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About Greg Moore

Founder and owner of Green Mountain Software, a consulting firm based in the Capital District of New York focusing on SQL Server. Formerly, a consulting DBA ("and other duties as assigned") by day, and sometimes night, and caver by night (and sometimes day). Now, a PA student working to add PA-C after my name so I can work as a Physician Assistant. When I'm not in front of a computer or with my family I'm often out hiking, biking, caving or teaching cave rescue skills.

Holy Frack! Less than 24 Hours

In just under 24 hours from the time I’m writing this blog I’ll be starting orientation with my fellow cohort of students at the Christiana campus of Arcadia University’s PA program. I can’t believe it. Everything I’ve worked for in the past 2 plus years is about to bear fruit.

That said, in the last 24 hours I’ve had two dreams.

The one two nights ago had me starting class. Strangely, one of my classmates was my wife. While she loves medicine and enjoys hearing me talk about it, she decided years ago that my path wasn’t for her. Still, it was an interesting subconscious take on where I’m headed. What’s interesting is we decided we’d sit in completely different parts of the classroom. You’d think we’d want to sit together, but we realized (at least in my dream) that our learning styles were different enough that we’d be better of separated. In any case, in that dream, things were going smoothly and I felt confident and excited.

Contrast that to the dream I had this morning. In reality, last night, via GroupMe, I started to organize a get together dinner for my classmates tonight. So far it looks like 8 of us (out of 49) will be showing up. That much is accurate.

But in my dream, I had been sitting on a sidewalk in the downtown of some city (I’m going to assume it’s Wilmington) when a childhood friend (who now lives in Florida) shows up and tell me it’s 6:27 and I had promised to make the reservation for 6:30 so I really had to move. I started to follow her to her car and then lost track of her. Fortunately after turning around and taking a turn, I found my car. Which turned into a bicycle when I got there. Which would be fine, but I had a large box of items I needed to carry with me. So I figured I’d text or call my friend back but now mysteriously on my phone all her contact information was gone.

Some more hijinks ensued, but suffice to say I didn’t make it to dinner in time and was panicking.

So in 24 hours I had gone from confidence and excitement to panic.

I suppose this sort of mirrors the thoughts swirling in my mind. I’m excited, but I’ve got to admit a bit of panic running through my head. Can I cut it? Will my current knowledge help me enough to get through? Will my improved study habits make a difference? What am I forgetting to panic? Will I make friends? What will it be like being the oldest student in my cohort?

Well, tomorrow I will find out!

I’m Too Old!

They say age is just a number. I wish that were true.

Otherwise my outlook sometimes wouldn’t be so blue.

The reality is quite mundane

One age and two is not quite the same

Ok, I give up, rhymed meter isn’t my thing.

But it’s still better than if I did sing.

Seriously now…

As the date of for starting PA school gets close (less than a week away) I have mixed emotions in my head. On one hand, I sometimes feel as giddy as I did when I first went off to college, or perhaps when I was in my twenties. For the first time in years, I intentionally won’t be earning an income. Instead, I’ll be paying good money for an education. I feel young in so many ways. In just over two years if all goes well, I’ll be starting a whole new career. I feel like I’ve got a whole new life ahead of me.

And I do.

But… the reality is, unless something changes, I have fewer days ahead of me than I have behind me. In fact, statistically, I have fewer days ahead of me than I have between when I finished college and now. My next career will certainly be far shorter than my previous one.

So I’m not too old to start school. I don’t feel all that old emotionally. Even physically I don’t feel too bad, though I’ll admit I’ve noticed the vagaries of aging in my body.

But I’m too old to mature in this career as much as I did my former one. Too old to do this career the justice I’d love to give it and then move on to something else.

But, I don’t care. I’m going to love and enjoy the heck out of the years I’ve got left and the career I’m moving into.

That said, if anyone has any secrets to longevity, reach out to me. Or heck, even if I could live to 200 or 300, that might do for all I want to do. Though I suspect at 150 or 250, I’d be wishing for more time to do more things.

