Institutional Responsiveness

Duke has been interesting in that they are constantly concerned with how their students feel about their courses. Beyond the ready availability of the course directors, we are given access to anonymous student surveys on a regular basis where we rate our professors on many key areas and have the option to write additional comments. And things actually change based on student feedback, which is good to know.

I was really impressed by the responsiveness of the instructors to the students. One of my classmates was really concerned about the timeline for getting grades back for our physiology final and emailed the course director. She had the tests graded and our scores entered online days before we were expecting them (unlike the rest of our exams this one was taken on paper and had a short answer portion so grading was more involved). A med student wanted to put together practice practicals for Gross Anatomy so the course director organized it and arranged for the lab to be staffed during them so if students had questions there was someone to help them. Someone didn't like that a particular microanatomy lab instructor didn't do presentations before diving right into slides, so even though he was a big proponent of active learning (ie: learning by doing/finding stuff yourself) he started giving introductions/additional handouts (still not as involved as some of the other lab instructors but in response to last year's students the powerpoint presentations given by other lab instructors were made available online). I know that there is at least one very vocal opponent to the number of mandatory class sessions in the Body and Disease course we will have in the spring. I'm not sure what the outcome was, but I know that he had a meeting scheduled with key personnel in the school of medicine to discuss it during exam week. It will be interesting to see what comes of it.

It is good to know that students have a voice and that the administration listens.

I got Robbins Pathology for Christmas!

Because all of the cool kids ask for pathology textbooks for Christmas! I also got some awesome stuff that will make my life cushier, and I get to get a facial! And my sister got me this, which is hilarious and makes me feel better about all the gross people in the world who don't wash their hands after they use the bathroom (you people know who you are!).

Christmas was good, we spent several days at my parents' house hanging out, eating tasty Filipino foods, playing board games, and sitting around talking to each other. We had our actual celebration on Christmas Eve, so we were able to head back to NC on Sunday. It has been the laziest week ever and I can't believe it is only Tuesday! I might even be completely caught up on sleep :) I still have to sort through the piles of laundry but other than that all that we have to do is ensure the dog gets walked and everyone gets fed. My husband is on vacation this week so he is here along with the dog. It is great to be together as a whole family for a while.

I have to swing by campus tomorrow since my laptop has a virus of some sort. I need to print a few things and check to see if the IT folks are there even though the school of medicine is on break. It would be fantastic if they are there, but I'm not going to get my hopes up! Luckily my dad is in SC with my mom until classes start up again so I stole his laptop for the week. I counted and it turns out we have five computers for two adults and two kids right now, which seems a little ridiculous. I could probably survive the six days between now and the start of intersession without my computer if I had to.

I'm excited about classes starting up again. It will be a completely different experience without the med students and getting to do the rotations. I can't wait to see what it will be like!

People I liked working with

Our final grades posted this morning and we got the official email announcing that we all passed the Normal Body unit. Our professors did a really good job of getting everything graded and posted quickly. Being officially done will make it easier to relax over break! Maybe now my dreams will stop tracing the flow of blood through the head.

January will be a fun month, we're splitting into two groups of four and will be alternating days on surgical pathology and autopsy pathology in addition to our lectures. It will be our first time working with the Duke PAs. I'm excited! This is what I've been waiting for since we started! I like grossing so much and I will get to do it again, hooray!

A couple of the people in the program have stayed employed where they worked before they started school and pick up a few hours over breaks but I didn't. It makes going back to where I worked before a sort of hazy area HIPAA compliance-wise. Especially since the grossing folks work nights and the supervisors aren't around to get permission from. I don't want to get anyone in trouble. Next time I'm remotely in town I will have to try to take everyone for mexican food or something. I worked with great people I really like, which is a plus in any job but especially important in something like grossing.

Where I worked there were three of us and the work was shared, which means that you had to be able to count on the people you worked with. If someone was out for whatever reason (illness or vacation) it meant the other two picked up the slack since there was no one else available to help. The gross room had the fewest sick days of any department in the company, not because we were particularly healthy but because anyone calling in was aware of how it affected the other two. And it was good to know that if you were one of the two people there doing the work of three that the other person working that day had your back. That they were willing to stay as late as you were to make sure everything got done that night that needed to be done, even if it meant working hours after our scheduled time off, shifting our schedule for the entire week, literally running to the bathroom when we couldn't take it anymore, and eating dinner as bites snatched standing up in the warehouse while a courier unloaded the next group of specimens. They were great people to work with and I hope I am even half as lucky when it comes to who I'll be working with after I graduate.

Some of our second years have already started job hunting (and at least one that I know of already had a job lined up for after graduation!!) and it is interesting to see the dynamics in a field like this where the demand is greater than the supply. As a grossing tech I was well compensated and had a fair amount of autonomy and trust where I was working, but if I were to change jobs? I would probably have taken a big pay cut and been limited to doing smalls. As a certified pathologists' assistant, the prospects are significantly better so students can be selective about location and work environment. As first years we are definitely paying attention to how the job hunt goes for the students who will be graduating next summer, and so far it is nothing but good news. :)

And still... the anxiety.

I spent a few days away from any place I could accurately call home. I was a guest, a halfhearted tourist in the mountains. I slept embarrassingly late, responsible for no one else. I took every meal in restaurants and started reading a book from which I will learn nothing.

I drove home late last night, coming down out of the mountains down dark deserted stretches of highway with nothing to see but my headlights bouncing back to me from the reflectors lining the road. I played my favorite album, the one I know all the words to without having to think about it. I drove through the night and into the small hours of morning singing and stewing.

I came back to the house where my husband still lives several hours after he went to sleep, but my dog was there to greet me. It was an unsettlingly familiar experience echoing every night I would arrive home from working second shift to a quiet house. Except everything is just a bit different now. The rooms echo stripped of furniture and everything smells faintly of new paint and drywall supplies rather than something simmering in the kitchen. I do not live here anymore.

It would be inaccurate to say that I'm not feeling just a bit sorry for myself at present. I don't want this blog to focus so strongly on me and my test anxiety because for other students reading this to see what PA school is like it will have no relevancy for them (or at least one would hope). But it is a definite part of my higher education experience.  It would be the miserable part, the only one. Even the long nights studying on campus or cloistered in my study room in my apartment isn't unpleasant since it feels fueled with a sense of purpose.

