PA-S1.66

I am now officially two-thirds of the way done with my first year of PA school (hence the S1.66 in the title; only 19 weeks (4 weeks of break, and spring semester)) now stand between me and 2nd-year status.  Again, I find myself in this bizarre paradoxical situation (as I did in college) where, going into PA school, I felt like I would have 3 WHOLE years to enjoy myself, learn as much as possible, and meet amazing people.  At the same time, 3 LONG years to wait and wonder what day-to-day clinical practice will be like.  However, right now I am marveling at how incredibly quickly my program seems to be going.  In a little over 2 years, I will officially be a PA, and practicing medicine for a living.

That is still a while away, and at this point, I am still recovering from fall semester.  I have 1 glorious month off for break, and I could not be happier.  It has been quite a while since I have written (midterms in October), and I feel like this is really the first time I have to breathe.  Life has been go, go, go since the beginning of November, with an endless stream of exams, papers, and a fair amount of coffee added to that mix.  Considering the fact that I had 10 (yes, 10) classes this semester, I found myself having many moments to myself.  If being in grad. school teaches you anything, it's how to manage your time so effectively, that you have time left over for yourself.

Fall semester definitely brought a multitude of new experiences, as well.  In October, as part of my physical diagnosis class, I had to practice performing pelvic/genitourinary exams on standardized patients.  While I was initially nervous about this, I am so grateful to the people who so willingly gave us their time to let myself and my classmates practice our exams on them, rather than having to fumble through the exam the first time during an actual patient encounter.

I think the biggest adjustment for me this semester was becoming accustomed to the semester system, itself.  Going to the University of Denver, I was used to the quarter system, with all of my classes lasting only 10 weeks, and getting out for a 6 week winter break shortly before Thanksgiving.  This year, however, I was barely finished with midterms after 10 weeks, and final exams were still more than 6 weeks away.  Needless to say, I was exhausted by the time finals rolled around last week, and I had very little left to give to my classes, friends, and family.  Much to my surprise, after taking some very difficult finals that I felt less than prepared for, I received news of my final grades, and all I can say is that I was extremely happy, and felt a huge sense of relief after working for 15 weeks.  Next semester, there will be 2 less credit hours than fall, I will be rotating in clinic on Tuesdays, I will have had time to recuperate from essentially 6 months of straight classes.

For now, all I can do is marvel at how much I have learned in just 6 months (I find myself laughing periodically when I watch ER now, when the doctors put their stethoscopes in their ears backward, and loving the fact that I understand why they are giving certain drugs during a trauma), and relish in this blissful time to myself.

I hope everyone has a very happy holiday season, and a wonderful, healthy, and blessed new year! 

Reflections after a very difficult week...

I wrote this text in an email to a family member earlier today, and realized it conveyed my feelings about the past few weeks very well, so I've decided to share it with you all:

....I am sitting here on the Anschutz Medical Campus, preparing for my 3rd of 3 exams this week, and just thanking God that this week is over.  Now that the month of October is halfway over, fall has really made its presence known here in the Denver area, and everything is beautiful.  I am looking out the window during this short study break, and admiring how beautiful the medical campus has become.  The medical campus is situated on the old Fitzsimons Airforce Base, and is in the last stages of development (they are currently in the middle of building an addition to the Children's Hospital, and building the new VA hospital.  I just remember when I first visited this campus 3 years ago when I was planning on applying to PA school, the campus seemed so "new."  The concrete sidewalks connecting the buildings still looked like they had been freshly laid, and the trees and shrubs were little babies.  Now, the trees that were so little just a short time ago have really grown, and the leaves are changing the most gorgeous colors of red, deep purple, and yellow, and the entire campus is covered in crunchy, dry leaves that I just love to go out of my way to step on when I'm passing from class to class.  I only wish I had more time to appreciate how pretty this beautiful campus is, in spite of the intermittent noise of Flight for Life helicopters taking off, and ambulances coming in and out from the many hospitals here.

