role reversal

So in less than a month, the tables will be turned and I will be the patient. I am having foot surgery to correct my bunion...again. Same foot. Yep, the first surgery, which was 2 days after my college graduation, only shaved the bone bump off. And the bone continued to curve, resulting in a nifty half-moon shape that is throwing the sesamoid bones (in the bottom of the foot) "off track". The bone needs to be broken and the tendons realigned. The surgery is Friday, 3/26, and I'm hoping to be back to school by Wednesday 3/31. The thing I dread is not being able to run for 8-10 weeks. Looks like I will be getting in some pool and biking time for the tri, huh?

This is the last week before spring break...I just have to get through this week, and then I can relax....sort of. I'll be studying over break, but at least I won't have classes and new material. School is going okay. Much to my surprise, A&P is actually not interesting me so much right now, but Microbiology is. I think it's because now we're studying immunology, and I find that so fascinating. Plus, I think immunology is related to oncology in many ways, and that's familiar to me.

Anyway...not much else is new. I've been studying and making notecards for my classes and studying some more, and writing for the ACS blog and articles for livestrong.com, so my life hasn't really felt like my own. Not to mention I need about 12 more hours in a day.

Dorothy had it wrong.

From "The Wonderful Wizard of Oz":

"Dorothy wanted to see more of the Princess, so she ran after her. But the china girl cried out, "Don't chase me! Don't chase me!" She had such a frightened little voice that Dorothy stopped and said, "Why not?"

"Because", answered the Princess, also stopping, a safe distance away, "if I run I may fall down and break myself."

"But could you not be mended?", asked the girl.

"Oh, yes; but one is never so pretty after being mended, you know", replied the Princess.

"I suppose not," said Dorothy.

It doesn't take a philosophy or Women's Studies major to see the broader meaning and implications about this...at least, I don't think so. Maybe it's just because of my psychology background, I don't know. In some way, aren't we all broken, or in the mending process? Maybe it's up to us to see the beauty in the cracks, to read the stories of the ridges and scars. Isn't it said that once a bone is broken, after it mends, it is stronger than before? Maybe our broken pieces give us strength. After all, if something sits on a shelf and is never enjoyed, that's not very exciting, is it? It's only by experiencing life that we become nicked here and there, maybe cracked open or even shattered. But eventually, we piece ourselves together with some help and love, and continue our journey.

There's such a collective emphasis in society of not showing weakness, not showing our broken or wounded parts. We like to show shiny, pretty surfaces and neat, tidy packages. But as someone recently pointed out to me, vulnerability often draws people closer; we often like them even more after we know that part of them, because we connect on that basic level. At our centers, we're all vulnerable.

Once something breaks us, even temporarily, we're never the same. Ever. We're different. Maybe we can become better, even. And I would venture to say that, no, we're never as pretty as we were prior to breaking. We're prettier.

this kind of work.

"This kind of work, it changes you....and it IS too easy to lose your way." These words were just spoken on Grey's Anatomy by the Chief of Surgery. He was talking to the physicians and telling them about his experience with a person with AIDS back when AIDS first came on the scene. And though Grey's is often far-flung from the truth, there is truth to these words. Hearing him say them...well, it sounds cheesy, but it reminded me why I am on this path and why I continue to slog through, despite setbacks and failures and struggle, despite having to take undergrad classes at the age of 29....I do it because I love it. I love oncology, and it feels right working in the field. I honestly cannot see myself doing anything else but something in oncology. There is something humbling in working with people and families living with cancer. Many days, you are the one being taught. There is something magical in the human spirit, that is amazing to watch and be a part of. Though it can be depressing work, the relationships and resilience and hope are also a huge part of it.

This is what I need to keep in the forefront of my mind when I get discouraged with my classes, or overwhelmed with memorizing. This is what I need to remember when I find myself thinking I'm crazy for doing this and not taking a job that is simply satisfactory but pays the bills. I need to remember my grandmothers' gratitude when I explained her pathology report to her. I need to remind myself of my dad's "thank you's" when I broke down my aunt's medical records in everyday language. Or R's pleased surprise when I call to see how she's holding up with radiation. I need to remember Erik, Sophia, Pop-Pop, Jennifer, Jaime N, Kendal....and all the other wonderful people I have in my life who have been affected by cancer. I am tired of hearing that someone else died, or someone has a recurrence. I'm frustrated that the scale is not tilting in a different direction with cancer.

But I guess that's why I chose oncology.

Or why it chose me.

"If children have the ability to ignore all odds and percentages, then maybe we can all learn from them. When you think about it, what other choice is there but to hope? We have two options, medically and emotionally: give up, or fight like hell." -- Lance Armstrong

how quick are you gonna get up?

