on not breaking your own heart.

I am back in New York, after being in North Carolina last week. It was great being back in the South. I visited McIntyre's Books, where I used to work and took home a bunch of ARCs and a tote bag (thanks, Keebe!). I now carry my Algonquin tote bag here in the city as a little piece of home. I went to my favorite touristy place to eat down there, Top of the Hill. It is classic Chapel Hill, and Bonnie and I had our picture taken with some people at the bar decked out in UNC gear and blue wigs (it was a game night, against Miami). I ate a typical Southern meal of buttermilk fried chicken, mashed potatoes, green beans and a buttermilk biscuit. It was delish. My gallbladder-less body was not happy, but I was. mmmmm. Then we went to Sugarland for cupcakes. Before I left, we went to Cook-Out, where I had a Cheerwine ice cream float and hush puppies. And of course, I took back liters and cases of Diet Cheerwine.

My aunt's death has not fully sunk in, I don't think. I was at Barnes and Noble tonight and saw a Hopkins Guide to Ovarian Cancer and instinctively picked it up off the shelf before I realized I had no use for it anymore. And then I felt like throwing it across the store. The Brighton bangles she got me for Christmas clink on my wrist and her Keurig sits in my kitchen. Her phone number is disconnected, although she is still in my cell phone contact list. It has made me think about life and death and dying. When someone dies, what remains? What of their life stays here, with the living? And what about the dead people walking, like my grandmother with Alzheimer's? They are, essentially, living a slow death of self. What remains? Lots to think about.

Classes started today. I am taking 17 credits - a nonfiction workshop; a class entitled "Memory and Morphology," about memory and writing/art and how it changes; a narrative medicine class on Applied Writing - "How We Write/Why We Write"; a nonfiction research methods class that I placed out of but decided to take anyway, to pursue my independent research interest; and a Master Class, which only lasts half a semester, called "Of Women Born: Motherhood in Literature." So I have exciting and interesting classes. And just from today, I left very inspired and feeling like my money is well spent here. In my workshop, my professor told us about recent MFA grads whose books have been optioned for movies, others who just got book deals....she said to not assume we'll immediately get a book deal to pay off our loans, but keep working hard, don't give up on your dreams, and eventually it will pay off. She said something brilliant - "I'm a big believer in not breaking your own heart. There are too many people out there more than happy to do it for you." She encouraged us to stick with it, believe in ourselves and our dreams, and just put in the work that needs to be done to excel. I left classes today feeling recharged and looking forward to the semester. Sometimes I am blown away by the professors and classes here, and today was one of them.

how we die.

It's a new year, with new beginnings. With beginnings come endings, though. My aunt passed away in the early morning hours of New Years Day. We had gotten a phone call around 8am on December 31, saying that her breathing was very slow and erratic. We all drove to her house, and she had a glassy stare and kept reaching up to the ceiling and shading her eyes. All the physical signs were there of impending death: glassy stare that looks "past" you; jerky muscle spasms due to loss of muscle control; mouth hanging open and eyes half-open. She was given medication to subdue the bodily twitching. It was something, though, to watch her reach toward something we could not see. I'd like to think that she was reaching toward Heaven and shading her eyes against the light. It's hard to fully believe, though. Faith and science are hard to reconcile.

As the hours went on, she became comatose, not responding to touch or sound, although they say hearing is the last thing to go. Her breathing was fast, then slow, then fast. She'd gotten so thin you could see her heart leaping with all its effort under her pajama top.

I know this death, by all accounts, was a "good" death. She was on hospice, pain-free and was in her own house, in her own bed. But honestly, it made me think, seeing her day after day, slowly ebbing away. We talk about "good" deaths, we want to die with "dignity." But I'm not sure if it's bullshit. The cancer grew unchecked and the bowel obstruction became complete. When she sat up, she vomited because of the pressure on her esophagus and when she lay down she couldn't breathe because of the tumors pressing on her lungs. She'd lost so much weight that she could see and feel the tumors poking against the skin of her abdomen. Her bodily fluids were coming out in bags and tubes and she barely had energy to talk. And this is a good death.

I don't know what a "good" death would look like, and I know that many diseases destroy any hope of a "good" dying process. I believe in G-d, and I consider my faith to be fairly strong. But this whole process has made me think and question. There are so many things I don't understand and probably never will.