Now that I am officially halfway through the semester, it feels like a huge relief knowing that there may actually be a light at the end of the tunnel of this, so far, very difficult semester.  I am doing very well in most of my classes, but I've also had the humbling experience this semester of failing an exam for the first time (actually, this just happened yesterday with my Pathology midterm).  However, I have resigned myself to just getting to the point of passing, and being happy with just that.  Having 10 classes at one time is crazy sometimes, but actually, quite manageable.  Even though most of the semester has been filled with the drudgery of classes day in and day out, I have had some interesting and clinically relevant experiences, such as learning how to perform a pelvic exam on a live person for the first time.  Although nerve-wracking at first, it felt for the first time that I am moving one step closer to actually practicing clinical medicine, which is a wonderful feeling.

As I have been moving through classes, some of them very clinically-based, I have also been slowly narrowing down my interests as far as fields of practice this semester, and have a very strong feeling that I would like to either pursue a career in Endocrine medicine, or Emergency Medicine, but, at this point, I am definitely leaning more toward Emergency Medicine, and have been for quite a while, even before I started the program.  I have always seemed to function best on a slightly elevated level of stress, and since there is always a level of high-anxiety/chaos in the ER, I feel like this would be a very good fit for me.

That seems to be all that is on my mind for now; back to studying for my Women's Health exam.

Finals start in T-minus....8 hours

As I head to bed for the evening, the evening before my first round of PA school finals, I am feeling sort of reflective tonight.  As difficult as this semester has been; as frustrating, maddening, and slow-going school seemed to go at times, I am in complete awe that I am here at the end of the semester already.  It's difficult to see how quickly time does pass when you live test to test, but looking toward the next 5 days of exams, I realize just how much I have learned in the last 10 weeks, and how much I stand to learn throughout the next two and half years.

The head and neck is a scary, scary region!

So, apparently I was a little too overzealous last time I wrote, and how excited I was about the head and neck.  REALLY overzealous!  I hate the head and neck...a lot.  It is the most exasperating, irritating, maddening, infuriating region of the entire body...although, still fascinating.  My head and neck exam is in 9 days, and it really feels like the pressure is starting to pile up.  We spent the last two days in Anatomy lecture going over the cranial nerves, the 12 nerves that start in the brain/associated structures.  For all non-science people, they are responsible for everything you see, smell, taste, hear, chewing, facial expressions, any sensation you feel on the skin of your face, crying, salivating, snot running from your nose (I just had to paint that picture), chewing, and the function of your entire digestive system.  So basically: they do a lot.  And each of the 12 nerves has multiple branches that travel through various regions of the skull, half of which (at least, in my mind) are imaginary, so sometimes it's pretty difficult to visualize where these nerves are going after they leave the brain, and attempting to draw them out on paper.  This is the first time all semester that I have truly felt overwhelmed at the amount of stuff that is contained in the body.  8 weeks into Anatomy, and I still have no idea how everything fits into our bodies.

Sometimes the most exciting things are the most tedious...

With only 2 and a half weeks left in the summer semester, my 11 day summer "vacation" seems so close, yet so completely out of reach.  Within that time, I still have: 1 Physical Diagnosis test, 2 Anatomy quizzes, 1 Head and Neck Anatomy exam (cadaver and written portions), 1 PD practicum exam, 1 simulated patient assessment note, 1 Clinical Reasoning final exam...I'm probably missing some stuff because, at this point, I can barely think ahead to tomorrow, let alone 2 weeks from now.  Anyway, there's a lot to be done, and it seems never-ending, daunting, and as if it will never end.

With the hell of the last 2 weeks behind me, in which there were 2 Anatomy exams covering 2 completely different units only 1 week apart, in addition to a paper and PD exam, this week was a nice breath of fresh air with no pressing need to study for the last 3 days.  Unfortunately, it was difficult to enjoy this brief time off from studying, because I was so exhausted from the last few weeks that all I wanted to do was sleep...and sleep some more.  I finally had a little time to myself, and all I could think about was sleeping, and even when I did sleep, I still felt tired.  PA school has finally started getting to me, and I am starting to feel that constant fatigue that happens when you combine too many lattes, late nights, stress, and zero personal time.  I seriously think that when I have my 11 days off from school, I will do nothing but sleep until noon, go to bed at 8, and watch movies/read books with the time I'm actually awake...it will be GLORIOUS!

