider is acting, or just to give you that moral support to actually voice your like, “Hey, what, wait, wait, wait, this is not right. Let's back up and talk about this again.” So I think that advice is important in so many intersections that I'm glad you laid it out like that.

JENNA: It's a really interesting conversation that I wound up having. I've had sleep problems my whole life and by the way, if you're ADHD and you have sleep problems, you're not alone. It's a pretty common symptom [chuckles] to have disrupted and disordered sleep partly because our brains get bored and then we wake up. Our brains don’t know how to focus on sleep. Interesting study that somebody's undertaking.

But my neurologist that I see for sleep asked me to be part of a panel conversation with a team of doctors and they basically asked me questions about being ADHD and having sleep issues. And one of the things that these doctors had never really considered is that I know enough about my own body and my own sleep to know why all of the things that they've suggested haven't worked.

One of them was like, “Did you try having more potassium?” I remember I just stopped myself and I said, “Listen, my parents have told me stories of how I wouldn't sleep as an infant.” We're talking about somebody who was sleeping 2, or 3 hours a night as a toddler. This is not a new thing. This is not insomnia. This is not stress related, stress induced sleep loss. This is a chronic medical condition.

I said, “If you think that I haven't tried more potassium, having peanut butter at night, turning off devices an hour before bed, not watching TV before bed, not reading before bed, using the sleep training apps, going for a sleep study. If you think I haven't done this stuff, I don't know how to help you, because if you think I've made it this far in my life without trying anything, we have a whole another conversation to have.” It's the same thing. I'm going to say this and it's going to sound really hurtful to providers, but they think that we were born yesterday and until that change, we just have to keep proving them wrong.

JAMEY: I think that you won't probably hopefully hurt the feelings of providers who aren't like that. Because my suspicion is that providers who aren't like that are like, “God, I know.”

[laughter]

JENNA: I hope so. I hope so because they're patients, too. I really wonder what it's like for them to go to a doctor.

JAMEY: Yeah. I didn't want to totally derail into a different conversation again, but I just want to kind of note that this all really resonates with me also as a trans person, because I know way more about trans healthcare than doctors do.

[chuckles]

So I go in and I say, “This is what we're going to do because I know all about this,” and my doctor's pretty good. He listens to me and he works with me, but he says like, “Cool, I don't know anything about that so sounds good,” and it's just wild to me that I have to learn about all of my own healthcare to do healthcare.

JENNA: Yeah, which that's a whole another conversation about how important it is to – like we talk about diversifying tech, which is important, but we also have to diversify the community. Until there are trans clinicians, until there are more Black clinicians, until there are more assigned female at birth clinicians, we are going to continue to find ourselves in these situations and we're going to continue to find ourselves in dangerous situations.

I think about—getting off track for a second because that's what I do. I live in Cleveland. Well, I don't live in the city of Cleveland, but Cleveland is my nearest metro area. I’m 10 minutes outside of the city. Cleveland has one of the worst infant and maternal mortality rates for Black women in the country. We also have some of the lowest numbers of Black OB-GYNs in the country. There is a direct correlation there.

No offense to my white men, friends, but all of these white men sitting here in their ivory tower guessing at how they're going to solve this problem while at the same time women like Serena Williams nearly die in childbirth because they don't listen to her. It's like, so you're going to come up with these solutions when you're not even listening to some of the most educated and informed patients that you have? It's why there's a whole coalition of Black women in Cleveland that have started a doula organization that they're becoming doula to support other Black women in the city because they don't feel like the medical community is here for them. It's the exact same thing. Like until we have this diversity that's so needed and required, and reflects patients, people are going to die.

JAMEY: Yeah. On the flip side of that, when you do have a provider that shares your background in that way, it's so empowering. My new endocrinologist is trans and the experience is just so different that I couldn't have even fathom how it was going to be different beforehand. [chuckles]

JENNA: That's amazing, though. That transforms your care, right?

JAMEY: Yeah. Totally.

JENNA: But it all comes back to what I said about how I care deeply about the human [chuckles] because this is all the human stuff. [chuckles]

JOHN: Yeah.

JAMEY: So what we like to talk about here on Greater Than Code, the human stuff.

JENNA: That's why I love Greater Than Code. [laughs] I can't help myself, though. Whenever I say human stuff, or think about human stuff, I think about Human Music from Rick and Morty.

[laughter]

That whole thing has always stuck out in my mind. [laughs] Just look up Human Music from Rick and Morty and you'll get a giggle. [laughs]

JAMEY: I think it's a great time to do reflections. What do you think?

JOHN: Yeah, I can start. I think there's probably a ton I'll be taking away from this. But I think what struck me the most is right at the beginning when you were talking about your superpower, you talked about yourself as a super human, not super human, but as a just super human, just you're really human. All of us are, but we don't think of ourselves that way. I just love that framing of it as just that I'm here as a human and I'm leaning into it. I really like thinking that way and I'll probably start using that term.

JACOB: I related really hard to the forgetting how to mask situation since COVID. I don't know if that's a full reflection, or not, but I relate really hard to that.

JAMEY: I feel like in a way my reflection is so general, I think it's so great to talk about stuff like this. I think that it's really important. Like I was kind of saying about we have more people realizing things about theirselves because people are just more are open about talking about this kind of topics. I think that that's really amazing and I think that when people like Jenna come on shows like Greater Than Code and we can provide this space to have these kind of conversations. That, to me feels like a real a real privilege and I almost can't come up with a more specific reflection because I hope people will listen to the whole show.

[chuckles]

JENNA: What's been really amazing is getting to talk about whatever just feels stream of consciousness in this conversation has connected a lot of dots for me, which is really neat because outside of tech, for folks who don't know, I'm a deacon at my church, which is also a very human thing because I provide pastoral care to people who are in the hospital, or who are homebound, or who are going through crisis, or in hospice care, or families who have experienced a loss.

All of these things interconnect—the way that I care for my community, the way that I care for my broader community because I have my church community, I have my tech community, I have my work community, I have my family. All of these very human spaces are the spaces that are most important to me.

If you are my friend, you are my friend and I am bad about phone calls and stuff, but you are still somebody who's on my mind and if something happens, I'm your person. You just message me and I'm there. It all interconnects back to all of these like disparate ideas that have just coalesced in one conversation and I love that and that makes my heart very full.

JAMEY: Thank you so much for coming on the show. Is there anything that you want to plug?

JENNA: So I have a couple of talks coming up. At InflectraCon, I am doing a risk-based testing talk and Agile Testing Days, I am doing a workshop on test design techniques. If you came to CodeMash, it's that workshop, it's fun. Support your local testers! That’s my big plug. Support your testers!

[laughter]

JAMEY: Think about them as the experimental cats. I think that will be helpful for people.

[laughter]

JENNA: Yes!

[laughter]

JAMEY: Thank you so much. This was great!

JOHN: Yeah, I loved the last line of your reflection. That was beautiful.

JENNA: Aw, thank you.

Special Guest: Jenna Charlton.

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