Typical Day

I wake up at 6:45 and leave the apartment by 7:45am. I get to the hospital by 8:45am. It can take anywhere between 25-50 minutes to drive 5 miles to the hospital! On alternate side parking days, the hospital parking lot is full, so it can take up to 30 minutes to find a parking spot and walk to the hospital. It costs $4.00/day to park in the lot (employee discount) or $45.00 to park on the wrong side of the street!

I meet my classmate outside of the hospital and we drink a cup of coffee and talk about what we learned the day before or what our preceptors told us to read up on. I have a great relationship with my classmate. We were always friendly towards each other in the classroom, but I had no idea that we'd ever get along so well. Although he's only 21 years old, he's very mature and very intelligent. We work well together.

At 9am we report to the Chief PA and he assigns us to our preceptor for the day. Last week I was on the Medicine floor and this week I'm on the Cardiology floor. I had the opportunity to work with the same PA twice last week and I thought she was brilliant. We got along really well and felt very comfortable working with her. I felt like I hit the jackpot with having her as my preceptor.

This week is a different story. The PA on the cardiology floor isn't so friendly. She's just not a friendly or personable person. Surprisingly, she's young...probably around 25 years old. Within a few minutes on Monday, I knew it was going to be a long week. She had the personality of a porcupine.

As a student, you walk a fine line with these preceptors. You are there to learn, yet you don't want to overwhelm your preceptor. You shouldn't ask every single question that pops into your head...you have to pick and choose your questions because they're short on time and you don't want to burden them. And you don't want to aggravate them.

This girl was born aggravated though, so I "killed" her with kindness. I got a kick out of myself and the way I interacted with her. I watched how the nurses and other PAs interacted with her and you could tell that everyone felt the same way. After a few hours of sitting around studying on my own, I asked her again if there was anything I could do. She looked at me and said, "No." And then she went back to working on the computer.

Instead of walking back to the corner of the room where I was studying, I stood there until she looked at me again. I smiled and said, "Well, I certainly don't want to waste any of your time. I can tell you are really busy since you haven't been able to interact with me today. So, I'm going to go back to the medicine floor to work with my other preceptor and follow up on the patients that I worked with last week. So, if you don't mind, I'd like for you to open up the staff room so I can get my things. And, I can call the chief PA if you'd like to get approval."

Needless to say, she walked me to the staff room where I gathered my stuff and told me to have a nice day.

When I returned to the Medicine floor, the PA I worked with last week was happy to see me. My classmate was working with her and she agreed to let me join them. So the three of us have been working together every afternoon from 2-7pm.

It's disappointing that I'm not able to see/do more on the cardiology floor. But most of my patients on the Medicine floor have cardiac problems, so I'm not really missing out. My classmate was miserable last week in Cardiology and now I understand why. It's a shame...but I'm glad that I spoke up and expressed what I wanted to do. Otherwise, I would have been sitting in the corner all day. And I didn't move to Brooklyn to sit in the corner!

Another cool thing is that my classmate and I don't compete with each other. We don't try to outshine each other. I've seen some really negative interactions between med students and it makes me realize how happy I am that I DIDN'T go to med school! My classmate and I are eager to learn yet we take turns with procedures. If he had something cool going on in one room, he'd come and get me and vice versa.

We saw a lot of action today. We observed a woman being intubated in order to keep her alive. We also observed a woman being extubated in order to let her pass away. We observed central lines being placed and were able to remove central lines. We took histories, performed physicals and wrote progress notes. We went down to the Emergency Room to work up an admission. We assisted in a wound debridement...it was bloody and full of pus, I was surprised that I found it cool. Oh yeah, and then there was the stool guiac exam. I let my classmate do it first...I'll get the next one!

A patient that I did a history and physical on in the ER last week was moved to a different floor this week. I've been going there to visit him everyday. He's 84 years old and presented with a diffuse rash that covered his entire body except for his face. Both of his legs were swollen and oozing. He's had the rash for 4 weeks...and the swollen legs for 2 weeks. It's been a couple of days and he still doesn't have a diagnosis. He's a widow and doesn't have any family in the area. Nobody has come to visit him, so I make sure that I see him everyday. My preceptor fears it's a malignancy. Since I am a student and I have time to talk to patients...that is what I do. Today when I left his room he grabbed my hand and thanked me for visiting him.

And that is why I'm doing what I'm doing. That makes all of the sacrifices up to this point worth it. And that's what keeps me motivated. I no longer study to pass a test. I study to help improve a person's life. And I think it's the coolest job in the world.

We finish work at 7pm and by then we're giddy and starving. It takes my classmate 3 hours to get home by train (if I didn't move...that's what I'd be doing too!). And it takes me about 45 minutes to get home. I've eaten the same exact thing every night this week! Black beans with broccoli on quinoa with a salad. I'm too tired to cook anything new. I talk with my roommate for a bit and then I go back into my room and study till midnight.

Then I wake up and do it all over again. I'm happy with this rotation. It ends in three short weeks and then I'm on to the next rotation. It's going by really fast.

So, I'm trying to enjoy every moment.

Pimpin

My first rotation is going well. I have been doing so many different things, running in different directions and dealing with so many different types of people....I'm exhausted. I'm working four 10-hour days and then I get three days off. The days go by really fast.

I'm going on day #3 though and I'm beat. But, I'm looking forward to going back tomorrow to learn some more. It's an unbelievable learning curve. Today I did rounds with 5 med students and a doctor. I was the only PA student. And the Doc pimped me like he pimped the others. He was a brilliant doctor and I loved the way he dealt with us. He flat out told me not to worry if I get the answer wrong because I'm there to learn and he doesn't expect me to know the answers to all of his questions. So, I knew some of the answers and didn't know some of the others! But the med students choked up on most of the ones I didn't know either.

I left the experience feeling pretty darn good. I've had one year of medical school...and they've had three.

Enough said.

Gotta sleep!

Self-defense

I wish I had a video camera following me around. I don't have the energy to come up with adequate words to describe what the last two days were like. I feel like this is all make believe. But, it's real. Very very very real.

It's so real that it feels make believe. I wonder how long this self-defense mechanism will last.

I'm seeing really sick patients. The average age of admitted patients in this hospital is 85 years old. Lots of ventilators. Lots of elderly people lying in beds without visitors. Yesterday they were talking and laughing and today they're intubated and unconscious.

Talk about a steep learning curve.

I need to sleep.

Rip Tide

I'm starting my first rotation in Internal Medicine tomorrow. I guess I should be nervous. But, I've been too busy moving into Brooklyn and getting settled. I took a nice tour of Brooklyn today. It took me 3.5 hours to go 10 miles.

Yes, 3.5 hours to go 10 miles.

There was a West Indian parade/festival today. I knew about it, but I didn't think that it would close down half of Brooklyn! It was unbelievable. I felt like I was in the Caribbean. A police officer actually asked me why I was in that area. I told him I was trying to find the hospital and he said, "You're the first blonde I've seen all day!" I had to laugh. It really was insane.

So, I spent the entire afternoon in the car. I found the hospital, the parking garage, the administration building and the chief PA's office. I'm going to give myself 90 minutes to go 5 miles tomorrow morning! Just in case there's another parade I don't know about!

I was drained after the driving debacle but headed out to the nearby park for a run. I trailed about 10 feet behind another girl and she unknowingly took me for a tour of the park! It was great since she unknowingly brought me back to where we started! I took a couple of looks behind me to make sure I wasn't being followed!

So, I'm pretty tired at the moment and trying not to think about tomorrow. I got about 5 freak out phone calls today from my classmates. I just laughed at them because most of them are within a 20 minute drive of their house! There is one classmate that does have the same rotation as I do. He was told to meet at the same time, so we'll see each other. That does make me feel better. He's only 21. I would be freaking out a lot more if I were 21. But, since I'm about to turn 30 (ahem, in 2 weeks!)...I'm trying to manage my anxiety by thinking about the crazy things I conquered in my early 20's. If I can get off an airplane in Tokyo and manage to live there for 2 years without any Japanese language training...I SHOULD be able to survive in Brooklyn.

Basically, I'm just trying to go with the flow...while avoiding the rip tide!

Wish me luck.

;)

Welcome to Brooklyn

Wow...I'm writing this from my apartment in Brooklyn! The last few weeks have been crazy...I have tons of stories to write about...but I'm short on time. It took some time to remember how to relax, but once I got there...it took some time to get back in the swing of things!

And, I am definitely back in the swing!

It's Sunday night and I start my Internal Medicine rotation Tuesday morning at 9am. That's all I know about the rotation. The chief PA wasn't that friendly and didn't offer any other information. So, I just said, "See you Tuesday!"

I'm trying to stay calm. I am excited about it, but I really can't believe it's happening. So, I'm just going to go with the flow. I felt the same way when I first moved to Japan. Everything is foreign. Everything is new. And nothing makes sense!

And I did fine. (and that's what I keep reminding myself)

But, it would be good if I could actually find the hospital! It's only 5 miles away from my apartment...but I'm beginning to realize that 5 miles in the NYC metro area is way different than 5 miles in Suffolk County! So, tomorrow I'm venturing out to find the best route. I have options. Car, bus, subway.

I tried to get there today by car, but there was a festival on the street that I needed to go down. So, I tried to go down a different street but got caught up in "one-way" streets so I retreated back home.

So, that's my mission for tomorrow!

On The Horizon

I start my first rotation 3 weeks from tomorrow. I have a list of things that I need to do before then. I have piles of notes stacked up in my room that need to be filed. It's about 3 feet tall! I have some books that I should read and I have to check out the apartment that I'm going to be living in. Yeah, I haven't seen it yet!

So, I think I'll procrastinate a little bit more and go away for the next few days and deal with that stuff next week. I'm not ready to face reality yet. It's that plain and simple. So I'm going to one of my most favorite spots in the world. Lake Wallenpaupack in the Pocono Mountains. My grandparents built a cabin in the late 60's and after they passed away their children have kept the place running. It's my happy place. I have so many fond memories...swimming in the lake, catching salamanders, getting lost in the woods, playing board games, lounging around without a care in the world. I haven't been there in a few years, so I'm really looking forward to it.

A couple of days in the mountains does wonders for my soul.