So for now, my plan is to die young as old as possible.

Transgender

Note, I started this about two months ago and only posting now, hence “yesterday”.

Yesterday I read that the National Park Service website for the Stonewall National Monument no longer references transgenderism or queerness and any references LGBT+ only reference LGB.

This is erasure plain and simple. Trans-women such as Marsha P. Johnson were a big part of the Stonewall riots.

In any case, this erasure is a good lead-in to a topic I’ve been wanting to blog about for awhile: sexual and gender identity

I’m going to touch on sexual identity first. This is in some ways the easiest to address from a purely factual point of view. There are plenty of posts elsewhere, such on Facebook that cover it, so I’ll keep this short. What you were taught in high school biology about sex being binary was a gross oversimplification. The whole XX=Female and XY=Male is not that simple.

The key words used here in a scientific sense are genotype and phenotype. Genotype is basically what genes you have, and phenotype is what you “see”. A classic example is eye color. If you have brown eyes, you may have both genes for brown eyes, or one each of the genes for brown and blue eyes. Brown “wins out” here. It’s the dominant gene. But if you have blue eyes, except in some very edge cases, both your genes for eye color will be blue. So if you see someone with brown eyes (phenotype) they could have both genes for brown eyes or one gene for brown eyes and one for blue eyes (genotype). There’s no way to tell without actually looking at their genes.

In a similar fashion, sexual characteristics have both a genotype and phenotype. Typically if you have XX chromosomes, as an adult, you will develop breasts, have a uterus, have gametes in the form of eggs and be capable of carrying a fetus. And if you have XY chromosomes as you mature, you will tend to grow more body hair, produce sperm gametes and not be able of carrying a fetus.

But Mother Nature is never that simple. It’s fully possible to develop characteristics where one appears to be male, but have only XX chromosomes. Or appear to be female and have XY chromosomes. Things can get very complex very quickly, including XO (no second sex chromosome) XXY, XYY, and more. (the only combination that doesn’t work is YO. There’s simply too many genes on the X chromosome that are required).

Anyway, the point is, sex is NOT binary and short of looking at someone’s genotype (which most of us will never do) it’s basically impossible to say what’s going on at the chromosomal level.

Ok, enough about sex. There’s plenty of better posts on the topic.

Now I want to talk about gender, or at least gender identity.

I’ll start with saying that the scientific consensus on this is a bit less clear-cut. And for that reason and others I’m not really going to go down a deep hole based on facts. Rather I want to take a different approach.

I’m going to start by saying I identify as a cis-male. Some people seem to think that cis is meant as an insult. It’s not. In the field of science, cis and trans basically mean “on this side” and “on the opposite side” or “across”. Think about terms like “trans-Atlantic flight. It simply means flying across the Atlantic or to the opposite side. You don’t hear the prefix cis used as much, but one example in recent memory would be the term cislunar flight, from the Apollo missions. Often times in science one might skip using the prefix cis and assume that as the default and only use trans to highlight something that’s not cis.

So I could say simply “I identify as male” and that would be accurate, but adding the prefix cis makes it a bit more accurate. In this case my gender identity matches my phenotypical (and as far as I know genotypical) sex.

That said, if you still think that transgender isn’t a thing, or it’s somehow “wrong” or “evil” or “sick” I want you to do a thought experiment with me. I’m going to start with the assumption if you feel that way, you do not identify as trans. As started above that makes you cis.

Since I’m male I’m going to center this on male identify, but the exercise can work as well for a female.

“What makes me male?” It’s really a simple question. Right? I mean I could answer, “well I have XY chromosomes. But as illustrated above, that MIGHT not be true. (Though given the fact that I’m a biological father to both a man and woman tends to suggest it’s very likely to be true.) So let’s go a bit beyond that.

Why do *I* think I’m male. The more I think about it, the harder it is to answer.

