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10:15am. Tuesday, April 17th: As some scrambled to submit their tax returns, and others recovered from the 26.2 mile run up Heartbreak Hill in Boston, I was going under general anesthesia, yet again. For my 13th surgery.

Sometimes I think about how I will explain these past unemployed years to a potential employer. I wish that bravery and resilience were as valued as sales numbers and masters’ degrees, that employers cared that Jess Danforth, who was once terrified of everything medical, can now put in and take out her own IV.

I wonder if people are born with different amounts of courage - variable reserves that are determined genetically, like eye color. Or maybe courage aggregates over time. Possibly we just become resilient or numb. I don't know.

My thirteenth trip to the OR was a completely unexpected, worst-case-scenario surgery. After multiple surgical attempts to stitch and bandage my radiated skin into wholeness, the skin lacked all blood supply and would not heal. After the latest removal of bandages and surgical wound vacs, my chest, once again, remained open. I risked sepsis. My situation had become an emergency.

One of the microsurgery residents arranged to meet me to review options. It was a Sunday night at 9pm and she had two little ones at home. She threw on clothes and opened up Mt. Zion at UCSF Medical Center. Drafting anatomical renderings in purple pen, she went through each of the four plausible surgical options and the reason why, despite surgeons rarely performing one particular surgery, I really only had one option.

Her iPhone continued to vibrate as text after text came in. “They are all about you,” she said. My oncologist and surgeons. Plastic Surgery, Microsurgery. The chief, fellows, residents. They scheduled the operating room for the next morning. My lead surgeon recused himself; he was too emotionally invested in my case.

I no longer have to show an ID or tell them who I am when I check-in for surgery. I just show up on the third floor of the Helen Diller Cancer Center. It has become my office in a way, and the surgeons and doctors and nurses and anesthesiologists, my co-workers.

There is a part of me that usually feels "safe" in the hospital. I feel like I am being taken care of and constantly distracted / surrounded by people. I feel like my time there is purposeful. A simple sense of security that comes with surgical scrubs and latex free environments and IV antibiotics that fades once you cross through the revolving doors, spit back into the real world.

The pre-op markings from my twelfth surgery were still visible on my chest, the bruises still present and the veins on my left hand still healing. This time, for the first time, my eyes became teary as the team wheeled me into the OR. For some reason, I wasn’t sure that I would come out alive. Thus, maybe, the reason for my heavily drugged “I am alive” texts that I sent out in multitude the following day.

Now I am home from the hospital and remember so very little from the past few weeks. From what I have been told, I had my first ambulance ride, I started using Snapchat and took full advantage of the meerkat feature, I chose an engagement ring (I am not engaged), I continued my love affair with UCSF quesadillas, I refused to wear anything but a hospital gown, I drank latissimus lattes and I was quite certain that I was at UCLA.

Today I walked down Chestnut Street in the Marina and was struck by what people couldn’t see, which is often the case with so many things in our lives. Who would have guessed that underneath my zipped-to-the-chin Patagonia are chest tubes and drains connected to and encircling the empty confines of my back? Who would have guessed that there is a one-foot plus incision held together by hundreds of stitches?

It reminds me of when strangers say, “You are so good with kids! Why don’t you have your own?” and I have no idea if I should tell them the truth or just brush it off with some witty comment to maintain the normalcy. How my heart sinks when people rant about how inconsiderate it is when people don’t breastfeed their kids.

Life happens to each of us. It scars us. It hurts us. It changes us. Some of us more so than others. Some of us in a more obvious manner than others. Imagine if all that is invisible suddenly became visible and our vulnerabilities, our tribulations and struggles were all displayed for the world to see? What if we all wore name tags that displayed break-ups and heartache, disease and death, mental illness and insecurities?

When I was first diagnosed with breast cancer, I decided to freeze my eggs. I started IVF and was in the lab getting my blood drawn. It was Halloween and as the super-exuberant phlebotomist inserted the needle into the crook of my timid arm, he said, “What fun plans do you have this weekend?”

I could have just said, “not much!” or brushed it off with an array of other socially appropriate responses but I said, “Not much. I was just diagnosed with cancer.” It must have made him feel terrible and, in retrospect, I shouldn’t have been so blunt but - cancer or not - I don’t think that many women going through a round of IVF have many fun weekend plans aside from stomach injections and raging hormones.

Suffering is inherent to being human. We go through our lives avoiding it at all costs but it’s a universality. Skills that our particular society deems instrumental are taught at a young age. We learn how to read and write. We learn to quantify the boundaries that divide us and operate within it’s confines. However, we don’t learn how to heal after experiencing death. We don’t learn how to interact with someone who has been diagnosed with a harrowing medical condition. We don’t learn how to be brave.

