Being a Tech Lead With a Chronic Medical Condition

Kristen Foster-Marks, Technical Lead, Technology Center of Excellence, Pluralsight

I met Kristen Foster-Marks, Technical Lead for the Technology Center of Excellence at Pluralsight when we were both speakers at LeadDev New York. As we got mic’d up to speak we got to know each other. I learned that we both navigate a chronic condition. I’d been looking for more stories about leading with a chronic condition, so five minutes later I invited her onto the podcast. We spoke about how she takes good care of herself while leading, how she manages vulnerability and authenticity, and being a recovering perfectionist, something I think many can understand. 

I know you, but for everyone else, can you introduce yourself?

Yeah, absolutely. I'm Kristen Foster-Marks. I'm a Technical Lead at Pluralsight's Technology Center of Excellence. The tech world is my second career. For the first part of my career, I was an English language teacher and I specialized in teaching English as a second and a foreign language. I spent a couple of years in South Korea right after I graduated with my undergrad, and ended up going to Colorado State University to do my Master's in teaching English as a second or foreign language. I ended up sticking around there for a few years teaching ESL to graduate students who were matriculating into the university. That was amazing. I loved working with that demographic. Just super bright, super motivated students.

I also spent some time teaching composition in the English department at CSU. Something that I do think it's worthwhile letting people know is that your college instructors, for the most part, do not make livable wages. Anybody familiar with the plight of the adjunct instructor knows that we don't get paid. At a certain point, I was like, this is no way to make a life. It's no way to make a career. I ended up enrolling in a six-month immersive full-stack web development boot camp, and that was 2016. The rest is history. I've been a software developer, software engineer, director of engineering, and technical lead in the time since then, and have never looked back.

Tell us a little bit more about what you do at Pluralsight.

I have the coolest job, truly the coolest job. I've been in this particular role for almost six months now. I'm with the Technology Center of Excellence in one of the sub-teams that we call the Pluralsight at Pluralsight team. We look for ways that we can upskill our folks internally with a focus on technical upskilling, using our own products, with a mind towards making our products even better. It's this really interesting and unique role. I'm loving it. 

I had no idea that roles like this existed. It's an amazing thing. I think also from the standpoint of the software engineers and developers who work at Pluralsight, how amazing that this is something that we invest time and energy into, designing and facilitating these programs where they can upskill at work. Pluralsight is paying everyone to learn. 

I love it. I come from the learning and development world. I know how fulfilling it can be to be in that space to help people and organizations grow and learn. It's a supreme pleasure in my opinion.

Absolutely. It's just such a fun job. As you said, we get to help people learn and grow and progress along their careers and it's just a very positive space to be in.

We were talking during the conference and we got to talking about conditions that we both manage. I wonder if you could share a little bit about what you told me about the chronic condition that you deal with.

I love that within five minutes of meeting each other, this is what we were talking about. We just dove into it. I suffer from Premenstrual Dysphoric Disorder (PMDD). I think it's something that likely a lot of folks haven't heard of. It's one of those conditions that just recently made it into the DSM, what are we on five or six? I think we're on five. It's a severe form of PMS. To qualify for a diagnosis, symptoms have to be so severe that they impact your ability to function in your social life and your professional life for a certain duration of time. It's only happening a certain number of days a month as it corresponds to the changes in your sex hormones associated with your cycle.

Some of the symptoms associated with PMDD are the physical symptoms that you hear folks talk about with PMS, but the symptoms that seem to most interfere with folks' ability to function are those cognitive and those psychological symptoms. For me, I become very unfocused. I'll be having a conversation with my husband and three minutes in I'll realize I haven't even been present in this conversation, just no ability to focus. I also become very despondent and almost nihilistic, which is so not me. I have a hunger for life. I have goals. I want to do things. I'm normally very energetic. I love being around people. When I'm suffering, I'm a different person. Just nothing seems like it's worth doing. I'm happy to just sit and stare at a wall for hours at a time.

The brain fog is very, very bad. I get very, very tired. I could just lay in bed for days on end. It's these cognitive and these psychological symptoms that make it very challenging to show up in life and show up at work for a certain number of days a month. Most women seem to suffer for about three to seven days, I think is what I'm seeing come out of the research the most. Once I figured out what was going on, I started tracking how many days a month I felt like this. For me the 10 days leading up to my period every month I was feeling like this. That's a third of my life. It was pretty impactful.

Wow. When did you get your diagnosis? How long ago?

In 2013. I had a sense of what was going on for probably about a year before that. It was interesting, it was my husband who brought to my attention that something wasn't quite right, that there was this period of time where I wasn't quite myself. That's when I started down this journey of let's track and let's collect some metrics and do a little bit of analysis. What do you know, it always corresponded to my cycle.

Got it. I have Fibromyalgia and Myalgic Encephalomyelitis, otherwise known as Chronic Fatigue Syndrome. It's really hard to get a diagnosis. How was the diagnosis process for you? 