Is it because I have a penis? Perhaps. But let’s say I was in a tragic accident and I lost that? Would I stop being male?

Is it because I grow hair on my chest? Perhaps. But if I shave it, do I somehow stop being male? Or if I lose it due to cancer or some other disease do I stop being male? Perhaps it’s fact that I don’t have breasts? Perhaps it’s muscle mass? But the truth is, as I’m growing older, I’m losing muscle mass. Does that mean I’m losing my maleness? What if I meet a woman who is similar in age to me and she has more muscle mass? Is she somehow more male than I am?

Hopefully you can see where I’m going with this. I can’t rely on any specific physical appearance to unequivocally state that I’m male.

Perhaps on certain actions? Long hair? Women in general are more likely then men to grow their hair longer. But that’s strictly cultural. And as someone who spotted a rat-tail or pony-tail or some sort of long hair for well over a decade, I don’t think that made me feel less male or somehow more female.

Perhaps it’s makeup? Well in some cultures, men very commonly wear make up (ancient Egypt for example).

Or is it shoes? I mean I’ll admit a woman in heels will make my head turn. But again, heel wearing is strictly cultural and in fact some of the earliest heels were worn by men, not women.

Many of the outward appearance we attribute to men or women are strictly cultural, not some innate part of the gender.

So, a few years ago, after giving this a lot of thought, I realized I couldn’t come up with a good set of criteria that clearly defined me as male. Now it’s possible I’m simply not creative enough to come up with a set of unambiguous criteria, but from talking to many others and giving it a lot of thought, I’m pretty convinced there’s no such list.

Ultimately like like Justice Potter Stewart’s famous quote about porn “I know it when I see it” I know I’m a man.

Just you as a reader probably deep down simply know, that you’re a man or a woman. You might not be able to articulate exactly why you know that, but you simply know that.

Now I want you to put yourself in a place of a transgender woman or transgender man. Deep down, just as strongly as you feel about your gender identity, they feel the same about theirs. The main difference is that their phenotype (appearance) simply doesn’t match what the feel deep down.

That’s really what it comes down to. It’s not a desire to sneak into a bathroom and perv on others. It’s not a desire to “mutilate” anyone. It’s simply (well partly not entirely simple) a desire to be able to express outwardly what one feels internally.

T – 1 Week and Counting

Pardon the language, but “shit’s getting real!” Technically as I write this, it’s less than 1 week. Officially I start orientation at 9:00 AM on Tuesday the 27th. It’s about 9:30 as I write this and publish it. But I think I can say 1 week without being accused of lying.

But then again, technically classes don’t start until Wednesday the 28th. So there’s that.

Then I have my nervous breakdown scheduled for Thursday night on the 29th as reality hits me.

Seriously though, the time is coming fast. I’m finalizing my housing plans (yes, I waited longer than I had planned, that’s a story in and of itself). I’m starting to put together a packing list of stuff I need.

And, I’m trying to set up a dentist appointment because apparently I had a chip come off a tooth last night. Fortunately there’s no discomfort.

Oh and last minute paperwork and drug testing for school.

And projects around the house.

But other than that, I’m ready.

I think.

People have asked some questions, so I guess I should put together a FAQ. (by the way, technically the term FAQ predates my Internet introduction, but only by a few years. It was partially developed by Eugene Miya, a name I know well from my early days on Usenet.)

