Monday, May 29, 2006

Skillz, +/- the "Mad" part

Oh, sure. I've enjoyed the microbiology, the genetics, the neuroscience, even the statistics. But you know what's really fun? Learning actual clinical skill-type stuff. The PA I've been shadowing most recently decided to send me home with some extra supplies from the Urgent Care, and I'm learning to sew. One of my housemates saw the tray full of instruments on the kitchen table, and yet didn't see the grapefruit skin, and got a little... concerned. But it's totally benign. Check it out:

This is a pretty crappy suturing job, to be honest about it. But it's the first time I've ever sewn on a grapefruit skin, and I was primarily happy that I didn't stab myself with the needle.

4-0 nylon is one of your basic all-purpose suture materials. It's a little more bendy than thin fishing line, and way more rigid than the thread I used to fix a pair of jeans earlier today. I guess I'm just in a sewing mood.

I got better with the convex shape of the sections, and learned not to cut through the grapefruit with the suture. And then I did another row...

A better camera (or a better photographer) might make this more obvious, but in general, yes, this is already a superior job.

This is Vicryl, which is an absorbable suture material. It's also way happier to work with, because it's more flexible. But it's more fragile too, and so demands some patience and some style, all at once.

I'm a little geeked out about this. But hey: the next time you accidentally cut a grapefruit and then realize you don't want it yet, you can call me.

Sunday, May 28, 2006


I may write more about this later, but before the term ends and all the ducks are safely in a row, I should mention that Saturday night I finally attended the big, Bennington-style rager that had been implicitly promised to me all along.

All is well, and I was entirely well-behaved. Nonetheless, it was glorious excess; if in the future I donate money to the school, it may well be because of the sweaty half-naked people dancing inside and jumping into the kiddie pool outside, as much as it is because of the education. Then again, maybe this is the heart of the real education.

I saw my friends who live in that house for probably a total of ten minutes; they were clearly occupied with their own mini-dramas, but that was fine because it left me to talk with just about anyone and everyone. It warms my grizzled old heart to have such a wide array of people all give me the same comment: "you're the only Post-Bac I see around." Well, yes, I'm afraid that's largely true... but thanks for noticing and thanks for the warm reception, ya crazy kids. And meanwhile, in work-related news:

My experiment went well. What you're looking at is his-auxotrophic e. coli bacteria, growing on a minimal-medium agar that should make their presence impossible. The reason the little guys are so hardy is that the substance being tested, a solution soaking that little round filter paper disc, caused reverse mutations that brought them back to self-sufficiency. They're making their own histidine, just like regular e. coli do, and partying down Bennington-style like everyone else.

I'll say more about the details another time, but the practical upshot is to be careful with some of your "natural" or "herbal" remedies: they can cause some impressive stuff to happen on a cellular level. And just because I didn't go in the kiddie-pool with the naked kids doesn't mean I would want to know what the heck is growing in that thing now.

Wednesday, May 24, 2006

And also

It's not "Staphlococcus oh-RAY-us," damn it. It's "OH-ree-us."

This is hardly an important topic, in the scheme of things, but wow. It feels good to get that out in the open.

term-ending madness

Necrotizing fasciitis
Microbes come and try to bite us
Overwhelming our immunity
Getting busy with impunity
Turning tissues black and gangrenous
They go all, like, damn and dang in us
Try the topical negative pressure
Pump the Vanco, up the measure
Cutting-edge docs have been learning some old tricks;
It seems maggots work via proteolytics
Whatever it is that finally works
You'll wish it was what you had thought to do first.

(In my head, there's a jaunty little music-hall sort of a tune under all that. Welcome to the final week of my classes, and t-minus seven and a half hours until the deadline for this paper.)

Sunday, May 14, 2006

Blog Niblets

1) The deer story turned out to be a decent way to work through not just the stress of, y'know, hitting a deer with my car and then watching Smokey put it down with a .45, but also the stress of writing my big essay. Huzzah! I have a draft, and it's 2960-some characters. So I'm skating mighty close to the edge of insanity -- but I should point out that I preserved my stylish paragraph breaks.

2) Last week, I wound up staying on campus to listen to live music and drink many $1 beers. Pretty frequently, too; I think it was 4 days out of 5 or something. I'm happy to report I heard an utterly bitchin' pop band; Saturday Looks Good To Me sounds like Husker Du plus Elvis Costello. They brought the rawk to Vermont, and that was special because now they've played in 48 of 50 states. Good luck with Wyoming and SoDak, guys.