But, as Cleo Wade says, “We are more resilient than we could ever imagine. Keep going.”

We met in high school standing by the day student mailboxes. I was enthralled by her cheetah backpack and her I don’t give a fuck attitude; this girl who knew everything about English Literature, who spoke French and played varsity squash. She told me that she had Cystic Fibrosis at a Dave Matthews concert when we were 16 years old. We were teenagers and drinking Bud Lights wearing perfectly curated pay-attention-to-me outfits and I had no idea what that was. That next week, I was seeing a therapist to talk about my parent's recent separation, and I asked her about CF. When the therapist’s eyes welled with tears, I knew that it was serious. We celebrated Caitlin’s 21st birthday party under a white tent in her backyard. The doctors didn't think that she would live to 20.

But Caitlin played lacrosse and she went to George Washington University, she traveled to Paris, worked at an art gallery and created a belt company. Intermittently, she would receive IV antibiotics via a PICC line. I would visit her in the hospital but, even there, she had a way of not making it about her. Her wrists were covered with bracelets and her hair was perfect and she wanted to know about you.

She was my best friend and our friendship strengthened by the year. When I lived in Kenya, we spoke daily. When I moved to San Francisco she sent me floral patterned plates. We incessantly sent each other Shopbop links with “do you like this?” and “thoughts?” in the subject line. We sent each other lists of our fears; things that we would never admit to anyone else. A Leo, she was fiercely loyal and infinitely protective.

A lung transplant was always on the horizon. But it was scary, and because of a rare bacteria she cultured - cenocepacia - no one in Boston would agree to take her case. Finally, when she was on oxygen 24/7, she was listed in Pittsburgh and uprooted her life. She lived in an apartment with her boyfriend and her parents. It was the nicest building in Pittsburgh with an easy layout for her to navigate with the long tubing which held the oxygen to which she was always connected.

Still, we talked daily. Not once or twice, but throughout the day.

And suddenly, we were 31 and 32 and I was diagnosed with breast cancer. She knew more about medicine than most and she researched everything. I sent her all of my labs, my side effects, my questions. She was a well-curated vault of medical knowledge and would have been an incredible doctor. I sent her screenshot after screenshot when a new drug was added to my regiment or I was deciding to taper off of something.

We talked about everything, but when were both sick, our conversations took on a new level of depth. We talked about death and about reincarnation; we talked about our purpose. On the evening of her 33rd birthday, we talked for hours and hours. I had just had another surgery and was tethered to my bed. She feared that her purpose here on this earth was to teach lessons to others. “No. No,” I said because I needed her here with me. The idea that she was here only to teach others was too much to bear. Our conversation continued and - after much back and forth - we decided that the tangible things that you need in this life are plane tickets and medical insurance. Freedom and stability.

When she was 11, she had part of her right lung removed and had a scar from the incision. I had matching clam-shell scars from my recent surgeries. We spent hours talking about the things that we would do when we were both healthy again. First, a trip within the US. Somewhere with access to the best hospitals. And then Russia because she wanted to see Red Square.

And now, I can't stop thinking about our conversation that occurred in the very late hours of July 31, 2016. About how - perhaps - her purpose here was to teach others lessons. They say that, when you are in the midst of a situation, it is hard to gain perspective. It’s virtually impossible to see the meaning in a shitty situation.

Her void feels more prominent by the day. “Give yourself time,” seems to be the therapists’ response of choice, but time isn’t doing the trick. When I can’t sleep, I find myself Googling, “what to do when your best friend dies” hoping that some piece of advice or some expertly placed words will resonate and help to quell the sickness within my heart.

Recently, I was admitted to UCSF and ended up staying for five nights. I was sitting on a bed in the ICU. Four different people had tried to start an IV. Caitlin always told me to be my own advocate and ask for a specific person when they were having trouble finding a vein, but I couldn’t remember who that person was. There were twelve failed attempts on my left hand alone. It was 11pm on a Friday night and I sat cross-legged on the hospital bed refusing to exchange my clothes for a hospital gown because I just wanted to go home. My roommates were all laced with wires and tubing and the incessant beeping wouldn’t stop. There was a code blue. I had left Van Jones at 10pm and went straight to the hospital with the injustices of our broken prison system still swirling in my head. Caitlin - on the east coast - would have been waking up momentarily to take her 3am beta blocker and I could have texted her. She would have responded immediately and known exactly what to do; who I should have asked for. Tears came as they drew labs and blood cultures and an array of other tests. Twenty attempts later, the rapid response team ended up being the ones to finally start the IV. The technician was probably my age with a scruffy woodsman beard and twinkly eyes and he said that I was the bravest IV patient that he had ever seen which made me cry even more because I felt so numb.

