Meant to be here

When I interviewed at OHSU, the Physician Assistant Program Director repeatedly emphasized how much care is taken during the application process to assemble each incoming class. He spoke about how deliberately each applicant is chosen in order to create a class that works well together and values collaboration instead of competition. The selection process is not random; each member of the incoming PA class is “meant to be here.”

Current PA students that participated in interview day events corroborated and elaborated on what we had been told. They spoke about how close their class was despite the short time they had been together. About how sharing individual strengths and knowledge in an effort to achieve a collective success was the norm, and how supportive everyone was of each other during the inevitable highs and lows that occur in a demanding PA program.

At the time, I was a bit skeptical. How was it possible to bring together over 40 complete strangers and create the chemistry that was being described? Could it be done? How did the admissions committee do it? And, after vying with scores of other students for top grades in college, it was hard to believe that the PA class was not competitive. They truly wanted everyone to succeed and cross the graduation finish line? What was the catch? And yet…even though the first year students had only been in school together for 5 months, they interacted like they had been friends for years.

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Buckets of water and ice

Summer is the funnest, easiest time of year. First, there’s the delightful sun and heat that we miss during the rather wet Oregon fall, winter and early spring that enables us to wear any shoe we wish (within reason) and not risk walking around all day with wet feet. Second, and best of all, you can be in lab all day, everyday and never be interrupted by classes or seminars or journal clubs…it is just you, a bench, and your experiment, the way nature intended. Third, there’s the excitement of all that happens in nerd culture during the summer:

1. Highly anticipated movies like the amazingly inspiring space opera that is Guardians of the Galaxy and its subsequent stellar (see what I did there?) soundtrack.

2. Videos of San Diego Comic-Con panels on a variety of topics from what Buzz Aldrin thinks about the future of NASA and a possible Mars colony to Game of Thrones, and finding out that art imitates life in that Kit Harrington really does not say a whole lot both onscreen and offscreen. Oh, and of course pictures of the cosplayers.

3. The highly debated topic of what the song of the summer really is going to be (spoiler alert, it is not “Come and Get Your Love,” but it should be).

4. The knowledge that shows that air in the winter, like Vikings and Game of Thrones, are filming their next season. EEEK!

5. Book signings at Powell’s which, I admit, is a year-round event. But I got to meet Deborah Harkness and tell her how much I love A Discovery of Witches in July, so I am going to include it on this list (she is definitely one of my spirit animals)!

All these things we know are going to happen and anticipate every year, sometimes more than we (or I) anticipate Christmas or neurosciences. And then there are the things that completely take you by surprise. In my case, that something is the ALS Ice Bucket Challenge. I study ALS. More specifically, I study the mechanisms of a loss of crawling behavior in a Drosophila model of ALS. Basically there is a protein in humans called TDP-43 whose loss of function is associated with ALS. Fruit flies have a version of this protein, called TBPH. When you knock-out TBPH in flies, they die as adults and as larvae they do not crawl well at all.

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Vital signs

It’s the fourth day of class, second day of real class (i.e. not orientation) and I’m sitting like an eager puppy in the second row of our Intro to Physical Diagnosis lecture. I have my pens in place, my laptop out, and I’m ready to go. Our professor poses the question, “How many of you took vital signs as part of your previous job duties? A sea of hands stretches to the ceiling.” So she asks, “Perhaps a better question would be, how many of you didn’t take vital signs?” My lonely hand reticently rises a few inches above my shoulder. “Oh shit. What have I gotten myself into?”

You see, I came from the world of human and social services, where we talked about patient advocacy, health equity, social (in)justice and conducted half-hour prevention counseling sessions. I ran a program working to make rapid HIV tests available to anyone who wanted one. My clinical hours racked up by performing HIV tests, delivering diagnoses, collecting samples for STD screens and drawing blood for syphilis screens.

But vital signs?! I got into PA school without ever taking someone’s blood pressure? I felt like a fool.

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Public health in Palau

StudentSpeak is pleased to share this guest post from M.P.H. candidate, Holly Lee, B.S.N., R.N. Holly is working abroad this summer in the Republic of Palau thanks in part to a summer travel scholarship and the OHSU Global Health Center.

Holly (left) with her friend and focus group colleague, Rus Kotaro (right).

My summer has been amazing! I am about halfway through an internship with the Ministry of Health in the Republic of Palau. Palau is a country made up of about 300 islands located north of Papua New Guinea, southeast of the Philippines and south of Guam. The main island is the state of Koror where I have been living and working.

I am working with Dr. Haley Cash, an epidemiologist at the Health Policy, Research, and Development office. I have been putting together a qualitative research project studying perceptions of pre-teens, teens and parents on underage drinking. There are high rates of binge drinking on the islands by both adults and teens. According to the Tobacco and Alcohol Secretariat of the Pacific Community, alcohol is considered the leading risk factor for disease burden in the Western Pacific, where Palau is located. The focus groups will provide insight into why Palauans think drinking rates are so high and explore their ideas for solutions.

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Clinical year begins

Today I completed my first clinical rotation.  What a challenging, humbling and incredibly fun experience.

Five weeks ago, I was assigned to a pediatric clinic in a small town in eastern Oregon.  Honestly, I wasn’t sure what to expect.  I was apprehensive about working with children – I have none of my own, and I haven’t spent much time around kids in the past (especially babies). Our pediatric unit in class was months ago, and I had long since forgotten the immunization schedule.  Not being a native Oregonian, I had never heard of the town of Ontario, and I didn’t know anything about the community. The thermometer read 103 in my car as I traversed the state, brushing up on my peds knowledge with podcasts and anticipating a new adventure.

