Friday, October 27, 2006

Hold the Mayo

Is it a bad idea to post while intoxicated?

...Or is that one of those un-answerable, eternal questions? One that's either blindingly obvious, or else so rich with complexity and nuance that it's pointless to try? EDIT: It's okay, as long as you save rather than post, and then edit yourself a few days later.

Anyway. I am officially 2 for 3 on my list of CASPA-application schools. I got the rejection letter today from the school that I always figured was a long-shot, the school that's -- no lie here, kids -- more competitive than some four-year med schools.

(...And if that offends you, then you're likely to be a pre-med, specifically one of the sort I enjoy seeing other people make fun of -- props at this juncture must go out to PA Forums poster Crooz, who has used, and as far as I know may have coined, the term "pre-med-onna").

Hey, it's just math. Nothing to get excited about. I'm not as depressed as I might be. If you're a school, and you get 200-ish applications, and you can accept only 14, then you're taking like 7 percent of your applicants. If your state med school is this picky, then your state has mostly good doctors. Feel free to get sick from time to time.

So I will apparently NOT be training at the U of Wisconsin-LaCrosse/ Mayo Clinic PA program. The letter was very nice, and specifically said that it was a tough process. They only interview 60 for those 14 spots, and they already know plenty of people who would be otherwise excellent candidates just didn't get a spot.

I like to think they mean me. With each glass I empty, it seems more plausible. If anything, I'm stung by not being in the top 60 out of 200-ish. Then again, I have bragged about being the king of the statistical "middle third," because my GPA scrapes the "you must be this tall to ride this ride" line represented by the posted minimum. Mayo actually reads all the applicant files, which is extremely cool. Presumably they give each one a score of some kind as they go through. But even so, finding that 60 has to be more cold-blooded than picking the 60 with the best stories, the most maturity, or whatever.

My suspicion is, you fiddle with the minimum GPA requirement, and see how many of your applicants would "qualify" for an interview with each increase. At least, that's what I would do. Even if that's only part of the equation, it must be a big part. And considering that a GPA minumum that allows me to go forward in the process is by definition one that lets everyone go through... well, that's no help.

Surely they got to a number around 60ish when they used a nice high GPA, a decently high GRE score, and some measure of experience. I probably did well except for the GPA. I'll ask them all about it after January 1st; the letter also said to feel free to consult with them about how to strengthen the old app, just not right now.

So for now, I'm going to start the healing process. In the spirit of "he was no good for you anyway" and other advice my female friends are always giving one another, here is a little about


1) Gotta wear a suit every day in clinicals (except in the ER): I just don't own that many suits. I mean, I have a vintage thing I love, but it's too shiny for most settings. And I have the new one that is being tailored right now, in prep for the Chicago trip coming up, but ye gods, how many suits does a guy need? I'm not a VP of Marketing and Brand Management, and that's on purpose, dammit. No sir, I want my stupid short white coat and my cargo pants, plus or minus a tie with a button-down shirt. There have been times in my life I've worn more formal attire than was needed, but those were the times I was bullshitting someone.

2) LaCrosse is beautiful... for a weekend. It's no Red Wing if you're into antiques and inns, and it's no Winona if you're into history. In New York terms, it's like Troy, only without the adjacent Albany. It's like any randomly-chosen 10% of Madison. It's... awww, you get the idea. Living in a small town for two years surely goes beyond charming and into "yes, I'd love to do a rotation out of town... anywhere out of town."

3) Seriously. Mayo? Isn't that a little... I don't know... legitimate and respectable? I'm supposed to be this rebel, this non-traditionalist. I'm the new face of healthcare in America. I can't be, you know, the Man. It's a part of why I saw my mighty-high GRE score and thought "I could apply to Yale!," followed close by with "...but yuck, I don't want to go to Yale." No, it's a normal school for me.

Or even better, one with a history of educating those that other schools maybe didn't feel the need to make room for. More later on why the Chiago school is so cool.

Anyway. I'm good enough. I'm smart enough. And I would have been great at the old temple of tradition. I won't get to say "Mayo" in answer to the question about where I trained, and that's too bad. I think I would have been able to finesse it to where I say "Mayo" but the other person hears "Mayo, you condescending jackass. I know less than you about some things, and more than you about some others, and let's not even go there, mm'kay?"

This way I'll simply have to do the same thing with another name. My new favorite school, the one in Chicago, has a really good name for that, actually.

