Sunday, January 30, 2011

The Advantages of Living Close to School


This is mostly going to be a common sense post. Over the past two months I've come to appreciate living in a very convenient area. In the picture above, I'm standing on the balcony just outside of my apartment. Over my left shoulder you can see Ruby Hospital and just behind is the Health Science Center where I commute every weekday for classes. Walking from the apartment to classes takes only 8 minutes so I have little need to own a car at the moment. I do have one back in California, but I wasn't too excited about the proposition of driving to West Virginia. Next year, when clinicals begin in Pittsburgh or Charleston, I'll more than likely need to buy one.

There are a lot of great things about living close to where you work or study.

- My commute time is only about 8 minutes one-way. I'm not certain but I imagine that for the average person, their commute time may be anywhere from 20-30 minutes. Short commute times mean more time for studying and sleeping. When you count the number of minutes saved per day over the course of a year it really adds up!
- If I forget a laptop, textbook or notebook, I can quickly run home, grab it and be back in time for class.
- I don't have to bring my lunch to school, nor do I have to make lunch early in the morning. I can walk home, get a bite to eat and be back for classes in no time. This also means I can avoid paying for $4 coffee just by walking back home. The price of food at the cafeteria is pretty reasonable, but with home so close by, you have the entire pantry and refrigerator as your selection.
- I don't have to worry about paying for parking either. No need to bend over at the gas station. (Although if I ride with someone I'll usually offer to pay for gas money. I can say for certain that the people here are much more courteous and obliging than some of the other places that I've been to.) Morgantown is notorious for bad traffic on game days and during bad weather. No more road rage for this student. When it snows, I don't have to scrape the snow off of the car and I don't have to worry about fish-tailing on a thin sheet of ice into a telephone pole.
- Walking to school also gives me some limited exercise. It's only 15-30 minutes everyday, but if you can kill two birds with one stone, go for it.


There has only been one drawback to walking to campus that I can think of. The winters here are pretty darn cold, so walking to and from school can sometimes mean walking for 8 minutes through Cocytus, the 9th level of Dante's Inferno. Though if you're cold-blooded then you don't need to worry.
Scroll to the bottom of this page if you want a description of the 9th level of hell.

Otherwise, living close to where you work or study is really great! Once you've been accepted into a PA program, try to choose a place so that your commute is between 5-15 minutes. If you have the option to live with your family or parents, saving thousands of dollars on rent is usually a better deal than saving on time. If your family is in California, don't try to commute from California unless you're superman/superwoman. And if you are, what are you doing in PA school?

Sunday, January 23, 2011

Impressions On Our First Cadaver Dissection

This past week was the first time for many of us to get hands on experience in human anatomy by beginning our first human dissection. For our program this year, four considerate people had decided to donate their bodies to us, and with 16 people in our class, that means there are four students per cadaver.

When many people think about a morgue or an autopsy examination room, they think of some horror film set or dungeon at the bottom of a stone staircase where an unknown man with a crazed look to his eyes is hunched over a body while dressed in blood stained garbs. The sound of the cutting of flesh and sawing of bone resonates throughout the cold corridors which are dimly lit by torches affixed to the walls. This kind of scene makes for great atmosphere in movies, but the reality is much less terrifying and more sanitary than what is portrayed in Hollywood films.

The room where we are in is quite large and has enough tables to hold perhaps a dozen or more bodies. It is well lit and the white walls somehow remind me of being inside of a hospital. It's not underground, but rather up on the fourth floor.

Although I had seen human cadavers before, I had never actually cut human flesh, let alone the flesh of a person who had already passed away. I could tell that even though we were all calm filing into the examination room and eager to begin, many of us, myself included, were hesitant to make that first cut. More than that, some of us were hesitant to even physically touch the corpses. It's one thing to handle a chicken to be put into the oven, but handling a deceased person is on a whole different level.

Nevertheless, without wanting to show our trepidation to our classmates, we quickly dove in. So much so that muscles were on more than one occasion cut entirely through and remained attached to the subcutaneous tissues. Surprisingly, within the first couple of minutes, all of us were cutting as comfortably as if we were carpenters working with wood.

(The speed at which we became accustomed to cutting human flesh was of some concern to me actually. If we became used to cutting flesh so quickly, an activity that in and of itself is mutilating to the human body, does that mean that human empathy for other human beings can really be overcome so easily? History books and the news provide us with many examples of horrific acts committed on people by people who seem to have lost their empathy for others. Soldiers committing torture at Abu Ghraib, hospitals that dump their destitute patients on the streets, even the person who pushes the button to inject a condemned criminal with a lethal concoction, all are people who must have struggled with or lost their empathy for others. I don't believe that cutting human flesh will make one more likely to murder someone anymore than a child who plays video games is to shoot up their classmates. But, at the same time, I can't help but think that if I were born in an era when violence and death in the media were less prevalent, I would have showed more apprehension in dissecting the deceased.)

