One Down

i get all worked up for interviews and then i usually do just fine. today's went well. i feel really blessed to have opportunities like this available when i'm out looking-even if they're few and far between. i think they liked me....but you never know. i might have squealed "I LOVE OBGYN! PICK ME! PICK ME!" one too many times. i'll have to wait to hear from them before i party like a rock star (when i actually do get a job i foresee hanging goats from chandeliers, trashing hotel rooms, snorting human remains, things such as these).

i'll keep you posted....


addendum: 3 hrs after i left the interview they called with a job offer! i couldn't be more excited. i don't know a lot of details yet (HR to contact me) but i am skipping around the house never the less with a big stupid grin on my face.

hide your goats.

And Now for Your Viewing Pleasure

to celebrate my 100th post and being exactly 4 weeks away from graduation, i am submitting to you, my dear bloggies, some hilarity. go forth and be merry whilst i go to 2 very important interviews this week. i am both scared and super excited. i think i'll pee.

The Great Debate

what do i want to be when i grow up? i kind of hoped i'd already answered that question. but now, when faced with all the possible disciplines and settings in which to practice medicine as a PA, i'm again feeling uncertain. the range of facilities is astounding, the quality of care each place provides, the hours, the scope of practice the PA gets, the benefits and salary...everything varies job to job. it's like comparing apples to kumquats. so i have to look at what i'm passionate for (like i LOVE and feel energized by obgyn but HATE and feel like throwing myself into a bus by pediatrics), quality of life, and money.

location: first of all, i hate commuting...so i'm sticking within a 30 min radius of my house. but my house is pretty central, so that leaves a lot of possibilities. there are positions both in swanky suburban spa-like clinics and in the ghett-o. (see it's less offensive if you call it "the ghett-o" with some flare...it's all about how you spin it). for example, i interviewed last week for a women's health job in a place with bars on the receptionist's window and a strip club 2 doors down....which might mean lots of business, but isn't very confidence inspiring.

mission: what kind of service do i want to provide? the folks in the low income clinic might have more need and be more vulnerable, more requiring my advocacy, education, and kindness. but i can do a lot of good in this discipline regardless of socioeconomics. and i will have more resources and maybe feel more safe in higher income areas. PLUS, with the position mentioned above, i happen to be from a totally different culture and speak a totally different language than the patient population there...when my goal is to really reach and teach folks, would i have that impact coming from such a different place?

scope of practice: how much will i be able to do as a PA in each job? are there other PA's? how will i be treated? i've heard tell that some groups that have never had a PA before don't really know what to do with their first one...and since i'll be a first-timer, that might be difficult. on the other hand, if you're the first, you set the contract. as far as ob/gyn goes...some hospitals allow their PA's, with many hours of supervision, to deliver on their own, 1st assist in C-sections and other surgeries, etc. and in other hospitals you're in triage, just ruling out labor and prescribing tylenol, rest and fluids. and in the clinic setting, you're doing prenatal and annual visits, maybe some colposcopies (takes some skill- this is a cervical exam w/ a microscope, looking to abnormal tissue to biopsy)...but no deliveries or surgeries. it just all varies.

passionate pursuit: i know that i love ob/gyn but there aren't many jobs in it and i might not be able to find the perfect one right now....so i got kind of a miraculous call the other day from a surgical dept looking for a general surgery PA and although i had to quickly amend my resume to read "surgery is my life" instead of "obgyn is my life" it's not too much of a stretch, since i love being in the OR and it would still be really good training for eventually working in ob/gyn. but then i also got a call from a labor and delivery dept looking for a PA to work nights....

hours: this also varies extremely. if you're salaried and work for a busy cardiologist, for example, you'll likely be working 60 hr weeks....but if you're hourly and working at a clinic or a hospital that's strict about overtime, you get your 40 in, and that's that. now because hospitals are open 24/7, this means there has to be night, weekend, and holiday coverage. sucks. in a clinic, it's usually better, but still weekends and evenings are often required. stupid health care. why can't people get sick from 9 to 5? so i'm considering working nights to get my foot in the door to a great ob/gyn job. it would be hard- i hear you lose friends and personality when you lose that much sleep over time and you're schedule is backwards from everyone you know...but i might find that i like it. and since it's 12 hr shifts, you only do 3 or 4 of them a week, and always have several days off each week.

income: PA's make good money for not a lot of schooling. it's just a fact. we make roughly 1/3rd of what the MD makes in our discipline. so since surgeons receive an ungodly amount of unmarked sacs of cash each year, surgical PA's also do really well....ob/gyn is less, but still good money, depending on the situation. it's very likely i'll get job offers that range in salary by 10's of thousands of dollars. eck. have you seen the "spongebob square pants" movie? every time i say the word 'money' i want to say it like mr. krabs does. "what's important to you in finding a job?" "why it's MONEY of course!"

