Time for some PA Advocacy!

If you are a frequent flyer to my blog, you already know I'm a Physician Assistant. Given the recent passing of national PA Week (October 6-12, 2013), lets take a moment to spread the word about PAs!

Definition: 
A PA (Physician Assistant) is a member of a medical care team supervised by a physician. Depending on what part of the country you are in, and what medical setting we are discussing, this medical team can include multiple physicians, PAs, nurses, medical assistants, or it can be a two person team consisting of just the physician and the PA.

The details of physician supervision varies by state, but overall the term generally means that physicians oversea and delegate the activities the PA performs and assumes some level of responsibility for the medical care provided by a PA. The physician need not always be in the same vicinity as the PA nor does the physician always dictate each and every medical decision a PA makes. PA's are an extension of physicians. We are educated in the same model as physicians and we are licensed by the state in which we practice to provide competent medical care. We must graduate from an accredited PA program and pass a national board examination in order to become licensed.

What I do:
I work for a major medical center in the department of hospital medicine (we take care of all the patients admitted to the hospital under general medicine, as opposed to a specialty such as neurology, surgery, cardiology). A day in my life begins with reviewing lab work, test results, vital signs, rounding on 12-16 patients with or without the physician present, make a medical plan with the physician and carrying out that medical plan whether it be ordering tests, prescribing medications, or calling specialty consultants. The physician may physically be on the floor with me for as little as 2 hours, or as many as 8-10 hours a day depending on their practicing style. When they are present, we work together coordinating patient care, tests, consults, and social needs with the social work team. When the physician is not present, I not only continue to carry out the plan discussed with the physician, but handle any issues that may come up in the meantime. However, I am never completely on my own and can always reach the physician on call by phone, pager, or text if needed.


For links to more information: Click here!

F is for Fall Fantasy Football

Fall used to be a simpler time for me - it would bring a simple sadness that winter was coming and my summer clothes would be doomed to darkness in the dresser for the next 9 months. The only bright light during this dim time would be Thanksgiving and the joys of the holiday season. But never fear, fantasy football is here.

This is my third season and I've graduated to participating in two leagues. Two leagues, I had hoped, would equal twice the fun. No. I was wrong. Two leagues = twice the disappointment, anxiety, and bitterness on each and every Sunday and Monday for the 4 months of this terrible and wonderful time of year. Let me explain:

The season starts with the giddy joy of being accepted back to the leagues (as a woman this is quite a feat). The excitement continues with the prospect of the draft - who will make the team? Will it be Drew Brees? Or will I finally believe Howie when he says I over-value quarterbacks and attempt to hoard receivers and runners? And what about my team name? Oh the pain of seeking a brilliant team name that strikes fears into the hearts of others in my league! In actuality, I really just hope my team name gets at least a chuckle for being mildly clever.

Then draft day arrives. With many windows open on my screen, I jump back and forth frazzled trying to look up the players I'm not as familiar with between picks. After all, before fantasy entered my life I only ever paid attention to the Giants - there are a lot of players in the NFL to learn about! The end of the draft brings some relief, but also the onset of nerves. Did I make the right picks? Is my team solid? Week one will tell.

A loss and a win. Okay, I can deal with that, its only week 1.

Week 2: a loss and a win. Alright, being 1:1 in both leagues is not bad... its still early.

Week 3: a loss and a loss. Ughhh. My defense is falling apart in one league... my receivers in the other are getting double covered on every play. My stars are falling to "Questionable" for next week. The players left on free agency are limited. I fear a trade. What to do? What to do? It's still early...

Week 4: Here we are. What started out as a hopeful Sunday in the lead after the 1:00pm games has turned into a nightmare and I'm looking at another 0-2 weekend. How can this happen? My teams were solid...