Railing against the universe wouldn't do much good here. Test anxiety was a part of my life well over a decade ago, I got treatment, I took many classes after it where it wasn't an issue, did quite well at rather important standardized tests, and thought it was all in the past. It was an extremely unpleasant surprise to find out that it was not. However, the fact is that being mad or sulking or collapsing into ball of self pity isn't going to make it go away.

So I told my husband about it because I know from the past that keeping it to myself without seeking help just allowed it to do more damage. I told my course director. I went for counseling and got a prescription to help alleviate the symptoms, which I had for the last three tests of the month of tests we had in October. And it helped. It wasn't magic but it removed me far enough from the anxiety to be able to function. I could still feel it but it didn't take over. The last week of exams was difficult, the anxiety built over the course of the days leading up to the first exam and continued to climb through the end of the week. I almost threw up on a cadaver during the final anatomy practical but I was able to eventually finish it.

I don't want to let the memory of the experience destroy the holiday break. I will go back and talk to the psychiatrist and reevaluate the treatment options I have. Therapy has been less helpful for me since I don't, in regular life, have anxiety, depression or much in the way of complaints. It is just the three hours or so of a given exam out of hundreds of other perfectly nice hours that are the problem. I have an elevated response to a normal and expected stress. It will be dealt with and life will move on.
Now I'm going to go spend time with my dog and start wrapping presents.

Christmas break!

My more typical notes

Exams have all been taken. After a week of them I feel completely wrung out. A week of exams, weeks of long days studying, stress, complete neglect of folding laundry (it is clean, just not folded but still taking over my room) and other non-essential life chores, etc and it is now Christmas break.

My youngest

I'm going to a friend's wedding tomorrow (but have to get something to wear to it and need to get a gift bag for the present I finally remembered to order on Monday), followed by a quick trip to see my best friend's new place in Asheville (I say new but it has been six months!), then to my old house until Christmas to spend time with my husband and my dog. It will be strange to go to where I used to live since we don't have any real furniture anymore but awesome to spend time with them. My mom is stealing my kids for a week since she hasn't seen them since September sometime and she has gone into withdrawal.

After Christmas we're all coming back here to re-organize the apartment and give everything a good de-cluttering. I think we'll finally be able to put up the kid's summer clothes. It should be a calm week, hopefully. Quiet and calm and tidy.

I look tired because I am

Did not have a good time with test anxiety during the gross anatomy final, I will have to wait and see what the impact was on my grade. I will have to discuss things with the doctor to see what can be done for the future. The spring with Body and Disease will have more TBL based learning/testing, which should help.


January will have surgical and autopsy rotations and neuroanatomy. I can't wait for that. And we received our schedules for Body and Disease earlier this week so that's something else to look forward to. A long stretch of pathology and microbiology, hooray microbiology! It was my undergraduate major and I love it. Who has two thumbs and is good at streaking for isolation? This girl! You want to know what agar to use to isolate and identify S. aureus? I know that! 

The book store was having a sale and had something in stock they have been out of for a while, so I bought myself a present. Hence the pictures. And why everyone in my family is getting Duke gear in their stockings. 

The fear of the fear.

I am going to assume that this week's anxiety is due to the back to back to back nature of the final exam schedule. Either that or I'm just a crazy person. I really hope it is the former and not the latter. I had a pretty good stretch there in October where we had tests every Monday, at least after the first Monday which was before I started anti-anxiety medication.

Sadly it isn't a magic pill that keeps all anxiety away. It does make things duller though, which helps. I think the fear of the fear is the thing that is the worst. The anticipation of having a reaction I don't have much control over.

But it could be worse.

Navel-gazing

I can't help but worry--as I study--about my anxiety. After the kids were in bed Saturday night I took a break for two hours to watch a movie with my husband, and the whole time I kept wondering how impacted I would be during the test. It seeps into my dreams.

Dullest manifesto ever

I wrote out notes, pages and pages of handwritten notes on 11 x 14 inch paper. My husband said they looked like a crazy person's manifesto. I re-watched lectures, I consolidated the notes group notes into handy references for each lecture. I read the instructor's notes that turned a 50 minute lecture into a 19 page document. And the entire time I'm doing this and studying and learning and relearning I'm completely cognizant of the fact that none of it may end up mattering because of the anxiety*.

The medication helps, it helps a lot, but things still come through. One of the instructors came into our room after the test started and wanted to look at my exam (the PAs have paper exams). My first thought was, OMG, he's looking at how wrong I am. My second thought was, what did I do? Did I do something wrong? I'd only answered a few questions by that point. He said he was just checking because another student seemed to be missing a question (I think it is more that one of the questions was at the bottom of a page and the table with the answer was on another page, we had a couple questions like that). Still, it was unsettling.

Even with that today wasn't horrible. My reaction was pretty normal, I think. There were things that didn't dawn on me that I knew until after I turned the test in but it felt like normal human fallacy and not the elevated, escalated mind going completely blank reaction of a panic attack.

No one really feels good about today. Favorite status from FB from a med student: On the bright side, I learned today that on a multiple choice exam, having no idea what's the right answer means click randomly and then leave early.

I miss working. I've never felt any anxiety with that in the slightest. I only get it with tests and not even every test. It would ironically be easier if this program mattered to me less.

*Alternately because the questions asked will inevitably not be the stuff I studied. Which, from the comments after today's test, seems to have been the case for everyone.

Studying for exams has eclipsed the rest of life

I haven't seen my kids in any meaningful way since Tuesday some time (and even then I was home but studying, so I'm not even sure that counts). I studied last night and tonight in the PA room until 9:15ish, which is well past their bedtime. I'm going home right after gross anatomy tomorrow and will stay home to study this weekend, so I'll see them off and on. I'll be holed up in my studying room in the apartment but I like to come out from time to time for hug breaks. My kids like hugging.

My dad has been in charge of feeding and tending the kids. He doesn't seem to be going crazy and they're still alive so that's a good sign.

Meanwhile, I'm so tired of studying but that's fine. It is only for another eight days, then it is a fabulous two and a half week break followed by January intersession. I'm so excited about January! We start with autopsy and surgical pathology rotations. But first I have to survive exams.

Everyone has to survive exams first. Med students are posting all over facebook with predictions of gloom and doom. Cumulative exams are horrific since after a couple months all you retain are concepts, not the level of detail you need for tests. There are a lot more lectures to study for this test.

I will write a real blog entry after exams.

