Snapshots

Last year, I celebrated New Year's Eve in the fetal position. 

I could count pain in milligrams of drug sufficient enough to tranquilize a giant, but not enough to alleviate the pain of sitting upright or putting on pants. 

My neighbors helped me safely navigate the 50-ft trek between our houses and strip off the leggings unable to accommodate a distended belly and overwhelmed stumps for legs.

In January I bought oversized clothes and met my at-home nurse who thought my 30-pound tumor lump was a baby. 

In February I relived the fetal position on the floor of a Port Authority bathroom stall. My best friend came, found me an ambulance, and stayed with me while the morphine dripped over my first encounter with a lymphoma-related bowel obstruction. 

In March I did extensive research on the topics of:

 "what foods will make me vomit," 

"how to eat: sort of,"

"why won't you stay down, you are liquid, what"

and finally,

"chemo and the case of the tummy tumors: I would laugh but I'm so hungry"

In April I had my first (+ hopefully last) experience with the NG tube, TPN, and "abdominal cut-and-paste." However, I did get to share my hospital bed and apple juice with my best friends and some service puppies.

The morning after I got out of the hospital, I took myself to my first appointment for BMS-936558, now Nivolumab.

In May, newly treated, I went back to Philly as a skeleton in a wig and relearned how to eat. 

In June I began the process of reorienting myself as a semi-independent person who eats and walks and talks and commutes every morning.

In July I was living.

In August I was living.

In September I was living.

In October, still living, I had a lung biopsy that resulted in a pause of treatment. Somehow, hearing the drug worked so well it caused inflammation made it OK. 

In November, living, I started a big kid job that involves Nerf gun fights and field trips to Medieval Times.

In December I'm alive, well, sunkissed from a trip away from home not involving an IV, blood test, or inpatient stay.

What a year.

Progress

I decided to geek out a little over the lab results MSKCC handily provides on my patient portal. Here is a little snapshot of my progress over the past year(s). (The numbers from the past three years have a lot of variance, shown below.)

For hemoglobin n00bs, check out wikipedia.

Past 3 years:

Hemoglobin levels from diagnosis (August 2010) - to now (October 2013) Hemoglobin indicates your blood's oxygen-carrying capacity. (Mayo Clinic) 

Past year:

My Hemoglobin levels over the past year (Oct 2012-Oct 2013) . 11.5 (g/dl) - 16(g/dl) is "normal", highlighted in red. (g/dl is grams per deciliter)

As you can see, there was a fairly steady drop from Nov 2012-Dec 2012 of last year, when I was "most sick" (comparatively). A non-bleeding ulcer discovery and several units of blood later, I was all shiny (ruddy) and new(ly treated).

You'll notice another big drop from March 2013-April 2013, when I had a major bowel obstruction resulting in an intestinal "cut-and-paste". I was then hospitalized for two weeks, learning how to eat and digest (again).

I began consistently hitting Hemoglobin levels in the "normal" range (highlighted in red) from May 2013 onward and have been vacillating between 12 (g/dl) - 13 (g/dl) since then.

This is a picture of wellness. This is improvement. This is living.

Death, Sex, and You: The Cancer Edition

"Not Today."

There may be times in life when you find yourself interacting with someone with a scary, perhaps even life-threatening illness. Maybe you meet them at work. In class. At a bar. Making small talk with tact can be difficult amongst all that is icky and emotional. How does one discuss awkward topics like cancer without being awkward? How does one discuss all that is depressing and debilitating? 

Some initial tips:

- Don't insinuate fault. Don't mention karma, "life teaches us lessons", or any other potentially blame-laying notions. 

-  There is a fine line between being light-hearted and being facetious. It is best to assume you are 1. not funny and 2. any inferences you make regarding life expectancy will be wrong and/or insulting. It is also best to refrain from trying to parlay an anticipated life expectancy into a one night stand because "life is short as you know, lolz, yolo".

Or how about we just avoid the topic of death altogether? No dead relatives, no asking about how long I have left, or how I think I would be as a ghost (though I will credit the individual who came up with that particularly precious bit of pillow talk with the most creative take to date on discussions of impending mortality). I know it is super tempting to dive straight into anticipated funeral arrangements when a person you encounter reveals (s)he has been stamped with the "Big C" (or other life-threateningly fun diseases), but how about we all collectively decide to hold back on the er, charm until at least the 3rd date. Or 10th date. Or never.

