The Start of Something Big

Several STEP exams have come and gone, two years of clinical rotations, and kid. It seems so crazy to sit back and consider where all I have been over the past few years. When we got back to the states, I studied for STEP 1 while Frances worked as a nanny. Once my score came back, we found out that we would be moving to California for my core clerkships. This was also when we found out that our son was on the way. Core Clerkships were hard but rewarding. I could not decide what I wanted to do as a specialty. However, I kept finding myself in the ER on every rotation, preferring it to call rooms and the library. Our son arrived just as I started Trauma Surgery. Needless to say it was a struggle for Frances. I do not know how she was so strong. After a brief period of flirting with the idea of pursuing surgery, I finally settled on what had already been in front of me since day one of clerkships, EM was my specialty. After rotations in California, NYC, Connecticut, Louisiana, and Nebraska I finally finished medical school and applied for the match. After a 6-month stint working again as a Paramedic after graduation, I finally began my dream of being a physician on July 1, 2017. I matched EM at UMMC in Jackson, MS in the class of 2020. Here is to the next big adventure in the long journey!

Semester the 5th

We are now on the down-hill slope. I have already started planning my Step I study schedule and plan to take it at the end of August/beginning of September. Hopefully, I will be able to make the October 1 start date deadline to make the 2016 match. Last semester went very well. Although I didn't wind up honoring Neurology, I came very very close and did very well in all my other courses. I ended the semester with almost an 87% cumulative for the semester and an 85% overall for the first four semesters. I hope to build on this momentum this semester even though my schedule is less than ideal. I finish my first class of the semester later this afternoon, Medical Ethics.
The downside to being this far along is seeing some friends head home. Both those who have failed and those who have finished. I know next semester will be even more challenging without all my close friends. Fortunately, I have my best friend with me until the end. I do not know how I could have come this far in the journey without her. Frances has been there for me every step of the way, even when I stumbled in the second semester.
One step at a time, one class at a time, I am slowly getting to my life goal of becoming a physician. I know there is a lot left ahead, but it never ceases to amaze me how far I have come. Until next time, be well, do good work, and keep your stick on the ice!

Semester the 4th

It has been over a year now since we came to the island. It seems like so long ago. Since I last wrote, we moved apartments, got a dog, and completed the third semester with high marks. In addition to school, I have been serving as the Presiding Senior of the Sigma Chi Mu chapter of the Phi Chi Medical Fraternity and a Harvey Tutor. I am very proud of what we have been able to accomplish over the past semester as an organization. We raised $1000 for charity last semester and completed over 500 hours of community service. This accounts for 1/6th of all monetary donations from the school to local organizations and nearly 1/4th of all community service hours done by students. We have started a series of talks via skype with physicians back in the states as well as students in the clinical years to clarify the road ahead for our fellow students.
This semester is already flying by. It is hard to comprehend that in just under a year, we will be leaving and preparing to take the Step. This coming break will be a nice long (3 week) respite despite all of the doctor appointments and family drama. I can hardly wait to see snow (Frances disagrees strongly on this point). Here is to the 4th semester, see you on the other side.

Semester Three

So here we are starting the third semester of medical school. Not even a year ago, I found out that was finally be given my chance. It has been tough, but medical school is supposed to be. Just over a year from now we will be headed home to take Step I. I am so grateful and looking forward to the remaining challenge in front of me.

The calls that knock you down and teach you

The call came in like any other, "68 y.o. Male feeling ill". As we arrived on the truck, there was no hint of the chaos that was about to unleash itself in the house on a quite street. The Paramedic on the ambulance, is often known for his ability to be calm under pressure, this night he looked panicked as he met us at the door and said," we need to go right now!" the man was pale,cool and diaphoretic. When we attached him to the four lead, he had tombstone t-waves. It looked like he was having a heart attack in the bottom part of his heart. When we placed the 12-lead on him, the ectopy had cleared and he was in normal sinus tachycardia. We where puzzled. Then things got worse. He began to complain of not being able to breath. His lungs where demonstrating pulmonary edema. One of the other medics on scene began to reach for a nebulizer mask, when the patients pupils dilated shifted to the left and he vomitted. now we where thinking neurological cause. As we sped towards the stroke center, he began to drop his Herat rate from about 160bpm to 40bpm rapidly. I remember asking, "do we have a pulse?" No pulse. "Ok gentleman, here we go." As we pulled into the ER, we got a pulse back, then lost it. We worked him in the ER for another 20 minutes before we got a pulse back, just as the attending physician was about to call it. During that 20 minutes, the ER attending took a portable ultrasound, and discovered a 7cm dissecting aortic aneurysm. They patient maintained a pulse into the OR where he died on the table. Many lessons where learned, but I often am left to wonder if my seeing all of this knowledge was worth the death of a father on the eve of fathers day? I have faith that one day, be it today or 30 years from now, that what we saw last night will effect the life of a patient and their family.

Location:S 25th St,Bellevue,United States

Changes and Challenges

Frances and I, despite a fair amount of jet-lag found a great place at a fair price and began to determine what we need to bring with us in the fall. I have included picture below. I still cannot help but shout from the rooftops that I am going to be a doctor!!!!
I had a hard time returning to work and dealing with all the normal everyday crap knowing that I am moving on in less than three months. I began to think that nothing I had to experience in that time would teach me, and then the call came in for a GSW following a pursuit. I expected to find the normal small caliber injuries that I have often dealt with in my career in EMS. Instead, I found high powered armor piercing round injuries. It was unreal, I had never actually seen a real pericardial syntesis until that afternoon when the Helo crew performed one on this patient. It was one of the most devastating calls that I have been involved with to date, but it taught me once again that in the face of the worst, I can be calm, cool, and collected. Additionally, in the midst of chaos, I could teach and simplify the most complex of concepts. While it is difficult to see these traumatic things, I can move forward in the knowledge that given the worst, I will be fine. All that I need to overcome now is the academic challenges of the first two years.
Enough of the depressing. Frances and I found a one bedroom apartment with all the amenities to make it comfortable for a newly married couple. It has a great view, a nice bathroom, and a kitchen that many a chef would be jealous of. It even has a wine-cooler! Here is to the adventure this fall, and any still waiting for me at work. Enjoy the photos below:

Things are happening fast...

A mere two weeks ago, I received a phone call that has utter changed my plans for this fall. The day before my graduation from graduate school I was planning on starting another masters in the fall. At approximately 3:30 that afternoon, I received the call that I have been working toward for the better part of a decade. "Noah, we are pleased to inform you that you have been accepted to our medical school for the class starting this fall!" In an instant my entire system of contingency plans became useless. No more studying for the MCAT, working as a Paramedic while at school full time, no more disheartening letters from medical schools informing me that they didn't want to admit me or I had been placed on the waitlist. The paperwork that has ensued has been enormous. If that did not make this opportunity a reality fast enough, I am leaving tomorrow to look at housing prospects for Frances and I this fall. This experience has taught me that the journey thus far may have been long and difficult, it has been worth every step. I am under no delusions as to the task that lies ahead of me, but I appreciate this chance more than any other person I know. I am just thrilled for the opportunity before me!

Location:Bellevue, NE