In Anatomy, we are finally covering my favorite area: the spine, head, and neck.  I love the head and neck, because so much goes on in terms of neurological functioning, and I honestly cannot think of anything more fascinating than the human nervous system...it's so delicate, yet so insanely complex.  To think that little nerve fibers control the entirety of our existence is mind-boggling, and, as I said, fascinating.  It's also very tedious.  The head and neck is the most complex area of the body, with endless arteries, veins, nervous structures, muscles, and bony landmarks.  I currently dislike the bony landmarks.  For this current unit, in a 25-page study guide for the exam, 8 pages are taken up by the bony landmarks of the skull alone.  Translated: there are hundreds of little holes, crevices, depressions, pointy things, not-so-pointy things, and imaginary places on the skull where nerves, arteries, veins, muscles, and other stuff go through, attach to, and go around to get to other places in the body.  There is truly nothing that kills your mood more than sitting and staring at a human skull, with a list of the landmarks you need to identify, and somehow get into your brain.  Finding them is not difficult; remembering what goes into/onto them is the challenging part.

In cadaver lab, as we have been encountering the spine, head, and neck, we have had some really interesting dissections, and some very tedious ones.  Earlier this week, we got to dissect the spinal column.  It was the most amazing lab EVER!!! Here's why: after removing the muscles of the back, we found the vertebral column, and after scraping away as much of the remaining muscle tissue on the vertebrae, I got to use an electric autopsy saw to remove the back of the spinal column from the ribcage to the tailbone, in order to visualize the spinal cord.  Using the autopsy saw was really cool, because it's designed to only cut through hard tissue, like bone, but spare soft tissue.  Theoretically, you can hold it up to your own hand while it's running, and it won't touch you.  However, I don't dare try it, just in case it malfunctioned for some reason :-P.  Anywho, after removing the spinal column, I saw the spinal cord.  It's actually relatively small in diameter (only about 1-2 cm thick) considering how important it is, but it was still the coolest thing I have seen this semester.  I was acting like a 9 year-old in a candy store the entire lab, because I was so fascinated and excited to see the spinal cord. 

Today's lab was not so exciting.  It was face dissection day.  I will spare you the details, but after we removed the dressing that kept the face covered for the last 7 weeks, we spent nearly 4 hours trying to remove the skin and find extremely delicate structures located in the face, and covered by very thick connective tissue.  Needless to say, it was very tiring, even when I wasn't dissecting, and by the time lab finished, we were all exhausted and very frustrated.  However, we get to open up the top of the skull and pull out the brain next week, so I am trying to stay positive, and get pumped up for the part of anatomy lab that I have been waiting for all summer.  It will be interesting to see what we find, not only in our cadaver, but everyone else as well; many of the cadavers died from strokes or brain bleeds, so it will be interesting to see if there is obvious evidence of brain death/damage when we open up the skull and pull out the brain.

That's all for now; sleep sounds so nice right now.

Balance is the key word

In PA school, everything is (supposedly) all about maintaining balance.  Being able to integrate and synthesize the massive amounts of knowledge being thrown at me, while having an outside life and remembering to care for myself at the same time is sometimes easier said than done.  However, I find that I actually have quite a large amount of time for myself and my personal interests, even though school is very difficult at times.

The first round of exams arrived and passed more than 2 weeks ago, and I am still here.  The first Anatomy exam was killer, but I was surprised to find out that I had done incredibly well, so I was very happy, but at the same time, there wasn't a whole lot of time to celebrate, as it was immediately on to new material.

After the hell of the upper extremity during the first unit, diving into the thorax, abdomen, and pelvis was really exciting...the "blood and guts" of anatomy is what really makes me go...it's just so fascinating.  It's where pathology is most evident, and my classmates have found some incredibly fascinating things in their cadavers.  There were several pacemakers found, evidence of central lines, surgical procedures (including several people who had multiple coronary bypass operations) and several cases of "organomegaly," or enlarged organs.  One cadaver had a heart that was nearly 5 times larger than normal, evidence of severe heart-failure. 