Re: the dead relative comment. Yes, it can be brought up with a certain level of finesse. Let us assume you, and any of your friends, coworkers, drinking buddies, etc do not have that level of finesse and therefore should avoid mentioning someone who died from the same disease/disease family the person you are speaking with has recently revealed they have. Some of you may find this a bit silly, or unnecessary to address but you would be surprised by how quickly an acquaintance can turn around and say "Hodgkin's Lymphoma? My aunt/grandmother/aging rock star had that. She's dead though..." when you make the mistake of mentioning you are ill.

And on the topic of illness, how does one indicate interest without being intrusive? Follow their lead. 

For many of those recently diagnosed, they are completely terrified and haven't the faintest idea what to expect. They may not be the best resource for specific disease-related information, as they are likely overwhelmed by all the new medical jargon they have yet to become fluent in. Ask lightly and let them tell you what they feel like telling you. This is not the time to be pedantic or preachy. If you have suggestions, provide them gently. Everyone has an anecdote about some treatment x or some supplement y that cured z disease. Try prefacing each suggestion with "I'm not sure if you've heard of this, but..." or  "I'm not sure this is something you'd be into but..." If you want to share something, make it accessible. Or better, send them the bottle/box/book with the understanding they may never use said product at their doctor's request or simply because they forgot.

Comments on changes in appearance or hair style should be entertained with caution. Really, all opinions except those of the unwaveringly positive or life-affirming sort should be kept to yourself.  Chemo (among other treatments and medications) does funky things to all things hair, skin, and body and your sick friend is most likely fully, if not hyper-aware of any/all minute changes their treatment has caused. Whenever you feel compelled to make facial or verbal expressions of disgust towards your friend's deteriorating physical state you can instead choose to not be a completely selfish, emotionally destructive human being and keep it to yourself.

As a friend, it is not your responsibility to enumerate all the ways getting sick can inhibit social, academic, or professional success. Hours of waiting room visits provide plenty of time for sick kids to examine every possible angle, every missed opportunity, every friend who no longer calls, every trip that requires too much energy, every scenario that could end in rejection simply because it has been revealed one has a less-than-stellar immune system. Refrain from asking leading questions such as:

"Who will want you if you're infertile?" 

"Why won't you work/exercise/go out/drink?" 

"Shouldn't you be married/promoted/back in school by now?" 

This may be difficult for the Type A among us to grasp, but you don't get to decide what your friend's limitations are. Or what is an acceptable career, life path, or timeline. Even if it may seem that control over circumstances no longer falls with your sick friend, it most certainly does not fall with you.

But the least welcome comment (in my opinion) is a prediction of failure. Perhaps you feel you the sick friend needs to be "brought back down to earth" with some friendly statistics, risk profiles, or mortality rates. They don't. And they especially don't need it from you, defeatist-masquerading-as-realist, non-medical-expert. Unless you have the spy capacity of the NSA or are a mind reader (in which case I'm impressed), it is safe to say you do not know what your sick friend knows or doesn't know about their treatment or potential quality of life.

"But what if I'm the god of death?"
All you need to know is:
not today.

Generation "Y (Are You Here?)"

You can wrap up my idea of happiness and sprinkle it with powdered sugar.

(...and then give my future self diabetes? Candy-coat me, baby.)

It is fortunate my baseline for happiness is the ability to stuff my face with fried dough without the worry I will involuntarily throw it up. I'd like to thank San Sebastiano for having a feast day so perfectly timed, rolling every unhealthy Italian food I could want into my (almost) backyard during this period of able-to-chew-and-swallow. I'd also like to thank my potassium levels again, for their cooperation in getting me temporarily kicked off the trial long enough to be able to sneak away from the house for a few hours without (physical or mental) collapse. This must be what the kids who cut 8th period in high school felt like: some bliss, some adrenaline, slight touch of guilt.

Eating. What a joy! Being able to take large bites, knowing the digestion thing will just sort of "happen"...magic.

Anti-nausea medication -- what a whirl. Big ups to you too, my man.

I'm in a good mood. Mind is a-buzzing. Living it up while I can.

By living it up I mean my day-to-day included the casual blood test, because they forgot to check if I was pregnant during Monday's. 

The conversation went a little like this:
Me: Dude. I have one vein left. And it is still bruised from the past 3 blood tests.
Clinical Trial Nurse: LOL, fuck your veins!