In the spirit of the last post, I thought this was interesting - Nike just put out an ad that has the song "Ali in the Jungle", and part of the chorus goes, "Everybody gets knocked down; how quick are you gonna get up?" I have been obsessed with this song, playing it over and over and watching the ad repeatedly. It's a great running song, as well as a reminder that people who succeed do, in fact, get knocked down over and over and over and over -- but their success comes from the fact that they got up and forged ahead, even if it meant repeated blows.

Human Chain from NikeSportswear on Vimeo.

getting over.

I had my first test on Tuesday. I have anatomy lab quizzes every Friday and had a lab exam last Friday, but this was my first class test. I didn't do well. I haven't gotten my grade, but I know I did not do well, despite having studied a lot (in my opinion). But I knew big-picture, and she was REALLY detail-oriented. In a class entitled MICRObiology, I probably should have seen that one coming. But I didn't. And though I've aced all the anatomy quizzes, I did not do well on the lab exam. Why? Because we had random bones on the table, spread out, and had to identify them. Without context. I wasn't prepared for that, and really, when will that ever happen? When will I get a random ulna on my desk and have to identify it as such? Anyway. So yesterday, after I came home from the micro test, I just cried. It was a rainy day, which didn't help. So I got on the treadmill and ran it out, but ended up going to bed by 9:30pm because I just wanted the day to be over and forgotten about. I was really upset, because I want this. I want to do well. This is a challenge, and I love challenges. It's just harder than anticipated, both the classwork AND rearranging my brain and thought processes to concrete sciences. I haven't had to do rote memorization in years, so it's been an adjustment. So I pretty much cried myself to sleep last night, feeling like I was failing at everything. And, like it always is, the morning was much better. I woke up with a clearer head and new resolve.

I did not get where I am, both personally and academically, by quitting or giving up. I don't know when I started to let myself get psyched out by little things, but that's not who I am at heart. I am a fighter, I'm "scrappy", as I was once called. I push and push and push and work til I get some sort of result. I need to build up my confidence and do better on the next exams. A woman I know, Katie, did college track & field back in the day, and she told me a story that I often fall back on. They needed her to do hurdles, which she typically didn't do. And she was talking to her coach, and her coach told her that he doesn't care how she gets over the hurdles, it doesn't have to be pretty, but just get over them. Get over the hurdles. I don't have to be pretty doing this; I don't have to get perfect scores, I just have to clear these hurdles one way or another. And that's what I'll do. It's what I've always done.

tri-WHAT?

So....I have signed up for the Ramblin' Rose sprint-triathlon that will be in Chapel Hill in October. Have you stopped laughing yet? I've never done anything like this before, and am nervous but excited. I am doing it with the Teal Toes team (individually, but representing Teal Toes), in honor of my aunt, who has advanced ovarian cancer. So I've been running since January, but now I am getting serious about it. The tri is a 250-yard swim, a 9 mile bike, and 2 mile run. I think I can do that, right? I have 8 months to train for it. I have to get a bike and swim goggles and some odds and ends, but I'm psyched. Plus, doesn't it just sound so tough, "training for a triathlon"? I think this will be a great stress reliever and motivation for me to keep healthy and take care of myself.

I also will be a featured blogger for a website, sheknows.com, in conjunction with a cancer awareness campaign the American Cancer Society is doing. Very excited about that, too.

School is going well, I think. I am studying all the time, and it still feels like never enough. I just have to get into the "science mindset". No one cares how I "feel" about the human body or germs, I just have to memorize concepts and terms. It's not analytical or esoteric; it's hard facts and information. There's been a slight learning curve in readjusting my reading and studying and approach to school. For the first time in....forever, school is really hard. I really have to work at it. The most valuable things come from hard work and struggle, or so I've been led to believe. With this, I'm inclined to agree. I think when all is said and done, my hard work, determination and tenacity will pay off, and I will get to where I want to be. At least I hope so.

2010 has certainly been a busy year so far. And it's only February.

strong in the broken places.

Things have been busy. I got the part-time job I interviewed for at the UNC School of Nursing; I start next Tuesday. It's a research job working on a study of survivors of acute childhood leukemia. I think it's a great opportunity and I'm really looking forward to starting it. I need something I'm passionate about right now.

