CHAPTER 7: FINDING OUR "-NESS"

But with life we never know
When we’re coming up to the end of the road
So what do we do then, with tragedy around the bend?
We live, we love, we forgive, and never give up
Because the days we are given are gifts from above
And today we remember to live and to love
“We Live” by: Superchicks

The other day I heard about a 16 year old boy who died during a trip to the Grand Canyon…he jumped into the Colorado River with two other boys wanting to get a cold dip from the summer heat, and never came back home.

It got me thinking…we never know when our last day on earth is going to come… we don’t know if I that day will arrive unexpectedly or after a long time of unwanted suffering. That young boy never had a fighting chance for his life. Whereas, as horrible as cancer is, and as sickening as the experience of going through it may be, at least I get a fighting chance…at least I get a chance to battle for my life.

Some people’s lives are taken away in the blink of an eye, and what sometimes we humans may judge to be prematurely. These people never get a chance to make a list of the things they want to do before their time on earth is over. They never get a chance to re-examine the relationships in their lives and decide which ones are worthy of their time, and which ones need to be kicked out the door. They never get a chance to remind the people they care about how much they really love them. They never get a chance to decide to not care about mean/obnoxious/rude/unpleasant people that they encounter, but to instead try their best to ignore such people in an effort to make their own lives more fulfilling and healthy. They never get a chance to relax and enjoy the little things rather than rush through life. These people cannot vow to enjoy every sip of their Starbucks cup of coffee while quietly and serenely reading a good book. They cannot vow to appreciate the shining sun and cool breeze outside more, or to take pleasure in the neighborhood park. Yes, it is very unfortunate what some people never get to experience, or rather experience more thoroughly without letting stress or unwanted people to get in the way, because their lives get taken away from them without a warning.

I used to be one of those people who wanted to die quickly, painlessly, and without prior knowledge of it (I believe this was my exact description a couple of years ago). However, things have changed and I have changed my mind as well. Of course, I still would like to die painlessly (and when I am a very wrinkly old woman!) Yet, being diagnosed with cancer has opened my eyes to so many things. Mortality becomes a part of reality when diagnosed with cancer. Death is not a remote concept anymore. The thoughts of dying at a young age before accomplishing much are undeniably scary, but the determination to fight for life also becomes stronger than ever.

Not only that, but I am also more determined now to live most of my days surrounded by happiness and enjoying what good things life has to offer (and there is plenty of loveliness that can be experienced once we decide to slow down and open our eyes.) Don’t get me wrong, I still have my crappy don’t-dare-get-near-me-or-I-will-blow-up-in-your-face days (I do have cancer after all-that’s when I like to play my cancer card), but seriously I am actively trying to limit those days, and heal my soul…with practice I hope to limit those unpleasant days to a minimum, or dare I even say completely eliminate them? (thereby becoming Monk Nancy) After all, they do say that practice makes perfect.

The point of this post is not to freak any of you out by talking about death. I know it is a very sensitive topic that can send many people running in the opposite direction. Rather, the point of this chapter is to call on all of you busy-bees guys and gals out there, who are rushing through life not enjoying any part of it (all the while convincing yourself that you will slow down once you reach that goal, get that promotion, have a family, or reach professional success). STOP DOING THAT! Life is happening now all around you. Stop waiting for that moment when something is accomplished before you can start enjoying it. You know as well as I do that day will never come, because there will always be something more that needs to be done. So, why not start enjoying life now while you still have it? It is all about adjusting your attitude, and then you will realize you can actually LIVE and be grateful for every day of your life. Life is happening now, while you’re busy thinking of the future. I am just as guilty of this as any of you. Why does it have to take something major and life-altering as a cancer diagnosis to get our wake-up call?

So, that is why I write this post…that is why I decide to share this chapter…in hopes that some of you will hear this call before it’s too late. So tomorrow morning when you wake up, try to listen to the birds’ chirping outside, try to enjoy the smell of freshly-brewed coffee, and try to look at a gorgeous blue and sunny sky (or a cloudy and rainy one if that’s more your thing). I hope by taking these small acts you will truly be able to alter the direction of your day. If you are happy and energetic that is when you will be the most efficient. Even better, hopefully your positive energy will emanate to others around you…after all, who says only negative forces have to spread like California wildfires? GO ON, I DARE YA! Spread that positivity and see if it doesn’t change you for the better.