There were a great many things that I noticed during our first dissection.

-The atmosphere of the four of us working together to cut away and expose muscles was actually quite fun (and of course educational). It was the first time for many of us to cut so there was a kind of euphoria of having discovered a completely different world, and we were able to share it all with our peers. It's like looking into a telescope and seeing Saturn for the first time.
-There's a saying I learned in Japan that goes like, "Ten people, ten colors", and just like people, cadavers are all different. (They were once people after all.) Some have a lot of subcutaneous adipose tissue to cut through, some have really dark muscles, some give off a pungent embalming fluid smell, some don't smell at all, etc...
-Scalpels are incredibly sharp. We all managed to make it without cutting ourselves, but I never realized how well scalpels can really cut.
-There were a few 'Aha!' moments of eureka that I only would have discovered by dissecting. Things that are difficult to comprehend from a book. For example, I could clearly see how far the trapezius extended down the spine, whereas before I had always imagined that the trapezius extended all the way down to the sacrum.
-Muscles are a lot more thin than I thought. Perhaps if we were dissecting bodybuilders the muscles would be thicker, but many of the muscles that we've reflected, such as the external, internal and transverse obliques are more like sheets of paper.
-Dissecting is quite a physical activity. Cleaning muscles and exposing fascia requires a lot of arm work. You also need nimble fingers for manipulating small instruments or separating tissues apart through blunt dissection.
-Dissecting, to the degree that we are, also takes quite a bit of time. Like in any profession where one has to be on their feet for a long time, your back can begin to hurt. We spent perhaps 3.5 hours dissecting and it's going to take many many more hours to explore everything.
-When you're working in close contact with the cadavers, you're bound to brush your skin or clothes up against the cadaver. In my case, when we decided to turn the cadaver over, I needed to reach under the cadaver and pull from underneath it. I was promptly rewarded with a river of embalming fluid running into my glove. Over time, I expect to just get used to these things.
-Working close to the cadaver also means that your clothes are going to be permeated with the smell. I didn't realize it until I got home to take a shower that my clothes smelt like embalming fluid.
-The cadavers that we received were treated with a kind of embalming fluid that made them feel less 'real'. I don't believe that cutting into these cadavers is quite the same feeling as cutting into a person who had just recently died hours earlier. Somehow, these cadavers didn't evoke any kind of terror or horror in me, but they did evoke a feeling of sympathy from me. It was as if these cadavers were tiny or helpless. They evoked a sense of pity in me in that these were once people and now this poor body is all that's left.
-People have often said that they get hungry when doing an autopsy or grossing. Whether it's the presence of meat, the long hours, the physical exertion or a combination of all three remains a mystery.

I don't know the four people who donated their bodies to us, nor their lives, nor their experiences in life. It's only after they've passed on do I get to meet them. It's a very strange relationship, but I am grateful that they have donated their bodies to us so that we may study anatomy. Through us, these people will have achieved their goal, that is to enrich the lives of those still living.

Sunday, January 16, 2011

Classes and Impressions on the First Week of School

Now that the first week of school has come and gone I have a general idea of how the semester is going to shape up. So far things are looking good.

The first thing that strikes me as different from my time in undergrad is the amount of reading material. As expected, in graduate school you can expect to go over much more material in a much shorter time frame than in undergrad. This first week, we've been assigned around 300 pages worth of textbook material from all of our classes. It's definitely manageable and I expect the workload to stay at this pace from here on out. Reading this much material every week doesn't mean that you'll be able absorb all of the information from one sitting, but it's a good prelude before going to lectures and studying.

Another difference is that there are no more "fluff" courses, that is, courses that are unrelated to your field of study. I don't mean to speak of classes like philosophy, history or underwater basket weaving in a pejorative light, but the classes that you'll be taking as a PA graduate student are the hard science courses you'll need for passing the ASCP certification exam and for when you go into the working world.

Because most of the courses you'll be taking are related to the human body and disease, there will be quite a significant amount of overlap in the learning material you'll have between courses. Some of the material you learn in one class might even show up on a test in another class. As you're studying, it's also easier to switch modes between anatomy and pathology than it is to switch between anatomy and literature.

Without further ado, here are the courses for the Pathologists' Assistant Program at WVU for the spring semester of 2011. You can also find general class information on the WVU PA website:
http://www.hsc.wvu.edu/som/PA/Curriculum.aspx

Advanced Forensic Photography                               3 hours
General Pathology                                                     5 hours
Anatomical Pathology Techniques                              4 hours
Human Anatomy for Pathologists' Assistants Lecture  3.5 hours
Human Anatomy Lab                                                4 hours
Basic Microanatomy                                                 1 hour

It goes without saying that classes at other PA schools are going to be slightly different, but I believe that this is a good representation of what you can expect.

