Category Archives: Meta thoughts

Half-way, Quarter-way, Some-way

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Most of the members of my PA school cohort are in a group chat. It was in this chat I received one of the better messages lately: “Today marks the halfway point of our didactic year!!” Now, this is a two year program, so it also marks approximately the one-quarter mark of our progress (the schedule for the clinical year is a bit more complex). In either case, it was a nice landmark to reach, especially considering that in 9 days we had 5 tests. And of that 9 days, 2 were the weekend. Of the 5 tests, 3 were, at least for me, particularly difficult. I passed all of them, one just barely. So it’s fair to say it’s been a particularly stressful part of the semester. Now it’s Friday night and I’m relaxing and starting to plan out how to finish up the rest of the semester.

I mentioned in a previous post about life being on hold. And often I still feel that way. I’d be lying if I said there weren’t times I have doubts about continuing on for the next half or three-quarters. It’s not about the grades. While I’d like to be doing a bit better, the truth is, based on what my professors tell me and what I’ve read, I’m well prepared for my clinicals next year and for eventually passing the PANCE. I rarely have doubts about my ability to get where I want to go.

What I wonder at times is a more existential question: Is it worth it? I’ve reflected upon this a bit in the past. I’ll be 59 by the time I become a PA. I know I’m going to enjoy it. But, for how long will I enjoy it? How long do I need to enjoy it to make two years of my life and over a $100,000 worth it? In terms of economic investment, while I haven’t done the math, I think if I had simply continued as an ED Tech for these two years and then three additional years and retired at 62 I’d be better off financially. In terms of time committed to something, I certainly could have worked far fewer hours in IT than the time I’m spending in school or as an ED Tech and come out ahead financially and in terms of leisure time.

So, unlike my classmates, who statistically will spend much of their career as a PA, I’ll spend perhaps 10 years as one. In terms of finances, it’s probably not the greatest career choice this late in life. In terms of work-life balance, at least for two years, it’s definitely not a great choice. I have no real work-life balance for now.

But you know what? Even with those doubts, I’m still confident I’m on the right course. I really enjoy medicine. While sometimes I’m frustrated, especially about pharmacy, I enjoy what I’m learning. I enjoy the problem solving that goes into making a diagnosis. I enjoy the work I know that will be involved. It will be worth it.

I’ll have my doubts at times. I’ll have the exams I’m sure I’m about to fail and I might even fail one or two (several professors have told me, “everyone fails at least one exam in PA school, I did.”). But I’ll get there. I’m half-way through the didactic year and about one quarter of the way through the whole process. Some way, I’ll finish it and be able to add PA-C after my name. I can’t wait.

The Dude Doesn’t Abide…

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I also don’t hate The Eagles. But they were on my mind this morning.

I was putting my contacts in when I realized the t-shirt I was wearing was from an event in 2011. That was 14 years ago. 2011 was a pivotal year for me. It’s when I semi-voluntarily left the job I had had in Washington DC for 4.5 years. I spent some time trying to decide what to do next and came up with the idea for QuiCR. It never became what I wanted, but I learned a lot about myself through that experience.

14 years though I realized was both a long time ago and a time that seems so near. I have a hard time comprehending that so many years have passed since then but also so seemingly quickly.

So what has this got to do with The Eagles? For some reason I have distinct memories of being in art-class in elementary school and drawing while Fly Like an Eagle was playing in the background and the line “Time keeps on slipping into the future” sticks in my mind. Now you’re probably thinking, “but Greg, that’s the Steve Miller Band” and you’d be right. But excuse me if my brain conflated the title of the song with the band The Eagles and hence we’re here.

Time keeps on slipping into the future and I can’t abide that. I’ve mentioned before how I feel a bit dichotomous about my age.

Ironically, one could argue that time slipped back an hour last night, but in reality that’s only our marking of time. Time itself still slipped into the future.

So I sit here, trying to gather thoughts into a coherent blog post, when I know I should be studying for this week’s tests (another pharm one, my 3rd, fortunately my second was even better than my first, so it looks like I’ll do ok in this class) as time continues to slip into the future.

I can’t abide it because there’s so much I want to do and realizing so little time left to do it.

So please, someone discover the fountain of youth. (or even the fountain of yutes).

“Life, Please Hold”

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My fellow students and I just completed what some called a week from hell. Two of our hardest test. Well for me one wasn’t too bad, but the other was on Pharmacology, and I’ll be honest, that is NOT my strong suite. On Monday night, I literally was trembling because I was sure I was going to fail the exam. Now I could fail it and still pass the others and be fine for staying in school. But if I failed it and any others in that class, odds would be high that my PA school effort would come to an end. But, it turns out I passed and honestly did better than I had even dare hope for. So one Pharm exam down, three to go. The next one I don’t expect to be nearly as bad, which does help.