My day was cooler than yours

I don't want to come off as weird or morbid or gruesome, but I had the coolest day ever today at school. I got to cut our cadaver's head off! It was amazing. It just isn't one of those things that happens very often and I'm glad that I got to do it. Would I want to do it a lot? No, probably not, but it was still really cool to get to do it once (The dens is really hard to cut through, by the way.). I got to stick my finger through the foramen magnum while we were checking our position and it was just so neat to trace the path of the spinal accessory nerves, the spinal arteries, etc. It is not an experience that most people will ever get to have and I feel lucky to have done it. I will never again have the opportunity to dissect a body so thoroughly. And for everyone who didn't come to gross anatomy (I'll talk about this in a separate blog entry) they missed out on that. It is completely their loss because that has been the best gross anatomy lab so far.

Quick, name all the structures!

This week is strange. We're not having a lot more new information presented but we're having clinical case information given to us and by taking patient history we're supposed to be able to go through the differential diagnosis process to decide what to test them for. They are mandatory for med students (well, mandatory-ish, since they aren't taking attendance) but optionally mandatory for us. The one today did go over some of the material and we will probably remember that course material better than the things we didn't have in symposium, but for the time it took it wasn't high yield study time. Oh, and when you ask a bunch of PA students what tests to run on someone with abnormal uterine bleeding you get answers like "Let's do an endometrial biopsy!" in addition to the blood tests you're probably after.

It looks to be a fairly light week, which is good because everybody is in a state of semi-panic over the upcoming exams. It is a terrifying amount of information to be tested on in just one week. It should be doable. I keep telling myself that it is doable. I am hopeful, oh so hopeful... and yet so very scared at the same time. I spent this past weekend studying, I'll study tonight after I finish writing this, I'll study for two hours tomorrow morning before class starts, an hour over lunch, and all tomorrow night.

My kids started basketball week, but my dad is taking my oldest for practice tomorrow and my husband and my dad will take both kids to their separate practices on Saturday. I'm still trying to decide if I'm going to study on campus or holed up in my study room with headphones in at home.

Eyes, Brains, Fertilization

I was right, our brain wasn't well fixed. My classmate that's had the most autopsy experience did a really good job of getting it out though. It involved four sets of hands and a bucket to catch the runoff, but it came out in one piece. We put it in fixative for a few days, but when we checked it today it was still mush. I didn't have high hopes, but we figured it couldn't hurt to try to fix it and it did firm up the parts that were less liquified. Oh well, there were a lot of really nicely fixed brains around so we were able to see all the nerves in person and I don't feel like I missed out on much.

Today we did eyes. One was left in place but the skull was dissected above it so we could see the superior muscles and the other one was taken anteriorly, which exposed all of the inferior muscles. The ear was optional but we didn't get to it today. I've done ear enucleation specimens in the gross room before but only from animals, so I do want to be able to see a human one to be able to compare them. I might be able to get to it on Friday, we're scheduled to do the neck but I can be in the skull while other people are working elsewhere.

Colorful, fuzzy brain worms.

One of our classmates took our bone box replica skull and marked the various foramens and canals with labeled pipe cleaners. I have to share a picture of it because it is fantastic.

Meanwhile, I'm up for notesgroup notes tomorrow for a lecture on fertilization. Luckily we are done with classes at noon tomorrow, so I am going to throw something together for the family to eat for dinner tomorrow and plan to stay until 8ish. It will give me a chance to do my notesgroup notes as well as go back over the lectures from Monday and Tuesday. Friday goes until 5, with both a microanatomy and a gross anatomy lab so I know I won't be in the mood to stay late then. I am planning to spend the weekend studying in the library or the PA room though since there are only two weekends left before final exams.

And then there were three...

A year ago, if you'd searched the internet for a pathologists' assistant student blog you wouldn't have found any results.You would have been a few weeks too early to find Forrest's first post as he was preparing to start at WVU's program in January. But now we are up to three, representing three of the nine NAACLS accredited Pathologists' Assistant programs.

If you're reading this you've obviously found my blog, but you might also be interested in reading the other two:

Forrest is a WVU student, and his blog is The Making of a Pathologists' Assistant.

Paul is a future Drexel student, due to start in May (I believe), and his blog is No Job Too Gross.

Must NOT make zombie jokes!

While January is our big neuroanatomy month, tomorrow the skull cap is going to come off. It will be a first for a lot of students; although, at least one of the med students did neurology research so it'll be no big thing for him.

To be honest, I'm not expecting particularly well preserved cranial contents because of the cause of death. Hopefully it won't be all liquified since it will make studying it easier, but if it is that's why it is nice to have friends on other tables.

When my sister was doing gross anatomy there was one guy in her class who every time an instructor said brains would do a zombie impersonation under his breath. It was sort of funny for the first few times, but he kept it up the whole class.

Tomorrow also starts the penultimate week of actual classes for the fall. After that we have a week with three exams (Monday, Wednesday, poorly time Canucks hockey game that I'm still excited about, Friday) and then we're half way done with our didactic year, hooray!

We've had a lot of countdowns. First it was Molecules and Cells when we hit the first test and we were a third of the way through, then it was two thirds of the way, and the we were done with Molecules and Cells (and we were happy!). Then Normal Body started and it was all about making it through October (did you notice the huge drop in blog entries in October? ha, it was sad), then we were focused on the second gross anatomy exam, and now it is two weeks of new material and studying up for our cumulative (yuck!) physiology and microanatomy exam. Chopping it up into smaller sections makes it easier to deal with since it is quite a lot to deal with, which is possibly why the cumulative final seems particularly unappealing but we'll make it through.

Edit: Can I mention that the temperature is in the seventies still? It is so strange for it to be the end of November and I'm still walking around in short sleeves! Atlanta is supposed to get a dusting of snow this week while we might drop down into the fifties.

Hobbies and Life Balance

This is outside the library on campus

Bring a grad student is a lot of work, a lot more than just having a job since you don't generally take your work home with you (especially in grossing!) but with school there is always more work to do, something else to review, make note cards for, etc. Studying is important, studying becomes a lot bigger part of your life than it has even been before. Studying can even be very interesting and the information can have correlations to things you will see in the gross room (I especially enjoyed the endoscopy lecture we had), but studying is very rarely fun. And studying all the time leads to burn out.

Going into grad school I acknowledged that I would be giving up a lot of my free time and set aside quite a few of my regular hobbies, passed on my responsibilities in organizations to others, and promised myself that it wouldn't be forever. I even left my sewing machine at home when I moved to North Carolina since I knew I wouldn't have the time for it.

