Course Descriptions

Alas, all good things come to an end. Spring Break is soon to be over but we have another good thing to look forward to. Learning new material! Only a little more than a month is left in the semester and I can't wait to nail this remaining material down cold.

You may have been wondering, what material are you really learning anyways?

Well, our three main classes are basically:

1) Pathology
2) Anatomy w/ lab
3) Anatomical Techniques

But just by looking at a course name doesn't really tell the whole story. I'll describe what to expect in these types of courses in PA school.

1) Pathology

Textbook: Pathologic Basis of Disease
http://www.amazon.com/Robbins-Cotran-Pathologic-Basis-Disease/dp/1416031219/ref=sr_1_6?ie=UTF8&qid=1301242683&sr=8-6

This class has been the most traditional of the classes that I've had so far. If you're familiar with the style of lectures that you've had during your undergraduate years, then the only thing different is the material. Think of a large lecture hall where the teacher gives a presentation, you'll have power point notes or a study guide on hand, material on the test can be found completely in the notes and lecture, you study the textbook when you're unclear about a topic, tests may be multiple choice or fill in the blank, etc... I'm sure many of you are familiar with this style of class.

Studying pathology is similar to studying many other subjects such as microbiology, immunology and ecology. Sure, there is a good amount of memorization, but grasping the concepts is also just as important. You won't be having to solve complex chemical reaction problems such as in organic chemistry nor will you be identifying parts of things in a picture like in histology or anatomy. It's using your base of memorized knowledge to link together why and how a disease works.

For example, how might esophageal varicosities (vericose veins surrounding the esophagus) and cirrhosis of the liver be related?
Well, we know that when liver tissue becomes replaced with fibrotic tissue, less blood will be able to get filtered through. That would cause blood to get backed up. Blood that can't go through the liver would be forced through other routes (collateral circulation). Blood gets diverted through the esophageal veins, causing them to become larger and the walls of the veins can become dangerously weak. So there you go! Now you can answer a hypothetical question such as:

Which of the following is most likely to cause esophageal varicosities?
a) chronic bronchitis
b) renal failure
c) cirrhosis of the liver
d) deep vein thrombosis

The first part of pathology covers topics that are the 'think big' topics such as clotting and blood pressure. The latter half of pathology moves on to the 'think small' topics that focus on organ systems, such as diseases of the kidneys or heart. Here's a basic outline of topics that you can be expected to cover:

cell injury
cell death
inflammation (very big)
healing
fibrosis
edema
hemorrhage
thrombosis
infarction
shock
blood vessels - atherosclerosis, hypertension, pathologies of blood vessels
heart - congestive heart failure, ischemic heart disease, infarction, valvular diseases, congenital diseases, etc...
lungs - atelectasis, obstructive lung diseases, restrictive lung diseases, embolism, infections, tumors, etc...
kidneys - glomerular diseases, tubular diseases, cystic diseases, renal stones, renal tumors, etc...
GI tract - esophageal diseases, stomach ulcers, tumors, inflammatory diseases of the small and large intestine, polyps, cancers, etc...
etc... etc... etc...



2) Anatomy w/ lab

 

Textbook: Clinically Oriented Anatomy

http://www.amazon.com/Clinically-Oriented-Anatomy-Keith-Moore/dp/1605476528/ref=sr_1_2?ie=UTF8&qid=1301246363&sr=8-2

My classmates seem to like this book but I hate it. I'd rather use wikipedia than try searching through that tome.

Anatomy was specially made for those individuals with photographic memory. There's no getting around it. This class is 90% memorization. You'll be memorizing names of things that you didn't even know had a name. I can just imagine each early anatomist combing through a cadaver with a magnifying glass, obsessively scrutinizing every little tiny bump and crevice so he could engrave his name into the scholarly pantheon of posterity. I wouldn't be surprised if anatomists of the 17th and 18th century showed symptoms of OCD.

The memorization intensive nature of anatomy has one advantage. It is a subject that you can easily study for even before classes start. Sure, you'll need diagrams and pictures to strengthen your ability to remember names, but these can be readily found online.

In class, you'll probably be given a set of notes or power point lectures to study off of. Tests may be multiple choice or fill in the blank. I highly doubt any essay questions will be of any significant length. You'll be asked questions such as, "name the four muscles that make up the rotator cuff", or "what part of the thalamus is the primary processing center for visual information from the retina".