training/further education: then, of course, i'm still thinking about a residency program that will beef up my ob/gyn skills...but will take my family across the country and completely disrupt our plans. most PA's are trained on the job and become "experts" in an area simply by having worked in it over time...while getting paid ("MONEY"). there's something appealing in that.

so....lots to think about. lots up in the air. but finally some really solid options that i'm extremely excited about. i flash between terror that i'm about to be released into the wild as a real life PA and excitement. i'm ready to not be a student anymore, i tell you that. on friday i almost backed my car over a nurse (i would have had to drive it into the hospital and to her department to do it) because she didn't trust that the orders i'd written were kosher from the MD i'm with and since i can't sign anything as my signature has no value/license behind it, we were squaring off in the nurses station.

and this is my 99th blog post! i'll have to find something super cool for my 100th one. stay tuned for that. thanks for hanging in there with me, being my sounding board, and laughing at my horrible jokes. :)

How to Get an "A" from a Preceptor

so life has been kind of nuts. i've been working a lot and making slow progress on job hunt and application for the residency program. i feel like i'm moving in slow motion, but also like i'm busy all the time. GARR! my classmates have been helping me out lately in the career quest, so that's been awesome.

you know what's not awesome? today the doc and myself were incising and draining a HUGE vulvar (outside lady parts) cyst on a poor patient. we sliced it open and compressed it and lots of stinky white puss and blood came out. you think that's gross? it is, but that's not all. just before the doc was about to pack the incision, i was examining the area and said out loud, "you know, this part here still seems really full and tense" and gave a little squeeze. and, well....out shoots a few tablespoons of this white/red nasty all over the front of the MD. on his shirt, arm, neck.....thank Allah he didn't have his mouth open. and that he has a good sense of humor. i couldn't help but giggle a bit. even the patient in her excruciating pain may have snickered some. it was disgusting.

but i love stuff like that (not dousing my MD in infected vagina juice)...procedures that are kind of gross but take a little finesse. i think it's cool.

so aside from that, i'm just pushing through each day, learning stuff and getting closer and closer to graduation. i have had one interview but there are about 15 reasons why it's not the job for me. and i really don't think i'm the one for them, either. but they're desperate for a female PA and i am one of those (well, will be....a PA i mean....already a female....k...) so they did offer me the job. but i have to keep trying, looking elsewhere.

lots to do! lots to do! i need a secretary or an agent to get resumes out for me and contact potential job sites. that would be cool. "hi, my name is stacey and i'm calling on behalf of an excellent young PA...let me tell you why your clinic/hospital department can't live without her..." that would be cool. but i can't so much afford an assistant on my salary of nothing. i guess i'll get after it my own self. sigh.

America is A-OK!

so happy Fourth of July, everyone! hope you enjoyed some brews and dogs and sparkly things on sticks and in the sky and enjoyed having a friday off. we had a great day, even though i worked for a few hrs in the morning....but mostly relaxed, picnicked with family and slept.


one thing i never do is reflect on the independence of our nation on that day. we americans are notorious for taking freedom for granted, since i think we feel safe and pretty much untouched by the foils of the rest of the world...comparatively, we've been attacked on our own soil very rarely. and in most of our lifetimes we've never been really pressed to go to bat (war) to protect our people...and, since freedom of speech is of such importance to us, we enjoy the freedom to bitch about our country and all of its blunders....so when we are sending soldiers to attack those who we think attacked us or might soon attack us, we certainly all share our opinions on that...

but it makes me wonder if we go too far. do we really know how good we have it? should we take at least this one day out a year to focus on the uniqueness, diversity, relative peace and freedom we enjoy rather than the gas prices, endless desert wars and scary/stupid politicians?


for the 4th of july, should i read up on our history of successful political movements our people have hatched instead of baking an american flag cake? would it be more productive if i investigated how i can do my small part to make us a more unified, kind people or to improve our image in the world instead of buying illegal fireworks from that guy down the street with the stained grey t-shirt with a bald eagle on it? maybe so.

alright, alright! don't look at me like that! i'll just eat my watermelon and be happy about it!

