:: eye of the storm ::


About Me

A 27-year-old PA student who wants to visit all seven continents, write a book, work at a pediatric clinic in Africa, and basically meet as many of the world's challenges as possible.

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Life List

(already accomplished)

Become a PA

Visit all 7 continents

Take a SwimTrek trip

Bike through Western Europe

Raft the Grand Canyon

Improve my Spanish proficiency

Go on safari in Africa

Trace my roots at Ellis Island

Vacation in Hawaii

Work on a hospital ship in a Third World country

Celebrate New Year's in Times Square

Visit all 50 states (29 to go: AK, AZ, AR, CA, CO, HI, ID, IL, IN, IA, KS, MI, MN, MO, MT, NE, NV, NM, ND, OK, OR, RI, SD, TX, UT, VT, WA, WV, WI, WY)

See the ruins at Pompeii

Swim in Capri's Blue Grotto

Tour Mt. Vesuvius

Throw a coin in the Trevi Fountain

Tour the Colosseum

Visit the D-Day beaches

See the Mona Lisa

Visit the palace at Versailles

See the Acropolis and Parthenon

See the Egyptian pyramids

Hike the Inca Trail

Walk El Camino Santiago

Take an Alaskan cruise

View the Taj Mahal at sunrise

Hike Table Mountain in South Africa

Climb through the Amazon canopy

Walk at least part of the Great Wall of China

Get laser hair removal

Learn to surf, ski, and snowboard

Learn to drive a stick-shift

Learn to play the piano

Go on a tropical cruise

Ride horseback on the beach

Ride in a hot air balloon

Get tickets to the Olympics

Go to adult Space Camp

Witness a shuttle launch from up close

Build a full-sized snowman

Sew a quilt out of my old race T-shirts

Update and continue my Life Scrapbook

Become the oldest person to ever do the River Run

Live to be a happy, healthy 100 years old - at least!

(unlikely dreams)

zondag 28 november 2010

Speaking in the spirit of Thanksgiving... it's unbelievable how much I have to be thankful for this year. Specifically, to be part of such an incredible group of people and finally living the dream of becoming a PA.

January 2007, when I first admitted to myself that linguistics wasn't actually what I wanted to do with my life, marked the beginning of a long, hard road. That year was one seemingly endless slog of roach-infested apartments, community college classes with nobody that I could really relate to, a job I hated which paid utterly crap money (I remember setting a $5-per-person cap on gifts that Christmas), Liz constantly sick with mysterious, painful 'attacks' which wouldn't be diagnosed as gallstones until six months had gone by, and a constant underlying current of stress. Am I ever going to 'get there'? Will things ever get easier? Will I ever feel more secure in what I want, more certain of my place in this world, more sure of what it is that I'm supposed to do?

In January 2008, things took a turn for the better when I got the pediatric nursing job. It was a relief to enjoy something in my life again, and the money situation eased up slightly, although I was still gutting out a full course load at Durham Tech and had virtually no life outside of work and school. Our lives improved further in the fall of that year, when we moved into our first truly decent apartment and I was down to just a couple of prerequisites. Liz started her second master's program at NCSU and met a new group of great friends, which was a great expansion to our social network. Still, the worry: Am I going to get into school anywhere? Are they going to think I'm ridiculous for taking all my classes at a community college? If I do get in, is it really going to be 'right' this time? I truly do *think* this is what I want... but what if I'm wrong again?

2009 was a banner year. Money was still tight, and I was still making a 50-mile round-trip commute every day, but I finally finished my prerequisites, turned in my PA school applications, and continued to work at a job I liked. I still felt pretty isolated in terms of having a true 'community' around me, but as I started receiving interview invitations and investigating the cities I could possibly be living in (Portland, Charleston, Gainesville...), I finally started to feel some twinges of excitement. Then, in the first week of September, I got the phone call: I'd been accepted to UF's PA program. I still had four other applications out, but it was official: I was going to PA school somewhere. It was really happening.

And then came November 12th, 2009, and with it, my Duke interview. I won't bore you by rehashing all the details, but I remember being told that they conducted interviews Monday through Thursday of each interview week, discussed candidates on Friday, and sent out acceptance emails on Monday or Tuesday of the following week. Needless to say, come Monday the 16th, I was a nervous wreck. I had my phone sitting on the desk beside me at work, and each time I returned to the nurses' station, I pressed Refresh on my email inbox. By lunchtime, still nothing. I was beginning to think they were going to keep me waiting until the next day -- or, worse, that I'd only made the alternate list, and wasn't going to hear anything until February.

And then, around 2pm, I hit Refresh for the millionth time.

Sender: CFM_PA_Admission

Subject: Congratulations on your Admission to the Duke PA Program!