What makes anatomy difficult is the volume of memorization you need to do in a short amount of time. That's why it's so imperative that you take advantage of any free time before entering into a PA program by studying anatomy. Some areas of memorization that will be expected of you:

know all of the bones of the body and the names of all their bumps and grooves
know all of the muscles of the body, be able to name their origins and insertions
know most of the arteries and veins in the body, know their locations and what they supply
know most of the nerves of the body and what organs and muscles they innervate
know all of the organs and the names of each of their important landmarks

The order in which you study the body may be different between each school, but here at WVU we have pretty much covered in order:

back
arms
armpit
breast
neck
face
skull
pharynx
eye / ear
vertebra / spine
brain
thorax
heart
lungs
esophagus
stomach
intestines
liver
etc... etc... etc...

This course also has a laboratory component with its own tests and grades, but getting a hands on experience really reinforces memorization. The best way to learn is by doing.



3) Anatomical Techniques

 
Textbook: Surgical Pathology Dissection
http://www.amazon.com/Surgical-Pathology-Dissection-Illustrated-ebook/dp/B000PY3QPM/ref=sr_1_3?ie=UTF8&m=AG56TWVU5XWC2&s=digital-text&qid=1301249503&sr=8-3

This could be the most useful class that you take. That is because this class is specifically designed to teach us how to work as pathologist assistants. It uses our knowledge of anatomy to teach us how to handle a specimen, describe it, ink it and dissect it. The first classes were geared towards new terminology and autopsies, but just as with pathology, the subject matter narrows down to 'think small' and concerns how to handle each and every kind of specimen one could possibly receive from the operating table. Each specimen, whether it be a larynx, a tonsil or a brain, has their own protocol on what to do.

This class also requires a good amount of memorization, but unlike anatomy, it's intuitive. For example, if a mandible is plopped in front of you, there are a number of things you'll need to do, including describing it, looking for any tumors or lesions, measuring it, fixing it, inking it and cutting it. Some questions on a test might be, "which fixative will you use if electron microscopy is ordered" or "how would you describe this tumor". Because of the nature of the subject, these tests are bound to have plenty of essay questions.

The course material follows the anatomy class for the most part. Some weeks the anatomical techniques class will be ahead and some weeks it'll be behind.



Fortunately, at least at WVU, the test materials often tend to overlap, so you might be studying about the lungs in pathology, anatomy and anatomical techniques all at the same time. A triple whammy of lectures means that it sticks with you much better and studying isn't (as) overwhelming.


Now you know a little bit more about what to expect in PA school. It's intimidating, but if you study more than you play you'll be fine. Chances are, if you're applying to graduate school, you already fit the bill.

Spring Break!

Never have I valued spring break as much as now. Imagine hiking up a steep mountain and the incline finally gives way to a more level path. You're still marching forward but it gives your legs a chance to cool down. Ahead of you lies the summit of the mountain. It's still oh so ever far away, but your destination is in sight. The level path ends shortly up ahead and you know that soon you'll be climbing up higher. In the meantime, you enjoy what short time you have before the steep incline begins again.

The majority of my classmates have wisely decided to spend their vacations in full, either going out of town for sightseeing or staying with family. I'll be spending this week here in Morgantown completing a forensic photography presentation and reviewing what we learned the previous two weeks in class for anatomy and anatomical techniques.

I appreciate our teachers for finishing up our tests before the spring break. There's no immediate test to worry about the day we come back after the break. I've come to realize that one of the things that I like about West Virginia University's PA Program is that the teachers have so far been flexible about test dates. If the test date conflicts with the schedules of anyone, we usually have a class vote on when to postpone the test. It has worked well so far. I'm not an advocate of being strict just for the sake of being strict.

Off Topic - Earthquake and Tsunami Hit Shinchi

Nightmares are things that occur when one goes to sleep. This time however, the nightmare started when I woke up.

As many of you all know, I'd spent the last 3 years living in Japan. I cannot say highly enough of how great of an experience living in Japan was. The main reason why it was so great was because of the people. There are certainly many kind people in America, but the kindness I received in Japan really left an impression on me that I'll never be able to repay.

After being accepted into the JET Program I was sent to teach English in Shinchi, a very rural town on the northern stretch of coastline in Fukushima-prefecture. It was my first taste of living in a small community. We Americans often spout the importance of community, but never have I truly experienced community like in Shinchi. Firstly, the population is only about 8,200 people, so everyone knows everyone. No matter where you go, you are always bumping into people you know, whether it be at the supermarket, the library or just walking down the street. Our junior high school had only 250 or so students, so I also knew all of their names and personalities on a 1-to-1 basis. I worked with many of the same coworkers for 3 years and had very close relations with all of them. Living like this, where everyone knows everyone, is really a necessary component of any community. Not surprisingly, I became one of them.