Wrap Up

I had two exams on Thursday. I averaged about 4 hours of sleep every night that week and by Thursday I was shot. The first exam was Pharmacology and an hour later I had to perform a full physical exam on a "patient" (student) in front of a proctor. I was so exhausted by the time I did the physical exam that I forgot to perform some very basic, very important, very obvious physical exam maneuvers.

VITAL SIGNS.

Yup, I totally forgot to take my patient's blood pressure, pulse, and respiration rate. I knew I had forgotten something as I went along with my exam. About halfway through I realized it, so I started laughing and luckily the proctor did too. My brain was my fried and I apologized, luckily I've worked with this proctor before and she knows my capabilities...but it took me a few hours to get over that blunder. The funniest part of this whole story is the fact that I take my personal training client's blood pressure and pulse every few months! I use this as a way to monitor their progress...oops!

That will never happen again!

I left there and stopped off at a bar to meet up with some classmates. We were all a bit shell shocked and unconvinced that we actually finished didactic year. There was a lot of laughter but a couple of hours later when we all went our separate ways...there were tears. There is a definite sense of separation anxiety. These people did become my second family and I'm grateful for having such a good class. I looked forward to seeing them everyday...and that made all the difference in the world. I never thought I'd laugh so much in PA school. And that is what got us through.

Laughter.

I crashed for 3 hours when I got home. I woke up and wasn't sure if it was the next morning! I felt like I had been hit by a bus. It was only 6pm though and my family took me out for a ride on the boat to celebrate. Everything felt surreal, I still felt like I had to get home to study for something.

When I woke up Friday and realized I didn't have to be anywhere...I was able to exhale for the first time in weeks and relax. Well, try to relax. I packed up my stuff and headed for the beach. I stopped off at a drug store and picked up a PEOPLE magazine. That was a first for me...I was just desperate to read something mindless! I soaked up some rays, napped and swam for several hours. Came home and got ready for a party. A party with my classmates!

The party was a lot of fun. It's always fun to meet up outside of the classroom and meet everyone's significant others/friends. By the end of the night, we sat around an open fire and listened to music. And every few minutes someone would remark, "it feels so good to do nothing." We would all smile and then drift back off...

I spent the rest of the weekend over at Fire Island. I partied with my sister and some old friends from High School. I'm proud to say that I was at the bar for "last call!" I partied more this weekend than I have all year! It felt good...I needed it.

I deserved it.

The End...Is Just The Beginning

I did it. It's done. It's over.

I rocked it.

Yes.

But...now what?

Sleep Deprived

I can honestly say that this is the HARDEST I've ever had to work...EVER. It's about making the impossible, possible. And I'm 3 exams away from achieving that goal.

Sweet.

6 hours of sleep over the last two nights.

2 exams done, 3 more exams in the next 2 days.

And then I can sleep.

*yawn*

Shocking

School ends Thursday!!!

Only 5 exams, 2 workshops and a psych presentation...in FOUR DAYS!

The amount of work still shocks me.

It always seems like it's an impossible feat.

Seriously. Shocking.

And then it's all done...and the real learning begins.

PDA

Picking the right PDA is not an easy task. It takes a lot of time to research the products and then get up enough nerve to plop down several hundred more dollars on a device that everyone says you HAVE TO HAVE. Up until now, it's been books and study guides...now we're going high tech.

So, I did my research and opted for the Palm Treo 700W. Here's the link: http://web.palm.com/products/smartphones/treo700w/ It's got more features than I'll probably ever use, but it's a phone and computer device all wrapped into one. The less I have to carry...the better.

I started to download some software onto the device and I have to say it's pretty cool. It takes pictures, videos, and I can download music onto it. I can also surf the internet with it and write email. It'll probably take me months to figure out how to do all that stuff...but, it's pretty cool!

Heat Wave!

They say timing is everything and this week, timing was not on my side.

The night before the Emergency Medicine final exam, our house lost electricity. Since this rarely ever happens, I figured that it would be back on within the hour so I decided that I'd go for a run to pass the time.

When I returned home and found that the power was not restored and the sun was quickly setting, I started to panic. During my run, I realized that it was only a small section of the neighborhood that lost power and not the entire county. So that meant that the rest of the class was most likely studying in their air conditioned rooms while I was slowly losing daylight and rushing around to find all my notes.

I retreated to my best friend's house. Yes, my best friend that had a baby 3 months ago. I tried my best to stay focused on studying, but who can resist a beautiful 3 month old baby that looks at you and smiles!?!?! My friend and her husband recently built a brand new house, so her husband set up a table for me in the baby's room to study. It was a really nice gesture but after 2 hours I was back on the couch with my girlfriend and the baby!

The power company told my family that the electricity would be back on by 12:30am. So, I left my girlfriend's house around that time and arrived home to total darkness. It was hot...really hot. No lights, no air conditioning, no fan...nothing.

I lit a few candles but that made it hotter, so I studied with a flashlight before passing out from the heat. It was an awkward, broken up sleep. The power came back on at 4am. I woke up at 8am and felt like I had been hit by a train. I was exhausted. I had 4 hours to cram Emergency Medicine into my head. I tried my best.

But...it was one of "those" exams. One of those exams that makes you feel like you haven't learned a thing since starting the program. One of those exams with innane, obscure questions that have little to do with real world medicine. One of those exams that when you go back to your notes, you realize that the answer is NOT even in your notes. It was just one of "those" exams.

It kicked my butt.

I came home afterwards and the power went out again! And then it came back on again and a few hours later...it went out again! I sat in the dark with an ice pack on my head with my new PDA/phone combo and "studied" using the Epocrates software I downloaded. Luckily, the power came back on by midnight and I was able to get some sleep.

It's been so hot that the NYS governor opened the state beaches for free today. The heat wave is supposed to break tomorrow...down to a more bearable 90 degrees?!!?

Preparing for 5 exams and a psych presentation next week will keep me busy indoors this weekend.

And right now...that ain't a bad thing!

What's Next?

Final Exams:
Neurology
Psychiatry
Emergency Medicine
Gastroenterology
Nephrology
Surgery
Pharmacology
Physical Diagnosis Lab

Workshops:
Suturing
Casting/Splinting
Clinical Skills
Procedures

Research Papers:
Emergency Medicine: Meningococcal Meningitis
Psychiatry: Bipolar Disorder I & II

Presentation:
Psychiatry: Bipolar Disorder

**all within 7 school days!**

Fun in the Sun?

It's a picture perfect summer day. 90 degrees, slight breeze, and not a cloud in the sky. I settled in to study for neurology, but can't seem to concentrate.

So, I'm going to the beach to read the 190 pages of powerpoint slides!

Fun in the sun has taken on a whole new meaning...

It's Pouring...

I got a call today from the personal training academy that certified me several years ago. They asked me if I was interested in presenting a 3-hour lecture on HIV/AIDS and personal training.

I had a brief conversation with the director of the program several years ago about HIV and he expressed interest in having me present at a later date. Well, 5 years later I get the call.

Of course he called at one of the busiest times in my life!

When it rains...it pours.

Wow!

I'm sitting here revising my EMED paper on Meningococcal Meningitis when I suddenly realized that today was the last official day of classes! Now all I have left are 8 final exams, two suturing/casting workshops and a clinical skills review.

Where did the time go?

Stuff

I'm 99.9% sure that I'll be moving to Brooklyn come September. I was hoping to have the time to drive to Brooklyn to check out the apartment this week, but my schedule is packed since it's the last week of class. I've known my future potential roommate for a few years and I trust her. That's the key. Besides...it'll only be for 10 weeks. (I won't even write, "what can go wrong in 10 weeks?"...because I know better by now!) So, pretend you didn't read that thought!

4 more days of school!! Then finals begin. I found out that my third rotation will be Pediatrics and fourth rotation will be Long Term Care. I'm liking the progression...although I'm really nervous about Internal Medicine.

Last semester, our Rheumatology instructor told us, "Cross you fingers that you don't get Internal Med as your first rotation!" In reality, it's an excellent rotation to start off with. I was just hoping for a small office with one doctor...not a big hospital with different floors full of patients! And "rounds"...having to do rounds scares the beejeezus out of me. I sometimes have a hard time coming up with answers in front of other people...even if I know the answer, I'll stutter or give the wrong answer. I have to work on that...

In the meanwhile...I have no idea how many exams we're getting socked with in the next couple of weeks. I have to get back to focusing on the "little stuff" for now. Funny, how the big stuff is now the little stuff....with even bigger stuff on the horizon.

The real stuff. The really scary stuff. The life or death, this ain't no multiple choice test stuff!

The stuff that's going to pave the way to my future.

What have I gotten myself into now?!?!

;)

Brooklyn Bound?

It's no secret that I've been spending the majority of my free time in Brooklyn over the last year. I've plugged George and Omar's restaurant, Bogota Latin Bistro (www.bogotabistro.com), numerous times in this blog. I've made many friends from my time hostessing, waitressing, managing, and flirting with the Mexicans! As a result, the opportunity to move to Brooklyn has presented itself. And I'm at a crossroads as to what to do.

The first offer came from the cutie patootie, 21 year old, Mexican cook. Although the thought of living with a cutie patootie that can cook is tempting...it's probably not the best move for me right now.

The second opportunity is to move in with a girl that I've known through George for a few years. She's a psychologist and waitresses part-time at Bogota. It just so happens that her roommate will be moving out at the end of August and her boyfriend is scheduled to move in with her the beginning of November. This leaves open the months of September and October. The same months that I will be doing rotations in Brooklyn and Queens. The timing is perfect and the details can be worked out.

If I don't move to Brooklyn, I will be commuting at least 4 hours a day. And the thought of that commute stresses me out. I'd much rather put my energy into learning and taking care of patients than recovering from frequent bouts of road rage!

I've got a week to figure everything out.

12 Days

Just finished 12 straight days of class! I have been surrounded by my classmates for the last 12 days...and since I've been house/dogsitting for my aunt & uncle, I've seen my classmates more than my family! Many of our days have been really long...between 8-12 hours. But, there is a sense of nostalgia that is permeating the air now. With only 5 more days of class before the official start of final exams, the end is near. We can see the finish line now.

