Gregory House, PA-C

Jerk Status

2011-10-02T13:08:00.002-04:00

Wow it has been a very, very long time. No doubt at this point I'm speaking to nobody.

Here's the long and the short. I need to change the title of this blog to Gregory House, PA-C. Yeah, that just happened.

I'm going to be working in Internal Medicine at a big academic hospital in the ghetto, ghetto. It's going to be a crazy start. I'm currently waiting for credentialing to finish, but I'm looking to start in the next couple of weeks. I'll keep you posted.

PA school is behind me and bitching about it is no longer something I do. It's over. None of that matters anymore. In reality PA school was probably 2 of the most fun years of my life. But I'm definitely looking forward to having a paycheck. The last of the student loans are running out and I don't want to become a pan handler.

The Beginning of the End and the Start of a New Beginning.

2011-05-23T23:33:00.003-04:00

This blog seems to only talk about PA school. Well it's really suppose to be about my general experiences in life. I, however, have very little life outside of PA school. But with the end in sight (2 rotations left) my fellow classmates/friends are making life decisions that extend past PA school.

My roommate got engaged yesterday. This isn't my first friend to get engaged. I have a pair of friends that got engaged a over a year ago. This is however my first friend that's getting engaged where I wasn't close friends with both parties. I'm also much closer to this friend than the others. I'm very happy for him. He was totally giddy on the phone when he told me. They've been dating forever, so this wasn't a surprise. However, I can't feel like this is the beginning of the end of the life I'm used to.

I follow Buddhism as a life philosophy. The focal teaching in Buddhism is that the only constant in life is change. In other words, nothing in life is forever. Change is inevitable and to fight change will be the cause of the suffering in your life.

I've been preparing myself for this event. It shouldn't be a big deal in the grand scheme of my life. I'm not the one getting married. But this will be a change to my life also. He has been one of my closest friends for the past 2 years. I do not foresee staying in touch with this friend as much as I would like for whatever number of reasons.

This isn't so much a life marker for me because of the distancing between us. It's more a life marker of friends starting to move away from each other, and to start their own life microcosm. In reality, everyone lives in their own life microcosm. They will just start to overlap less.

Buddhism doesn't tell people to ignore their emotions. If I'm melancholy about this, that's not a bad thing. It's necessary to acknowledge what is upsetting me, as to not let is fester and grow into something more and possibly debilitating. Buddhism just tries to prepare you for these events. They are going to come, but life continues. There is no reason to think this makes life worse. It shouldn't make me fearful of life without this close friendship. Live in the moment of now, not the past or hypothetical future.

Written Directly from the Belly of the Beast

2011-05-10T11:02:00.001-04:00

I haven't been updating much and for that I apologize. This really should be the time I update because I've been having the most negative experiences lately. I think people prefer reading about the horror stories of medical training, rather than the good. Since I'm currently on a horrible rotation where I'm kept for hours without having anything to do I might as well update. So, let's start from he very beginning. (a very good place to start)

A little while ago I had my pediatrics rotation in an ER. I hadn't been looking forward to this for two reasons. 1) I don't have a knack for peds. 2) I already kind of knew the preceptor and I didn't anticipate us meshing well.

Let me first say that I don't dislike children. However, it seems that if you do not have a strong love and appreciation for children, which increases exponentially the younger they are, then you are not a "kid person." This is a little unfair. It's kind of like the opposite for geriatric patients. The assumed default feeling towards geriatrics is a negative one, but if you don't hold this bias then you're automatically a "old people person." Whatever, if people want to see me as a hater of children and lover of old people then so be it. In my eyes though they're all the same. I don't necessarily like one group more than the other purely based off age. I prefer puppies above all of them.

The children themselves were easy. Children don't give long histories, and generally don't have complicated histories. They don't go on and on about vague symptoms that have gone on for months. Their parents on the other hand are a different story. I swear I think people become dumber when they have children. People were bringing in kids cause they have a temp of 99 for less than a day (temps start at 100.4, no exceptions), or because they vomited once 6 hours ago but have successfully eaten since. It was so odd. My family would never bring kids to a doctor for these things, even if it was their first kid. My grandmother laughed at the things people brought kids in for. Or you would have parents bringing there kids in too late. Why didn't you bring the kid in when the temp was 104? What was it about 106 that finally made you bring them in. Oh it was the fact that WERE NO LONGER RESPONSIVE?! But it's true what they say. Parents are worse than the kids. Overall I didn't dislike peds. I feel fairly competent in the ER setting with children, and wouldn't run away from them like many other ER providers. Can they tolerate fluids? Does their fever respond to motrin? These are the big questions.

My preceptor wasn't as bad as I expected, but don't let that fool you. I'm still not a fan of his. As far as providing patient care he was fabulous. I learned a lot from him and he was a great teacher. However, his personal demeanor left much to be desired. This man thought he was the greatest doctor of all time. He constantly talked about all the shit he did in his mother country. How he single handily ran an entire hospital his first year after med school. Along with this he was also very quick to criticize everyone else. You were a moron if you didn't something wrong, and he would let you and everyone else know it. He had zero patience for ineptitude.

He especially had a special type of contempt for PAs. If they did something he didn't like it was much worse than if a physician did something he didn't agree with. For instance, one physician did an entire septic workup on a child that in reality didn't even have a fever. He very discreetly went up to that physician and gave his input and didn't make a big show about it. However, if a PA came up to him at 11:50PM and asked if he was done seeing patients he WENT OFF on them. His shift ended at 12AM and he would condescendingly ask, "If I wasn't hear then what would you do with that patient? You would see them. You can see them now even if I am here. I have 10 minutes left. I'm not seeing more patients." This occured with a PA that had worked with him one time before. He went on and on speaking audibly to himself about how outrageous that the PA tried to get out of doing work.

He would also complain about how the PAs never saw any peds patient when he was there. He said they should be seeing all the injury patients that don't require his expertise. He however didn't care of the the EM docs didn't see peds patients. You see in his eyes, PAs are suppose to do all the work the docs don't want to do. Docs have the privledge of choosing who they want to see. In short, this guy was an ass.

In addition to this he was also nasty to the nurses and techs. One story that stands out was when I went to see a patient and they complained that the bed wasn't made. I looked at the sheet and indeed the sheet looked soiled. In my head I thought it was just a permanent stain, but I left to tell someone it needed to be changed. When my preceotor asked why I wasn't seeing the patient I told him that the sheet needed to be changed, and he started going on a tirade. He searched out the tech who was suppose to change the sheet. She had been told by the nurse that it was changed. I witnessed this. The nurse indeed said she had changed the sheet, and I believe she did. However, the preceptor continued giving it to the tech. He went as far as to say, "I don't change the sheets in my own home? Do you really expect me to change them here?!" Wow. That was just about the rudest thing I ever heard.

This preceptor also could not stop talking about his kids. He pushed his kids so hard that it made me pitty them. He expected only 110% from them. It was very much like that WSJ article on "Chinese Mothers." I do believe there is something to that philosophy, but you don't need to tell me everything there is to know about your kids. Save it. I didn't ask. He was also very defensive when a doc asked me about the high school I went to becuase it's consider very prestigous where I'm from. My preceptor could not handle the fact that my high school was considered better than his kid's. As if it somehow reflected poorly on his kids. I defused that situation by saying, "My school's minimum student performance was just higher than other schools. It by no means means that kids at other schools can't out perform kids from my school. You just couldn't coast by as easily at mine." He excepted that explanation.

I use this guy as a life lesson. I hope to never turn into him. I'm pretty sure that won't happen, since I already never talk about my accomplishments, and down play any praise I receive. Horray Catholic guilt.

Next post: Surgery

Pointing the finger

2011-03-12T20:11:00.002-05:00

Parents come in with child. Child had closed a door on his hand and lost the tip of his finger. When the plastic surgeon came in he was under the impression that they had brought the tip of the finger in with them. They explained that the tip of the finger was found, but at home. So the surgeon explained this means the kid will have a bit of a stubby finger.

Later in the day the parents call the ER and say they have the finger and want to know what to do with it. I would have told them to stick it up their ass.

Rough Sex

2011-03-04T02:30:00.004-05:00

I was hanging around the fast track ED station when a PA comes from behind me asking my preceptor, "Can I borrow Greg for a male genital examination?" He allowed it and I was taken away like a library book.

We got the door of the examination room and the PA asked the patient behind the curtain if he had changed. He said that he needed just one more moment.

"What's the patient here for?"
"Some scrotal pain and a possible mass."
"Think it's epididymitis?"
"Could be the beginning of an abscess."
"I didn't even know you could get an abscess there..." And we walked in.

The patient sat there with the opening of his gown in the front, his shirt off, and boxers on. He had been specifically told to take everything off from the waist down with the opening on the gown to the back. I have learned to just expect these things.

(I'm going to be perfectly honest though and say he had a rockin body. So I wasn't complaining about the show. Go ahead and tell me that it's inappropriate to even think like that. But give me a break, I'm HUMAN.)

I looked on as the PA put her gloves on and the patient positioned himself flat on the table. She told him to show her what was going on, and he tried lowering his underwear as little as possible. The PA eventually just told him to take it off.

The PA started examining his scrotum and testes with her hand, while asking him where it hurt and how it felt. He then took that opportunity to tell us the whole story leading up to this.

"I was sitting at home and my shawty was on my lap. She started dry humping me a little, you know just for fun. I guess she was grinding her butt into me too hard. It didn't hurt when she was sitting on me, but did later on."

Personally the only part of this story that shocked me was that someone actually used the word "shawty" outside of a Bring It On franchise film. But what do I know I'm just a sheltered, suburban white boy.

The PA finished her examination and told the patient she needed a urine sample. She explained he could put his boxers back on, flip the opening of the gown to the back, and use the bathroom. I knew this went right over his head when he said, "Okay, I can go now," looking at us as if he was going to piss right in front of us. I told him the bathroom was across the hall.

This 40-something mother of 3 teenage daughters looked mortified as we walked back to the station.

"That was more information than I ever needed to know. All he needed to say was that he had rough sex."
"You mean rough foreplay."

Change of Heart

2011-02-09T14:19:00.006-05:00

Woopsies! It has been a little while since my last post.

So the last time we spoke I had just finished Emergency Medicine. I have since also completed my Geriatrics rotation. This was my first medical inpatient rotation. I really enjoyed this rotation and part of that has to do with the 4 day weekends. But I also enjoyed it because it showed me an area of medicine that I was interested in pursuing.

Notice I say "was." I'm still interested in Hospitalist medicine but it's definitely a lot more stressful than I thought it would be. You are responsible for EVERY SINGLE PROBLEM THEY'VE EVER HAD! That's a shit ton of things to be held accountable for. Now it's not that I don't want to help these patients. But when you have failed to control your blood sugar, hypertension, high cholesterol and never stopped smoking... well I just don't think it's fair how much liability is put on me. If you're not willing to take care of yourself, then why should that be put on me?

I also got a lot of experience in the ICU. This was particularly helpful because my elective rotation was going to be in critical care. I got a good sense of what you see in the ICU. It's normally either very old people that should be in hospice, very complicated patients that I mentioned before, or rarely acutely sick people that make full recoveries. The reason I was interested in critical care was because of those few acutely ill people that have the potential to have good recoveries. So I still maintain interest for critical care, just not as exclusively. I enjoy the complicated inter-system workings of the field, but it rarely even matters that I understand why things are going wrong. Getting a patient to "stable" isn't nearly as satisfying as I thought it would be. Because of this exposure to critical care I decided that I didn't need a rotation dedicated to critical care to know what it's all about.

