MD vs. PA: Part II

I don’t pretend to be someone that only dreamt of white coat days in an MD haze. For myself and many others, the question between MD vs. PA school manifests itself. But to what extent and when is anyone’s guess. The last summer after year one and calls to 4 PA friends doesn’t seem ideal, but neither is regret over staying simply because you are capable/smart/expected to etc.

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You Don’t Have to Be a Doctor

Says my mom. This during another lengthy debate concerning the pros and cons of becoming one. And since registration for second year isn’t a declaration of marriage, I’ve flirted a bit with various career options in the medical field.

My first go around was this spring. Lilacs a’ bloomin’ and sun a’ shinin’ and a PhD a’ smilin’. What’s so alluring about the whole gig? I pictured falling in love with…

-No STEP or shelf exams

-Making science happen

-Finding the cure for cancer

-Analyzing data from home (it’s a no-no to bring your patients home)

-Writing Dr. on checks and what not

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How to Skip Ahead

Getting past my schedule for the next 6 years of med school life is pretty hard to do. But, this weekend, I’ve managed to beat the lines, get the DL, and seize the day. I hope you take time to:

1. Get your patients early.

There are physicians that fly through their same-day surgeries. Once I have people to the holding room in an appropriately early fashion, I can kick back. It’s a trend that’s worth keeping for my second year studies. Get things done before they’re due!

2. Read book 3 before you’ve started book 2.

At work, Hunger Games was the big topic. And so I asked why the second book had this disjointed approach. How was there some explosion left unexplained? What was so bad that they going after President Snow?

That’s when the awsomest, sweetest holding room nurse ever interjected, “Stop reading!” I had nearly finished the third part of the series!!! All by piecing together much of the second book’s plot… which I hadn’t read. But hey, if you’re a smart cookie, sometimes reading ahead will help understand what you missed.

3. Eat ice cream for lunch.

While in ATL visiting the long distance BF, I came across an ad for this ice cream fun day in a park along with family-oriented physical activities. Three of my favorite things–running around, SigO, frozen deliciousness. In one place.

Mmmm!

Mmmm!

Dearest medical school friends, last year, I would take mini-vacations and skip class to visit people in Detroit or Boston or wherever. (Online lecture studying occurred for sure.) But have a wonderful break before med schools say you should.

P.S. unless you’re enrolled in a compressed medical school program, there’s no true skipping ahead. And, like one wise OB/GYN told me, you wouldn’t want to. Our conversation began as his last case finished:

Doc: what year are you in school?

Me: just finished my first year… unfortunately.

Doc: You mean fortunately!?! The further you go along the more responsibilities you have. 

Me: [frowny face]

Doc: Your excuse this past case and for a long time will be “I’m a second year.”

Me: [Mind blown because I had forgotten where the cervix was and everything else down there during the surgery] So true. 

That’s why I am pumped to be going into and staying in my second year for as long as the system has me scheduled.

Avoiding the Doctor Disease

It’s endemic. There are lots of unhappy and mean doctors out there. And I’m not just talking about the orthopod who screams at his staff. Or my childhood dentist. Or that proctologist (ewwwww.)

Recently, my friend’s mom told me about this disorder of frustrated arrogance comorbid with entitled inhumanity that often begins somewhere between first and second year of medical school and incubates into a full blown infection by the end of residency.

While I don’t quite hate sick people yet, my head does have a tendency to swell after passing anatomy rounds and biochem exams. Frighteningly, 60% of doctors would retire if they could, according to Forbes… but since they can’t, we still have to put up with their snarling over the burdensome task of willingly treating sick people who requested their services. How dare someone want to see them!

Pushing patients around has given me a new perspective on my role in medicine. I hold the privileged title of surgical orderly, transporter, bottom on the totem pole. But even the least of these sees a lot of patient contact–guiding medicated ones to their beds, calming their nervousness, talking past their worst fears.

can do lots of things but, like today, my boss just needed someone to organize anesthesia labels. The patient just needed someone to hold up a blanket in front of the door which we couldn’t get to close as she was getting back in her bed. Maybe doctors would be less epileptic if they met people where they’re needed.