I've given myself permission to keep up with a few things. I read at least one book for fun a month (thanks to the kindle app on my phone I can sneak a few minutes' worth of reading on the bus or while eating) and I have one or two TV shows I keep up with (thanks to Hulu, which currently has a Hulu prime trial membership that is a month or so for folks with a .edu email address, just FYI). I'm also averaging about one outing to the movies a month and play Words with Friends (user name is Thatgirlwiththescalpel, btw if you're interested!). I blog, which you've probably noticed, and that makes it okay that I have stopped my other writing for a year or two.

My food looked a lot like this, it was so good!

I like to go out to eat a couple times a month (today was Vietnamese food, which included a Vietnamese classmate who clued us in on all the different food types. The company was good and the food was absolutely delicious.) and try new things. Durham/Chapel Hill was voted America's Foodiest Small Town by Bonappetite magazine, which means it could take years and years to explore the various fantastic local food options. And I like to host dinners once a month or so (or as my budget and schedule allows it) for the company and the joy of sharing my food/culture with others.

Nice study view, right?

I also like to take time when possible to enjoy the views on campus. I know, I know! I've mentioned how gorgeous Duke is on a regular basis, but it really does make you feel better to walk out into those surroundings, take a deep breath of clear fall air and just soak in the scenery. Even if it is just going outside for an hour during lunch to soak up some sun and fresh air, or throwing open the windows in the PA student room. The view from the computer lab/printing room upstairs is quite nice as well, it looks like something from a Jane Austen novel (see picture).

Those are the things that keep me feeling like a balanced human being and not an academic automaton. I don't have any complaints, I'm busy but I'm happy and it has been a great experience so far. Of course, I'm eagerly anticipating our rotations but until then at least the studying part isn't driving me crazy :-D

Thanksgiving and things that are not a radius

Cutest invitations ever :-D

Our class had its own Thanksgiving dinner last week and I just had to share the invitations made by the classmate who hosted! They're super cute :-) Dinner was awesome too. It was a blasty-blast, because everything with my classmates is a blasty blast (ah, that would be funnier if you were one of my classmates).

I was talking to one of our professors about something else and he told me that the instructors thought our class was one of the best in years in terms of working well together and integrating with the med students. Aw, that's nice to hear. Of course, hearing how we were the smartest people ever would have been super as well, but I'll take what I can get. There are worse things for people to be saying about us than that we're friendly and get along well.

Actually, it is really helpful having classmates you like. My husband was in town this weekend so I sequestered myself on campus to study for Monday's gross anatomy test while he took care of the kids (they went to the Museum of Life and Science on Saturday, the kids love it). Between Saturday and Sunday I spent 26 hours in the PA room. On Saturday I was in there with one classmate and on Sunday I was there with two different ones. Even though everyone was focused on studying their own stuff, it was still good to have company (especially since it gets a little eerie being in a building mostly by yourself), so when you have a question there is someone there to ask.

Someone even labeled our bones so you know which one isn't the radius!

Of course sometimes it can backfire. When we got our bone box (a suitcase full of model bones that we can take home and study at our leisure) one of our classmates pulled out the fibula and said, "Is this the radius?" and it has been a running gag ever since. Oh ha ha, the fibula is not the radius and we all know that only a mutant with freakishly long arms could ever have a fibula sized radius. Then on our practical we had a fibula and when I saw it I chuckled to myself about how it definitely wasn't the radius. It wasn't until I was at the next station that I realized that I had scribbled down radius as my answer because my subconscious has a sick sense of humor. That would have been horrifically embarrassing to get wrong! I don't think I ever would have lived it down.

I'm glad that test is over though. I am pretty sure I spent more time studying last week than not studying. Which makes this week, where we've been off since Monday, even more appreciated. I'm still studying this week because it isn't too much longer before we have our cumulative (that is a dirty word!) physiology exam, but no where near as intensely.

Oh, and because it is almost Thanksgiving I will take a moment to be grateful. I am incredibly thankful for my father for picking up and moving here so I could go to school and still have my kids with me. And to my mom for her support, prayers, and caring. I'm grateful for my husband who lets me neglect him when he comes to visit on a test weekends, and who I love like a crazy person. I'm grateful for getting to spend more time with my children, even though they are huge study distractions they bring so much affection and cuddling to my life. I am so grateful that I got into Duke and that I have the classmates I have, I can't imagine going through this without them. Also, I am extremely thankful for anti-anxiety drugs so I can take tests without throwing up. I'm thankful that everyone I love is healthy, and that I have so many people to love. I am sure there are a lot of things that I am forgetting, but that's a good list for now. :-D

Not not appendicitis...

Since Saturday my oldest child has had intermittent abdominal pain either low along the mid line or in the lower right quadrant. He was fine Sunday evening and most of Monday, and started up again with pain/nausea/unwillingness to eat this morning. But the intensity waxes and wanes, he said his pain level (based on the frowny face chart) is usually around a 2 but has gone up to 6/7 more than once for extended periods of time.

Now I know the technical term for things, fancy yes?

He has pain at McBurney's point when palpated but pain is diffusely present throughout the lower right quadrant pretty much all the time. Doing a heel strike made it hurt but that is a new development tonight. Laying on his left side made it hurt more. Flexing his hip caused marked increased pain. He doesn't have rebound pain.

We started out at urgent care because I was hoping it was a stomach bug or something similar, but they told us to go to the ER because it had a lot of the hallmarks of appendicitis. The ER had mixed results but we didn't do anything quantifiably diagnostic (blood work, ultrasound, etc), so I was given the option of admitting him for observation or taking him home for observation. Since his symptoms were fairly mild I took him home with instructions to come back if it got worse... It hasn't gotten markedly worse but it isn't better.

So I don't know what to do. I mean we could go back to the ER but I don't know that it would do us any good since he's not much more likely to get a firm diagnosis of anything today than he was Saturday. Basically I'm just waiting around for this to either go away (fingers crossed on this option!!!) or turn into miserable acute appendicitis.

Meanwhile the doctor at the ER scared him a bit by introducing the idea of a ruptured appendix. Luckily, I could assure him that I'd seen a couple hundred appendixes a year for several years and while many of them were big and angry, very few were actually ruptured (I think he took what the doctor said to mean that his appendix would literally burst like a balloon).