So, just the FAQs Ma’am, Just the FAQs

  • Is the family going with you? – Nope. Two of the three have local jobs, the third is looking. Besides someone has to maintain the family estate!
  • How long will you be gone? – Two years, but not really. It’s one year of didactic and then one year of clinicals. I have ten clinicals I have to complete in variations specialties. Most will be within 90 miles of where my campus is, but I can do several in other locations including at least one overseas rotation. So more like nine months of the second year I’ll be in Delaware, and if I can group the other three into a single block, I’ll be elsewhere, but not sure where yet. That will impact any apartment leases I book.
  • Will you come home weekends? – In most cases not. This is for several reasons. For one, since I won’t really be working, not coming home every weekend will save money. For another, I expect to be studying most weekends and wouldn’t have time for travel. That said, I expect often if I do travel home, it’ll be via train so I can sleep or study while in motion.
  • How hard is the program? – That’s a great question. One analogy I’ve been using and is told is accurate is it’s like drinking from a firehose. Another is that I’ll be sprinting a series of marathons. Imagine packing three semesters into one year for starters. The first semester is 18 credits. The second 25, and I believe the third also over 20. Basically I can count on a test every week. I’ll be learning in one year what many medical students spread out over a couple of years.
  • Are you nervous? – I’d be lying if I said I weren’t. There are moments where I completely doubt myself. But, as a member of my Council of Moore reassured me the other day when I asked for a confidence boost, that’s exactly the right attitude. It’ll keep me from becoming complacent. Mostly I think I’m nervous about the amount of rote memorization I’ll need to achieve. This is something that older brains in general aren’t necessarily as good at as younger ones. Most of my classmates will be half my age or even younger, so they’ve got me beat there. On the other hand, just because of my experiences in general, including working in the ED, I am fairly confident that understanding systems, pathophysiology, and physiology in general are strong. I’ve always been good at the “big picture.” I even noticed this, to brag a bit, in the ED when sometimes an attending would be quizzing a medical student or even a resident about a case and while I might not know some of the details, I was often able to understand the overall picture better than the student or resident.

    I also worry that my student habits from my BS will resurface. But that said, I proved my study habits in my prereq classes worked and I’ll of course be using them again. I’ve also built a good support system for myself.

    So yes, there will be moments where I doubt myself and even moments where I might not do as well as I’d like, but overall, I think I’ll do fine.

    But ask me in two years.
  • Are you excited? – Overall yes. But ask me in a week. Right now I’m just stressing about all the final prep.
  • Isn’t this costing a lot? – Honestly, yes. One reason I had hoped to get into a local program (there’s really only two that are considered local) was to save money and be home more. But alas, that’s not what happened. And honestly, I’ll be trading two years of income for two years of spending. And even when I graduate, I’ll probably be making less than if I had simply stuck in IT or even teched in the ED for those two years. But, ultimately I’m pretty confident I wouldn’t be as happy or as fulfilled.

    Years ago in either Dear Abby or Ann Landers, I recall someone writing in who was I believe like 46 asking if she should spend four years going to college or if it was a waste of time. The response was, that either way in four years, she’d be 50, so she should do what she thought would fulfill her the most. That’s my attitude. In two more years I’ll be 59. So I might as well be 59 with a masters in something I believe I have a passion for than 59 without that masters.

    Now, that said, if anyone wants to give me money, let’s talk 🙂
  • I like PAs, can you be my PA after you graduate? – I’ve already had one person ask this. I pointed out my goal is to work in the local trauma center. Do you still want to see me at work? 🙂
  • Will you keep blogging? – Definitely. I’m actually surprised and appreciate how many people (i.e. more than one person) actually appreciates to hear about my PA journey. It’s also my way of venting and keeping sane. Thanks for reading.

That was Then, this is Now

I had a few photos that didn’t really fit into my previous post so decided to create a separate one.

Heading into my final shift

This was my first shift actually in the ED. I think the bottom set of scrubs were some I bought locally. Marginally better than what I was given at the end of my first week of preliminary orientation.

Celebrating the 1000 hour Mark

By now I was 1000 hours into teching. You can’t tell from this photo, but my scrubs are better fitting and I’m feeling far more comfortable in the job.

Heading into work for my final shift was a fulltime tech

Definitely comfortable now!

Poised for a quick getaway!

While we don’t have assigned spots, I usually considered one of the spots around here as “mine”. I could usually get such a spot about 90% of the time. Why so important to me? My car was headed straight down the ramp. So by not having to back out, or come down from other areas, I could get out of the garage that much faster.