My options seem to be dwindling and despite the appearances of solidarity on a "stacked" team, my players still can't keep it all together to get me a win. What looks like a solid lead turns into a 30 point deficit just because Tony Gonzalez has a breakout 38-point achievement that never should have happened while my defense dwindles into negative points for the 2nd or 3rd week in a row.

I know this is all of a lot of jargon and for those of you who don't participate in fantasy football, this is probably a nonsense post. I just can't help but reflect how my fall has changed from a time of mourning the seasonal equinox to anticipation over how my 17 players from 10+ different teams will play in their weekend match-ups. I now worry over predictions and averages and rivalries. In some ways, my fall is a lot more exciting, especially when my team wins. Its also brought me closer to a sport I grew up with but did not fully appreciate before. However, it also brings with it the emotional roller coaster of a lifetime. Oh fantasy. 

The light at the end of the tunnel

Six weeks post-wedding and here we are! This will be my last wedding related post. I couldn't leave you all hanging at the 2 months-to-go mark so here is a synopsis of the craziness that happened at the end.

{Since this is the last "getting married" post, I just want to remind anyone who is reading who needs some helpful links and vendor recs to see the Wedding Links page under the "More.." tab.}

Where we left off ...
     Engagement photos: We had wanted to do these in April. Then we wanted to do them in May. Then we scheduled them for mid-June. With everything we had going on at the time, we sprung for the extra $200 to have the photographer come to us in NY from his home base outside Philly - which was well worth it. This was one thing I had initially thought I was not going to do at the beginning of my engagement, but boy am I glad I did. Not only do we now have tons of professionally done pictures of the two of us (as opposed to only having a handful of photos taken with smartphones on tipsy nights in poorly lit bars, clubs, or restaurants), but we also got to know our photographer and have a lighthearted "date" of sorts with each other to ease some stress.

     Flowers: Last we chatted flowers were not done at the two month mark. Thankfully all it took was a skype date with a smaller mom & pop florist shop and a bit of chemistry to check this off the list. I showed her a few pictures of flower arrangements I liked based on my likes and dislikes I sorted out from the first shop we almost contracted with.

     Transportation: I ended up feeling frazzled enough that I ended up putting this in the hands of my then-fiance. He contacted my brother who knew of bus companies in the area from his fraternity events-coordinator days and he called up a few limo companies found via google. We calculated the best way to limit the number of vehicles we needed by deciding to transport the bridal party around in shifts using one limo, and likewise scheduling shifts with one school bus for transporting our guests between the hotel and reception venue.

     Favors: We knew we wanted something that was not going to be thrown out when people got home the next day. We didn't want a personalized trinket or "souvenir" to send our guests home with. So my mom suggested we give away Hope's Cookies, a local mini-chain in the Villanova area that baked and packaged the cookies in pairs for us. All we had to do was pick them up. It was perfect.

     Seating Plan: This was tricky. We only had approximately 2 weeks to sit down and do this and its really the type of chore that you just have to buckle down and get it done.

     The Extras: The last week before the wedding there were, of course, a million little extras that needed to get done. At first I was not going to take that entire week off from work, but boy am I glad that I did! I needed the time to finish all the miscellaneous details and feel secure that we did all we could to make it "perfect".

     The Big Day: Surprisingly, the entire occasion went off without a hitch on the day of - except for my own nerves of course. All the details were perfect, the flowers were perfect, the DJ was perfect. We had an amazing time and really enjoyed our celebration. If you are planning your wedding in the greater Philadelphia area please see the wedding links page (under the "Extras" tab) for our vendor suggestions - we LOVED each and every one of them.

     The Honeymoon! YAY! The best part of everything! We booked in June for the end of August. We wanted somewhere non-traditional after our bold original plan of going to Italy fell through. I knew it needed adventure and relaxation to appease both of our interests so we chose Belize! It was absolutely fantastic and we would go again in a heartbeat. Beach, ocean, snorkeling, Mayan ruins exploration, swimming with sharks, zip-lining, fantastic food, we couldn't have asked for more!