I didn't even open the message, just gasped, broke into a huge grin, and jumped up and started running through the office, hugging everyone. I couldn't believe it. Almost exactly three years after the agonizing decision to abandon the known in favor of the unknown... I had actually made it! Somebody had looked at all that work, all that misery, all that stress, and thought that *I* was worthy of representing their school -- and not just any school, but Duke University, the institution responsible for inventing the PA profession, the school with the number-two PA program in the entire country. They wanted me.

Dear Jessica,

Congratulations on your acceptance to the Duke University Physician Assistant program. The Admissions Committee has approved your application for the class entering August 16, 2010. An official letter will be mailed to you this week. In that letter any contingencies to your admission will be clearly stated.

Please note that your $700 deposit and response forms are due in our offices by December 2, 2009. This is explained in more detail in the offer letter of admission.

If for some reason you do not receive your official notification by November 24, 2009, please contact the Admissions Office at...

Again, congratulations!


Now that I'm three and a half months into this program, I can say with certainty that there is nowhere on the planet that I'd rather be, and no place that could possibly be a better fit for me. I remember feeling like this during the IB Program in high school, but this is multiplied exponentially. It's such a relief to feel like I somehow managed to make all the right decisions in the midst of all that stress. I'm slowly getting the answers to all the clinical questions I wondered about during my three years in the medical field, and it's an amazing feeling each time that light bulb goes on. All the things I worried about -- will I be able to keep up academically? Will I make friends -- true friends, not just friendly acquaintances? Will I actually like what I'm doing enough this time to want to turn it into a career? ... all those concerns have long been laid to rest. I love every minute of what I'm doing, and already, I've made friends that I know I'll still be close to a decade from now. I can see my future unfolding in front of me -- the possibilities for the next few years slowly solidifying. If I were to win the lottery tomorrow, I'd still want to have a job and work as a PA, which isn't something I could ever say as a pre-linguist.

It's utterly incredible how far I've come in only three and a half months. We did our physical exam practical finals right before break started -- 154 exam components, performed on a classmate, completely from memory, in under 45 minutes. We had to wear our white coats and move through the exam as though we didn't know the 'patient' at all, using all our 'toys' appropriately and verbalizing everything we saw and felt. During the first week of school, when they showed us the video of a second-year student doing this same exam, we all sat there incredulously, absolutely terrified, each of us certain that we'd never be that professional, that Duke had made a huge mistake letting us into this program. The first time I tried to do a complete run-through of my own, I hung onto my cheat sheet for dear life and needed 90 minutes to get through the entire thing. Again, I was frustrated, scared, and sure that I'd never be able to do it. And then... somehow, during the latter part of October and early November, it all came together. By the third run-through, I no longer needed or wanted the cheat sheet. And when my exam day came (last Monday), I slammed through the entire exam in 39 minutes, forgetting only a few things and earning a score of 94. My classmates all reported similar experiences. I am so incredibly proud of us and how far we've all come in such a short time. I've obviously got a very long way to go (20 more months), and I'm still far from pinning down a specialty or knowing every detail of all the things I need to know... but as of this moment, November 28, 2010, there isn't a day that goes by that I'm not overwhelmingly thankful to be one of the 75 people sitting in that Duke lecture hall. For the first time, I really feel like I'm carrying the Thanksgiving mindset around permanently, the way we're told that we should.

I'm not sure how I got this lucky... but I'm humbled to have such an awesome life.

Anyway, it was a great Thanksgiving. My parents came to Durham for a couple of days (swooped in and fixed the shredder, cleaned the trash can, bought us an ottoman, and did a myriad of other things around the house... they are so amazing) and then we drove to Charlotte on Wednesday. I experienced IKEA for the first time on that trip, and I can say with some certainty that I now know exactly what my downtown Durham loft will look like when I get it... LOL! We spent Thanksgiving with my aunt and uncle in Fort Mill (on the outskirts of Charlotte), and then I took the train back to Durham on Friday. (Can I just say how much I love the train? Cheap, easy, tons of legroom, onboard wireless... I wish I had more opportunities to use it.) I went out to dinner with one of my friends that night and then actually did a little bit of studying the next day (yesterday). So far I've spent today cleaning and Christmas-ifying the apartment a little bit, and I'm about to head out to buy groceries and (LONG overdue) new running shoes. Liz comes home tomorrow, and since our class schedule changed and I'm going to be in class longer than I thought, her friend Erin is going to pick her up at the airport. I'll see her when I get home at 5:30. She made it safely from Spain to Italy and had a really amazing Thanksgiving there (you can read about it here).