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Things I like about being a graduate student (yes, really!)

StudentSpeak is pleased to share this guest post from Kelly Chacón, a fifth year Ph.D. student and president of the OHSU Graduate Student Organization.

Venting about what stinks about graduate school can be a really nice way to commiserate with my fellow graduate students – especially over a whiskey. Whether we talk about how hard it is to obtain an email reply from our advisors (or the double-edged sword that is their cryptic two-word response), or about how we are still sometimes treated like first-year undergrads while in our thirties, it can be really cathartic to share what makes grad school tough. And I don’t think we should ever stop sharing those things, whether face-to-face, or on our blogs. It’s real talk!

But on one sunny day a few weeks ago, when my experiments were going O.K., my caffeine levels had reached that perfect zone and my boss had given me some rare praise…I decided to consider what I like about grad school at OHSU. Because, actually? It’s a pretty good gig, and I think I sometimes forget that.

First off, I often forget the significance of the fact that I get paid to get my doctorate. Sometimes it’s important for me to let that sink in.

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Assessing maternal health in Ethiopia

StudentSpeak is pleased to share this guest post from Elena Phoutrides, MS2, a student in the joint M.D./M.P.H. program. Elena is working abroad this summer in Tigray, Ethiopia thanks in part to the R. Bradley Sack International Scholarship and the OHSU Global Health Center.

It’s mid-morning: somewhat watery sunlight lighting up the bougainvillea, the appealing smell of fresh-roasted coffee in the air. Just about time for a coffee break here in Mekelle town in Tigray, Ethiopia.

I am fortunate to be working this summer with Healing Hands of Joy (HHOJ), a non-profit, nongovernmental organization based in Mekelle. HHOJ works with women who have experienced obstetric fistula; this condition occurs during prolonged obstructed labor, which creates a hole between the uterus and the bladder, the rectum, or both. The direct result of this injury is urinary or fecal incontinence. Indirectly, many women who experience fistula are traumatized and socially isolated as a result of the smell that accompanies obstetric fistula.

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Reflections from year one

StudentSpeak is pleased to share this post, reprinted with permission from Roheet’s blog, The Biopsy.

“What is your hand on?” the surgeon asked, her question punctuated by the whirr of the ventilator wheezing away in the chilly operating room.

I stood there for a moment, quietly, just trying to get a sense of my orientation. In reality, I knew just where my hand was placed. It wasn’t a trick question and it wasn’t particularly hard to answer. Part of me, though, just didn’t allow the realization to sink in. So, I stood there, searching for something more, something other than what my fingers obviously felt.

My mind stretched back to anatomy and embryology at the very beginning of the year for answers. Last August, everything, everyone, was new. My white coat was freshly white, uncreased, neatly kept, gleaming with my newly minted nametag – “Roheet Kakaday, Medical Student”. I had achieved the dream, but the promise had yet to be fulfilled.

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A year older, a year wiser

Almost a year ago to date I attended new student orientation as a very anxious and excited new student. I peppered the students going into their final term with lots of questions and eagerly awaited the first day of this program. Today, I was one of the “seasoned” students who was answering new student questions. I have less than 100 days until graduation. Approximately 300 clinical hours, 1 skills lab, 1 simulation, a few other random things and a test (that shall not be named) stand between me and those magical letters R.N. after my name. I think my greatest learning is yet to come this summer but today’s reminder of where I started got me thinking.

A student asked me today if it feels like last year’s orientation felt like forever ago or a blink and my answer was both. This program has absolutely flown by but I don’t feel like the same person I was when I started it so it also feels long that way. I’ve stretched and mushed my brain with new knowledge until it was coming out of my ears. My heart has constantly been full…hearing a refugee’s story, caring for a patient in a vulnerable moment, or just feeling so much passion for this work. I’ve picked up this new language that is nursing. I’ve incorporated so much into my definition of nursing. Teaching. Being present. Holding space. Translating. Safe guarding. Nursing is so much more than I initially envisioned and it really is forever evolving, especially right now.

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You know you’re a grad student when….PART DEUX!

I was going through some old posts – my little, growing collection of posts – and realized that some of them are just, well, kind of depressing.  That’s not to say grad school itself is depressing, or that I am even depressed. And then I found one of my all-time favorites ‘You Know You’re a Grad Student When…” I wrote that post in March of my second year. Those were good times – sigh. But now, on the flip side of third year, it occurs to me there are a few things that really, really should be added. So, without further ado…you know you’re finishing your third year of graduate school when…

1. Your PI has to confirm how many years you’ve been in lab because, well, it feels like you’ve been there forever (true story).

2. The post-doc who hates pink and Hello Kitty left to Taiwain for three weeks and you papered his bench with Hello Kitty as a welcome back treat (also a true story).

3. You haven’t seen some of your classmates since first year.

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Ever wondered what life is like as a student at OHSU? What does it take to become a researcher? Just how gross is gross anatomy? Welcome to the blog that answers these – and many other – questions. It’s students writing first-hand about their commitment to careers in science and health care. It’s honest about the challenges as well as the joys. It’s not always pretty. But it is our story. Thank you for sharing it with us. And please, let us know what you think.

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