However, the thorax and abdomen presents its own set of problems, such as the fact that there is SO MUCH going on once you peel back the anterior abdominal wall.  There are so many different organ systems represented, and arteries traversing over veins, nerves, lymphatic drainage ducts, and other things.

Round 2 of exams started today with Physical Diagnosis, which I did really well on, but there are still 2 Anatomy exams (thorax/abdomen, and then, after spending only 1 week on the lower extremity, another exam exactly 1 week after the upcoming one on the 19th), a patient-chart note, and a simulated patient interview on the last day of July.  The next two weeks are absolutely pure-hell, and I yearn for it to be August 1st already, and for this mess of exams to be behind me.  After this, it's 3 weeks in the head and neck, which I'm super excited for, especially when we dissect out the spine/spinal cord, brain, and peripheral nerves.  Since neurosurgery is one of the specialties that is high on my list, I am extremely interested in all things neuro.  As I said, 3 weeks in the head and neck, and the Anatomy exam associated with that, and 1 Physical Diagnosis comprehensive physical examination, where we are put in a room with standardized patients and graded on our physical exam techniques. 

My brief summer break seems so close, and yet, so far away.  Think good thoughts for me over the next two weeks.  I love and miss you all!

And it begins piling up...

It has been a little while since I've been able to post, but the work, true to form, is piling up.  I have only been in school for 2 full weeks (tomorrow begins the 3rd), and exam time is already looming.  There is so much content to be tested on, but unlike any academic endeavors any of us have experienced before, we actually have to remember what we learn...how else would we even know where to begin if one of our patients came in with "winged scapula" to deduct that this patient could have paralysis of the Dorsal scapula nerve, which supplies the Rhomboid muscles, allowing them to help hold the scapula flat against the thorax?  (You can tell that I was just trying to review the material as I typed).  The nice thing, though, is that everything is very intuitive, and all of the structures are grouped regionally, so rather than learning the ENTIRE muscular system at once, or the ENTIRE nervous system at once, we learn only the structures of the region we are studying.  That being said, this way of tackling Anatomy is also very difficult, and requires a great deal of skill when it comes to synthesizing the material, because we are dealing with all of the bony landmarks, muscles, joints, ligaments, nerves, arteries, veins, and lymphatic drainage of the upper extremity.

It is sometimes hard to remember that I also have 3 other classes that require attention, too, because Anatomy really takes up most of my time.  But, PA school is all about balance, and how to keep several things going at once.  I thought I was good at multi-tasking before this, but this is the biggest challenge to that thought ever.

At this moment in time, a lot of us, including myself, occasionally have to remind ourselves why we're here: to eventually become the great PAs we envisioned ourselves being, and attempt to make our way in the world.

Seeing what few others see...

Today was quite a day.  In addition to Anatomy lecture this morning at 8, and another class called "Intro. to Clinical Reasoning and Problem-Based Learning," we had our first Anatomy lab today at 1pm.  I can honestly say that I wasn't able to pay attention much to any of this morning's classes, because 1pm was looming in my mind.  I was so pre-occupied with the thought of being in my first cadaver lab, that I couldn't even focus.

I am not a squeamish person in the slightest (as my family can certainly attest to, considering I have often found it difficult to NOT discuss the nasty, but interesting things I learned about in school), but my emotions were swirling in my brain today, and I was so nervous about actually seeing the body for the first time today.  Even when we went up to the 5th floor of the education building (where the Gross Anatomy lab is housed) I started getting a little nervous.  But, considering the fact that I have 10 weeks of many long hours in the lab, I got over my nerves very quickly.  There is not a whole lot of time to contemplate being nervous, although there were moments of it throughout the afternoon.

The cadaver lab itself is beautiful.  Since the Anschutz Medical Campus is completely brand-new, all of the facilities (barring the old Army hospital, where President Eisenhower stayed when he had a heart attack) are pristine, and gorgeous.  The anatomy lab has big, bright windows that look out to the old army hospital, fondly known at "Building 500," and they let a lot of light in, which is nice, since a good chunk of the lovely summer weather will be going away during lab times.  There are 5 interconnecting lab areas, so we can freely walk about the long hallway of cadavers, and observe what others are seeing, and the techniques others are using.

