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.

“Remote DBA Wanted”

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Since I have not really deactivated or updated my LinkedIn profile, I still get emails and the occasional text tempting me with a job offer of some sort. And as I sit here, trying to contemplate my study plans for the night and weekend, I have to say the idea of responding to one of them is appealing. For one thing, the money would be far better. Instead of burning through savings, I’d be building savings back up.

But the truth be told, that thought is only a fleeting one. Firstly, I’ve been away from active DBA work for a couple of years now. I’d have to take time to come up to speed and that would be stressful in and of itself. But also, ultimately I suspect I’d be bored or frustrated again.

And there are definitely nights I miss working as a Tech in the ED. Yeah, there were shifts I hated, but overall I enjoyed it. However, I’ll still pick up some over holidays over the course of the next year. That should sate some of my desire.

My biggest doubts come on nights like tonight where the doubts creep into my head. One of my classmates has tracked how many tests and quizzes we’ve had and the approximate number left in our didactic year. I don’t know the number, but it’s up there. Each one brings a new period of stress. And of course, after our didactic year comes our clinical year, 10 rotations, 4 weeks each. Not only will I be stressed about each area I’ll be assigned to, I may often have to figure out housing for that period of time (and how to pay for it!)

But I remind myself, that it’ll be worth it. That the ED is where I want to be, and while I think I’ve done a lot of good as a Tech, I hope to do even more as a PA.

But those regular hours, and higher pay, they are tempting. Just not like they used to.

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.

“What’s your favorite cave?”

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Today I had the pleasure of co-leading some incoming freshman to RPI on a caving trip. I was asked a question I’ve been asked before and honestly, I don’t have a single answer for it.

“What’s your favorite cave?”

It sounds like a simple question, but honestly, I can’t easily answer it.

I can say that the cave I was in today, Clarksville Cave, is not my favorite cave. Though, if the question is qualified, “What is your favorite cave to take beginners into?” then Clarksville might be up there. It’s close to the road, easy parking and enough variation in terrain to make it interesting and challenging to almost any beginner.

A cave that ranks near the top of my favorites would be Eagle Cave at Chimney Mountain. Traditionally it wasn’t the easiest to get to, it was about a three-quarter mile hike up the mountain which could be strenuous. But parking was easy. That was then. Now, because some cavers or hikers could not respect the wishes of the folks who owned the parking lot, the landowners no longer allow parking on their land. This has turned the approach into a 5 mile hike. I have not been back since.

That said, the cave is a great one because unlike most in New York, it’s not solutional. It was formed basically by the side of the mountain falling away. It’s very different from most New York caves. But it’s also a 2.5 hour drive from home. So, is it my favorite? I don’t know. It’s got a lot going for it, but also has some drawbacks.

What about Knox? Great cave, I love it. And I’m thankful for the bypass to the Gun-Barrell, or else I’d probably stop going to it. It has a lot of variety and a lot to see. So it’s up there among favorites.

If I look beyond New York, I could add Flowing Stone as one of my favorite vertical caves.

Or I could add Tumbling Rock as it has some awesome features.

But what if I include commercial caves? (including National Parks) Then I might put Carlsbad up there. The large room is still one of the most impressive rooms I’ve seen in a cave.

Lava tubes? I can’t say I remember the names of too many, but there are some cool ones out there.

I guess I can’t say I have a favorite cave.

But I can say I have a least favorite one: Park’s Ranch Cave. No offense but…

And even then I have some fun stories to tell of it.

One Semester Down

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My final exam of the semester was yesterday (Wednesday morning) at 8:30 AM. It was our 5th exam of the semester in Anatomy. I’m not sure why, but stuff wasn’t really clicking for it. I did about as well as I estimated I would do, but not nearly as well as I would have liked. But I’ll live with it.

I’m waiting for two final grades that represent 35% of the grade in a 2 credit class. I expect them to be decent and assuming no surprised, that means I’ll finish this semester with a 3.2. In a previous post I mentioned we need a 2.7 or better to continue So I’m good on that. That said, it’s not the 3.7 I thought I was looking at mid-semester. I should be happy and proud, but honestly, I’m still a bit stressed. My last two anatomy exams definitely had a bit of a drop and two of my exams (including one of the anatomy ones) that I thought I did really well on, I didn’t.