(I see they were at the 400 Bar in September last year, so my momentary swagger at hearing a bitchin' band before Jon might be premature. Hmm.)

3) I set up a MySpace, and then I realized that I no-way-no-how want it linked to here. I seem to say this pretty frequently lately, but it's true: although this is not some kind of "deep, deep, deep undercover" thing, and I don't imagine I have true anonymity here, I like that there's a certain obscurity. I'm sure not everyone who would like to know about El Blog are aware of my little growing empire of essays, but people who should know I write here probably do. So, if you read this 'cuz you know me, and you don't get an email invitation to join my posse, it's because MySpace sucks, and I only joined because so many of my friends have pages, and you need to be a member to enjoy the full spectrum of suck.

4) I have ten days to finish everything, here in the last semester of my program. This is, in other words, a fun little slice of what we like to call The Crazy Time. If I put up incoherent rants, or if you see "this post has been deleted by a hallucinatory, orange, twelve-foot-tall pond frog," that would most likely be why.

5) Wet-colloidon photography is just about the coolest thing ever. I learned that recently.

Wednesday, May 10, 2006

Red In Tooth And Claw

Last Monday night on my way home, I hit a deer. I realize that recent posts have been all about the fun I've been having, and/or the stress of getting the rest of my life in order, but it's not that I'm self-involved.

That is to say, this is a blog, so yes, of course it's self-involved. It's the captured thoughts of a writer doing whatever he feels like, at the moment he feels it. That's the nature of the beast. But the nature of this other beast has been on my mind lately, and it's taken a few days to ponder. So here's the story.

I was coming home, having wrapped up the first part of my first draft of my essay. I worked in the coffee-shop-esque part of the student center for a while after leaving the Hall of Science, because nothing is less productive than three post-baccs with individual laptops and WiFi at 10pm. But by 10:40, with one mocha on-board, I was ready to head.

10 or 15 minutes later, I was tooling along the winding, mountainous road I enjoy so, so very much in my V6, and I noticed: hey look, some deer. I see deer all the friggin' time out here. They were majestic and special at first, and I didn't believe it when native New Englanders said they would soon become a nuisance, like raccoons but with more body mass. Now, I totally get it. But that's skipping ahead.

I saw three of 'em over on the right side, in somebody's yard, and they stayed still as I ripped by. Good deer. And now I was on alert, because apparently it was a good night to be a out and about for our local cervine-American* population.

A few miles later, after slowing to 40 through the little town with the volunteer fire station, I came back up to 55 or so, and as I crested a hill I saw another one, about a hundred yards ahead and down the hill, standing in the other lane, close to the shoulder. Hmmmm. I slowed down. It had tan fur, about the color of my Carhartt jacket.

It was facing the other way, and looked at my car over its shoulder. The long axis of the rectangle formed by the deer's hooves pointed diagonally away from me and across the road. It started out acting more or less intelligently, taking a tentative step straight forward and off the road in the other lane, as I slowed down on my approach. I thought for a moment it was going to be okay.

Then, the dumb beast apparently decided the grade was too steep on that side -- they leap something like 15 feet over, onto, and out of the embankments on either side of my road all the time, up at the farm, so this one was either crazy or just a total wuss -- and decided to dash directly in front of me instead. All I could think was "no no no no no," as my reflexes took over.

If I hadn't slowed down, maybe I would have plowed into it with the kind of force you hear about, Emergency Department-grade force, the kind that brings people into my workplace on a long spine board, escorted by medics bearing Polaroids of starred windshields and indented A-columns**. Its head might have been even with my left headlight, and the speed would have bounced its body right up over the hood and on top of me, the lone occupant of the car, with only a thin film of glass between us. That image, frankly, I don't need -- but the one I got sucked pretty badly, too. In the imaginary scenario, at least the deer's neck might have been broken instantly, painlessly, mercifully.

Instead, what we both got was a textbook-perfect broadside. Obviously, my part of it was scary and depressing, but painless and ultimately harmless. I don't even think my tires squealed, and my airbag didn't deploy. I nailed the deer's right side flatly: its shoulder and hip fit perfectly in the space between my headlights. The plastic front grill shattered, and the hood buckled only slightly; this must have been at about 40 mph. I stopped, hit the blinkers, and turned on my cell phone. The deer had skidded, bounced really, forward and over, finally making it to the ditch on my side of the road, and went about five feet downward and 25 feet away, where it stopped and laid down.

