What Next?

Looks like Google changed the design behind the scenes, and I haven't taken the time to figure out how the new set up works. Hmm. Anyways...

I'm going to be finished with my Job in roughly two weeks now, and I'll get to move back up to DC. I'm happy about that, since I've realized I like living there a good deal more than out where I am now. I'll miss my job a bit  - it really was fun and neat - but I won't complain about the extra sleep/time. I'm sure I'll be able to eat better and, as fun as being on the night shift was, I'm not going to complain about going back to a regular schedule either. It makes it a lot harder to take care of basic things like getting groceries, cook meals, or exercise when you're up all night and asleep all day. It was fun, but a bit harder to keep up than I'd expected.

I'm probably going to have surgery on my right shoulder to fix that up at some point in the near future; that's the main reason I'm finishing my job now, although I have various other less legitimate reasons as well. At any rate, I decided I didn't really want to stick around for the new company taking over our contracts, so I'm off.

What happens next?

Well, I'm becoming more and more anxious over the MCAT. I'm close to ready, but not quite there yet. There's too many equations that I memorize, and than realize I've forgotten two weeks later. I've certainly made progress, and can probably get an average to slightly above average score at this point. The problem with that is that an average score is too low to get accepted anywhere in most cases. So, I have to decide if I want to take it as scheduled, or put it off two months or so (no way am I putting it off a whole year again, I'd just get lazy and stop studying if I had that much time. An extra two months would be very helpful though, and I feel confident I'd do well enough with that time).

The problem is that if I put it off two months, I pretty much can't apply this year.

I don't want to put my application off another year. I really really don't. And I don't want to deal with the feeling that I failed to get ready in time (although, apparently, I sort of have. And it's probably best if I can just come to terms with that). The upside is that if I apply next year with a score from this year, I can apply at the very start of the application cycle. That would help out because most schools have rolling admissions, and I'd be at the very front of the line before any spots were taken up. If I take the test as scheduled in June, I'll be close to the back of line. Then again, it doesn't look that great on my part if I've taken two years to get this test over with - even if I do get a nice score on it. I'd have to get a really nice score to make people gloss over that fact entirely.

So, looking at all of these facts, I went to talk to my premed adviser who said.... nothing.

Yep. That's right. I've still been trying to get in touch for nearly a month now. I've been leaving e-mails, and physical papers. I've been trying to drive up to DC to stop by in person. No luck on any count, I just can't manage to get in touch. I'm not sure why. It definitely leaves me feeling like things have dropped through the cracks somewhere, somehow. That alone makes me lean towards taking the MCAT a bit later. I have no idea how my committee letter is going, or if it's even being done as I was told it would be. I'm very hesitant to send out an application not having a clue what's going on with the people I need to back me up behind the scenes.

I can't really explain how frustrating this is, but you can probably guess.

Anyways, I /think/ the last day to change my test registration is June 7th if I understand what I've read correctly, so I have enough time to try getting in touch with people a little bit more. If I can't get in touch with anyone before June 5th, I'll probably postpone the test by default. If I can get in touch, I'll see what they think should happen. I'm still leaning towards putting it off two months, since there's really no reason to take the test if I'm not positive I'll do well on it (there are even good reasons to not do that, since it would stay on my record).

I'm just so unhappy at the thought of putting it off more. But we'll see. Maybe that's the best choice, unpleasant as it is.

Or... Hard to Wrap Up

So I thought it would be fairly simple to streamline my old 5200 word personal statement, fashioning it into the required 5200 character one. Since I had (and still have) so much MCAT studying to do, and since I didn't expect this to be much of a challenge, I put it off.

The other day I decided I'd drive up to my old apartment and work on it on the little net-book there, so I'd be free of all the distractions that can jump up when one is trying to write. Big mistake. I'd never used the net-book for word processing before (it's not mine, it's my father's, and it's just been laying around my old apartment), but it turns out you can only see one paragraph or so at a time on its monitor.

Needless to say this drove me crazy. I got some basic outlining done, but no real work, and essentially wasted the day driving there and back. Working on the statement at my home computer today, I realized it's actually a lot harder to distill a 5200 word essay into a 5200 character one that you might think. I'm practically having to do a new one.... only I don't have the time for a new one, since this has to be done by the time I leave for work tomorrow evening.

