Ore-gone

I don’t visit a lot of blog sites, but my favorite bloggers don’t post on a regular, predictable schedule. It makes things fun, I think; it’s almost like a present each time you wander back to their page.

A new post???? Merry Christmas to MEEEEE!!!
A new post???? Merry Christmas to MEEEEE!!!

That’s how I’m choosing to view this blog. I don’t want people to have to spend an entire afternoon catching up on what is going on in our life. The reality is that much of the same thing happens in each location. My opinions haven’t changed about many things and they likely won’t surprise anyone when I express them, so why bother sounding like a broken record?

But the nature of this blog is to keep our friends and family updated, so this post is going to be a very fact-forward. We spent four months in Oregon. As far as location is concerned, Oregon was AWESOME. I have to give it a fair shake and do the whole breakdown of point distribution, but I can tell you right now that, if the job had been more my style, I would have stayed there forever. For the Redditors out there, here is my TL;DR summary (the Reader’s Digest version, if you will). After living in Oregon for only a few months, my closet started to look like an REI catalogue (#win). There’s an excellent brewery in every town. I learned rather quickly that adult oncology is not for me. My sister lived less than 2 hours away and I saw her at least twice a month. That, hands down, was the best part of living in Corvallis.

This is pretty much how we greet each other. Every time.
This is pretty much how we greet each other. Every time.

Food: 9

In Denver, there were amazing restaurants but not a lot of local fare. In Corvallis, it was the opposite. There were a few good restaurants, but there was such an abundance of farm fresh food it made up for it ten-fold.

Produce! Produce everywhere!
Produce! Produce everywhere!

That’s not to say the restaurants were anything to sniff at. For such a small college town, Corvallis boasted some eclectic options, but a lot of the best food was actually at their numerous breweries…which brings us to the next category.

Libations: 10

I mean…it’s Oregon. There’s at least one brewery in every town; usually multiple breweries, actually, especially in Bend (a little slice of heaven). Jason is fond of saying that if you throw a rock in Bend, you will probably hit a brewery. Corvallis wasn’t a slouch with the beer either. Block 15 became our frequent watering hole and I don’t think it’s a coincidence that it was the first place we visited when we arrived in Corvallis. Combine that with Two Towns Ciderhouse, which has forever ruined all other hard cider for me, and we were pretty well stocked during our four months.

I'm so happy!!
I’m so happy!!

Outdoors: 9

Oregon is beautiful- from the coast to the mountains. The space, the greenery, the water- did I mention the mountains? There were plenty of places to explore the outdoors in Corvallis, and with Bend only 2 hours away and 1 hour to the coast, there was an abundance of natural beauty. Our first three months were full of sunshine and warm weather. Then October arrived, at which point the sun gave Corvallis the middle finger and was never seen again. That was rough. I never realized how much I don’t want to explore the outdoors when it’s grey, rainy and cold. Admittedly it seems harsh to give it a 9 just because of the rainy weather that it’s known for, but man if it didn’t affect me like crazy.

I'm not even sure what happened.
I’m not even sure what happened.

Transportation: 8

Bike lanes! Bike lanes for all! Getting around Corvallis was a breeze on a bike. The bus system was free, but unreliable. I actually had a bus driver yell at me because I rode my bike to a bus stop to catch up to the bus when he was 5 minutes late at my designated stop. I guess when people don’t pay to use the bus, you don’t have to worry about being a jerk to the people riding.

I'm not sure what I expected
I’m not sure what I expected

Due to the unpredictability of the bus system, transportation got a bit complicated when it got rainy and miserable. In the last month, I drove the car a lot. That being said, Corvallis isn’t a very large city so getting around via bike/foot is very doable, which is no small thing when you share a car.