During said blood test, the nurse gave my mother the low-down on her 22-year-old daughter who lies around all day and the stampede of 15-year-olds on welfare coming in with children and expensive shoes and all I could think was "Oh god this woman thinks I am some vicious combination of her hack daughter and every pregnant adolescent she's ever encountered." It is at such times I wish I had some sort of membership card, stamp, tattoo that signals to the world that I am not living in my parent's house by choice, omission, lack of job offer. Do they offer these things? And can I get it with the Penn crest? Something that implies "This person accomplishes shit occasionally. Also, she is totally not pregnant." (...as of last week's blood test.) 

But le sigh, there was no time for me to "accio" my degree, as indignant nurse was busy going off on the laziness of Gen Y (which she made sure to  clarify as "Why are you here?") I was fuming, which happens to look a lot like smiling and nodding.

Sometimes I wonder if this thing is just one big joke.

Drug Vacation

I've missed my brain.

I know, what a strange thing to miss. Surely it is always present, except during the occasional romantic fling in which it flees? For most yes, but mine had officially "left the building", as they say. I am uncloudy-ish for the first time in weeks. The strange thing is, I'm still on pain killers. Just (temporarily) off the study drug. Who knew how nice a drug vacation could be? Especially when it's potentially life-saving cancer treatment... but I'm happy, I am. I think I needed this. To reminded that I can in fact, compose sentences without drooling (it was getting weird) and stare at words for extended periods and have them make sense to me. So thank you, shoddy potassium levels, for giving me this required break from the clinical trial to pop candy-looking (not candy-tasting, sadly) potassium supplements. Compared to the study drug-oxy-vicodin combo, oxy-vicodin is a walk in the park. Like wow. You don't appreciate what you have until you're given the equivalent of an ACME mallet to the head in the form of a pill. yeesh.

So I suppose I should inform you that yes, I made it into the clinical trial. (that I was then "temporarily" taken off of. See Above.) I went to Ohio alone for 6 days and, with newfound nausea and poor appetite, (what a stellar combination!) force-fed myself whatever it is Midwesterners refer to as "food". Day 1 I attempted the cafeteria, only to discover it was in fact a Wendy's. It was at this point (and many others) I had to ask myself: is this real life? 

Dear god, it is. 

Anyway, so I go off my coffee/caffeine kick (suck it, doubters!) while in Ohio and developed a taste for apple juice. Yes, I traded in coffee for apple juice. 

...I was on drugs, okay?! Sheesh. 

I haven't fully recovered from the transition, that is, haven't been having much of any coffee mostly because there's no point in even pretending I'm going to be productive on the toxic combination of study drug-painkiller. I basically spend the days sleeping or counting the hours until I get to sleep. Or watching shitty TV. 

Also, I really like juice.

So I really just wanted to get in this tiny bit of writing before study drug starts back up again (potentially later today if EKG goes well) and makes me an actual dope. (Is panobinostat-lenalidomide dope? Meh.) If I can squeeze anything else out before the mallet falls, I'll send out another update. 

This is (Probably) Your Brain on Drugs

The key to becoming a master writer?
Hemingway: Writing drunk and editing sober.

Upon hearing this, the glowing bits in my liver were like:
- HA HA!
- Sucks to suck

...among other things, because I am sure they are sentient beings and can like, talk and stuff.

But I now realize I don't need to drink, because I am in a state of perpetual confusion! Prescription pain killers: the pregame of choice!!! I now get to double up on the fun because my doctors pity me and I admitted to feeling anxious over having to take Vicodin every 4 hours because that is hardly enough time for a good nap or to forget one is about to be in pain. So, now we have a once-every-12-hour "base" of Oxy and the occasional Vicodin.
I have gone from 0 to Real Housewives of Orange County in a matter of days. Truly impressive.

Once upon a time, I could say: All I need in life is Gatorade and Tylenol. Then it became: I run on Gatorade and Vicodin. Now it would be most accurate to say: In my bloodstream one will find Gatorade and (insert any narcotic Prep school boys snort in the locker room). Oh, and pita chips.

Oh lord, I cannot think. I just want to make weird sounds, roll over, and take another nap because really what else am I capable of these days? I must say I have become fantastic at napping, sweating, and "totally not crying" as in "I am totally not crying during 'Prince of Egypt' because of my newfound narcotics-inspired appreciation for music". I don't know why people take painkillers when they're not supposed to because I actually feel crazy. Maybe I am just a "high functioning crazy".
I should not give myself too much credit. We will go with "functioning crazy".

Lately I've been giving myself points for interacting with human brings outside of the house. This requires me to actually leave the house, so... fuck? Is it socially acceptable to walk around in a blanket as Linus so artfully did? I don't want to be a style-biter or worse, bullied by a tyrannical 9-year-old girl with a bad haircut.
These are the things I concern myself with.