I'm confident I'll have something done, so in the worst case scenario it will at least be finished. It's my sincere hope that the April 15th deadline is a "soft" deadline though, and I'll be able to snag two or three days more to edit this. I won't be able to find that out until April 15th though.

Unfortunately though, it looks like I finally have an application blunder I can't pin on anyone but myself.

All My Cards In Place

I had a chance to talk to the last person who needed talking to today; the professor who I needed to help me with my committee letter. She's still up for it, and I e-mailed her the necessary papers today. So, more or less, all that I need to do now is find a way to manage my MCAT (and edit something I wrote last year by April 15th, but that will be easy enough to wrap up).

A New Employer

So we got an e-mail today saying that we (the scribes) are going to shift from being EMA employes to being employees of a company called (I think) Scribe America. I don't like change, just in general, so that was a bit stressful to find out. Especially because the e-mail didn't really go over any details.

I followed up with someone in HR and it looks like we're guaranteed employment with the new company (at least initially), and will remain employed at the same hospital we're at now. Both of which came as a relief. Apparently the actual change won't take place for roughly three months, so it's not worth stressing over. If I'm going to stress over something for the next three months (and I am), I want to make it the MCAT, not this.

My initial feeling is that it's too bad though. I liked the company that hired me for whatever reason. Even named my adopted cat after them... but guess that's not enough to prevent change.

Anyways.

I followed up with the premed people at AU who (hopefully?) will get my e-mail this time. Sent them an updated copy of my resume and tried to check in on the status of my letters of rec again. I tried to talk to my faculty mentor there last week, but she was out because of car troubles. Hopefully I'll be able to see her in person next week, since I have a few things I'd like to discuss with her.

I'm rapidly doing some physics review now, and plan on starting my fancy expensive online MCAT course by March 21st. I wanted to quickly do my own physics review before I start though, so I can have gone over all the topics on the exam in at least some detail.

I might have talked about this earlier, but physics really is magical. I lost sight of that in the midst of exams, and stress, and stuff, but it's neat. Where else can you be "we need to find the distance/acceleration/whatever of this block going down at this angle, but to do that we'll pretend it's going down and horizontally in two separate vectors rather than the one vector we actually see.... and that will let us solve for one variable, which won't actually give us an answer.... until we decide to plug that into the equation for the second one!" And then all the answers just suddenly crystallize.

I don't know exactly how to describe it. It just seems so arbitrary/forced/nonsensical, but then all of a sudden it all comes together so perfectly. It's neat.

At any rate, I feel like I can do the basic problems I've looked at now. Or will be able to, once I sit down and memorize the equations and get some practice. Will I be able to do them fast enough to score well? That's another question. But I'm hard at work on it.

My Day's Been Made

Well: I'm was plagued by insomnia (bad start to the day), so I got up and called my post-bac's premed office one last time before driving up in person, in the hope I could get an answer and not the voice mail for once. I was pleasantly shocked and surprised when that's what happened. I was even more pleasantly surprised when they confirmed that I could, indeed, still get a committee letter. That puts a /lot/ of recent stress I've been having to rest. A /LOT/.

I also found out they still didn't get my physics teacher's letter of recommendation after he submitted it twice (really?) and it looks like one or two other things might have gotten misplaced over the last year. One or two other things yet need updating (like my resume). But all that bad news pales in the knowledge that I can actually get my committee letter as planned.

I also talked about the MCAT date I signed up for (June 21st; oops, forgot to post about signing up for it again, but that's when I'm up). It sounds like it's not too late to use. And I can get the old "meaningless" fluff letter of rec from my personal physician replaced by a much more professional one from the doctors I'm working with now (if their letter is received... grumble... I'd better get ontop of that post-haste, actually, since the dead line is April 15th and I wouldn't be at all surprised if they told me it hadn't been received).

And lastly, I definitely need to get in touch with my faculty mentor (something I should have done months ago, but was just too stressed out over thinking I no longer had a mentor or committee....). I'll try getting in touch with her by e-mail asap, and if that doesn't work I have two days off work this week I can use to drive up to DC and try to say hi.

So there's a lot of stuff that needs to get done. But overall, I feel great right now.