My aunt's mother, my grandmother, has Alzheimer's that has rapidly progressed. I mean to the point where today at the memorial, she asked where Edie (my aunt) was. She has to be retold that her daughter died, and it's like the first time, every time. She doesn't remember basic things and perseverates on everything. She is not even herself any more. It must be scary, not knowing your own life after a while. This is its own kind of death, I think. A living death, almost. Where you can die and yet remain very much physically alive. I'm not sure which is worse sometimes; watching someone die of cancer or watching someone die from Alzheimer's.

fixing what is broken.

To anyone who's read this blog for oh, more than a few posts, it's obvious I still have a strong interest in medicine/oncology. And believe me, if I were good at science, I'd be in med school or nursing school in a heartbeat (ahem, see spring 2010). But that is not the case. I still read Atul Gawande, Jerome Groopman, Perri Klass and Danielle Ofri, and whenever I go into a bookstore I usually go to the medical section first, to see if any doctor, nurse or student has written a new book I might like. If I'm completely honest, a tiny minuscule piece of me still would love to be a pediatric oncologist. So it's safe to say I have strong feelings about medicine and the kind of doctor I like, and would want to be.

My nephew and I were in the car today; I was driving us to meet my dad so we could go to my aunt's house to visit her. I had asked my nephew if he knew my aunt was sick and going to Heaven soon. I reassured him that he would not go to Heaven for a verrrrrrrry long time, and neither would his daddy, Aunt JJ or anyone else, and that my aunt was sick with something called cancer, that the doctors cannot always fix. There was a pause, and then this little voice from the back of my Jeep says, "But JJ, I thought doctors fix people and make them better. They can't make Aunt Edie better?" I explained that they want to make people with cancer better, but sometimes it is very hard. But geez, kids have a way of saying the most starkly important things in such a matter-of-fact, innocent way.....because isn't that what we all, at our most basic level, wonder when someone we love is ill? You're a doctor; doctors are supposed to make us better. And kids say it out loud, with no anger, embarassment or anything. There's something refreshing about that, and I think it's why I loved working in pediatrics.

I can understand the feeling, too. When my friends Erik and Sophia were sick in middle school from leukemia and a brain tumor, respectively, even at the age of 12 or 13, walking around CHOP, I realized that something wasn't right - why isn't everyone going home, I thought doctors could make kids better. When friends or family members get sick, we all have that first irrational thought of, why can't they FIX THIS NOW. And if they die, we think this wasn't supposed to happen. We rail against G-d, doctors, each other, ourselves.....because sometimes things break. Sometimes things fail. And even four years of college, four years of med school and subsequent years of internship, residency and fellowships cannot fix everything that is broken, no matter how much we wish it would.

Pura Vida

I posted a year or so ago about Kiel James Patrick bracelets, and how they provided actual, real customer service. Kiel is a great guy and has stood by his word and I love to buy his things when I can. It can be really hard to find companies that actually practice what they preach and stand by their values, but I found another one - Pura Vida bracelets. Pura vida means "pure life," meaning you should enjoy every moment and not take anything for granted. The company was founded by 2 friends who were in Costa Rica when they noticed a guy named Jorge selling handmade bracelets. They started talking with him, and found out he and his family were living in a single room.The friends asked him to make 400 bracelets to take back with them to the US, and when they did, they sold out like crazy. They were simple string bracelets, but the simplicity spoke for itself. They teamed up with Jorge, who finally had enough money to buy a house for his family, and to this day, the bracelets are handmade in Costa Rica, providing jobs for locals. A portion of all their sales go to the Surfrider Foundation, which helps keep beaches and oceans clean, and they also sell charity bracelets - $1 from each bracelet goes to the charity for which it is made. (The bracelets themselves are only $5 for regular ones). The charities range from March of Dimes to the Wounded Warrior project to numerous cancer funds.

Everyone with whom I have spoken there has been wonderful in replacing broken bracelets to making sure I got them in time, and I've been happy to support them.

obligatory end-of-year book list.

Columbia just sent us a new revised packet of course listings and master classes....and their line up this coming Spring is fantastic, I have to say. Eileen Myles, Sloane Crosley, Emily Fox Gordon, Elisa Albert....super excited. I would love to take ALL THE CLASSES. I just read Albert's book (I blogged about it in the last post), and would love to take her class. Myles is a poetry goddess superstar, Gordon's essays are great, and Crosley is awesome. sigh.

I'm seeing all these lists everywhere about the Best Books of 2011, and I feel like I should list some. I don't have specific rankings, but here are some books I read this year that I loved:

1. Blue Nights, by Joan Didion. Memoir of losing her daughter, Quintana, and thoughts about aging, death, life and mortality. Didion can do no wrong.