I wish I had a slightly more advanced way to diagnosis this than "let's wait and see what happens" but unless it is already fairly inflamed an ultrasound might not pick it up and I'm not doing to give him the massive dose of radiation that would go along with a CT scan (which was an option presented to me by the ER doc, but presented in such a way that it was obvious he was just mentioning to have it down that he did mention the option, even though we both seemed to be in agreement that it was not going to be a viable option).

So that is where we stand. My son has pain that is not diagnosable as appendicitis, but at the same time appendicitis hasn't been ruled out.

UPDATE: The pediatrician thinks he has some bowel inflammation, so he has a prescription he will drink for a few days and hopefully things will calm down and all will be well.  

Absolutely gorgeous!

I forgot to mention this earlier, but the weather here is gorgeous. It is amazingly nice for November, highs in the 70's, sunny, breezy, short sleeve weather.

I like to go outside during lunch to get some sunshine and fresh air. Today I sat down on a bench with my online anatomy flashcards and all of a sudden a small horde of med students descended on the benches all around me. Less quite, more social, and it was nice to sit beneath trees with friendly people, a blanket of soft yellow leaves all around us.

Before too long my classmates came down from our student room bringing their lunches along with them, drawn by the fantastic fall weather. They actually managed to snag a table (the courtyard was packed today, for obvious reasons!) since they have amazing timing, which made eating a lot easier than the whole balancing my laptop and lunch on my knees maneuver I was attempting on the bench. I gave up on studying at that point and stuck my laptop back in my bag. Although, I do love that one of my classmates brought a femur down with her to study while eating lunch. :-)

Tomorrow's high is 77 degrees. Even typing that makes me happy inside. Weather like this just makes me happy :-D

The things I choose to do.

I can neglect a lot of the other chores (*cough* laundry *cough*)  but every night I cook a homemade meal from scratch. If I'm staying late on campus to study then I make something my dad can pop in the oven to heat up (pot roast works well for this).  I just feel like eating a real meal as a family around the table is important, even though it takes up an hour or two a night. The kids like to help me cook and I hope it helps them develop good eating habits for life.

Of course on pretest weekends, especially when my husband is in town, I neglect everyone and a lot of scavenging occurs (and leftovers finally get consumed). The kids get to do things like eat hotdogs or get pizza delivery. They would love for me to have more tests, perhaps even daily tests. Tests mean a serious decline in the number of vegetables served and a huge upswing in sodium intake.

But this is why you don't let 5 and 7 year olds make their own menus since they'd end up as hypertensive diabetics with scurvy. I have decided not to feel guilty about these interludes. It is one year of their life where they get to eat more processed food than they would normally, and even that is only a couple weekends a month. I figure if that's the worst that happens to them because I'm in school then we're doing okay. If it ever gets to the point where figuring out what to have for dinner means consulting a stack of take out menus, I'll send them to live with my mom (who has been wanting that to happen since they were born anyway since my mom loves her grandsons like crazy). I don't see that happening though! :-D

The Absolute Best Pathologists' Assistant Program!

Is any one PA program better than any other? Well yes and no... They are all going to qualify you to sit for the certification exam and they're all held to the same standards by NAACLS. So in that sense they are all good programs and will allow you to be a pathologists' assistant (which, conceivably, is your goal, right?). 

Each school has its advantages and disadvantages. The cost of tuition is not insignificant regardless of where you go, but if you're lucky you will be a resident in one of the states where being a resident can save you tens of thousands of dollars. However, tuition isn't the only cost since a big part of your loans will be allotted for living costs. The city you live in will make a big difference. The Durham area, for instance, is really quite affordable so for $600 you can get a two bedroom apartment and have a roommate.

Location matters, not just for cost of living, but for lifestyle reasons since Philadelphia is a very different city from Durham which is very different from Detroit, etc. Weather might also matter for some people, so if you don't like snow I would advise against going to school in Connecticut for instance. Plus, if you're close to your family and they live in Indiana then you probably wouldn't want to go to school here in North Carolina but would be thrilled with getting accepted into IUPUI.

There are differences in the programs to consider as well. How big do you want your class to be? Class sizes range from four to thirty three. How the classes are taught varies as well, we take all of ours with the Duke medical students which concentrates their didactic curriculum into a single year. In other schools you might have some classes with nursing students, some with dental students, some with physicians' assistants, while in the programs with larger enrollment numbers you might have PA only classes.

Rotations vary as well. We stay fairly localized for ours, while other programs send their students to other states, and even other regions of the country. That was actually a huge factor for me since I was bringing my kids along, I wanted them to be able to stay in the same school/state/environment for the two years I would be in graduate school and not have to worry about being sent to Texas or UCLA (of course if you're from a western state and would like to be closer to home, then one of those programs would be great!).

There are a lot of other factors. Each program is different and you can't look at one or the other and say in every instance, for ever case, there is one superior one. Apply to every program you think you could live with going to, because ultimate the best program--the absolute best one--is the one that accepts you as a student.

Oh, that's bad...

I get home tonight to find my school laptop, which had been placed closed on a desk, open on the floor next to my couch. The couch my 7 year old is sleeping on, the couch on which my 7 year old had an couch wetting accident, which dripped off the couch into my laptop. :-( So I took out the battery, unplugged it, wiped it down and stuck it in some rice to soak up any moisture (we're going to call it moisture and not think about what specific kind of moisture it is!) for the rest of the night.

Hopefully it turns on in the morning because I have studying to do :-(

Edit: It seems to be working, except for the "C" key which I have to press really hard to make work. It is enough that I will be able to study today and tomorrow I will stop in to see those nice guys in the laptop support office (my fourth visit, and third time having it sent off for physical repair, but the other two weren't really my fault).

I have the most awesome classmates ever!

Dinner was a blast! And I think everything was actually cooked and set out to serve within 20 minutes of when everyone was told to arrive.

One of my classmates showed up an hour early and helped out, which was amazing. It makes it so much easier when there is another set of hands! As other people arrived everyone pitched in and there were more people in my kitchen than I ever thought could fit in there! One of my favorite med students took over the cheese slicing while someone else was arranging it on the platters, one of my classmates is actually getting really good at making pancit, and other people were organizing dishes and setting out dishes. It is a great sense of community. People brought homemade bread and dip and delicious desserts--everything from colorful Vietnamese mixed fruits and jellies to puppy chow (which I've never had before, I love the cultural exchange lol).