During didactic year class I was always very interested in Urology, but the only elective we had was in Uro-oncology. That was a little too specific for my interest, but nonetheless a very important and relevant aspect of Urology. While in geriatrics we had a couple of urologists lecture to us and it reminded my past interest. It was also quite obvious that Urologists love what they do. They don't seem as burnt out and they seem to get gratification from what they do. One urologist also pointed out that this is becoming a very PA in demand field. Urologist are finding great ways to utilize PAs and other PAs are telling me it's a great PA field.

All this being said I still have no idea what PAs do in urology. I don't know what kind of patients they see in clinic, what their role is like in surgery or what kind of procedures they get to do on their own. So I decided this is what an elective rotation is suppose to be used for. I have an area of medicine that I'm interested in but don't have a clue what day-to-day is like. My clinical coordinator gave me a little grief saying I'm always changing my mind on my elective but said it was an easy enough change. In my defense I only asked her once about her thoughts on me doing CT-Surg. I've never actually changed my elective before.

This rotation isn't Uro-oncology though. She told me that we have a general urology rotation at our affiliated hospital. She also said they are BEGGING her for students, which often means they are looking to hire. I would DIE to get a job at this hospital since it's TWO blocks from the apartment I'm moving to this upcoming summer. I won't deny that this also plays a role into my decision.

I'm currently doing pediatrics. I've only been there for 2 days and I already have a cold. I guess that's what happens when you are holding a kid down that's getting an IV and they're spitting into your mouth.

Next Step

2010-12-23T01:18:00.003-05:00

So I've now completed my Primary Care, Psychiatry and Emergency Medicine rotations. 6 to go.

Next up in Long Term Care. This rotation is normally a big snooze, but I've heard that I'll see some really complicated patients and that the preceptor loves to teach. I'm actually looking forward to it. It's not going to take place in an actual long term care site. We'll rotate through a hospital visiting the preceptor's private practice patients and also rotate through an acute care/rehab facility. There is also a nursing home that we're officially affiliated with, but I've heard we spend minimal time there. It should be a good experience.

As graduation comes closer plans need to start to be made. We all know that I'm a big planner. Love me some planning. Right now it looks like I'll be moving from my apartment at the end of the summer, and most likely leaving my roommate. I don't know if he's aware of this. But since he's going and getting all engaged this summer (and consequently married the next summer) I'm looking for someone a little more long term. So I'm going to be moving in with a long time friend (who happens to have the name last name as my current roommate). His roommate (also a long time friend of mine) is going to be moving in with his girlfriend (another long time friend). (I have a lot of friends)

We're going to ignore the fact that a bunch of my friends are moving in with significant others.

I've started the wheels on some professional plans. I'm a little nervous to share these online, so I'll remain vague. I have already decided on a place I'm applying to. I'll be applying this upcoming spring, and will know if it's happening before I graduate (end of August). We'll call this "Plan A." We want Plan A to be successful, although it wouldn't be heart breaking if it didn't. Plan B is applying for jobs shortly before and following graduation. There is nothing special about that.

Want a short summary on Emergency Medicine? Okay!

It was ehhh. It's interesting to see totally random things, but it can often be slow. I also never got to work in the high acuity section. The patients I saw did often get admitted, but no one ever seemed to be in imminent danger. As soon as I had a patient that I found interesting they would be admitted. I would never get to see what happen to them. This is how I know Emergency Medicine isn't for me. Definitely would prefer a Hospitalist or maybe Critical Care job. Those rotations aren't until the very end. That's okay though. I should be well prepared to kick ass by then.

Do people actually want relationships?

2010-11-15T01:03:00.001-05:00

It seems that at my age (24) everyone is looking for a relationship. Those who are not in them seem particularly miserable about it. But then I see my peers who are in relationships, and I don't find myself filled with envy. To be honest, I know very few couples that make me wish I had what they have.

I've realized that the "relationship" people want they've created in their minds. It's as if they've been incepted with this concept that they've never seen in real life. I think an english major friend of mine once told me that the idea of "relationships of love" didn't show up until the victorian era or something. I don't know whether that's true or not, but I feel this is where people base their desire for another.

I do realize that there is a biological component to this. There is the innate desire to reproduce and stay mated long enough to rear healthy offspring. I'm big into evolutionary psychology, but I've also learned that our natural instincts are full of shit. Cheating on each other is a natural instinct. It profits you by having more offspring. Look at the animal kingdom. Everything they do is instinctive. This is what defines humans from animals. Therefore people, quit listening to your instincts.

I come from all of this happy. I realize that seems odd. But realizing that a relationship isn't actually going to make you happy is liberating. I'm not saying I'm opposed to them. I'm saying that my happiness won't be defined by one. I'm happy now without a relationship, so why can't I be forever?

I wrote this for other people to benefit from. I want people to be happy. Stop thinking that you need something just because you feel you do. Look around you. People that have what you want are often not nearly as happy as you think you would be.

The grass is always greener on the other side, but I hate mowing.

Questions from the masses

2010-10-26T20:01:00.002-04:00

Hey everyone! Psych is going really well. Love it so much. Would definitely consider a job in it, but since there aren't many PA jobs in psych I'm not going to be holding out for psych specifically. Actually, lately I've been thinking about moving to a different city after graduation, but that's for another post.

Below are some responses to an email I got today. Feel free to send me your own questions at GregoryHousePA@gmail.com

1) the fact that MD's really don’t have the horizontal movement PA's do between
specialties (so if you ever get burnt out doing EM for example, you could
switch to ortho, GI, or whatever)

There is no comparison to PAs in terms of horizontal mobility. This is one of the biggest things to bring up when comparing NP to PA. NPs are trained in a specific area of medicine, whereas PA are trained in all aspect of medicine. We're trained to be able to adapt to new specialties making us the most versatile members in health care. Granted if you do find one area of medicine that you truly love and only want to work in then you may feel slighted that you're not the MD and hesitate to go back to medical school. I know myself I'm not going to find one area of medicine that I'll want to stay in forever. I need change.

2) the ridiculous amount of time you spend in med school, and insane amount of
debt you rack up (especially considering how physicians salaries are likely to
go down in the future even though demand for health care is going up...seems
the golden age of doctors and medicine is over)

The golden age of medicine for doctors is over. These are the exact words that physicians have said to me when I asked them if they would go to medical school if they could make the decision all over again. You do spend a crazy amount of time in school and residency. I'm sure that when you're all done with your training it may be worth it. I had one PA tell me to go to medical school because I have time on my hands, since I'm so young (24). No other PA has ever said this. I didn't want to sacrifice my 20's for a career that isn't going to be the center of my life. Medicine is a job for me, not a life's passion. I enjoy the work and that's why I'm going into it.

As for the debt, I'm going to be 100K in debt for a Master's and looking at a starting salary around 80K. You can be more economical going to medical school depending on whether it's an instate tuition and such, but there are cheaper PA schools also. Mine is one of the more expensive.

3) the difference between the two in terms of LIFE balance (IE not working like
a dog for the rest of your life, having decent hours, being able to enjoy your
life outside of medicine, have a easier time meeting a partner/starting a
family, etc. This is probably the most important factor for me personally. What
is the point of the prestige and money of being a doctor, if you can’t enjoy it
like you should?)

I kind of touched on this previously. I chose PA partly because medicine isn't my life, it's my job. Being a PA means that I have a ton of job opportunities. Varying types of atmospheres (hospital vs private practice), schedules (shift work jobs vs 9-5), getting per diem jobs on the side to make a little extra cash. It's a profession that allows me the greatest flexibility when designing my lifestyle. If I want to work a ton, I can. If I don't want to work crazy hours, then I simply don't take one of those jobs. But remember, you can't always get the job that pays what you want, is located where you want, and is in the specialty that you want. You need to compromise something somewhere probably.

So far browsing through the PA forums there have been a few people who say PA's
really don't have that great of a schedule compared to MD/DO's and sometimes
work even more (for less $$ too), but it seems like the greater majority of
PA's and PA students seem to agree that PA's do have better scheduling and more
time to enjoy outside interests (things like playing an instrument, family time,
training for triathlons, or whatever you have as a hobby). Has this been your
experience as a PA, with other PA’s you know, and the things you have seen so
far? I just don't want to go to PA school with some false ideas being the basis
for it. I guess the overall point of this letter was to ask you if any of the
reasons I have for wanting to be a PA are unfounded or untrue, and ask you why
you personally decided to be a PA as opposed to an MD, DO, NP, or any other
health care provider. If you could do anything over again, such as going the MD
route would you, or are you very happy as a PA?

Bottom line: I'm very happy with my decision. That being said I'm not a working PA yet. I haven't had to find a job. Some PAs complain about their hours and there pay. Those PAs should switch their jobs. There are lots of job opportunities. You can find a job that works for you. But this can be very dependent on where you live. The city I currently live in has lots of PA jobs, but not very well paying. I'm probably going to move to a different city because there are more opportunities and better pay. This works for me because I love that city and have always wanted to live there. This plan wouldn't work out for you if the city you want to live in has a shitty PA situation. I can't say that because you're a PA you're guaranteed to "have a life." But you should have the opportunities to, assuming the life you want doesn't require a 200K+ income. (You would have to work multiple jobs to make 200K as a PA)

I would have to apply for the 2012 PA class since I would first
have to take anatomy/physiology and the GRE this year then do the whole
interview process again next year if I got any (I think I am a decent
candidate, I have 3.9 GPA, worked on a collegiate student run rescue squad as
an EMT-B for 2.5 years, was a nurses assistant for 2 summers, have lots of
volunteer work and shadowing, etc). I would also need to find a job for next
year as well. I still have a lot of time though to sit on my acceptance/deferral
to med school and don’t have to tell VCU no until August/September of next year,
so until then I will definitely pursue this. Thanks again.

There are plenty of schools that don't require the GRE. I didn't apply to any schools that required it, mainly on the east coast. (18) As long as you get A+P done by the start of PA school then there isn't a reason you can't apply now, but late October is really late in the application process. You may not want to apply this cycle. I personally LOVED my year off between college and PA school. I got a job as a medical assistant in derm and it was fun. I learned how to act with patients and was well prepared for school because of it. Also that job definitely helped a lot getting into PA school, so having a job would offer you more school options.

Passive Aggressive

2010-10-14T17:37:00.003-04:00

Since being on rotations I seem to have developed a rather passive aggressive behavior. It's one that my faculty told me to adopt whilst being on rotations, but I almost feel it's getting out of hand. When ever a preceptor tells me something blatantly wrong I never correct them. I'll tell them what I think, but if they say I'm wrong I don't fight it at all. I mean this is overall a good thing I guess. It makes me seem non-confrontational, but shouldn't the right answer prevail? I don't have an issue continuing like this, but I feel like I'm getting borderline aggressive with this tactic. I'm actually getting a kick out of people telling me the wrong thing. Internally I know that I'm right and they're wrong. That's all that matters to me.