The month of November has really flown by. Usually I'm the first one off the mark when it comes to holiday playlists, party plans, Christmas gift ideas, and so forth -- I often get going as soon as Halloween is over -- but this year it's really the lowest thing on my radar, probably because so many of my thoughts are wrapped up in school. I'm trying to get myself in the spirit by playing holiday music and decorating the apartment a little (but not too much, or Liz will be upset that she didn't get to help :)). It's been a great mini-break, but the next three weeks are going to be absolutely brutal in terms of school, so any holiday-mindsetting that's going to happen is going to have to occur today. Though I suspect I'm going to be dragged out to purchase a tree sometime in the next two or three days whether I like it or not... :)

dinsdag 16 november 2010

We are not slowing our velocity at all just because of a silly little thing like the Thanksgiving holiday. We're barreling through cardiology, EKG, and orthopedics at breakneck speed, slogging our way through Evidence-Based Medicine (which basically teaches us how to read and interpret scientific studies/statistics), and still trudging along through anatomy at the same depressing pace. There's a faint light at the end of the tunnel for anatomy -- only three more lectures, two more labs, and one more exam! -- but it's still going to drag on for the rest of the semester.

The biggest thing looming over our heads right now is that we have our Complete Physical Exam finals starting the day after tomorrow. Mine is on Monday morning (immediately following a two-hour cardiology exam... I did mention breakneck speed, right?) and I am also serving as a 'patient' for three of my classmates, so a good percentage of DPAP is going to be familiar with much of my anatomy by the time vacation starts. I'm really nervous about the exam -- it's 154 components, completely from memory, with a time limit of 45 minutes. I'm doing a little better in terms of remembering all the components, but it currently takes me well over an hour to get through the whole thing, so I definitely need to put in some more practice time in the next six days.

Other things on the horizon:

Tomorrow: EKG exam plus 2 two-hour CPLs (basically, case discussions that we walk through in small groups... one for hypertension and chest pain)
Thursday: done with school at noon today, and then a group of 17 of us are having dinner at my house and going to the midnight showing of Harry Potter 7, yippee!
Friday: second-to-last anatomy lab plus the Duke/Colgate basketball game
Saturday: serve as a mock patient for one of my friends' physical exams
Sunday: breathe!!!
Monday: 8am cardio exam, 10am be a mock patient, 11am perform my own exam (yikes!)... and then my parents roll into town tonight!
Tuesday: explore Durham with the rents (I think there might need to be some Parker & Otis and Local Yogurt action) and also serve as a patient one more time for another friend.
Wednesday: drive to my aunt's house in Charlotte
Thursday: Thanksgiving Day
Friday: take the train back to Durham
Saturday: chill, study, breathe
Sunday: chill, study, breathe
Monday: back to school (jumping headlong into oncology, from the looks of things), plus Liz comes home from Spain!
Tuesday: full day of school
Wednesday: our first scary scary scary CPX!!!

CPXs, or Controlled Patient eXperiences, are scenarios where medical actors pretend to be patients. We wear our white coats, knock on the door, introduce ourselves, and then have 15 minutes to take a history, perform a focused physical exam, come up with a diagnosis, and plan the next steps, all as if we were the sole provider. We are videotaped and then have to watch ourselves and give feedback as well as accept feedback from the mock patients (who do this for all the medical learners in the Duke system, from MDs to PAs to DPTs, and so are very good at critiquing us). I knew these scenarios were going to start happening at some point, but I thought I'd feel 'more ready' by the time they came about; we were given an intro lecture to the CPX concept yesterday and I was rudely disabused of my comfy little notion that I wouldn't have anything else to be nervous about if I could just get through the 45-minute final exam. The CPXs are ten times as nerve-wracking. To me, at least. I'm sure they won't seem so scary once we get through the first one, but right now... ugh. So much for a worry-free break.

In other news, I tripped over a curb in the dark on the way back from the basketball game on Sunday and essentially ripped off my entire left big toenail. It's at that awkward stage where it's too attached for me to get the rest of it off and have done with it, but too detached (sticking up at an angle) for me to put on a close-toed shoe and go on with life. It's nowhere near as painful as it was the night it happened (I could literally see the pulse beating in the exposed nail bed), but it's still bothersome. I've just been soaking it, drenching it in Neosporin, and wearing flipflops -- hopefully the rest of the nail will come off quickly so I can get back to running.

OK, we're getting started with anatomy lecture, so I better peace out...

maandag 1 november 2010

Quotes from my microbiology / infectious disease professor that will still be ringing in my ears when I start rotations:

"A vesicular lesion on an erythematous base is always herpes, herpes, herpes."

"Any closed collection of pus, think Staph aureus."

"Anytime you see monoarticular arthritis in a young sexually active female, gonorrhea should be the first thing on your differential."

"Fever and CVA tenderness makes the diagnosis of pyelo[nephritis]."

"You don't need to treat hot tub folliculitis; just get them out of the hot tub."

"The number-one cause of meningitis in adults is Strep pneumo[niae]."

"30% of patients with pneumonia will have a positive blood culture."

"Most ear and sinus infections are caused by The Big Three -- Strep pneumo[niae], M cat[arrhalis], and H [in]flu[enzae]."

"Folliculitis is staph, cellulitis is strep, impetigo is either/or."

Other people have songs or movie lines running through their head... I have 'Peggy's Postulates'. :) She has repeated all of those things so many times that I will remember them forever... which is simultaneously awesome and amusing.

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