yay babies!

I have a new baby cousin Cole!! yay! My one cousin and his wife had a baby this morning! Life is beautiful.

200th post!

This is my 200th post! Yay! It feels like a lot more than that, though.

This is a picture of a shofar, siddur, and tallis.

So, next weekend is Rosh Hashanah, the Jewish New Year, and one of the High Holidays. It is one of the holiest days of the year. It is a day of judgement, when G-d looks in the Book of Life and makes decisions on people. It is a day of reflection, and 10 days later is Yom Kippur, when we repent for any wrongdoings so we can be sealed in the Book of Life. It is customary to wish each other "Shanah Tovah", to have a good year, or to tell people you wish them a sweet new year. We eat apples dipped in honey, and challah dipped in honey (which I am eating right now; it's my favorite part of the holiday!). It's also traditional to say "Next year in Jerusalem!" Gosh, I would love that - to be in Israel for the High Holidays. I miss it so much. I will return one day, this I know.

Rosh Hashanah was not always a sweet holiday. 14 years ago - half my lifetime ago - on Rosh Hashanah, events were set in motion that eventually resulted in my parents' divorce. At the time, I thought my life was over. And though it took me a while, my life gradually got larger and though it stings deep down, I am able to enjoy the holiday. This year, we have so much to be thankful for. I am so thankful that my grandmother beat breast cancer and is healthy and back to her socializing self, I am thankful that my nephew is talking and is healthy and happy, I am thankful that my family is able to help me, and I am thankful for my health. Overall, life is sweet, and I have high hopes for the coming year.

living in the moment.

My friend Lily commented on this picture that my nephew looked totally happy and fully present in the moment, and he really does. But isn't that how all kids are? We could learn a lot from them. If you notice, the dog's leash is clipped to his shirt. His new thing is pretending to be a dog. He even does "pee pee on the grass" - he goes on the grass and squats, and says "peepee grass", and pretends to go like a dog. He is definitely my brother's child. But at least he dresses well, which is more than I can say for my brother. :)

it's not faith if you use your eyes...

This picture captures the essence of how I feel lately, but not necessarily in a bad way. Let me explain. I have always been that intense, neurotic girl who planned her life in detail. No joke, I actually wrote out Jaime's Life Plan when I was in college, right down to where I wanted to do my PsyD internship, when I wanted to get married, etc. Needless to say, there have been quite a few detours. I don't like surprises. I'm not a spontaneous person. I used to be terrified of making "the wrong decision"....but it has taken me over 5 years to realize that there was no wrong decision. Every experience I've had, every place I've lived, every program in which I've studied, have a place and reason in my life. And though I have yet to find my place in this confusing and crazy world, I think I'm getting closer. I hope I am. It feels like I am. I may be in pediatric oncology, just not the way I thought. I may be in medicine, but not as a doctor. I don't want to sound Pollyanna-ish....has this been easy? No way. Do I still question my decisions? Constantly. I still fight feelings of doubt and disappointment, but at the age of 28, maybe I am finally headed on the right path.

Things happen for a reason. Going to UNC for my MPH was a dream come true, and I came out of it a little bruised, but still here. I have found a place I can call home, and really, truly love where I live. Dare I say - I'm like a real adult. There have been so many unexplainable and unjustifiable (in my opinon) things that have happened in my life, and I have just come to have blind faith that it will all come together in the end.

I've never been like this before. I've never NOT had a plan. I've never NOT had a clear, laid-out trajectory. I've never doubted myself so strongly in my entire life. The whole PhD debacle really shook my confidence, and I need to regain my belief in myself. Maybe this is all part of the growth process we all go through.

Over 10 years ago, a mentor told me about "blind faith". Taking that leap when you have no idea what's on the other side, but having faith that it would work out. It's only now that I can appreciate that concept the way I think she meant it.

i'm beginning to really hate the color teal.