I’ve mentioned this to a few folks, but needed to elaborate a bit. It’s not the grade per-se that bothers me. It’s fact that I thought I had done much better than I actually did. I’ve walked out of one or two tests (including this last anatomy exam) not feeling great about it, and the final grade reflected my feelings. But when I think I did great and didn’t, that’s another whole story. It’s giving me a lot of self-doubt.

But my advisor and other faculty have assured me not to worry. But, I will.

That said, I’ve been analyzing some of the reasons for not doing as well on the exams as I would have liked. Some is simply “this ain’t easy.” I didn’t expect it to be and some of it is rote memorization and that’s honestly harder for me. Don’t ask me about all the muscles in the lower leg and foot and their innervation or vasculature.

Some of it, I honestly was trying some different study techniques that didn’t work. I honestly should have taken my own advice and gone back to what I wrote about here. I had started to rely a bit too much on using ChatGPT in a particular way (basically a “quiz” mode) that I ended up being a bit biased in what I felt confident one. That I think explains a lot of the issue with the two exams where I walked in really confident but didn’t walk out with a great grade. I’ve gone back to some of my basics and also modified how I work with ChatGTP. While my last anatomy exam wasn’t nearly as high as I’d have liked, I think it was far better than it would have been had I not adopted these changes to my study methods.

My advisor and mentor and our didactic coordinator have been great. They’ve given me some good advice and guidance. A common them I’ve heard is that while the work gets harder in some ways (and more of it, 25 credits vs 18), there’s less memorization and more integration and honestly, I think I’m better at that. So we’ll see.

I should note, nearly one-third of those credits is Medicine 1, an eight credit class. So a lot is riding on me doing well in that class!

I think if I can make it through the second semester, then I’ll be set. Not to say it’ll be easy, but I’ll be that much closer.

My biggest stress about my clinical year will be the logistics. But that’s about nine months away.

That said, the other emotion running through my head is, “I should be studying.” I’ve spent pretty much every waking hour of the last 10 weeks studying. Not having something immediately study for is really wreaking havoc on my brain. I’m trying to get a bit more into “relax” mode and having difficulty.

I wouldn’t exactly say it’s trauma, but in a sense it is. I haven’t really been hyped on adrenaline for the past 10 weeks, but it does feel a bit like withdrawal.

So I’m home for about 10 more days. What am I going to do? Pick up some shifts in the ED. Partly for the money, partly to keep my skills sharp, and really honestly, to catch up with my coworkers. I honestly miss them.

I’m going to take a bunch of incoming freshman at RPI on a caving trip.

And I’m having a pool party.

And then at 9:00 AM on August 25th we start fall orientation. That’s of an hour and then it’s straight into our first lecture: “Evidence Based Practice.”

Near the End of the First Semester

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Well, the first semester is almost over. It’s been over a month since my last blog entry. I had hoped to blog more often, but well honestly I haven’t had the time or energy. To give you an example, this past Saturday I never left my apartment. I spent pretty much the entire day studying, and most of that for a single exam which was this morning.

And to be honest, I’m not sure I did as well on the exam as I had hoped. And a week ago, I walked out of an anatomy exam, thinking I had aced it, only to discover the next day I had barely passed it. By far my lowest grade yet.

I’ve tried to tell myself, “it’s only one grade” but truth is, it’s rattled me a bit. Scratch that, a lot. And not knowing this morning’s exam grade has me on tenterhooks.

Compound with that this Wednesday is another exam that I definitely do not feel prepared for. And strangely, I wouldn’t say it’s necessarily the hardest subject or even hardest exam, but it’s perhaps the most objectives we’ve had in a single exam. So after taking a short break, I’ll get back to studying for it. I’ve already spent close to two hours on it today and will spend at least four more today and probably eight tomorrow. And even with that, I know it won’t be easy.

But enough of my complaining. I wanted to share something else.

While I sit here and question my life choices between two hard exams, I thought I’d share one update.

I blogged earlier that when I got accepted at Arcadia, their program was on “Accreditation – Probationary”. This was a bit concerning because in theory their accreditation could have been yanked and I’d be out money and time.

But, I talked to a couple of faculty and staff and chatted online with one of the students at the time. No one could make any guarantees, but their comments and answers did give me a good feeling. So, between that and the honest fact no other school was willing to take a risk on me, I accepted and obviously am now attending.

Well about two weeks ago we finally got an update. Arcadia is now “Accreditation-Continued”. This is excellent news. This means barring a catastrophe (like the entire faculty coming down with Ebola at once) when I graduate, I can set for the PANCE (our certification exam). So that’s one bit of good news.

So I’ll close on that.