The Human Race

There was a time when I believed racism did not exist. There was a time when I thought people in my social class, in my town, in my neighborhood, in my family could never possess the capacity to be racist knowingly or unknowingly. There was a time when I thought it was just a non-issue in my life. I'm hesitant to write on this subject, but part of me feels that I need to record these feelings somewhere.

When I was a child, my mother's mission in raising me was to raise me to be perfect. An ambitious task that clearly failed, as no one can obtain perfection. However, her attempts were not fruitless and my parents certainly got a few things right. Somehow they taught me to love people. I was painstakingly encouraged to find the good in everyone, to treat them well, and to love each one. As a child I would befriend anyone, it never mattered if they were small, large, boy, girl, black, brown, "cool," or "weird." I lived in a nearly homogeneous town - approximately 95% white. Race was never a big deal because there wasn't much of it. Of the handful of non-whites in my class, all of them found a crowd to belong to. I never experienced or witnessed discrimination. College was another near-homogneous environment and life continued as it always had. My husband and I met a week before I turned 18 the first full day of orientation at our undergraduate university. We became friends and we shared friends we had in common. He was black and I white, but I never noticed. It was just something seen but not processed - it didn't matter.

I had a moment when Howie and I both seriously entertained the idea of dating. The thought first crossed my mind: "Oh, he's black... does that matter? What will my parents think? What will my friends think?" To this point I had never met an interracial couple, I had never faced this concept, and while my instincts about befriending people bore no colored glasses, I consciously entertained the idea for a moment. What did this mean? For all my parents hard work to raise me right, to raise me blind to this taboo social constraint, I had a moment in which I hesitated. I consciously took the issue and made a decision about it in that moment. If race never meant anything to me for the first 19 years of my life, I was not going to let it affect me now. It was stupid and superficial, especially when a deep love for that person was already nesting in my soul.

I was 19 when racism first grazed my life.

Our dads were not so keen on our black/white-ness at the beginning. It was a stress that became a part of our first months of dating. It didn't take convincing, per say; I never had to sit down and explain my reasoning for dating this person to my dad, nor he to his dad. But it did take time and encouragement from our mothers for them to identify the fact that they needed a moment. They needed a moment to consciously hold the question in their minds and face the issue. And unsurprisingly with a little time and patience they both embraced each of us as their children. Perhaps its because they are our dads that it was easier for us to not really take this to heart as a personal attack after it all settled down and to move forward along with them.

We continued living in our relative bubble of life, which did not include racism. Surrounded by our peers in age, education, and socioeconomics, we remained a part of a homogenous society.

Sadly, just 15 days before our wedding day racism struck again.

We received a message on our wedding website from an anonymous source criticizing our interracial union. Its unknowable if it was a family member, a friend, or a random passerby to our site who felt it their moral obligation to butt into business that is not their own. But the message was racist and did just what racism is meant to do - incite insecurity and inferiority. The author made a series of points including "a person truly secure with themselves instinctively wants their children to look like them," "you're the beautiful young lady you are because your parents and grandparents respected the fundamental to marry within their own heritages," "sure you and Howie can be friends, but raising a family is serious business and you should marry within your heritage especially since our kind is quickly becoming a minority," and finally ending with the statement that "your friends and family are ready to support you in your decision to cancel this event [meaning my wedding]. Sincerely, A Friend."

I was, needless to say, shocked. Stunned. Speechless. I was reeling with disbelief, anger, and insecurity. My inner monologue was practically on speed with spite and sarcasm... Well clearly, I am so insecure that I would like to hide my genes behind the dominant black genes that are sure to take over. I'm certain my children won't look one bit like me after those genes have done their work. And yes, only white European mutts are beautiful, clearly people like Halle Barry, Alicia Keys, and Mariah Carey are not beautiful. Who talks about "heritages" anyway... and does this person realize I'm a mix of at least 5 different Caucasion "heritages" from across western to eastern Europe all the way up to Russia? Good job, ancestors, for marrying only within your own. Maybe "our kind" becoming extinct isn't so bad if it means narrow minded people like you become extinct with them. Signed a Friend? A Friend? What kind of "Friend" is this. And do they realize the wedding is in 15 days... If you are such a concerned friend, then why now after I've been engaged for almost 3 years. They better not be invited to the wedding, and if they are, they better not be coming. What if they are coming, what if they say something at the mass? What if this "friend" feels the need to make a scene, or say something to my parents or me in person? 