In slightly unrelated realms work has been going great as well. I keep getting to see all sorts of interesting cases, people, and procedures. I get to pick up a few basic things, and find out all sorts of tidbits (three or four consecutive ribs in an area can get broken and left to heal with just pain medicine - body casting was used for that decades ago, but it found that hurt much more than it helped because disease was induced as contraction of the rib cage was prevented. More recently, another study was cut short in which we were trying to treat slightly irregular EKG's of the type produced by having a bit of hypertension and excessive caffeine, where you have occasional skipped beats. It turned out that most of the medicines resulted in premature death, and there was very little adverse affect to having your EKG be slightly off baseline in this manner in the first place.)

Some people are really fun to deal with. Some interesting. Some you just have to. And very occasionally someone comes along who you wish hadn't. Someone who'll harass the nurses, or hit them because they're drunk or in an altered mental state or for whatever other reason. When you're working with people for 12 hour shifts most days of the week, you can end up seeing them more than your own family, so when someone comes in and does anything like that it's incredibly upsetting.

Of course, that's just a randomly chosen example that by no means necessarily occurred. But the ED staff works hard, and occasionally has to put up with various stuff they shouldn't. It's tough work, and people there can really empathize with one another. That's one of the nicest parts of the job too though, I think - you really do get to spend a lot of time under stress with the people you work with, so they do become like family. In a way.

As for me.... I guess I'm going to go have lunch and try to fall asleep again. I have to do this whole work thing tomorrow, plus get back to studying for my MCAT on double pace now that my biggest concerns have been cleared up.

Kaplan

Well, my cursory chemistry review is continuing on pace - I'm a bit over half through. I remember everything I'm reviewing, although there are a few types of problems I won't be able to do without some more in depth studying than I'm giving them at the moment. That doesn't worry me too much though; I was able to do them in school, and am quite sure I'll be able to do them again with a more in depth review after I finish this cursory sweep.

The chemistry section is somewhat naturally more given towards problems and equations than the general biology section was. I'm not sure how this will play out in the actual MCAT questions on chemistry yet (will they somehow be broadly generalized and passage based, as in biology, or will the passages involve the need to have more equations memorized). While I'm not worried about it, I am interested to find out - it could have a big impact on Physics, where I'm not half as confident in my ability to review and remember things that I never fully understood in the first place.

If the chemistry questions are largely broad-based though, then it's very likely the physics ones will be as well. And that would be good news.

As far as other studying stuff goes, I looked around the Kaplan site a bit and they have a few packages. The one I'm leaning towards costs a somewhat painful $1900 dollars to sign up for (although there's a $250 rebate of sorts). I'm pretty positive I'll be signing up for that in a few days nonetheless though, once I get my checks to post at the bank. Given the test design, this seems too helpful to not take given the opportunity.

I've still had no luck getting anyone from AU's premed office to reply to me, despite leaving a voice mail and e-mails. Fun. So I went and e-mailed my old undergraduate premed office at Vanderbilt with a few questions today. Hopefully they'll get back to me next week sometime - they've been good in the past. I'm going to wait on that before registering for the MCAT, although that needs to get done really soon too.

First Practice Test (Segment)

So I finally took a practice segment for Biology. I didn't do great, but I did ok. Or I would have apart from one set of 7 questions that I bombed. Had I gotten those though, I'd be happy (enough) to move on. So what I'll do now is review DNA/RNA again (since those 7 questions came from that area) today and tomorrow. The other few questions I got wrong were, for the most part, things I either should have got right or could have with a bit more review. But the review neccesary to cover every complete set of possible questions like that is time consuming enough it could go on for months, which doesn't work. Getting 2 or 3 more questions right by spending another month on Biology doesn't make sense when I can spend that month on Chemistry and get an extra 10 right (or however many). At any rate I'll start working on Chemistry on the 13th now, almost on schedule, and will keep looking over my Biology notes periodically.

The biggest thing I got out of this though was that it's not a science test. At all. I know I posted that earlier from reading it and being told that, but since I hadn't taken any practice segments I didn't really know what the test was like.

Of ~40 questions maybe only 8 or 10 required "know this" knowledge. The rest was largely stuff you could get from passages if you had an idea what was being talked about. So most of the questions I got wrong (apart from that section on DNA) ended up being things I could probably get right just by taking a hundred practice tests - a lot like the LSAT. A lot of the stuff I spent the last few months looking at was talked about (Lutenizing Hormones and Follicle Stimulating Hormones, for example), but it was looked at in the context of a passage and not as a "LH is created in the a) anterior pituitary, b) thymus, c) pineal gland, or d) hypothalamus". You didn't (really) have to know what LH did either, you just had to have a hang of the basic concept.