Job: 5

I want to be very clear- my reasons for not liking my job had nothing to do with my coworkers or my patients. I truly enjoyed being able to have adult conversations and not talk about Bubble Guppies or Paw Patrol. And I certainly found several kindred spirits along the way. I don’t know if my emotional state influenced how I felt about the job, or if it was just the work flow. I do know that I really liked my coworkers, I loved my manager and the doctor was difficult to work with. I also know that I made some fast friends both with patients and coworkers- I’m thankful for that.

Average Score: 8.2

So I’m back at Lucile Packard for the next 3 months (YAY!) and this time we’re living in San Bruno (DOUBLE YAY!!!). More updates to follow. Hopefully sooner than this last break. Perhaps.

A Moonshot

September and October are always weird for me. On the one hand, you have Childhood Cancer Awareness, a cause I have dedicated time, money and even hair to. Close on its heels comes October and Breast Cancer Awareness month- something I feel equally passionate about for obvious reasons. I always feel a little torn, like I don’t have enough to dedicate fully to either month. Lately, I’ve been feeling a paradigm shift happening and it’s really come into focus today.

Back in February, my aunt emailed me while sitting in her infusion chair where toxic chemicals slowly dripped into her bloodstream. Vice President Biden was having another round table discussion at Huntsman Cancer Institute. “If you’re bored” she prefaced, with the link to the live video feed. I was currently out with the flu- feeling much better but certainly not well enough to be among the ranks of my fellow nurses yet. So yes, I was bored.

I watched as doctors, senators, family members, patients and nurses discussed the best ways to make our research more cohesive. That was a large part of the discussion- how can we bring our research together and make it more accessible and translatable?

Of course I heard about the “moonshot” initiative. Initially, there was a big push with the Pediatric Oncology community to try and get more focus for optimizing treatment in childhood cancers. For years I have railed against the lack of federal funding for childhood cancer research (a whopping 4% according to some sources).

But in the last few months, I realized that the reason behind such focus on research and treatment in adult oncology is because so many adults don’t make it. I haven’t lost sight of the fact that the treatment we offer children affects them for the rest of their lives; that more federal funding could actually help to tailor treatments to minimize permanent damage to these children. Working in Corvallis during this time helped me gain insight into the need for better treatments for everyone. The mantra keeps repeating in my head.

We are all in this together.

Yet, something Vice President Biden mentioned on several occasions struck me back then. What interventions could be made in order to make access to cancer treatment and research more available? Namely, are there barriers that could be either removed or at least minimized by our government? These past few months, it made itself plainly known.

Mr Vice President, I know of a barrier that continues to prevent patients from receiving quick and efficient cancer treatment: insurance companies.

When treatment is delayed-sometimes by precious, life-saving weeks- because the insurance company needs to “authorize” the treatment protocol.

When the insurance company refuses to cover BRCA testing for a patient because of the expense, even though this testing would help with prevention and surveillance of cancer in her children and grandchildren.

When a person who is dying from metastatic disease has to choose between hospice and palliative chemotherapy- because even palliative treatment is still, in fact, “treatment” and insurance will only pay for one or the other. Not both.

When research and pharmaceutical companies need to offer grant programs to help pay for life-saving treatments because insurance companies won’t.

These are the barriers to care that both adult and pediatric oncologists face. Yes, we need more research. We need people to get involved in studies, we need donations to Susan G. Komen, American Cancer Society, St. Baldricks, CureSearch– because we are all in this together.

We need better treatments, but we also need a better focus on quality of life. We need insurance coverage for adjunct therapies that have proven to be effective in reducing pain and stress. Most importantly, we need insurance companies to stop dictating the quality of care that patients receive.

Don’t think that just because it hasn’t happened to you or someone you know or someone you love that it doesn’t affect you. Cancer affects everyone. Kids, teens, adults.

WE ARE ALL IN THIS TOGETHER.

And if the government wants to get on board…yeah…that’d be great.