It is strange to think that I won't be seeing my classmates everyday after August 11th. We will have to report back to school once a month for "call backs". Basically, we go to school to take an exam based on the rotation that we finished. But, the insanity of what we've been through didactic year is coming to a close.

And although I cannot wait to get out of the classroom and get a move on with my life...(read: get one step closer to a paycheck!), I'm embracing the next few weeks. The last 3 weeks of didactic year.

Unbelievable.

BUSY

This is what stands between me and finishing the didactic component of this program (August 10th):

2 weeks straight of classes because of an ACLS 2 day training this weekend!
2 papers
14 cumulative final exams
1 week of suturing, casting, splinting, charting, etc. (Transition Week)

Needless to say, I'm a little stressed out!

And this is what I have to look forward to:

1st Rotation: September 5th, Internal Medicine (hospital), BROOKLYN
2nd Rotation: October 5th, Primary Care (private practice), QUEENS

I live in Suffolk County, Long Island. I'm more concerned about the torturous commutes than anything else right now. At least 2 hours each way...at least.

I can't wait til vacation starts August 11th!

I need it.

Who Let The Dogs Out?

I left a BBQ party early to come home to study orthopedics on a Saturday night. When I arrived at home I realized that there was a block party around the corner.

So, right now, I'm listening to a DJ encouraging kids to scream at the top of their lungs with "Who Let The Dogs Out?" playing in the background. It's been the same song for the last 20 minutes...I think they're playing musical chairs.

At this point, all I can do is laugh...and fantasize about walking around the corner and unplugging the power cord.

PA School = Party Pooper!

Party Time

Wow.

Our exam was changed from July 5th to July 3rd.

And we don't have class until 3pm on July 5th.

Party Time!

Top 5

What am I going to do after I graduate?

That's the question that has been swirling around my mind lately. Will I specialize? If so, what specialty? Will I move out of NY? If so, where will I go?

I did some research and according to the AAPA (American Academy of Physician Assistants) this is where the money is:

Tope 5 States for New Grads
Nevada
California
Alabama
Massachusettes
Maryland

Top 5 States for Experienced PAs
Arkansas
California
Alaska
Nevada
Connecticut

Top 5 Specialties:
CT/CV Surgery (cardiothoracic/cardiovascular)
Dermatology
Neurosurgery
Emergency Medicine
Surgical Subspecialties

I wouldn't mind moving to California...that would bring me closer to Hollywood. So, I can be an extra on ER or Grey's Anatomy during my downtime as a Cardiothoracic Surgical PA.

Um...I'm working on Plan B. (and C, D, E, & F)!!!

Knuckleheads

I am not a big fan of the 4th of July. Celebrating the Independence of America is great...but I could do without the knuckleheads that feel the need to blow things up.

But, I was looking forward to this year's holiday. One of my friends from class is throwing a party on the 4th. She started planning this party months ago and everyone from class is invited. We've all been looking forward to this party since we haven't really had the chance for everyone to get together for a "proper" college party. Yup...beer pong, keg stands, turbo cups, and jello shots were all on the agenda.

Well, we got our schedule for July today. There is only ONE exam scheduled for the entire month of July.

Guess when that is???

July 5th at 9am!

We offered to take the exam two days earlier than scheduled, but the admin refused. We got the same old speech..."We told you at the interview that you'd have to make sacrifices, that you'd be missing parties, weddings, funerals, etc. "

blah blah blah blah blah blah blah

Party or no party...I know I won't get much studying done on the 4th anyway! I'll be too distracted by the knuckleheads blowing up the neighborhood.

Geez, I can't wait until next year when I'll be treating these same knuckleheads in the ER.

Embryology

Embryology is no longer part of the curriculum. I don't know when that changed, but many of our instructors would refer to embryology during second semester and we'd always respond with, "we didn't take embryology!"

After a few weeks, when a new instructor would refer to embryology, the class would laugh. It became somewhat of an inside joke for us.

About a month ago, the director of the program addressed our class and our concerns about our education. One of the students brought up the fact that every instructor was referring to embryology, yet it wasn't part of our curriculum.

Well, a few days later, the director sent us a memo letting us know that if more than half the class wanted to take embryology then he would set it up. Only a handful of people wanted to take the class but before we had the opportunity to vote...we were informed that there would be a mandatory embryology class. The catch is we wouldn't receive any credit for taking the class nor would it appear on our transcripts.

Needless to say, that didn't go over well with the class. It is a 4 hour class, which doesn't sound that bad in comparison to everything that we've been through. But, the class is broken up to 4 days of 1 hour classes. And before every class, we will take a quiz. Although we won't receive a grade OR credit for the class...we have to pass the quizzes.

So, we had our first embryology class last Friday and the instructor is a PhD. Semester 2 was all MDs and PAs....we didn't have any PhD faculty. And there is a huge...HUGE...difference. Basically, the MDs and PAs teach us what we need to know and the PhDs teach us everything we never wanted to know!

This class is out there. This class is totally irrelevant to everything that we've been learning. It feels like we're going in reverse instead of forward. It feels like we're being punished for speaking up. Yup....that's what it is....punishment.

We had our first quiz today. 10 matching questions in 5 minutes. I thought the prof was kidding...but, she wasn't. Matching questions usually aren't that tough...but these sure were! Although there were 10 questions...she gave 15 choices...and you could re-use answers. It was a nightmare...all the while she was counting down the minutes.

There were a lot of unhappy students after the quiz. And the student who initially brought the missing embryology class to the director's attention really should consider getting a bodyguard.

It's not solely her fault...but, sometimes you really, really, REALLY, have to be careful with what you wish for...

...I certainly wouldn't wish this class on anyone!

Senior Talk

We had the much anticipated "Senior Talk" today. Some of the PA preceptors that we will be doing rotations with visited and gave us an overview of what the next year will be like. We were congratulated for making it to this point in the program and encouraged to continue being successful. At that point, we all smiled and patted ourselves on the back. But...that didn't last very long!

The meeting lasted about an hour and we were hit with a lot of overwhelming information. We received a list of all of the doctors and PAs that will be our preceptors. A lot of the offices/hospitals are located in Brooklyn and NYC. We were also given a procedure log that we need to carry on every rotation. There is a list of 17 required procedures and 7 optional procedures.

Here is the list of procedures (all must be completed 3 times).

Required:

Venipuncture
IV Insertion
Blood Culture
Arterial Blood Gas
Fingerstick
PPD/SC Injection
EKG
Nasogastric Tube Insertion
PAP Smear
Foley Catheter Insertion
Pelvic Exam
Rectal Exam
Dressing Change
Throat Culture
Suturing/Stapling
Splinting/Casting

Optional x 3:

Chest Tube Intubation
Endotracheal Intubation
Central Line Placement
Wound Debridement
Newborn Delivery
Removal of Foreign Body From Eye
Fecal Disimpaction

Of course the goal is to do every single procedure as many times as possible. As well as do any type of procedure that an MD/PA asks of you.

Every rotation lasts 5 weeks. Here are the required rotations:

Internal Medicine
Pediatrics
Emergency Medicine
Family Practice
Surgery
Geriatrics
OB/Gyn

We have to repeat one of the required rotations as well as choose one elective rotation (ie. psychiatry, dermatology, orthopedics, neurosurgery...basically any specialty/subspecialty of our choice).

At the end of the 5 weeks, there is an exam. You must pass the exam to move on to the next rotation. We will also be assigned a medical topic and have to present a powerpoint presentation to our classmates and faculty at some point during the year. There is also a required community service project of our choice that we have to complete (30 hours). And faculty will be visiting us at the hospitals/medical offices where we will present interesting patient cases including history and physical, labs, diagnoses, treatment (etc) to them.

When the meeting ended, there were a lot of blank stares and strained faces.

The guy sitting next to me whispered, "I'm scared!"

I let out a nervous giggle and winked...

"Me too...but don't tell anyone!"

On With The Show!

School has been pretty slow and laid back lately. So, I've been taking advantage of the hot weather that's currently blanketing Long Island with my usual favorite outdoor activities...mostly rollerblading and basking in the sun. Although, thanks to my dermatology class...I've become paranoid about every freckle on my body. If I don't become a hypochondriac by the end of this program it will be a miracle!

This past weekend I travelled up to Ontario, Canada to attend a wedding. This wedding was unlike any wedding that I have ever attended. In fact, this wedding is considered illegal in the United States. But, 130 people from around the U.S. travelled to Canada to witness the marriage of two of my girlfriends from college. Same-sex marriages are legal in Ontario and many people travel there to get married, but according to the locals, a same-sex wedding of this size has never been seen. Local news reporters were even there to capture the event!

The ceremony took place in a hotel overlooking Niagara Falls. The site was breathtaking. Both of the bride's fathers gave heartfelt speeches at the reception, and there wasn't a dry eye in the house afterwards. So, in that sense...it was like any other wedding I've attended...

Love is love is love is love. Love is Love.

Overall, it was a great weekend spent catching up with old friends, partying like rockstars, and forgetting that I'm a PA student (thanks to the cute bartender at the Martini Bar!). I came back to school feeling refreshed, refocused, and excited to get on with the show.

11 weeks until rotations!

Still Here...

Well, I just realized that it's been a while since I've last written. We're finishing up week #2 of the final semester of didactic year and it's been pretty much uneventful! At this point, not much phases me. Classes have been cancelled and added at the last minute and our schedule for June has been revised five times already (that's a record!). So, it's hard to plan anything outside of school.

There are a few weekends where we have class on Sundays. That is irritating when there is plenty of time to fit it in during the week, but for whatever reason...we have to be there...on Sundays in the Summer. (bummer)

The best decision I made in choosing a school is choosing one close to home. I live about 15 minutes away from campus and my gym is located in between. Some students travel as much as 2 hours (each way) and I would have gone insane by now. Sometimes we'll have up to 6 hour breaks and I can't sit in the library and study all day.

I've been doing a lot of rollerblading lately and I validate that by listening to lectures as I work up a sweat. Or I go to the gym and read my notes while doing cardio. Or in my car at the beach or boat dock. This week it was warm enough to sunbathe and study at the same time! Always a multi-tasker, I will basically find any excuse to avoid sitting at my desk lately.