My most recent and completely unexpected surgery happened at the very end of June. I was in the north of Spain, just south of the France border, when my chest split open. Instead of seeking refuge in a Barcelona hospital, I immediately flew back to California. It was a Saturday night. I landed and my team was waiting for me in the emergency room at UCSF. As there was a shortage of space, they had a room for me on the lung transplant floor. I stepped off of the elevator and looked at my surgeon. Without any exchange of words, she knew that I couldn't be there.

My 11th surgery is scheduled for November 30th. Lately, my chest feels like a metaphor for the world - one area is stitched up and begins to heal while another goes astray. It’s like herding cats or this which Caitlin would have loved.

The Simama Transition Home in Nanyuki, Kenya

Castro avoided over 600 assassination attempts throughout his life, but even he couldn’t hide from 2016.

2017 is the year of the Rooster and the year that a person who has never held public office is slated to become the 45th President of the United States of America. It was supposed to be the year that I traveled to Red Square with Caitlin. The year of Harry Potter lungs and silicone implants. The year that we emerged with our matching clamshell scars. But it’s not and it won’t be.

This is my first time writing in months. Usually it helps to express and manifest the inexpressible but, in this case, it wasn’t helping. I have tried to make sense of what happened, to play each and every scenario over in my head. Also, everything that I ever wrote, I always sent to Caitlin with the flagrant subject line “DRAFT” -- and she would quickly respond with candid feedback. She was my editor.

When I returned from India in the middle of December - from the cacophony of Jaipur and the undulating hills of Udaipur - I immediately flew to Pittsburgh. Caitlin had been on life support for a few days while she waited for lungs. I arrived in the city of bridges, home of the Steelers and quickly enmeshed myself into the daily routine. We - Maryanne, Nick, Andrew, & I - took shifts, ensuring that one of us was always by her side in the CTICU. We held her hands, we massaged her feet, and we read Mary Oliver passages aloud -- a small act which seemed to perk up her waning blood pressure.

Last week, I had this terrible moment where a dear friend that I met while living in Kenya texted me after returning from several weeks in Cuba. She wrote, "Did Caitlin get her transplant?" I froze. I slowly typed,"Yes, she did" and then added "but she died" after that. So awful. Little things like that keep happening. I don't want time to move on because I am so afraid of forgetting. The only image in my head is of Caitlin in the ICU and I am having such a hard time remembering anything before then. There is a dichotomy -- as Caitlin's situation has made me less afraid of dying because I know that she is there (wherever there is) paired with this unyielding desire to live, to really live -- for her.

I left Pittsburgh on the morning of December 20th. I had to fly back to San Francisco for chemo but I planned to be in California for just a day or so. I left UPMC - the hospital - and texted the other three, “I'm en route to the airport with Jim but I will see you all in a few days for five little pig Christmas. I'm just a phone call away if you need anything at all. Don't let leather jacket man steal my chair-bed, keep writing in the chapel book, and keep the sails up...”

Later that afternoon, Caitlin died. She was supposed to live. She should have lived. She should have had the chance to use her new, perfect lungs; to see her oxygen saturation at 100%. But she had to wait too long for her transplant, and her body had been through far more than any should endure.

Below are the promises that I made to her when I spoke at her memorial service:

I promise to do something extraordinary. I promise to make you proud and I promise to keep your light and your spirit alive.

I promise to do all that I can to fix the organ donation system

I promise to plant a garden that will mean for many what Prouty meant for you

I promise to smile at sad looking strangers and to address little pups in your Henry voice

I promise to always be kind

I promise to learn more about astrology and its intricacies

I promise to trust my intuition; to listen to my own voice and to be in a state of non-resistance

I promise to take care of your Mom and Dad and Andrew

I promise to order Watermelon Sherbet in July

I promise to always say Rabbit Rabbit

I promise to do something - once a day - in your honor

I promise to advocate for those who are unable to advocate for themselves; to always be aware of the plights of others.

I promise to listen to Joni Mitchell and to text you when Losing My Religion just happens to play on the radio

I promise to finally see a movie by myself. A good movie. None of that junk.

I promise to keep wearing giant pearls and continue adding to our tribal wrist collection

I promise to find the magic; the unsung beauty.

I promise to attempt to write a Modern Love that tells the story of our friendship; our matching clam shell scars.

I promise to have a day where the only words that I speak are “can I have a water and a muffin?”

I promise to live; to really live; to stay away from the surface and to go deep; deep where the lobsters go.

I promise to keep having faith. Faith that there is beauty in this sometimes tragic life.

I promise to never take my lungs for granted. I promise to cherish each and every breath.

