hitting a wall.

I want this Jeep. It's a Lilly Pulitzer Jeep Wrangler. How prep-tastic is this??

So. It's been a week of applying to jobs, soul-searching, nannying, and sleeping. It's getting discouraging, the whole job situation. I am still waiting about MSKCC and calling the HR woman this week, and I've looked at Georgetown's cancer center and Northwestern. I applied for a position at UNC today that sounds neat, and hopefully it will lead to something. I'm just struggling to find my place right now. And so are many of those in my cohort, so I don't feel so bad - because I know how amazing everyone is, and how lucky employers would be to hire us. I've been thinking a lot lately about my life here in Chapel Hill and how much I love it, but I was also reminded today about how I loved living in Manhattan last summer. I was watching "The City", and it reminded me of when I'd leave my apt and walk to the 96th st subway in the already-stifling humid morning air, feeling confident in my clothes and excited to go to work. Every day I could honestly say I loved my job. How many people can say that? So why am I so ambivalent about the possibility of returning?? How many people honestly ever say no to MSKCC? It's an amazing place. I left every day exhausted and spent, but inspired and satisfied. Seriously, I read my journal from last summer, and nearly every entry starts with "I had the best day". I love just soaking up all that it had to offer, and I miss my coworkers and attending. I miss free Starbucks iced coffee on wednesdays with Rika. I miss gchat conversations when we were 3 cubicles away from each other. I miss Pinkberry lunches and Buttercup BakeShop obsessions and snack runs. I miss the energy of the city, the humming that seemed to infuse the pavement and electrify the environment. I miss the Barnes & Noble across the street from my office (dangerous) that opened at 7am and going there for a morning coffee and magazine browsing time. I don't miss paying $5 for a box of cereal and always feeling poor and unattractive (because living in NY has the tendency to make one immediately feel ugly and fat). 

How do I reconcile my love of the city and my love for Chapel Hill? Here my life is so much more relaxed, that's a given. I don't feel pressure to "be" a certain way, or dress a certain way. People are nicer, life is affordable, I love my neighborhood....I don't know. The two seem at odds with each other, and I'm not sure I can resolve it. I mean, I wear a sterling silver 5th Ave charm around my neck! Its weight reminds me every time I wear it of Manhattan and my connections to the city. 

But I've been obsessing over MSKCC for nearly 5 years now. Working there last summer has been the highlight of my life, to date. Working there full-time....would be what I've been waiting for and working towards. So it's a lot to think about. 

There is a girl I went to high school with, J, and lately she's been on my mind a lot. After we graduated high school, she had breast cancer at the age of 19 and went through treatment, etc. Recently she was diagnosed with a recurrence, at the age of 29. She just had a bilateral mastectomy - mandatory on one side, prophylactic on the other, with tissue expanders, and eventually, reconstruction. And then chemo/rtx. This terrifies and angers me. It terrifies me because how could this possibly happen to someone my age?? And yet it angers me because....how could this possibly happen to someone my age? The questions are the same, and I keep running up against a wall when I try to search for some answers. Faith provides no comfort, medicine provides no acceptable explanations. I'm not sure what I would do if I were faced with her situation. Although I had come to the decision a few months ago that if my grandmother was positive for the BRCA gene, and I turned out to be positive, I would elect to have a prophylactic bilateral mastectomy with reconstruction. Thankfully, I do not have to make such a decision, because my grandmother was negative. But that's not to say that, G-d forbid, I won't have to make that decision in the future at some point. 

I don't know....I was thinking about this the other night. I don't want to sound like a traitor, but when do we stop fooling ourselves? Like with certain Stage IV cancers, when do we stop fighting and start palliating? Of course, this is a per-patient decision, but on a larger scale....survivorship. I'm interested in the field, I've worked in the field....sometimes it just seems cruel. Sometimes I want to scream, SHOW ME A LONG-TERM SURVIVOR OF GLIOBLASTOMA MULTIFORME WITH A DECENT LIFE when confronted with a survivor of GBM that's 1 or 2 years post-dx. Maybe I'm just in a pessimistic mood tonight, but right now, I feel like we are NOT winning the so-called "war on cancer". And maybe we never will. But damnit, why are the drugs still so toxic? Why are the surgeries still so disfiguring? Why do we not have better screening? Why are there such still disparities among populations? Why are some cancers virtually ignored, while others get money thrown at them with abandon? It is this anger that propels me into the field of oncology. This anger is that voice in the back of my head saying, don't you dare waste this passion for oncology, don't you DARE. This anger stems from watching friends and family deal with cancer and die from cancer. This anger makes me want to do something, it reminds me that there's still so much that needs to be done.