Back to the point system -- Doctors and hospital staff aren't supposed to count but today I've decided that they do because my doctor and nurse told me they loved me in two separate instances. I don't know if it was to see if they could get a react out of me, drug zombie, or I am actually in a relationship with my hospital as I've suspected all along. It would make sense, as I've felt guilty "cheating" on hospital with the other hospitals I've been visiting.

If people can fall in love with ostriches and mailboxes, surely I can be in a relationship with my hospital? Let's not even explore the logistics of that as I've already carried this a bit too far for my liking.
Besides, I'm only back at my hospital to do screening tests for a clinical trial I'm ditching it for next week (hopefully). And get more drugzz, obviously.
The screening tests cover a host of things, but they're mostly concerned with how not pregnant I am. Under the clinical trial's exclusions, amidst all the blood, goo, heart, mind specifics that can disqualify a person, for those who still have some shred of a uterus one must be really, really unpregnant. If there are degrees of "not being pregnant", clinical trial patients should be on the "vagina dentate" end of the spectrum.
Me, clueless, is all: So uhmmm, do I just pick up a pregnancy test?
...Because I have long awaited the day my mother and I would go pregnancy test shopping together.
*drinks bleach*
Clinical trial facilitator: Uh, no.
She informed me I had to go to "legitimate testing center" where they send the requesting facility a report indicating if the eggo is in fact, preggo.

Unfortunately, the testing center we went to was run by a woman who, even after being corrected multiple times, was convinced I was born in 1998. So I am a little bit worried about the results getting...anywhere. Or getting a call from child services. Fortunately the other tests are being handled at a facility where the receptionists have proven themselves capable of entering numbers/can read and stuff.

Things are looking up.

Vicodin Consulting

I write to you in fever and Vicodin haze. 


It seems things have taken a turn for the worse since I've last posted, as my mutant inhabitants have rendered me (at times) incapacitated, writhing in pain, calling out for some god, spirit, cereal mascot to intervene. The pharmaceutical gods have smiled on me, however, and now I get Vicodin!! 

I have also tapped into the alternative medicine font for pain relief. I am always amazed by the ability of properly placed acupuncture needle to reduce pain; the ability of peppermint oil to cool fever heat. Apparently, acetaminophen can be harmful to the liver in large doses! Which is super, not just because of the whole "my liver is already fucked" thing, but because I will probably be on some form of the drug for at least a month or two as I wait for a clinical trial spot to open up, which happens when they kill off a patient or see a cohort (group of patients) through a full treatment cycle. Of course I was not informed of this by my oncologist, who prescribed the acetaminophen, because he really likes for me to learn things on my own. Or at least that is what I tell myself.

...to convince myself he still possesses some iota of usefulness as I attempt to finagle a treatment plan with the combined efforts of my family and friends. 
So anyway, some creativity is needed on the pain relief front.

In order to circumvent the lack of guidance in this whole "finding a clinical trial so my tumors shrink and I do not die" thing, I have transformed myself into a clinical trial consultant. The job, like so many other glamorous consulting gigs, has a large travel component -- involving flying around the country to less-than-desirable locations to conduct industry research and facilitate deals. By "conducting industry research", I mean determining whether any of the information provided before the visit via phone, email, idiot nurse or clinicaltrial.gov posting is at all factual or rooted in reality. By "facilitating deals", I mean pitching my disease profile to oncologists while not-so-subtly begging them to test unproven toxic chemicals on my person. Unlike most top consulting firms, company X ("my body") provides no training or any actual benefits. Though company X's clinical trial team promises to cover all the bases of a proper consulting experience: schmoozing, analysis, long hours, and pretending I can solve complex problems in front of others. 

Tomorrow I arrive in the culinary capital of the world: Rochester, Minnesota. Frequent guests of the hotel I'm staying at boast proximity to the very best in Midwestern fine dining. This apparently refers to the Red Lobster and Olive Garden in the neighboring strip mall. 

This is of course assuming I even make it to the hotel in question, as I managed to book a flight on what is probably the only airline in history to receive multiple 'zero out of ten' customer reviews. This is all because I insisted on a direct flight, as any less time I can spend not catching pneumonia in a freezing cold cabin with wheezing old men is worthwhile. Side note: fevers are wildly useful if you find yourself in need of a makeshift radiator when dealing with what can only be the airline's best take on an adventure in Antarctica. There is some sweating involved, but I am told sweaty is the new "not sweaty", so ..