Phew, I’ve become good at this inspirational talk. Maybe I need a change of career? Maybe, I should become a motivational speaker instead…I will find my “Nancy-ness” and help others find their “-ness” as well like Dupree in the movie “You, Me, and Dupree”! (If you have not seen this movie yet, go watch it NOW-it will give you a good chuckle)…

I have told you this so that my joy might be in you
And your joy might be complete.
This is my commandment:
Love one another as I love you.
John 15:11-12

CHAPTER 6: TURKEY DAY PLANS

My strength is almost gone, how can I carry on, if I can’t find you?
As the thunder rolls, I barely hear you whisper through the rain “I’m with you”
And as your mercy falls, I raise my hands and praise the God who gives and takes away…
You are who you are, no matter where I am
Every tear I cry, you hold in your hand
You never left my side, and though my heart is torn
I will praise you in this storm!
“Praise you in this Storm” by Casting Crowns

Thursday Nov. 27th, 2008: America is busy cooking turkeys, mashing potatoes, and baking pumpkin pies in preparation for Thanksgiving dinner; whereas, my family and I were preparing for my first chemotherapy session. While the rest of America was busy eating home-cooked food, I was busy enjoying my first-taste of the delicious ABVD combo. What is the ABVD combo? And where can you get some of that goodness? Well, I’m glad you asked; that is what I am here for-to tell you! ABVD stands for the 4 chemotherapy drugs most commonly used to treat Hodgkin’s Lymphoma (Adriamycin, Bleomycin, Vinblastine, and Dacarbazine)…you got them memorized? Good, because I am going to quiz you on them next time around. As for your other question of where you can get this tasty combo, well I apologize, but we Hodgkin’s folks like to keep that as our little secret-the only way to get a taste of this treat is by developing Hodgkin’s and then you can get back to me and I will gladly share the secret with you.

Anyways, I was going to receive only my first session of chemotherapy in the hospital, the rest were going to be outpatient. They prefer to do the first session inpatient to monitor the body’s reaction to it, especially Bleomycin which can cause pulmonary (lung) problems or an allergic reaction in some people. They tested a small amount of it on me first; I did not develop an allergic reaction -bummer! Now there was no escaping receiving the combo (ok fine, I did kind of want to get the treatment if it was going to cure me). Speaking of cure, this has become like my favorite word (NOT really). So, Hodgkin’s has a very high cure rate, about 75% of cases are completely cured (with no future relapse I believe). But this becomes a slightly annoying fact, especially when everyone likes to remind me of that statistic every time I question their optimism-the doctors, the medical staff, family, and friends. It is as if the stats make the whole experience easy, just because there is a chance I am going to be cured. Yes, I know 75% is a high percentage, but it is not the same as a 100%. It is not a guaranteed cure, which means the doubts, the fear, and the uncertainty that comes with any cancer diagnosis is still present. Plus, I still had to go through chemotherapy AND radiation, so the experience of cancer is similar to any other cancer whether curable, temporarily treatable, or not. Oh, and to tell someone with Hodgkin’s something along the lines of “this is the good kind of cancer” or “if someone was to have cancer, this is the one they would pick/want” is absolutely ridiculous! Cancer is bad, all of it, in all of its forms, shapes, names, etc. No one wants to have ANY kind of cancer, no matter how curable it may be. Yes, I understand there are some cancers that are more bearable than others, but please do not ever tell someone they have the “good” kind of cancer, got it? Ok, I am done lecturing now.

My first chemotherapy session is not that memorable, besides the fact that I was in the hospital on Thanksgiving Day and I did not want to be. The oncology floor nurses at MC were amazing! Most were extremely nice and sweet, thus making my 5-day hospital stay a lot less miserable. The nurse who was administering my chemotherapy talked to me throughout the whole thing so I did not even notice the passing of time. Since this was my first chemotherapy session, I was not really nervous. I know that sounds paradoxical, but the fact that I had not experienced its side-effects yet meant I could not completely fathom what they were going to be like. It did not matter how many times the words nausea/vomiting/hair loss etc. were mentioned-hearing the words is completely different from actually experiencing them. Still, I was a little worried about the side-effects that were to come, but these days they have some pretty awesome anti-emetic drugs (drugs that counter the nausea/vomiting) that help tremendously.

In medicine we study about the five stages of grief that everyone goes through (or SHOULD go through) when dealing with any difficult situation (death, illness, divorce etc.) The stages are taught to occur in the following order: denial, anger, bargaining, depression, and finally acceptance. I believe that these stages do occur and are in fact needed, but they don’t occur in that same order necessarily-at least not in the case of cancer (or perhaps any chronic illness). Because I knew about the five stages of grief, I was consciously looking for their appearance in my life post-diagnosis. I was looking for the day when I would get to the acceptance stage and everything will become perfectly fine, cancer and all. Well, it does not exactly happen that way. I think I have hit the acceptance phase multiple times already in the past six months, along with the other stages as well. I keep going through the stages over and over again. I have experienced anger, depression, and acceptance too many times already. As for bargaining I do not always notice myself doing it, but I think it happens a lot during my prayers. I think I only experienced denial in the very beginning; after the definite diagnosis, it is hard to deny the fact that I have cancer especially while going through the treatment. My mom tried to take me down that route a couple of times as she voiced her concerns, telling me that maybe I should get a second opinion or maybe there was a mistake in the medical reports. I would consider it for a moment, but then refuse to go down that path of doubt. I trusted MC, and I trusted my doctors. I was in the medical field already as a student and it was easy to spot incompetence, and MC was definitely not one such place! (As if they needed me to certify that for them; as if they did not already have the worldwide recognition they deserved anyways).