2. The Night Circus, by Erin Morgenstern. A beautiful, richly described, vibrant book about two illusionists who fall in love, despite being pitted against one another to be the best. I stayed up until the early morning hours reading this and finished my ARC of it in 2 days.

3. We Wanted to Be Writers: Life, Love and Literature at Iowa Writers' Workshop, by Eric Olsen and Glenn Schaeffer. A book filled with alumni rememberances about the Workshop, how they write, their thoughts on process, etc. Honest, engaging and insightful for any writer.

4. The Cure for Grief, by Nellie Hermann. Quietly devastating but cautiously optimistic, this is a book about a young girl whose family implodes, leaving her to deal with the loss of her father and two brothers to mental and physical illnesses.

5. Death is Not an Option, by Suzanne Rivecca. A wonderful short story collection about strength, life, survival and love.

6. The Vanishers, by Heidi Julavits (coming out in March 2012). I read this ARC back in November and wanted to skip class to finish it, it was that good. I didn't love her other books, but this one, about a young woman with psychic gifts who is caught in a web of deceit and magic, is brilliantly crafted.

7. Anthropology of an American Girl, by Hilary Thayer Hamann. Despite the 400+ pages, I finished this in 2 days this past summer. The book follows Eveline through her adolescence and young adulthood in the late 1970s and early 80s, and Hamann captures miniscule details perfectly, which transport the reader right into the richly written prose.

8. Best American Essays 2011, edited by Edwidge Danticat. Some years are a miss, this year's collection is a hit. Essays on family, illness, writing and more fill this book, with a few contributors who are alums of the Columbia MFA program, actually. There was not one essay in this collection (which includes Zadie Smith) that I did not like, which is amazing.

9. Hold Still, by Nina LaCour. This is a YA book that rivals "13 Reasons Why," and I actually think is a little bit better. After Caitlin's best friend Ingrid commits suicide, she finds Ingrid's journal in her room. While still struggling with grief, she begins reading the journal to find out why Ingrid killed herself, and in the process, finds out how to continue living.

10. The Homecoming of Samuel Lake, by Jenny Wingfield. A great Southern story about a family who returns to the father's hometown, where the daughter Swan (reminiscient of Harper Lee's Scout) befriends an abused little boy, with devastating yet ultimately positive results.

To read over break: new issues of Ecotone and Ploughshares; "Blue Blood:Duke vs Carolina;" Best Food Writing 2011; Best American Nonrequired Reading 2011; Narrative Medicine

read ALL the blogs!

There is a blog I love, called Hyperbole and a Half. I don't remember who told me about it or when I first started reading it, but it's great. I laugh out loud as I read it. AAAAAANNNNNDDD she has a book deal. So kinda jealous. But it's hilarious. And reading about cancer is not, so that's why she has the book deal. Below are some pictures from her blog.

I kind of want to be her.

lifecycles.

All that stands between me and winter break are two books, a paper, and workshop critiques. And 3 classes. I need this break. I need to read for pleasure, need to read brain candy YA books or sports books or US Weekly. I don't want to see a New Yorker or a Believer once over break. I'll make an exception for lit journals like Ecotone and Ploughshares. My brain is just wiped out. This week in particular has kind of kicked my ass. I just went through a whole bunch of bureaucratic/administrative red tape that did not end in my favor. So I can't do my Independent Study, which is like, the ONE thing I was really excited about for next semester. I never really got a firm reason why, but I think it's internal stuff. It was a whole week of stressful emails and conversations that never really met on the same common ground, ending in disappointment and, I admit, a very small feeling of defeat. But I hate feeling defeated, and after an afternoon of moping, got my scrappy self together and I know that somehow, I will pursue my interests in a really in-depth way. And when I am a famous writer, on panels with Atul Gawande and Jerome Groopman, I will say, "Let me tell you about this one time I wasn't allowed to do this Independent Study...."

A girl can dream, can't she?

Then I found out I didn't get the research fellowship for which I interviewed. I was really crushed, and honestly - without sounding like a total asshole - I do have more research experience than almost everyone in the program. I've done research at the Hospital of the University of Pennsylvania, Memorial Sloan-Kettering, the UNC Schools of Public Health and Nursing, and the Cancer Institute of NJ. I don't think that's too shabby. But, I guess it wasn't what they were looking for. Which is a shame, because I genuinely enjoy research. Which may explain why I am blogging on a Friday night.