---

I meant to update sooner, but waking up around 5:30 every morning to writhe, cry, take drugs, and pray for some medically induced coma to befall me until I get into a clinical trial has a less than positive impact on one's ability to focus. I learn something new every day! If all goes well, you will have another Vicodin-fueled post coming at you soon. 

To tide you over, I'll leave you with some highlights of my Ohio trip:

sticky-handed oncologists, naps on stone slabs, and a pizza guy with an affinity for left-handers. yow-za.

Everything You Ever Wanted to Know About Becoming a Cat Lady

Some stay in New York for a job. Others stay for a significant other.

I stayed in New York for a hospital.

But now we're breaking up. Or at the very least, decided to see other people. Taking a break. We will "stay friends", keep each other posted on comings and goings, and occasionally share bodily fluids.
...in the least sexual way.

As happens in many relationships, we've outgrown each other. Rather, my hospital has nothing compelling to offer me in this stage of my life (/cancer).
So, I'm on the prowl. My hospital has encouraged me to play the field and check out multiple options before settling down. (The relationship analogies will eventually stop.)

(...but not just yet).

I'm flying out tomorrow to meet someone new. As with all first dates, I will gain no useful information. We will exchange basics and backgrounds. Only on a slightly different tune, as I will be regaling them with tales of the failed relationships of my past and every health malady I can scrounge up from recent memory and record. (Note: this is not a dating advice column. Everyone knows such material should be saved for dates 3 and 5!)

Unfortunately, the decision to have a second date is as much theirs as it is mine. As I court this new hospital, he may decide to wait before following up. (hospital will now be referred to as "he" in keeping with the theme.) He may decide that he is "not ready for something serious right now".  The timing may not be right. He may be unable to give me what I want. (drugs) He may be unable to satisfy my needs. (drugs) He may do and say all of the right things (read: give me the right drugs), as others have before him, and still come up short.

I share a concern of many women far older than I: the biological clock. Mine is also ticking, but not so much in the reproductive sense as in the productive sense. My ability to function independently is diminished every single day I go without effective treatment, as the tumors colonizing my vital organs grow unfettered. Each symptom of their success is a new warning sign, a new harbinger of doom.

Fever, fatigue, pain, and malfunction may very well be the Four Horsemen.

(Now that I've made you sufficiently depressed...)

Like so many sensing their own draining hourglass, I find myself in a rush to settle down. I find myself anxious to find the right hospital to grow old with. And like so many, I worry I may end up alone.

(Or with a cat or something. I'm not picky.)

Real Housewives

I don't want to be the well-heeled couple gushing
to another couple
about the many things we have bought and are buying.
The description of a carpet installation. The importance
of a theme-appropriate centerpiece.
Then I think:
I should be so lucky to make it to 40 and have a
normal enough suburban existence to appreciate
the mundane.
Revel in the negligible.
So what is it that I feel when I overhear them? Pity or
envy?
Each stomach spasm makes it harder to tell.

"after death"

19/30

I, your Lazarus,
require a savior to remove my stubborn stone.
is he (she?) to be delivered unto me
via Harvard med school prophesy?

For rebirth commands some kind of death,
bathed in some newness of
carefully constructed DNA
dangling strands intertwining,
(presumably not strangling)
the delicate ecosystem of my inner self.
I must open myself up to the suffering:
lay myself upon the perilously uncomfortable bed
intended for everything but rest,
to be strapped up as sacrifice
to the life-eating bits
sniffing out prey in my blood stream.
take me, all of me, render me useless
pull the hair from my scalp,
strand by loving strand
20,000 pangs and
only then may I begin anew.

Take the varnish off nails and
ruddiness off cheeks
the spring from my step
and the step from my feet
My mind’s a wedding cake
and you’ve had but a bite
it’s bad luck not to take but one more slice.

To rise again they say I must first die
To the graph I host I beg:
don’t even try.

I’ve added up karma and hope for a 10th cone free:
have pity upon a reincarnated me.

Transplant Me, Baby

A social optimist who casually dips in morbidity,
I bask in a sun whose clouds are
dispersed by the right word.
I handle the drizzle of a rained-on parade and
dictate the rules of a world outside of my own.

I know nothing of altruism, save for
human beings' willingness to share
literal pieces of themselves to
save the life of a stranger.
Be the match! A profile
never more clearly indicated compatibility.
10 defining factors.
(But, what if you don't like dogs ...or long walks on the beach!?)
Can I still accept you into myself, in order to become whole?
A marriage to last for eternity,
(or at least the next scan)
to divorce is to divide the children
organs, maybe.
I hear the court hearing is absolutely deadly.