I know this sounds terribly arrogant, but trust me this isn't occurring a hundred times a day. It may only be 1 occurrence a day, if even. And it's not even always about medical facts. It might just be about how I heard the healthy miner's were getting brought up first, then followed by the more frail miners. People disagreed about it with me, but I had literally heard that on the morning news an hour earlier. But whatever. Should it even matter?

PS - I'm currently on Psych and I'm loving it. I also think I take to it exceptionally well. I really want a job offer from this site. I don't think it's going to happen though, but only because there isn't a job opening.

Surprising Revelations

2010-09-14T00:25:00.003-04:00

I can't believe I'm saying this, but I like primary care more than I thought I was going to. I thought I was just going to see colds all day, but so many things end up being something entirely different from what they seem. It's a nice surprise.

The thing I like the most about this specialty (can you even call it that) is that you're generally the first person to see a new problem. It has the highest degree of problem solving. And not only does it have a high degree of problem solving, but you also see the problem to its end. That's one of the things I hold against Emergency Medicine. You diagnose a problem but then you either admit and never hear from them again, or they leave the ER never to be heard of again. (I know that's a total lie.)

I would consider doing one of the two year commitments for loan repayment. But I'm seeing that they only offer 50k now. I could have sworn that use to be 80k. Another thing that's nice about those loan repayment programs is that you can find work in interesting places. Hawaii for 2 years? I bet I could make that happen.

Rotation Schedule

2010-08-17T23:51:00.003-04:00

Primary Care - So happy I'm starting with this. I'm theory I'm best prepared for it. It's what I asked for and suppose to be a great site. Hopefully I'll be wrong about not liking Primary Care.

Psych - Far, far commute but suppose to be a great rotation site. Was told by many to sit in on Music Therapy.

Emergency Medicine - Didn't get what I wanted and felt a little taken advantage of, but it's a <15 minute commute and I've heard it's a good site.

Long Term Care - Again, taken advantage of because I have a car. There were two sites 15 minutes from me but they give me the one 1 hour away (before traffic). Oh well, not the end of the world.

Pediatrics (ER) - Got what I asked for, for better or worse. Another really short commute at the same site I have EM. They're going to get to know me there.

Surgery - Got what I asked for. I'm at a site that has like zero students and is very one-on-one with the surgeon. Lots of OR time, again for better or worse.

OBGYN - Easy commute. Heard you don't do much. That is a blessing.

Internal Medicine - Been hearing mixed reviews about this site. I'm very happy it's one of my last rotations. I'll be better prepared for the site, which is important because I want to excel at that site. I'm hoping I can get a job offer at this site.

ICU - This is my elective. It's pure perfection that it's my last rotation AND right after Internal Medicine at the SAME hospital as Internal Medicine.

At first I was feeling taken advantage of because I said I had a car and could live with my family (which is closer to other sites). But you know, none of the sites have bad reviews. I thought it over and realized that this is probably going to be a great experience. Hopefully it means more interesting posts. I'm really excited and eager to start rotations. I feel surprisingly ready for them. My experience of working somewhere that I had no prior experience helps a great deal. I'm not afraid to interject myself, get criticized and say "I don't know."

Start date: Tuesday September 7.

Phase One: Complete

2010-08-13T01:51:00.003-04:00

Friday the 13th. The day of the cumulative didactic year final exam.

I'm sorry that we haven't spoken until now. But to be honest I haven't had anything exciting to talk about this semester of PA school. Well I have become more serious about Buddhism. Maybe I'll talk about that in the future.

Psychiatry, Orthopedics, Geriatrics, Rheumatology, Emergency Medicine, Pediatrics. They've all been completed. I really stopped trying nearly as hard as I did during the rest of the year. And I mean I really didn't work very hard. I would read over the lectures a max of once. I'm sure there were topics I didn't read at all, especially Emergency Medicine and Geriatrics. I also stopped going to lecture once Emergency Medicine and Pediatrics came around. I just can't put my sanity through lecture anymore. You know what? I don't regret it at all. I'm probably going to get a B+ in Medicine III and I'm totally cool with that.

I can't say I'm really that nervous for tomorrow's test. Although I am having a hard time falling asleep tonight, so that's probably not entirely true. (I've also been sleeping until 12PM everyday and going to bed at 2-3AM, so that probably plays a role also) I haven't studied that crazily for this test. I've done well in my Medicine class the entire year. I retain the things I learn very well for the long term. I can't imagine they're going to start asking about the thing I wasn't able to learn for the short term. And as mentioned before, I haven't really been studying for tests this semester. It has yet to bite me in the ass. We'll see what happens.

After the test tomorrow I become a Clinical Year student. Should provide much better material to share with all of you. :-)

CODE BLUE

2010-07-17T02:15:00.003-04:00

Today we were getting ACLS certified and I was called upon to be the team leader. Previous to class starting everyone was freaking out memorizing their algorithms during a fire drill. I decided not to cause I'm sick of studying 24/7 and wanted to enjoy my iced latte.

The instructors showed a video that ran through a code a couple of times. Made it look very systematic and methodical. No big deal right? Follow the algorithm. They stressed to use that it's recommended that you carry your algorithm on you even while a practicing PA. How hard could this be?! They're telling me to carry and refer to a cheat sheet.

The class then broke into groups, but we basically were running through codes at each station. The instructors called on different people to be the team leader and use the group for their team members. I got to see a couple of classmates go through it, but no one was very confident and most were stumbling through it.

As most stories go, I then got called on to be team leader. And this is the part were you expect to here about how I crashed and burned after being put on the spot. I would then learn my lesson for being cocky and grow a little as human being.

TWIST!

I fucking rocked it. I set up my team no sweat. Got my ABC's down. Recognized the rhythm and ordered all the right meds and shocks. After I was finished the head instructor praised me for my job well done and said that I was on par with many cardiologists that he teaches.

I basically had a repeat performance with the other two groups. The token hard ass physician instructor called on me to be team leader once. He picked me out after talking about how easy it is to see what people are doing wrong when you're not the team leader. He really thought he was going to get me when the EKG was a Second Degree Type 2 heart block. I got that shit. I knew I got his approval when all he said at the end was "Good work. You're off the hook."

SAVE ACCUTANE!!!!

2010-07-01T18:11:00.003-04:00

Today we were learning about adolescent medicine. This is the only type of primary care I could ever practice. I don't have the bubbliness to get babies to like me and I don't have the patience for the bullshit adults come in with. But I get teenagers, I respect them, and they like me back. I also feel for them cause I had plenty of their same issues growing up.

There is a new advertisement on TV that attacks Accutane making claims that it gives your Chrone's disease. I challenge those lawyers to show me the evidence based medicine behind that. Accutane is a MIRACLE drug. This is no exaggeration. Cystic acne is a horrible, life scarring condition. I had it and treated it late. My face shows the damage. I've worked in dermatology. I know there is NOTHING the touches the results Accutane produces. The only lasting side effect I have from Accutane is dry lips. I'll fucking take it. My aunt and uncle went on Accutane 30 years ago. They're perfectly healthy. My uncle has even donated part of his liver. THAT'S HOW HEALTHY HIS LIVER WAS AFTERWARDS.

Anyone who's reading this, I ask you not only to have a positive view on Accutane, but advocate for it to stay on the market.

Whine Central

2010-06-26T13:08:00.002-04:00

Okay so I was really enjoying running. My feet were doing great. My feet were always the reason I couldn't run. Shoes solved the problem.

Evidently if I run for more than 2 weeks then my knee give me the finger. I'm walking like a 90 year old man with horrible arthritis. I'm dependent on NSAIDs and I don't like it. Until my knees feel absolutely fine without NSAIDs I'm on a running hiatus. I have no idea what I'm going to start doing for aerobic exercise. Boooooo

Eff This

2010-06-21T07:20:00.000-04:00

Ugh. +3.0lbs.

Someone just get me lipo.

Running

2010-06-21T00:31:00.009-04:00

Eating right, and lifting weights hasn't really been doing much for my weight. For the record I'm not overweight. I'm just not in love with certain aspects about my body, and would just like to work on having a lower body fat percentage.

I have however had improvements with my shoulders and chest. So that's nice. I didn't increase my caloric intake once I started working out, but have incorporated much more protein into my diet, via whey protein. I attribute this to the gross muscle growth.

I have the diet in place - avoid sugar, increase protein. I've got the weight training - hit all muscles groups not just the showy ones. There was just one thing I've been missing - aerobics. I think that because I never do aerobics I never deplete the glycogen reserves in my liver and skeletal muscles. My diet has been enough to help with any repairs my body needs from the weight lifting, but not so much that I've been gaining fat. But what I need is for my body to need to go into the reserves (aka body fat). By running I help deplete those glycogen reserves and make my body go to the body fat for energy.

I have avoided running because I'm a bad pronator. I get horrible leg pains that have always deterred me from running. But I decided I need to change something about what I was doing if I want to see improvements. So I went out to a running store and get fitted for shoes that would help my pronating. The shoes are amazing. I actually enjoy running now. I follow the training method of Doctor Mama to the "t."

The only downside is that I get lots of random aches an pains. They generally subsdie after a day or two and don't return to the same spot. I unfortunately can't say this about the pain in my knees. Coincidentally I'm now learning orthopedics in class. I think I've got some patellafemoral syndrome pain going on. I'm hoping it's going to subside with time, but I've got PT exercises printed out just in case. I also think that for this condition it's okay to treat with NSAIDs. They sure do help, but I reserve them for pre-treating before a run. What I really need to do is starting icing after running.

Tomorrow is a weight in day. Let's hope I continue losing 2 weeks in a row!

Theory on Flamboyance

2010-06-02T23:41:00.002-04:00

I recently met a couple of gay guys through friends. They were in short, "flamers." I'm pretty far from ever being called a flamer, and this obvious difference sometimes make me feel like an outcast in my own society.

I feel like you never see as many older flamers. Is being excessively flamboyant a stage? I'm starting to think it is. I started thinking about what the major differences between the 20 somethings and the 30+ somethings are.

One thing that stands out is that those that are 30+ are often more professional stabile. When I think back to the two guys I met there was a distinct commonality they shared. At one point they both made it clear that they were proud of where they were in life. They didn't like their current jobs, weren't meeting the goals and such.

Could the flamboyance be an act? People have always coupled homosexuality with flamboyance. But what if flamboyance was a defense mechanism to come off more confident than they actually felt. This could be a defense mechanism that is specific to homosexuals, as opposed to a standard trait specific to homosexuals.

Hell, this defense mechanism may not be specific to homos at all. I think straight men, women, lesbians probably all put this front up in one way or another. They like to go out and be the center of attention and pretend like nothing bothers them. They try to make it look like they are totally cool with where they are in life, who they are, etc. Maybe this pumped up faux-confidence just turns the volume up on the already present feminine/flamboyant qualities of homosexuals.

Of course I'm speaking in general terms. I'm sure there are some people that truly are that confident, and THAT GAY.

DADT

2010-06-01T20:37:00.006-04:00

Over on the Physician Assistant Forum there was a discussion about Don't Ask Don't tell. There were some diverse opinions on the matter. You can refer to the link to see the spectrum. Some people were totally against gays in the military, some supported DADT, some thought gays should be able to serve openly. It was a fiery debate. I like to think that my response was one of the more cool, calm and collected:

I read the first 6 pages of this thread, so I feel I got a good sense of what's going on. Why not throw my $0.02. Where to start...