I started 2 classes - I'm not in an academic program, but I am a part-time student taking prereq's that an accelerated BSN would need. Right now, I'm not even sure my brain works this way. It's just that all the health educator jobs I saw, wanted a NURSE health educator. Didn't matter that I had my MPH; they wanted a clinical degree. I was pretty discouraged. I still look at PhD programs in health psych and public health, but not sure what path will get me to what I want to do. Which is work in oncology, doing patient advocacy and education, and psychosocial oncology research. There are just hurdles, like to do original research, in most institutions, you need a doctorate. Even lots of research jobs I saw at UNC needed a PhD. Frustrating. I think more experience working on research will help me, and these classes will let me know if my brain works in a scientific way. The PhD program at UNC that I had applied to last year seemed to incorporate it all; we all know how THAT turned out. And I didn't have the heart to apply again this year, because I hadn't done any research since then to boost my application, so I didn't think it would make a difference. If I continue to do research throughout this year, I might apply in December...but that's a long way away. Lots can change before then. I think my goal this year is to get research work experience, mainly. I guess I will reevaluate in July/August about reapplying.

The 2 classes I am taking are Anatomy & Physiology, and Medical Microbiology. They are kicking my butt. My brain is on overload. I like the material, but I've never struggled in school like this before. I never studied much before, ever. Now I'm studying for hours each day. Science requires a whole new way of thinking; the homework isn't analytical or asking how I *feel* about anything -- it's very black and white, definite right and wrong answers, and enormous amounts of information. It's like trying to take a sip of water from a firehose. I've been studying every spare minute of the day, but not sure if I'm retaining anything. We'll see, either way, I guess. I've just never felt so inept at school in my life. For someone whose identity is wrapped largely in her academic ability and achievements, this is a bitter pill to swallow.

So, we'll see. I'm just looking forward to my job, which will place me in an area I am comfortable with and knowledgeable about - pediatric cancer. It is familiar, and a passion of mine, so I think I will be okay with that.

"The world breaks everyone, and afterwards, many are strong in the broken places." - Ernest Hemingway

there's no place like home....

The Old Well at UNC

Much of the time, I find myself missing New York. More specifically, Manhattan. I lived there twice; once on the Upper West Side when I went to Columbia for a year, and once on the Upper East Side, when I interned at MSKCC. I consider New York to be one of my homes...it is one of the few places where it immediately, instinctually felt like home the minute I arrived. Whenever the "homesickness" gets to be too much, I find myself reading the NY travel guides I have. Despite having lived in North Carolina for over 2 years, I still subscribe to New York magazine and regularly buy Time Out New York, when I can find it. No cupcakes here will ever live up to Buttercup Bake Shop or Crumbs, no bagel here will be half as good as H&H, and don't even think about giving me a black and white that isn't from the city.

Though not a native New Yorker, I am definitely a Northerner, born and bred. I walk fast, talk fast, can be an aggressive driver, and often find myself (unfortunately) short on patience. So how on earth did I find myself making Chapel Hill my home? When I applied to grad schools, I mostly applied to Northern schools, with GW and UNC being the exceptions. Oh yeah, and Emory. I was headed to GW when I got the acceptance to UNC, and found myself south-bound, not quite sure what to expect. The friendliness was disarming at first, and the unspoken social rules hard to decipher. The fact that many people don't lock their house doors until they go to bed at night blew my mind. I'd never been to a school the size of UNC before, and never lived in a college town like Chapel Hill. When I first got here, I liked it, but was pretty sure I would move back North when I graduated.

Long story short, over the 2 years of my MPH program, I found myself liking the slower pace here, liking the friendliness, LOVING the affordability, and feeling...well....feeling like I could adopt this town as a home. Graduation came, and I knew I would stay in the South, unless a dream job in NY opened up - and even then, it would have been a tough decision.

Chapel Hill is often called "the Southern part of Heaven", and I can see why. I love my neighborhood, which is a New Urbanist neighborhood (although some people think it's too Stepford-esque), I feel safe here, and there's a quaintness to the town that I can't fully place. When I first got a Chapel Hill address, I loved the fact that I could write "Chapel Hill" - it had been a place I'd heard of over and over, with Tar Heel sports, but actually living there was something different. Although I read NY Magazine, I also find myself regularly reading Chapel Hill Magazine. Over the past 2 and a half years, I have made this town my home. I have found favorite restaurants, cupcake haunts, and people who remember me at coffee shops. Though I miss my family often, I know they are a short plane ride away. Last summer I had the opportunity to show both my mom and my grandparents, and my dad, around Chapel Hill and where I have lived, and yet nothing I showed them could adequately portray why I like it here so much. I can never fully explain to people up North the intensity of the UNC-Duke rivalry. Or why, when basketball season rolls around, I suddenly turn into a sports fan. (although the fact that my other fave team, UMiami, is also in the ACC, sometimes poses a problem).