This steers me a lot towards buying Kaplans online program. Or at least looking at it closely in the next few days. It also steers me in the direction of rushing through my traditional studying in favor of spamming practice exams once I've got a very rough hang of the basics.

I'll try doing Chemistry fast in ~2 weeks, and we'll see how that goes. If it works just as well as having spent ~2 months on Biology I'll be very happy, because time's a commodity here.

Updates

No posts since January 10th huh? Wow. It's been awhile. Part of that's probably due to a week long vacation I took where I went traveling. I was "almost" sick throughout. You could think of that as either good or bad, I guess. It broke out into a real cold once I got home (which I can only think of as bad...) Otherwise things have continued to be uneventful but busy.

I'm still waiting on a reply from the premed office concerning the maintenance and status of my file there. Technically it's only been two or three days, since I sent my e-mail on a Friday and they don't work weekends. To me though, it feels like it's been closer to a week. Which is frustrating. My current frame of mind is that I'm going to just put the application/file on second priority (although it's still, obviously, important). What I want to focus on is the MCAT. If I take it and score well, things will work themselves out with or without good support from the premed office. The worst case would be I have to postpone my admittance a bit. Conversely, if I don't get a good MCAT, it really doesn't matter if my file is in good order or not because I won't get in anywhere.

Speaking of the MCAT, my Biology reviewing is going well. It's almost finished, in fact. I aim to wrap that up by February 12th - taking a little biology section practice test from Kaplan. If I do reasonably well on that, I'll move along to Chemistry which I hope to complete reviewing by the end of February (not much time, but it's probably my strongest subject to make up for that). If I can stay on schedule with those two, things will be going fairly well.

I have to sign up (again...joy) for the MCAT. I'm hoping to hear back from the premed office first, but if I don't I'll just go ahead with that anyways towards the end of this week or the start of next week.

And lastly, regarding HIPAA and patient privacy, I simply haven't had the time to look into what I can and can't legally post. I still would like to check into that at some point, but I'm occupied enough with MCAT work, job work, and trying to sleep that it's not likely to happen soon. So I have two choices. I can either take this off the internet and turn it into a personal log which no one would ever see, or I can keep it up and just not include anything that could even remotely be construed as a violation. I'm sure no one is reading this but me anyways, so it probably doesn't matter, but I'll take the second choice for now. I enjoy having this up even if I am the only one who looks at it.

A Patient I /Can/ Talk About:: Me!

So today was an interesting day. It was an off-day from work, which I started with my "morning" coffee around 7:00pm. I told the lady there I'd just woke up, and she asked what I did. When I told her where I worked she went off on this awkward rant about how she didn't like my hospital... and I was a bit too dazed to reply well. If I hadn't gotten up I'd have probably worked harder to explain how everyone at the hospital tries the best they can to get everything done quickly but well, and how hard it is to do everything both quickly and properly, but how we really do try for that. As was, I just wanted my coffee and a quick exit.

Anyways. Later after "breakfast" I came back home when it was all dark, and tripped over an empty litter-box in my hallway. I caught my arm/shoulder on the wall falling, heard a bit of a crack, and felt a lot of pain (that quickly subsided in a minute or two). Normally I probably wouldn't do anything about it, but I was a bit nervous since I have a history of shoulder dislocations, as you probably know if you've been following this blog, and wanted to be positive I didn't keep it out over night if something /was/ wrong, even though I was pretty sure it was just in pain but otherwise ok (the biggest clue was I had full range of motion, with pain, and in all my previous dislocations I certainly haven't).

I really didn't want to go to the ED because I know first hand how busy they are, and how many unnecessary cases they get, and I felt kind of awful becoming one of those.... but I ended up going anyways. I have a vacation coming up, and I didn't want it spoiled by an actual injury.

Well, needless to say I was ok (which is fortunate, but was unpleasant at the same time, if that makes any sense. I'd kind of have rather had a minor discernible problem). Everyone was nice and worked well to get me in, and it was fun seeing things at the ED from the side of a patient for a change.

I guess the take-home message here is that I should try to be a bit more mentally accomodating of people who come in with complaints that make one go ::sigh:: It's really easy to get tired of them after you run into enough, and to start looking at people as room numbers. But everyone really is a person, and you shouldn't let yourself forget that. They probably did think they should be in the ER, even if you can't really understand why.