I called 911; I was fine. Controlled stop. No issues among the humans involved. The dispatcher had a category in his computer program for "car/deer accident," and got me through to the New York State Patrol.

It was the saddest thing in the world, hearing the tall grass thrash around and then become quiet, as the deer discovered it couldn't move well. I was afraid it was dying right there and then. I shined my ludicrously-bright tactical light toward the faint orange glow of its eyes, and saw it was breathing, but had a bloody hind leg. Since my white car was a little dented but spotless, I knew this was probably a secondary injury from sharp broken bone cutting the deer's hip from the inside. I switched off the light when the deer seemed to think I was coming down there and started thrashing again, its legs making swimming motions on the grass.

My car was only cosmetically scrunched, and had tufts of hair in a corner of the hood closure. The VW insignia in the center of the grill was gone, never to be seen again. My real damage was hopefully just as minor, but it's psychic, because I stayed with the poor thing until the trooper arrived. I talked to it. I apologized, over and over again. I kept my voice even and tried to calm it, from my place up on the embankment. It was either a female or an adolescent male, with big radio-dish ears, and black markings on its face. Eventually, an SUV with cherry lights came up the hill, passed, and turned around.

The trooper, a smallish, 30-something woman with a remarkably Midwestern demeanor, verified that I was okay, and I told her what had happened. I indicated where the deer was. After a moment, she got out of her car, paused to retrieve and put on her Smokey hat, and we started walking. She told me how she'd seen deer all over the place that night. We talked about how often this kind of thing happens, and I said I'd figured a near-miss would pretty much have to happen eventually, considering the sheer numbers of the things on and near our property. The trooper kept going, down into the ditch, and the back part of my brain sort of gave me a little tap on the shoulder, saying "naah. Stay here." So I stopped at the top of the embankment above the deer, as she continued.

I didn't expect we were going to splint the deer's leg and take it to a petting zoo; there is obviously a reason the State Patrol responds to these calls and the local volley-fire guys don't. And furthermore, I know (and knew) perfectly well what that reason is. But it was still a shock of sorts when the trooper walked calmly down into the ditch, still talking to me, and drew her weapon in mid-sentence.

It would be logical to think the expression "pop a cap" is just the bravado of street thugs and rappers who want to sound worldly and unimpressed by dangerous things. But the weird thing is, it's accurate. If you've heard a .45 caliber handgun fired, and/or fired one yourself, you know. It doesn't boom, it doesn't go "pa-whoomp" like in the movies; it pops. It sounds exactly like one of your more powerful firecrackers, sure, but nothing worse than what you can buy on the roadside in some of our more civilized states.

I last discharged a handgun something like 15 years ago. The first thing that surprised me was the heft of the thing. The second was the sharpness and bite of that unexpected noise, and the kick was close behind that. It's not back, like a hunting rifle; it's straight up, as if the gun is trying to escape you. It feels to me like holding the beginnings of a summer thunderstorm in your two cupped hands. For me, this power-to-size effect comes across as a basic, instinctual, almost preternatural sense of wrongness. The order of things is either altered, or maybe just mocked, by this apparatus of springs and levers that doesn't seem to belong in the world.

The point is, I did know, and I agreed completely and fervently, when after the first shot, the trooper sighed with regret and true sympathy, saying, "man, these .45's just don't have the right kind of power. You really need a magnum."

And so she shot the deer a second time, again in the head, to still its twitching front legs. She kept the gun raised, in case it would need a third before we would be able to say we had been merciful.

* Cervine: adj. Deer-related. Like "porcine" is for pigs, "murine" is for mice, and "bovine" is for cows. I heart the Internet for letting me find that. I used to know an awesome horse-racing guy, and he half-jokingly refused to call the horses "horses." They were always "the equine athletes."

** A-Column: n. The part of the frame of the car that is the front corner between the windshield and the forward part of the driver- and passenger-door windows. The B column is between the front and back windows, and if you don't have a truck you probably have a C column too, where the back window meets the frame.

Tuesday, May 09, 2006

The Essay (take one)

Hm? Oh no, I'm not posting my essay here. Not yet, anyhow. I've already told you, it'll be put up in this space after I get my acceptance from [name of world-class program here]. Heck, CASPA just opened up a week ago. No, this post is to laugh at myself and how verbose I am. And simultaneously demonstrate.

The instructions at the mack-daddy app site say this:

USING YOUR OWN WORDS, in the space provided (2970 character count, this is about 495 words), write a brief statement expressing your motivation or desire to become a physician assistant. You are encouraged to save your work often in the event that your are timed out of the system.