With most disasters, you don't have any relation to the people involved, so you view things from a detached perspective. In this case, I knew all of the people of Shinchi because I was part of their community. I went on vacations with them, ate at restaurants with them, participated in festivals with them, worked along side them and taught their children nearly everyday.

Shinchi Beach

Shinchi is mostly a fishing town and my house was only a ten minute walk away from the beach. I'd go there on the weekends and take a swim in the summer, sometimes with my students. Near the beach are the houses of many of my students, their parents and even some of my fellow teachers.

Origin of the 8.9 earthquake. Sendai, the city where I always did my shopping and where I met my girlfriend, received waves 10 meters high. Thank goodness she lives far inland.

Yesterday, at around 3PM in Japan time the 8.9 magnitude earthquake struck and sent a tsunami 7 meters tall penetrating as far as 1 km into Shinchi. The tsunami is said to have swept away as many as 500 households just in Shinchi alone. (500 households in a town of 8,200 is devastating.) Since the tsunami struck during school hours and the school is located on a large hill overlooking the town, I'm certain that my former students and coworkers are safe. However, what is certain is that many of them have lost everything to the tsunami. I can't imagine what it would have been like to be looking down from the school terrace and watching all of their homes being destroyed in an instant. They may have also had grandparents still trapped at home when it came.

The tsunami went so far as to reach the train station and even topple over the train. The Japanese military has also stepped in to Shinchi to survey the damage.

http://headlines.yahoo.co.jp/hl?a=20110311-00000154-mai-soci

I've sent out emails to everyone, but without power they won't be able to reply. I sincerely hope that they and all of their families are safe, but I know it's just not possible with the magnitude of something this big. I'd be tempted to fly over right now and clean up the wreckage were it not for PA school.

A picture from outside my house pointing towards the ocean. Just behind the tree line is/was a huge housing complex of 100 or so houses lined up along the beach.

Treasure what you have now, because you just never know.



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Update 3/11/2011 9:00 PM

I've lost contact with Hanako. On the news I read that 7 million households are without power and she's affected. The supermarkets are empty as well. At night, it's still nearly zero-degree (Celsius) weather over there and I hope that they can ride it out.

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Update 3/12/2011 8:20 AM

This morning I received an email from one of my former students, Emi. She said that the town is mostly covered in mud and debris and that some students still haven't been reunited with their families. Her house is further up towards the mountains, so her place was ok, but the whole area is without electricity and gas.

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Update 3/12/2011 9:00 AM

Damn. These are some pictures of my neighborhood. I recognize these houses. I lived just just a 1 minute walk from here. My former house is probably gone as well. In Shinchi, they upgraded the height of the tsunami from 7 meters high to up to almost 12 meters high.

http://sankei.jp.msn.com/affairs/news/110312/dst11031211440172-n1.htm

The train station which I used to always go to in Shinchi has been completely decimated. The only thing standing is the overpass to get to the other side of the train.

http://www.nikkei.com/news/headline/article/g=96958A9C93819695E3E0E2E7E78DE3E0E2E1E0E2E3E39180EAE2E2E2

http://sankei.jp.msn.com/affairs/photos/110312/dst11031222110288-p2.htm

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Update 3/12/2011 3:00 PM

I finally found a video on the web showing an aerial view of the damage in Shinchi. It's quite frightening. I've taken a screen shot of it.

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Update 3/12/2011 5:00 PM

I finally got an email from Hanako. Currently, her house is without electricity and water. The only news that she has gotten has been from the newspaper. It's situations like these where you realize that in a disaster zone it's just a total information blackout.

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Update 3/12/2011 8:00 PM

I got another email from Emi. She mentioned that Eri, one of my favorite students and Emi's friend, had her house completely wiped out. Boats were swept all the way up to international highway 6 (６号線) which runs through the middle of the town. The 3rd year students were supposed to be graduating soon but the junior high school has shut down for now.

In addition, the nearby nuclear power plant seems to be emitting radioactivity. Already 9 people near the plant have got radiation sickness. For now, Shinchi seems to be largely ok, but they have been told to not go outside.

As of right now, there are 13 confirmed dead and still many more missing.

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Update 3/13/2011 5:00 PM

This is a site that shows some before and after pictures of areas that were by the coast in Fukushima and Miyagi prefectures. Included are some pictures of Minamisoma/Haranomachi.

http://www.abc.net.au/news/events/japan-quake-2011/beforeafter.htm

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Update 3/14/2011 9:00 AM

In some other good news, I received an email from my friend, Mikihiko, living in Furukawa City in Miyagi Prefecture. He says that he's alright but without electricity, gas and water.