And so, 2017 will be the year of Caitlin O'Hara. My ruby slipper, my person, my heart.

Simama Project in Nanyuki, Kenya

Several weeks ago, I flew home from LA where I spent the last official weekend of summer. Showing up late to the airport and usually cutting it quite close is one of my flaws defining characteristics and, because I didn’t have my license or, for that matter, any other photo ID on me, I was held up by TSA. Thank you, Mercury Retrograde. I quickly learned that the agents do not care if you miss your flight, which I suppose that, for the security of our nation, is a very good thing. To make a long story short, I was receiving an especially thorough pat-down as my name was called over the loudspeaker. I needed to be on this flight in order to be in-gown with my hands above my head for my daily 9:20 am radiation appointment at UCSF. I forgot about the tiny Peruvian worry doll that had spent the summer in the back pocket of my cut-off jean shorts. The metal detectors did not. In a slightly fortuitous turn of events, the flight doors were re-opened. The passengers were silent as I boarded the plane and searched for an empty space in the overhead. On strict orders not to lift anything over twenty pounds, I asked the flight attendant if she might be able to assist me with my bag.

“Thank you very much. I just had surgery and am not able to lift things quite yet,” I said.

“Oh! What kind of surgery?” she questioned in an overly cheerful elf-like manner.

Her effervescent disposition was unsettling and I could feel the blood rushing towards my face and hundreds of caffeinated Tuesday morning eyes staring in my direction while the entire plane awaited my response. Time stood still and I contemplated making a joke about airplane safety or something but there was no time for wit. Instead, I blurted out - “a mastectomy” - and that was that.

Illness has the ability to define you. It has the potential to be narcissistic and self-indulgent and a scapegoat or, on the contrary, it can provide you with a heightened sense of empathy. I hope that I have fallen into the latter of the two categories. Gone are my days of small talk, pleasantries and the need for a pre-conditioned response. I feel grateful that people - even those that I hardly know - feel comfortable talking to me about absolutely anything. I also have a desire to explain to others what this is like because, as my oncologist mentioned the other day, 1 in 7 will develop breast cancer.

After my most recent surgery, I cried for days. My body was filled with anesthesia, pain medicine and an array of other drugs that I needed to detox from and perhaps tears were my body’s way of accomplishing such. I had lost a lot of blood in the operating room, my hematocrit and hemoglobin were low, I hadn’t slept in six nights and the drainage tube placed during surgery was pressing into my ribs. Terms like pulmonary embolism were being thrown around. I couldn’t walk up a flight of stairs. It was during this time that I distinctly remember forgetting how big the world was. It was this horrible, suffocating feeling that often comes with illness when you feel incessantly disconnected and isolated. You forget that the planet consists of millions upon millions of other people. I wasn’t able to recall all of the inequality and bullshit and I wasn’t able to put anything into perspective. But time moves forward and each day feels different than the last. Sometimes worse and sometimes better; always slightly different. You connect with people again and this alone provides grounding. It reignites you and provides a sense of spaciousness; helps you to get out of your own mind and out of the worry. The futile worry that does nothing but demand headspace.

My third surgery is now complete and I continued my awkward-after-anesthesia streak by telling the anesthesiologist that I was going to jump on him like a spider monkey. I am not quite sure where my mind pulled that very specific animal reference from but clearly, I was eager to use it. My next surgery is scheduled for February so I have a bit of a break from the operating room. On August 25th, I started five weeks of daily radiation. Because my cancer returned so quickly, I am also being put on a trial immunotherapy/chemotherapy drug called TMD1, which will target the HER2+ part of my disease. This afternoon, I have my fourth round of treatment.

Lately, I have also been on a bit of a self-help kick. Nestled between Fates and Furies and Pulitzer Prize winning, The Sympathizer, lay How We Choose to Be Happy: The 9 Choices of Extremely Happy People and Big Magic. I originally waffled back and forth between the two genres hoping that one would somehow explain things. That something would just click and it would all suddenly make sense. But, what I have realized over the past few months, is that this is never going to happen. I have come to a point where I have accepted the fact that before cancer and after cancer are indelible; that certain events such as these have a way of cleaving time in two. It’s hard to go back to your old self. It’s impossible not to be spontaneous. It’s impossible not to tell people how you feel. It’s impossible not to be kind and it’s impossible not to at least try to live in the liberating joy of the present.

brav·er·y (noun): courageous behavior or character

When I was young, there was a Mary Engelbreit calendar that hung on a single nail on the kitchen wall. My Dad would mark off the days that he was going to be out of town for work with a simple “JD” scribbled in the bottom right corner of each box. The calendar included all social engagements and appointments, and each year, as school came to a close, a day in July would be marked “JLD check-up.” The day immediately became a permanent fixture in my mind; a constant source of worry as I dreaded the doctor. It didn’t matter that my Mom was a Nurse Practitioner in that very office, and that my pediatrician was one of her closest friends. Everything about it scared me: the annual finger-sticks, a potential throat culture, the vaccinations – the unexpected. It was a seemingly paralyzing fear.

