I should be doing homework is the thought in my head. Ah well. I used to celebrate a job well done (any job, let’s be real here) or even actual things like a promotion or a completed project. Now I am checking grades on tests and quizzes (an 88 and 100, thank you) and celebrating with the application of a cucumber face mask and my phenomenal Lands’ End sheepskin slippers. I’ve got cravings for ice cream and french fries and if I could sleep for 100 days, I still don’t think it would be enough. No, I’m not pregnant. Just a student.

These days it seems the inspiration ebbs and flows with my energy level, which is generally an eternal state of low-tide, but I may be having a creative moment so let’s go with it. I was just reading a friend’s blog (she’s way better at this than I am) and she was expressing her love for October. I, too, have a supreme attraction to this month, for so many reasons.

Naturally, the weather suits me: the crisp, cool air, the crunch of leaves, the pumpkin flavor, whether just the seeds or a pie, or a latte, all these things make me content. Seriously, all I need is an October day to really feel the sunshine. It’s the only time I actually enjoy sun.

Yesterday I did my first swim set in YEARS, and I was amazed at how nostalgic I felt for that lifestyle I once had – school, swimming/water polo, wet hair in the cool October air, so hungry I could eat a cow and so tired I could fall asleep mid-bite. This feeling of utter exhaustion, mentally and physically, was always something that I cherished, knowing that I was pushing myself as hard as I could, earning every day.

I’m back there again, certainly not in the shape I used to be in – mentally or physically – but I’ll get there. And if I don’t, I’m sort of aiming for something different anyway. I feel like I’ve finally become one of those people who does a workout because she wants to, she craves it, she needs it to keep her balanced.

As I prepare for my final exam — yes, five weeks in, we have a final exam for our crash course in pediatric pathology — I think to myself: I have never, ever been so tired on so many levels. This is the hardest thing I’ve ever done.  Actually, as I write this, I am falling asleep, so please excuse me if it is littered with spelling errors and grammatical mistakes. But that’s just it, honey. That’s the whole point of this journey, of life: to keep pushing, keep achieving, keep wearing myself out so I can build myself back up again. This is how we grow.  To so many people, Autumn symbolizes the beginning of the end, but to me, it is a sign that I’m back to my old tricks, suffering through, telling myself it’s too much, I can’t do it….

It is the end of my fourth week of nursing school (fifth, if you count blitz week) and I am tired. I have felt emotions ranging from excitement to sadness to depression to triumph to failure to hysterical delirium. I have answered correctly and not; I have had multiple “aha” moments and I have said aloud, “I can’t do this.” And yet, the constant remains: I must do what I love. I must leave it better than I found it.

Through it all, my loves have pushed and pulled and lifted me through. My mother, who manages to listen to me sob hysterically one day and then glow giddily the next, is ever-present, hands stretched out, ready to catch me, only to put me back on my feet. My man, who massages my trapezius (read: neck), my gastrocnemius muscles (read: calves), my ego (read: EGO), without my asking, tells me he believes in me. I wonder if he knows the power that gives me. My kindred spirit, my dear friend, my keeper of the heavenly cloud bed, calls and writes tirelessly, reminding me of the wisdom of her mother: “Everything is temporary, honey. Everything is survivable. Well, except death.” I’ve just returned from clinical rotation and the poignancy astounds me.

I am surrounded by people who use words that empower me. It may be a card from my best friend, one where she assures me, “the world will be a better place because you will be taking care of a small corner of it.” Or a dirty text message from my man, keeping both my sense of humor and my sex drive in tact. Or, perhaps my favorite, from my mother during a frantic phone call: “You can vent to me any time, honey, and I’ll be your ventilator.” From one nurse to another.

Almost…

The most common congenital heart defect in children is Ventricular Septal Defect (VSD), which occurs when there’s a hole between the ventricles (those are the bottom parts) of the heart. Good news is that if it’s small it can sometimes close on its own within the first six months of life. Otherwise, you’re lookin’ at surgery for little Johnny.

Tetralogy of Fallot (TOF) is a congenital defect that combines four, count ‘em, FOUR different defects. You’ve got VSD (see above), but in addition to that, you’ve got a hypertrophic right ventricle, which basically means the tissue of the heart is inflammed, making that little ventricle even smaller, which applies more pressure to the pulmonary artery. But on top of that, you’ve got PS, which is pulmonic stenosis, or basically a narrowing of the pulmonary valve, so alllll that pressure that’s building up in the smaller-than-normal-right-ventricle-with-added-blood-rushing-in-from-the-left-ventricle, has nowhere to go except back into systemic circulation without any oxygen cause that darn valve won’t let it get to the lungs. The fourth defect – I know, there’s more?!  – is that the aorta opens up into both ventricles (normally it would only open into the left), so on top of all that you’re getting deoxygenated blood mixed in with oxygenated blood going into circulation. All of this equals decreased pulmonary blood flow, which equals cyanosis, hepatosplenomegaly, and polycythemia, not to mention your basic dyspnea and metabolic acidosis. And this happens to newborns. Talk about a broken heart.