I remember the day before when my oncologist (Dr. Scotty) spoke to me about the biopsy results and the treatment plan. I had just been brought up to the room post-biopsy, and I was still pretty groggy. I was trying so hard to keep my eyes open and listen to him speak, but the whole time I was thinking to myself: “why can’t you wait until I’m fully awake to come talk to me, when I’m actually able to focus and communicate!” The next day when Dr. Scotty came to see me during his rounds, I made sure to ask him a bunch of questions most of which he had probably already addressed previously, but oh well, it was his fault for talking to me when I was half-conscious. Dr. Scotty was the kind of doctor you instantly liked; with his Scottish accent, perpetual smile and optimism it was hard not to like him. He explained to me that I was going to have a chemotherapy session once every two weeks for a total of eight sessions (4 months) followed by radiation as they determined necessary. He also seemed to save his biggest goofy smile for when he reminded me, pointing to my long hair, that I will be losing it all during chemotherapy-just seemed a tad bit inappropriate to tell me that with a smile plastered across his face (but that is another story I will get to later).

“When can I leave the hospital?” was what I wanted to know. I was told I could leave the next day-so I just had to slightly modify things in 2008 and celebrate Thanksgiving Day on a Friday…

Have no anxiety at all, but in everything, by prayer and petition,
with thanksgiving, make your requests known to God.
Then the peace of God that surpasses all understanding
will guard your hearts and minds in Christ Jesus.
Philippians 4:6-7

CHAPTER 5: LET THE FUN BEGIN!

You only get just one time around,
You only get one shot at this,
One chance,
To find out,
The one thing that you don't want to miss,
One day when it's all said and done
I hope you see that it was enough,
This one ride,
One try,
One life,
To love.

"One Life to Love" by 33 Miles

My eyes opened, blinked a couple of times to try and re-focus the blurry image, and looked around barely moving my head…hmmm, ok I guess I'm in the post-op recovery area. "Man! My lips are so dry I could drink an ocean!" I thought. Just then a nurse noticed me moving and came towards me; she confirmed what I suspected, I was in the recovery area and the biopsy went fine… "Can I have some ice chips please?" I asked knowing that water is not allowed. After popping a few of the delicious ice chips in my mouth I drifted back into sleep (or more like being half unconscious). Not long after, I felt my hospital bed being wheeled upstairs to the oncology floor where I was to remain a resident for a few more days.

Things had moved quite fast once I had arrived to Arizona on Saturday. Since it was the weekend, I had to wait until Monday morning to call and try to get an appointment. I was lucky enough that one of the renowned cancer treatment centers was located in the phoenix area (I will refer to it as MC)-I decided after I did a lot of research on the web that this is where I should go, after all it was world famous on its cancer research for a reason! I was so glad that things worked smoothly for me. When I called MC Monday and asked for an appointment as soon as possible, the lady told me that she may be able to schedule me in for next week…next week?! Sheesh I cannot wait that long knowing there is a tumor roaming around in my body-well it wasn't really roaming thank God; it was just sitting there chilling and being rowdy sometimes but still! So I begged the lady ever so nicely to please try to find something for me that same day or the next day if possible. I explained to her about the mass and the thrombus and how urgent it was that I see someone pronto, but I did not know exactly who to see or where to start. She put me on hold. Dum dum da dum doo da…music playing…I hate it when they play music while putting people on hold, because you focus on the music and forget how much time has passed. Anyhow, phone lady comes back and tells me she scheduled me in to see a general Internal Medicine doctor who will then refer me to the appropriate doctor/department. Halleluiah for small miracles like getting same-day appointments when your life depends on it!

I made it to MC that afternoon with my sister not knowing what to expect or how things were going to turn out. The first good sign was the building itself. It was so beautiful and clean and airy that I did not feel like I was in a clinic. Second positive sign was the doctor herself whom I was scheduled to see (Dr. #1). Dr. #1 was so nice and understanding, and her physical exam was so thorough-due in part to the fact that she found out I was a 3^rd year medical student, and I would notice if she just put the stethoscope on my lungs and moved it before I even took a breath…so she actually listened to my lungs! (Ok it could also be because she is an excellent doctor who is working at an exceptional clinic, but she was going to refer me anyways and having been introduced to the clinical world myself and seen how doctors work the first reason for her thoroughness made more sense).

