A Work in Progress

I am happy to report that I officially got my "C" last week.  PA-C that is, after stumbling through a five hour, life-changing exam.   A few weeks ago I was really feeling fine about it until my neighbor said "Oh you're test is soon?  Pretty cool as it's like the culmination of two years work right?"  I left the conversation wide-eyed thinking, yes, two years of work.  Although that isn't so accurate.  Really, it's been like three years of taking prerequisites, re-teaching myself chemistry, saving money, boosting my resume, applying, being rejected, applying again, waiting to start, then 26 months of studying and scraping by, moving twice, working all of the holidays, first days, feeling intimidated, scrubbing in, fitting in, moving on, conferences, studying, studying, studying.  As I walked away and all of this sank in, I started to panic, and panic studying gets me nowhere.   What did I do with the last few months?  Why did I re-w...

Suffice to say it has been a weird period in PA school. We were pulled from clinical sites in the middle of March and it is possible we won't go back before graduation.  Second year is clinical only so there is little substitute to be had.  We have been doing some workshops and CME and case studies and the like, but it is a pale replacement to actual clinical experience.  Experience that I sorely miss not only because it was something to do, and a great learning experience, but I see the value in being able to practice as a student.  Potentially the next time I take on a patient it will be totally for real and my responsibility which is terrifying. I am glad to be a second year, as our first year students have had to finish out the semester online and take all of their mid terms and finals online.  UGH.  I am a very bad online learner, so that might have broken me.  School is doing everything they can to keep us on track and are very focused on gett...

My internal medicine rotation was in at ICU.  This was unusual, as most internal med rotations were at an office or as a hospitalist.  This rotation gave me fascinating insight into a very complex world and patient population.  As a first rotation, it was terrifying, and I am sure would be equally terrifying now. We aren't taught much critical care in PA school.  Bits and pieces here and there but the ability to put it all together and make sense of it is truly daunting.  Every detail matters in the ICU, something I loved, and something I hated.  Attention to detail is the PA student's default setting.  We may not know what it means, but we will asked about it!   I feel like I could spend an hour combing through the patients medical record and still not have full grasp of what was happening. Happily, my paramedic training came in handy, as I could show off my only trick of EKG reading and knowledge of ACLS.  But that is merely a sprin...

One post to encompass an entire year?  Pretty much, yes.  Because this year was exhausting, exciting, interesting, overwhelming, and stressful at all times.  Information flies at insane speeds into your brain, and in most cases...right out again.  PA schools seem to know that it's important to lay a foundation, then when students start seeing patients, the conditions will be reiterated and solidified.  So far, that's working, but I still worry that I won't remember the right thing at the right time.  That, and there are literal books filled with the things I don't know yet. But...didactic year is over!  "The hard part" is over!  In ways I miss it.  I miss seeing everyone every day, and now we only see each other as a class once every six weeks. I do not miss the constant fear, looming tests, and constantly feeling behind.  Wait...constantly feeling behind is still there, but at least I can study whatever I want to catch up.  Silve...

I liked pediatrics.  This seems to surprise many of my friends, but not having children doesn't mean that I don't like children.  This rotation was fun and frustrating, as at times I was seeing an entire family at one time.  I saw newborns and 18 year olds and everything in between.  I got close to memorizing vaccination schedules, milestones, and most importantly learned over and over what normal is.  Having this rotation in August led me to do so many sports physicals.  Oh, so many.  Pediatrics has its seasons and I am glad I got sport physical season and not flu season. Kids are fun and their parents aren't (typically) but I was surprised how much I liked interacting with the kids, joking with them, comforting them.  Unfortunately the office I was in didn't have anyone else in it so I spent 20 minutes examining patients, making them feel like the pediatrician office is cool and safe, only to return 5 minutes later and jab them in the leg....

I just had the shortest "-mester" of my life.  By week 2 we were taking a 'midterm'.  Which was pretty funny.  We covered OB mostly, which I enjoyed and many were horrified by.  We did four credits in as many weeks, and it wasn't that bad. And I'm not saying this because I have already forgotten how bad it was.  It was okay!  In the last week we took ACLS which was a looooong 2 days for me, but will help me keep my paramedic cert up to date. And then spring started!  A week early even. We had one week of instruction a weekend off (technically) and now we are back at it for 15 weeks.  I am slightly concerned as my usual semester burn out time is about 11 weeks in, which will come four weeks early this semester, because really this is a long semester indeed.  But. The spring is different. It is a continuation of several classes from the fall, but also has some new things.  A lab class, where we will finally get to learn some new trick...