And now, I have a 5 day weekend. It couldn’t come at a better time. We all needed the break before heading into the rest of the semester. We actually have more exams in the last half of the semester than the first, so it won’t be a walk in the park, but at least we have a breather here. But then we pick up the pace again.

A few weekends ago I had to miss a square dance event that I’ve been to for several years. I haven’t had the opportunity to do some of my favorite fall hikes in New York and New England.

Back from 2007 to 2011, I had a job in Washington DC that kept me away from home quite a bit. But even with that I was generally home 3 out of every 4 weekends. So not only was I seeing my family on a regular basis, i was able to get out on weekend hikes, go caving once in awhile and in general catch up with friends and the like. Yes, I wasn’t as active locally as I would have liked to be, but I felt like life was moving on. I could also take vacations when I wanted.

But now? Life is on hold. Other than scheduled breaks during or between semesters and a quick trip home for a family memorial, I haven’t taken a break and won’t have many in the future. Much of every day is spent studying. Even my weekends have been spent studying. I am actually spending much of this 5 day weekend studying and catching up.

So for about 24 months of my life, 2 whole years, my life is on hold. As much as I’d love to see many of you and do fun things, please understand, my life is on hold.

But did you die?

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Some of my friends, especially caver ones, may recognize that quote. I saw it on a bumper sticker today. Often it’s said after someone tells a story about some harrowing caving or hiking trip. “But did you die?” Well you’re telling the story, so obviously not, so it’s all good.

But while biking I saw it today and it reminded me that my existence is but a brief second in the so far 15 billion year history of the universe. Some unique set of circumstances overcame quantum disturbances and locally countered the Second Law of Thermodynamics and I came into existence. At some point my consciousness will flicker out and the universe will carry on. But in the meantime, I am alive. I am here. I exist. And I will enjoy every moment of that existence. I will rejoice in the dancing of cosmic dust that has come together for this brief moment to create me.

Someday I will die. But for now, did I die? No, I revel in life!

The Changing Size of the World

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I was reflecting earlier how the size of my “world” has changed over time.

When I was an infant, I didn’t know of a world beyond my crib. But as I got older, the world got bigger. While I have memories of going between Storrs and Falls Village CT, I think my first realization of a bigger world was when I followed some older boys in the housing complex in Storrs and ended up lost (I suspect they probably ditched me since who wants the 4yo following them around and ruining your fun when you’re 8 years old.) That ended up with a happy ending as a stranger found me and quite literally drove around asking if I recognized my apartment building. Apparently I did. I can’t imagine that scenario playing out today. That said, well before I can remember, my parents did do a trial move to California, but I don’t count that in my awareness, though I have a vague memory of me brushing my teeth while sitting on the tailgate of the Scout which I suspect was from one of the early road trips my dad and mom did.

When I was a bit older, I recall going to New York City with my parents and being confused because somehow I had gotten the idea that a city was bigger than a state and couldn’t figure out how New York City could be IN New York State. But even then, my world consisted mostly of trips to New Haven, CT to see my paternal grandparents and Bennington VT to see my maternal ones. And then there was the occasional trip to Boston to see my aunt and uncle (technically half-aunt, but there was never anything half about Aunt Sue).

At one point, I want to say when I was seven or so, I know I did a trip with my parents to Cape Code and to Bar Harbor ME. My world was getting bigger.

A few years later, a very different trip to Bar Harbor and then the Cape. That ended well but didn’t start so well.

Then a few years after that my world jumped in size. My dad and his then girlfriend and her daughter (four years my junior) and I travelled first to the Grand Canyon and Havasu Canyon. Suddenly I was outside the comfort of the northeast. And I loved it.

There were a few trips to Florida in there too, including my first time flying alone.

A few years after that I went to St. Croix USVI with my dad. My first long flight over water.

Years later I accompanied my paternal grandmother (my grandfather having passed on years previously) to the UK for my cousin’s wedding. Again, my world had expanded.

The NCRC has also helped expand my world due to having training all over the country.

And over the years, including this one, I have been back to the Grand Canyon three times since and have with the family seen much of the west coast, the Rockies and more.

And pre-Covid, the family and I visited the UK, France, and Belgium. My world continued to grow.

Going forward, I’m sure I’ll see more of the world.

And yet, in some ways, my world has shrunk and for a sad reason.

Other than a couple of brief trips to or through, I haven’t been to New Haven since my grandmother’s memorial.

I still go to Bennington, because my mom is there, but even then there’s a bit I don’t go to, my grandparent’s house. It’s no longer in the family since they’ve passed.