Since being diagnosed with cancer, I no longer have these fears. During treatment, I am at the hospital daily. I walk into the lab and greet Betty as I sit in Chair #1 and surrender my left arm to her. Four vials of blood later she wraps the crook of my arm with red tape because, in her culture, the color represents good luck. I have had ports and intramuscular injections and hundreds of IVs. Nothing seems to faze me now. My once paralyzing fear has turned into a kinship of sorts as I know that each and every nurse and doctor are just trying to help. People say that I am brave but I struggle with this. Am I brave? What makes a person brave? Is everyone fighting a disease or illness considered to be brave? We call cancer patients “brave” but there is nothing brave about showing up for chemotherapy or surgery or radiation because we don’t really have a choice but to undergo treatment. I think that the idea of bravery implies choice, and many patients have very little choice.

Perhaps bravery is the desire to live – the desire to remain here on this planet this go-around. It is the sparkle in your eyes when your potassium levels and your blood pressure have dropped to nothing. It’s being able to make light of your situation; to change the energy in the room. Cancer carries with it this sublime quality in which everything becomes clear; all of the extraneous bullshit melts away and you are left with the core of you and, in the end, all that really matters is kindness. Everything is amplified – your personal relationships, your outlook on life, your aspirations. People are always telling me to fight or to beat this cancer but a battle indicates a winner and a loser and there is no part of me that wants to be at odds with my own body. I want all of the surgeries, the chemotherapy, and the radiation to serve as allies; to transform my cells so that nothing but vitality flows through my body and everything works together in a symphonious manner.

Maybe this is better described as resilience, the quality that some have to bounce back despite whatever their world has thrown at them. I look at Holocaust survivors, Syrian refugees, and I marvel at their resilience. Ever since living in Kenya, I have loved photography. What I have always hoped to portray through my portraits is the resilience of these East African children. Beginning tomorrow, five of my photographs will be included in an exhibit, which – ironically – is titled “Resilience” at a gallery in San Francisco. I have never considered myself to be a professional photographer, but everyone begins somewhere and perhaps this is my beginning. If my photographs sell, I will donate the proceeds back to Kenya.

So I’m not brave. Maybe resilient, but not brave. I’m just living and, like everyone else on this planet, I am just doing the very best that I can.

“You have experienced the world of un-magic,” the nurse said as she clipped the stitches from my glued together surgery scars. She started on the left side of my chest and moved her way over to my right while tears flooded my eyelash-less eyes. My pathology came back and my margins were cleared so I am onto radiation next month. I should have been overjoyed but something still didn’t feel right. The chemotherapy worked as best it could and my surgery is complete but I have never cried so much in my entire life. Everyone says “you must be so happy” and I am. I am grateful but I have so much ahead. My oncologist appointments are spent talking about all of the things that I still need to do, the medicines awaiting pharmacy pick-up, the side effects that I have yet to experience and the recurrence rates which, because of my age, are a constant topic of discussion. I will continue Herceptin infusions through January, Zoladex injections for the next three years, Tamoxifen or aromatase inhibitors for the next ten years and see my oncologist every 6-9 weeks for the next 5 years. There is no certificate or gold star. It is so overwhelming and, at times, I feel like I am not a part of this world anymore. I feel lost and un-tethered and my priorities have all changed. I have this insatiable desire for something to just be easy. For some signal from the universe to tell me that things are going to be okay. Cancer is supposed to change you. Everyone says that you come out on the other end with greater insight into your life’s purpose. It felt so much easier when my fears were tangible. I could be afraid of needles and surgery and anesthesia and waiting and it made sense. Now my fears feel intangible and I feel lonely. I can’t explain much to anyone.

I wrote that almost six weeks ago. Since then, I have been healing from surgery - I even went for two three-mile runs - and preparing for radiation; the last of my three major treatments. A series of CT-scans along with seven small tattoos prepared me for the daily dose of high-energy waves. My 8:20am appointment time was confirmed and parking arranged. All that I needed was a baseline mammogram and I was ready to start the five-week daily regiment. I traveled up to the second floor and changed into my third hospital gown of the day. I knew that something wasn’t right when they called me back in for a second round of images. Finally, the nurse came out and asked, “Is your Mom or someone with you? We have some bad news.” It felt all too oddly familiar and PTSD kicked in. “We found some calcifications that are suspicious and we need to run them by your surgeon.” Radiation was postponed and I spent the next morning in the confines of an MRI machine; concentrated contrast dye being pumped through my veins. Because of surgery, the results were irregular and the image “lit up” so continuing with radiation was no longer an option. A unilateral mastectomy (with reconstruction) was the next course of action and, despite my cancer being gone, it intuitively felt like the right decision.