A Final (De)grade

The University of Pennsylvania has failed me.

Not in the academic sense, but in the other academic sense.

I'll clarify: I desire to take the maximum recommended courses as determined by my oncologist, and Penn does not wish to accommodate me. My case was petitioned and shut down, and with it my opportunity to (somewhat) comfortably continue my education. Instead, they have unyieldingly offered me the options of 

-  a full course load (to which my oncologist has explicitly objected ) 

- a part time course load with full tuition AND automatic academic probation (a nice, permanent addition to the academic record)

- surrendering my status and privileges as a CAS student and becoming LPS

- leaving.

The decision to continue to take courses is not a foolhardy one, nor one without some basis of understanding of the limitations of my...predicament. Doctors seem to agree that the practice of being "normal", however one chooses to define it, is essential for maintaining the positive psyche necessary to successfully complete treatment. The University of Pennsylvania has decided that it knows better than my oncologist regarding my health. The mindset: Why don't I just leave them alone to deal with healthier, happier students? Or, more forgivingly, we can assume their actions intended to alleviate. Benevolent intention or not, they have just made me all the more stressed, which according to medical professionals will weaken me, my resolve, and ultimately, my chances at recovery. So thank you, University of Pennsylvania, for placing yet another obstacle in my path to relative normalcy, already cluttered with things like hair loss, overwhelming fatigue, potential infertility, oh and the massive tumor in my chest. Who doesn't appreciate a good kick when they're down?

The combative(read: ornery) nature of this post does not go unnoticed. I would like to blame it on the 30 years I've aged in the past few months. The sort of lethargy attributed to years of simply existing.Though the wrinkles haven't developed (yet), there is a sort of grey that has taken over my eyes in place of the usual glint. I am worn down and embittered. Gravity(multiple references here) has hit physically and mentally.

I understand higher education is a service industry. This is not lost on me. The fact that I have to pay full tuition for part time (and be put on probation) as part of a policy to discourage students from "coasting", when in fact part time is the maximum allowable given that I will have chemotherapy cocktails (aka vicious cell-destroying poisons) circulating my body, accurately depicts this notion. Not to mention, going to class will prove difficult when I am confined to a hospital bed for 3 weeks at the end of term. This is not to suggest I do not find myself capable of completing a part-time course load successfully. This is also not to suggest I seek special treatment beyond the recommendation of my Harvard Medical School-trained oncologist.  I intend to contribute to my classes to the best of my abilities, and I hope to be held to such a standard. I simply ask to be accommodated where accommodation is needed. It's not about sympathy, it's about fairness.

Another frustrating aspect is the guise of assistance they paint upon themselves. Support! Advising! Come to us for this session on x,y,z, we'll help you do x,y,z. File a report! Tell your RA!  The means through which problems are supposed to be solved. Yet, in circumstances these means would most useful (I'm going to go out on a limb here and suggest cancer is an extenuating circumstance), they instead choose to adhere to policies and rules that do not acknowledge extraordinary circumstances. They are as black and white as the text in which they are written. To give credit, they do allow one to leave and come back. Or drift off into the world of LPS. But I should not have to choose between going at the full speed I was once able to maintain and stopping entirely. I also should not have to switch into a school of general studies, inconveniencing and potentially endangering to my ability to graduate with my desired major in a reasonable period, in order to accommodate. I should not be penalized (read: put on probation) for desperately trying to continue my education amidst limitations outside of my control.

The policy is unfair and does not support the kind of student it seeks to protect. It fails to consider the needs of the ambitious and determined; the kind of student that demands the challenge Penn is supposed to provide. The kind of student Penn recruits and spits out into the world to make something (exceptional) of him/herself. The kind of student that does not simply "give up" when presented with adversity. This is the stuff of college admissions essays - you should know better. 

So I ask you, University of Pennsylvania, to allow me to do all that I am capable of. Hold me to the standard of excellence assumed when you accepted me (I'm going to assume there was one - go with it).

Here's the plan:

Regardless of what happens over the next few months of surgery, treatment, and hospitalization, I'm going to graduate from the College of Arts and Sciences. Maybe even by my projected graduation date! (I know I'm reaching here.) I would make some sort of statement asserting "you can't stop me," but I feel that would be excessive, and too easily considered a dare. 

I understand that cancer makes the assertion of future goals presumptuous. But I refuse to allow this affliction to define me. I wish you would do the same.