At times, you study and you study, and you meet with your group, and you go to the white board and you study some more.  And you goof off, and watch game of thrones, and study a bit more, but is it enough?  No one knows.  The formula isn't perfect. It's different for every student.  And that's all I want. All I want is 'enough'.  Is passing.  To be one up from the butt of the joke "You know what you call the guy who graduated last from med school?"  "Doctor". It's a funny joke because the person last in their class isn't dumb.  They didn't work less hard than anyone else.  In fact, that could be the person who worked the most hard.  Who had an instinct for patient care, but was was bad a chemistry.  The person who put the most hours in and still fell short of the person with an aptitude for pathophysiology.  In PA school, that's the person with 3 kids at home, a decades absence from full time schooling, or a 15 year career a...

Wow, work is weird after a six month absence  My first patient back was really sick and I was panicked,-"Somebody do something!"  I shouted in my head, but it's me- it's me, just like old times.  And I have be be the interview, provider, and advocate for this patient.  My assessment is twice as long as it used to bed (and half a useful in the prehospital arena).  I actively think that I should have more to offer patients by now. I'm a PA student now. I know some things.  But all they need was what I always had to give to them.  An IV, an EKG, and a recognition of sick or not sick.  That I can do.  That I sill have an instinct for.  Thank God.

The first full semester of didactic year did not disappoint.  It did not slow down, it did not let up.  I was, with out dramatization, the most difficult semester of my life.  This could be because it was really hard, or it could be because my undergrad is a complete blur.  I'm going to go with it was really hard....'cause it was.  It was something like 19 credits.  By mid terms, we were all swimming around, grasping at the information floating around and trying to get it into our brains in any way possible (sometimes with brute force).   Not to say it was completely without fun.  We had a really fun PA week, a great Halloween party, and I went home a few times for fun reasons.   I really an just writing this for posterity.  So if I look back in 10 years, or if someone who is thinking about PA school asks me, I give the right answer: "That semester sucked."  I have a tendency to forget how hard things are, maybe...

Objective Structured Clinical Exam "OSEC's" is a rite of passage for PA students. This is a test with a live, paid actor as the patient.  Our first one involved doing a full head-to-toe physical, and then taking a history that takes 30 minutes to get through. I can say that before I got started, this was one of the more stressful tests I've taken.  The physical alone had 130 items to get to and while we were given 60 minutes to do, it it went so fast. But a strange thing happened.  Muscle memory told me what to do.  My brain could almost be on auto pilot for this exam.  Just tick all the boxes, just like in practice, just like I wrote on the white board 100 times.  The time did go by so fast, and when I emerged as the first one finished in my group, I did begin to panic.  But it was done! The next day, I had to ask my patient over 200 questions to get to and explore their complaint.  All while trying not to look stupid, trip over words, and he...

Last week I learned that I can prepare for something for seven months and on the day before, still feel unprepared and panicked.  But, once I calmed down and collected myself, school started.  In the next five (now four) weeks we will complete- no rest for the weary.  Our first classes are anatomy, public, health, patient assessment and ethics. A good mix and a good intro.  Once a week we have a cadaver lab.  That is a new experience.  The last cadaver lab I had was in paramedic school and then we did intubation and did cricothyrotomy (the ol' knife and a straw routine) on them.  This was way cooler with actual looking at things and touching things, and....okay, gross.  Yes, I know.  First week in, and I brought my lunch every day (a fact, I'm very proud of), made (roughly) 33 new friends, and been to two happy hours.  I've written 1/4 of a paper, done research, taken 4 quizzes, and made an alarming number of flash cards.  Can't ...

Preppin'

In September 2009 I remember sitting on the floor of my empty apartment, having just called the cable company to cancel my service. I was nearing the eve of my departure to England.  By that time, I was feeling a little less than zen about the whole idea.  The feeling is hard to articulate: a happiness, an excitement, a sadness, a dread. I want to have a stout heart and a calm mind, but both will fail at least for a few minutes in the execution of wild-ass plans. Yesterday I felt that 'little less than zen feeling" and I described myself as "An 'Ellie' 8 [out of 10]...which is a normal person's 12."  But now that I am here and the cats didn't pee, throw up, poo, or die on the ride down, I feel a lot better. We all have a lot to get used to. In the last week I had two last days at work, a great going away party, and several meals and several more drinks with people before I left.  Yesterday I packed up the last of my essentials and the cats and the...

There is now a cast of 33 new characters in my life.  My classmates and future colleagues.  The 33 other people who, like me, are thinking, "I hope I can do this".  They will help me learn, help me grow, and build me up.  I hope I can return the favor Orientation, was like many other orientations I have been to:  awkward, stressful, and extremely boring. Administrivia has never been my strong suit.  Also, I just about ran out of business attire within the three days, so I guess I still have some shopping to do.  My ongoing closet emergency. I have never been simultaneously built up and broken down before.  It is an odd and confusing sensation that has (actually) kept me up at night.  The entire three days vacillated between welcoming us, telling us we were great, and gearing us for the tsunami that is about to break upon us.  "Congratulations on being here. You should be proud. This will be the worst summer of your life. Don't think...