I ended up being admitted to the MC hospital that same day. Dr. #1 thought it would be easier and faster to run all the necessary tests and see all the appropriate doctors if I was inpatient. The hospital was in a different location, and I was stunned even more when I saw the hospital building. I thought the clinic was nice, ha! The hospital felt like a 5-star hotel; they even had a piano in the lobby where a volunteer was playing some sweet music. Ok, I suppose this qualifies as good sign #3. So far so good…that is until all the poking, probing, and scanning came along…oh yeah and the ever-so-fashionable hospital gown! What is it with hospitals and trying to force patients out of all their dignity with the stupid open-back gowns? Well, I was a freaking med student and as fragile as I was at that moment, I was determined to keep some of my dignity however hard that may be. So I asked for a second gown which I wore with the opening to the front that way covering up my dignity, and I brought my scrub pants from home to wear under the gown!

Being the good medical student that I was, I had typed a history form of myself and printed out several copies to give to every doctor, resident, student, PA, nurse, or janitor who came in to question and examine me (the history for non-medical people is when the doctors ask you all these questions about your illness, your past illnesses, your social life, your ancestors illnesses etc. trust me they do that for a reason other than to annoy you!) well, I did that for two reasons: 1) it gave me something to do besides driving myself crazy with thinking during the long flight home, and 2) I really did not want to be annoyed and repeat the same story and answer the same questions over a 100 times. I wrote down everything I could think of, including any symptom I had experienced in the past few months whether imagined or real (that was for the real doctors to figure out.) I was so happy I had written that history, it saved me a lot of talking sometimes, and I got a few impressed looks and comments from some of the medical people (it was about time too for someone to tell me something positive about my medical skills after being stomped on as a med student for the past few months!)

I had such a difficult time internally accepting that I was on the other side of it-now I was the patient. Giving up control, and trying to become a cooperative patient who did not question every single thing the doctors said (whether out loud or inside my head) was a really hard task. As the months passed by though, I realized that sometimes it is easier to just be a patient. Sometimes I even hated that I knew so much, and I could search scientific medical articles and read them in the blink of an eye. I got some un-needed stress as I read about all the horrible side-effects, complications, and mistakes that could happen. This is one situation where sometimes it helps to be ignorant or at least not know so much. But on the other hand, my medical background helped me tremendously at other times (like that time when I was in the hospital and the nurse kept bringing me medicines to take that my doctor had already stopped, but they were still on my chart. I had to tell her that I'm not on those meds anymore, so she would smile, apologize and go double check!)

Anyways, I had a bone marrow biopsy and a thoracoscopy (took a sample from the mediastinal mass to analyze in lab and determine what the mass was definitively) done on Wednesday. Between the time I had checked into the hospital Monday afternoon and the biopsy on Wednesday, I had undergone numerous other tests and was seen by multiple doctors. Most of the other tests came back negative (meaning normal), which was especially comforting when it came to the Brain MRI and the Echocardiogram they had ordered. YES! At least my heart and brain were normal and functioning like they're supposed to-I have got to celebrate the little victories like these when my world seems to be collapsing around me!

That same day, on Wednesday Nov. 26^th, 2008, the biopsy results confirmed what the doctors had primarily suspected. I definitely had Hodgkin's Lymphoma; no doubt about it now after the pathology report showed that the mass sample contained Reed-Sternberg cells (which are THE cells that identify Hodgkin's.) These cells are the ugliest looking little monsters with two huge eyes that stare back at you as if mocking you and telling you "I've invaded your body, now what can you do about it?!"

I was told that my first chemo session would be the very next day! Oh joy! Ok seriously, things were not just moving fast, things were zooming past my eyes at the speed of light making it hard for my brain to digest and absorb all these new unwelcomed facts. I mean less than a week ago my biggest worry was how to impress my attending, now I'm getting chemotherapy?!!! Whoa! Actually in a way I realize how lucky I am that I was diagnosed with cancer this quickly, because most cancer patients spend months going from doctor to doctor with their symptoms before they get diagnosed. So, at least I did not have to go through that, but still I needed at least a two-week notice to be able to process all of this. Nope, no such luck!

Chemo, here comes Nancy-your newest victim…

I have told you this so that you might have peace in me.
In the world you will have trouble,
but take courage, I have conquered the world.
John 16:33

CHAPTER 4: TELLING MOM

When you can't wait any longer

But there's no end in sight

when you need to find the strength

It's your faith that makes you stronger

The only way you get there

Is one step at a time

“one step at a time” by Jordan Sparks

Arriving at Phoenix Sky Harbor International Airport the next day was one of the greatest moments of relief I had experienced in a while. I was HOME! I was with the people who will take care of me selflessly and unconditionally-my family. I caught a glimpse of my sister who was anxiously awaiting my arrival. I hurried over towards her, and when we hugged it was as if this was the first time I had breathed since learning of the terrible news. Still, I could not forget that the hardest task remained ahead-telling MOM!