I make this look good

5,500 hours ago I know I would not have looked so relaxed and comfortable at work. But now, I’m definitely comfortable and relaxed. Even in the middle of a trauma. I think I’ve come pretty far. And now I set off on the next part of my journey.

It’s the End of the World as We Know It

And I feel fine…

Ok, that’s not quite true. It’s actually pretty bittersweet. As I’ve written in my last few posts, my last scheduled shift was last night. I said farewell to many people. Actually all week it’s been series of goodbyes.

Sunday was my second to last official shift. But even before it was over, I had already planned on picking up a shift Monday night. The ED was short staffed and I figured I’d take the extra money and also help out. I mention that because I knew that one of my fellow Techs, Mike S. had been planning something for my final shift last night.

So I was a bit confused when my ANM (Assistant Nurse Manager) came to me around 6:00 AM or so and whispered in my ear, “I’m going to need you for a special huddle.” I was a bit confused, but thought perhaps she was going to privately say good-bye or give me some final words of wisdom.

Around 6:45 I took aside the orient I had that night and told her she was going to give the report to the incoming tech and asked her what she was going to present. I’ve done this dozens times as part of a new techs orientation, especially when they’re about done. Well, it’s a good thing I did since at about 6:58 the ANM came and practically dragged me by the elbow, “we’ve got to get to huddle.” Now I was completely confused. I couldn’t figure out why it was so important I get to huddle. That’s generally only for the incoming shift and the only folks who brief is an ANM or the person taking over as Charge Nurse. In any event, my orient ended up giving the hand-off report without me and did great.

Well imagine my surprise when I walked in and saw a table full of donuts and bagels and folks congratulating me. All I could keep saying was “but I have two more shifts!” I was at first a bit embarrassed, partly between the attention being given me and the fact that I felt it was a bit premature. But by the end I’ll admit I was on the verge of tears. It was a very touching moment.

Last night, despite it not being a surprise, was also very touching. While I greatly appreciated the day shift send off, the truth is, most I hadn’t worked with much or if I had, it had been well over a year ago. The night shift send-off though; I knew most of them very well. We’ve done battle together. We’ve broken bread together. We’ve staved off death together. And sometimes, we’ve mourned together. They’re my ride or die crew. So having a chance to celebrate with them was extra special to me.

Some of my night shift ride or die crewmates

Besides the food and music though, I was looking forward to one more tradition afforded folks leaving. The picture in one of our trauma bays.

Nurses, doctors and techs sitting in a trauma bay.
Part of the Night Crew giving me a silly send off

After the photo in the trauma bay, we received a Level 1 trauma that took me the rest of my shift to help with, including getting them to the OR. It was a sad, but somehow appropriate way, to end my shift.

The part that meant the most to me tonight were the well wishes and votes of confidence from my colleagues. In a few short weeks I’m going to embark on what’s probably going to be one of the hardest, prolonged challenges of my life, and it really meant a lot to hear so many people saying positive things.

Yes, I’ll pick up a few shifts over school breaks, but it won’t be the same. This was the end of an era. Over 5,500 hours (by my best estimate) of working as a tech. I’ve learned so much and made such friends and gained such mentors. So I walk away a bit sad that I’ll miss working with such great people on a regular basis. But also extremely excited about my new challenge and honored that such folks have such faith in me.

And as always, my views and thoughts do not reflect those of my employer Albany Med Health System.

Reflections on Being an ED Tech – Some of What I’ve Learned

As PA school quickly approaches I’ve been reflecting a lot on my job as an ED Tech over the last 2.5 years. I’ll probably end up blogging a few times on this topic.

My first official day working in the ED (as opposed to the orientation I underwent the week previous) was on October 18th, 2022. Most of the PA schools I applied to required a minimum of 1000 hours of patient care experience. Obviously more was better. I hit that in under 6 months.