My pre-op appointments were scheduled and I spent the majority of last week at UCSF meeting with the nurses, anesthesiologists, plastic surgeons and oncologists. Everything was set for the 14th of June. During my final appointment of the day on Wednesday, I mentioned the scar tissue that had formed on my right side where my original tumor once was. My surgeon examined the area that I had pointed out and reassured me that it was nothing to worry about; there was no chance that my cancer could have returned. Well, a fine needle biopsy later, I learned that it had. It was something that both of my oncologists had only seen once in their 30+ years of practice. There was a .001% chance of it happening so, in the off-chance that my luck turned the other way, I bought a few scratch tickets on the walk home that night. I won $1.

And so, tomorrow, I return to the operating table. Dr. Laura Esserman is my surgeon. She was just named one of 100 “Most Influential People in the World” by Time Magazine. She sings to her patients just as general anesthesia is being administered. My first time around, I chose “Blackbird” by the Beatles (thank you, Dede). She sang it in perfect harmony with her hands cupped over mine, as oxygen was placed over my mouth and I drifted off to sleep. This go around, I asked her to choose the song - "Defying Gravity" from the musical Wicked. Here's to hoping for a little bit of magic.

“I carry your heart with me” - e.e. cummings

My Mom has been a light in my otherwise monochromatic world. A bit of magic when everything felt like it was slipping away. She was there when my weight dropped down to 95. She befriended my chemo nurses and brought them bagels and Bob’s donuts. She burned moxa on my leg meridians and held my hand when IVs just wouldn’t seem to go in. She shared a 500 sq. foot space with me and slept by my side for three months while I tossed and turned throughout the night. She made me Magic Miracle broth, roasted organic chickens, and made sure that we always had unsweetened almond milk. She gave me IVF shots in my stomach and made sure that my llama pajama pants were always clean. She scrubbed the bathtub and filled bottles with flouride-free water. She made sure that there were always fresh flowers by my bed and she laid with me when nothing felt funny anymore; when all I could do was cry. She brushed my hair when there wasn’t much to brush and offered to shave her eyebrows in an act of solidarity. Her occasional road rage and auto-corrects always made me smile.

She is the most “real” person that I know and her energy is infectious. When she laughs, she really laughs. She has this lightness about her that is contagious. My eyes fill with tears when I even try to fathom how lucky I am to have her in my life; when I try to explain how much I love her.

Happy Mother’s Day, Mummy! Thank you - from my whole heart - for everything. You are magnificent. xx

Lately, I feel like Mrs. McAllister when she is mid-Atlantic and remembers that she forgot Kevin back in Chicago. I always feel like I am forgetting something. It is this lingering feeling that, despite meticulous to-do lists and other blatant reminders, is always present. Probably because I left my passport at a screening of The Danish Girl, found my Zenefits ID under the bathroom sink and tried filling the car with diesel fuel. I can’t be trusted anywhere. My mind feels like a swirl of milky stars with blurred edges and undefined boundaries.

There were 10 new breast cancer patients that started chemo last Friday. TEN. They say that I am the youngest patient but everyday I hear about others that have been recently diagnosed in their early thirties. I have this unquenched desire to figure it all out. To figure out why we all have cancer cells within our bodies but some of us develop cancer, what we can do to avoid recurrence, etc. I have tried to take as holistic an approach as possible, which seems like an oxymoron considering the toxicity of chemo but I have consulted an array of doctors – both Eastern as well as Western and tried to follow whichever advice resonates most at the time; whichever feels most visceral. It is hard to know what to do. I am constantly overwhelmed by the amount of information out there and everyone seems to have conflicting advice; something that worked for them that didn’t work for someone else. Sugar quite literally causes cancer but, the other day, a generic white sheet cake was passed around the Infusion Center celebrating a patient’s last treatment. While you wait for a mammogram, they offer you candy bars and I am the girl who always takes them and feels no shame while asking for more. I think that there is surely a link, as others diagnosed seem to possess the same insane sugar infatuation that I have been graced with. Habits are supposed to form after thirty-days but it has been almost five months trying to avoid refined sugar and the white stuff is still top of mind.

I have officially completed 125 days of chemotherapy. I finished three months of Taxol and started my first round of AC on the 9th of February. The last six weeks have been long and I have spend the majority of the days in the hospital. This round of chemo is nothing like the last. Much like I tried to tell the doctors that I did not have cancer, I have also tried to talk my way out of these last few rounds of treatment but it’s not happening.