Yeah-THATD-BE-1rlu82

Bloom Where You’re Planted

Sometimes I like to imagine that I can somehow prepare for the future. That maybe weighing all the possibilities will guide my decisions and that later, when I look back, I’ll think “thank goodness I thought of this in advance!” While Jason and I have been exploring various locations, I have been able to put some of this thinking aside and focus in the short term. There’s no stress about the long term goal, no question of “where do you see yourself in five years?” because our timeline lasts only about 3-6 months. But that nagging voice in the back of my mind always begs the question- is this our new home?

When I took this job in Corvallis, OR, I was excited for a number of reasons. Of course we were thrilled to get a chance to finally live in Oregon, and it most certainly has not disappointed us. Oregon manages to combine all the things we love about Colorado and North Carolina (specifically, Durham), like beer, mountains, water, farmer’s markets and hands down, the best cider I have ever had-I tell ya, folks, Two Towns is going places. Keep in mind, we still have yet to experience two very important parts of living here- football season and winter. Oregon State is just down the street from our apartment and winter is notoriously gloomy. So, needless to say, our opinion might be a bit skewed.

I could get use to this...
I could get use to this…

I was also eager for the chance to work in adult oncology. Most places wouldn’t accept a travel nurse with limited adult oncology experience and no certification. Being a private clinic, the requirements weren’t as stringent. They were just glad I knew how to administer chemotherapy -they weren’t too picky about the average age of my population. The pace is much slower than what I’m accustomed to, but I’ve come to enjoy the break. I really like the other nurses I work with; despite a significant amount of turnaround in the last year, they have managed to create a really positive work environment in the face of a lot of uncertainty. The clinic seems to be constantly on the brink of disaster (for reasons I am not at liberty to divulge), but the nurses truly care about their patients and want to offer the best care possible.

Even with all of these positives, I just cannot deny that my true passion remains in pediatric hem/onc and I said as much to my manager and co-workers. That still didn’t stop them from trying to convince me to stay permanently. I was flattered, but guilt gnawed at me when I thought of leaving them high and dry come the holidays. It really does make a difference having that extra nurse available. So I offered to stay through January to help cover vacations until they could find someone permanent. Then, I bit the bullet, paid the hefty sum, and signed up to take my certification exam for pediatric hem/onc.

Take my money

Something that has helped me keep my sanity through all this is looking at other travel jobs. It’s just a reminder to me that I can always go somewhere else and start new. But lately, I’ve found myself looking at more permanent positions, if only to assure myself that when the time comes I can find a job doing what I love. It was during one of these late night random browsings on Indeed.com that I came across, and eventually applied to a permanent job with Seattle Cancer Care Alliance. It was a great opportunity involving their infusion center, focusing on groundbreaking research between Fred Hutchison, Seattle Children’s and University of Washington. I think I was scared that another opportunity like this wouldn’t come along and I threw myself out there, thinking “there’s no way.” After all, I had applied to a few permanent positions in Colorado and only heard back once.

It turns out that I did get a call from Seattle…and to make a long story short, I had an existential crisis. For pithiness sake, I have included a diagram to explain why I began to feel daily anxiety regarding my next steps.

You're welcome
You’re welcome

 

I’m not really one to believe that everything happens for an ultimate purpose, but I do think that for all my worrying I am reminded of the many forces in our lives at work. One can only be open to the path that unfolds before us, rather than trying to predict what that path might be or where it might lead. I followed through with the interview, and discovered that they already filled the pediatric position internally. The remaining position was for adult infusion. Seeing as I already made my decision to continue with pediatric hem/onc, this seemed like a pretty easy fix. Luckily, the manager was very honest about their availability of pediatric positions and understanding regarding my decision to stay in pediatrics.

This experience did make me realize that if I truly want to stay in pediatric hem/onc, my options are going to be limited. We may not have the flexibility to move wherever our heart desires. In my dream world, I would work in a peds hem/onc clinic in Bend, OR, but life just doesn’t work that way. What I do have is a set of skills, a passion for my field and a wonderful partner to help us bloom wherever we are planted.