I spent many months convincing myself that it was a good, financially sound, and safe idea to commute to school.  After all, it's only every single day for a year, and then pretty much every single day for 14 months after that.  I would only put 30,000 miles on the car (in the first year) and I would definitely love getting up at 5 am.  I can be a morning person!  It's only an hour drive (in theory and only on sunday afternoons and weekdays at midnight) and the traffic is predictable. This PA journey will force me to change many things about my lifestyle.  Mostly it will dictate when I sleep and when I wake, and what I do with my spare time, and what and when I eat, and how often I can go kayaking, and how much I can spend on everything, and that's all!  These lifestyle changes are what worry me the most about school.  I am used to being in charge of me, but now I'm going to have to let a lot of stuff go.  Pretty much everything I've gotten use...

I took today to catch up on some blogging I should have done a long time ago. So...there is Greece (that should have been done in August) I do need to write some EMS stuff, but, maybe in like 4 months. I have been trying to get a list of things that need to be done and then finished before school starts. After a couple of months fretting about how the school probably forgot about me and/or kicked me out already, I finally got news of the start date. Early June I will start my adventure/sentence. In May we have a three day orientation with two hours set aside for 'instrument purchasing'. Ooh, let the spending begin! I am hoping that my 12 year old stethoscope will pass muster as it is probably the only useful medical instrument I own at the moment.  It was a relief to hear something from school as it had been a while.  Although it did open up another little bit of panic as now I need to collect things to get started like vaccine records and get a physical, and eno...

Back in August, I was invited to interview for PA school. I didn't say much about it here as I fear failure and getting to the interview stage is like being within arms reach of the dream. It was too close, and felt very fragile.  Instead I spent weeks agonizing over how to articulate my flaws without making them sound too negative.  It's pretty hard to justify "I don't take direction well."  "I am too independent"  "I actually hate people" "I lack motivation."  "I am too laid back."  "I'm only in this for the money".   You cannot be honest.  And definitely answers like "I care too much"  Or "I am too thorough" are frowned upon. Googling "how to survive a PA school interview" is a slippery and horrible slope. Everyone has advice.  Most of which was very useful. Some of which was down right terrifying. "They will ask you about the shortcomings of your application." one ...

So.  I guess I should do a little update...then about 100 more. Three years ago I made the decision to "go to PA school"  which I wanted to keep to myself due to the absolute impossibility of success. Somehow, everyone found out anyway.  I wanted to prevent the future conversation of "Hey, weren't you going to go back to school?"  "Me?"(looks around feebly) "No, I don't remember that." Quite happily, I can report that I won't be having that conversation (Unless it goes "Hey, weren't you in PA school?"  "Me?"(looks around feebly) "No, I don't remember that.")  and I will be starting PA school in the coming summer! I found out last week and have vacillated between joy, disbelief, and terror ever since. There was literally a 0.05 % chance of success so it really seems crazy to me. I couldn't even tell you 'why me?' although I am sure my overly kind-hearted friends would give you so...

I know that so many of you are waiting for an update on "Wild ass plan-apply to PA school". Well get ready! Basically, it's boring. I am slogging through my last prerequisite "Intro to organic and biochemistry". Did I save the best for last or what?! Truly, this is the class that I know I will struggle with. How do I know that? Well, it's been two weeks and I already am! This class is offered at several schools but is accepted for all of the programs in my state. When we had our obligatory introductions on the first class, it became clear that I am not alone in my wild ass plan. Indeed, the competition for these programs was never made more clear. 28 out of 30 students want to be PA's. 28 out of 30 students went home that night and cried themselves to sleep. Those that hadn't already done the math of 1000 PA school applicants for a class of 35 were for the first time feeling the pressure. It's a mixed bag of backgrounds and ages.  ...

Last week I stayed up until midnight, on a day when I really didn't want to, in order to register for spring classes.  I have a vague memory of the first time I went to community college of waiting in line and hoping that the class you wanted and fit perfectly into your schedule would be open.  Now, I just have to remember a password (or let google remember it for me) and register in the comfort of my living room.  I am probably wearing the same outfit. I've been taking medical terminology online.  This is my first and hopefully last foray into online class-taking.  From the beginning I felt very old.  It took me way too long to figure out how to get to the class, find assignments, and just figure out what the hell was going on.  Oh, my I felt old.  I did figure it out and I am just going to assume that every student in an online class is cheating.  Basically, especially in a class based on memorization, everything is open book. Once I f...