It will take my body quite a while to heal, to detox from the chemotherapy and for my immune system to kick back in before surgery on the 12th of April.

My last chemo is on Tuesday. Two days from now. I feel like that at least deserves a Funfetti cake...

When I was six, my Dad asked me what my favorite song was. I wasn't sure, but knowing such a fact seemed instrumental in this thing called life. I quickly decided on R.E.M.’s “Losing My Religion” - not an obvious selection for a first grader.

And now, 25 years later, I have remained steadfast in my decision. But I have never purchased the song on iTunes, added to any Spotify playlist and I don’t seek out hits from the early 90s on the off chance that I will hear it. The song possesses unicorn-like qualities and has become somewhat of a faith to me. Sometimes I don’t hear it for months at a time but it's okay. I always see it’s presence as a sign.

Two weeks ago, I was able to travel from San Francisco back to Boston for the weekend. It was such a treat to see family and friends, the winter’s first snowstorm and just hang. It was hard to leave. I finished my 12th round of Taxol last week and, this afternoon, I completed my first round of the infamous Adriamycin Cytoxan. Three more rounds will follow.

Chemo turns paper cuts into something of substance. It makes your skin soft and your eyes heavy. It shows no mercy to your eyebrows. One of the hardest parts of chemotherapy is losing your hair. It is a constant reminder of your illness. Sometimes I stare at myself in the mirror for extended periods of time assessing the changes; the adaptations that my body has made to make way.

When I was diagnosed, I immediately thought about having a baby. It is the one thing that I have always been sure about wanting. I froze my eggs and, following my retrieval, people said “you must be so happy” but I wasn’t. I was stoic. I didn’t respond to texts or emails and went through the days in a monotonous state. The 30 eggs retrieved were a reminder of what I wanted, and what now seemed so far away. The trajectory of my life had changed.

I worried about dairy and gluten and refined sugar and what I could eat. I thought about milky iced coffee and spicy chai tea and butter chicken and large cheese pizzas. I worried about chemotherapy. I attended “chemo teach” at UCSF. The side effects of each round of chemo were laid out; separated one by one. Hair loss was first. I hadn't really thought about it until that point. This will come as no surprise to anyone but I have a big head. My face is not the least bit tiny and the look would do nothing for my cheekbones or lack-there-of. That being said, I decided to partake in a study at UCSF in the hopes of saving the hair on my head. Nothing was guaranteed and the process adds an extra four hours to each chemo session -- but I was willing to try. Because the Penguin Cold Caps are not FDA approved, the nurses are not allowed to touch them. Thus, you must come to chemo with someone who has learned how to be your cold-capper. This person has to handle them, apply them, and stay with you for 8 hours to change the - 40 degree caps every half hour. And get me rice noodle Pho from the Vietnamese place down the street. It is no small task.

Three months later, I still have my hair. Some of it at least. My blonde has taken on an ombre hue and I can only wash it once a week in freezing cold water, but it is still there.

“Losing My Religion” is an old southern expression for being at the end of one’s rope or pushed to one’s limit. The song is about unrequited love. It is about moving on with grace. It is balancing the moments when your heart feel like it is going to collapse with those moments where it feels filled to the brim. Currently, everything is decisions and outcomes, waiting and news. The best are the moments where you can feel the blood; when you feel so happy that your eyes well up with tears. These are the moments that are the real impetus to keep going, the times when you feel like you can keep doing this thing called life even when it feels incredibly shitty. I was able to fly to Boston, the Penguin Cold Caps are working, my tumor is shrinking, etc. But it all doesn’t culminate into relief until there is some sort of sign -- whether religious or not; maybe just a sign from within. You are still scared and things are still shitty and you don't know what's going to happen but “Losing My Religion is still out there, and it will still play. I don’t know when, but it will. In this, I have faith.

Before flying back to California, I grabbed lunch with my sister. We went to Life Alive in Cambridge to pick up gluten-free, dairy-free, sugar-free Swami bowls. A trifecta of sorts. As I walked into the Massachusetts Ave. street corner, my heart perked up a bit as “Losing My Religion” just happened to be playing.

At times, I feel as though cancer is associated with the US and, if I only escape it’s boundaries, and head to Tulum or Bali, Cuba, India or back to Kenya, the inky stamp on my passport will negate my diagnosis. I suppose it's because I am not able to leave that I feel so confined to America; because the next 10 months are filled with chemotherapy, MRIs, radiation, oncologist appointments, surgery, etc.