I haven't really been blogging, and most of the time, it's because I'm not even sure how to form words to express what I am feeling. Yesterday it finally hit me (yes, it took that long to REALLY hit me) how bad my aunt's cancer is. It's pretty freakin' bad. I operate like this: when something bad happens like this, I go on autopilot - I start researching, making phone calls and connections, figuring out what needs to be done. When there is nothing more to be done, the intellectualizing and depersonalizing stops, and emotion finally surfaces. And that's what has finally happened.

Like I did when my grandmother had breast cancer, I am praying and sending a guided imagery cd and cards, but it's frustrating not to do more, all over again. It is so painful to watch events unfold and feel in my heart that an altered outcome would have happened had different decisions been made in this whole situation. We aren't talking cure, or even possibly remission. I'm talking a few more months, or the possibility of a clinical trial, or even optimal debulking, at this point. I'm talking about giving her the best possible chances, given the situation; the best possible prognostic indicators. I'm talking about the realities of the limitations of chemotherapy and the balance with quality of life. Palliation versus treatment. I am struggling with accepting the decisions that have been made. I don't understand them, but I am struggling to respect them. It is hard work. It makes me wonder if I can really work in this field......how will I react when a patient and their family chooses a course of action I strongly disagree with? Maybe since they're not family, it would be different. It likely would be very different, but it worries me. How do we evaluate decisions when it's a lose-lose situation? In your medical ethics classes and patient advocacy classes, you can debate this all you want. When you're faced with it in real life, when someone you love is the patient in question, all of that ceases to matter. Decisions aren't black and white, and sometimes, not even grey. Sometimes there is no right answer, and maybe there isn't any answer at all.

When am I going to learn that I cannot save people? That I am not Supergirl, that I cannot "fix" things. Sometimes I think that's what draws me to being an oncologist - "fixing" things. Go in, remove what's wrong, and it's "fixed". For some reason I think being an oncologist would be less hard on me emotionally, rather than being an oncology nurse.

September is Ovarian Cancer Awareness month, ironically. Teal ribbons will be everywhere. Last year, when my grandmother was diagnosed with breast cancer, it was October, and Breast Cancer Awareness month. Oh, the irony.

I am rereading a book that I'd read years ago - "help me live: 20 things people with cancer want you to know". I was lucky enough to "friend" the author on facebook recently - although I didn't realize at all who she was at the time - and decided to reread it. I would say these guidelines even apply to loved ones of the patients...as in, when I tell you my aunt has ovarian cancer, and you know about my grandmother's breast cancer, please do not get a stricken look on your face followed by pity. Do not assume I have a BRCA mutation running amok in my family, or even a HBOC (hereditary breast and ovarian cancer) issue. I worry about that enough for both of us, I don't need the reminder. When I tell you about my aunt being in the hospital for a few more weeks, please do not say to me "Do you really think she'll leave the hospital?" (Yes, horrendously enough, someone said that to me this week). Don't think that because I am living my life as usual that it's not on my mind. It is on my mind when I wake up, and it is the reason I can't fall asleep. It's okay to ask me about it. Otherwise, it's a big teal elephant following me around. And that just cramps my style.

Randoms: check out Teal Toes for ovarian cancer awareness! If you get pedicures, get your nails painted teal next month! When people ask you about it, tell them about the early symptoms of the disease.

I am still raising money for the Avon Breast Cancer Walk.....not sure if I will actually walk, do crew, or even be able to GO, but I'd like to raise as much money as I can. Please let me know if you're interested and I can send you the link! Thank you!

post-grad.....