Another reason why I can't stand studying at my desk is because I've recently lost my email buddies. I had a few friends that I would consistently correspond with over the last several months. Some were email and others were through instant messenger. Some have gotten married, had babies, moved in with significant others, or simply faded. And these disappearing acts happened simultaneously within a few weeks time.

I didn't realize how dependent I had become on having friends to chat with while I was up all night studying. Most of them lived in different time zones so that always kept it interesting. I had friends in Italy and Japan that I would correspond with for hours on end. But within the last couple of months, things have changed. It's always an adjustment when your life steers in a different direction as your friends. That has probably been the most consistent development throughout my 20's.

Here today...gone tomorrow...life is constantly changing.

Life changes...but I still have studying to do! That has not changed. I can't wait for rotations to begin. I'm really looking forward to getting started and gettng a move on with my life. Things feel stale lately...somewhat stagnant. I know I am moving forward, but it feels more like I'm treading water lately. That is why they say the third semester is the hardest, I'm tired of drinking from the fire hydrant. I'm ready to start using this information that has been crammed into my head.

I'm ready to hit the ground running...

Semester # 3!

Tomorrow is the first day of the 3rd and final semester of the didactic year! I start rotations exactly 3 MONTHS from tomorrow!!! I can't believe how fast time has gone by!

I thoroughly enjoyed our one week vacation. The last week of finals really kicked my butt. It wasn't fun, but I got through it. And from what I hear, we didn't lose anybody...which is awesome.

We have 8 more weeks of classroom work and then I am apparently ready to take on some patients?!? I have the same feelings about starting rotations as I did a year ago before starting the didactic year. Anxious and scared are a given, but I really feel excited to get out and start practicing. I'm looking forward to seeing what opportunities I find and the different paths that present themselves...and the people that I will meet.

We start off this semester with a bang. This week we have three 12 hour days and that seems to be the norm throughout the month.

I'm looking forward to seeing my classmates again. I'm looking forward to learning again. I feel rested. My batteries are recharged.

Bring It On!

It Takes a Village

It's Friday night and I'm totally exhausted. The week from Hell came and went...and I passed all of my finals! We didn't get our hematology grades back yet, but we were told that if we had failed, we would have been notified.

And I was not notified.

13 exams in one month. 6 of them were this week. Studying (cramming) a semester's worth of information into your brain the night before a cumulative exam, that would stand as your grade for the entire course, was daunting. And this happened 5 nights in a row!

It was a struggle to block out everything else going on in life to sit down and study a different subject day after day. Knowing that once you finished a 100 question exam, it was time to hit the books to tackle the next one. There was no time for distraction. No time for relaxation. No time to smell the roses. No time to simply have a bad day! I felt more like a robot than a human being as the week dragged on. A robot that had a few screws loose and was about to short circuit!!

The pressure over the last few weeks left me feeling really vulnerable and I found myself leaning on my family, friends and other classmates to help me get through it. Although I know that's a natural reaction to high stress and pressure...I don't like feeling that way. But, I'm lucky and grateful to those that stood by my side, listened to me and encouraged me.

It Takes a Village...and in my case...a village that spans the globe!"

Muchos gracias. Domo arigato gozaimasu.

Thank you very much!!!!!

Great Story!

Now this is a doctor that I wouldn't mind working with! (Although his buddies taking his blood should be wearing gloves!)

http://news.yahoo.com/s/ap/20060527/ap_on_he_me/surgeon_s_blood

Bloody Insane!

This morning's Hematology exam was a mess. This is the third class that this instructor has taught us and his last three exams have been challenging, but fair. So, we weren't expecting a torturous exam. The first ten questions sent quivers throughout the classroom because you could hear people moaning and groaning.

We all left the classroom feeling the same way and saying the same thing, "I think I failed."

Unfortunately, those words came out of my mouth too.

There's no time to dwell on it though...cumulative dermatology exam 20 hours from now. It's rumored to be a very challenging exam...

...the insanity continues.

Halfway There...

It's Tuesday and three exams are behind me...three more to go.

Surgery Part 2,
Physical Diagnosis,
Radiology.............................Done!

Tomorrow: Hematology (not fun)
Thursday: Dermatology (interesting)
Friday: Rheumatology (somewhat interesting)

The worst part about finals week is the lack of sleep. It's the lack of sleep that exacerbates the anxiety, fear, tension...that leads to panic, tears....and more tears! Cramming a semester's worth of work into your brain the night before a cumulative final exam that accounts for your entire grade for the semester is INSANE. Absolutely insane.

This week has been the toughest week to get through since the program started. This finals week makes last semester's finals week seem like a cake walk. And I'm sure I'll be saying the same thing when Semester 3 comes to a finish. Word has it that next semester is harder b/c all of the exams are held to the end...and it's the summertime!

Summer + PA School = Lethal Combination

SADD

I have diagnosed myself with a new disorder.

SADD

This disorder does not currently exist, but I'm sure every PA student in the country will back me up. Perhaps I'll write my senior thesis on this subject.

Springtime Attention Deficit Disorder (SADD).

I had no problem hitting the books in the Fall and Winter. But, ever since the birds started chirping...I have a much harder time concentrating on my studies.

Unfortunately, I think this disorder will carry through the summertime...

My motivation at this point is simple. I want to go to Washington D.C. for Memorial Day Weekend. If I pass all of my finals this week, I am off the following week. If I don't pass my finals, then I have to stick around to take a cumulative make up final. And that would ruin my plans for the weekend.

I basically only have one non-married girlfriend left in this world!! And she lives in D.C. We always have a great time together...and t-rex is definitely in need of some F-U-N!!!

6 more finals to go....

Commitment Phobia

I can't believe that we finished our last class for semester 2 tonight!

Only 6 more exams (in 5 days) and then it's over! Unbelievable.

What's even more unbelievable is that I start rotations in less than 4 months! We were given a "wish list" a few days ago. We have to do 7 required rotations in family medicine, internal medicine, OB/GYN, pediatrics, long term care, ER, and surgery. Each rotation lasts 5 weeks. But, we also have to repeat one of the required rotations and choose an elective rotation. The elective rotation can be anywhere and doing anything. For example, forensics, plastic surgery, neurosurgery, cardiothoracic surgery, dermatology, psychiatry etc.

I was overwhelmed by all of the options and unsure of what elective I wanted to choose. The kicker was that the "wish list" is due tomorrow! Yeah, we were given 3 days to map out our future. We are able to change it as we go along next year...

So, for now I chose to repeat either primary care or emergency medicine. And I chose infectious disease, psychiatry, and dermatology as my three elective choices. We'll see how that turns out...I know I will be changing my mind often. I am somewhat of a commitment phobe!

But, that's the beauty of this profession...unlike MDs...I can change specialities throughout my career. I just want to make sure I get a very well rounded rotation experience!

Million Dollar Baby

Going to the gym is my way of dealing with stress. 30 minutes on the arc trainer and life is good again! If I have extra time to lift weights...birds start singing and rainbows appear! As busy as the program keeps me, I still try to get there at least 3 times a week.

Last summer I took boxing lessons with some of the other personal trainers at the gym. I saw the boxing trainer trainer tonight and he started asking me about the program. I guess I sounded like a sissy, because he smirked at me and reached for his gloves.

He handed me the gloves and told me to start throwing punches. It felt good to be "back in the ring" again. We sparred together but he never actually hits me (hard, anyway). As we were sparring he kept yelling at me to keep my guard up. And he said something that really struck home..."Step into the Punch!"

"You know you're going to get hit and if you shy away from the punch, then you're going to knocked out! You have to step into the punch and take it. Then fight your way through it! Keep you guard up and step into the punch!"

So, I'm done being a sissy with this school stuff.

My guard is back up, and it's time to start stepping into these punches!

T-rex

Welcome to Hell!

So the feeling I had a few weeks ago that I was just going to cruise through the rest of the semester has been obliterated! There is a lot of stuff going on within the program and as a result, they've added on two more exams. Basically, the admin "forgot" to give us the surgery mid-term! So, now they added on that exam as well as another pharmacology exam. Apparently, the admin "forgot" to put antibiotics on the exam we took the other day. So, they're throwing together another exam for that.

Of course my class wasn't going to take this without a fight. So, the director of the program addressed the class and apologized for the miscommunication and carelessness of the staff. He also opened up the floor to hear all of our criticisms and concerns about how things are going. There are a handful of instructors that do not take their job as seriously or as professionally as we (as a class) would like. So, once that was revealed, I was surprised that the director actually took it to heart and promised that he would look into it. He is the type of guy that you DON'T want to get in a confrontation with!

He came back and addressed the class again the next day and told us that he is addressing all of our concerns. He even typed up a 3 page memo detailing the changes that he's making in the program. He also asked us to type up an anonymous letter with any other concerns we have about our education and the instructors. I was impressed...very, very, very impressed.

He went on to tell us that we are an exceptional class. He said that some of our concerns are the same as previous classes and that some of our complaints are common at all PA programs, especially at this stage in the game. But, he said that our class approached the issue professionally and that he is pleased with how well our class gets along and at how well we are all doing. Apparently, the senior class does not get along and they have a lot of problems. Our main class is next to the director's office and he says that he never heard so much laughter coming from a PA class before. There were other experienced instructors in the room that agreed with him.

So, that was very encouraging. But, then he went on to talk about the summer semester and our rotations in September. He went on to tell us that we are in HELL and will not be getting out of it anytime soon. He sympathized with our situation by acknowleding the stress we are under and the fact that unless you've been through this process you don't/can't truly understand it. The truth of the matter is that it's only going to get more intense, especially when rotations begin.

I tried to walk away from the meeting focused on the good stuff that was highlighted. But, it is getting tougher in the sense that we all feel like we don't know a damn thing. And they tell us that is exactly how we're supposed to feel. But, that is NOT a good feeling! As much as I enjoy learning about medicine, there is a constant, nagging, feeling of vulnerability and insecurity. And the realization that all of this training (torture) is for a J-O-B!