Immediately upon walking into the lab this afternoon, my nose let me know right away that there was no other place on campus that this area could be except the Gross Anatomy lab.  Surprisingly though, I adapted quickly to the smell.

We proceeded to our designated humidor, sort of a large, stainless-steel tray with a lid that folds down.  We opened the lid, and the black body bag with our cadaver was inside.  After unzipping the body bag, we figured out that we had a female cadaver, and the tag on the table said the date of death was July of 2009.  The hands, feet, and face are covered by gauze bandages for now, which definitely helped with the emotional disconnect that had to happen before I was ok to dive in and cut.  

During the entire lab session today, I kept thinking about how amazing we are as a species, and being able to see it first-hand really reinforces that.  Even though I felt a little emotional when lab was all over tonight, when I was actually doing the dissection, I was completely fascinated by the structures, and actually being able to see what I've been learning about and studying throughout my life as a student...it's pretty amazing.

As you can tell, today was a day for Anatomy, and nothing much else happened today.  I have to study and read ahead for lecture tomorrow and Thursday, and prepare for what we will be dissecting on Thursday, when we will encounter the upper extremity.

Tomorrow is the big day!

The first day of classes is finally here!  It's been almost 6 months since I found out I had been accepted, and those 6 months have been the longest of my life in many respects.  They have been long months of anxiously waiting for school to start, of worrying about whether I could handle the challenges being in PA school would present, of being so excited to finally be living out my dream...just 6 very long months. 

Now that it is here, I have gotten over MOST of my insecurities, and am totally ready to dive into the insane workload of the summer semester.  I have 4 classes, but undoubtedly, the one that will dominate my life this summer is Human Anatomy.  Lecture is scheduled 4 days a week, Monday-Thursday from 8-10am, with the corresponding lab scheduled 2 days a week, Tuesday and Thursday from 1-5pm.  That being said, I will certainly be spending more that 8 hours a week in the Anatomy lab, considering there is so much material to learn, and not nearly enough time in that 8 hours per week to finish the required dissections, and actually retain what the heck we are seeing inside.  Just the amount of books I have had to purchase for Anatomy alone (8 in total) bears some idea of the kind of workload I am about to undertake.  None the less, I am so excited, a true testament to how much I love medicine, and the great extent to which my life is dominated by it.  I willingly commit my time to reading books that many wouldn't touch, unless threatened, and I actually find everything I read fascinating.

That being said, any of you out there reading can probably already foresee the future, when, at the end of the summer, I will be blogging about how much I cannot stand Anatomy, and how happy I will be to be done with that class forever.  But, being fresh-faced and not tainted by late nights, too much coffee, too-little sleep, and long hours in the cadaver lab, I can still stand here and honestly say how much I love Anatomy.

That is all for now, since I actually have to set the alarm and return to the academic schedule.  At least I have a pot of coffee ready to brew the minute that alarm goes off at 5:45 tomorrow morning.

Hi, my name is Katie, and I'm a Physician Assistant (Associate?)

I, like many PA students and currently practicing members in the profession, closely follow news associated with said profession.  The PA profession, still being relatively young, is a tight-knit one, and whenever an issue arises within the field, it is widely talked about on the PA blogs and news sites.  Upon logging onto my Facebook page this morning, my news feed displayed the news from one of the PA blog pages I follow, and a very interesting article was linked, which I enclose below.  It speaks of the suggestion that a change of title be employed, and that "Physician Assistant" be changed to "Physician Associate," to clear up any ambiguities there are within the general public about what we actually do, and what responsibilities we have.

I, for one, am 100% in favor of the seemingly simple name change, that has the potential to drastically change how people outside of the medical profession see us.  Even though I haven't even started school yet, I have lost count of the hundreds of times that I have had to explain exactly what PAs do, often because the word "assistant" throws many people off; most people assume that Physician Assistants are on the same level as Medical Assistants, which couldn't be further from the truth.  The word "assistant" really isn't quite accurate anymore, seeing as how PAs have a very distinct set of responsibilities and duties when it comes to patient care.  Since we are trained under the medical model, the same model that doctors are educated under, we can perform many of the duties as doctors, such as physical exams, ordering/interpreting tests, prescribing medications, and assisting in surgery.  Medical assistants, on the other hand, take vitals and ready the patient for the PA/Dr. to perform their duties.