By now, I'm sure you've seen the previews for the movie "Post-grad" that is coming out tomorrow, with Alexis Bledel. It's about a girl who graduated from college, moved back in with her parents, and is looking for a job, a life, and love....not in that order, necessarily. Every time I watch this preview, I am irritated by it. It makes post-graduation, unemployed life look like so much fun. Obviously, it doesn't look like the movie. Real life looks like credit card bills that you can barely pay the minimum balance on, endless job searching and applying, dealing with feelings of fear and failure (nice alliteration there, huh?), and worrying. It's applying to jobs well beneath your education level, and not getting them, most likely for that very reason. It's dealing with citibank and nelnet for student loan payments that stress you out. It's that creeping feeling of...shit, is this what it is like being an adult? And ironically, at a time when we're supposed to have a degree in our future job area, most of us STILL have no idea what we want to be when we grow up.

So here we are, with advanced degrees, closets full of clothes for jobs we don't have, eating cereal for breakfast, lunch, and dinner. And we're the future of America.

my next tattoo.

I want this to be my next tattoo. It's the MSKCC symbol, surrounded by the breast cancer ribbon and the ovarian cancer ribbon. Right now, this sums up my life, my interests, my passions, and everything important to me and who I have become. Now I just need the money to get this done! (And figure out where I would get it).

breathe in...and out....

Like I said, last time I posted probably wasn't the best time to blog. But things are better now, like they always are....life is manageable once again. My dear friend R and I went out for lunch and coffee Friday in the midst of my UNCdeletingmyONYENcrisis, and I felt much, much better afterwards. This weekend has been filled with talking with family and catching up with friends, and reading good books. I have also been running, which is a great stress-reliever and endorphin producer.

My nursing application is in. It is out of my hands, and all I can do now is wait, and hope.

Speaking of hope....I struggle to reconcile hope with fact. With my aunt's diagnosis, intellectually, I know it is less than ideal. But I also know that inherently, when it comes to individual people, statistics mean nothing. They are just numbers. We all know people who beat the odds, who shouldn't have lived, who have come much further than was ever expected of them. Look at Lance Armstrong. Look at Patrick Swayze. Never underestimate the power of will to live, of a fighting spirit. I often overlook this, because I can't "quantify" it, can't measure it, can't prove it. It defies simple, logical explanation and that bothers me to no end. But it happens. And in this line of work, that can be nice to remember. It's necessary to remember.

This is also my first time dealing with the whirlwind that accompanies a late-stage cancer diagnosis of someone I love. I didn't know about J's late stage of her breast cancer until afterwards, when she was in remission, and R's cancer is a recurrence....so this, this is new. And it's shocking. It is all-encompassing, pulltheflooroutfromunderyou stunning. Things were fine one week, the next, all hell has broken loose. It goes against everything explainable. And the anger....but there's no one or nothing to be angry at, because this cancer has no good screening test. It has no super-early warning signs. There's not a pin-pointable cause. No rhyme or reason. Which just seems to fuel the anger. Or at least my anger, anyway. I'm angry because I'm not a doctor and I can't make this alright. I'm angry because I'm not up there. I'm angry because oncology doesn't have better things to offer her, and what we have seems so inadequate when you're faced with the knowledge of how this disease works and where it is right now.

So what am I doing? I am reading my books, reading the Bible, praying (even if I don't fully understand where G-d is coming from), drinking my coffee, listening to my nephew's laugh on the phone, and enjoying the sunshine every day. What else can I do?

"There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle." - Albert Einstein

i like my coffee dark and bitter, like my soul, thanks.

Right now is probably not the best time to blog. I'm in a wicked bad mood, angry at everyone and everything, hating my life, and annoyed at the stupid internet. I'm at Barnes & Noble because my stupid Mac won't connect well to the internet at home, and even here, I'm trying to apply to the goddamn nursing program at UNC and it keeps messing up. WTF? I am NOT happy. Not at all. I am missing my family. I miss my nephew like crazy. It's times like these - when I am stressed and upset - that he has the power to make me feel so much better about life just by wrapping his little arms around me and smiling in my face. I miss him so much I ache. It is days like this that I wonder, what is really keeping me here in Chapel Hill? Sometimes I don't know. 

My aunt had her surgery on tuesday. Right now they are saying it's stage IIIc. I don't even have the energy to elaborate more. Not that anyone wants to hear about it, from what I can tell. 

