Goodnight Sweet Friend.

It has been a long time since I have blogged. Though I have had nearly 2 weeks to deal with this, I am still at a loss and become nauseated each time I think of it.

My dear mentor, friend and physician Kate died from a recurrence of cervical cancer (sarcoma) on Monday, November 9, 2009. She was 54.

Maybe one day I will post her real name, she is one who affected not just those in her family and community, but society as a whole. I am better for having known her.

I saw Kate today. She looked wonderful. Her hair is gone, but her eyes are sparkling, her color is great and she seems to have put on some weight. I am so thrilled.

I discussed the transition to NP school and she was supportive. I think it surprised her. Frankly, it surprised me. Anyway, now that it is official I am in unfamiliar waters. I have spent so much time and effort (not to mention money) learning about what I need to do to get into medical school that I, of course, know little about the rest. I have done some investigating. I spoke with a friend who is in the program that I will be hopefully getting into and I have changed my schedule for next semester. Someone apparently dropped Human Physiology today and I was able to pick up that spot. No lab spot though. I will call and arrange an appointment at the nursing school next week to just sit and talk with someone about this and that. I will also be contacting an NP over at XYZ Cancer Center to see if I can get a few minutes with her to pick her brain. My mom called and they have a friend who is a Peds Onc NP in San Antonio and I will be shadowing her in May when I go down to visit.

The change is exciting and I think it will be a great fit, but now I have all this knowledge about med school admissions that is useless to me. It was fun learning about it the first time...I guess I better get back in the mood.

TIMMMMMMBER!

Sadly, it seems that every time something happens to someone else, my motivation for medicine gets renewed. What a horrible thought. But, that is the way it is. Hopefully, I am not as distorted as that seems superficially. This morning, the choir (of which I am a member) was performing the annual Christmas Cantata. It was warm..especially when layered with polyester choir robes. I became quite warm and left for a brief time to get some air and a drink. I missed a song, but returned. As soon as I walked back in and took an empty place on the end as we were standing during the performance, I heard a big thump. One of our sopranos had passed out and fallen over an amplifier. Thankfully, our choirmaster saw her coming down and put his hand between her head and the piano. That would have been a bad injury...his hand was still red about 45 minutes later. I hurried over and helped her out of the sanctuary where another friend of mine (a nurse currently studying for her NP) met us. We took her robe off of her and underneath she had a wool sweater and lined wool pants. Her skin was burning up! I felt so badly for her. She was so embarrassed. When we left the sanctuary, the pastor (who was also singing in the Cantata) announced to the congregation that it was hot and asked if someone would turn off the heat. Of course, standing for and extending period of time is not good either as people have a tendency to lock their knees.

Anyway, I have mentioned in the past that fainting is my biggest fear. I am no longer afraid of other people fainting. I am not keen on the idea of me fainting, simply because I don't like feeling bad and mainly because I never have. This paragraph makes me seem like it is fine for others to experience bad things but not me. That's not it at all. My point is that I got over a fear today. I have been on a high all day. Not to mention, I got to be helpful. That was cool.

I just finished my workout and my arms are exhausted. Out of here for now.

Dr. Underdog

P.S. Good news! Kate was doing so well that her oncologist gave the ok to drop the remaining 2 rounds of chemo...did I already mention that?

Looking Up!

I am feeling really good today..definitely a lot more like myself. Kate and I had a conversation yesterday and somehow it really helped. I knew that I had to get out of this rut and well...(knock on wood) it seems to be subsiding. Seeing her yesterday was pretty difficult though. Her hair has begun to thin and her skin appears a bit gray.

Anyway, Thursday I have my first big Chemistry exam. Thankfully, this change in emotion/mindset came just in time. Unfortunately, I have to learn 4 weeks worth of Chemistry in about 4 days. I have not been able to concentrate and my retention has been pretty much nil. I will be able to do it...somehow. Chemistry is fun when you know what you are doing. I gave up on actually understanding anything, but have become a master regurgitator of class material which is probably why Anatomy was so enjoyable. I mean besides the fact that I just love Anatomy. What actually happens in the 3rd and 4th ventricle? Geez, I don't think I ever got that down. But, they look like sea animals!