I'm a Muss

i stole that term from tony shalhoub's character 'adrien monk' in the very witty USA show "monk" about a phobia-driven OCD detective. he says in exasperation at one point that he's 1/2 man and 1/2 wuss....so he's a "muss." since i'm a WOman and a wuss, the fun word that makes is just "wuss" so that doesn't really work. i guess i could be 1/2 female and 1/2 wuss and be a "fuss" but that also doesn't have the same effect. still, i think "muss" works for me since right now i am definitely a combination of a 'wuss' and a 'mess.' (a "wess?" oh, i give up....)

so i've been a complete wreck over the last few weeks since i have not gotten any closer to acquiring a job and am even thinking about a major move for an Ob/Gyn residency program across the country. so much up in the air. and graduation looming not so far ahead. i want the perfect job and i hope i can be patient for it....but i also really could use some income. and the idea of selling plasma or going back to waiting tables isn't so appealing now that i'm 100 years old and will soon have a masters degree.

and you see that? see how i get ahead of myself? every thing's always so dire with me. i need to relax and keep the faith. grow some patience. and perhaps start using sedatives. :) no....a little red wine (and a lot of chocolate cake) is as close as i get to self-medication.

realistically, i'll be fine- just in a huge transition period. i was on my school's campus today to get a transcript and buy myself some school spirit and felt very mournful walking around the grounds i'll forever be leaving soon. school's been trying, but it's been wonderful....and now i'm about to be unleashed onto the world.

...and it's just that i get this anxiety when i actually pick up the phone to make the call to a potential employer. or have to write YET ANOTHER description of how awesome i am and why i would be THE BEST DARNED candidate for the position. i just hate the whole process. eck. i might have to get a body double to do the actual interviewing for me. (if you know any good actresses looking for work, let me know....actually, i'd even settle for a drag queen for the right price....maybe the large hands and unique gender perspective would actually help secure a job in women's health....ya think?)

but i have been more proactive this week- i sent out a half dozen resumes to area hospitals and clinics and have been following up with phone calls. even though i've been hearing a lot of "we're not hiring right now" i also get "...but i'll keep you in mind and will pass your info on to other people i know" so i'm hopeful that my networks will network for me. and i'm also applying for the residency program in case i don't find the right thing locally or i determine that i definetely want the training. and i still have a few more local leads to try....

so anyway....please send your prayers, thoughts, juju, mojo, and well wishes in my direction. especially while my mental wellness seems to be hanging by a fraying thread. :) thanks kindly. i appreciate the support.

The Miracle of Birth

so today was a crazy long day. the doc i'm with was on-call for new admissions in the ER last night (for patients unassigned to other docs), so we had a bunch of admissions to do first thing this morning. then i went and shadowed a PA in OB/GYN for a while at a different hospital, then came back and saw more patients and ran around like an unproductive chicken with its head cut off. (although i wonder how many headless chickens actually get stuff done).

so i've determined i don't like chest pain and bloody bowels enough to do internal medicine all the time. i just want more and more to do women's health. that's it. i promise that i word this differently when i'm talking to potential employers, but the truth is, when it comes down to it, i just want to deal with women and their broken hoo-ha's and baby growing/hatching. one way or the other, i have to find work in it. i think that waking up every day to work in that field would make me feel really accomplished and happy.

and on that note, i saw a commercial last night that referred to "the miracle of birth" and i was thinking- the way that humans are created and grow and most often come out as little perfect human beans is truly miraculous. but the actual BIRTH? i know i've talked a lot about how gory it can be- but the word "miracle" makes me think of pastoral scenes of angels singing and lambs frolicking and stuff. in fact....

a "miracle," as defined by Webster, is " An extraordinary event manifesting divine intervention in human affairs" and its origins are from the latin word 'miraculum' which means 'a wonder or marvel.'

a google images search for "the miracle of birth" gave me lots of helpful pictures such as this hyah below and other cutesy baby pics and links to several animal husbandry sites, a placenta cookbook (don't do it), and even one link to a very strange hair metal band.

but in the births i've seen there is much more stretching, tearing, moaning, screaming, panicking, aching, and even hitting and biting than there is singing and frolicking. 9 months is a long time to grow a parasite inside of you as it zaps your resources, stretches every ligament and muscle you have, maybe even separates your bones and compresses your nerves....then when you start feeling like you can't stand it any longer, you can look forward to multiple hours of ripping pain such that you've never felt...so bad that when we ask a patient to classify their, say, heart attack pain or hemorrhaging brain pain, we ask them to use labor pain as a '10 out of 10.' and to top it all off--- when you're FINally contracting and pushing successfully and bearing down hard like you're having a bowel movement- you might, in fact, have a bowel movement- often with eager family members cheering you on/videotaping the whole ordeal.

charming.

so, i guess i tell you this not to scare you into celibacy or anything, but just to reiterate how challenging birthing is and how important it is to have a comforting, competent person (me) at the bedside. there are so many opportunities to positively effect the experience of women in labor. and this is why i want to be part of this incredible process. for as unholy and gruesome as it can seem, the outcome is absolutely amazing. so much so, that women (those crazy and sturdy, durable and heroic beings) often choose to do that whole thing i listed above MORE THAN ONCE.

now that's a miraculum.