Interviews and figuring out the future...

It has been an interesting week and I'm really sad that I missed out on the earlier interviews. I really do trust my classmate's opinions since the group's opinion on the folks we've met this week has tracked right along with my own. Tomorrow is the last interview and the admissions committee will meet next week to make decisions... we're sending a representative, so I'm glad that I don't have to be there. It is a hard decision every year and I don't see it being any easier this year, but they keep the program the size it is because it means that we can get much more personalized instruction and they can maintain the standards of its graduates.

In the meantime I've had a challenging time personally. I've done some research into locum tenens/traveling PA jobs including talking to one of our staff PAs who has done it in the past and getting in contact with a graduate from last year that wanted to travel. Unless a permanent job opens up within commuting distance of where we live (even a miserable commute), it is most likely the route I'm going to have to go after graduation. I'm still looking at permanent positions in other areas since it would be worth it to live apart for the right opportunity, but I've somewhat come to terms with moving back to SC.

My husband is amazing and my future is uncertain...

Today my husband was officially promoted into a management position with his company back in South Carolina, which is an amazing opportunity for him. I am so proud of him, and he's worked very hard to get where he is now.

It is funny to think back over the course of our marriage and the ups and downs of finances and employment outlooks, and how given where we were when we first got married to see where we are now. On paper, we looked dicey but I know I married someone that was smart and hardworking, and good things happen when you are willing to put in the effort. He is amazing and we've completely blown past what our ten year plan was ten years ago... It is time to write a new plan and see if we can leapfrog those goals as well.

But still, it means that instead of being able to throw open our options to anywhere in the country we are faced with some hard choices. My options are to try to find something within commuting distance to where our house is (in Columbia, SC), pursue part-time travel jobs with Columbia as my home base, live apart from my husband (again) until something comes up in Columbia, or... become a housewife (this one is probably not going to happen, I can't picture myself not working).

Injury, interviews, and surveys.

It happens when you work with scalpels all the time that you might cut yourself, and I did while I was at the medical examiner's office. It was the first time I was doing a full evisceration by myself and resulted in two stitches and a visit with the exposure folks at Duke who talked to me about infection rates, blood draws, and side effects of anti-retroviral drugs. If I was going to cut myself during my clinical rotations I would have preferred doing it on formalin fixed tissue or on a case where I had the full clinical history. Of course if I could have chosen, I probably would have opted not to cut myself at all but these things happen.

Anyway, the time at the medical examiner's office was busy and instructional. It was so much evisceration, and really good exposure. It did make me realize that I missed being involved in the prosection part of the autopsy! Two weeks of doing no organ dissection at all felt like a long time, so I'll be glad to be heading back to surg path at Duke this coming week.

And being back means that I'll get to meet some of the interviewees for the class of 2015! I missed the first week or so of them, but I trust my classmate's opinions on the folks that I wasn't able to meet. Good luck to everyone and I hope that people are having a good experience throughout this application season.

In other news, I'm still job hunting. It is getting more into the time period where most people tend of find jobs. I've been applying here and there as there have been openings that interest me, but nothing too seriously. I had an interview on Friday that went really well, but I withdrew myself from the running because of salary. As an AAPA member I have access to its member surveys which are broken down by state and include things like salary, so going into an interview I have an idea of what typical salaries are for a given area (in addition to using cost of living calculators online for specific cities since some places are cheaper to live than others). It was unfortunate, but it would have been a waste of their time and mine to continue on given how large the disparity was between their salary range and the range typical for the state. Still, it was good interview practice!

Day one at the medical examiner's office...

I'm on an external rotation for the next two weeks at the office of the medical examiner. It will be good practice eviscerating, which I really look forward to getting. They had around 1,500 cases last year so I don't doubt that there will be a lot of opportunity for observation and hands on learning. I was told that I'd be watching for the first few days and start eviscerating on Thursday.

I had to go by Duke this morning for a class before heading over so I came in during the middle of their work day. Someone showed me the PPE and then it was sort of self guided from there. I watched as many cases as I could and as many different techs as I could for today. As Mondays tend to be their busiest day (they are closed on Sunday), there wasn't a shortage of things to see.

It is very quick, and they take a lot fewer measurements. And, the patient population is different since a lot of the Duke cases are patients who have been treated at the hospital for a while or who have a long history of disease...whereas the ME gets homicides, accidental deaths, etc. Or at least that's my opinion so far, could be wrong. We'll see. I think people imagine that a lot of pathologists assistants work in forensic pathology, but PA programs are not the route to go if that is your interest (even the FAQ for Duke's program says so). Our studies focus on pathological processes and disease, and not on forensic science.

Also, one of the pathologists at the ME's office worked at the company where I grossed before starting the PA program. He left a year or so before I did and worked at one of the hospitals while I worked at the main location (although I do remember seeing him sometimes during the monthly doctor's meetings). It is funny because as soon as I was accepted into the program* our chief medical officer said I would get to see him, and has apparently been telling him to watch out for me for the past year and a half. He took my picture today to send to her. It is so nice to be remembered.

In other news, I think tomorrow I'll hit 40,000 blog views, which is a strange thing to think about. Thanks for everyone who reads!

And in other, other news, the ankle is getting better-ish! It hurts steadily, but it isn't keeping me from sleeping anymore and most of the swelling is gone except for this weird (8 x 4 cm) area that feels like it is going to stick around for a while. The walking cast helps a lot (and is driving me crazy at the same time!) and serves as a solid justification for all of those knee high cutely patterned socks I bought ages ago.

*Almost literally. I think I got the phone call and then walked down the hall to tell my former manager (and best boss ever) that I'd been accepted and she happened to be in my manager's office at the time.

Calling and calling...

This is my on-call weekend. I called last night and there wasn't a case. I went to bed at 10 pm and set my alarm for 6 am. I called at 6 am, no answer from the decedent care office... So I kept calling and calling. At 6:30 I got in the car and headed to the hospital because I have to be there at 7 if there is a case, regardless of if someone is there to tell me that we have one or not. I get a text from my fellow oncall student ten minutes later to say that he's giving up and heading in too. I keep calling. I left my number to be paged and a voicemail on their line. As I'm pulling into the parking garage one of the autopsy techs gives me a call saying he heard my message and that we're clear. It saved me the walk in from the parking garage, which considering how little I'm enjoying walking right now, was pretty nice.

I don't mind going in if there is a case since around a third of all of the autopsies happen on the weekend, and I go to bed early so I'm okay waking up and being there on time. But this morning was frustrating, doing what we are supposed to do and getting no answer.

Hopefully tomorrow is better!

Meanwhile, I'm in a walking boot. It is a huge improvement over the crutches! It still hurts to walk but I can walk.

That is less helpful...

So yesterday I was going down the stairs leaving my friend's house and when I stepped off the last step I landed funny and dropped like a rock. It was not one of my more graceful moments! That resulted to a trip to Urgent Care this morning and x-rays. Apparently I injured it previously (but not that I explicitly noticed) and this fall just made it worse, and the folks at Urgent Care told me that I have fractured my ankle. I'll find out what that means in a practical sense tomorrow... for today I've been set up with a cast and a set of crutches.

I've also been given a prescription for Vicodin and instructions to minimize standing and try to keep my leg elevated. None of which goes well with clinical rotations, but the VA staff were very nice and arranged things so I could gross sitting down. I'm great as long as I don't have to walk anywhere! And I'm sure after I figure out how to actually walk with crutches, that part will get better as well.

In the meantime, I'm so glad to be home and finally resting. Elevation and ice are definitely helping to bring down my pain levels, which were getting pretty awful.