Going to Kenya was perhaps the best thing that I have done. I didn’t do what others might do and my life looked nothing like I thought it would at 29. That being said, it’s not looking as I thought it might at 31 either, but that’s okay. I have asked a few doctors and patients what the hardest part of this process is. “Definitely the diagnosis and weeks leading up to your first chemotherapy treatment,” some have said. Others think that your last treatment is the most difficult part. When your Tuesdays no longer consist of chemo and your surgery scars are all healed up. When your radiation is complete, hormone therapy prescribed and you are set free - back into the world with a little less breast tissue and a little more vigor. When I was first diagnosed, I found this hard to comprehend.

Having any life threatening illness is a crash course in overcoming fear. I was terrified by the idea of having a port placed in my chest. In a failed attempt to quell such thoughts, I headed to Google because most medical fears are quickly alleviated via WebMD and an extensive image search. An hour or so later I was somehow reading a blog about a man who woke up in the night to pee, tripped over his port and ripped it out of his chest. When the hospital called me the next morning to confirm the procedure, I told them that I would not be making it as I had actually [mistakenly] consumed some water and, therefore, broken the uncompromising pre-surgery guidelines. I rescheduled several other times before succumbing.

I have quickly come to realize that we, as humans, are dictated by fear. We put money into our 401k because we are afraid, we buy homes and accrue other tangible assets because we want to feel grounded and seek permanence. At this stage in my life, I am just doing what I can do on a daily basis. My Type-A planner self is beginning to melt away again as I spend my days trying to consume green juice and an array of supplements, learn to meditate and do whatever I can to heal my body.

In Europe, they are studying prototypes of those individuals that develop breast cancer because, aside from genetics, diet and environmental factors, many believe that there is an emotional component. Throughout this process, I have been asked by several different people whether or not I like opening gifts in front of people. I don’t. I have actually dreaded it in the past whether it be at birthday parties, Christmas Day or the awkward office Yankee Swap. I don't like all of the attention; all eyes on me waiting for a pre-conditioned response. Same thing with surprise parties. Maybe I prefer giving gifts/coordinating parties for others because I remain in control? A big part of cancer and any other serious illness is being put in a position to receive. I need my nurses with me to administer chemotherapy, I need friends and family around me, I need financial support. “I’m fine,” is one of my go-to responses as I don’t ever want to bother anyone but putting down my guard and learning to accept from others may be one of the greatest lessons in this journey that is cancer.

I was diagnosed on the 27th of October. It was a Tuesday. I don’t recall much about the day, but it was dark outside and the hospital was closing. I lay in a gown with my right arm suspended by my side. I was ready to get out of there; ready to call an Uber and head back to my office when the Chief of Radiation and several other doctors were ushered into the tiny ultrasound room where I lay. “It looks like you have cancer.”

All notion of time suspended and my breath settled in my throat. “I actually don’t,” I replied. “I have to go back to work.” My defensiveness quickly dissipated into panic as they lay me down to apply another coat of jelly and further examine my right side. I felt like I was slipping in and out of consciousness as the team of white-coated specialists rattled off buzzwords like lymph nodes, tumor, 5 millimeter and calcification. I was then escorted away for the first of many needle biopsies and formally diagnosed with breast cancer the following afternoon. My Mom flew in from Boston and sat with me while my preliminary treatment plan was outlined – chemotherapy, surgery, radiation, hormone therapy. I needed to freeze my eggs, have a port placed in my chest, schedule genetic tests and meet with my oncologist. Everything needed to be done right away.

I took a lot of Ativan those first few days. I didn’t have the urge to feel much. I waited almost a week for the PET-CT results to determine if the cancer had spread elsewhere in my body.

That was almost 9 weeks ago and I just finished my 7th round of chemotherapy. The last few months have been hard – lots of decisions and a multitude of opinions. I have been in my head a lot.

The upside is that I have been overwhelmed by the kindness of humanity. While I was sitting in the Infusion Center on Tuesday, I was reminded of the movie Love Actually, a holiday favorite. The scene when the narrator says that you should go to the airport arrival gate at Heathrow to see that love actually is all around us. I see that sentiment echoed on the 5th floor as loved ones sit with cancer patients and nurses hurry around to ensure that everyone is okay. I was absolutely terrified by the idea of chemotherapy but, sitting there now, I feel [completely] calm. It is the kind of calm that you feel after the first big snowfall of the year; when the snowflakes are slowing down and the world is void of all footprints and disruption.

You can’t connect the dots looking forward you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future. You have to trust in something: your gut, destiny, life, karma, whatever. Because believing that the dots will connect down the road will give you the confidence to follow your heart, even when it leads you off the well worn path.

Steve Jobs at the Stanford Commencement Address, 2005

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