It all gets old. At least that is what my mother noted about practicing nurse anesthesia. But nonetheless she loves what she does. What makes her atropine pushing any more exciting than that of an anesthesiologist?

She draws shapes with betadine before inserting an epidural. She sings her patients to sleep. She takes cardiac arrests in stride, prays a COPD-er through waking up, and thinks her way out of paper bags all day long.

Stole this adorable thing!

Ok, so I love my mom. But I’m just saying that finding joy in the mundane is an antidote to the doctor disease.

But what if you can’t see it?

Medical school teaches us to gather the chief complaint first. Transporting only permits me to see the person. I know their surgical procedure and nothing except what’s picked away by small talk. In their answers I catch glimpses of myself, bad and good. The little joys appear as my humanity is reflected back off their own hopes, dreams, and struggles. Bit by bit, petit à petit, the curmudgeon in me makes room for a hopeful doc indeed.

Yesteryears of Medicine

Hi. My name’s Cassie and I’m here to take you back… At least that’s my spiel as a part-time transporter / surgical orderly. But I’d rather transport you to the 1960’s. 1963 to be exact. That was the year the Gonzaga family immigrated from the Philippines so Lolo could meet Frederick and Philip Smith. They would hire my great-grandfather at the same exact hospital that now employs me!

That was when men smoked in the OR. At the scrub in sink. There is one doctor remaining, an anesthesiologist, who can recount my great-grandfather’s hand-washing ritual. Dr. D told the story again today:

He would come at the same time every morning. And we’d say,”Dr. Gonzaga, you don’t have patients until after Dr. So and So finishes!” But he would wash his hands anyways, then sit there. In the room. Both arms up like this [as a referee announcing a fieldgoal]. All clean until the other doctor finished.

–here? [referring to the rooms behind the nurses’ station]

[Nod.]

And I asked about the story of the fruit once more.

Oh, you know, for Grand Rounds, they would give us big baskets of fruit. And so we would see Dr. Gonzaga with a banana in one pocket here and apples in his side pockets there and oranges in his back pocket. And we would wonder what he was doing, but he was giving the fruit away to the nursing staff at his clinic!

As pictured his accounts with family stories of Lolo’s temper, Dr. D continued,

It used to be like that. We were all a family. Dr. Gonzaga lived right across from Dr. S and a couple doors down was Dr. C and, closer to the main road, was Dr. H. We would go in and out of each others’ houses all the time.

That was when we were still doing research on dogs too. We used to do a lot of that at Smith Clinic. It was here that Dr. Uddin discovered the Uddin umbrella. Do you know what the Uddin umbrella is? President Nixon got one and they are still using that procedure today. Uddin was a cardiologist, here, at Smith Clinic.

In fact, Frederic [Smith] once brought in his dog for surgery. He removed a kidney stone in the lab.

wait, how’d he know that?!?!

He found the blood in the urine and diagnosed it with a kidney stone. So I did the anesthesia. I did the anesthesia for the research lab in the afternoons… And when your great-grandfather had that ruptured aneurysm, I remember doing anesthesia for him…

here??

[Nod.]

I got along very well with Dr. Gonzaga. He was kind of quiet. And he wouldn’t agree that you should place a lens after removal of the cataract [what is now opthamology standard] But we got along. He was a good man. He would go every year to the Philippines, take our old equipment over, and deliver babies, do breast surgery, stomach surgery. Everything. He practiced in the mountains. He was a freedom fighter. Did you know he fought for the resistance?

I glanced at the clock and had to fetch the next patient. But my thoughts remained with my great-Lolo, who never learned to drive a car but served American soldiers in WWII. Who gave my dad terrible spankings but let his five children and their families live in his basement and sent countless nieces and nephews through college. Who left me an inheritance of family, freedom, and faith.