Monday, October 23, 2006

freaky-deakies need medical care, too

Dear Admissions Committees,

Check how well-rounded I am. Even after a complete 3-to-11:30 shift in the ED, I managed to get home, put on my House outfit (which is eerily similar to what I wear anyhow), and get over to a Halloween party. A party documented by my pal, future Golden Globe-winning screenwriter (and eventual Hollywood Squares center square) Diablo Cody. click for the scoop, Twin Cities insiders!

Taking time to play is vital to the ability to work hard. In my 12 years in Corporate America and the year I spent in my intesive, one-year post-bac program, I learned how important it is to be where you are. Ya know, dude?

Hah, no pictures of me there! My anonymity is safe for one more day.

Now I need to come up with a good answer to that question about "what is your weakness?" So far, I'm not past the idea that it's an unfair and a sort of stupid question, and so my best answer so far seems to be this:


That is very impressive. Tell us about some areas where you're not as strong. What about your weaknesses?

(Pauses, thoughtfully. Leans forward in his chair. Makes eye contact.)


Yeah, I'm working on it. Trixi has turned out to be an unexpectedly rich source of interview prep, and has a decent answer. I'll tell you later. And maybe I'll get over the idea it's a dumb question if I hear some additional good answers. What do you say, in a job interview or whatnot, when asked about your weakness?

Thursday, October 19, 2006

Chicago Style

Here's the rundown on "my programs ," aka the schools where I've applied to join the PA training dealio. I won't use their real names here, because I'm superstitious, paranoid, and like making up names.

1) The Best School Evah. This one is affiliated with a nationally-- no wait, internationally-- known four-year medical school and hospital/clinic system. BSE's PA program takes exactly 24 months, with 12 months in classrooms (here's where the 'affiliated' comes in, because it's about 80 miles from the four-year med school) and 12 months on the wards doing clinical training. Let's just say that these clinical sites are niiiiiiiice. Think of the place you'd go if you had all your local docs stumped. Or if you're the ruler of a country. That's the place.

This school is so prestigious, the admissions guy at another school wasn't the slightest bit offended when I said it was my top choice. If I had ego issues of a certain kind, and cared about validation from strangers, I'd want to be an MD, not a PA. But I'll admit, the idea that my dorky short white coat might have this place's patch on it is a sweet one. The name stands for excellence, innovation, and compassionate care... it also serves to shut people up in the "so where did you train?" arms race.

2) Chipotle University. This is a small school in the Southwestern US, mostly known for their nursing program. They make the US News list of "best" schools, so there's a lot to reccommend them. The PA program is sort of new, though, and there's a state school with a med school AND a PA program in the same town, so they snatch up the "best" training sites for clinicals.

However, this was one of the first schools I investigated, and it made my first cut of "places where I already have all the pre-reqs done" when I got into it last winter. And the admissions guy was so great about answering questions and taking time that I got a little drawn in. I had thought the process was supposed to be cutthroat and elbowy; instead, it feels sort of like I'm being head-hunted. This guy sent me an email when my GRE score came through, to say "you did very, very well."

Chipotle invited me to interview. The interview was early in October. I didn't go. They are one of the schools that start up in January, and that was too early for me. Having been away for a year, and then back six months, I couldn't run off for another two years. I missed friends and family too much. I immediately let them know, and asked if I could be considered for January 2008 rather than 2007.

It would be unfair to call them a fall-back or a safety school. I would love to live and train in a warm part of the country, and if things work out so that this becomes the place, I'd be very happy. It is cool that if the summer 2007 schools don't work out, I have half a year rather than a full year to work on the next launch window, but it's not like that was my plan all along. ...or was it?

3) Respected Chicago University of Medicine and Whatnot. This is a North-Side institution not quite 100 years old, with a strong PA program. One of my letter-writers went there. (Oddly, after a few years as a PA, she decided to go for the extra responsibility and pain of full-on doctorhood, and she's now at BSE's four-year school. Funny, eh?) I like everything I know about them, except that I need to take another Chem course to get in, but they seem to like me too. A recent email told me as much.

So, I am about to buy a ticket to Chicago and set up my first interview. That's two for three, for those of you following along at home. And the BSE will be informing all applicants about interviews sometime before the end of the month. Could it be a sweep? Stay tuned...

Tuesday, October 10, 2006

This old House

Here's the funniest thing I've seen on the Web today:

The blotch on the left is the logo for the fictional Princeton Plainsboro teaching hospital. It's pretty perfect. The sticker is available at some dude's CafePress store, here. Never let it be said I used bandwidth for purely selfish reasons.