On the drive home, my sister and I discussed how to approach the subject so that I can deliver the news to mom as gently as possible. Dad was working overseas and we would have to tell him over the phone (which was exactly what I wanted to avoid doing), but we will tackle the dad issue later. We decided that we would ease mom into this by telling her that the mass could be something simple and benign and possibly easily treatable. Since we really did not know what it was yet, there was no point of mentioning the frightening word “cancer” in that conversation.


However, I realized that I had underestimated mom. Sometimes in situations of extreme difficulties, certain people who may otherwise be fragile and vulnerable may surprise us. I was mom’s child, and I think she realized how much I needed her to be strong for me during this time…and she was! She accepted what I was telling her so much better than I had imagined, and we quickly started discussing what the next steps were that we had to take. Of course she was my sweet emotional mom too, so the tears still flowed, but she remained strong and rational even though I know inside she was full of fear and uncertainty. So was I, so was my sister, and so were my brothers. We were all just putting on a façade of being strong, because sometimes when life hits you with unimaginable blows that is the only way to survive! Breaking down and crumbling into a human ball may seem like the more attractive alternative in such circumstances, but it is not the way that will win the battles of life. To win a struggle, one must face it with determination, strength, hope, and sometimes even belief in what may seem like the impossible…Kind of like what Elizabeth Gilbert says in her book Eat, Pray, Love:

“…my Guru once said---that you should never give yourself a chance to fall apart because, when you do, it becomes a tendency and it happens over and over again. You must practice staying strong, instead”...

For in hope we have been saved,
but hope that is seen is not hope;
for who hopes for what he already sees?
But if we hope for what we do not see,
with perseverance we wait eagerly for it.
Romans 8:24-25

CHAPTER 3: GOODBYE FLORIDA

I think I'm moving but I go nowhere

Yeah, I know that everyone gets scared

But I've become what I can't be, oh

Stop and stare

You start to wonder why you're 'here' not 'there'

And you'd give anything to get what's fair

But fair ain't what you really need

Oh, can you see what I see?
“Stop and Stare” by One Republic

I was thinking about what to include in this chapter of my story, and I had the sense that it was going to have a mainly melancholic tone. However, I woke up this morning and listened to one of my favorite spiritual leaders, Joel Osteen, on TV. His message for today was titled “Be Glad Continually” and it was exactly what I needed to hear during this time of my life. His message can be summed up when he says, “Don’t be determined to never have problems, but be determined to always have joy in the midst of all your problems.” Basically, he calls on us to always have a smile on our faces despite what we might be going through in life; the smile that reflects that even when we feel that we have no control of our own lives, we still know that God is in control! After listening to that, I want to somehow make this chapter “upbeat”, and try to make at least a couple of my readers laugh or smile by the end of it. I hope I am successful, so here it goes-chapter 3…

As I was getting ready to leave the Florida ER, Dr. Comfort gave me prescriptions for the medicines I would need until I made it home to Arizona. That basically included a steroid to keep my facial swelling under control so I don’t unintentionally scare any innocent bystanders by having another “puff face” episode. I also got Plavix (a blood thinner) for the suspected thrombus on my neck. The intern, Dr. Blessing, walked with me as I was leaving the ER. At this point, her eyes were visibly red from all the crying she had done as we heard the CT scan news. We stood outside. She hugged me goodbye, now crying even more, and gave me her phone number to call her if I needed anything. The funny thing is that anyone seeing the two of us then would have thought that she was the one who was just diagnosed with a mass, and I was the one comforting her. Poor thing kept apologizing for breaking down like that, and telling me how strong I was for keeping it together. I wish I could have told her two things. First, I just wanted to make her understand that apologizing for something like this was not only silly, but it was a crime! She was apologizing for being compassionate, for being supportive, and for feeling sad that such a monster was growing in me. No one should have to apologize for being that humane, but I did not have the strength to tell her that at the time. All I could do then was hug her back, and say “thank you!” Second, the truth is that I am good at faking being in control of my emotions in public; it is really like a kind of art. Proof of that is that I had only shed a few tears in the ER, which I quickly put under control, but as soon as I made it to my car and I was alone, I broke down crying. It was little tears at first of “oh my God, is this really happening to me?!”, but the flood gates opened wide when I finally made it to the loneliness of my apartment!