I’m now at over 5,500 hours I believe. I honestly stopped counting awhile ago. In the past 2.5 years I’ve worked a LOT of extra shifts. And for the most part, I’ve loved it. Yeah, there are the shifts where I’ve been given an assignment I wasn’t keen on, or the shifts that I went home from emotionally drained. But overall it’s all been worth it.

At some point I might talk about the specific skills I’ve learned. But the most valuable thing I gained was “my voice.” Anyone who knows me, knows that in general I don’t have a problem sharing my thoughts (as this sometimes self-indulgent blog is proof of). But the difference in my confidence between that first shift and now is stark.

On my first shift, heck my first hundred or more shifts, I often followed the lead of others. There were multiple reasons for this, but basically it came down to two: they had the credentials and they had the experience. Related to this, they didn’t know me so they couldn’t necessarily trust me.

I’m proud to say, that has changed. I still don’t have the credentials, but I now have the experience, and they know me and trust me. One example is the language I’ll use at times. One night a nurse went into one of the trauma bays to grab a bag of saline. Now there are signs that tell folks not to do this, but I’ll be honest, it happens. Two years ago I might not have said anything or if I did, it would have been phrased, “Oh, you took something out of the trauma bay? I’ll make sure to restock it.” This time I said, “Oh you took something out of my trauma bay? I’ll have to make sure to restock it.” Yes, it went from “the trauma bay” to “my trauma bay.” I realized the more I worked on the trauma side of the department that I was taking ownership of things like the trauma bays. I take pride in making sure they’re ready for a trauma. This pride means that a few weeks ago, when in the middle of the trauma a nurse reached for an item and it wasn’t available, my stomach dropped. I felt like I had failed them, even though honestly this was I think the third trauma in a row in that bay and I had had no time to stock. No one blamed me or even looked askance at me. But I still felt like I had failed. So yes, when I’m working in that zone, the bays became “mine” in the sense I took pride in making sure they were setup.

Another example is my interaction with the providers and nurses. When I first started, I would always wait for their cue on what to do outside of the most basic expected skills. Now, I’m far more likely to make a suggestion or be expected to contribute. A few months ago with a patient with several severe bleeding wounds, I was the one that suggested to one of the providers to use a clotting agent we keep in the trauma bay. He wasn’t aware we had it, let alone how well it would work in this case. Fortunately between taking a Stop the Bleed class and being responsible for stocking the trauma bays, I knew it was there. Recently, one of the nurses asked me to show her and a couple of others how to set up a particular piece of equipment based on the manufacturer’s instructions. I’ve earned the trust and confidence of my coworkers. This is an amazing feeling.

I want to add one key note to this. I’ve said before and I’ll say again, one thing I really appreciate about where I work is that it’s a teaching hospital. I basically sat in on a graduate level lecture on pain meds given by one of the attendings to a med student one night (it was a slow night so I had time to stand around and listen.) The attendings, especially a few in particular I work with, encourage questions. This has been invaluable. “Hey why did you do X? Would Y have worked?” I’ve learned a lot this way.

So it turns out, not only was being an ED Tech the right thing for me, I’ve learned a lot and absolutely loved it. Who knows, maybe I’ll write a book someday about it. In the meantime, just one more shift before I head off to PA school.

And as always, my views and thoughts do not reflect those of my employer Albany Med Health System.

T-12 hours and Counting

I’ve been counting down my final shifts for about a month ago. You’d think it would be easy, but it’s a bit harder than you think. Officially I’m what’s known as a .6 FTE (Full Time Equivalent). This means I’m scheduled for 24 hours a week (i.e. 60% of a 40 hour work week). In reality, I pick up a LOT of extra shifts. I’ve done this for three main reasons:

  • To get into PA School I needed a high number of Patient Contact Experience hours.
  • I get overtime pay
  • Often times the apartment is very short-staffed and well, I can help out and get the above benefits.

So, even two months ago I could easily say, “Ok, with my vacation. I have X number of shifts left.” But like how NASA countdowns don’t proceed uninterrupted or without changes, my countdown had its own changes and interruptions, including picking up more shifts.