My initial anger gradually changed to anxiety. I promptly removed the post from the website in my wild desire to attempt to make this issue now disappear. But the feelings remained and the words continued to sting my memory. It wouldn't disappear. And I knew that it wouldn't disappear as the anxiety swelled and the fear of hearing someone agree compelled me to keep this quiet and secret from most everybody.

It was troubling and challenging to deal with, partly because it was something I had never dealt with or witnessed (at least to my knowledge I had never witnessed it). I had developed a distrust for my extended family and friends and a sense of resentment toward my own race. In fact, I felt my race had been taken away... or rather that I was giving it up. I didn't want to be seen as white anymore. I didn't want to belong to a race, a group of people that, for all the hurts it caused and supposedly regrets still carries on with the same haughtiness and sense of superiority and entitlement that enabled itself to commit those prior crimes in the first place. Not to say all whites are the same, surely many would never feel those feelings. But in that moment and the following days, I was facing the inferiority and insecurity created by a racist note from and unknown party. I felt like the world was against me and I didn't realize it was a conspiracy until too late - I felt like I was walking into a trap, that my wedding was a set up and all I loved and knew would crumble. I no longer felt like the blissful outsider I once was. My ideals about society and the human race had been stripped from me. I thought we had finally figured out that being part of the human race was enough to unite us, at least here in my American, educated, middle class bubble it should be enough -- it should be enough, right? We should know better. Perhaps I should have known better...

An Adventure

This is a personal shout out post in honor of my PA school besties (holla at a dolla honey boo boos!).

We've been fortunate enough to be able to take time to go on mini-vacays (mini-vacations) and local outings in between our studies and now in between our work schedules. All have ended successfully, but let me tell you - they were not always smooth sailing, complicated often by rain, cranky non-morning people, missed transportation, or other series of unfortunate events. Let me take you on an adventure with a little creative writing of our most recent get-away:

***

With the rolling in of early spring, we were absolutely tired. Tired of winter, tired of work, tired of the monotony that our lives had recently transformed into. It was time. After the success of our last mini-vacay to Florida, we were ready to embark once again. While sitting on the couch at an impromptu and very rare evening get together, Misterious and myself were chatting.

"I'm tired of work, I need a beach," I said.
"I know, we need to go on a vacation," Misterious replied.
"Well lets do it, when can we go? How about June? We don't have our schedules, we can request off now."

With that, Talulah meandered in "What's that?"
"We are going on a mini-vacay, wanna come?" I asserted.
"We are? Where are we going?" Talulah questioned hesitantly.
"Anywhere, lets just go, why not?"

And so the planning commenced. We were each a bit nervous at first if we should all commit to the request, and it took some convincing to get Mr. Napkin Head to agree to take time off, but finally we picked the dates: a Monday-Wednesday in early-mid June. We had the destination, we had our bathing suits, we had the booze (what we didn't have was a promising weather forecast). That Sunday night we settled departure times. Monday morning we woke to a dreary clouded sky with sprinkles of rain in the air. Last minute errands were accomplished and Mist texted me to let me know they were on the way to pick me up. I was in my usual state of last minute rushing trying to play musical dufflebags so all of my belongings, snacks, and sun lotion would fit.