Seriously though, if you ever have people over my classmates are the best! They bring stuff, they're great to play games with, are adventurous about foreign foods, and clean up after we're done. Maybe next time I'll finally remember to take pictures, but we're always so busy with the eating and socializing that we're slack about that. Good times though. :-D

Edit: I forgot to add that we had a small fire! It was so weird to look over and see flames. Luckily it was just some stuff that had fallen below the burner that caught on fire so it wasn't any actual food that was ruined. Very exciting. 

State of the student...

I wrote about test anxiety/panic attacks back in September and then made the post private because I felt vulnerable having documentation of that experience out there while the situation was still fresh and I couldn't get an appointment with a counselor for a couple weeks.

In more recent news I've been prescribed a very useful anti-anxiety medication. It is immensely helpful. On Monday we had a Gross Anatomy test and there was a section on autonomics, which was both a weak area for me and a surprisingly long section of the test. It would have been a huge trigger for me if I hadn't gotten help, instead of moving on and doing the questions I felt better about I would have just stayed on that one section getting more anxious, changing my answers and constantly second guessing myself. Instead I went ahead to the other questions and then went back to that section and tried my best. Since the practical was immediately after the written, I'm particularly glad that I didn't get too stressed out over the written part.

We have a multi-week gap before our next test and I am seriously looking forward to a weekend where it won't be 100% about studying. I'm still going to study some but it'll just be a few hours each day to go back over the material from this week.

Hopefully mine turns out something like this!

And since we don't have an upcoming test, I thought I'd invite everyone over for dinner and boardgames. Hooray! I invited the second years as well, and a handful of medical students and the evolutionary anthropology graduates students that two of the PA students were paired with for gross anatomy. They very nice and since they're just with us for this class they don't know any of the med students. Plus it is kind of weird for them to be thrown together with a bunch of strangers who all know each other. So we've tried to be friendly since we're friendly kind of folks :-) I don't have that many chairs but I think we'll all at least fit in the apartment.

The menu is mostly Filipino (I'm going to try to make Sinigang Na Baboy for the first time!) with some American food thrown in because one of my classmates has mentioned a couple times that she wants a corned beef brisket. One of our classmates is going to make a Vietnamese dessert that I'm excited about because it is pretty similar to Filipino dish called Halo halo that I don't make a lot because it requires a lot of ingredients. Someone is baking bread and someone's wife is making a pumpkin roll (yum!). Oh, and I will have a scaled down cheese plate because it just isn't the same without cheese (and cold weather just always makes me want a nice capricho de cabra).

It should be fun, maybe a bit loud but luckily I'm on the outside corner of my apartment building and my bedroom separates my living room from the neighbor most likely to be disturbed by noise. I'm not sure what games people are bringing but we should have several options and enough people that we can be doing different things.

And for my next trick...

Today we sawed our cadaver in half. Outside of becoming a magician I never thought I'd had the opportunity to saw a person in half. 

It was surprisingly easy since we'd emptied out the abdominal cavity last week. I think another course is going to be dissecting one of the legs, so we also split the lower half through the pelvis (seeing a spinal column in sagittal section is very interesting. Actually seeing a lot of stuff in person is very interesting and it is remarkable how somethings look just like the book and how a lot of others look nothing like the book (generally the vasculature, ie: what is this small brown squishy tube??).

This course goes into so much more detail than an autopsy does, so this is my first time seeing a lot of the structures in situ outside of my textbooks. I love blunt dissection! I might be getting a bit of a reputation among my group mates because I'm a big fan of just getting in there with my hands and going to work.

Our first gross anatomy test and practical are on Monday and I'm pretty sure I've heard everyone in my class despair of failing it at least once today. But we actually stayed after lab for a few hours and reviewed a lot of the structures we would expect to see on the practical. And, at the student's request, the TAs and course directors are setting up a practice practical this weekend where there will be multiple stations with pinned structures where we can go in during certain times and test ourselves.

It will be a long week and a long weekend of studying. But hopefully it will pay off. I'm learning a lot. It has been really neat to finally realize why it was that the pathologists could tell a gastric biopsy apart from a colon biopsy even when they aren't labeled. Or to see where a vaginal fornix is after having gotten biopsies from there for ages. Having worked with the tissues it is good to know things about them other than where they come from in general.

Still alive!

This coming Monday is our last test for a few weeks (after weekly tests for the past month!) so hopefully I'll have some time after that to play catch up.

Right now my free time is spent studying, cooking and shepherding the kids around to various Halloween activities/crafting costumes.

Normal Body

So this second unit is called Normal Body.

I like the names of the units at Duke, they sound so innocuous, so very not stressful at all.

Unlike the first unit (Molecules and Cells) Normal Body is subdivided into Physiology, Microanatomy, Gross Anatomy (<3!!) and Embryology.

For testing purposes the embryology subject material is on the gross anatomy tests and microanatomy is on the physiology tests; although microanatomy and gross anatomy have practicals in addition to written tests.

Some weeks have had more gross anatomy lectures and others (like last week) skew more towards physiology. But it all tries to tie in together, like we dissected the hearts when we were studying electrocardiology and hemodynamics.

This unit is so much more fun than Molecules and Cells. I know I've already gushed about how much I love Gross Anatomy, but I do! And the course director is very enthusiastic about his subject which helps immensely.

We still have TBLs, but the individual portion is done at home/open book and the group exercise is done in class and usually incorporates multiple topics. There are also GA TBLs which are at the end of the lab sessions and are closed notes but open cadaver.

Unlike Molecules and Cells where we had a test every 2 weeks on everything we've been taught in the previous 2 weeks, Normal Body had a 3 week stretch without a test, followed by something every Monday for the next month. It sounds bad and it does kill your social life, but it isn't as horrible as it could be since each week is a different subject (next week is the microanatomy practical, but happily we just had to study the MA lectures for the physiology midterm we had today so that should all be fresh in our minds. And frees up some study time so I can spend the next two weeks studying the heck out of our GA and embryology materials since that's the Monday after next).

My husband came up this weekend so I had to strike a little bit of a study/life balance and go out on a date with him. It was good to spend a few hours not thinking about anything more complex than what to order for dinner. He was pretty awesome and took the kids for a hike while I sequestered myself in my study room. I hope if I study ahead enough that I can give him more time when he comes up again Halloween weekend (can I mention how it is my absolute favorite holiday ever and I'm really sad at the idea of not getting to make costumes this year?? But I left my sewing machine at home for a reason. It is only one year afterall).

I'll make a separate entry about how I'm doing personally, but I've been meaning to put this one out there for a while. I think the course set up is very interesting and this set up with having the different units is unique (at least in my academic experience). Overall I think it works well.