So, I had a rough idea that when I had say 8 official, scheduled shifts left, I likely had 12-16 total shifts left.

So barring any changes, Thursday is my last shift as .6 FTE ED Tech.

Note I tossed in the .6 FTE. That’s because for a few reasons I applied for and was accepted as a “student” track tech. This means during my few breaks from PA school I’ll be able to pick up a few shifts. But I won’t be picking any up right away. Between Thursday and the start of school I’ll be finishing figuring out where I’m living, packing, finishing some projects about the house. So Thursday is it for awhile.

But honestly, I’m ready to move on. I’m excited and nervous. I’m also a bit sad. I will miss working with so many great people and having such an impact on the lives of people.

So, “We are at T-12 Hours and counting.”

Countdown T – 1 Month

I’ll be posting a few more follow-ups to my recent road trip but for now a break from that and something else: counting down.

One month from today, on May 27th, I’ll be going through orientation for my PA program. I’ve already met a few classmates at the open house a few months ago, but this is the first time all of us will be in the same place at once.

Then the very next day classes start. Or as I like to think of it, I’ll be starting a marathon of sprints. The next two years will be very busy for me.

I think I’ve mentioned before, the first year is all didactic teaching. I’ll be spending a lot of time in the classroom, lab, study areas, and in my apartment, focusing on learning and memorization.

While I took over 40 credits of classes as prereqs in prep for this, that was spread out over the course of about two years and I never took more than 12 credits at a time. And these were undergrad level classes. My first semester I’ll be taking 18 credits. All graduate level. (Ok, I’m not sure I’m too worried about the one credit class, “Professional Practice I” but still that leaves a lot). On the other hand, I won’t be doing any IT consulting or ED teching during this time, so my primary focus will be just that, learning. But I’m still nervous. I want to do as well as possible. I can’t afford to have a repeat of my undergrad experience in terms of grades and study habits.

The second year is my clinical year. This is where I have 10 clinical rotations of 4 weeks each, with testing between them. This I’m not too worried about. For one thing, my hands on experience and observations in the ER should help me a lot here.

In fact I recently spoke to a friend of mine who is currently in a PA program. She’s had years of hands on experience as a paramedic. She mentioned it was striking how uncomfortable some of her fellow students whose medical background was basically that of “scribe” were with the hands on stuff. I mean I get it. For example, sticking a needle to draw blood in a living breathing human being is a bit daunting. For her, that was just another Monday.

In the meantime though, before I can even start classes, I have a number of things to do:

  • Put the BMW on the market – it needs work and I don’t have the time for it or need.
  • Find an apartment – I’ve got a place picked out, just need to sign the lease. Ideally I’d have a roommate to cut costs, but looks like that’s not happening.
  • Come up with a list of items I’m bringing with me for the apartment (clothing, cooking utensils, etc)
  • Acquire bigger items (like a bed, possibly a dresser).
  • Finish projects around the house
  • 4 more scheduled (and I’ll probably pick up 1 or 2 other) ED Tech shifts
  • Work to change from a .6 FTE ED Tech to what they call the “school” track where I can work during breaks.
  • Get a lot of paperwork done. I’ve already authorized the background checks and other paperwork. I have to start getting my vaccination information together. One they want details on is chickenpox. Well I was born well before the varicella vaccine was even out there. So I don’t have any vaccination records for that. Fortunately they’ll accept a titer for that.
  • Mow the lawn!
  • Finish up some other projects around the house.
  • Attend Rebecca’s Senior Film showing (that I also happened to act in!)
  • Attend Rebecca’s graduation!
  • Run an Orientation to Cave Rescue class in two weeks
  • Give a talk to the local ER docs (and others) about Medicine in Cave Rescue
  • Write above talk!
  • And much more.

There’s a lot to do, and on one hand a month seems like forever, on the other hand, it seems like it’s not enough time.