Honestly? I have 2 graduate degrees, and right now, they're about as useful as toilet paper. I feel like it's all been a waste, frankly. I've been pursuing the wrong things for too many years, the wrong jobs, the wrong professions....and look where it's gotten me. I just can't do this anymore. This is not what I signed up for. I want a huge do-over. I want the last 10 years back. 

So I sit here at B&N, furiously trying to blink back the tears that are threatening to spill over onto the table. Was it really only a few weeks ago that I was in NJ, having dinner with B and C, and staying late at the office, talking with Jonel and Nicole? Was it really so recently that I spent the entire weekend with my sweet Trey, waking up to his little body sneaking through my bedroom door and then a big smile an inch from my face? Was it really only a few weeks ago that my entire family was healthy? That the biggest worry was baby Cole's impending arrival? Unreal. I want that time back. I want to be back up North, enjoying that time again, enjoying my lunch at the Cheesecake Factory with  my grandparents, enjoying lunch at Ponzios, laughing with Natalie, bringing Trey everywhere, going to breakfast with my mom...I am THISclose to just charging the damn ticket, just to get some peace of mind and relaxation. 

it whispers.

I haven't written recently....I've been applying to jobs, contemplating oncology nursing, and missing family. And, unfortunately, worrying. Last night my aunt - my only aunt - was diagnosed with ovarian cancer and primary peritoneal carcinoma. PPC is similar to epithelial ovarian cancer, it reacts the same to treatment, etc. It's just in the peritoneum, or the lining of the abdominal cavity. Her surgery - TAH +BSO, and any debulking, will be done tuesday, and we should know the Stage better by then....although the doctors have hinted of spread. She had 7 pounds of ascites drained from her abdomen....and the docs said it will likely come back. This can be a sign of advanced disease. 

She went to her doctor a few months ago, with a bloated abdomen, fatigue, constipation....and like many doctors, he didn't suspect ovarian cancer. He told her it was likely high cortisol levels from her stressful job. He didn't do a transvaginal ultrasound or anything - most docs don't. As they say in medicine, "when you hear hoofbeats, think horses, not zebras." Unfortunately, ovarian cancer is a bit of a zebra. Many women are told their symptoms are just part of getting older, or stress, or they're worked up for GI problems....this is why the majority of women who are diagnosed with ovarian cancer present with advanced disease. It's been said that ovarian cancer "whispers", because its symptoms are so quiet and nonspecific.  

I am struggling with not saying too much to my cousin, her son, who seems to think she's Stage I or II. Of course he wants to believe this - he needs to. He's going to be a father in a month, and needs his mother to be around and well. I am fighting to choose hope. I keep reminding myself statistics are just numbers. I am hoping for optimal debulking. I am hoping the chemotherapy that we have - most likely, I assume she'll be treated with a platinum-based drug, like carboplatin/cisplatin, and paclitaxel - isn't too harsh and will actually do its job. Like Jerome Groopman has written, "It is hard to be a person of faith and a person of science." I struggle with that all the time, and even more so now. 

But honestly? My first reaction is neither mature or logical. My first reaction is what the fuck? Two people in my family in less than a year are diagnosed with cancer? This has got to be some sort of mistake. My family is not that big to have these statistics. My first reaction is to rail against G-d, to turn my back on prayer and faith, and to get angry. But then I settle down, and I know that G-d did not do this, that renegade cells did this, and prayer might help. 

Seriously, things like this reinforce my drive to be an oncologist. This is surreal. And, of course, now, when I got to doctors, I now have ovarian and breast cancer in my family. But they're on opposite sides of the family, and my aunt is not Jewish, so I doubt there's a risk of BRCA, since my grandmother tested negative. 

So, please, if you read this, please keep my aunt in your thoughts and prayers - I know you all did that for my grandmother, and she's doing super. :)  thanks.