The Giant Fork in My Road

I'm beginning to get a little scared. And a little frustrated with myself. I'm sorry that I keep getting on here and "boohooing" - I have so much to be thankful for and it's not that I'm not grateful for all of the blessings I've been given - but this really sucks. I had a path. I knew where my life was headed. Now I don't.

I also don't know how to remedy this situation. I thought I knew what I wanted once, and I was wrong, so how do I go about making another decision now? I've lost some amount of faith in my ability to discern what's best for me, and I'm beginning to feel like I don't know myself very well at all. I've never been in this situation before - at least not that I was ever aware of. Turns out I didn't really know what I wanted before, but I didn't know that at the time. Now I know that I didn't really know what I wanted, and worse, that I still don't know what I want. And even more terrifying, I don't have a clue as to where to start. I don't know how to figure out what I want, I don't know how to make a decision, and I don't know how to trust that decision either.

These are the options that I currently find myself considering: (a) I could return to medical school (though I'm 98% certain that's not happening), (b) I could go to nursing school, or (c) I could get a PhD and do CF research forever. A month or so ago, I would've said that I was sold on nursing school. You could still say that I'm leaning in that direction, and to be honest I do still expect that that's where I'll end up when the dust settles, but there's been a little hiccup in the plan. I fell in love with research again. Oops.

Nearly every day at work, I find myself loving what I do. When I'm in lab meetings talking through data with my colleagues and thinking about new questions to pursue, I'm sold on research. I enjoy bench work, I enjoy thinking through the complexities of cellular mechanisms and genetics and experimental protocols, and I enjoy working with real clinical data. Six months ago I would've laughed in your face if you had told me that I'd fall in love with research all over again one day - I thought that I was burned out. Done. Sick of it. But I discovered that as soon as I found a field of research that I truly cared about and was invested in, the entire game changed. It all matters to me now. I love hearing about the other projects going on in the lab, I love considering the projects that I could contribute to, and I love hearing my boss get passionate about learning more about CF. It used to be that I sat through lab meetings and listened politely, but never truly cared about anyone else's projects and never got particularly 'fired up' to work harder on my own. Maybe it's just this lab or this boss, but I think it's CF. When I think about moving on and leaving CF research behind, it just breaks my heart.

The most direct path to stay involved in what I'm doing now would be the PhD route. I can keep doing bench research, even stay here at Hopkins (if I get in!) and even stay in this lab if I play my cards right. And in the basic sciences PhDs are always grant-funded, so students don't pay their own tuition (the program pays initially until a thesis lab is selected, and then the thesis lab pays), and they even get a living expense stipend (read: no more loans). It's about a 5 or 6 year endeavor for most people, depending on how long it takes you to complete your thesis project, but it's only 2 years of didactic, lecture-based study - the rest is more like a 9-5 research job (read: relatively conducive to childbearing).

However, the PhD route means letting go of the clinical world and saying goodbye to the prospect of any patient contact. Sure, I might work with patient samples, but I won't take care of patients in any capacity. This also breaks my heart. And so the pendulum swings back toward nursing school. The program I've applied to will spit me out in 16 months with a BSN (converts my BS in biochemistry and molecular biology to a BS in Nursing, essentially) and a Masters, with the title "Clinical Nurse Leader" (in addition to RN). I'd be Jenna Bonner, RN, CNL, BSN, MS. LOL! I don't know about the order, but something along those lines ;] Anyway, financially this program is not the better choice. I already have a mountain of educational loan debt (I don't think people quite understand what I mean when I say that, so just to give you an idea, we're talking several brand new cars-worth), and this would add at least another $50 or $60K to that. We're approaching a threshold at which I fear my nursing salary won't be enough to comfortably pay off all these loans. A PhD salary would be much more comfortable, and I'd keep my loan balance where it sits now.

The nursing path does leave more doors open, which is what makes it so appealing to me. Ultimately I could choose bedside care, nursing research, clinical research coordination, or some combination of these things. I could see patients two days and week and work as a study coordinator for the other three, for example. I know nurses who do all sorts of things you'd never expect nurses to do - it's really a surprisingly diverse career field... SO much more than bedside care. The key, for me, is that it leaves open the possibility of incorporating patient care and research into my career. HOWEVER - insert caveat here - I believe that the kind of research that I enjoy doing would require a PhD. I could participate with clinical studies or coordinate clinical research projects as a nurse, but in order to do the basic bench science, I'd have to go back after a few years of working as a nurse to get a nursing PhD. We all know that once I'm working and I have a few kids the whole PhD thing will be sidelined for a good while, so if I'm being honest with myself (which I'm really trying to focus on doing these days!), research is probably something I'd get into later in my nursing career. I could certainly get involved sooner as a clinical study coordinator, but I won't be able to do much "bench research" without a PhD.

Now, to be fair, there is a third option. I could apply to the MD/PhD program at my school as an internal applicant - MD/PhDs do both clinical and research work. But I think we've already established that being an MD is just too much career commitment for me. Throwing research responsibilities on top of that isn't exactly a solution to the problem, it's an exacerbation of the problem! So we'll just go ahead and scratch that one off the list, I think ;]

Then there's this pesky little issue of time. I've already applied to nursing school, and PhD program applications are due next month. I basically just decided to apply to both to cover my bases while I sit here scratching my head til next fall, in hopes that by then I will have made a decision and can start down whichever path I choose (so long as I get in to both programs... perhaps if I only get in to one that'll be my sign!). "Why the rush for next fall" you might ask...? Because as long as I'm not in school I'm forced to pay on my mountain of loans, and that's money that I just don't have laying around (ya know how I said it was several brand new cars-worth? So, the payments will be several car payments-worth, per month). So, you see, I'm stuck either making a decision soon, or paying on my loans for another entire year. I'm already paying on some of them, but I'll be able to defer payments for this spring semester because I'm enrolled in community college classes to complete some prerequisites for the nursing program (score!). But after May, I'll be on my own.

So, here I sit. Unable to make a decision, and stressed about the financial ramifications of each choice (including the choice to postpone making that decision). Not to mention the ramifications for my future in general... you know, the fact that this decision is going to determine what I do with 8 (or more) hours of every day for the rest of my life. No big deal, right?!

Sorry if I'm being melodramatic. I'm just a little lost, a little frustrated, a little stressed... and I just don't know what to do about any of it!