I’ll go to Boston again, but not as frequently since my aunt has died.

And I have yet to go back to Falls Village, ever since my closing out my dad’s estate. That one is just too hard, even years later.

You’ll note there’s a theme to the places I’m less likely to visit. And it’s one that I expect to become more common as I age.

So the world is bigger than ever and I’m still exploring it (as my spring road trip shows) but ironically in some ways, it’s grown a bit smaller. And that saddens me.

And so it goes.

F’ Cancer

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This year I’ve lost two people close to me. Both died of cancer. Their deaths have hit me in different ways. Both were linked to each other and to me through caving.

I obliquely referred to the first in a post earlier this year. Don Paquette was a friend, colleague and mentor. His intensity could easily fill a room. As an instructor, he was quick to let you know where you stood. I know some thought he might be overly harsh or strict or that he might have unreasonable standards. But the truth is, he simply wanted everyone to try their best. He didn’t necessarily expect everyone to be perfect in the skills taught. But if he thought you could do better, he’d push you to do so. And deep down, he cared.

Don was known for judging how well students would lay out the gear cache during training. He felt strongly that a well laid out gear cache was a key part of a well-run and organized rescue. In the last few years of his life, when he couldn’t make it to training, I’d text him a photo of a cache and wait for his grade so I could report back to students.

Don might give this a B on a good day

He also was an advocate of what some might call a “Command Voice”. A command voice was more than simply being louder than the rest, it was a tone that caught your attention, made you listen, and moreover, want to to do what was asked.

And that’s where Cordelia Ross enters the picture, or Cordie as we all knew her. I first recall meeting Cordie at the NCRC weeklong in Indiana in 2009. I was helping to teach the Level 2 class, along with Don, while Cordie was taking it. During much of the week, Don kept encouraging Cordie to be a bit louder and more commanding. This wasn’t exactly Cordie’s style however.

Cordie is on the left

We were doing an exercise in Sullivan Cave. The students weren’t quite as organized as they could have been, but as one of the goals of Level 2 is to teach leadership, we as instructors were sitting back letting things unfold to see how the students would cope and if they’d organize themselves.

And then it happened. From the top of the breakdown pile we heard a loud and commanding voice: “Stop!” Everyone, and I mean everyone, including the instructors, stopped what they were doing and waited for instructions to come forth. I recall looking up at Cordie who then, in a much quieter but forceful tone started to direct her fellow students on what to do next. It took us instructors a second to realize that she wasn’t giving us commands. But her voice had been so commanding for an instant, had she given us instructions, we would have no doubt followed them. We liked to joke that Cordie had found her command voice. But she made it clear, she hadn’t found it, she simply had used the one she had had all along, but held in reserve until the right time. I tend to think she was right. After that Don never again gave her any flack about her lack of command voice.

That episode with Cordie really personified her to me. She was a petite woman, often surrounded by firefighters and cavers twice her size. But she was the mouse that could roar. Many might describe her as quiet, but that wasn’t true. When she did speak, it was with authenticity and power. Many might underestimate her, but never more than once.

In my final visit with Don, we talked about many things, including our times instructing fellow cavers. He reminded me of a time where we played a prank on a set of students on a haul team. He had a deep sense of humor. His death was tough and I grieved and still grieve for him, but also know that having lived into his 70s he had lived a good life. He had seen his kids grown and even watched his grandkids grow up. We often talked about his travels with his family on Amtrak. While I know he would have loved to live longer and had more to do, he expressed no regrets to me. He led a good life.

Cordie’s death though strikes a deeper chord. Her family was just starting. Just over a year ago she had given birth to her daughter, Viola. Her cancer diagnosis was a surprise and sadly didn’t give her enough time in this world. Her husband Wayne now has the unenviable task of being what some might call a “single father”. Technically that may be true, but I know there is a whole community out there that will help him. And much of that community will help Viola know the woman who was her mother. Whereas Don had much to look back on, Cordie had so much to look forward to. Cordie looked forward to being a mother and I suspect far down the road, a grandmother. She had so much she wished to teach Viola. And Viola, sadly will never grow up truly knowing her mother. The world is a smaller place because of Cordie’s untimely death.

Whereas Don and I talked Amtrak and travels, Cordie and I discussed New England (because she had gone to school at Dartmouth) and literature. Both were people to whom I had a connection far more than simply caving or cave rescue. Both are people that I dearly wish I could sit down with at least one more time and talk to.

Both I will miss but in different ways.

And for both, I say fuck cancer.

Holy Frack! Less than 24 Hours

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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!

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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.

That was Then, this is Now

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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

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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.