I know things will get better again once we get through the next 2 weeks, but we're all freaking out. We're all questioning the process. We're all wondering how and why we got ourselves into this in the first place! So, we moan and groan and tears of frustration are pretty common. The thought of keeping up this intensity for the next year and a half is daunting. Knowing that it will get worse come September is downright frightening! But, as a class, we pick each other up and that is really what keeps us going. That is what keeps me going. I also bank on the satisfaction that will come when I start treating patients. It's a short program, but a long road to travel.

And right now we're traveling over some bumpy ground.

A Glimpse of the Finish Line

Semester 2 Completed Classes!
Cardiology
Pediatrics
Pharmacology
Pathology
Pulmonology
Ophthalmology

Final Exams on Deck:
OB/GYN
Lab Medicine
Radiology
Surgery (2 finals)
Hematology
Rheumatology
Dermatology
Physical Diagnosis

The Simple Life

I was talking to a friend the other day about how I feel like the weight of the world is back on my shoulders. He questioned why I felt that way and I didn't really have an answer. Besides the 10 final exams that are waiting for me, life is good. But, there is a heaviness that comes with this program, with this responsibility...with practicing medicine. And some days that heaviness simply wears you down.

But then my friend broke it down for me, in very simple terms. "You will study, you will pass these exams, and then you'll start the 3rd semester. You will study, you will pass exams, and then you'll start your rotations. You'll study, you'll pass your exams, and learn during your rotations. And then you will graduate, and study, and pass the board exam. And then you will work as a PA."

I couldn't argue with him, because he was right. But, it does not feel that simple. There is so much to learn about medicine and it's impossible for one person to know it all. And therein lies the responsibility...the heaviness.

On the flip side, if it were that simple...I wouldn't be interested anyway!!

Semester 2 Countdown

I really cannot believe that Semester 2 is coming to a close. Three finals are done...only 10 more to go!!

This week was a rough one though. I spent the majority of the week recovering from a stomach virus. That was not fun and it made last week's jet lag seem like a piece of cake! When you're not feeling great, it's hard to focus on anything...especially studying.

Today was our Pediatrics final exam. I did really well on the first two exams but I had a feeling that this exam was going to be a doozy. And, although my gut was out of whack this week...I was right. One of the best things about my class is that we all seem to react to the exams in the same way. And it feels really good when you walk out of the classroom and see your classmates in the hallway with expressions on their faces that match exactly how you're feeling.

After several minutes of moaning, groaning, and bickering about answers, we wind up laughing at each other and at ourselves for the different reasons why we chose an answer. My personal favorite is, "when in doubt...pick all of the above!" We've learned by now, that life goes on after ridiculous exams...especially on Fridays when Happy Hour begins at noon!

I have learned some very useful skills over the last few weeks. I've learned how to insert foley catheters, nasogastric tubes, and draw blood. Learning how to draw blood has been my least favorite experience. I do not have a problem dealing with the sight of blood...as long as it's someone else's blood! I do not like to have my blood drawn. I do not like needles going into my own arm. And I do not like having students practice drawing blood on my arm!

I was lucky though since my partner was an experienced phlebotomist!

Trust me, that was not a lucky coincidence! ;)

Scrubs

If you took the cast of Scrubs and filmed them during the didactic year of medical school, you'd get a really good sense of what it's like to be in my class! Tonight was yet another episode full of laughter!

We had two hours of Physical Diagnosis lecture tonight and the MD featured the entire two hours on the RECTUM. Normally this MD gives us powerpoint handouts, but tonight he told us that he just wanted us to sit back and learn by observation. Yup, that meant that we looked at slides of different rectal disorders for 2 hours!!! It was downright disgusting!!!!

The doc lecturing us has a great sense of humor so that encouraged the other comedians in the class to bring it up a notch. I laughed so hard that tears were streaming down my face.

It's nights like this that carry us through...

Last week was a long week but I got through it and the jet lag is gone. But, I'm still getting to bed before midnight and I'm kind of liking the extra sleep! I wound up doing really well on the cardiology and ophthalmology final exams. Which is ironic since I didn't study as much as I usually would for them. So, perhaps I don't need to study as much as I think I do?!?! (wouldn't that be nice?)

We got our May schedule and the semester ends on the 26th. We have 12 final exams to get through in 26 days! At this point in the game, I'm not even phased. We do have 5 exams back to back in 5 days though, so that will be rough no matter what. But, all things considered I feel like I'm on auto pilot now and cruising through. I'm not saying it's gotten any easier, but I know what to expect at this point.

I really enjoy being around my classmates, we're a quirky bunch, and that makes all the difference in the world. When things get ridiculously stressful, someone will break the ice and make us laugh. Spit balls and passing notes has become a favorite pasttime. Before I started the program, I never would have thought that spit balls would be part of the equation! But, when you're bombarded with 9 hours of lecture, day after day, your brain turns to mush and wacky things start happening. And I wouldn't have it any other way...until, of course, I get nailed in the head with a spit ball!

So, I get a week off in between semesters, then it's full throttle until August 10th. Then we actually get a 3 week vacation before clinical rotations start September 5th. And although the thought of rotations is scary...I'm ready to move out of the classroom and into the field. They say the first year is learning how to pass exams in order to pass the PANCE (PA National Certification Exam). And the second year is when the real learning begins. All of the MD and PA instructors keep reiterating that medicine is not learned from a book...it's learned in practice. And, quite frankly, I'm ready to start practicing!

But, before I get to that hurdle I have get through the next 12 exams!!!

Un Dia Sin Inmigrantes

Wow. I apparently missed a lot of news while I was away.

I'm tempted to skip school and show support for the "Day Without Immigrants" rallies planned across the country. Or perhaps I'll just boycott big business for the day.

I'm hoping that a lot of good comes out of these demonstrations.

Every girl has a dream...

http://news.yahoo.com/s/ap/20060430/ap_on_re_us/immigration_boycott_day

Jet Lag Recovery

I will never complain about last minute scheduling changes again!! (yeah, right!)

Well, luck is on my "Jet-lag recovery" side. Today's opthalmology exam was fair. And our Dermatology class from 4-8pm was cancelled! Then we were informed that our Cardiology final exam was being rescheduled for Wednesday morning! Apparently, the MD forgot to fax the exam to the office before he left for his Las Vegas vacation!

Thank God MDs are human!!!

This gives me another night to get back on track. I'm finding it really odd that I've been in bed by 10pm and up by 6am every day...I know that's normal for most normal people...but, it's really odd for me. Especially since I'm studying early in the morning instead of late at night.

But, I'm sure I'll be back to my normal 2am, lights-out, routine by the end of the week.

Oh, there's also a rumor that we will be getting a 3 week vacation in August...right before we start our clinical rotations in September!

I'm already trying to figure out where to go next...

Post-Nippon Blues

My trip to Japan was wonderful. Unfortunately, I do not have the time to write about it. Which is a real shame. I have two exams over the next two days and Jet Lag is kicking my butt. It's always harder coming home...even harder trying to study!!!

My greatest piece of advice to prospective PA students has been to simplify your life as best you can. Well, my trip to Japan blew open the doors I had steadfastly closed shut for the last couple of years. Now that they're open, I'm not so willing to close them back up.

I'm distracted. I'm daydreaming. I'm totally preoccupied. I'm longing for another chance to go..."on the road."

I did have a lucid nightmare in Japan, about showing up to school totally unprepared for an exam. So, school was never too far from my mind. And I know that once I see my classmates tomorrow, reality will sink in and I'll get back into the race.

But, for now...I'm dreaming of cherry blossoms and clinging to the love that radiates from a country 6,000 miles away.

Most things in Japan get "lost in translation"...but love never does.

It just never does.

Full Circle

I've been pretty busy studying and preparing for my trip to Japan. By preparing, I mean bringing over enough "omiyage" (gifts) in order to make sure I don't offend anyone. I basically have to bring a gift to every home that I visit...and it's also wise to have some extra gifts handy just in case I wind up somewhere unexpected (like back at the school where I used to teach etc. )

I've been really enjoying getting to know my classmates. First semester was about surviving and proving to myself (and others) that I do indeed belong there. Second semester has been about stressing less about passing tests and more about strengthening bonds with people in the class. Before you start PA school, everyone tells you that your PA class will become your second family....and that truly is the case once second semester rolls around.

I feel as though the experiences I've had in the past are definitely carrying me through this semester as well as enriching my life as far as being able to connect with others. My experiences traveling the world is on top of the list. My Cambodian classmate is going back to Cambodia during spring break but must fly to Vietnam first. I've been helping him out with his plans. He originally planned on crossing the Mekong Delta in a canoe, but realized over the weekend that because of the "Dry Season", there's not enough water to carry him over and walking it would take too long. My father bought him the Lonely Planet travel "bible" on Cambodia and I sat down with him this morning and we mapped out a plan for him. It's also a much safer plan than the one he originally proposed. There are still plenty of mines that haven't been detonated in the forest between Vietnam and Cambodia...something he hadn't considered.

I also have a classmate that was a corpsman in Iraq. He saw a lot of death and destruction and he asked me about my father's experiences in Vietnam. So, I showed him an article that I wrote about my father's trip back to Vietnam in 2000 and now they're email buddies.

My experiences working for an AIDS organization has given me the opportunity to work more closely with some of the administrators/instructors of my program. I've been asked to help out in finding a Doc/PA/NP to come in and teach our class about HIV medications. I'm also hoping that I will be able to lecture my classmates on HIV/AIDS disease progression and dispelling the myths that still surround HIV. Unfortunately, some of the experienced medical professionals that have taught us about HIV are addressing topics insensitively and misinterpreting the laws regarding partner notification.

So we'll see how that goes...

I've got one more exam and three classes to get through before I can focus on my trip! I'll be up late Tuesday night packing....then heading to the airport Wednesday morning. I'm psyched about this trip. I've had my head in the books for the last 8 months and I need to get a grip on the BIG PICTURE. Leaving the U.S. always does it for me! I did have a hard time making the decision on whether or not to go...but I've definitely learned that I function better when I have more stuff on my plate. And my plate is definitely full...2 exams the first two days after break!!

But, I have two 14 hour flights....that's plenty of time to study!

This is my time to get back to living my life...

DVT

So we're sitting in Pathology class and the prof is talking about DVT (deep vein thrombosis) and his example for DVT was, "a passenger on a 14 hour flight to Tokyo is at risk for DVT!"