It's a very relevant question in the realm of PMDD because again, it has only recently been accepted by the medical community to the extent that it's now in the DSM-5. I was worried about going to my doctor with this because I was worried about being discounted. The academic in me, the scholar in me, I did a lot of research. I used my access to the university databases to pull papers. Vetting some of that research beforehand gave me the confidence to go to my doctor and be like, "I think that this is happening to me. Let me describe to you my experience and get your opinion." 

Luckily I had a very good relationship with my primary care physician. She knew me. She knew that I'm exuberant and energetic and a happy person. As I'm describing to her, "Okay, this is how I'm feeling for these days of the month, and it's always happening right up before my period starts." She was like, "Yeah, Kristen. That's not you. What you're describing here, I know you. I know that that's not how you are. What you're describing, you sound like a different person during that time." It was a good experience and I'm very fortunate that I didn't experience any push back from my doctor. That's not everyone's experience.

Okay, good. We're going to talk more about this, but I want to go back for a minute and talk about becoming a tech lead. Was leadership something you saw for yourself? 

Not at all. I didn't think that it was possible for me to be a leader because with that many days of my life not being sharp and not being able to sit through a meeting and walk away actually remembering what happened in that meeting, with my confidence being so low those days that I often didn't feel like I could show up in meetings and contribute something meaningful, just all of these psychological factors and things I was suffering from, I didn't think I could do something like lead. So nope. Leadership was never a dream of mine.

How did it happen?

I had a leader who in an engineering all hands opened up the meeting by telling everyone a story of how she's sitting at the dinner table with her family and all of a sudden her vision becomes blurry. How these physical symptoms start to set in, in addition to the blurriness of vision, and how she goes through this process of going to the doctor and trying to figure out what is going on. All of this leads to a diagnosis of Multiple Sclerosis. I just remember I'm sitting there and I'm like, "What? This badass woman, who is the best leader, the best engineering leader that we have on this team, we all look up to, we all trust. One of the smartest people I've ever met, just a superhero, incredibly accomplished. She suffers from this chronic condition." 

To be able to look at this leader and see this role model, it sounds so trite to say, I know at this point, but we really do need to see ourselves in leadership to know that we can do it. She did that for me and many other people that day in that meeting. I think that caused a little bit of a shift for me mentally and holy camoly, could I do that someday? People with chronic conditions can lead. Okay, awesome.

So, that happened. Also, she was my boss. I was her direct report. That really opened up the conversation for her and me to connect on that level. She believed in me. I think she saw leadership potential in me, in the engineering space before I did. She ended up taking a job a step above her and asked me to take her place. I was still reporting to her. We both just moved up the ladder a rung together. That's how moving into engineering leadership happened for me. It was this interesting juxtaposition of her advocating for me at the same time that I was seeing her in this new complete light knowing that she'd been suffering from this and that she'd been kicking ass at leadership while doing it.

You highlight part of why I do this series – to show the full spectrum of what leadership can look like. It’s one of the reasons I was so excited to share your story. If we have something that can be debilitating, it can make us feel not hopeful about our work – can I have a career, is leadership a possibility for me? 

Oh my gosh, yes. It's so important. It is so, so important. Yep.

How do you manage your condition while leading? 

There's the physical component of managing my condition and then there's the mental component. From a physical perspective, I am down to three days a month where I'm low functioning. From ten to three! I've done a lot of work to get there. Cleaning up my diet has been crucial for me in mitigating some of that brain fog. I have a little calendar reminder on my work calendar, and on my personal calendar when I know that I am in the five-day range of probably my period's going to start within the next five days, I start eating all the good foods and I start eating foods that evidence suggests decrease anxiety and decrease brain fog and all that. That's been crucial for me. Exercise, there's so much evidence that suggests that exercise lessens the symptoms of PMDD, PMS, and a whole host of mental issues and conditions. It makes a difference. That, and pills. I love my SSRI. I tried to manage my symptoms without going on medication. I even tried to go off medication at one point and it was a disaster. I've learned to not give myself a hard time over taking a pill. There's nothing wrong with taking a pill and it really, really helps me. So that's the physical stuff that I do to just manage. 

From a mental perspective, I have found that I just need to be stinking kind to myself when I'm suffering. I have this beautiful gift of knowing what's going on and knowing when it's going to happen every month approximately. I may be a couple of days off, but some people feel this way every single day of their lives.

Some people, I think that it's similar in ways to bipolar disorder, where you've got these manic phases and you've got these depressive phases. I think that PMDD can feel that way where you've got your depressive phase and then you come out of it and you're like, "Holy camoly, I feel like a new person. I've got all my energy back. I can conquer the world." I know when it's going to happen. I think it's easier to manage in that way. One of the things that I just try to do is just be really kind to myself. I think I mentioned earlier, one of the things that happens for me is I sometimes just want to sit and stare at a wall. I'm not even necessarily reflecting or thinking or doing anything. I am just sitting there and it's all really that I can muster the energy to do.

I used to beat myself up so much about that. I love being productive. I've got my list of things I want to do today and this week and this month and in life, and I can really beat myself up at times when I'm not working towards those goals. Now when I'm feeling low on those days, I just let myself sit and stare at the wall and that's okay. 