As for the shoulder, it's ok. I got some extra-strength motrin and just a few pills of hydrocodone to last a day or two. Hopefully it will all right itself by then.

As an aside there was another patient earlier this month or last that I'd like to talk about but, obviously, I can't. I'm going to read up on HIPPA and privacy stuff, and see if maybe it would be ok to talk about a hypothetically similar case that doesn't actually have anything to do with the real one, but manages to broadly convey what I was feeling. Because it created an interesting ethical situation and left quite a mark on me.

So I haven't Stopped Studying

Not yet at least, this time. This is, needless to say, good.

What's more interesting than the fact that I'm still studying is that while I'm studying I run into stuff I've been seeing/doing at work, which makes it a lot easier to remember things. I've been recording/tracking the blood and protein returned in urine tests, for instance. Then I studying I learned that what those are looking for (among other things) are possible defects in the glomerulus of the kidney (which is supposed to "filter" out large molecules). You get an "oh, neat" moment when you read about stuff you've been doing. And then it becomes even more interesting to do as well.

The other day when the pace slowed down for a bit in the ED I also got taught what an x-ray of a patient with pneumonia looks like, some basics of ekg reading, and a four-step outline for treating hyperkalemia in patients.

Fun stuff.

What I Learned (2)

Takotsubo Syndrome: Commonly referred to as Broken Heart Syndrome because it's a condition typcially precipitated by severe emotional stress, Takotsubo Syndrom is a sort of cardiomyopathy that is hard to detect on an EKG because it mimics the readings that would be expected of a STEMI (a type of heart attack - ST elevated myocardial infarction).

In Takotsubo Syndrome however, the left ventrical of the heart gets bent out of its proper shape. It's a (relatively) recent diagnosis, originally discovered by researchers in Japan (Takotsubo means octopus pot, a reference to traps used to catch the creatures and, in this case, the shape assumed by the deformed cardiac muscle), but is being seen somewhat more commonly in other countries now that people know about it. If the patient survives the initial attack, the condition is usually temporary and resolves itself over a period of several months.

I ran into a case of this. Very sad that the person had it of course, but I think the idea that you can actually get broken heart syndrome/die from a broken heart is really fascinating.

In other affairs, I've changed my MCAT study approach from trying to knock out my worse subject first (Physics), to trying to start with things I'm better at (Biology, and I'll do Gen. Chem after that). With the hard stuff first, I was making very slow progress. With slow progress I'd constantly see how much other material was left to cover, and I'd freak out even more, which would further slow my progress down until I "took a break" (read, stopped). The idea here is to simply knock out what I know I can knock out, and then do the hard stuff last (but hopefully still have over a month for it).

So far, this new approach has been going very well. I've gotten a lot of Biology review done in the last few days, and if I can keep it up things look to be going great. The biggest catch is to not get /too/ caught up in the details. It's a fine line - the MCAT expects me to know a lot about respiration, for example, but it doesn't expect me to know all the details of the proteins involved in the ETC, or all about ubiquinone, or every individual reaction that takes place in the Krebs Cycle. It's easy to get side tracked into trying to re-memorize all of that like you might have for a normal exam, but that's not a good use of time (and will put undue stress on you as well, because memorizing that many details isn't a simple task).

Anyways, I hope you all had a happy Thanksgiving if you're reading this (and if you're from the US). I had the day off and got to spend some time back home, which was nice. I'll post again later.

What I Learned (1)

Children get lots of ear infections. I know I used to as a young kid, and in general I've seen several people come in complaining of that lately. I never thought about it until a few weeks ago, but I realized that at "some" point I'd more or less stopped getting ear infections entirely. Why was that?

It turns out that children have smaller Eustachian tubes (little tubes linking the pharynx to the middle ear) in their ears than adults, and that the tubes are more level than in adults as well. These conditions combine to make it hard for fluid to drain from a child's ear - especially when the tube is partially filled with mucus or another substance. This creates an ideal condition for bacteria to be trapped, starting a middle ear infection (otitis media).

This isn't actually the first thing I've learned from my job, but it's the first thing that hit me as ::Oh! So that's why that happened!:: I think I'll try to put down future stuff on here occasionally that I find interesting. Especially since there's not too much else I can go on about without violating patient privacy laws or simply getting painfully repetitive.

November Schedule

Well, there's no way of knowing how my schedule will keep working out in Dec/Jan/etc, but for November at least I've been able to get one that's entirely made up of 9pm and 10pm to 7am shifts, which is fantastic (doubly so, if I can keep that going for the next few months as well).