Ok, gotta jet...yes, that was abrupt. ;)

Universal health care and other things that look good on paper

Today was a decent day. I was kinda bummed that my back hurt all day and today was lab (and therefore STANDING) intensive but I got through it anyway. I wasn't sure when exactly that Kate was going to end up beginning her first round of chemo, but we exchanged emails this afternoon. Apparently, it began a week later than originally scheduled..so that was yesterday and she said that she has 15 hours left. She indicated it was going well so I am glad.

I can't express how thrilled I am with my friend who turned out to be my Chem lab partner! It is so much fun to go to that class. It could be such a drag, but we laugh so much. Not to mention, she is intelligent so I am not having to question whether or not her analysis is accurate because she doesn't care. I hate that. I guess I WAS that person the first time around, but things have been very different this time.

I finally got the notes over to Disability Services for my student. I have been a volunteer notetaker for a couple of semesters for 2 different students with learning disabilities. I may have mentioned that. Anyway, it is nothing earth-shattering, I just take clearer notes and have to go make copies of them at least once a week. I was feeling so bad on Friday (when I usually take care of that) that I ended up abandoning the effort altogether. Yesterday wasn't much better, but today I am thrilled to say that the notes are waiting for my classmate. Part of the whole thing is that it is confidential, so while it would be a lot easier to just hand the notes to the guy in class (yes, I know who he is), I have to trek over to the official office and deposit them there.

Universal healthcare...hum. A lot of people have been discussing this with me lately. What do I think? Does it matter? Here's my ineloquent, if not ignorant, take on the matter... Do I think that we some form of health coverage for everyone..ABSOLUTELY. Do I think that the government should resort to a socialist form of care...ABSOLUTELY NOT. Here's the deal, I see the crap that my docs have to go through to get paid by my health insurance company and I have excellent coverage. I see on my EOBs that are sent to me what kind of pitiful sum they are paid to see me. I know that I have taken well more of their time than what they are paid for. There is a huge misconception that doctors make too much money and that the problem lies with the medical community. I strongly disagree. Why is it that we can handle athletes and CEOs of companies making manifold what docs make and yet fail to consider the fact that physicians must pay exhorbiant malpractice fees, very high education costs (which many are still paying off >10 years later), staff salaries (God forbid someone have to wait longer than they want), equipment costs (because we all want the latest technology...or at least something from the 20th century), they work WAY more than people give them credit for (call the doc because you have a question..they don't get paid for that...no insurance billing code...how many of those questions even if not directly from your mouth do they have to field in a day in between 30-50 patients to be seen in 15 minute increments) and all done for (in my experience) 25-75% of what they actually charge. Are their fees excessive? We will take my pulmonologist as an example, he went through 4 years of college, 4 years of medical school, and 5-6 years of internship/residency. By that time many new doctors are >$200K in debt compounding interest constantly. After all of that time, how much would you say that YOUR time would be worth? Then add on all the things mentioned above which just make it possible for a physician to provide adequate care for patients.

I don't expect to make a lot as a doctor. I will be 43 when I complete residency and then have the joy of paying back all the loans. I will likely never own my own practice. Perhaps group or hospital based practice will be for me. I have nothing to gain by saying that government run universal health care is a bad idea, except the opportunity to care for my patients in the best way possible. If the government wants to get involved then it should pay private insurance companies to cover every citizen of the U.S. and then it needs to make sure that the insurance companies are making good on their obligations to the patient and the doctor.

The last 2 questions...Do I think we will have universal health care in the U.S. in the next 10 years? Yes. Do I believe that it will be a good system? No.

TTFN.

A few words...