I cracked up laughing and so did my friends around me. Although I have no other risk factors for DVT, it's definitely going to be on my mind. I'll be the annoying passenger telling others on the plane to walk around!

I have 4 exams to bulldoze through before I leave next Wednesday! Exams have been going really well and I'm encouraged by the fact that most have been board exam scenarios. I cannot believe the amount of material we have blasted through over the last 7 months...it's enough to make my head spin.

And it's enough to give me insomnia. Other than that...things are well.

I'm hoping jet lag will cure me!!!

Japan Bound

I bought my ticket to Japan!

Japan Bound!!

We finally got our April schedules...on March 31st. Waiting for the following month's schedule is perhaps the most frustrating aspect of my program. Especially when spring break is fast approaching!

I knew the dates of spring break, but I didn't know the exam schedule. To my surprise, April looks like a manageable month for exams. However, 2 more classes were added on: radiology and hematology. But, we're finishing up pathology and cardiology soon.

I've been weighing the pros and cons to taking an impromptu trip to Japan all week. The most obvious con is jet lag. BUT...I haven't slept well since the program began back in September!!! So, I know I can deal with it.

After I booked my trip, I felt relieved and excited! I have received welcoming emails from my friends in Japan. All I really want to do is visit the people that became my second family while living 3,000 miles from home. Life in Japan can be a very isolating experience. If you want a glimpse as to what I'm talking about, rent the movie "Lost in Translation".

When I decided to extend my teaching contract for a second year, I decided I would really focus on solidifying my relationships with my Japanese friends and surrogate families. And that decision has brought many blessings into my life.

And that is why I want to return to Japan.

Spring Break

Big decision to make.

Spring break is quickly approaching. I've been thinking about going to Japan to visit my friends and "family" for some time now. I met some amazing people during the two years I lived there and it would be somewhat of a homecoming for me. I left Japan in 2000, visited in 2003...and it's now 2006.

My former JHS students are now in college! More friends have gotten married and more babies have been born.

And I'm a PA student.

It may be time to introduce the Japanese to the PA profession...

OB/GYN

When it comes to OB/GYN...ignorance is bliss!!!!

OB/GYN

We have an OB/GYN mid-term on Tuesday. During class today (sunday class, mind you)...the guy sitting next to me whispered, "I think I have PMS!" He was studying the OB/GYN notes and told me he was suffering from the following symptoms:

Weight Gain
Headaches
Irritability
Aggression
Tension
Anxiety
Depression
Lethargy
Insomnia
Appetite change
Loss of concentration
Poor coordination
Clumsiness

Although these are all somatic/psychological symptoms of PMS, I opted to diagnose him with the most obvious differential diagnosis: PA School Blues. Then I swiftly reminded him that his symptoms will resolve in 18 months. Unlike the rest of the females in the class...

But, perhaps that is why there are more females in PA school these days.

We're genetically programmed to handle the recurring and unrelenting stressful symptoms of both PA school and PMS!

Who knew PMS could be such a blessing?!?!?!

Dept of Labor

The Dept. of Labor ranks the PA profession as one of the fastest growing occupations in the country. Because of this ranking (last I heard it was #4), it's been featured in magazines and newspapers around the country. I'm not sure which publication featured the profession in the NYC area, but everytime I'm in Brooklyn and tell someone what I'm doing...I usually get one of the following responses:

1. Why not be a doctor?
2. That's great, it's only a two year program!
3. That's great, you're going to make a lot of money!

For the sake of time, I usually only address the first statement and nod my head to the 2nd and 3rd statements. But...here's what I'd like to say...

1. The PA profession is a better fit for my personality, career goals, and personal goals. And PAs report greater job satisfaction in comparison to MDs!

2. It's not really a two year program. The professional phase is 2 years. The pre-requisite phase is 2 years. The health care experience requirement is at least 2 years. Considering my previous psych degree, healthcare experience and pre-reqs...I'm in year 10! TEN YEARS!

3. If you're motivation to become a PA is to make a lot of money, you're NOT going to make it through school. PAs do make a healthy living, but can you really equate a dollar amount to the responsibility that comes with having patient's lives in your hands? You have to be passionate about medicine, passionate about helping people, passionate about learning. Medicine is constantly changing, it is a life long educational process.

There are continuing medical education credits that need to be completed on a yearly basis as well as re-certification board exams every 6 years. In my opinion, there are easier ways to make a comparable salary...and if money is your main goal...re-evaluate your options.

You will not be a happy camper.

Mach Speed

Besides the absolutely insane, mind blowing pulmonary exam 2 weeks ago....March has been a very quiet month. We had a physical diagnosis exam a few days ago and I didn't even get nervous. I had to perform a neurological exam on a fellow student and it worked out really well. We are required to memorize a ridiculous amount of information for these practical exams as well as perform a ridiculous amount of maneuvers/tests that aren't really used in practice anymore. It can be frustrating, but at the same time, it is a confidence booster once it is all done.

We have our first OB/GYN exam next week and although there is a ton of material, it's the only exam next week, so it's definitely manageable. And that's the scary thing...March has been manageable.

April and May will NOT be the same. Once again, we KNOW this is the calm before the storm. Once again, we KNOW we're going to get slammed with several back to back exams for a few weeks in a row. Once again, we KNOW we will be challenged intellectually, emotionally, and physically.

Once again, we KNOW we'll do fine...but we'll freak out anyway!! I know I will get a phone call at 2am the night before an exam from one of classmates freaking out! I know I will call one of my classmates the night before and freak out as well! And I also know that as long as I walk away from an exam knowing I tried my best...I will sleep well that night.

April will be interesting. We have 7 days of class and then we have Spring Break! Unfortunately, we will have exams the week after break. And by then, it will be the end of April...the semester ends mid-May!!

Once again, life is about to take off at mach speed!!

I'm ready!

School Daze

School is going well again. And I'm enjoying all of my classes. Here's a list of the classes for this semester:

Cardiology
Pharmacology
Pathology
OB/GYN
Opthalmology
Dermatology
Physical Diagnosis Lab
Physical Diagnosis Lecture
Intro to Surgery
Surgical Nutrition
Lab Medicine
Pediatrics
Hematology
Pulmonology
ENT (Ears Nose Throat)

So, that's the reason why we're in school 6 days a week. At this point, I don't really mind it because I love learning about medicine. It does stifle social plans...but, I'm used to that by now. I feel really lucky to be surrounded by the classmates in my class. I've gotten to know everyone a lot more compared to last semester. Last semester for me was all about survival and making my mark. This semester is about embracing where I'm at and building confidence by gaining knowledge and next semester...next semester will be about breaking out my wings....cause in September, it's time to fly!!!

The greatest difference between this semester and last semester is the schedule. Last semester we had to be in school by 9am every morning. Each class was 3 hours long. Most days we had between 6-9 hours of lecture.

This semester, most classes start at 10am, but some days, not until 2pm! Lectures last anywhere from 2 hours to 6 hours!!! There is no routine, no flow...every week is different. We also have several instructors for one class. Nothing is routine. Nothing.

I'm handling it a lot better now. As are most of my classmates. It's so reassuring when everyone else complains about the same thing! But, it took us a while to figure out why we were all stressing out so much compared to last semester.

As excited as I am to start rotations (September), it does cause a lot of anxiety. I'm pretty confident sitting down to take exams now. If you give me a multiple choice question, I'm pretty good at picking the right answer. The real challenge for me will be when I'm doing rounds and my supervising physician asks me a question without giving me a, b, c, or d!!! I know this is a common fear shared by all of my classmates...but, the thought still freaks me out.

So, I try to keep it all in the day. I'll deal with it when I get there!

Read This

http://hotzone.yahoo.com/b/hotzone/blogs2986

This is an incredible story.

The "Fun" Stuff

Today was one of those days that I will remember for years to come. We learned how to perform pelvic exams!

Thankfully, we practiced on plastic models and NOT on each other! There are 2 guys in my physical diagnosis lab group and they had absolutely NO idea what women went through each year! Watching their facial expressions during the demonstration was priceless.

Although we were only practicing on plastic models, it was great practice for the real deal. And although I really am not looking forward to performing countless number of pelvic exams during my OB/GYN rotation, I'm excited that I now possess the knowledge and skills to perform such an important medical screening procedure.

Next week: Rectal exams! Once again, I'm thankful that we're practicing on practice models and not on each other!!!

Greater Perspective

I've been struggling lately with re-gaining my perspective on what I'm doing. The last few weeks have been really challenging, both intellectually and psychologically. The last few weeks haven't been that much fun either. And although I always try to focus on the big picture...I readily admit that I lost my perspective for a while.

Over the last few days, the universe helped me get it back. Thanks to the help of supportive family members (st. patty's day family party) and friends (www.bogotabistro.com) . As well as a phone call from an old soccer teammate, who is now the chief resident of pediatrics in Chicago.

My childhood friend attended an accelerated 6 year medical program (undergrad plus medical school) and became an MD by age 24! She is now moving back to NYC to complete a fellowship in pediatric cardiology. She empathized with my feelings and listening to her express how she felt while in medical school comforted me. I know she continues to make personal sacrifices in order to be the best doctor she can be. She's an inspiration to me, and always has been. Her phone call came at a time when I needed it most.

Thanks, Dr. Shetty!

Temporary Insanity

Just when you thought it couldn't get anymore stressful...

We now have classes 6 days a week! My only day off is Saturday.

I will continue to train clients at the gym Saturday mornings.
But, no more hostessing. No more sleeping in.

Something's gotta give.

My new daily mantra, "This is only temporary!"
Temporary insanity.

T-rex Ain't Going Down Like That!

We weren't supposed to have class until 5pm on Thursday (the day after the "Nerds Gone Wild"). I was really looking forward to sleeping in, making eggs, and watching The View with a nice cup of coffee. But when my phone rang at 10am, I knew my plans for a relaxing morning were ruined.

I wasn't a very happy camper when our class president called saying that we were EXPECTED to be at the school at noon to review the test (massacre) from the day before. The stress from the day before was still lingering. And the post-test anxiety kept me awake half of the night. Needless to say, my nerves were still frazzled.