I should be a lot less exhausted with a fixed schedule. Even if it's one fixed at night like this. Plus, as I'm sure I've said before, I enjoy being around hospitals at night (always, really, but especially at night).

Whether I can make good use of the new schedule with studying remains to be seen. If I can't... problems. If I can, things might be looking up.

What do they call someone who got a 70 in Med School?

A: A doctor.

Words of encouragement from a nice Doctor who had the night shift after I had just passed my training (yay! I passed~) on the lower end of the score requirement (not 70, since we needed an 82% to pass, but same idea). I didn't do all that bad, really. I don't want to overly criticize the test, since we're not supposed to criticize/talk about internal processes, plus it's not fair to since they're in the middle of rearranging the test. I'll just say that because of that rearrangement a few questions were asked multiple times and, for some reason, those mostly happened to be the questions I didn't know. So instead of getting -1, I got a few -2's for not knowing one thing.

Not to excuse me or anything - I'm still responsible for knowing the material whether it's asked one time or a hundred.

From now on there's just sort of a constant evaluation process I think, where the HPIs/forms I write up get randomly audited on a once (I think) per month basis, and an unknown doctor evaluates me once per month as well. So if I can do ok, and avoid making anyone dislike me, things are starting to look like they're going well (enough).

My biggest concern is getting to my studying now. My exam studying. As neat/fun/interesting as this job is, it's been a huge drain on my time completely incommensurate with the number of hours I've been working. Studying for the job, taking shifts at odd hours, and driving up to DC for my PT, and then back for a job, has resulted in me staying up for the better part of three days in a row at times, with little naps here and there. I'm hoping as of November I'll get a more consistent schedule, and I know I can officially ease up with the job-related studying now. But I still have to find/make self-study time.

My apartment still has little furniture. I'm giving increasingly serious thought to a sofa as a place of study because otherwise... I'm just doing it on the floor or something. And that's not conducive to studying at all. A table is probably less relaxed than a sofa, but I've not been too goo about working at tables previously; a little bit of coziness isn't all bad. It would have to be a pretty cheap sofa though...

Is The Month Over Already?

Well that went fast. Way too fast. On the up-side I have a job I like and have learned a ton of things for it. On the downside, I'm going to be tested on those things in a week or so and need to make sure I do well enough to keep the job.

Between that, my move, and my adoption of a new cat/kitten (Her name's Ema, and she needs to go to the vet soon too...) I really haven't been able to get my "real" studying done. I've also had multiple problems with companies thinking bills are late because my change of address apparently didn't work properly, and my insurance company is now saying I owe some 30,000 dollars for my surgery (which I don't....) I have a lot of excuses, and feel that they're "good" (or as good as excuses can be) since all the stuff that's been keeping me busy lately has been necessary, but this is still starting to get problematic a bit; it's beginning to get worrisome at the very least.

At any rate. The plan is to keep focusing just on job stuff until my exam for that in a week, because I really couldn't deal with loosing this job through being unprepared. After that I'll turn my attention back towards my real studying. The upside here is that the necessary learning for my job started off steep, but really plateaus and I can relax once I get it all down. It's true that there's plenty more I can learn /through/ the job, but that's more a perk of the job than anything needed to /do/ the job. So if things work out here I know I'll need less time to study my for job, and will have that time back to study for my MCAT.

My Move

Well, I haven't posted in awhile, but it's not for lack of happenings this time. It's just that I was without internet access until today while I waited on Comcast to get things set up in my new place (and it's still not entirely set up right, but I do have my cable now. Only need to figure out how to use the wifi to connect it to my tv and other things).

Anyways, I've been very busy lately. Moving in was pretty exhausting. There were a lot of boxes that had to go up three flights of stairs, which was a huge pain, although it will be worth it later. It's nice being on the top floor of places, and having no one thumping on your ceiling. My apartment is pretty well located as far as neighbors go, actually. To one side is a cable/satellite/mechanics room so I have no one on my right to bother (or who'd bother me), and because my apartment is in the corner of the building in a sort of broad V angle, I don't have anyone directly opposite me either. There's even a hallway to my left, so no one is on that side as well. The only people who'd bother me/I'd bother are those living below me, and that apartment could be empty for all I know.