Except there was a lot that needed to be done, and I obviously could not do any of it if my hands remained occupied with the box of tissues! So, with tears under control, first thing I did was call my brother in Atlanta; I decided it would be easier to start with him. Plus, I wanted to arrange for my flight home to have a layover in Atlanta so I could see him. I made sure my voice was as calm as I could manage before I called him. He was shocked to say the least; I only talked a few minutes with him and we hung up, I could tell it was a lot of “fresh” news for him to handle. But he called me back a few minutes later, and started doing the brotherly thing, you know, comforting me, telling me not to worry and that everything will be just fine etc. etc. He later confessed that in between the two calls he had kicked a few walls and doors on his way to class! (This explains why he was much more composed during the second call ;) Next, I called my sister in Arizona after I booked my flight, explaining everything all over again. I told her to pick me up the next day from the airport, and to not mention ANYTHING to mom. It would be much easier to explain things to mom face to face.

After that, I realized staying in my apartment alone was out of the question. So, I gathered up my laptop and purse and went to a Panera Bread that was just down the road from my apartment. If I was going to stay sane, I needed to be around people---even if the people were complete strangers. Once there, I called the only true new friend I had made down in Florida, “Zero”, and asked her to meet me at Panera after work (there is a very funny story behind the nickname I chose for her, which I will not disclose here!) I also called my good friend, HRL, and asked her if she would meet with me after her shift ended because I really needed to be with someone. HRL told me she would meet me at Panera as soon as she could leave; she called me back less than 30 minutes later and told me that her attending allowed her to leave early and that she was on her way. I felt so relieved, I really did not want to spend that evening/night alone, and now the two people I could count on in Florida were going to be there for me when I needed them the most.

That night turned out to be a very fun one, which is ironic considering the circumstances. After I explained my current life crisis, Zero and HRL did what friends do—they started comforting me and offering their help. Zero offered to drive me to the airport the next morning, which I appreciated greatly considering I had to leave at 6AM! (She had also made me a “get well” card from scratch and colored it with crayons when she had run into me in the ER earlier that morning!) Zero left after dinner, and HRL said she would spend the night with me even though she had to be at work at 5AM! And in a typical HRL fashion, that night, I laughed more than I had in a long time. We were even making jokes about the possibilities of what this mysterious mass may be. Somehow we ended up watching “Patch Adams” after I had mentioned that I’ve never seen it; HRL of course thought that it would be the perfect end to a memorable night of ice cream eating and laughter. She actually drove all the way to her apartment and back to fetch the DVD just so we could watch it that night. We fell asleep halfway through the movie. I did not have the deepest of sleeps that night, but when I woke up around 4AM and glanced towards the other couch where HRL was sleeping (we had decided to just camp out in my living room), all I could feel was peace and gratitude that I had friends who cared.

When it was finally time to get off the couch and get ready for the airport, I had this sense of excitement and relief. I had made it through the night, and I will be home with my family in a few hours; I don’t know what else I was expecting, but I suppose the previous day’s news had rattled me a little more than I thought.

Zero was at my door right on time, all awake and smiling as if it was not only 6AM! During the short drive to the airport, I realized that I did not know if I would see my friend Zero again. I did not know what the future held, but I knew I would not be coming back to Florida anytime soon. I felt a little sad. I had grown to love this friend even though we had only met a few months ago; she had definitely proven to be a true friend-the kind that a person would like to keep for life. She dropped me off by the curbside, and we hugged each other goodbye.

I boarded my flight. Soon, the plane started to move, and I found myself silently saying a little prayer. “Dear God, please just get me to my family safely and without incident…please, don’t allow the little thrombus to dislodge and damage my beautiful brain!” Following that little plea I could feel all of my fears evaporating, or at least becoming temporarily suspended for the rest of the flight…

Consider it all joy, my brethren, when you encounter various trials,
knowing that the testing of your faith produces endurance.
And let endurance have its perfect result, so that you may be perfect and complete, lacking in nothing.
James 1:2-4

CHAPTER 2: To Leave or Not to Leave?

“Never really said too much
Afraid it wouldn’t be enough
Just try to keep my spirits up
When there’s no point in grieving”
“Light On” by David Cook

It was a Friday morning on Nov. 21st, 2008 when I woke up feeling exhausted. “Of course I’m exhausted, I’m a medical student on a surgery rotation” I thought to myself, “all med students are exhausted right?” I slowly dragged my body out of bed, and looked in the big square mirror I had leaning against the wall in my room (because I had no one around to hang it on the wall for me). Why is my face looking puffier today? DAMN! My face is swollen! I examined my reflection in the mirror more closely and saw that my lips and eyelids were especially swollen to about twice their size. I sat on my bed and started crying. Now, the tears were not just because I saw my face swollen. It was a multiple of factors that caused me to cry that morning, one of which was fear, because I had no idea what to do. Should I still go to work? Should I call in my attending and take the day off? But then what? I will be trapped here in my apartment alone not knowing what was wrong with me. So I finally decided to attend the morning lecture for students/residents, and maybe ask some of the nice interns for their advice or see if they have a doctor that they recommend for me to go see.