I am sitting here doing homework..well, studying for a Physics exam. Is there any difference? I am having a lot of trouble keeping my mind in the game and my eyes fell to my wrist and the yellow bracelet. It got me to thinking about how when Kate and I were talking and she had noticed that it was once again on my wrist, I mentioned how, along with its obvious purpose, it helped to motivate me to workout and keep going when the effort seemed too much. She asked me "How?" I gave some stupid answer because I have been so forward with my feelings lately that I didn't want to overwhelm her. I have been too honest with my feelings. I didn't want to discuss any of this with her. I wanted to help her..not the other way around. So I gave a cheesy-ass short and shallow answer (that really didn't answer the question) that I have since forgotten. What was the real answer? If I had been honest with her at that moment what would I have said?

"Because someday I am going to have a patient who means to someone what you and all those other wonderful people in my life who have fought cancer have meant and mean to me. I want to be in my best shape, both mentally and physically. That person doesn't deserve anything less than my best."

Perhaps my real answer is as cheesy as the substance-less one I spouted... but at least this one was honest. I have lost 4 pounds. I don't care if it is just a momentary hiccup that went my way. Four pounds is 4 pounds and I have worked for it.

Anyway, I had to get that off my chest. Now it is back to Physics.

More of the same

A friend of mine took the MCAT today...I am sure she did well. (BP, I know you did!) I am not looking forward to taking it in May, but it is a necessary evil.

Thankfully, the school week is over. I have quite a bit of studying to do this weekend, but Fridays always bring about a sigh of relief. I haven't been very successful at keeping Kate off my mind this week. Maybe because I saw her on Wednesday and whenever I do, it is like picking the scab. Anyway, I am really down in the dumps. I am so sad that I am beginning to get angry at her for causing me this pain. Though it is logically stupid and completely off...not to mention inaccurate and selfish, I am actually grateful for the evolution of this emotion. Maybe it will allow me to get away from the sadness. Gosh, the profound sadness. She keeps asking me if I think she is going to die. I don't. I finally asked her.. "Do you think that you are going to die?" Her answer was simple and honest. "It is a possibility." Of course it is a possibility.

Anyway, my struggle is within myself. The sadness. The freaking overwhelming sadness.

I hope that everyone is having a great week and it is topped off with a fabulous weekend.

FREE MUSIC

I have today off and my mind is with Kate. I was watching a YouTube video earlier and ran across a great song by Wideawake. It came out last year. Where have I been? No clue. I was only vaguely familiar with Wideawake. Ok, I may have heard of the group. (I really like their sound and will be listening to more.) Anyway, the song is called "Maybe Tonight, Maybe Tomorrow." All proceeds from the sale of this single on iTunes go to the Lance Armstrong Foundation. Now, go spend a buck (not even) and buy it!

Here is the video to Maybe Tonight, Maybe Tomorrow



I'll even go a step further... for the first 50 people that email me their receipt (email: goalmd@gmail.com) from the purchase of "Maybe Tonight, Maybe Tomorrow" on iTunes. I will send you a dollar. There, it didn't cost you a thing! The artist has gotten publicity for writing such a great song, the LAF benefits, you got a great song and hopefully will mention it to someone else furthering the cause.

Be sure to put your snail mail address in the email.


And for a bit of perspective....

Moving on and holding on

I just want to get something straight that I am sure some are thinking...YES, I KNOW THIS IS NOT ABOUT ME! This blog is comprised of MY thoughts and MY feelings from MY perspective so it is not objective in any way. Now, with that out of the way...


I am feeling emotionally and physically exhausted, but much better overall. The care package was a huge hit and that made me so happy. Obviously, I saw Kate today. It was a rather tearful encounter, but it wouldn't have been had she not pushed me. I told her repeatedly that I didn't want to talk about how I felt with her because that was totally horrible and unfair. She kept pushing and pushing and PUSHING. So, damn...there it went. She was in a fabulous mood and I really wanted to keep it there. Unfortunately, I think I was overcompensating for feeling so sad by putting on this disastrous front to hide my true emotions. Even I wasn't buying it but couldn't correct in time. Anyway, long story short. Chemo begins September 10, just after radiation ends.

I didn't cry after seeing her today. I talked her briefly on the phone as I neared my house, but it was nothing big.