I went on to google earth and took a screen shot of Shinchi from last year. I still haven't heard back from anyone else yet.

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Update 3/15/2011 7:00 AM

This morning I got a brief message from my former co-worker, Takezawa-sensei. She's an English teacher at Shoei Junior High School. She said that the teachers and junior high school students are alive, but their largest worry is radiation.

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Update 3/15/2011 7:30 AM

My dad scanned this article from the Fresno Bee about the damage in Soma. I'll still haven't heard any reply from Kajita-sensei who lives there.

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Update 3/15/2011 8:30 AM

The remaining residents in Soma have been ordered to stay indoors to limit their radiation exposure.

http://news.yahoo.com/s/ap/20110315/ap_on_bi_ge/as_japan_earthquake

I imagine the same is true in Shinchi.

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Update 3/15/2011 10:30 AM

I finally got contact with Hanako. Last I heard from her was 4 days ago. Her area is on rolling black outs. She says her water is working but they have no food and the stores are empty. As you may know, in Japan, people don't stock up on food like we do here. Their houses aren't built with pantries. All they have are their refrigerators.

The problem with the nuclear plants is especially troubling. If there's a meltdown, she and all of the people in Fukushima, Miyagi and most of northern Japan have no where to run. The roads are gone, buses aren't running, the trains aren't runinng, Sendai Airport isn't operational and there's no gas to be found anywhere.

I also received another email from Emi in Shinchi. She said that Eri is currently taking refuge at one of the local elementary schools. Her mother was killed and both of her grandparents are still missing. Shinchi is much closer to the nuclear plants and access to Shinchi is impossible. The roads are filled with debris and mud and there's no gas to be found either. The water isn't running either, so who knows how long they can last. Everyone is staying indoors due to elevating radiation levels. The only way to escape would be on foot, which is nearly impossible in the first place.

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Update 3/15/2011 3:00 PM

It looks like another tsunami, this one 3 meters high hit Shinchi and Soma yesterday on the 14th. There probably wasn't much left to destroy.

http://mainichi.jp/select/weathernews/news/m20110314k0000e040039000c.html

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Update 3/16/2011 6:30 PM

I have much reason to believe that Japan is censoring vital radiation level information in Miyagi and Fukushima Prefectures. Take a look at the following map:

Notice that both radiation levels in Fukushima and Miyagi are labeled as "Under Survey". In other words, the Japanese government knows the radiation levels but is not releasing it to the public. (There is no reason that the Japanese government wouldn't have this information. Japan is a highly industrialized country so lack of sensors are not an issue and incidentally, these two prefectures are the ones most at risk for radiation fallout.) Covering up this information is a huge mistake. They may believe that by censoring the information they are preventing chaos and pandemonium, but by not releasing the information many more hundreds of thousands of people will possibly be exposed to radiation as soon as the wind changes. Those people include my friends, co-workers, students, my girlfriend and her family. I will never forgive the Japanese government if their silence and censorship lead to more people becoming exposed to radiation.

In addition, the Japanese government has enacted Article 15.

http://www.marksmarketanalysis.com/2011/03/japan-imposes-article-15.html

Japan Imposes Article 15

Japan has banned all its government agencies, including its nuclear regulatory and protection agencies, from issuing any statements about the nuclear crisis situation in Japan, according to Yochi Shimatsu, former editor of the Japan Times.

Statements will only be issued from the senior level of the Japanese government.
"Article 15" is an article unfamiliar to most Japanese, including most Japanese journalists. It is apparently an emergency regulatory clause that allows the senior levels of the Japanese government to stop other Japanese government agencies from communicating with the public and news media, . 

So much for expecting the Japanese government to be honest.

It looks to me like things are falling apart. The government has just now upped the radiation limit that a person can take from 100 millisieverts to 250 millisieverts. I expect that they are doing this to make it look like fewer people have radiation poisoning.

http://www.zerohedge.com/article/when-all-else-fails-change-rules-japan-doubles-maximum-dose-allowed-nuclear-workers

Also, Japan and the rest of the world are at odds with regards to damage at the reactors. Japan's government is downplaying events while every other country is reporting events as being more serious. By Japan's recent behavior, I'm inclined to believe the international community and say that things are getting worse.

US says plant's spent fuel rods dry; Japan says no

http://news.yahoo.com/s/ap/20110316/ap_on_bi_ge/as_japan_earthquake

The US has issued a warning to all US citizens living within 80 km of the Fukushima power plants to leave immediately or stay indoors. The Japanese government's radius is much smaller at 32 km. I'm inclined to believe the US has a better position in this case. 