My driver's license, registration, voting record, and in-state tuition status all point to the fact that I am a bona-fide North Carolinian. Am I a Tar Heel born and bred? No, not exactly. But right now, I am a Tar Heel, and that's good enough for me. In fact, I just found this article written by - of all things - a native New Yorker who goes to UNC. She describes many of the same sentiments.

Maybe my sweet nephew will become a Tar Heel - he already loves Ramses the ram!

year in review

Wow. So it's the end of 2009. The past decade has been chock-full of change. From starting it at the age of 19 to now, at 29, my life has turned out to be nothing like I had expected it to be or planned on it being. And maybe that's exactly how it's supposed to be. This decade has brought me a Bachelor's degree and 2 Master's degrees, living in Manhattan twice, a stint in South Florida, losing a grandparent and gaining a nephew and new baby cousin, and watching 2 people in my family meet cancer face to face.

This past year has brought the remission of my grandmother's cancer, the diagnosis of my aunt's cancer, the devastation of not getting into a doctoral public health program, figuring out who I am and what I want to do with my life and finally taking my writing seriously and earning money from it. This year has also brought the Stage IV breast cancer diagnosis of a friend of mine, numerous new friendships into my life, and the end of some unhealthy friendships. I have had to reconcile what I thought I wanted with what I *really* want in life, and am realizing that everything I planned might work out in the end, but not the way I thought it would. Am I always 100% happy and okay with this? No, it's a struggle. But I'm slowly becoming okay with the roundabout way my life has gone. I've learned a lot from every experience, and have met people on every step of my journey that have taught me and that enrich my life. These people in my life are constantly surprising me with their kindness and generosity.

What will happen in 2010? I guess we'll see.....

dancing in the rain

The day after Christmas....although I do not personally celebrate Christmas, half my family is Roman Catholic, so we usually go to my aunt's house for Christmas dinner and to exchange presents. Despite the fact that she was in the hospital this year, we still went to her house, where my cousin and his wife had been staying for the past week. We had homemade lasagna (which was excellent), vegetables, potatoes, etc. It didn't feel like the holiday, though, because my aunt's absence was palpable. I think there were a lot of feelings that were like an undercurrent to the day. We did go to the hospital after our gift exchange. Given the circumstances, my aunt looked good. She had been walking around, eating some solid food (although not as much as she needs to; even her doctor told her she especially needs protein after surgery and during chemo), and not in too much pain or discomfort. I have to admit, it was jarring. And being in the field, I hate that I was taken aback. But the last time I saw her, she had been wearing a wig and had eyebrows and eyelashes....and yesterday she wore a surgical cap and was bald, with no eyebrows and (to me) no visible eyelashes. It brought the whole emotional aspect of cancer home, real fast. But despite that, I think she looked okay. She got an IP (intraperitoneal) port during the surgery, and the plan is to start IP chemo 2 weeks after surgery. I worry about that; IP chemo is notoriously hard. According to the Manual of Clinical Oncology, the majority of ovarian cancer patients do not end up completing all 6 rounds of IP chemo because of the side effects and toxicities. It's harsh. For patients with Stage III ovarian cancer, it has been shown to extend survival, but for patients with Stage IV ovarian cancer, it is not clear whether there is significant benefit. I don't just want her to have extended survival - I want my aunt to have extended *quality, pain-free or low-pain* survival. Survival where she knows who her family is and isn't on massive amounts of medication for pain. Survival where she can travel or go places and do what she wants and not be homebound or bed-ridden. Survival where she can laugh with her grandson and my nephew. This is what everyone wants for their loved ones; quality time. And hopefully, once IP chemo is over, this will happen. That is my hope right now. Hope. Hope. Such an intangible thing that bears the burden of so many wishes and dreams.....

It's been good being up North. I do miss Carolina, and when I go back, I will start 2 classes....Intro to Medical Microbiology and its lab, and Intro to Human Anatomy & Physiology and its lab. I'm terrified and exhilarated. I am taking these classes, and if I do well, I will take one more over the summer - these are prerequisites for the accelerated BSN. Nothing is set in stone, though, and for all I know, I might fail spectacularly. We'll see. I also have an interview for a research assistanship on AYAs and cancer. *fingers crossed*. It sounds amazing, and exactly what I study and what my main focus is.....so hopefully it will work out!

2010 is a week away....this year, 2009, has brought surprises, disappointments, bad news, good news, the end of some friendships and the making of new ones, and taught me a lot about myself. Am I where I thought I'd be? Nope. Am I following the path I thought I would? Not right now, but we'll see in a few months. As one of my mom's holiday cards said, Life isn't about waiting for the storm to pass; it's about learning how to dance in the rain.