When I explain to others that PAs have such a wide scope of duties, many question my decision to attend PA school, and not go for medical school.  Again, this one silly word causes many of the people that know me to assume that I am settling for an "assistant" job, rather than "suck it up" and become a Dr.  But it is purely a lifestyle choice, one that allows me to have the kind of life that I want, and treat my patients in a way that I envision medical care to be. 

Even though a name change, if it is to happen, is far from occurring, I have hopes that it would cut down the confusion and more accurately reflect the rich history and wonderful scope of the profession I have chosen to dedicate my life to.

For the full article, click the link:
http://physician-assistant.advanceweb.com/editorial/content/editorial.aspx?cc=219643

45 days and counting...

It has been quite awhile since I've posted, and during that time, quite a lot has happened.  As the start of PA school inches closer, the number of items on my to-do list has increased exponentially.  Just when I think I'm making headway on the massive list, I get another email with upcoming dates to remember, or I think of things that must be done before I move into my new apt. and start school.  Setting up my utilities, cable, internet, and making appts. to have immunizations and TB tests done are only a small part of what I accomplished only today.

Even though my list is long, I am continually reminded what this list signifies; it represents what I have to accomplish in order to be as ready as possible for the start of PA school...and I am really excited! 

Included in the last "new student" newsletter from the CU PA program was the list of textbooks and supplies I will need for the summer semester...and if I thought my own list was long, this one threw me right out of the ballpark.  This summer will consist of 4 classes: Human Anatomy with cadaver lab, Introduction to Clinical Reasoning, Physical Diagnosis, and The Psychosocial Aspects of Healthcare.  Between the 4 classes, I had to order a total of 8 books, which were not evenly distributed.  Human Anatomy will definitely be the most time-consuming and heavy of my classes, if I am judging by the book list alone: "Clinically Oriented Anatomy," "Cross-sectional Human Anatomy," "Grant's Dissector," "Netter's Atlas of Human Anatomy," and "Netter's Human Anatomy Coloring Book."  Even though I have taken Anatomy twice before, and am familiar with much of the human anatomy, there is a lot to be forgotten as soon as the class is over, and since this time is for real (as in, I have to actually remember this stuff in order to treat my patients) I am thoroughly committed to learning it and having it stick...I hope.

My other books were for Introduction to Clinical Reasoning and my Physical Diagnosis class.  Throughout my book and supply ordering process, I experienced the biggest geek-out moments of my life.  In addition to the textbooks for these classes (which I will get to briefly), I had to order my medical equipment.  As someone who has been dreaming about practicing medicine since I was 4, this was one of the greatest moments of my life.  I ordered my diagnostic kit, which includes an ophthalmoscope and otoscope, my blood pressure equipment, and my very own stethoscope, with burgundy tubing.  I can't believe I am going to own a stethoscope!  YAY!

The same geeking out ensued when I received my physical diagnosis and clinical reasoning books in the mail, which consisted of Pediatric and Adult symptom guides, a medical terminology guide, and a 1000+ page behemoth detailing the various steps and components of a complete physical exam.  I got so excited upon opening the package, that I'm sure my mother was wondering what type of stimulants I was on :-).  But it really is hard to put into words how exciting it is to know that I will actually learn and remember what these books contain in a few short months/years: the knowledge pertaining to the practice of medicine.

I don't know how it feels when brain cells die....

...but I'm pretty sure what I'm feeling now must come close.  It has been 8 months since I have last been in school, and I have, for the most part, embraced my time off, and the ability to give my brain a rest after college.  However, there comes a point for me, when having time off to watch movies, read books, bake, cook, and sleep in becomes WAY too much.  Plainly stated: I AM SO BORED!  I think my brain cells are starting to die (not literally because of boredom, as several thousand brain cells die every day, but figuratively speaking). 