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I can’t help but wonder, who are the practitioners in your life that left a legacy of service?

Why I Go to Medical School

Hopefully my previous post hasn’t scared off any great future doctors out there. And if you’re already in medical school–cheers to living the dream! Here are my reasons for staying:

  • I love helping hurting people.

If you’re like me, your heart breaks at the sight of a stubbed toe… ok, more like a congenital tracheoesophageal fistula. But you want to hug it all away, mentally/emotionally, for the less affectionate types. Crying alongside patients who have lost physical functions, family members, or their dreams = comforting sick people = medicine.

  • I can’t picture life outside of a clinical setting.

And you don’t remember a time when you weren’t sporting a plastic doctor kit. My CRNA mom gave us the birds and the bees talk when I was six and Jon was 4–Netter style. Emergency intubation? I’ma come along. Gummy bears? I’ma perform brain surgery.

My brother and I used to transplant arms and legs and whole heads. Preggo gummies exist too.

Transplant, tumorous, pregnant, amputated gummies. All sorts out there.

  • The above criteria is satisfied and…

Some inner aspiration or undigested bit of broccoli within me says,”Learn all life long! Delay gratification for a couple six more years! Become creative, caring, independent leader in local community!”

I think you can OD on vegetables.

  • I hope that my today doesn’t look much different than my tomorrow.

What counts is community, faith, family and friends, and health, so I try to work medicine around that. A rising second year gave the best advice last summer to treat medical school as an eight to five job.

Much of the whining around a physician’s hours concerns life choices. Before medical school, did you truly put family and friends before that research abstract? In medical school, did you skip breakfasts during a week-long cram session? I liken getting to the gym or church or soup kitchen to climbing Mt. Everest. Backwards. On a good day. During some pseudo holiday break of sorts.

Becoming a doctor can’t be any less scary to a 20 something year old than trying to figure out what to do with the rest of life. And who knows? I might just have fun.

Why I Go to Medical School

Hopefully my previous post hasn’t scared off any great future doctors out there. And if you’re already in medical school–cheers to living the dream! Here are my reasons for staying:

  • I love helping hurting people.

If you’re like me, your heart breaks at the sight of a stubbed toe… ok, more like a congenital tracheoesophageal fistula. But you want to hug it all away, mentally/emotionally, for the less affectionate types. Crying alongside patients who have lost physical functions, family members, or their dreams = comforting sick people = medicine.

  • I can’t picture life outside of a clinical setting.

And you don’t remember a time when you weren’t sporting a plastic doctor kit. My CRNA mom gave us the birds and the bees talk when I was six and Jon was 4–Netter style. Emergency intubation? I’ma come along. Gummy bears? I’ma perform brain surgery.

My brother and I used to transplant arms and legs and whole heads. Preggo gummies exist too.

Transplant, tumorous, pregnant, amputated gummies. All sorts out there.

  • The above criteria is satisfied and…

Some inner aspiration or undigested bit of broccoli within me says,”Learn all life long! Delay gratification for a couple six more years! Become creative, caring, independent leader in local community!”

I think you can OD on vegetables.

  • I hope that my today doesn’t look much different than my tomorrow.

What counts is community, faith, family and friends, and health, so I try to work medicine around that. A rising second year gave the best advice last summer to treat medical school as an eight to five job.

Much of the whining around a physician’s hours concerns life choices. Before medical school, did you truly put family and friends before that research abstract? In medical school, did you skip breakfasts during a week-long cram session? I liken getting to the gym or church or soup kitchen to climbing Mt. Everest. Backwards. On a good day. During some pseudo holiday break of sorts.

Becoming a doctor can’t be any less scary to a 20 something year old than trying to figure out what to do with the rest of life. And who knows? I might just have fun.