But honestly, all of that is small in the grand scheme of things. My aunt is on hospice and if she lives through the year, I will be pleasantly surprised. She looked almost ghoulish at Thanksgiving, with her skin stretched across her face and greyish skin; not the aunt I know. Cancer is relentless, it is fucking relentless - especially ovarian cancer. I never really found cancer "scary" before, like the "civilians" who don't do cancer research (that's how I thought of it). But since I've stopped reading oncology textbooks in my spare time, I better understand those feelings. Like I mentioned in a previous post, I've been thinking a lot about death, terminal illness, and what we think of as a "good" death, and dying with dignity. I've also been thinking a lot about grief. I have been a lucky girl. Although I have had my hardships and lost people I've loved, my life has been relatively spared from serious grief. I am lucky enough to still have 3 grandparents who are feisty and alive (although one is slipping into Alzheimer's - the other two have more active social lives than me), I have two parents who are well, a brother and nephew, and a cousin/his wife/their baby. I haven't wanted for much, and for the most part, haven't really struggled in school. I know I am lucky, and I am very thankful for this. But death and dying bring grief to everyone. And I guess maybe I am highly attuned to it now because I'm writing/reading constantly and have opened myself up more. But grief has a particular quality to it. It's sort of like a shadow or a mist that lays itself on you and is absorbed, and then expands until there is no room for anything else. It is constantly tumbling, like an ocean before a storm - sometimes it is fiercely violent, other times there's just rolling waves. But always there. I felt something similar to grief but not exactly, when Lambee had breast cancer. I would sit on the bus back to my neighborhood after classes and look out the window and think, there is so much sadness in the world. Because everything became tinged with fear and a sort of grief those first few weeks.

And of course, me being me, I've turned to books. I'd probably have a binder full of research on hospice/grief if I weren't drowning in schoolwork, just like I had bags full of research/peer-reviewed journal articles when Lambee had cancer. So I've mostly been reading fiction and some nonfiction. The Book of Dahlia. She's actually a graduate of Columbia's MFA program. Blue Nights. It's Joan Didion; no explanation needed. The Cure for Grief. This was written by one of my professors (also a graduate of the program). I've read it several times before, but each time there's a different nuance; I find different things. It's funny though; not many people want to ever talk about death/dying/grief, even in the abstract. You ask people for book recommendations and they stare blankly at you, or offer up religious texts. (Which, hey, I'm not knocking "When Bad Things Happen to Good People" or "Blue Like Jazz" - I've read both. I just don't want that right now).

I'm just rambling now. Not enough sleep, too much caffeine.

Listening: The Like, "Are You Thinking What I'm Thinking?"

Reading: too much stuff.

Snacking: Twizzlers, Haribo gummy bears

Thirty one.

I am 31 today. So much has happened in the last year, for which I am very thankful. In some ways I look back and I cannot believe how much has changed. I read what I wrote last year and I think so far, I've done what I said I was going to do. I hope I have. This time last year I wanted to make choices based on hope, not fear. Making the choice to go to Columbia and move to NY was definitely not made out of fear - I wanted to move back to NC - now that would have been my fear talking. And though I miss Carolina every single day, sometimes to the point of tears, I'm glad, in the end, that I made the choice to come to NY. Last year I said that I wanted my thirties to be about abundance and not restriction - and I think that's an ongoing process. I want to take up space and be heard, not just sit there and go with the crowd and be a pretty face. I want to DO something. Hopefully I will.

This time last year I could have never have imagined I would be here now. I didn't think I'd get in to Columbia - it was a total reach. I wasn't sure what my life path was, and whether I was truly good at anything. When I got into Columbia, even after several times of me deciding not to go, I somehow made it here....and am finding out that maybe, just maybe, I can do this.

I was kind of sad the other day, because last year was the best birthday I've ever had. I was in Chapel Hill, I spent the night doing quintessentially Chapel Hill things - dinner at Top of the Hill, cupcakes at Sugarland and drinks at Spanky's. I was with friends I loved and was very happy. This year.....yes, while I am happy to be at Columbia, sometimes it is honestly very hard to be happy in NY. Sometimes the sadness is so overwhelming that it steals my speech; I can't even construct the words to hold a conversation. But my friend from undergrad A came to NY from Chicago, and we went to go see Avenue Q with her brothers - amazing show - and then we went to dinner at Zen Palate and had a drink at a NOLA-themed bar/lounge. It was a good night. Today we're going for brunch and then exploring Central Park...and maybe I will go to my favorite indie bookstore in the city, McNally Jackson. I wanted to work there but never got a reply email. Sad face.