I'm gay. (That makes like 2 people total here, right?) I use to consider myself a Republican, but then realized current Republicans weren't actually Republican. So I have no real party affiliation or team bias. I've never served. I could give my religion, but don't see how that's relevant since we live in a country based off secularism. As a side note, being "secular" doesn't mean being godless or without morals. It means being respectful of all people regardless of their personal beliefs.

I understand where these disapproving people come from when they say, "I don't want gays checking out my junk." That's fair, you're uncomfortable, and women and men have always been split apart. You want some mutual respect. My response is that I don't understand why women and men need to be split apart. Aren't they all adults on a mission? IDK - I've never served so maybe I'm missing something here. When I'm seen as a patient, or seeing a patient I don't care about gender. But if it's really that big of a need to split men from women, then yes it should be done by sexual orientation also. Men have rights too.

Outside of this living condition situation I think it's ridiculous that gays shouldn't be able to serve openly in the military. What part of being gay is a hinderance to service? Oh, it makes some good old boys uncomfortable and they make up a large percentage of the military? I dare say that a number of people felt just as uncomfortable next to blacks when they started serving without segregation. People are different. Get over it. You would be shocked that you might actually like and respect these people.

As for whether homosexuality is a "lifestyle choice" or not - does it matter? If people don't approve or respect me because of my "choices" then so be it. It's not like I have to approve of you either. I'll still show you respect. I'm not touching the "sin" aspect because that is purely up for interpretation based off you religion.

Which leads me to this last ridiculous question about being gay and a Christian musician. Believe it or not, there are sects of Christianity that don't believe homosexuality is a sin. Crazy I know. They're the same groups that also believe in evolution, women's right and that slavery is out of fashion. What is this world coming to.

Addition:
To people who support gays via DADT: Why are heteros allowed to talk about their families and spouses and maybe daresay occasionally their sexual desires, while gays aren't allowed to express anything similarly? I listen to my straight friends talk all day about their raunchy desires. If I say "I want to see Prince of Persia simply for Jake Gyllenhall," then damn(!) let me get that off my chest! It's not like I'm humping your leg!

Previously, on LOST...

2010-05-24T01:17:00.003-04:00

I don't think I can refer to myself as House anymore. I cried during every single Flashback in the LOST finale, and was then inconsolable for a half hour after the show ended. There are still specific scenes that could make me lose it at the mere thought.

I'm such a little bitch.

A Lesson in PR

2010-05-21T18:04:00.001-04:00

Remember when I was all excited because AAPA was using a quote from me in the latest edition of PA Professional? Well they did use the quote, but didn't mention the name of my blog. I think that's a pretty dick move.

wompcity.

Grades

2010-05-20T16:09:00.002-04:00

I am one very, very lucky boy.

I comfortably got an A in Pharmacology and A- in Evidence Based Medicine.

By the skin of my teeth I got an A- in Clinical Medicine (89.97). And when I didn't think I had any skin on my teeth left I get another A- in Clinical Applications (89.60!!!).

I got a B+ in Lab Medicine, but whatever. The A in Pharm evens it out to an A- average. I'm doing so so so much better in grad school than undergrad. w00t!

Yellowstone

2010-05-18T01:51:00.000-04:00

Big Sky Country

2010-05-14T11:59:00.004-04:00

I passed all my finals - most better than expected. Though I have to say I'm a little surprised at how many people have to remediate.

I'm off to Big Sky Country for the weekend . Catch you never!!

Finals Syndrome

2010-05-10T15:55:00.004-04:00

For the past month or so I've gained about 8lbs. The funny thing is I've started regularly working out during this time and have maintained my (snack free) diet. I've especially been noticing the inner-tube around my gut getting larger. My reaction has been WTF?!?!!

I have also recently come down with a sore throat. I would generally attributed this to a post-nasal drip 2˚ to allergies. But I've been really good with my Zyrtec and have had barely a sniffle. Again, WTF?!?!?

I have my Medicine final tomorrow. I'm really worried. I failed the Infectious Disease test and didn't do that hot on OB/GYN. I dedicated a full day to each of those topics, which leaves me with one day for Cardio, Neph/Uro, Neuro and Endo. The saddest thing about this is that I don't even feel remotely comfortable with ID or OBGYN. I'm stressed.

So I'm sitting here studying Endo and it dawns on me. This past month I've had a test every week. 4 finals last week. A case study that I had to remediate TWICE, among numerous other assignments due at the end of the semester. I've been stressed. Stress leads to increase cortisol. Increased cortisol inhibits the immune system and stimulates lipogenesis, especially abdominally.

FUCK FINALS!!!!!!

The Amazing Race

2010-05-04T12:56:00.003-04:00

I simply cannot get enough of this show. When when when am I going to be able to have the time to do the show and someone to do it wiiiiiiithhh??????? I've been watching this shows since the first season and I still haven't had the opportunity, but have printed the application numerous times.

Maybe the Army is right for me...

2010-05-01T23:05:00.001-04:00

Clearly DADT isn't keeping anyone out of the Army.

Speaking of mentoring...

2010-04-30T01:01:00.003-04:00

A former co-worker of mine called out of a the blue at 12AM. She claimed the reason she called was because she wanted to know if I would be facebook friends with her. I told her sure, but that you don't generally ask permission to friend request someone.

She then went from that topic to asking if I think it's okay for girls to call back guys. (Random...)

She then asked if I was still gay. (More random) She thought that since I'm around so many girls that I must have turned straight by now. Her cultural background traditionally doesn't quite understand (read as: approve of) homosexuality. But this is a common trend in her life. She often doesn't understand her own desires or behaviors, let alone others'. As introspective as she thinks she is, she generally comes up from the depths of her mind empty handed.

She then said that she knew what she was doing about medical school, but wasn't ready to tell me. She said this without me asking about medical school. I told her she didn't have to tell me, but that she obviously wanted to since she brought it up on her own. Evidently she's planning on going to Cuba and was very afraid of my reaction. I don't even know why she would care. I barely ever speak to her and haven't seen her in real life since working with her.

The conversation only got stranger from this point. In fact it was so strange that I don't think I can even summarize. It basically came down to me calling her out on not living in reality. She gets so caught up in the future, that she's not seeing the world around. I went a little Buddha on her ass. All she thinks about is the "dream life" that she wants. Now I'm all about having goals and such, but you can't become that blinded by them. I truly believe that she's going to be miserable going through this process and that the outcome isn't going to be what she suspects it to be.

Sometimes I wonder if I'm all that successful at Buddhism. But then I see people like this, and I realized how far along I really am. I try to help her "see the light" but it's difficult. How bodhicitta of me.

Mentals!

2010-04-28T21:34:00.002-04:00

A couple of people in my class decided they wanted to organize a mentor group for the incoming PA class. This is so standard of our class. We're always so nice to each other, and helping each other, and doing all these Q+A sessions during the applicant. A group of effing saints. So unlike the current senior class. They want absolutely nothing to do with us, and nothing to do with each other. And if you thought the whining was bad in my class, it's nothing compared to the seniors. The faculty despises them, as do we. But I digress...

So I was asked to take part in this mentor project and I eagerly agreed! I love mentoring people. Back in the day I wanted to be a psychologist because I love talking people through life issues. I'm good at helping putting things into perspective.

This new development has really made me happy and gotten me out of my finals depression.

Class Etiquette: Grade bitching

2010-04-28T15:53:00.003-04:00

Our class recently got back a SOAP note assignment. Many people failed. But many more weren't happy with their passing grades. It was an ugly scene. I think it was interesting that the people that didn't fail complained way more about their grade than those who didn't. I'm not surprised about this because the people that complain about grades are generally the more OCD, whiney, gunner students. It therefore makes sense that they were the ones that passed. But for the love of god people don't say things like:

I can't believe the grade I got. I practically copied what someone else did and they got 15 more points than me. With this grade I have a 97 average and I mean that's only 3 point away from not getting an A. There is no reason someone shouldn't get an A in Clinical Application. But you know I really don't care that much about grades.

OMG. STFU. The entire class doesn't want to hear you go on and on and on about your passing grade. Grades don't matter. Your grades especially don't matter to me. And don't tell me you don't care about grades when all you do is bitch about your grades and compare them with other students'.

I was one of the people who failed. I'm fairly indifferent about this. Grades really don't matter when it comes to getting a job. I definitely learned a lot from this assignment. I think it was a positive experience overall. I think things stick with you more when you get them wrong, and then realize why you're wrong. That's not to say that people should aim to get things wrong... But I wish some of my classmates would care more about the comments left on their paper and less about the number on the top.

2010-04-28T09:06:00.002-04:00

Scratch that. I'm getting passive aggressively attacked about why I
wanted pa over np and how np is better.

Is it suppose to be a good thing that you have to do less CMEs? Damn
If I had known that then I definitely would have been an NP...

Sent from my iPhone

2010-04-27T23:31:00.001-04:00

Today I did something I've never done before. I was so stressed out tonight I had a beer to calm down. Not a fan of this.

Missed Pneumothorax?

2010-04-26T12:06:00.004-04:00

My physical went fine today. The NP was nice and we chatted a little. Anytime I mentioned anything about what I'm doing in school she totally ignored it. What eves.

I have self-diagnosed myself with Marfans Syndrome. I didn't tell her this, but she had all the necessary information to make a diagnosis. Tall and thin with long digits, mitral valve prolapse murmur, she also thought she heard a different murmur, borderline glaucoma when I was younger, scoliosis (she did this exam but didn't comment on it), nearsighted, low muscle tone.

So when I was asked about chest pain I told her that I sometimes get stabbing chest pain over my right chest with aerobic exercise. This has been going on since HS. I've never been to concerned about it because it would go away with rest and I never got dizzy. I told her that I actually think it may be a spontaneous pneumothorax. She looked at me totally skeptical. Then I said I'm probably just a crazy PA student that over thinks thing. But I actually do think I have this since I definitely have to some degree Marfans, am a tall white male and spontaneous pneumothorax is a common complication of both of those. And it if you've had one you're more likely to have them again. It's a pneumothorax we're not talking about, not a tail growing out of my arm. They happen.

I guess since I wasn't playing basketball when I got these chest pains then it doesn't count...

Scared of the NP

2010-04-22T00:18:00.004-04:00

I have my annual physical coming up. I have to use my school's health center, because I use my school's insurance and they call the shots. My school has a large nursing program and the student health center I think is run entirely by NPs. I personally have no beef with NPs. This is unfortunately not the case on their end.

Almost every nurse I've met has given me shit about being a PA student. They all question why I would want to be a PA and "never work under your own license." Little do they know I will have my own medical license. I honestly don't even know why they care. They think that because I chose PA over RN/NP that I'm saying it's better than them. How about the fact that I was never a nurse to begin with, so why would I go through that extra training? Also, I don't want to be an RN. I never want to have to work as an RN. It's a thankless, miserable job. I respect RNs, but I definitely don't want to have to do what they do. Hell I did do what they do when I was a medical assistant. I literally had the same responsibilities as the actual nurse at my job, and it SUCKED.

So I know that I don't actually have to worry about how my physical exam is going to go. But I would really prefer if they didn't know I was a PA student. Unfortunately my pages of paper work that I need them to fill out is going to give it away.

womp womp.