Thankfully, after washing my face and applying some makeup my face looked more normal, but I was sure people would still notice (or at least I could easily tell it was not my normal face). I made it to the hospital and kept my head down while I walked to the elevator; I did not want to scare anyone with my abnormally puffy face! I still secretly hoped one of the interns or students would notice though, so they could help me decide on what to do. As I was waiting for the elevator, one of my favorite interns came with his breakfast in hand. He greeted me and immediately followed that with “you look tired today Nancy.” well no kidding! By the way, this is one of my favorite statements to hear from people (sarcastically speaking). It is usually a nice and polite way of saying “you look like hell today” or even, “dear God! what made you think you should come out in public today!” Anyhow, today I was glad I received that comment, because I took it as my opportunity to tell the intern what was going on and ask for his advice. (I will refer to this intern from here on out as Dr. Fine).

After all, I was scared. I felt alone, and I did not have my family and closest friends around to run to for help. No, I was on my own in Florida, after I had made the unwise choice of moving down here to do my third year rotations leaving everything familiar behind. I thought it would be an exciting adventure…Living somewhere new, meeting new people, and being so close to the beach! However, I should have listened to the saying that “home is where the heart is.” I had left my heart stranded, confused, and divided somewhere between Georgia (and the south) and Arizona, and because of that reason I never felt at home in Florida-not even for a day! In fact, I was counting down the days to when I would leave that wretched place.

After listening to me, Dr. Fine suggested that I talk to the doctor who was actually giving us the lecture that morning. He also reassured me that whether it’s an allergic reaction or something else then I will most likely just be given some steroids to bring the swelling down. My other option, Dr. Fine said, would be to go down to the hospital’s ER and just talk to the ER doctor there after lecture was over. I liked the second option better mainly because I knew all the ER doctors and staff since I had already completed that rotation months earlier.

Lecture was torture that morning (even more so than usual); I do not remember paying attention to any of it. I just wanted it to end so I could leave. One of my friends sat next to me, and asked me what was wrong; when I said “nothing I will be ok” she replied quietly “yeah right!” But she let it go, probably sensing that I did not want to talk about it then and there. Honestly, I was just feeling vulnerable that morning, and I was sure that if I tried to talk about it I was going to break down into tears, which was something I wanted to avoid at all costs. I also hate the feeling of not being in control, and that day I could tell that I was not in control of anything!

Lecture over. I take the elevator down, this time with another one of the nice interns (whom I will call Dr. Blessing because of all her help to me that morning). She too asks if I was tired or something along those lines. Man, I must have truly looked terrible that day! At any rate, this time I could not hold it in anymore, and I started crying right there in the elevator as I explained to her how I had no idea why my face was swollen, and I did not know if I really wanted to go to the ER or not. Dr. Blessing immediately said that she will come with me to the ER and talk to the doctor herself, and that I should not worry. I cannot express how much I appreciate what she did for me, but from that point on that day in the ER she pretty much took care of everything I needed. She stayed with me until I left the ER at 11:45 AM (keep in mind, that Dr. Blessing had just ended her night shift at 7AM…went to morning lecture…and was probably ready to just go home and crash in bed by the time lecture ended at 8:15AM! But she refused to leave me despite my many attempts later on at telling her that I was ok.)

Once I made it to the ER with Dr. Blessing, things moved pretty fast. We both talked to one of my favorite doctors, who thankfully had the morning shift that day (Dr. Comfort). He thought that I did not really need a neck CT scan since he suspected it was just an allergic reaction, which was what I thought as well. I had been on my surgery rotation since the beginning of November, and I had to scrub in multiple times a day, so I explained to him that maybe I was allergic to the scrubbing detergent or gloves or…?

However, that morning I had also noticed my right neck vein was visibly distended. This was the most concerning thing to me, and I did not see how it could be explained by a simple allergic reaction. So upon the insistence of Dr. Blessing and me, Dr. Comfort ordered the neck CT scan.

While we sat waiting for the CT tech to come get me, I was joking around with Dr. Blessing about how I am going to end up having a brain tumor or some kind of weird case that they can present later on at one of the morning lectures. You see, paranoia and hypochondriacism are the two most common traits among the oh-so-intelligent human breed of medical students and residents. Well, as it turns out I did not have a brain tumor but I sure did have a tumor ha! Ok universe, lesson learned…I will never ever joke about things like that anymore, or will I?!