Gross anatomy

You know what is awesome? Gross anatomy.

Cadaver dissection is an excellent way to learn anatomy.

I have Gray's Anatomy for Students, Netter's Atas, and flashcards on order from Amazon. I've even read Grays, but nothing has been as useful as hands on anatomy lessons. Time spent teasing muscles apart along the langer's lines is time spent reinforcing which muscle it is exactly we are reflecting. Want to be able to visualize a vena cava? Stick your finger in one and follow it to the right atrium.

I love it! We are encouraged to go around and look at other groups' cadavers, and it has been really interesting to see the variations in "normal" and the impact of different diseases/pathologies.

Our group is taking its time to ensure everyone is comfortable with all the parts of the day's dissection and can identify the structures. It means we take a bit longer to go through everything but so far no one has had any problem with going in during non-lab time to catch up. Our group is probably a bit more enthusiastic than the others about the whole thing, I'm sure you can imagine ;-)

They like me! They really like me!

Or at least my notes.

Remember that lecture slide I posted yesterday? That was from the lecture assigned to me for the *Notes Group.

Today I was in the bathroom and one of the med students was saying to one of the others that whoever did the notes yesterday also put up a really good outline for that slide.

Yay! I was worried people would think it was awful. I'm glad to overhear nice things about me, not that I was eavesdropping intentionally or anything ;-)

It was a good lecture to have to do since there was so much information given and being responsible for the notes group meant having to listen to it twice and having to make my notes while it was still fresh in my mind.

*If you're not familiar with the concept, every lecture is assigned to a different person who makes notes and shares them with everyone else in the group so in exchange for a little bit of work (you should be doing anyway!) you get access to a lot of information. The med students organize one every year, but this has been the first year that we've been so openly invited. Our med students have been amazingly inclusive, it is nice :)

Power Point Tips for the Medical Educator

I promise I will write a real entry on the classes we have in block 2, but for right now I just want to make a comment on Power Point slides.

Most of our lectures range from 30 to 55 slides per hour long lecture and the doctors do a pretty good job of keeping the amount of information on each slide reasonable. We've had a couple insanely complicated graphs but they have been relatively isolated incidences.

If, as an instructor, you have a topic that you are planning to discuss for more than half an hour maybe try breaking it down into more than one slide. That way your text won't be teeny tiny and your students will have more room on their slide print outs to make notes (instead of having to use a second copy because they run out of room on the first one...).

I normally print two to four slides to a page, but should have printed singles for this one.

When I had to take a class in public speaking they taught us that you should try to limit yourself to no more than six lines of text per slide. That sounds reasonable and it is even better if you toss in a picture or an animation every now and then... Not to say that I didn't learn a lot but that one slide was turned into a four page outline! Four pages! That seems like a lot, right? I thought so anyway. At least it is a good instructor otherwise it could have been a lot worse!

A castle full of books

I want to pose on these stairs in a costume...

Yesterday I decided to go to the library to study since the kids were having a crazy sort of day. Up until then I'd only seen it from the outside and it looked appropriately Duke-ish (which is to say there was a definite castle-y Hogwarts sort of vibe), but the little foyer I stepped into really surprised me. It is so pretty!

The rest of the library was quite nice as well (and much more modern!) with a lot of different areas for studying. It was also incredibly quiet, which was fantastic and surprising given how many people were there.

But yeah, I just had to share these pictures because Duke is gorgeous.

Where babies come from and other things

Everyone's early baby pictures would look like this.

We had our first Embryology lecture today. The consensus was "OMG that's a lot of information all at once" but the lecturer was good. I'm glad I've already had kids though because I imagine being pregnant while knowing all the things that can go wrong would drive a person insane.

From the beginning of life to the end.

Gross Anatomy started today. There is a lot of variance in size and health, but we are very lucky with our cadaver. He doesn't have a lot of fat while having decent musculature. Having surveyed the rest of the room, it is a rare combination that makes our job much easier. We have named him Atlas Revadac (cadaver spelled backwards because one of our group members really wanted to give him that last name). His back was so nice everyone else was told to come to our table to look at him.

I have a copy of Netter's Atlas of Human Anatomy being shipped from Amazon and sent an email to my sister to see if she still has her copy of Gray's before buying one. Our group did well though, we finished a bit ahead of schedule so we flipped all the muscles back to their original position and had a review. I think the plan is to go back over everything again at the beginning of lab on Monday.

The course director for Gross Anatomy was saying today in lecture how he liked for people to come to class because he felt like it made it worth his time for there to actually be students to teach to. Same sort of thing for going to the lab. Someone, or their family, had to choose to donate their body, someone has set up the facility and multiple people who could be doing research or teaching a class are staffing the anatomy lab. It is disrespectful all the way down the line not to go. Plus, you can probably guess, our group is just motivated in general to be there.

I meet my cadaver tomorrow

Not just my cadaver of course, I will be sharing it with the other PA students. I can't wait to see if we have a man or a woman. Which ever gender we have, I hope one of the groups with med students we're friendliest with have the opposite gender.

Autopsies are no where near as involved as gross anatomy so this will be a completely new experience for me. I am excited about it.

This anatomy chart will not be helpful at all, but our second years have been really helpful in letting us know which dissectors are more useful. I'm going with Netters. Plus the PA room has a copy for us to have in the anatomy room (which no one ever wants to touch without gloves) as well as dissecting kits so that is less money we have to spend.

I'm wearing scrubs to school tomorrow. I didn't think to get any from the hospital but I should have some from home somewhere.

Pretest mood: Surprisingly not stressed

Procrastination Horse is eating my note cards :-O  Bad Horse!

With the exception of one class last summer I've been out of school for a long time (I graduated in 2007), so getting back into studying has been strange--especially studying on this scale.

This is our third test and I'm feeling okay. I don't feel rushed or that I won't have enough time to study everything.  I managed to make it through the weekend without completely neglecting my family or driving myself crazy.

I have about 3 hours before I go to sleep and I have one last note set to look over. I also have the old tests printed off to go over, but my timeline is pretty good. I'll also have some time in the morning to look over my flashcards.

The silly thing is, having this ridiculous stuffed horse on my desk has helped. If I find myself slacking off he's staring me down (you have to admit it is a disquieting stare) and it reminds me to get back to work.

After my test tomorrow I have to take my youngest child to the doctor for a school physical and then it is time to study up on my histology slides. I feel pretty good about the histology exam, but that isn't an excuse to not study for it!