The downside to all this is that my apartment lacks light. Because of the weird V shape it's forced into, it only gets direct light from 7-11 in the morning or so. On one hand that means I'll never have the glare problems of my old place. On the other hand... it does get a bit dark. It's ok though. It's a nice enough place, and would look great decorated. Decorating it is being postponed a bit though, because I drove my car into the sidewalk (don't ask how...) and will have to pay for a new bumper. The bumper's not damaged nearly so severely that it /must/ be replaced, but it looks tacky and I can't have that.

The moving process was tiring and exhausting, but when my family left afterwards, and nothing had to be moved anymore, it got so oddly quiet by contrast. It really felt pretty lonely and depressing that night, although everything is better now (although I'm still kind of living in the middle of nowhere).

I had a meeting at the hospital on the 10th, and got my ID badge, so I'm now officially good to go. I hadn't started real work yet because I was out of touch due to the move, but I expect I'll be able to get moving forward with that any day now and am looking forwards to it. I've been working on my MCAT studying as well, although a little bit less than I might have hoped. It's just been really busy lately though with the move, and I've been making a 4 hour round trip twice a week as well for physical therapy for my shoulder. But I have been getting some studying done. I've decided to go over physics first, since that was probably my weakest point.

I'm hoping to have my review of that done by the middle of October if possible, so I have enough time to get in a good overview of the other subjects as well. Then I'll start really narrowing down my studying in late winter/early spring, prior to the actual exam. But I need to start with a really broad overview of everything before I can find my weakest points.

That's it for now I think. I still have a lot of studying to do for my job as well; there's still 200 some terms and abbreviations I need to learn for training, along with all the procedures and forms I ought to familiarize myself with.

Back to Studying

Today I went and arranged to get my pants hemmed for work, and those are supposed to get finished for my by next Wednesday. I also got a confirmation yesterday that my drug test came back negative and my other papers had been received(how the drug test came back negative when I was on percocet, I'll never know... but whatever). So other than my move, all my pre-work stuff appears to be taken care of. As for the move itself, someone else in my building seems to have reserved the elevator on the 10th. Which could be a problem, but could be ok as well since the only thing I really need an elevator for is my desk (most everything else is reasonably small, and can be carried well enough by one or two people).

What I get to do next is study. I get to keep studying for the MCAT, and I have to study the binders I got at work to memorize a few hundred abbreviations as well. Memorizing the abbreviations is probably going to be my short-term priority, since it has to get done for me to get/keep my job. It's fairly interesting anyways, actually, and it's much easier to memorize abbreviations than study for the MCAT, so it will probably be a good change of pace. I'll probably go out and grab a few sets of flashcards for that purpose tomorrow.

I have to memorize these fast though, so I can get back to studying for the MCAT; in the end, that's the only test that counts.

And Then A Hurricane?

Really? Really? Really: because an earthquake in a part of America that doesn't get those wasn't enough - we clearly needed an unusual storm as well.

Everyone is expecting the power to go down, which will be inconvenient for my faxing/emailing records back and forth to all the people who need them. Hopefully it manages to get fixed soon enough though, and I can finish my pre-employment requirements prior to my move.

I kept things going today by getting the PPD test for TB, and the first of a series of Hepatitis B vaccinations (the only one needed before work can start). I have to wait till Monday for the PPD results, before I can fax that and my vaccination form over to HR. Once that's been done, I'm effectively finished. They still haven't contacted me for the drug testing, and I'm worried that will cause me trouble. I also still need to get my scrubs hemmed so they fit me properly. All the fundamentally necessary paperwork and visits are now taken care of though.

Earthquakes and Drug Tests

So we had an earthquake. Yeah, a 5.8 one. Nothing particularly relevant to this blog, but it was a pretty exciting event since we hardly ever get them over here in DC. Apparently it was the biggest one we've had in the last 69 years too. It still wasn't that big, although it did break a few pieces on top of the national cathedral, and knock things off walls. There's a bit of a crack in my parent's apartment now, and there seems to be in the Washington Monument as well.

I remember it because it woke me up. My thought process was pretty much: "Why didn't they tell us they'd be working on the roof this morning.... why do they have to shake the roof to work on it... why to they have to shake the building to work on the roof..." And then I was awake enough to figure out what was happening. It wasn't my first earthquake, since I'd been in a few of similar sizes back when I visited Japan. But it was still neat enough. We don't get much weather like that on the east coast. No hurricanes or tornadoes or tsunamis or earthquakes to remind us how small we are.

