I finally mailed my grant proposal off to a few readers today, a whole week late. But the good news is my advisor picked a later review date than I was expecting, so it will all work out. I was so ill when I was emailing it off I almost threw up. I am not very good at soliciting criticism.

I've been going crazy this week, between the grant writing and the sudden rush of new patients into the studies I'm working on. I do home visits for women with GYN cancers, mostly ovarian but some other sites as well. I think the first visit and the last visit are the hardest- the first visit I have to be friendly and solicitious and somehow accomplish establishing a trusting relationship with these women. The last visit I have to say good-bye to them after having followed them for six weeks. There is no real closure, just the regular visit and a brief hope that they will be the unlikely survivors of their terrible disease. I haven't met a woman yet I didn't enjoy following, although some of them are a little more trying than others.

One of the biggest lessons I am learning is that life really is fleeting. I've talked to so many women who were just out and about, living their lives and they had some strange spotting or maybe a little wierdness in their abdomen and three months later they've gone through major surgery and are in the middle of chemotherapy. I've learned that most people with cancer need to tell the story of their diagnosis, so that's usually where I start when I first meet them. I don't really need that information for the study, but it is interesting and it gives me a good jumping-off point.

The last few patients I've had have shared incredible stories with me about their lives with their now deceased husbands. I felt this acutely when we first were married and I flashing back to those same ideas again now. These women spent their lives with their partners, had children and homes and travel and holidays and each day was spent with this other person. Then they either got sick or their husband died and now they are living a life that is very different from what they ever imagined. Yesterday I had a patient tell me all about the ten years she and her husband traveled together after they retired. this patient was so thankful that they had spent that time together because those were the memories that kept her going through the rough patches.

Last fall I had a patient and her husband wax bitterly about the injustice of having spent an entire life working to save for retirement only to find themselves so ill from cancer and smoking related illnesses that they couldn't do any of the things they had planned. Their story made my heart just ache- I've never seen people so acutely aware of all they were missing out on as those two.

Today as I was driving home from another initial visit I was thinking about my grandfather and his last years. He worked like a maniac, because he loved to work. He and my grandmother had an incredibly good life together, although their time in this world together was too short. At age 79 my grandfather learned he had colon cancer and soon thereafter he learned it wasn't curable. He died just days after his 80th birthday.

I remember flying down to New Mexico the fall before he died because he needed someone to help him make the drive from Santa Fe to Oklahoma for the tribe's annual gathering. I don't know really why they asked me to do it, but I was happy to take the time. I wonder if he knew that was going to be his last visit back to the state where he was born.

My grandpa was in chemo then, and although he wasn't really sick from it, he was definitely very tired. He drove as far as he could, probably all the way to Amarillo, Texas, before he asked me to take over. He gave me very specific instructions on how to set the cruise control and then crashed out in the back seat of the minivan. I remember that he was sleeping, but not really because every time I had to slow the van down for some reason he would sit up and ask if everything was okay. Yes, grandpa, it's okay. Then he would lay back down and sleep some more.

That drive across Texas is pretty dull. I found myself entertained by counting the counties as we drove through, marveling at how small each little town was- all those little blibs on the map. We drove into Oklahoma and it was almost as if my Grandpa had a special sense for the state. He sat up again and started instructing me on the back roads I should take in order to get to Apache, where the gathering was to take place.

If you've ever made this trip, you'll know that there is a part of Oklahoma that has this rich deep red soil. It seemed as though this soil was home to Grandpa. The moment the soil in hte fields along the road changed from normal dirt brown to this red color he made me pull over. Then he got out of the van and just stood at the side of the road, breathing in.

It struck me today that he must have known then that he may never return to Oklahoma. He was an amazing man, my grandpa, and I miss him horribly. That memory mixed with the reminiscing of these women with cancer bring me wholly into the present. This is my chance to make those memories that will fuel me during the hard times. These are my joyful days. Why do I feel like I am struggling? How do I allow myself to become bogged down?

Apaches believe that heaven is a place just like this. As hard as it is to imagine, this IS my heaven. I need to stop struggling and feeling overwhelmed and enjoy my heaven, create my heaven. I would hate to think that I am wasting my chance at joy and peace by being overwhelmed by the minutae.