I am going to try to out this in the back of my mind for a few weeks. I will send her a little note next week just to let her know that we are praying for her, but other than that I really want to keep my mind on school. Funny, through the whole thing today she somehow found a way to relate EVERYTHING to school or medicine whether or not it was related. Go figure. That is so her.

I am so grateful to have such a wonderful role model. Please keep her in your prayers.

Numb

How does one get over something? Stupid, I know. I feel like I don't have a right to my feelings. I didn't sleep well last night. Somewhere around 2:15am I woke up just to see that I had not turned off the TV before I somehow dozed off and now a talentless installment of "The Greg Behrendt Show" was mocking me in its own little way. Luckily, my husband's phone (as it is known to do) accidentally called me at 2:34 from the hospital. It is during these phone calls that I listen to the ambient sounds of a break room or cafeteria and yell "Hello?" into the receiver. Eventually, I page him and tell him that his pants have called me again. Two thirty in the morning or not, when I finally got him on the phone we talked for a while.

This morning, I was still preoccupied with Kate's diagnosis. I searched the websites of all the major medical centers that she had said had been consulted and found essentially the same thing on each one. What was I expecting? Really. I did learn a bit more about the specific radiation treatment that she said she had begun. I finished "Final Exam" and thumbed through "getting into med school" books. The end of "Final Exam" was as wonderful as the rest of the book had been, but my mind kept replaying the conversation from yesterday.

Gosh. (It seems like such an insubstantial word.) But, gosh, what must she be feeling? Why didn't I just ask? She kept talking. She wanted to. Why did I feel like I had to keep some level of strength in the conversation? It was up to her, why didn't I give her what perhaps she wanted? Geez, I don't know. What is she thinking? Is more effort going into keeping a positive attitude or praying that other people don't get you down? I was grateful for the gush of information she gave me yesterday. I have a hard time prying into her life that way. Funny, we actually talked about that yesterday. She said that I had been distancing her. Weird. I didn't see it that way, but looking back perhaps she was right.

I am numb in a very weird way. I feel like I don't have the right to feel like this. I feel helpless and I am angry at myself for thinking of ME at all.

Damn.

Unfortunately, my intuition was correct. My mentor, Kate* a wonderful person that I care for and appreciate very much, has cancer. A very rare type, so treatment is kind of still up for debate.

She told me today. Actually, I kind of told her. We were talking when she stopped, much like she did almost 2 months ago. I simply looked at her and said "You have cancer, don't you?" She said "Yes." I immediately burst into tears and covered my face. It was a reaction that I have never had before. I knew I had to get myself together. When I managed to lift my head from my hands, I saw her eyes also full of tears. She wanted to know how I had known. "No one knew, how did you?" she asked. The only way I could explain it was "I just did." Not a line full of brilliance or comfort, just the truth. The disgusting truth. How was she feeling when she was told? Was it difficult to tell others or therapeutic? She joked about the wig in her future and how she had wanted to get "big hair" but her family protested. Was all that she was telling me for her benefit or mine? I was hoping it was for her. As much as I wanted to alleviate her pain, was she really as happy-go-lucky about the situation as she would have seemed to have others believe? Had I hurt her with my reaction? What did she want from me? Was I delivering? How could I help?

Cancer is not a new thing for me. I have known many people who have had it, some have lost the battle but thankfully most are winning. My aunt/godmother was diagnosed with stage 4 ovarian cancer and has now been cancer-free for four years. A dear friend, Monica* was diagnosed with breast cancer which later metastasized to her lungs and brain. She is currently in remission. My father-in-law, whom I never knew, died from 3 primary cancers. Bob*, a guy that I had known for many years as a family friend and then later dated very briefly, unfortunately died of 2 brain tumors. It was a horrible death. A terrible, slow progression capped by a discolored body lying lifeless in an open coffin.

It took me 4 hours to get home because of traffic. I needed every minute of those four hours. I was glad to be alone so that I could cry, think and prepare. What is going through her mind? What is she feeling?

I need to head back to the halls of the cancer center and start volunteering again. It is the place where I feel useful.

You are in my prayers, Kate. I hope you know that.




* not his/her real name