Although it seems like there are a lot of hours of class time, the reality is that some classes can be cut short if the material is finished early or classes can be canceled due to holidays. Judging a workload solely by the number of hours spent at school is not going to give you an accurate representation of how busy you'll be. Thus far, the amount of work that we have can be comparable to about 18-19 units, which is certainly busy but not so much that you need to eat, drink and sleep at school.

In addition to the above,  we are scheduled to attend 1-2 hours of lectures regarding pathology on a weekly basis. These are lectures that resident's of the medical school attend and are presided over by one of the many doctors who teach and work at the university. (The powerpoint lecture that we saw the first week was on various kinds of nevi and malignant melanomas. I definitely look forward to seeing every one of these that I can.)

Later on in the semester we'll also get a brief chance to spend a few days in the gross room and the histology room. This is to get us familiar with how the laboratories operate and we'll even get a little hands on experience.

So if you're wondering whether or not you'll be able to handle the workload, imagine taking 18-19 units of upper-division hard undergraduate science courses. The difficulty is actually not bad at all, at least not as bad as I had first thought. If you had already studied anatomy/physiology/pathology/histology during your time in undergrad and got A's in those courses, it feels more like 16-17 units. If you have photographic memory, make it 8 units. (Most of anatomy really just involves the memorization of names, structures and the relationships between those structures. What this also means is that you can very easily study anatomy before you're accepted into a PA Program and have a laid-back 1st semester. Hint-hint.)

But just because it might feel easy for you doesn't mean that you should actually take it easy! What you learn here will actually go with you for the rest of your career, so make the most of your time.

Saturday, January 8, 2011

Orientation

I was pleasantly surprised to learn that the Pathologists' Assistant Program at WVU does hold a two-day orientation for incoming students. Holding an orientation may not be practical for other master's programs, but when one considers that many different people from all over the country are coming together to a foreign city, it seems prudent. Due to the small class sizes, as we progress through the year I expect that we'll become more and more of a tightly knit "family" and this kind of an orientation more easily facilitates becoming acquainted with each other.

Whenever a dozen or so strangers are put into a room for the first time, it's no surprise that people may be tense and their minds scrambling to find anything at all to say to keep the dread of silence away. We started off with breakfast and an ice-breaker game to get to know a little more about each of the 16 of us. It may seem cliche, but you really can't judge a book by its cover. My classmates and I are like books and although we've read the first chapter of everyone's book (the ice-breaker game), only by spending a year or so with each other will we really see what makes each of us tick. I definitely look forward to getting to know everyone better.

After the usual syllabus review and tour of the facilities we received our laptops. It looks like every student at the health science center is required to have the same standardized laptop for classes and tests. I can imagine that this is the kind of laptop that The Jetsons would use since there are so many functions. It's mind boggling. I'll probably never even use half of the things that this thing is capable of. It's too early to say what I think of the Jetsons' laptop, but at nearly $2000 a pop, it had better be worth it.

The next day, we had lunch and attended a few more lectures regarding laboratory safety, using the library, etc... WVU is unique in that it is not only a university, it is also a miniature theme park. The PRT (Personal Rapid Transit) system is like a caboose on wheels and it can shuttle you between different parts of the campus in just a minute or two. Since the area is hilly, you get a nice little roller coaster ride whenever you want to go between campuses. No air time though. Too bad. The day ended with dinner at a nice restaurant.

The program directors really took good care of us these past two days. Perhaps, too good, since now I've got to be conscious of how much I eat at all of these mini-buffets they have been providing us with. No complaints here.

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Classes start on Monday. I'm glad that I was able to complete up through dissection 19 of 32 on the University of Michigan Medical Gross Anatomy online course, but if I didn't have to study for the GRE I would have already finished it. One more reason to hate tests that hold no relevance to what one studies.

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I should also mention that we completed an online HIPAA (Health Insurance Portability and Accountability Act) training course. Those who work in the field of health care need to be aware of the rules and regulations concerning patient information. (The rules are fairly intuitive, but it makes you feel like you're working in some sort of top-secret facility where one slip of the tongue can lead to nuclear winter. I can imagine walking down the hallway and seeing one of those wartime posters of "How about a nice big cup of ___?" ) In any case, the proper handling of patient information is essential to top quality patient oriented medical care, and I wouldn't want it any other way.

A training module on HIPAA can be found here:
http://www.hhs.gov/ocr/privacy/hipaa/understanding/training/index.html