Monthly Archives: January 2012

The First Day of the Rest of My Life


A week ago I sat here trembling in worry that I would fail majestically on my first day in Clinic.  I did not fail majestically.  Or fail at all for that matter.  It turns out that they were right, I know more than I think I know.  I saw five patients with my preceptor, and unlike some of my frantic compadres that chased their preceptors around all day at hectic urgent care and community clinics, my day was rather pleasant!  We had time to debrief every patient visit.  I got all my questions answered.  I wrote up my first official “note” which is doctorspeak for synopsis of problem+exam+solution of patient visit.  I tried out some of the apps on my loathed Android.  Half worked.  I looked stuff up, read, wrote notes, asked more questions, and went home thinking,

I can do this.  There’s no reason any other PA can do it and not me.  In fact, dammit, I WILL do this!

There’s a LOT I still don’t know, and a LOT I’ve already forgotten, but I felt a sensation of peace when I walked out the door.  I am headed back tomorrow morning, white coat in tow.  I really do feel an enormous sense of respect for the power I will have as a provider.  It’s not that having a fancy coat is the be-all-end-all, it’s that people will be entrusting their lives and bodies to my own knowledge, judgment, resources, and character.  That’s a big deal.  It’s more forgivable to have a bad day as a third grade teacher.  Heck, the kids could play games and I could go on the internet.  Not that I ever did that. 🙂  But it’s not so cool to have a bad day as a medical provider.  I’m sure I will, but the stakes are higher now.  Incompetence is all around us, and usually we can just roll our eyes, write a strongly-worded letter,.. maybe even chew out customer service,… not that I would ever do that,.. but incompetence in the medical field costs people their lives.  So, I’m thankful to be in a program where I get this added blessing of Friday clinicals and the mentorship/apprenticeship it provides.  I can say “I don’t know, I’m going to go look that up,” and it’s ok.  As the months go along, I will gain more confidence, and I’ll start remembering more things because I’ll have actual patients to attach things to.  So, that’s where things stand, a week after my trepidatious rant last Thursday.  Wish I could gab about all the cool stuff I learned and the patients I had but I think there’s probably a law somewhere about that………. But the finale of this mini-story is that last Friday was FUN.  Which is a good thing, since this is what I’ve signed on for?  Fun.  Interesting.  Intriguing.  Challenging.  Strangely comfortable.  Fun.  Phew!


White Coated


So the moment has come in which I have a white coat on my shoulders and I look down, and realize in some sort of mixture of amazement and terror that there’s a name tag on it with my name on it,.. this isn’t some sort of sick joke or mistake, someone actually thinks it’s a good idea to send me out into masses of poor unsuspecting patients tomorrow, assuming that something other than nausea/mayhem/confusion/stupor will result. Something resembling a legitimate patient encounter in which a patient presents a problem, and leaves with some sort of appropriate plan in place. Orchestrated in part…. by me.

Sorry I had to take a moment to hunt down that barf bag I saved from my last plane flight for just such an occasion….

It’s true that I have been spending hours too numerous to count in the classroom and on my couch and at my desk under a pile of syllabi, tissue, coffee mugs and cats,… and it’s also true that I have some grades to show for it,. but here’s the rub: I now have to REMEMBER everything I’ve learned. Maybe not tomorrow exactly, unless I have a patient who comes in with a rash and upon examination is also found to have glaucoma, murmur, kidney stones, bunions, nose polyps, stomach parasite, and hemorrhoids at age 7 which would just about cover the classes I have had,… but chances are the patients I see will have something I know nothing about, and won’t know about until April, which by then will be far too late to impress my apparently “incredibly smart” preceptor, Alex, who will surely shake his head muttering something in Russian (he speaks Russian) and call our program to see if they sent the right person, or if they were just seeking revenge on him for something he did when he was in the program in the recent past.
Despite the angst and vexation I feel, I do intend to hold up my end of the bargain and show up with my stethoscope in tow. Alex seems to be a nice enough chap who may not send me to my death on the first day, but I’m pretty sure that over the next, oh,..say six months’ worth of Fridays the most common sentences you will hear coming out of my mouth will be a mixture of: “I don’t know.” “I forgot to ask them that.” “I’m going to go look that up.” “huh?” “Nope,.. I don’t know.”
I’ve actually gone to Costco, there was a coupon in their monthly deals so I stocked up on 10-packs of Humble Pie, I intend to indulge myself readily this spring. Care to join me? Just go to PA school.
Well,.. I think I have adequately expressed the joy and trepidation I feel at this moment,… Friday clinicals were one of the main reasons why I wanted to come to Utah,.. I’m not sure what I was thinking but here I am! Our faculty has assured us that we’re ready, and perhaps they’re right,. you never feel ready for any major endeavor you undertake,.. think I ever felt “ready” to teach third grade each year that I taught? I was excited if I went home thinking, “yep,. I knew what I was doing today.” So perhaps it’s going to be overwhelming for a while, and then slowly I will be able to wean myself off the Dramamine and be able to sit through a whole office visit with a patient without peeing my pants.
Thanks for the support,. I’m a stress eater so if you feel sorry enough you can send anything chocolate my way! Anyway, here’s to making it far enough in PA school to earn the coat, and to 18 more months of effort to ensure that I get to keep it! Blessings.