Silly Breeders

2010-04-19T19:40:00.002-04:00

I had the most horrid Infectious Disease exam today. It was all parasites, hepatitis testing and CD4 count related illnesses. Where was the sepsis, pneumonia, TB, STDs?!?! I wouldn't complain about the hepatitis testing questions if the lecturer had actually explained clearly what each test measured. And when am I ever going to be given ONLY a CD4 count and asked to diagnosis the HIV complication. I mean really people. Throw me ONE symptom.

There was one question though that I unknowingly had an advantage on.

Who is at the highest risk of contracting HIV?

The catcher (anal)
The pitcher (anal)
The pitcher (vaginal)
The catcher (oral)

Score 1 for team gay. Evidently the whole class was really thrown by the question.

Let's Get Real

2010-04-14T23:32:00.000-04:00

I've been doing a lot of reading of what is required of people to join the military. One of the biggest things is that you have to be ready and willing to get shot and killed. This sounds like a bunch of bullshit. You think that all those kids coming out of high school have really thought about getting shot and killed seriously?

I ask a question like: what is the likelihood of getting seriously harmed as an Army Medical Specialist (PA) Officer and these are the answers I get. YOU MUST BE READY AND WILLING TO BE KILLED. This is not helpful for the logically inclined. Yes, I'm aware of the dangers. Could you please answer my question now?

Follow Up

2010-04-13T17:05:00.001-04:00

When I'm going through a case study with a faculty member and they start justifying their treatment plans because it avoids litigation it makes the Army sound better and better. I refuse to practice defensive, CYA (cover your ass) medicine.

I say this now...

Military?

2010-04-12T20:05:00.001-04:00

For a few years the idea of being a military PA has always crossed my mind. I have no idea why. I don't come from a military family. The only members that have been in the armed forced are my grandfathers who were drafted. Unfortunately the only one who saw action died before I could get to know him. So I don't even really know what military life is like. I'm seriously perplexed as to why this interest keeps popping up.

I really have no interest in seeing any action. In fact I would try my hardest to pick the safest branch of the military possible, without having to work in family medicine. Nothing in the world could be worse that working family medicine.

When I think about the areas of medicine I'm interested in (Critical Care, ER, Hospitalist) it might make some sense. I really only want to see sick patients. I want to treat people that actually need medical attention. Clearly in the military you would be seeing this. I don't have a huge reserve for seeing patients that just like to bitch and moan and just like the idea of being sick, as opposed to wanting to know how to get better.

I'm definitely not going to rush into anything. How about we wait until a graduate and pass the PANCE. We'll see what kind of job offers I get and if I'm doing anything with my life.

Sticklers

2010-04-12T15:47:00.001-04:00

I just did my neuro physical exam practical. It overall went fine. I think it's amazing how strictly we're graded on Barbara Bate's method. For instance, to test for light touch I lightly touched my patient with my hammer. I got points off because a hammer isn't considered light. Last time I checked the hammer isn't exerting a force on its own. The pressure I supply determines whether it's light or not. But alas, I got point off for that.

There are some things we never have to perform and just need to describe such as taking femoral pulse, creamasteric reflex and anal wink reflex. They will give me full credit for describing how to do the test, but when I forget a paper clip I get no credit for describing how to perform 2-point discrimination perfectly. I guess the joke is on them since I have never successfully found a femoral pulse, yet the grade says I have.

Vent over. Be present. Be the Buddha.

2010-04-10T02:33:00.001-04:00

Tonight a girl in my class was getting hit on by a guy she didn't want
anything to do with. I showed up at the bar and she told the guy she
was with me from across the room. He promptly left her alone. I'm the
man.

Sent from my iPhone

Out Gay'd

2010-04-09T22:51:00.001-04:00

My straight guy friend are in and intense conversation about American
idol. I'm just staring with a look of disbelief. I can never get shit
for watching project runway ever again.

Sent from my iPhone

Class Etiquette

2010-04-07T19:31:00.001-04:00

People in class like to get into groups and split up lecture topics to write study guides for. Someone people freely hand out their study guides to whomever wants them, regardless of getting something back. Others don't like people leeching off their work unless they're getting something in return. If you work in a study group don't hand out the notes that you receive from other people in the group. It just creates tension within the group.

I personally don't take part in any of these groups. I don't like being on a deadline and being held to other people's crazy studying standards. I've never even look at the Course Objectives, let alone create a comprehensive study guide for them. I also NEVER ask for study guides from people and rarely accept them when offered. There are a couple of times when I accept them because I'll offend someone if I don't. I rarely use these guides since 1. I don't trust most people in my class, 2. They are so overly in depth that I find them impractical.

I like that I still have a little House left in me.

2010-04-07T17:55:00.001-04:00

Hmmm. Blogging from my phone. This should be interesting....

Sent from my iPhone

Speaking of Anonymity

2010-04-07T14:22:00.003-04:00

I was just asked by the PA Professional magazine to give a quote on the pro's and con's of blogging anonymously and why I choose it. That's pretty neat.

Anonymity Compromised!

2010-04-06T20:15:00.004-04:00

I try to keep this website anonymous. It doesn't help when you accidentally send out two e-mails using your blogging address to people who know you. Damn you Apple Mail! You can't say that it's from Personal e-mail, but then send it through Blogger e-mail. That's not cool.

Soooo..

Dearest Pharmacology Professor,
I love you. You're wonderful. And everyone agrees that you have the most smoking body post-2 children ever. I feel proficient at diabetes medications and will correct every patient's blood glucose levels that I meet. I will become a diabetes managing animal because of you.

Please don't tell anyone about my blog!

G

I think there is a greater likelihood of her not searching my address name and finding this site, but lets hope I don't need to self-destruct this site's ass. Not like I really write anything to scandalous anyway. My grandmother has more to lose at this point than I do.

Crap.

2010-04-04T01:45:00.002-04:00

For some reason I was talking to my grandmother about weight loss methods. I mentioned the pill Alli and how it works. I half heartedly suggested that my overweight uncle should give it a try, since obviously the diet he's perpetually starting "tomorrow" isn't cutting it. And that clearly he's letting himself cheat more than he should be.

Today my grandmother started asking me all these questions about Alli again. Would it be considered a supplement, vitamin, etc? Where would one find it? How do you spell it? As she asked all this I was assuming she was thinking about buying it for my uncle, but I decided to confirm this. NOPE. She wants to use it herself.

For those of you would don't know how Alli works: dietary fat is blocked from being absorbed and is excreted with feces. This can often lead to oily (read as: explosive) bowel movements, increased frequency, etc. It's really more of a behavioral modification tool. It's to get people to stop eating too much fat because otherwise they're going to shit their brains out.

I never meant to suggest this to my grandmother. I had no idea she would consider this for herself. I should have known better. I'm trying to think of a way to tell her not to do this. If she was one of my patients I wouldn't have an issue with this, but when it's my grandmother I feel condescending. I think I'm just going to be a straight shooter with her and tell her the gory details. I have told her the possible side effects, but I don't think she's following me. She has a hard time following me on most things.

What a literally shitty situation.

2010-03-25T20:39:00.001-04:00

I hate anatomy.

That is all.

Anesthesiologists: Are they using their own gas?

2010-03-24T09:15:00.003-04:00

Maybe it's that more anesthesiologists visit The Underwear Drawer that other specialities, but it seems none of them know the role of PAs. The only people that have said unintentionally (or intentionally) disrespectful things about the PA have been anesthesiologist. What gives?

2010-03-23T00:15:00.002-04:00

I just had a really funny moment. I had commented on The Underwear Drawer about what the role of a Physician Assistant was. You know, a professional one with a high level of training. One where there actually is a certain degree of autonomy, regardless of what the title implies.

An anesthesiologist (not the author) commented back that a PA is "no where close to being a physician and never will be." I literally laughed out loud at that. It's just such an obviously moronic comment. This is a typical example of someone who thinks that just because he went to medical school only he knows all the magic words. Guess what pal, patients are coming into office speaking accurate medical-ese. You do not have to go to medical school in order to be intelligent in a subject. In fact, I bet there are people who have gone to medical school that are totally moronic about what they're supposedly an expert of.

I think someone is a little bitter that they're never really the head of the OR, and never will be. It's okay, he can trounce on the mid-levelers all he wants. It's not going to stop me from getting a job and being happy. It will however make his life harder having a few less people willing to help him out. I hope someone points out to him that he's not the puppet master. There are no orders he can write that I have to carry out.

Humility shows wisdom.
Karma's a bitch.

Landlord Underestimates Me

2010-03-10T00:20:00.002-05:00

I told my landlord that our washer is leaking. He responded that he's having a stress test done tomorrow (s/p MI 3 mos ago) and that he needs a couple days of rest afterwards. He's going to get back to me next week.

Who does he think he's kidding? I know perfectly well that you don't need a few days rest after a 20 minutes treadmill workout. Clearly he doesn't take the PA profession seriously.

I also need to start caring about school again. I've been slacking majorly since starting this semester. I don't care about having high grades just like the faculty has stressed to us. But failing your oral presentation because you were too lackadaisical is totally unacceptable. And that OB/GYN test was an eye opener too. However, I did end up passing it.

New leaf turned.

Ban on Gay Blood

2010-03-08T17:52:00.003-05:00

A classmate's family member is working on a PSA to have the ban on gay men donating blood lifted. Classmate asked if anyone in the class wanted to be a part of this effort. Being one of the two gay males in class I felt I had to give this especially close consideration.

After thinking about it I've decided that I don't support this. Whether we like it or not gay men are a high risk group of carrying HIV. It's the FDA's job to protect the integrity of the blood bank resources, which includes using effective screening protocols. It's not as if gay men are the only people denied this option. If anything, I believe that there are groups of people that are less likely to have AIDS that are also banned.

I'm a man of science and statistics. I would be doing a disservice to my patients to be basing medical decisions often off statistics, yet saying statistics shouldn't be used as a screening tool because of it being "stereotypical." I've said for a long time that stereotypes don't come from no where. There is often a statistical correlation to back them up. I stand by my word.

So much for OB/GYN

2010-03-04T13:42:00.002-05:00

While we're on the topic of not knowing female anatomy, I also don't seem to know much in the ways of female medicine.

OB/GYN, I think not...

FML

2010-02-04T23:04:00.003-05:00

I did what people think is the impossible.

Anatomy Practical of the Pelvis and Perineum

A: My answer = uterine artery
Actual answer = vas deferens

B: My answer = ovary
Actual answer = seminal vesicle

Summary: I put male organs. The answers were female organs.

In my defense they removed all the organs inside the pelvis and I'm pretty sure you couldn't see external genitalia.

Fail.

Blogging Therapy

2010-01-18T14:11:00.003-05:00

One of my PA-S friends suggested that I go on vacation with him and his husband over spring break. My obvious hesitation is being the third wheel. I've expressed these concerns but he assures me that after being together 6+ years they don't get all cutesy in public and that I'm not going to feel like a third wheel. I still have my hesitations.

These hesitations were confirmed last night when I went out with them. As any normal couple does after a few drinks they were all upon each other. It was okay last night because there was a fourth person (who they were trying to set me up with), but I wouldn't be able to handle it alone. It wouldn't even be that it's awkward, it's more depressing for me than anything.