Shortly after the CT scan was performed was when I found myself standing in Dr. Melodrama’s radiology room. He had so graciously agreed that I be present in the room while he read the scans, and he treated me more as a colleague than as a patient. I realize that it was an exception he made for me since I was a med student, and I thank him for that.

After the finding of that nasty anterior superior mediastinal mass (which basically means a tumor/mass in the area behind the breastbone and above the heart)—things started to get more ridiculous. All I wanted to do was get on the next available plane and fly home, but Dr. Comfort was concerned and did not want me to leave the hospital. Something else had showed up in my scans that Dr. Melodrama read as a thrombus in the left neck vein (thrombus = blood clot). Dr. Comfort was explaining to me the risks of flying while having a blood clot that could dislodge at any second, and go to my brain causing some serious damage (or what we call in the medical field a stroke!) Of course I knew all of that, but I did not care; I wanted to go home to my family as soon as possible. I did not want to be admitted to a hospital in Florida, and certainly not THIS hospital where I knew practically half the medical staff.

I could see it in Dr. Comfort’s eyes that he really did not want to let me go, he was worried about me almost like a father worries about his daughter. However, I was his patient, and patients have autonomy. It is this autonomy that allows patients to leave the hospital AMA (Against Medical Advice) by signing a paper indicating that they have listened to the doctor’s explanation of why it is necessary for them to stay in the hospital and what the risks of leaving are, but they still choose to leave at their own will. That was what I chose that day; I decided to leave the hospital AMA…

But when Jesus heard this, He answered him,
"Do not be afraid any longer; only believe, and she will be made well."
Luke 8:50

CHAPTER 1: HOW IT ALL BEGAN

"I'm hangin' on another day
Just to see what you throw my way
And I'm hanging on to the words you say
You said that I will be OK"
"Broken" by Lifehouse

I stood in the cold and dark radiology room staring into the computer screen showing the many slices of my body. I don't think my eyes were blinking much. My brain was trying to stay focused on every word that Dr. Melodrama was saying but that became increasingly difficult after hearing the words "anterior mediastinal mass."

Probably sensing or expecting my state of shock, Dr. Melodrama found the need to repeat his sentence multiple times while placing his hands on my shoulders and looking me in the eye, "are you hearing me young lady? What you have is a superior anterior mediastinal mass." Now with my limited medical knowledge as a third year medical student I sort of knew what that was but not exactly; the words "mass" or "tumor" are generally bad and would involve numerous tests and possibly numerous doctors to determine exactly what the mass is. All I knew at the time though was that my life was going to change and it was not a change that I was going to welcome.

My mind was flooding with questions that needed immediate answers. What is this mass? Is it treatable? How drastically is my life going to change? Am I going to have to halt everything I'm doing with my life for this mass?

Oh dear God, how am I going to tell my parents? I don't want to put them through this (again)!

You see, I am not one of those people whose life has been easy for them up to "this point"; the point when something major happens to change their entire life, like say having to face cancer. I thought my life has been plenty difficult to last me my entire earthly existence thank you very much! And silly me, I honestly thought I had already faced the biggest hurdle of my life back when I was 13 and was diagnosed and treated for severe scoliosis. Well, apparently the universe did not think so; the powers out there thought that "oh maybe little Nancy has not had enough yet, let's spice it up for her a bit more!"

I am Nancy. I'm 25 years old, and this is how my story with Hodgkin's Lymphoma starts. The decision to share my story on the World Wide Web took me over 4 months to make, but I finally decided it was something I had to do, both for myself and for others out there who may be struggling through the same battle. I also figured it will be much easier to update my friends and family on my progress in this battle, which I realize is a lifelong battle, but one I am very determined to win!

Finally, through this blog I can write, and write regularly hopefully, which has always been one of my passions. Unfortunately, it is a passion that was lost and became one of the many victims of my choice of going to medical school three years ago. It is a passion that I can now claim back (however temporarily) while I "enjoy" my one year medical leave of absence from the crazy life of a medical student!

My blog will be organized into "chapters" and even though I am just starting to publish the posts (in April 2009), I was actually diagnosed with Hodgkin's back in Nov. 26^th, 2008. I will try to mention the major dates in the chapters when they are relevant. The idea of organizing the blog into chapters comes from my dream of one day having my writings published into a book (or two or many ;)

I will also start each chapter with a line from a song and end it with a verse from the bible. The two things that are keeping me strong and motivated during this time in my life (besides the support of so many people around me) are my faith in Jesus and his unending love, and the lyrics from my favorite songs! I don't think there is anything else in the world right now that affects me as strongly as the truth found in the bible and the beauty and strength that I find in some song lyrics. So I hope you find solace and strength in those lines as much as I do!

Wait for the Lord;
Be strong and let your heart take courage;
Yes, wait for the LORD."
Psalm 27:14