I received a few phone calls from classmates that were thinking about not going in early as a form of protest. I fully understood where they were coming from, and as much as I didn't want to go in early, I couldn't not go. I signed up for this. I chose this path. And this was part of the game.

About 90% of my classmates showed up. When our pulmonary instructor walked through the door he smiled and said, "Don't attack me!" I was relieved to see him smiling. I was certain we were going to get yelled at for doing so poorly on the exam. But, to my surprise, we heard the opposite.

The instructor said, "I know you guys were upset with me and with the exam, but I am VERY happy with the results! You guys did a great job!"

WHAT?!?!?!

The instructor then addressed EVERY SINGLE one of our concerns. He listened to us as we expressed our disgust at getting tested on information we never learned. He listened to us as we expressed our dissatisfaction with some of our lectures. He listened to us as we told him about the unnecessary stress we went through.

The bottomline is that HE LISTENED TO US. And that made us all feel better.

Then the director of the program came into the room and also congratulated us on doing a good job on the exam. He told us that they purposefully put 30-40 questions on the exam that they knew we weren't prepared for. They did it on purpose. They wanted to see how we would do. They wanted to see if we'd crack under the pressure.

The highest grade on the exam was an 80. They told us that if we scored between a 60-80 then we did well. They told us that the majority of the class did score in that range and that our scores were higher than the national average for board questions at this point in our training. They told us to be proud of ourselves.

I felt very confused and overwhelmed by what he was saying. My classmates weren't fully buying it. The director also fielded questions and addressed our criticisms and concerns about our education. The director responded with, "You guys have to TRUST ME...we've been doing this for a long time and we want every one of you to succeed and pass the boards...TRUST ME!"

After he left, the instructor spent the next 2.5 hours reviewing the exam with us. He reviewed the questions that the majority of the class got wrong. There were 35 questions on his list and with every question he asked us why we got it wrong...what we thought the answer was...and if it was a fair question based on the education we received to that point. It was unbelievable and even moreso when the class accepted responsibility for the questions we legitimately got wrong.

I have to say that my classmates are extremely professional and mature when it comes to stuff like this. It's refreshing to be surrounded by classmates that hold themselves accountable for their actions. A class that is more concered with learning how to take care of patients than outscoring each other on exams. Although I have a hard time believing everything we're told...I do believe them when they say we're a "special group". Your classmates make all the difference.

After we finished reviewing the exam, we all went upstairs to the program office to get our "unofficial" grade. The grades will be curved after all. But we all wanted to know if we fell within the coveted 60-80 range. So we waited on line, single file, and one by one went into the office to get our grade.

When I walked into the office the instructor said, "Good job!" I scored within the range. But, I still felt uneasy about the experience.

It's taken me a couple of days to recover from that traumatic day. For the first time in my life, I've put ALL of my eggs into one basket. My life revolves around school. I've never had to work so hard before to achieve a goal. I've made many sacrifices to get to this point and to sit down at an exam and not know the answer to 20+ questions is a very unsettling experience. It freaked me out and I got scared. And for the first time since the program started, I caught myself thinking, "What am I doing this for?"

So, my next challenge is to turn that fear into motivation. I'll be damned if I sit down for an exam and get hosed like that again.

T-rex ain't going down like that.

Nerds Gone Wild!

Today was not a good day.

We had a cumulative final exam on the pulmonary system. I did well on the mid-term so I felt somewhat secure going into the final. But, I still studied my butt off and sacrificed yet another weekend to hit the books. But, for some reason...in the back of my mind...I felt like no matter how hard I studied...it wasn't going to pay off.

I started the exam and the first 5 questions were easy. I was getting into the groove and felt optimistic about the next 95 questions. But, for some reason, I noticed that the room was especially quiet.

It was, indeed, the calm before the storm.

Twenty minutes into the exam one of my classmates busted out laughing and said, "Are you kidding me, we never learned this!" This classmate is usually very reserved and quiet (no, it wasn't me!) and shocked the proctor. In fact, she shocked the entire class. The proctor quickly walked over to her, but by then, it was too late. The ENTIRE class had erupted into chaos.

For the record, our class is normally well behaved and professional.

"Who wrote this exam?"
"Where is the instructor, this is ridiculous!"
"Are you ***** kidding me?"

I've never seen anything like it. A class full of angry, smart people revolting over the fact that they were getting hosed on an exam.

"Nerds Gone Wild!"

When other people freak out, I get calm. So, I sat back and observed. Some were so angry, their faces were bright red. Some were muttering curse words under their breathe. Others wiped tears from their eyes. One girl even stood up and walked around to calm herself down. I'm telling you...it was CRAZY!

It may sound strange, but some of the questions provoked strong feelings of anger and betrayal. And I will try to explain why...

We were set up by the same man that told us..."there ain't no crying in PA school". The same man that reminded us that we would be held accountable for everything that we've learned up to this point, on any exam, at any time. So we studied our butts off...and we were given questions on information that was never EVER presented to us. I'm not talking about a few questions here and there....I'm talking about blocks of questions...between 30-40 questions on a 100 question exam!

There were clinical questions that included lab results and radiology findings. Yet, we haven't taken lab medicine or radiology yet. Clinical questions require critical thinking and that is what this exam was all about. Critical thinking was not the problem. But, when you haven't been taught two major components that would lead you to a diagnosis...it's frustrating. VERY VERY FRUSTRATING!

The worst part was that halfway through the exam, the proctor left and brought in one of the instructors that wrote questions for the exam. With a smirk on his face, he said, "these are the types of questions you will get on the BOARD EXAM!" That didn't do anything to help my psyche. Although we don't take the board exam for another year and a half (!!!!)...it still struck a nerve within each and every one of us.

Some students left the exam early. Others put down random answers. The majority of us stuck it out and battled through it. We were given 3 hours for the exam. It took me 2 hours and 45 minutes.

I felt completely drained afterwards. As well as the stupidest PA student to ever walk the earth. It wasn't a humbling experience...it was a demeaning experience. Nobody likes to feel stupid. But for some reason, they put us through it. For some reason, they upped the ante without dealing out all the cards.

For some reason, they wanted to strike that nerve within us.

And T-rex doesn't like that.

The Art of Practice

Medicine is not an absolute science. Our pediatrics instructor constantly reminds us that practicing medicine is an art form. There are so many variables and so many different treatment options. When you become a PA or an MD, you get a license to PRACTICE medicine. The key word is practice.

Now, I didn't learn that from a PA/MD/PhD instructor. I learned that from a man living with AIDS. A man who was told he was going to die since he only had a handful of t-cells left. For 2 years, that man was continually told he was at the brink of death. But, he continued to live. And one day, his t-cell count began to rise. And suddenly his medical team was telling him he was going to live. And he did...for 8 more years.

Before he died, I told him I was considering a career as a PA. I had many doubts about whether or not I had the brain capacity to know all there is to know about medicine. And that is when he told me, "Medicine is very challenging, but you have to keep in mind that you will get a license to PRACTICE medicine. I used to get very angry with my medical team until I realized and accepted that there wasn't one person with all of the answers. Until I realized that no 2 human bodies are exactly the same. And I found great peace when I discovered the power of the human spirit. I was told I was going to die 8 years ago...and my spirit said NO!"

So when I find myself getting aggravated by the "know-it-all" PA/MD/PhD instructors...I think of this man, this man who defied the transient laws of medicine and I quickly regain my perspective.

I am a student studying the art of medicine. And like every artist in training, I'm developing my own style. A style that will incorporate the power of the human spirit.

STOP Smoking People!

If people didn't smoke, I'd have a lot LESS studying to do.

Smoking is a risk factor for a bizillion different diseases. And I have to know them all!!!

So, if you're lacking in motivation...please do it for me!!!

This PSA announcement is brought to you by a very tired (sick of studying) PA student.

Academy Awards

Life requires skillful acting at times.

After my performance this weekend, I'm likely to be nominated for an Academy Award next year.

So, after PA school, I think I'll head to Hollywood. Afterall, I wouldn't mind playing opposite Patrick Dempsey on Grey's Anatomy.

I've got the medical terminology down...

Good Stuff!

The messy fog of doom and gloom has lifted.

1. My Godson, Cross Alexander, was born Monday night!
2. I can read EKGs!!!
3. Mid-terms have ended!
4. I slept for 7 straight hours last night...the most sleep I've gotten in 10 days!
5. I will be hostessing Friday night at Bogota!

I feel like a new woman! (actually, it's just nice to feel HUMAN again)

Although mid-terms ended last night, FINALS begin next week for some of the classes. Time is going by so fast that it's hard to figure out what is going on at all times. I can't believe it's March 1st!!!

I START ROTATIONS EXACTLY 6 MONTHS FROM NOW!!!!!

Heartbreak

I suddenly realized why I DETEST Cardiology.

The human heart breaks too easily.

Busted Weekend

I declined on the two party invites.
I cancelled all of my gym clients.
My friend from out of town flaked.
And study group plans went awry.

All in all...it was a busted weekend. This was the third weekend in a row that I spent holed up in my room studying. Two more exams this week and no idea what is happening next week, because we haven't gotten the schedule yet.

I'm a strong girl and I can take the hits, but this semester is a nightmare compared to last semester. One of my peers remarked, "I don't want you to take this the wrong way, but it kind of makes me feel better knowing that you're struggling with everything right now...you're always so composed and stoic."

I didn't take it the wrong way. Misery loves company. And right now...misery abounds. We're all feeling this way and now I realize why they say your peers become your family. In that respect, it's awesome.

I know it will change and I know it will get better. And I know it's par for the course.

And I also know that I need to go to Bogota for some much needed TLC.

www.bogotabistro.com

Snack On This

According to the 2001 Surgeon General's report..."the gains made in past years to improving cardiovascular health have been reversed due to obesity."

Since McDonald's opened it's doors (1950's?), there has been a 300% INCREASE in OBESITY.

Lastly, the greatest factor correlating with the development of obesity is the presence of a TV in a child's bedroom.

Just random facts I wanted to share.