Anyhow, back on topic. I went out for my drug test today (the company giving it is separate from the one I will be working for). The receptionist just kind of gave me a dull stare when I showed up and asked for my documents. I said I had been given none. Then she asked for a confirmation code, which had been given to me but I had forgotten all about because I've never ever needed something like that for an appointment before. I ask if I can use their computer to quickly check my e-mail and get it, and got another big dull-eyed stare. Apparently I can't borrow their computer for one minute to get the code. So I'm reasonably frustrated. It's not particularly close, and I really didn't feel like coming back the next day.

Anyways, I went back to my car to leave and fortunately realized that I'd left the folder from the orientation in the car, and had written my code down in that as well. When I came back there was a new receptionist who was much more personable and I was able to get the drug test after all, although I wasn't able to just give them my prescription bottle of percocet to prove it's legitimate. Apparently I have to wait for them to call me back once I test positive before I can present it to them. And since it's a drug test I doubt they'll take my word for it over the phone, so it seems I'm going to get to drive all the way back up there anyways. Yay.

But at least things are moving. I faxed over my vaccination records as well, so I'm making pretty good progress. I still need to get my Hep B vaccination and a TB test, so I'm going to try and set those up in short order. Otherwise, things look to be coming along well. My moving date is rapidly approaching, and I checked the wheels of my car and added pressure to them for that. I've been picking up some boxes and bubble wrap as well.

Edit: The new blog design is very crisp. And white. I like the big change in design, as I'm making a corresponding big step forward with my plans. The design feels a bit empty though, so maybe I can find a picture in the coming weeks. With moving ahead though, looking for good pictures isn't much of a priority. I might end up posting a picture of the hospital, but I should probably take my own for that later rather than use a copyrighted one from the hospital's site.

Orientation

The first of several job orientation sessions took place today, from 9 to 5. It was pretty exhausting, but in a good way. The last year or two of courses being taken as prereqs for medical school admissions really managed to replace a lot of the initial excitement of my decision to leave law for medicine with stress focused on tests, application essays, letters of recommendation, and all sorts of other things that seemingly tried to drown a bit of my soul. This orientation reminded me how fun/neat medicine is though, and how exciting it can be to work with it (or even just around it in an emergency department setting).

The bulk of the time was spent learning the basics of how to chart patients. I'm still learning how it works of course, but the general gist of it is that the form used looks at the HPI (History of Present Illness) to attempt to codify each patient's situation. Things looked at include the location of the injury, the severity of the injury, the timing of the injury, the duration of the injury, the context in which the injury took place, the quality of the injury, any modifying factors, and any other associated signs and symptoms. The ROS (Review of Systems) is a second set of items that is looked at, and includes the PFSH (Past Family and Social History) as well as the physical exam which will look at the Global (general) system, the Eyes, the Neck, the Respiratory System, the Cardiovascular System, and various other systems.

To chart all this down, we get to expand our vocabulary with hundreds of new words. We get to learn about Bradycarida (a cardiovascular rate under 50), Scleral Icterus (the yellowing of eyes), and all sorts of other stuff. We'll also get to associate what conditions match up to what symptoms. It's like taking a course, really, except we get paid for it.

Then to take notes and write down the charts, there's a whole set of abbreviations as well. I'd put them down, but they're not all /that/ interesting on their own. I'd put up an example patient history, but the one's in the materials we got handed are probably copyrighted/not my intellectual property, so I'd hesitate to put it up on the internet. And I haven't learned how to do it well enough to put up a perfect example of my own yet. Maybe I'll get around to it later.

I still have to take my drug test, and that's been set up now. I can go anytime over the next week, but I'm hoping to knock it out tomorrow. I'm still on percocet from my surgery, but have more or less cut that down to one a day. For some reason, I'd feel weird not taking one on the day of my drug test, but bringing the bottle to explain why I'm testing positive. At any rate, I'm going to try and do that in the next day or two, and then I'll finish stopping the percocet completely.

I also need to fax a copy of my vaccination records and get another TB test, but then I'll be pretty good to go. ... for a second orientation, that is. It looks like the start of my real work is still a ways off, although I'll be shuttling around between the HR office and the Hospital quite a bit. Anyways, I'm pretty excited again, and think things are looking good.

I suppose that calls for a new background on this site, so I'm going to go see what I can find to mark this watershed moment.