At 31, maybe it's a bit late to finally figure out what you want to do with your life. I'd be lying if I said I didn't envy my friends with stable jobs, who have a mortgage and are settled into family life. I do wish I could be like them, going on vacations and not stressing over every little bill or rent payment or student loan. But I'll get there. And honestly, although I am STILL in school and am swamped with work and sometimes wonder if it really is or will be worth it......there's a part of me that knows that I'm doing what I love, what I've always loved and yet never really ran with it. I'm reading and writing. A ton. My success isn't how I always pictured it would be. But maybe it's enough that I'm doing something I truly love - how many people can really say that?

Not enough people, in my opinion.

the end is in sight.....

In less than two weeks my first semester of art school will be done, and three semesters of coursework will remain. I'm not sure I've ever been so busy in my life. Now, reading 3 books a week seems normal. I've accepted being constantly tired, my eyes overworked from reading for hours. Coffee has replaced much of the blood in my veins, and yet it never seems to be enough. I had an interview for a fellowship this morning (not the major one that covers all your costs - didn't even make the interview round for that one). It's a research fellowship, which actually fits with my interests/abilities better, I think. Crossing my fingers. Workshop has greatly improved since the first one. Now I'm actually getting really great feedback from the professor and my peers. The changes they suggest are sometimes obvious ones, and other times totally brilliant ones that I never would have thought of. But that's what 11 new pairs of eyes on your writing gives you, I guess. I'm definitely more confident in my writing, which I feel has grown stronger.

It's been interesting, this journey from medical-oriented study to art school. I'm not sure I see myself as creative or as an artist yet, and I always feel like I'm "pretending" to be an artist when I say I go to art school or the School of the Arts. I haven't yet totally embraced that aspect of myself into my identity. I've managed to incorporate my medical knowledge/research into personal essays and plan on taking Narrative Medicine classes, so I think it's turned out to be a good match. Sometimes I still have that rush of overwhelming fear and panic - what the hell was I thinking, actually believing I could be a writer and make a living out of this - but I try to push that away with being in the here and now. I just have to believe it will work out in the end, that doing something I love - have loved forever - will be enough of a safety net to keep me afloat.

Limited time only.

What would you do if you were told you had weeks to live? We've all thought about this at one point or another in our lives - "If I had 6 months to live," "If I had a month to live..." But what happens if you find yourself in a situation where you are faced with exactly that? My aunt will be going home on hospice sometime this week, after living with ovarian cancer for two years. Her oncologist said she has weeks. I keep thinking about hearing those words, and how scary it must be, late at night, lost in your own thoughts knowing your time is limited. Granted, all of us have limited time here, but to be told a quantifiable number is beyond comprehension. Because realistically, she is weak. On a feeding tube. Sick. Forget all those things you'd think you'd do - go here and there, eat this and that - what if you can't do that in the time you have left?

We like to talk about a "good death," or "dying with dignity." And I'm all for that. I am all for palliative medicine and not using extreme measures at the end of life that are only going to cause pain and suffering. I am all for dying at home, with loved ones by your side, being lucid enough to be able to tell everyone how you feel. But really, when you think about it, when it comes, it is really good? Is there such a thing as a good death? I don't know. Maybe it's something personal for each person, and only you can be the judge of what is "good."

And as schmaltzy as it sounds, why wait until you hear that from a doctor? By that point, there are good odds you might not be able to do all those things on your "Bucket List." One of the many reasons I chose to follow my passion and write is because I realized that life is short. Why waste the time I have on earth doing something I'm not crazy about? I think lots of people put things off until they "have time," or "when the time is right," or whatever. And planning and responsibility is a good thing - but some people, myself included - tend to get so busy in the planning and worrying and waiting that we miss our chance.

Last year on my birthday, I vowed that my thirties would be about abundance, about making choices based in love and hope instead of fear. So far, it has been a struggle, but the choices I have made from those places have paid off exponentially. I don't want to turn 40 and say "I wish I'd done that." G-d forbid I get sick and am told I have limited time, I don't want to lay in the hospital and fiercely wish I'd done certain things.

Thanksgiving is coming up, and lots of people take the time to think about what they're thankful for. An "attitude of gratitude," if you will. Because when you are filled with gratitude, it's hard to feel anything like emptiness or sadness. This Thanksgiving, I am thankful for my entire family, my new friends in NY, supportive people, my health and my life.

What more is there?