I don't know how deeply into my personal life I want to get on my blog, but I'll quickly share my latest match.com story. Over break I went on 3 dates with this guy and things seemed to be going okay. My only problem was that I initiated EVERYTHING. Granted he went along with anything I suggested. I'm a very good conversationalist, but I was struggling by the 3rd date. So the day after the third date I just said "hi" to him online and decided I was tired of always being the pursuer and that I was going to leave it up to him to show any kind of initiative. Haven't heard from him since. This doesn't bother me that much because it's not like I was head-over-heels for this guy. I just wish he could have at least taken the initiative to say, "thanks but I'm not feeling it." I don't like being taken for a ride.

So now I'm hypersensitive about my single life. I don't like being like this. It completely goes against the personality I thought I had. (Being House-ish) I've definitely been losing this personality more and more lately. Blaaaahhhh. It's because all my friends in school are very emotional, and touchy-feely with each other, and overall really nice people. They're rubbing off on me. Bahh humbug. This will teach me to spend my entire weekend being surrounded by my close friends who are in relationships.

My Two Cents: Same-Sex Marriage

2010-01-12T17:11:00.004-05:00

With all this news surrounding the Same-Sex Marriage debate, I figure I should share my opinion. Hell it's my blog, I can do whatever I want.

My position is definitely not an original one, but not necessarily one of the mainstream viewpoints. I think it's ridiculous that marriage is a government regulated institution. Last time I checked a marriage was generally based off religion. Marriage is traditionally the bonding of two people, under the same faith, that are going to spread their seed and consequentially their religion. Isn't this a country that's suppose to separate the beliefs of church and state.

Not only is this an example of religion's influence on government, but also government's control over religion. People are suppose to be able to practice their religion without the government getting in the way. But government gets directly involved in the practices of a religion when they determine who can get married, and who cannot. Should government really be allowed to determine which religion's marriages count and which don't?

Then what about the growing atheist population? They have no religion and will still be allowed the same "Marriage License" that those of faith get. Shouldn't they only be allowed to get Civil Unions, since they have no religion to officiate their marriage? Why don't all the Christianites ever try to stop these marriages?

Bottom line: I think marriage should be a strictly religious institution and that everyone who wants tax benefits (etc) should be required to get Civil Unions. Granted, then you'll probably have the same arguments made against Same-Sex Civil Unions, but I don't see how it could hold up. In order to have a Civil Union you must be able to procreate? What about those who don't plan, or cannot have children?

Winter Break 2009: recap

2010-01-09T18:52:00.004-05:00

Accomplished all goals of the break except seeing Nine. But from what I hear that might be for the best. I guess I'm waiting for that one on DVD.

Classes restart Monday. First topic: the breast exam. (gaaaaah)

They told us that we MUST by the OB/GYN text book. I refuse since I didn't use a single text book last semester. Let this be a lesson to anyone starting PA school, don't buy the textbooks.

They also told us to read the EKG textbook over the break. I didn't do it, but is not something I would discourage people from doing. We have a total of 4 lectures dedicated to interpreting EKGs. That is a huge amount of time. I'm slightly nervous, but refuse to spend my break reading PA things, since that's all I do when I'm in school.

Review: The Twilight Saga

2010-01-04T01:36:00.004-05:00

This book has given me the confidence that I could write a fiction series that would be successful. I mean hell, if an angsty 16 year old high school girl can do it, who obviously didn't have an old school Catholic HS grammar/writing education, then surely I can do it.

This may be one of the rare cases where the movies are better than the book.

Review: Amazon Kindle

2009-12-26T01:40:00.003-05:00

This thing is effing amazing. I don't know which I like better about it: the comfort of reading from it, or the huge discounts you get.

I bought the Complete Collection of Sherlock Holmes for $2.37. That was a 67% discount! And I know it's probably a lot more comfortable reading on this thing than the super cheap generic paperback it would have come on. I also just bought SuperFreakonomics for $10, another 60% discount!

I finished my first shorter Sherlock story, A Study in Scarlet. Next I'm reading SuperFreakonomics. After that it's either going to be another Holmes, or the first Twilight. I'm not particularly proud to be reading that, but I want to see what all the hoopla is all about before I bash it (any further.)

Winter Break 2009!

2009-12-22T23:14:00.007-05:00

I survived what is supposedly the hardest semester of PA school. Horrah! Not only did I survive, but I came out with a 3.85GPA! I'm doing so much better in grad school than college. I honestly think it's because all the tests are multiple choice. w00t!

Leading up to the break I made a long list of things I wanted to do over the break:

Get some dates on Match.com
Read on my Kindle (that I'll get on Christmas) in public places
Finish Level 2 of Spanish Rosetta Stone
Catch up on V and Flashforward
See Avatar, Up In the Air, Nine and Battlestar Galactica: The Plan
Sleep

I made quick work with the first one. I had a date planned within 3 days of joining. (And it was actually with my first choice!) And I know I said I wanted "some dates," but does it count that I have a second date planned with the same person after NYE? w00tw00t

I don't have a Kindle yet, but I have started reading Sherlock Holmes, which was the last book I attempted to read before PA school started.

Rosetta Stone is going to take time, but I've done it two nights in a row so far. I'm not going to be able to start it again until I'm back from visiting with my family.

I've watched the first 6 episodes of Flashforward, but that's really good considering the season has only had 10 episodes.

I saw Avatar today. My eyes took a little adjusting to the 3D, but it was entertaining overall. The story was pretty simple - Pocahontas meets Fern Gully, plus a splash of Jurassic Park.

You'll all be happy to know I'm back to my old ways of going to bed late, and waking up later.

It's good to be on break. I refuse to allow the fact that I'll be in my mid-20's once the next semester starts ruin it.

Almost There

2009-12-13T01:49:00.001-05:00

I promise a recap on the year is coming.

Lab Medicine, Clinical Application, Pathophysiology are the in the past.

Pharmacology, Medicine and Anatomy await me next week.

You have no idea how much I look forward to this winter break.

Elective Rotation

2009-11-24T14:29:00.001-05:00

Chosen. Medical ICU. Done&Done.

PA Hopeful Interviews

2009-11-09T17:04:00.002-05:00

I have realized that going to interview sessions to answer applicant questions is an AWESOME place to meet people. It's encouraged for me to ask question of people, and not weird when you give them your contact information. And I'm the only single gay in my class. NO COMPETITION

Look out of your a cute guy interviewing at my schoool ;-)

Dr. K!!!!

2009-11-08T23:55:00.002-05:00

Dr. K why has your blog, That Mirror Belongs to Frank, been closed to meeeeee. Please let me into your life, because I live vicariously through blogs. The current status of mine is far to boring to keep my sane. You were just getting to the fruits of your labor!

E-mail me!
gregoryhousepa@gmail.com

Cardiac Innervation.... about that....

2009-11-06T19:05:00.003-05:00

So you know how I said I didn't ace Heme/Onc? I lied. I got a 93. I evidently have a knack for blood work results.

This last anatomy exam on the other hand.... That was rough goings. I have no idea what type of functional fibers go where or what innervates what... It was a mess. There were lots of "all of the following are true EXCEPT" questions. You know it's not good when you get it down to three answers and think to yourself, "Wow, I didn't know that maybe A, C and D were true! I've learned something."

Hey, if I commit those five choices to memory, then only 1/5 of my information is faulty. Testing can be a learning experience!

I predict a 56 on the written exam and a 76 on the practical. Womp womp. I accept that I can't win them all. As should all medical and PA students.

Stopped Caring and Still Succeeding

2009-10-28T17:02:00.002-04:00

We had our Heme/Onc test today. My class threw a fit during the exam review. I personally had no beef with the test. Was it hard? Yes. The answers don't just jump out at you like other subjects. You have lots of lab values to think about before you can come up with an answer. Everyone started blaming the faculty for not preparing us enough and not telling us what to study. Are they kidding me? They give us the objectives and the tests are made from it. If one of the guest lecturers didn't cover an objective then look it up.

I don't know if anyone actually complained that the test wasn't representative of the objectives. I can't comment on this because I didn't even look at the objectives. There is an insane number of objectives. I can't effectively study if I worry about everyone of those objectives. I just study the power point notes and assume that the major stuff will be covered. It's working out okay for me. Not to toot my own horn, but I literally read over the power points once. You can effectively study from them. I didn't see anything on the test that wasn't on the power points. People were claiming that you had to study other classes' materials to do well. Not true.

However, my professor's response to their complaints threw me off the deep end. She was telling us that we HAVE TO DO THE READING and that power points aren't enough to pass. She said that we need to be staying in every weekend and doing work every single night after school. Hey lady, this weekend I didn't leave my dining room table. I literally spent over 24 hours studying last weekend. As for needing to read to pass - that is bull shit. First off, there is NO TIME to do extra reading. The amount of material in the lectures is overwhelming enough. Second off, reading is not required to pass. I'm proof of this. I've never done any of the scheduled reading and I'm doing just fine. The faculty hides behind Reading is necessary for when students call them out on not covering something.

Anyway Pathophys and Heme/Onc were not aced, but comfortably passed. That is the mission objective. Mission accomplished.

Reasons Against Primary Care:

2009-10-24T19:19:00.001-04:00

Coumadin management.

2009-10-20T14:16:00.001-04:00

Day off before a Pathophys test and what do I do? Studying? Hell no. I make chili and pumpkin bread for the review session later today. Duhhh

Topics on test: Eyes, Ears, Pulmonary, Cardiac, Hematology, Cellular Phys/Inflammation

Baby's First Fail

2009-10-20T00:41:00.003-04:00

I got an estimated 78 on my Clinical Micro test last week. Passing is 80. Womp. I hate micro. It's all memorizing. There is nothing to figure out. I need ideas to put together. Things that require memorizing have never worked out well for me. If you give me a pathology where I'm asked the general symptoms or mechanism of action I often will just figure it out during the test, and not have them previously memorized.

Cry for me.

Results

2009-10-13T16:12:00.001-04:00

Aced Dermatology, but slightly annoyed I couldn't pull off a 100.

Passed Anatomy with a greater margin than anticipated.

A Day of Revelations

2009-10-12T18:40:00.003-04:00

I went to the podiatrist today because I always get bad leg pain when standing for too long. I figured I should finally do something about this before I had to hang out in the hospitals for long periods of time. What she told me blew my mind away. MY RIGHT LEG IS SHORTER THAN MY LEFT!!! Evidently my knees do some crazy movements in order to keep the upper half of me aligned, which she said I do very well all things considered. I don't understand the mechanics of it all but it somehow forces me to put too much weight on my heels and my knees hurts cause I move them too much when I walk. Somehow orthotics will fix this. This is also evidently why the tongues of my shoes always love laterally. Crazy.

The other revelation....

We got the rest of this semesters schedule today. Can you say 2 exams a week for the rest of the year? Strike me dead now.

This Week:

2009-10-12T07:13:00.002-04:00

Tests in Dermatology and Clinical Microbiology.

I feel more prepared for one over the other. Can you guess which?

2009-10-09T09:35:00.003-04:00

More Lesbians than Gays kicked out of the Army

These people are clueless. The reason there is a "disproportionate" amount of lesbians being kicked out of the military is because lesbians are much more likely to join the armed forces than gay men. Helllloooo, just look at Shambo on Survivor.

Octobre, no es bueno.

2009-10-08T19:03:00.002-04:00

This month we have 8 exams. 2 Pharmacology, 1 Pathophysiology, 1 Anatomy, 1 Clinical Micro, 1 Derm, 1 Heme/Onc, 1 HEENT.