NERD

Sorry to keep you hanging with the last post. Everything is ok. The instructor (a 30 year old "doogie howser" type PA) called us in early simply to review the test. He got a lot of feedback after the exam and gave us the benefit of the doubt on some of the questions. He reviewed the questions that the majority of the class got wrong and then entertained our arguments. I didn't have to contribute during this process because my peers who are used to getting 100's on every exam (there's always a few in every class!) were practically throwing darts at the instructor.

I found it quite comical. But, it was nice of the instructor to review the exam. I wound up doing well on it...considering I thought I had failed. He admitted that there were TWO RIGHT ANSWERS to most of the questions, but that the Board Exam we take to get licensed is written in the same format. So, you have to pick the MOST RIGHT answer.

So, it was definitely a learning experience.

I've been really busy this weekend studying for the next round of exams. We have Pediatrics and Pathology back to back (Tues/Wed). I'm grateful for the 3-day weekend, but it's not long enough. You have no choice but to cram for every exam. It's Sunday night and I still haven't touched Pathology yet.

On Thursday, I go to the hospital to conduct a history and physical on my first real live patient (don't worry, they've already been examined and admitted!)! I'm totally looking forward to it, but the timing could be better. Not only do we have exams, but we have between 6-8 hours of lecture each day as well.

And then there's CARDIOLOGY. I am NOT a fan of cardiology. I can't articulate why I'm not a fan, but I've felt this way for quite a while. And we were taught how to read an EKG in three hours. And three hours wasn't long enough for me! I don't like it. I read an EKG and get a headache from the tiny little boxes. All of the waves look the same to me. To top it all off...the instructor (Cardiologist MD), told us that we HAVE to be able to read an EKG in 15 SECONDS. I thought he was going to say 15 MINUTES. At that point in the class, I started laughing. And this is the first time since the program started that I feel totally clueless.

The EMTs and paramedics in the class say that reading an EKG isn't hard. But most of them have been ACLS certified and reading them for years. So, my advice to pre-PA students...learn how to read EKGs before starting a program. I think it should be a pre-requisite!

If it was a pre-requisite, I'd be able to enjoy next weekend. I have a friend coming in from out of town whom I would like to spend time with, as well as two party invites. But, I won't be able to relax until I nail the EKGs...and unfortunately, there is not enough time to get that done before next weekend.

Adios mio...it's not easy being a NERD!!! ;)

Uh Oh!

I just got a call from our class president. The instructor of our pulmonology class wants everyone to report to class an hour earlier than scheduled...today! We originally didn't have to be at school until 2pm...I got the phone call at 11am. My classmates are scattered all over Long Island...from Brooklyn to the Hamptons!

One more reason why I'm glad I only live 15 minutes away from school!

The instructor wants to review the exam that we just took on Monday. The exam that I said I didn't think I did well on. The exam that everyone left saying they didn't think they did well on. This is the first time an instructor is reviewing an exam with us....and it's the first time that we've had to report to school early and unexpectedly.

The fun never ends...

Happy V-day

I survived the autopsy experience. We were "lucky" in that we were able to view 4 different bodies. Some days there aren't any bodies being worked on.

LUCKY ME!

This is some background on one of the bodies. It was unreal.

http://www.newsday.com/news/local/longisland/ny-lifire114622595feb11,0,2608836.story

As well as a 58 year old man that dropped dead after shoveling.

There was also a 22 year old man who died of a heart attack. Cocaine was suspected.

And then there was the 70 year old man whose body wasn't found until 4 weeks after he died.

The smells are worse than the visuals.

More about this later...my brain hasn't had enough time to fully process what I saw today. And I'm trying not to think about the families in mourning.

It's not easy.

On a side note, it was a great bonding experience for me and my classmates. The six of us (2 guys, 4 girls) went to a diner afterwards and chatted for over 2 hours. It was great to vent and realize that we're all feeling the same way about this new semester. It was also a good opportunity to poke fun at the GUY that was dry heaving during the autopsies!

He's never going to live it down!

Autopsy Tomorrow

The autopsy will go on as scheduled. Our group leader called and there is a body waiting for us tomorrow morning. There are 6 other students in my group and they are 6 of my closest friends from class. That puts me more at ease, because if I happen to pass out, I know they'll catch me!!! The two guys in our group are tall, so if need be...I can always stand behind them.

I asked our group leader if he had any information on the body. His response was, "Think about it like Christmas morning, you always want to be surprised, right?"

So if you want to go to PA school, add one more pre-requisite on your list: a sick and twisted sense of humor!

It's necessary for your survival!

Keep your fingers crossed...

Everest

So the first two exams of the semester are done. One of them went amazingly well (physical diagnosis lab) and the other (pulmonology), not so well.

I had two answers for many of the pulmonology questions. I also had information in the back of my brain supporting either answer. In the beginning of the semester, this instructor told us that he didn't care what our grades were on the exam. He only cared that we learned the material. He also mentioned that he was open to being challenged on some of his exam questions.

I clearly remembered his words and feared that he would give us ambiguous test questions. Well, today's exam just proved that his exam questions are open for discussion. I think he would rather have students in his office proving what they know verbally, than on a multiple choice exam. I did my best on the exam and wrote down the reasons why I could have gone either way with each answer. If I do poorly on the exam, I'll be the first one at his office door.

Medicine is not simple. You need to think outside of the box. I have a tendency to think way, way, way outside of the box! That skill will help me as a diagnositician...but not as a test taker. I don't like rote memorization. I want to know who, what, when, where, and why. And there is not enough time for that.

Last semester was very challenging, but it only brought me to base camp. This semester, I feel like I'm at the foot of Mt. Everest. And when I look up, I'm easily intimidated. But, when I look down, I realize there's no turning back. I've got no other recourse but to keep on climbing; step by step, steady and slow.

I have to get to the other side of the mountain.

I just have to.

Stress

The stress is back on. Exams start next week. 5 exams in 2 weeks, but there is the possibility that more will be added on. This semester has a different feel to it and I'm not exactly comfortable yet. All of the instructors are practicing PAs and MDs...the PhDs are gone. Every class is clinical...no more fanciful theories that enabled your mind to wander and explore. Now, it's medicine.

Now it's all about coming up with diagnoses and differential diagnoses. At this point, I'm blown away by the fact that I have the knowledge to be able to do this. The learning curve has increased exponentially. More is expected of us. Last semester was about passing every class. This semester is about nailing every exam and increasing your knowledge base.

As our director said, "You are all thoroughbreds now and the starting gate has opened. You need to get to the head of the pack and stay there. There's no looking back...you gotta keep on running."

I've cancelled my plans for the weekend.

It's time to get serious again.

Valentine's Day

I've already got a date lined up for Valentine's Day! And it promises to be one of those, "I'm going to remember this for the rest of my life" experiences! Sounds intriguing, eh?

Well, I'm scheduled to go down to the County Medical Examiner's Office to view an autopsy.

Yup, an autopsy on V-day...how apropos!

Our pathology instructor says it's part of the desensitization process. I'm always up for a new experience, but I will admit that I am nervous about this one. At least with the cadavers, we knew it was going to be one male and one female. And we also knew that they donated their bodies to science. We won't have any idea if we're going to be watching an autopsy of a baby, kid, adolescent, adult, or senior...until we walk through the door.

And I find that quite unnerving.

But, as my father stated so eloquently, "You gotta get over it, KID!"

Brooklyn Birthday

It's Superbowl Sunday and instead of settling down with chips and beer, I'm prepping to go to Brooklyn to celebrate George's 30th birthday at Bogota! Apparently, watching football isn't something cool, hip Brooklynites do anymore. So, I'll be sipping on a mojito, snacking on shrimp ceviche, and mingling with the non-football loving types!

I simply enjoy watching any kind of competitive sport. I didn't get to watch much football this past season because I was always studying. The fact that I'm missing the big game is a testament to the love I have for my dear friend, George.

However, there is a hoppin sports bar down the street that I may just have to visit. C'mon, I'm a single gal that loves football. This is MY night to shine! haha

Happy Birthday, George!

www.bogotabistro.com

It's Not Good

I was hoping to leave the bio-chemical terrorism seminar with some inside information. I was hoping to share some good news about the progress that has been made over the last few years. But, from a healthcare standpoint, it's not good. It's actually really disturbing and if I get into it, I won't sleep tonight.

I can't really say that I learned anything new other than the fact that there's evidence of bio-chemical warfare dating back to 2000 BC! Which means that people have been trying to kill other people with chemicals for a really long time. I don't consider myself an optimist, pessimist or even a fatalist. I happen to jive with the realists. Most experts say that it's not a matter of if...it's a matter of when, and where. And I believe that to be true. I believe that to be the reality of the world that we live in.

I really hope that I am not working in the ER when it happens.

But, if I am working, I am now trained to recognize the signs and symptoms of a bio-chemical attack. I'll even know what to do, but I learned that there are not enough meds to go around. I learned that nearby hospitals do have protective gear for healthcare workers, but when today's speaker visited the local hospital, the healthcare staff couldn't find them!

Like I said, it's not good. And I'm starting to get into it...and it's late and I need to sleep so I can learn how to practice medicine tomorrow. Perhaps when I complete this program and walk away with my Master's in Public Health...I'll be able to work on a solution. But, for right now, I'm saying a prayer, then pulling the wool over my eyes and going to sleep.

That's the best I can do...for now.

Sunday School

Sunday School has an entirely different meaning for me now. Tomorrow kicks off the Sunday School experience with a 7 hour seminar on Bio-chemical Terrorism!

Nothing like a relaxing, peaceful, harmonious Sunday to start your week off right.

"There's No Crying in PA School"

The title of this post is a direct quote from the director of our program. Dr. P waivers between nuturing us and terrifying us! He had told us in the beginning of the year that he was trying to change his approach towards students in response to negative criticism he has gotten in the past. I give him credit for acknowledging this criticism and attempting to change his ways.

"There's No Crying PA School" is in response to previous students' complaints about material on exams. Students have complained that during the 2nd and 3rd semester information that is presented by one instructor is often tested by another instructor in a different course. Basically, we're responsible for everything that is being taught to us at all times! Sounds like a reasonable request, but when you have 11 subjects being taught in one semester...it's a bit much. So, we were warned NOT to approach the admin or the instuctors about this! And if we end up crying to him in his office, he will kick us out!

So, I'll save my crying for this blog!