At work, I don't always show up as my best self to meetings on those days. I don't always do my best work. Sometimes I find that I'm two hours into the workday and I haven't accomplished anything. I've just been moving my cursor around. On those days, I let myself just step away from the computer, go for a walk, and see if I can regroup, recalibrate, and if I can't, then it's a sick day. It's a mental health day.

How open are you at work about your condition?

I kept this a secret from almost everybody, like friends, family, and absolutely in the workplace for a long, long time. A couple of years ago, and it was when I first stepped into a leadership position, I was the Director of Engineering for a value delivery team. I was struggling with authenticity as a leader because we don't see a lot of energetic, exuberant, female engineering leaders. It can feel like such a serious space sometimes.

I was struggling with authenticity and there was a woman who I had been admiring from afar since I started at Pluralsight. Something that I just loved about her was that she was so obviously just herself, warts and all. She's just somebody who showed up vulnerably and authentically. I sought her out for mentorship. We established this formal mentorship. We spent six months together working on authenticity. Through the course of the very heavy work that we did together, I told her about my PMDD. She was the first work person I ever told about this. She was like, "Kristen, you need to tell your leader about this." I was like, "Are you bonkers? There's no way I'm telling my leader about this. Absolutely not." We went over this for three months. It took a lot of conversations. She called me out on a lot of bullshit. I had some mythology that I had to break through. 

At the end of that three months of talking with my mentor, I told my leader. It was transformative for me because this is the same leader who had told everybody, "Hey, I've got MS." 

She had modeled that, and yet I was still afraid.

People always think the physical part is the hardest of a chronic condition. The hardest part is how it can mess with your head. When you’re also a leader you feel like you have to be strong, and tough at all times. 

Absolutely. We forget that, hey, I can have this condition and I can also still be strong. Right? They're not mutually exclusive.

Even if I'm vulnerable, I can still lead. Even if I'm not physically strong, I can still lead.

Yes, absolutely. 

As somebody who also has a chronic condition, I've learned a lot about boundaries and scheduling and how to take care of myself. I'm curious about you. What have you learned? 

Yeah, that scheduling piece is so important. Again, that's one of the reasons I feel so grateful that if I'm going to have a condition, it's on a schedule because it makes it easier. I've got my calendar notification that we're within that five-day range. Let's start to look ahead at the calendar and see what we can start moving and removing. That's been huge for me. I think that that's a really good boundary to set.

It's something where it is really powerful to share with your leader if you're suffering from something like this and even with your teammates. I haven't shared it with all of my teammates, but for those teammates who I feel that I have a good relationship with, and whom I trust, I share with them. When I wake up in the morning and I'm like, "Oh, yep, feeling it strong today, look at the calendar." I will not hesitate to reach out to someone and say, "Hey, the PMDD is strong today. Can we move this to next week?" Or, "Can we do this asynchronously?" I'll be able to keep up with the conversation a little bit better if I have just that time to do that.

Advocating for a schedule that allows me to do the best that I can at that moment in time is very important. Also, that kindness piece is a boundary that I've had to set with myself…If there is a meeting that I absolutely cannot move and I have to show up to and contribute something substantive, if I bonk it, I have learned to just be kind to myself. That's a boundary that I had to create. I had to set that boundary with myself of my expectations, my performance expectations essentially. 

What are one or two pieces of advice for leaders who are supporting others with chronic conditions?

I think that one piece of advice that I think is tricky to implement, to be honest, is creating a space for folks to share with you as a leader that they suffer from something like this. Again, that's tricky. I mean, there are legal implications here. You can't ask someone, "Hey, do you have any chronic conditions? Do you want to tell me about that?" We can't do that, obviously, but there are tactful ways that you can make it very clear to the folks reporting up to you that you're here for that conversation and that if they want you to know, that you are happy to know and happy to support them in any way that they need. To go back to my leader who shared with everyone that she was suffering from MS, she created that space for me. Again, you have to get creative with it sometimes, I think. There are ways to just let your folks know that, "Hey, I'm here for it and I'm ready to support you."

I think you're speaking a lot to trust and psychological safety, that creating that environment is an important building block.

What advice do you have for leaders who find themselves in a leadership role and are diagnosed with a chronic condition?

Share with others that this is going on for you. For two big reasons. Number one, you cannot be afraid to ask for help. 

It's okay to ask for help. I spent a long time just keeping this to myself and feeling like asking for help would be a sign of weakness. As soon as I let my leader know and asked for help, just mentally knowing that she was aware and that she was there for me and she was ready to jump in and help if I needed it, was a load off of my mind. It was just huge for me. 

Share so that you can then ask for help because sometimes we need to.

Also, speak up so that you can be that role model for other people who are suffering silently and just need somebody to show them that they can be public with this. That you can have a chronic condition and that you can kick ass at your career and that you can lead and that you can do it. 

One of the lessons that PMDD has taught me is that you don't need to be perfect every day.

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