I so far have taken the Derm/ANS Pharm test (98) and the HEENT practical (94).

The pharm test was easy for me, but I'm nervous about the next tests because they're more names and less concept.

The HEENT practical was pretty hilarious. My class-bffl and I happened to be partnered together. He was a nervous mess. He introduced himself as a "Physician Student Assistant..... Student." Couple this with the fact that he's from the Dominican Republic and has learned English over the course of the past 4-5 years. He did a good job. The only problem was that he was having crazy coughing fits. He didn't cough all day except for this. It was kind of funny how many times he had to stop to cough. But the thing that got my professor literally bending over laughing was when he was doing the otoscopic exam on me and just started coughing all over my face. She also was the fear in my eyes when he was checking my throat. Why not guarantee I get the Spanish Influenza and cough right into my throat! It was also really funny how high he jumped and how loud he yelled when he was racking his brain for the thing he missed. "THE SINUSES!!!!!"

I think I took the cake though. I went through my practical and at the end I asked how much time I had left. She told me 15 minutes, half the total amount of time. I MUST have forgotten something huge. I had never gone through the examination that fast. I went through all my motions and couldn't figure it out. I don't know how it dawned on me, but I remembered. In a state of shock and embarrassment I said aloud, "O-M-G, I didn't take vitals." My friend and professor both gave the biggest sighs of relief once I said that.

Today I took the Anatomy test. That was not good. The written part I think I did fine (read as: passing) because I knew AT LEAST half the answers and the rest I was able to get down to two possible answers. I'm assuming I follow the laws of probability.

The practical on the other hand. God who knows. I'm just hoping for passing. Thank god they made this class pass/fail.

How Not to Help the War

2009-09-29T17:51:00.001-04:00

While on line to get a required flu shot

RN: So why did you want to be a PA and not a nurse?
Roommate: Because I don't want to wipe ass.

fin.

This is not considered helpful in terms of mending the gap between nurses and PAs.

Accomplishment

2009-09-22T20:35:00.000-04:00

Visual contact of the Fundus: check.

My Life Challenge

2009-09-11T16:25:00.001-04:00

I one day want to treat a DIC patient, and keep them alive. Critical care gives me a hard on.

Relationships

2009-09-02T16:54:00.005-04:00

I have always been told that med and PA school will break relationships. This idea has not yet deterred me from still trying to meet people and get myself into a relationship. But recent events have made me think that maybe I'm lucky for not being successful in my endeavors.

Roommate has been in a relationships since freshman year of college, the past 5 years. Last year they stayed together strong, even though they were multiple states away from each other. This year they live in adjacent states, very close to each other, and shit couldn't be going worse. It has been well agreed what the cause of this issue is. GF is not liking the fact that he has a whole new life and she's "stuck" at home, not meeting new people, not where she wants to be professionally, etc. She feels neglected, and I say honestly and objectively that she has no reason to feel like this. I call my friends out when they treat their significant other like shit. Roommate is easily the greatest BF I've ever met, and she's letting her insecurities get in the way of seeing the true situation at hand. Trust me when I say there has been a lot of drama going on.

I have become chief adviser/therapist/bro to Roommate. Not an unfamiliar role, but more intense since this was a relationship that was looking towards marriage - something that people my age are only starting to breach. I've provided all the analysis and advice I can. I know that I'm dead on, and I know that if I were listened to there would be the greatest likelihood for success. This is the kind of stuff I do, and I strive at it. Roommate agrees with my analysis, but isn't heeding my treatment plan because it goes against his philosophy of "picking your battles." I've yet to convince him that this is a battle worth fighting.

The weirdest part about all of this is how emotionally taxing this is on me. I have legit anxiety about all of this, and can't even imagine what Roommate is experiencing. (Especially since we're probably finding out tonight if this relationship is continuing or not tonight -gaaaaah!!!) I think it's because I really have been in the trenches, unlike other experiences. This is a good thing though. I've been trying hard to work on my empathy and being in touch with my own and others' emotions. When I was seeing patients last week I was definitely trying to reflect a little more on the situation, instead of letting their neurosis get on my nerves. I've been trying to give Roommate more emotional support as opposed to just rationalizing everything like I generally do. It's definitely weird handling the whole situation in a less "masculine" way. In the past I would probably worry about how I was coming off, not wanting to seem too "gay." But hell, that's exactly what I am and that's exactly what he's getting.

I just hope I don't lose the logical/rational side of me by embracing these new feelings. I wouldn't want to have to change this blog's title to "The Future Izzie Stevens, PA."

Round 2

2009-09-02T00:36:00.002-04:00

Round One was a blood bath. That semester didn't stand a chance against me, but lets also remember that was only 7 credits. This upcoming semester is 19. And it's 19 REAL credits. This is going to be an entirely different ballgame.

Pathophys
Medicine
Gross Anatomy
Pharmacology
Clinical Application
Lab Science

The schedule is totally mixed up. One week we'll have Pharm once, the next week we'll have it 3 times. Basically they arrange it however the faculties schedule will allow.

I had gone back to work at the Derm office for a week. That was a terrible idea. I hate that job. That office is so freaking crazy and the job I have is so miserable. The one nice thing was that I refused to do anything in terms of phone messages, lab follow ups, prior authorizations and all that other grudge work. The first day back I tried doing all that stuff and became miserable quickly. I then realized I'm a TEMP. I was getting paid half the amount the non-college educated medical assistants. That's horse shit. So now they're getting what they pay for.

The first month of our Medicine class is Dermatology. I ready and excited for this. I'm not excited because I'm excited about dermatology. I'm excited because after looking over the course objectives I already know a lot of the material. Maybe that job will continue helping me out. Horray for me.

Semester One: Check

2009-08-21T17:29:00.002-04:00

1 Didactic semester down. 4 to go.

3:45AM

2009-08-16T07:51:00.003-04:00

After a (should have been longer) night of studying gastrointestinal physiology, what phone call do I get? My friend calling because (s)he is throwing up, shaking and had water poo. I honestly didn't know what to tell her. I just said you should throw up more than once before you consider the ER.

My first medical "emergency" phone call. Lame. Sleep is better.

Good Idea

2009-08-08T14:28:00.003-04:00

Movies early on a Saturday are a good idea because:

1. You pay more than half less for the ticket.

2. You're bright and shiny for the rest of the day.

I saw Julie&Julia this morning. It was very pleasant with great acting. Check it out.

SHE'S BACK!!!!!

2009-08-02T14:24:00.004-04:00

MICHELLE AT THE UNDERWEAR DRAWER HAS RETURNED!!!! I don't have a religion, but I think this is the joy Christians get at Easter. I knew she would come back. This was longer than her other unannounced breaks, but it was a test of faith. I PASSED.

Yay PA School

2009-07-28T18:17:00.004-04:00

School is going very well. Tomorrow is our Physiology midterm and I'm feeling good. My mentality is that I just need to pass, and that's what the faculty keep telling us. They tell us to study to learn, not study to get A's. I'm doing just that. I feel very comfortable with the majority of the material and definitely good enough to get that B. I kind of like knowing that I don't need to know everything. I know enough to pass and that takes stress away, which I think helps me learn more in the long run.

The reason the faculty says "just pass" is because they never get asked what our grades were by employers. They care more about if we bitch and moan, work well with others, act professionally and if we passed. This is a huge difference from med school, which I didn't realize until now. In med school your grades still matter so much, especially for residency. I couldn't imagine needing to care about grades anymore. I'm sick of caring about grades and looking forward to more applications.

It's nice to know that the specialty I want won't be determined by grades, but more by my reputation and job opening. Screw you medschool!

Ethical Dilemma

2009-07-23T17:36:00.004-04:00

Ethics is my thing, especially bioethics. They were my favorite classes in college and I was always well received in the classes. I hope to one day be on a hospital ethics committee. I'm currently taking bioethics, and it sucks. The professor is horrible. I feel she makes his opinions known way to often, which inhibits the class from telling their true feelings. I know a couple of instances where people didn't agree with what was being said in the class and specifically kept it to themselves because the professor made it so clear what (s)he thought about the issue.

The other day we had an online discussion assignment asking if we thought a patient was mentally capable to make decisions or not. Most of the class went on a tangent and answered the question by saying what they would do as the PA. There was no vagueness to this question. It clearly said, "Do you agree that this patient in mentally capable and explain?" When I read people's responses going into the details of the actions they would do, I cringed. That wasn't the question.

I thought I really killed it. I kept it within the 250 word limit. Directly answered the question and clearly explained how I came to this conclusion. 1-2-3. My response got the most replies of anyone else, and most everyone praised me for the analogy I used. One of the few people who did not was the professor. In short, the professor shat on me.

But his/her criticism was that I didn't take into account societal effects on my decision. (S)he basically didn't like my opinion on why I wouldn't have the person committed. THAT WASN'T THE QUESTION. The professor loved all the answers where people regurgitated the stupid sayings the professor had in class and showed that they cared a lot about what happened outside the clinic to third parties. I could have had a whole discussion on how the actions of the patient outside the clinic do matter at all, but I'll save it SINCE THAT'S NOT THE QUESTION.

AHHHHHH!!!!! This professor is from now on called Prof. Biased.

I e-mailed Prof. Biased highlighting my intentions in the answer and trying to avoid reading more into my answer than intended. No professor, I didn't try to argue whether it's moral to have her committed since that wasn't asked. So don't assume I was trying to do that because everyone else in the class did.

Advice

2009-07-15T07:55:00.000-04:00

I have recently interviewed for several medical assistant positions. Although I haven't been accepted yet, I would like to ask you some questions about your experience as a medical assistant. I have a B.S. in Biology but no experience whatsoever. I know you were in a similar situation. How difficult was it for you to do certain procedures or duties? Can you please give me some advice or any tips on how to be successful and learn as much as possible?

You graduated from college. You are then totally capable of handling any medical assistant duty they throw at you. The hardest thing for me to learn was how to load a patient and get the starts of a history. It also took me a while to be comfortable taking the notes of what the assessment and plan was for each patient. But this is the stuff you learn in PA/Med school! It's not suppose to be easy. So if you go in accepting that you're probably going to suck at the beginning, then you'll be okay.

There were other things that were easy, but uncomfortable like giving an injection, doing a little cauterization during a surgery, laser treatments. But again, you have to accept that it might suck the first time you do it, but you're not going to kill the person.

Make sure you take the job that will give you the most patient contact possible. I feel like my job gave me an inordinate amount of responsibilities. I was quite literally doing the same job as the ACTUAL nurses.

In short: Accept that there is a learning curve and that you will suck at your job at first. If providers go nuts on you, don't take it to heart. They get what they pay for - an untrained new college grad.

Day 1 Report

2009-07-15T00:03:00.003-04:00

Orientation went fine. A lot of the students put us to ease about the impossibleness of the work load. Time will tell if they're lying or not.

Roommate and I went out with a lot of the students tonight. A good time was had and I enjoy the company of everyone.

There are two guys that seem particularly cool towards me. I'm not sure if it's in my head, but Roommate says they've been really nice to him. Don't know what the deal is there. I had told one of the two of them that I'm gay when I had asked him if he wanted to live with me and Roommate. I don't know whether that's playing a role or not. I certainly don't feel like I'm bonding with the guys though. I'll keep you updated.

Physiology tomorrow. Yessss!!! My favorite!!!!