Okay, well, first off, the all-caps reminding people not to plagiarize doesn't inspire a lot of awe in me, when it comes to who my competitors are going to be. I mean, there's already an anecdotal undercurrent of complaining out on SDN and other sites, because many of today's PA school grads are fresh-faced young kids with no experience to speak of, rather than the hardened vets that began the profession. (Not that I've seen anything like the complaints about Australian 6th-years who can't find the prostate on a diagram, but these things are relative.) If they're at all likely to get all Trace Viswanathan on top of that, then heck, I'm a friggin' paragon of virtue over here! Witness over a year's worth of my unique narrative voice, n' stuff.

Yeah, that's right. The blog might actually be helpful to the app process. Conceivably. Maybe. Crazy like a fox, yo.

Secondly, if you needed any further evidence that this is the 21st century, dig that "2970 characters" thing. I absolutely adore the fact that nobody decided to just bump it to 3000 and call it good. Long about interview season, I imagine many of us will start thinking of that 2970 as some Lost-style clue about what dark forces actually underlie the application process.

Third, a typo? On the instructions for the application? "in the event that your are timed out of the system," huh. Okey-fine, but I get a typo in return, and you can't ding me for it.

Lastly, CASPA earns my respect (and a sweet, chaste kiss on its sharply-designed but user-friendly little cheek) for that reminder to save often. Although, seriously. Everybody knows that if you're actually composing your 400-odd words right there on the spot, rather than just copy-n-pasting it into the text box, then you're either a total schmoe-donkey or you're Chuck Norris.

Anyway, here's the great thing about my first draft: 806 words (non-Asian words, thank you Microsoft Word for that). 3774 characters with no spaces.

And the relevant number? With spaces and punctuation, 4578.


(special thanks to my housemate the Drummer, for the term "schmoe-donkey.")

Monday, May 08, 2006

Like, totally awesome

You know what's fun? Roller skating.

You know what's more fun than merely roller skating? Roller skating after midnight, in the wood-floored auditorium normally used for orchestra concerts (and fashion shows, since I go the school I go to, but still; it's at school, see). And to ramp up the fun to stupid levels, what you do is you rent 300 pairs of skates, you hang a disco ball in the rafters, and you have 80s music blaring.

Then, since I go to the school I go to, what happens is the kids get all dressed up like crazy rolling ravers. Sugary snacks were provided, so at any given time about a quarter of the people on the floor were sporting pacifier-style suckers with big red plastic lips on the outside. We had ice princess skirts, we had roller derby people of many genders, we had one dude dressed like a mountain goat, we had a woman who wore bloomers and a camisole with the face and boobs of an inflatable doll pasted on the appropriate places of the outfit. And we had me, looking completely normal but being one of the few if not the only one who ever went roller skating like that, as a suburban youth, when the music was current.

What's different now, as opposed to when I was 14? Well, for one, I watched the Suns beat the crap out of the Lakers at the campus pub before I went over, and had a nice four-beer buzz on, so I was more fluid and relaxed -- and that turns out to be quite handy when you're negotiating a crowd of skaters that's 30% better than you, 40% as good as you, and 30% much, much worse. Like the man said: you fall three times, you get up four. That was me. But three falls in three hours ain't bad.

Other than that, it was exactly the same as 7th grade: say hi to some friends, but generally keep moving. Get the hell off the floor to show the DJ my disdain for Meat Loaf, and get out there for the Duran Duran and the Van Halen. Totally not get any much attention from the ladies. (Which of course is more than okay these days.)

The college's irony switch was on the fritz that night, so I couldn't tell who was making fun of skating and who was just skating. Several people might have had actual, non-snarky fun. Someone I know was shouting at a friend at intervals, as he came around the oval each time:

"Admit that you're skating!"


Tuesday, May 02, 2006

Time keeps on slippin', slippin'...

Yeah, no post for a while. Oops. TeslaGrl was here on a visit (aww, the last one of the year! Last meal at the diner; last Dramamine dose on the plane!), plus things are speeding up. I'm done with my A&P class -- well, will be, after Friday's final. And catching up on back homework.

Then I'm done with the whole year as of the end of this new month. Sheeeez.

Today I got a list of questions to answer, for my final advising interview. Questions like, "why do you want to be a PA?" and "why this, as opposed to other health professions?"

Aha. Sweetness. Because this is where I start to feel like a pretty good candidate: you see, I know the answers to these questions.