Although many students currently in the PA program have said to study anything before the program starts is as close to committing a sin as you can possibly get, but I have decided that I need some sort of intellectual stimulation before all of my brain cells die entirely, and there are none left for the actual program.

I have yet to decide what I am going to do in order to satisfy my need to learn and do something intellectual, but I have contemplated volunteering at the museum, or tutoring, or (Heaven forbid) simply pulling out one of my old college textbooks and reviewing some of the stuff I have learned.  I love learning, especially science, and that may just be the way that I get rid of this monumental brain cell-slowly-dying feeling. 

How I am currently spending my time off...

When I first graduated last June, having not been accepted to PA school, I was dreading the prospect of having a year off.  After all, it was in the middle of my PLAN (you know, the absolutely perfect, nothing will EVER destroy this, everything will go according to it plan?).  I had always just thought that I would go straight to grad. school after college, and never even thought about taking a break.  When all of that changed, I was not happy.  I had previously been a person that was adamantly against change.  And I really hated not going back to school in the fall, and not having a set structure to my day. 

Now that I've been accepted, I can fully appreciate the time that I have off, and realize how good it was for me to not get in the first time, because I really needed time for myself and to pursue things other than school.  It gave me time to rest and recouperate, and appreciate what gifts learning and education really are.

And, in addition to appreciating stuff, I am certainly occupying my time with nothing of importance or value, except to my sanity.  For the first time in forever, I am able to turn on the TV at night, flip through the channels, and find the worst, absolutely corny, tasteless, or mindless television show, and sit through an entire episode without worrying about homework or the exam I have to take tomorrow (unless, of course, it's Thursday, when I have a standing engagement with ABC for Grey's Anatomy...it's the only show I really watched during college, and always made sure my homework was done before the episode started).  I have also read a good chunk of the books I bought but never got around to reading during college, although the pile is still quite voluminous, and it will take me a great while to get through them.  I am just happy I have time to read again.  I have time to sleep in, make a real breakfast, enjoy cooking, reading the magazines that come in the mail, and really plan for the things that I will need to have in order come June. 

That is all...off to do something of no particular value, except to my sanity.  I don't know quite what that is yet, but will find out when I settle on whatever it is.

Excitement turned into frustration

When I was first accepted into PA school, I was absolutely ecstatic!  I couldn't believe that I was finally there, after all of the hard work and worry that I had invested into this goal.  Although I am still quite ecstatic, the predominant feeling that I am now feeling is frustration and worry about everything related to starting grad. school, such as filling out financial aid forms, finding a safe apartment that does not break my budget, and finding the money to make the deposit for my apartment, buy my medical supplies and textbooks, and other stuff.

When I was getting ready to attend college, I don't remember it ever being this difficult.  When I got accepted, I deposited and that was it...I packed up my stuff and moved into my dorm, and started college.  But everything I have to do and the timing of everything for PA school is so much different, and it's just not making the noton that I will be attending grad. school any more exciting or fun.  I can only hope that everything will fall into place for the start of classes.

Worries about being out of my element

I was just now thinking about how every time I begin a new phase in my education, I worry about being out of my element and not knowing what I am doing there.  When I left high school, I had graduated salutatorian and was part of the group at the very top of intellectual and extracurricular achievement.  But when I entered my first Introductory Biology class at DU, I was suddenly humbled and taken aback by the achievements of the other pre-meds in my class.  Seriously, some of these kids had done cancer research internships with their spare time during high school.  I was suddenly no longer at the top, but in the middle of a bunch of some really smart people.  But, as the quarter waged on, I settled into my niche and realized that I could definitely tackle college academics.  I ended up graduating with honors, and again, left near the top of achievement in the bio. dept.

Now, I am only four and a half months away from starting PA school, and I find myself worrying again about no longer being able to find my footing and being out of my element.  I am so insanely excited about starting school, and finally being at the stage in my education where I am learning about how to practice medicine, but at the same time, I am scared s***less.  I worry about not remembering the stuff I learned in undergrad, being able to master the complexities of Gross Anatomy or Pharmacology, and learning to find that balance between academia and time for myself that I found during undergrad.

Just some thoughts as I sit here finishing the last of my acceptance paperwork and battle some insomnia....