Blaaaaah

2009-07-14T07:16:00.000-04:00

Why am I up so early (for me)?! School here I come.

Advice

2009-07-13T19:03:00.002-04:00

Question:
I expect to be applying through CASPA next year. I was wondering' which school you're going to and why did you select it? You could help me narrow down my choices...

Sorry but I try to keep my identity anonymous, so I don't tell people where I go to school.

I wouldn't be the one to help you narrow down your choices anyway. I applied to 18 schools. My criteria for school was that it didn't require the GRE, was in a city I wouldn't hate, and I fulfilled the prereq's. Oh, I also didn't bother applying to any schools not on CASPA simply because I was too lazy. My top schools were all somewhat around my hometown, or a city that I really wanted to move to (Boston). I didn't look into things like rotation sites, curriculums, etc. I did check out the schools' PANCE pass rates, but those are generally high at every school (90+%). I was all about giving myself the greatest possible chance of getting into school. Compared to the cost of attending PA school, the application fee is nothing.

As for why I chose my school. I chose it cause it was the only 1 I got into. Lucky for me it happened to be one of those top choice schools. I got very, very lucky and plan on asking the admissions committee what it was about my application that got me in. (it wasn't the grades)

One Hair at a Time

2009-07-13T15:01:00.002-04:00

I just went to a hair design school for my haircut. It was the first haircut this girl had ever done. She did a good job, but jesus it took forever. What generally takes 20 minutes TOPS took 2 hours. I literally took multiple naps while she cut my hair. I wasn't sure if I was suppose to tip or not, but I didn't. I figure I'm not going to be getting paid anything while I'm a student, why should she.

It was funny though because she took a lot of picture with her phone. She was very excited and proud of the work she did and she should be.

2009-07-13T11:03:00.001-04:00

The countdown says zero, but I actually start tomorrow. Don't cry for me yet.

The Schedule

2009-07-10T02:49:00.002-04:00

Dr. K, ask and you shall receive.

Summer I: Monday-Thursday 9a-4p
Human Physiology
Psychosocial Medicine
Professionalism and Bioethics

Fall: Monday-Friday 8a-3p
Gross Anatomy/Cadaver Lab I
Clinical Medicine I
Medical Pharmacology I
Pathophysiology
Basic and Laboratory Science I
Clinical Application I

Spring: Monday-Friday 8a-3p
Gross Anatomy/Cadaver Lab II
Clinical Medicine II
Medical Pharmacology II
Clinical Application II
Basic and Laboratory Science II
Epidemiology and Evidence Based Medicine

Summer II
Clinical Medicine III

Summer III
Clinical Medicine III
Health Promotion and Disease Prevention

Clinical Rotations: 14 Months
Internal Medicine
Pediatrics
Obstetrics/Gynecology
Psychiatry
Primary Care
Emergency Medicine
Surgery
Long-Term Care
Elective (Abroad?!)
Senior Year Capstone (Dealing with Death)
Research Methods/Master Project

My Wallet is Crying, While my Closet is in Celebration

2009-07-09T17:31:00.003-04:00

School needs to start soon for the sake of my wallet. For the past three days I have gone shopping for clothes for school. And to make this even more difficult I just learned that Big City doesn't have sales tax on clothing. Gaaaaaah This could never end, and it needs to right now.

But on a more positive note I think I will be the most well dressed male in my program. This isn't saying much since there are only like 9 and I'm the only le gay.

HyperCare!

2009-07-05T17:14:00.001-04:00

My prescription antiperspirant cost less than the OTC "prescription strength" one. Niiiiice.

Touchy Nurses

2009-07-05T02:46:00.004-04:00

My friend Maria is in nursing school right now. Of my hometown circle of friends she's the only one going into health care. She also plans on eventually going on to become an NP. This is a dangerous situation because Maria is a very aggressive in your face person. I get along well with her, but you don't want to get on her bad side.

My other friend one time unknowingly started a small NP vs. PA battle. He had jokingly said something to me about coming to me when he needs the "good stuff." Maria then looked at me with a confused face and said, "But aren't you going to PA school? How will you get him the 'good stuff." She had no idea that PA could prescribe medication. I don't think she has any idea what the role of a PA is. I'm fairly sure the only PA she's ever seen on rotations was a surgical one and she admitted that they were doing hardcore work with the surgeon. But I still don't think she realize PAs see their own patients in most medical specialities.

Tonight I was playing a drinking game against her and at one point called her "Nurse Maria." She immediately got offended and said, "Whatever. I'm going to be making more money than you." I was taken aback. Not because she was so delusional about that comment, but that she thought I was trying to be offensive. I think nursing is a very respectable field. I don't compare it to being a physician or a PA because they're not the same. Nursing does their thing, and Medicine does theirs.

I try to avoid this whole NP/PA battle as much as possible. I don't judge people's performance at work based off their title. I base it off their actions. If they're a competent provider then I respect them and their opinion. I don't care if that comes from nursing, PA or medical school. Medicine is not this big secret where only med students get taught the magic words.

Classic Convo

2009-07-04T03:30:00.002-04:00

[Watching Fox News about Palin's resignation]

Me: (After listening to grandma defending Palin on and on and on..) I'm just going to throw this out - I don't like her.
Grandma: How can you say that?! You don't even know her! I love her!
Me: I know her just as well as you do and we come to two different conclusions.
Grandma: (jokingly) I think you're just a liberal!
Me: Yes, I'm a big liberal that refuses to shave.
[I do in fact refuse to shave because regardless of what my grandparents think, facial hair is not some hippie protest and is actually my attempt to look hot. I've got the Grey's Anatomy scruff going on for the past 5 years. They skill haven't accepted this.]

This side of the family might as well be Evangelicals. Fox News is basically the only channel they watch. They'll watch CNN late at night. But they basically consider everyone outside of Fox News big liberals.

I personally think the liberals and conservatives have run away with what the original Democrats and Republicans stood for. I consider myself Republican and NOT conservative. There is a difference between the two, but the line has been greatly fogged.

The Salesman

2009-07-04T02:28:00.004-04:00

Again I wonder if I'm a bad person for telling people the reasons I chose PA school over med school. Some people respond well. Tonight I had the exact opposite experience that I had in that older post.

The pre-med student asked questions about what I thought about her goals, and I answered them truthfully. She listened to the reason why I chose PA over medschool. After everything she said I was a "very good salesman." That made me feel dirty. I'm not trying to "sell" the profession. The profession sold itself to me. I'm just showing her what I liked about it.

I truly am not someone who tries to talk people out of med school. We need doctors. For some people medschool is a better match than PA school. But also there are many, many doctors who realize too late that this isn't what they signed up for. I listened to those doctors and took those opinions into account when I made my decision. I'm a big fan of basing decisions off other people's experience. I realize that I'm not that different from others. If a lot of people tell me one thing, chances are I will react the same way. So if most docs tell me "DON'T DO MED SCHOOL" and most PAs tell me "I LOVE MY JOB," then what's the logical thing to choose?

This specific pre-med's concern was whether she could have a family life, while being a physician. I think this is one of the hardest things to accomplish. Some specialties lend itself better to family life than others. She said cardiothoracic surgery. That is not one of them... I told her that 70%+ of most PA classes are woman. If you asked them why PA and not MD most will tell you "because it's easier to balance being a PA with having a family." It's true.

In college I shadowed a very intense breast cancer surgeon. She was trained by the best and wasn't above name dropping. She talked about job offers she got at Mayo Clinic and such. She was full of herself, but she was good and she was also very happy. The latter was surprising. I asked her if she had any children. She said no, and "by choice." Her profession was her love and enjoyed going home and spending time with her husband. I respected this answer immensely. She knew what she wanted in life, and was honest with herself. She was happy because she understood the reality of the situation.

I'm not the one crushing dreams. It's the reality of life that does that. In the long run I think I'm helping people by pointing out the truths that people like to ignore. Ignoring reality doesn't help anyone, it only prolongs disappointment.

Obvious Revelation

2009-07-03T12:58:00.002-04:00

This whole time I've trying to get into PA school and waiting for it to start it never dawned on me what that really meant. It means that I'm GOING BACK TO SCHOOL. Gaaaaaaaaah.

I enjoyed working. I liked doing what I liked, getting paid for it, and going home and not working anymore. Doing the school work was the part of college I don't miss. I mean I always knew PA school was going to be hard but I'm just remembering now what the actual act of studying feels like. It's the shit.

Now I'm going to have to remind myself that it's only 12 months of classes. Rotations I can handle. I prefer the abuse during the day and then going home, rather than sitting in class all day just to study more at home. And yes, I'm well aware that there is studying during rotations, but there is just something different about that I think. Maybe I'm completely wrong. I guess time will tell.

I'm going to go stare at my profile on facebook now. Specifically the education "Grad School: M.S., Physician Assistant Studies." I know I'm kind of pathetic.

Introductions

2009-06-29T18:55:00.001-04:00

I know this is a topic that has been talked about, but I never came across this option.

Physicians always introduce themselves as Dr. Smith, and from what I see PAs generally always introduce themselves like "Hi, I'm John a Physician Assistant." Many PAs have said that they like to keep it personal by using their first name only.

At the same time though many PAs feel they are not taken as seriously as they should be. People question them and we mainly attribute it to the word Assistant being in the title.

While I think the word "assistant" definitely contributes to this, I wonder if introducing oneself as "John Smith the Physician Assistant" may help make the difference. If we want to be treated like the professionals we are, then maybe we have to start carrying ourselves like that. Lawyers, business men, etc never introduce themselves by just their first name.

I personally think I'm always going to use my first+last name. Let your bedside manner make the patient feel comfortable, not the name you use to introduce yourself.

Advice

2009-06-29T06:15:00.004-04:00

If anyone ever has questions for me it should be known that you can e-mail me at gregoryhousepa[at]gmail[dot]com. And I think I'll post the questions and responses in order to make this blog a little more useful. I'll even try to start using the tagging feature, so that maybe one day I'll have an easy to access archive of advice. And also, questions don't have to pertain to PA school and such. I'm pretty sought after for advice because I'm coldly logical and honest.

Question:
I read in your blog that you have an EMT degree and was able to get a job as a medical assistant. Do you also have a medical assistant degree or was your EMT degree enough for you to qualify for this job? I hope to hear from you soon and goodluck on your first day of PA school. :)

The reason that I got the EMT-B was because from what I saw many, many PAs started out as EMTs. I should actually say many of the "older generation" PAs use to be EMTs. They all told me that it was a great entry field for health care and would give me good experience learning how to do an initial examination and assessment. The training did just that, but to be perfectly honest I didn't learn much in terms of medicine outside of doing a history. But learning how to do a history is critical. Before the class I had a B.S. in biomedical science, and knew much more on the science side than my classmates and maybe some of the instructor EMTs. I digress.

I also did the course because I thought it would help me get a job as an EMT. I later found out in my area there are very few paying EMT-B jobs.

I know that I would have gotten my job as a medical assistant without getting the EMT. However, I can't say that I would have gotten into PA school. They did ask me about my EMT training and why I did it. They liked my answer about how I did it because senior PAs told me to and that it gave me a valuable knowledge on taking a history.

So in short. No, the EMT-B did not help me get my Medical Assistant job. My college degree did. And no, I did not get a medical assistant degree. The EMT-B did help me get into PA school though, and so did my job.