I made the decision in December of 2021 to apply for PA School. At the time I had the outrageous idea that I’d be able to apply in 2022 and start in 2023. I realized very quickly that was unrealistic and impractical so I set a new goal of applying in 2023 and starting in 2024. I knew that was an outside shot, something like 70% of first time applicants don’t get in, and I had my very low undergrad GPA hampering me. So, here it is, I did a second round of applications in 2024 and am, starting in 2025. So not too far off my first realistic schedule.

I’m excited. And nervous. But mostly excited.

Roadtripping – Bathrooms and Rest Stops

For some reason I found myself taking more pictures in bathrooms on my recent road trip than I think is healthy. So now I’ve decided to share my non-healthy apparent obsession with bathrooms.

Restroom with Opioid Overdoes Supply box on the wall.

The first one is from Ohio. It’s a sad state of affairs that such things are necessary at all. That said, I do have to wonder how many times these are accessed at rest stops along the Interstate. I suspect not often just because in most cases folks who are overdosing are in cities and towns. But overall, probably doesn’t cost much as a just in case measure.

 Two pay phones on the wall with a divider between them.

These days I’m often surprised to see pay phones any place, let alone two of them. While strictly not a bathroom, this was at a rest stop. This was in Missouri.

Vending machine with sign pointing to an available microwave machine.

At the same rest stop. Only one I’ve seen with a microwave. And honestly, the prices weren’t terrible for the microvable food in the vending machine. Had I not already eaten, I might have taken advantage of this.

Sign on wall above urinal: Do not spit tobacco into urinal.

Taken at a restaurant I ate dinner at in Texas. This was when I really knew I was in Texas!

Very tall restroom at Amarillo Texas "Visitor Center"

I had mentioned how nice the rest stop/Visitor Center in Amarillo was. The bathroom itself was clean and had VERY tall ceilings. It was a bit weird, but kind of cool too.

Messy outhouse at 1.5 mile rest house in Grand Canyon.

This how I found the 1.5 Mile Rest House outhouse on the Bright Angel Trail. At about 3:00 AM in the morning. Seriously folks, do better!

Roof of 1.5 mile rest stop outhouse as seen from the Rim.

From the Rim. From here you can’t tell what horrors await you when you step into the outhouse proper (as seen in the previous photo.)

Same image as above, but with telephoto.

Taken from teh same spot as the previous photo, but with the telephoto lens on my camera. This is beyond the 3x physical lens and includes “digital telephoto”. But I’m still very happy with it compared to my old phone!

Urinals at Hoover Dam

This one is at Hover Dam. I took it for two reasons. For one, the unusual bowl shape. It recalls a woman’s urinal I once saw in a bathroom at West Hall at RPI. Yes, you read that right, a woman’s urinal. Far more practical (and apparently common) when women almost exclusively wore skirts or dresses. But this was the men’s urinal. Another factor that makes it interesting is the location. Along the edge of the top of the dam (where the original road crossing the Colorado was) there’s a walkway with some towers built in. One each contains a men’s and women’s bathroom. Interesting enough. More so, and the second reason I took the photo, because you have to go upstairs to access them (Hoover Dam built long before ADA bathrooms were a requirement). I was really hoping they had windows from the bathrooms overlooking the Colorado downstream but I was disappointed. No windows. But interesting urinals.

Sign on restroom door at Bryce Canyon warning about Mountain Lions spotted in the area. Almost 12 years ago!

Seen at the Loop B restroom at Bryce Canyon. I mention Loop B because my camping spot was in Loo C. I was a little upset to discover the restroom at Loop C was closed for renovations. Loop B was far enough I drove over twice to use the restroom.

While I appreciate the warning, I do have to wonder if it’s still relevant and if so, perhaps they should update the sign a bit?

This was taken at the Meteor Crater Rest stop outside of Winslow Arizona. Also a very tall ceiling.

And that’s it for bathrooms on this trip.