Okay, so I'm obsessed with House. Whatever. I'm up to my axillae in the Season One DVDs, and it's as good as a TV-on-DVD favorite as it was as a new show. High praise.

Monday, October 09, 2006

Eww, baby, eww

Tonight, at work, I was in on a childbirth. I got to witness the Miracle of Birth -- the human version, not the State Fair farm-animal version.

Yes, it was magical. I was suffused with a sense of the world being a good, kind, and loving place.

On the other hand, it was not so different from the State Fair version, when you come right down to it. And the bit they did on Scrubs pretty much nails it: in a faux-1950's Health Class filmstrip, JD-as-wise doctor guy intones "you'll fart, pee, and poop in a room full of people." A-yup. There was in fact a lil' bit of that.

So I have to revise my rule about when you smell the poopoo in the trauma room. If it's a trauma patient who has lost bowel control, then yes, that is still a dire neurological finding, and a sign things are Very Bad Indeed. However, the mere fact of a "code brown" does not mean badness; there's a loophole in the rule allowing for childbirth-related dropping of the deuce.

Still a miracle, though. Tiny fingers and toes, etc. Yes yes. I'm not totally jaded.

Saturday, October 07, 2006

Out of the Woods... ish

Hey, I'm surviving. The worst of the 10-year flare is over, and I've survived it.

What can I say? I'm a survivor. I'm not gonna give up. I'm not gon' stop. I'm gonna work harder. I'm a survivor. I'm gonna make it. I will survive. Keep on surviving.

It's pretty much just what I do. I learned a few things, in the last couple weeks.

I think I said somewhere earlier that when the time comes, Amgen-Wyeth won't need to send me on golf weekends or anything, considering how much I love their drug Enbrel. What I've learned recently is that without it, I am ska-roooed. So big ups to Enbrel, 50mg BIW SQ. Here we are, four doses later over a week and a half, and we've turned back the clock. Sure, I suspect I have a lingering low-level strep infection (there's pain in my inguinal lymph nodes and throughout my legs, plus this weird guttae rash), but it's like there never was arthritis blimping up my left foot. And that thing was friggin huge, so much that the doc checked for gout just for the hell of it.

Also, I've stopped popping Vicodin and walking with my cane. Just for the record, I was doing the cane and stubble thing in the early '90s, before anyone heard of House, MD. ...Which brings me to my next note: Vicodin kicks ass. No wonder it's habit-forming and easy to abuse; it's easy to abuse those things that you love dearly and want to be a part of you all the time.

Seriously, it's a wonderful drug. You know how sometimes, you'll find yourself thinking about something, without thinking of it? Like your mind wanders away from the subject of its focus, like "I wonder if I left the light on in the bathroom?" or "hey, it's getting cooler in the afternoons; where did I put that scarf that everybody is always saying looks nice?" What Vicodin does is put pain in that category, where things you've lost track of seem to drift away to. Sure, if you concentrate, you can remember where the pain is, and what it's like... but it's not easy, and anyhow why would you want to?

It also left me, at any rate, able to do everything else with reasonable clarity. I got five days of Prednisone to try to arrest the flare (did I mention I saw one of my favorite docs?), and that made me surly. But the Vicodin treated me fairly, and left me more or less in control of my faculties. If one and a half beers dulled pain, that would be Vicodin, basically.

Outstanding. From a neuroscience perspective, I have to give them a good solid A. Would have been a B+, but there's goodwill that comes with doing a "very good" job with "excellent"-level enthusiasm. And so now that I've weaned off my lil' buddies, I am of course hoarding those last few. We loves them, preciouss, and nothing will take them from ussss.

So... yeah. I'm back to work. I don't feel awesome, and I'm fairly scary-looking, if you know where to look. I've had many conversations about psoriasis, and that's fine. Some are the "oooh, honey" variety; yep, it itches, and actually, when it's bad, it hurts. Some are the educational variety; inflammation blah blah tnf-alpha, blah blah cytokines, etc. Some are "hey, my roommate's sister has that," which are sort of cool. I guess. Mehh.

So I'm back to being an ambassador for a medical condition. It's not all awesome, but it's easier knowing that I'm fighting back, and in a smart way. Plus, once this is all over, I'll be in better shape than I've been in for quite some time. We are after all hitting the Enbrel at twice the level I've been at since I started, two-plus years ago.

Hey, I could even be all one color again, someday soon. How cool would that be?