If you have any relatives, friends or acquaintances living within 80 km of the Fukushima power plants, please warn them to leave or stay indoors if they can't leave.

http://www.reuters.com/article/2011/03/16/japan-usa-shelter-idUSLDE72F2HX20110316

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Update 3/19/2011 4:30 PM

Two days ago I finally got word that Kajita-sensei and his family are safe! I wasn't able to contact him directly, but my friend Miki told me so. His email account was through the city of Soma's email server, and that was damaged in the tsunami, so every time I sent him an email it would be returned to me. I still worry about his situation though. Soma is only about 40 km away from the Daiichi Fukushima Power Plant and the Japanese government is still keeping things hush-hush about the situation. I can only hope that he has already evacuated.

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Update 3/24/2011 9:00 AM

More than half of the residents of Soma have left the city.

http://www.telegraph.co.uk/news/worldnews/asia/japan/8403040/Japan-nuclear-crisis-family-refuses-to-leave-home-despite-radiation-threat.html

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Update 3/27/2011 5:00 PM

I finally received an email from Mr. Katsunori. He was the person who looked after me during my first few days upon arriving in Japan and we went to relax at many onsen together. He often invited me to have dinner with his family as well. He has informed me that up to 150 people in Shinchi were killed by the tsunami. A few stores have reopened so food and water are a little more accessible now. He also sent me some pictures he took himself of the devastation in Shinchi.

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Update 4/4/2011 6:30 PM

"Govt did not reveal high level radiation estimate" NHK World English    (22:00 April 4th)

http://www3.nhk.or.jp/daily/english/04_10.html

Well, looks like I was right yet again, unfortunately. For those who may have doubted my assertion that the Japanese government was censoring radiation levels, here is the nail in the coffin. When it comes to your personal safety in times of crisis, there is no better person out there to look after yourself other than yourself. I'm glad I warned my friends in Japan of the censorship. It may have helped them avoid some amount of radiation exposure.

Relationships and Pathologists' Assistant School

Relationships are tough. Pathologists' Assistant School is tough. Mix the two together and you get tough².

Being in a relationship during PA school is a mixed bag. Unless you're from the local area, most likely you've had to move a couple hundred miles to live close to campus. That means that if you were in a relationship before getting accepted, now you've transitioned into a long distance relationship.

Long distance relationships are especially difficult (I should know since my first ldr failed). I've read on the internet that between 60-90% of long distance relationships fail within the first year. It's hard to believe, but I can see the truth in it. Relationships are like flowers and if you don't give them enough water or sunlight, they'll wilt and eventually die. Obviously, being in a long distance relationship means that it's difficult to maintain the couple of ingredients that relationships need such as communication and physical presence. Stripping away these two necessities from a relationship is akin to blocking sunlight and water from reaching a flower. Where once it was easy and required almost no effort for the flower to grow, now the flower struggles against the elements just to make it to the next season. It is only through sheer determination that the flower refuses to die.

In PA School, your most valuable asset for building and sustaining a relationship, time, is needed for studying. This also implies that school needs to be your number one priority. For many graduate students, relationships often and unfortunately get relegated to the back of the bus out of necessity.

If you find yourself in a long distance relationship and in pathologists' assistant school, you needn't give up all hope. There are a few things that you can try to do to keep the flower alive. In my opinion, the most important thing that couples can do is to maintain contact. Keeping connected is the most important thing that you have control over. You won't be able to text each other every hour, but you should make a schedule where you write an email or call each other and stick to it. With my previous ldr, our emails went from once a day to once a week to once a month and then proceeded directly into oblivion. Do not pass go. The End. Don't make my mistake and think that things will get better.

If it's possible, try to meet up in person whenever possible. For us students, there are only a limited number of times throughout the year where we have a break long enough to travel out of town. They include spring break, summer vacation, Thanksgiving and Christmas/New Years. Even then, your significant other may have other obligations such as work. Being able to meet up is like a rain in the desert. You should savor it because they are few and far between.

PA school is stressful enough and relationships don't make the stress go away. They can also add to your worries, which is the last thing you'll need before a test. Fortunately, those of us who apply to PA school are all hard workers and we apply that perseverance to both our studying and our personal lives. I'm very happy to be with my girl even though we are separated by 8,000 miles of stone and molten iron. We keep in touch by emailing each other at least once a day and talking on SKYPE at least once a week. It's enough to keep that flower going, but it's definitely tough to be in a state of limbo.

PA school is the place to be for learning, but I'm certain that graduating will be the happiest day of my life. That and summer vacation is too far away.