And then Tuesday night and Wednesday are going to be amazingly awesome!!!!!!!! Why? Because for the first time in six weeks I won't have to feel like any time I take for myself is time away from studying. We will have a day and a half of downtime. Delicious, delightful downtime! I'm going to catch up on laundry for the first time in a month (I have 4 Ikea bags full of clean but unsorted/unfolded clothes), deep clean my apartment, and on Wednesday night I'm having my classmates over for dinner and game night. Yay! I'm making Filipino food again, but different kinds of Filipino food because I polled everyone and that's how the votes fell. At some point I'm going to have to figure out how to feed the second years as well! I feel bad not including everyone, but I don't know that I could fit everyone into my apartment.

The kids are going to go insane, because there's nothing they love more than strangers in our house. Massive amounts of excited over stimulation!!  But hopefully they'll still be able to go to bed on a normalish schedule. I might have to set up a sleeping area for them in my study room which is more removed from the living room than their bedroom but we will see. :) I have to survive these upcoming tests first!!

Procrastination Horse is a Bad Influence

He's watching you! And someone to your right.

When I find myself stressed out and near a doll grab I usually permit myself to waste a dollar on it. And between the dog and the kids someone is usually happy enough to take custody of my winnings. Monday night I won this crazy eyed horse and dubbed him Procrastination Horse. He's brightly colored and looks interesting and fun...but isn't really anything worth getting distracted by--much like every TV show, book, or random project that comes up whenever it is supposed to be study time.

I'm going to put him on top of the shelves in my desk so he can watch over me and remind me that studying is more important than fun looking stuff without any purpose or substance.

Class Schedule AKA There is no typical day in the life of a PA student!

The first six weeks of PA School at Duke (and to be technical, a first year medical student at Duke) are spent in a class called "Molecules and Cells." The first five weeks have included courses with names such as: Pathways of Signal Transduction, Chromosomes and Cytogenetics, and Action Potential Generation. We have a test every two weeks and a TBL session on the weeks we don't have tests.

Days can run from 8:30 to 4:30 with an occasional delightfully short day when the med students have something in the afternoon that we aren't required to go to. Most of our days are filled solely with lecture but a few times a week we also have histology lab which is usually on a structure we've studied in class. We can have one to five different lecturers on a given day. Sometimes the day's lectures are distinct topics, but you can also get two part lessons as well. We did have that one week that covered metabolism in depth (I cannot stress how much it helped to have the doctor we had teaching it teaching it. *He was fantastic!), but that's been the only time we've had something that distinctly inter-related over that long a time period.

There are one to two clinical correlations a week. The format is pretty similar--a physician comes in and gives a presentation on a given disease, followed by a patient who is generous enough with their time to come in and discuss their condition. The clinical correlations are really interesting and hopefully give the future physicians some perspective into the patient's point of view. 

There are two half hour Q&A sessions each week which are pretty free-form, some days have more questions than others. Last year's med students voted to discontinue them but this year's still seem to be utilizing them. Attendance is not mandatory and they start before the normal class time so it doesn't hurt to have them.

We usually have an hour for lunch and 10 minute breaks between classes. Since we stay in the same amphitheater and it is right by the food court and restrooms the 10 minutes is usually more than enough. The labs, which are also where we have tests, are up on the forth story in a different part of the building (not that far as long as you don't get lost, and I don't get lost nearly as much anymore!).

Our parking garage is a ten or fifteen minute walk (depending on how fast you walk) from the amphitheater. Sometimes in the morning I will take the bus if it is there when I arrive, but since the time waiting for the bus plus the time it takes to go through its route is longer than the time it takes to walk waiting for it doesn't make sense. In the afternoons we usually tend to walk back to the parking garage in a large group chatting and socializing.

Then I get to go home, feed the family, do the dishes, make an effort to keep the laundry levels under control and study enough to keep from having to cram before tests. This weekend is the first time I'm ever having to play catch up, so I'll have to see how much time that takes.

It is busy, the days are full, and every time we have a clinical correlation I have to wear business casual clothes but I really do love it.  I'm happy. Every other weekend I am intensely stressed out about the upcoming test, but every week that passes is another week closer to grossing again.

Now that my overview is finished, and my husband has made it into town (3.5 hour drive for him) I have to go get ready so we can go out to Chapel Hill with some of the med students and some of the other PA students (two of our number are out of town, and one's wife is running a half marathon starting early tomorrow). Hope you guys have a good weekend! I'm going to go off and enjoy maintaining my life/school balance for a few hours ;-)

Classes to make up :(

If I was going to choose a week to be sick, then this one was a good one to pick. Our schedules are intensely variable (I will try to write about our schedule for molecules and cells this weekend!), but because we were off Monday and had a test Tuesday this week has been our lightest so far.


Which is good because I am officially behind. I missed 2/3rds of yesterday's classes since my fever was in the 100s again and I only went in for the mandatory session. Today the fever was significantly better but I was exhausted and slept 14 hours (until 11:30! I felt like a sloth!) so I missed my morning classes. That was entirely unintentional though. I took the kids to school and was going to just lay down for another half hour before I had to drive to class... But then I slept through both my alarm clock alarm and my cell phone alarm (I don't remember doing so but I apparently got out of bed, walked across the room and unplugged my alarm clock). Luckily when I woke up I felt better than I have in days and made it to histology lab this afternoon.

I'm not happy about missing the classes but they are pretty easy to make up. All of our non-mandatory classes are available to be streamed online about 20 minutes after the class ends any time you need them. The majority of the medical students don't come to class unless it is mandatory (I counted once and there were about 40% actually in class) and just stream the lectures either at home or at the library on campus. A couple of the PA students will do that occasionally but for the most part we go to class, so I felt weird not going!

Today's Histology Lab Topic: Cartilage and Bone

It would have been much harder to make up missing my histology lab. Even though I can look at the slides on my laptop at home (isn't technology useful? Instead of two dozen microscopes, or one microscope hooked up to an overhead projector we can all just view the slides online.) and just follow along with my lab manual, you can't replace having a teacher available for when you get stuck on something. Today having an instructor handy was very useful at least twice and the end of lab review was helpful as always.

So it could have been worse, but I still feel bad having missed most of the past two day's worth of classes. At the pace we go, two days is a lot of material! At least I will have time this weekend to be caught up since the next (and final M&C test!) will be here before I know it.