The phone starts ringing, which is also usual when I'm rushing. It's Talulah. "Heyyy..." I answer in my what's up voice. "Soooo... I don't know about making the 12:15 ferry....", "Uhh... why?", "We just got in an accident..." Talulah proceeds to explain to me that no one was hurt (thankfully), but that the guy who hit them is crazy and it might be a while.

1 hour later via text "how you guys doing?", "waiting for the police", "they haven't arrived yet? what's with these bronx po po"

2 hours later via text "po po show up?", "nope, not yet", "what?! that's crazy!", "we just called 911 again"

3 hours later the phone rings. It's Talulah. "Soooo... we just got back to the apartment and are switching cars now, so we should be there in a half hour." Finally we were on our way again headed towards our mini vacay. After a stop for coffee, cash (real cash, no checks), and a run back to the house for a wine bottle opener we hit the highway. After our drive over the bridge and through the woods we made it to Bayshore. We grabbed a quick snack and found the ferry boats - the only visible ferry boats from the parking lot, mind you. It was rush-rush as usual since we had exactly enough time to buy our tickets and hop on the boat before it departed.

After twenty or so minutes of mouthing sentences to each other on the very loud ferry boat we landed at stop 1 and then shimmied over to stop 2 where we departed into the light drizzle. We walked about 30 steps and called the hotel to find out where to go.

(Side note, this is my personal interpretation of the phone conversation that took place since it was not I who was on the phone):
"You're where?!?" The receptionist exclaimed.
"Uh... Ocean Bay Park? Right?" We nodded in agreement.
"Ocean Bay Park, you girls took the wrong ferry!" I hope you are inserting the Long Island accent when this receptionist is speaking... it really makes the translation better.
"Ok...."
"Well, I mean, I guess you have to either walk here or you can take the ferry back to Bay Shore and come back on the other ferry."
"Well, how far is it?"
"A mile."
"Then it seems like it makes more sense to just walk, I guess."
"Alright well just keep walking for a mile towards the water tower and you will find Ocean Beach." We looked around, and alas, no water tower insight. But fortunately we were right next to a bar so Misterious peeked her head in, asked for directions and we embarked on our mile long journey, each with multiple heavy bags, plus groceries in our hands.

As we began hobbling along, our faces sunk. Ten yards away was a puddle the size of a small pond blocking our walkway. We hesitantly glided through the cool water as frowns of concern traversed our faces. What were we walking through? What were we gonna do? We forged forward calculating when our last tetanus shots were through alternating dry and puddled walkways. Some puddles were as deep as our ankles, others we could hop around on the outskirts of the walk. On two occasions we were greeted by extremely friendly deer. The first attempted to follow us until we reached a puddled, the second darted at our bags and sniffed them before trotting off.

With Talulah on the google maps navigator we made it, "The blue ball says we are at Ocean Beach, now what?" We couldn't see anything obvious to walk towards so we called our receptionist friend once again.
"You're where?!"
"Cottage," the name of the walkway we were on.
"Oohhkay, Just turn this way, walk to town, go right, then right, then I'll be looking for you." So we walked to town, and the rains came down. Our clothes began turning see through, our bags became heavier, and I felt as though I needed windshield wipers for my eyes. We got to town and traversed the puddles with Mr. Napkin Head on the phone with the receptionist until we finally made it.

With a great huff she said, "Aww, look at you, the lost girls, let me get you some towels. I guess you've never been to Fire Island before." We weren't quite sure if she thought we were complete idiots or if she genuinely felt for us, but the towels were warm and we were aching from our bags so we went with it. Our journey wasn't quite over, though. We had a two block walk to our apartment through yet more puddles before finally being able to change into dry clothes and lay our our belongings to dry. Once we accomplished that, you can guess what a group of four sensible women like ourselves did - made good use of that bottle opener.

Thoughts for food

I actually had every intention of sharing a recipe with you in this next post. I then forgot to take pictures of said recipe so I decided I would wait until the next day and share a different recipe. Alas, my work week started and so I became even more forgetful during my evenings and have no pictures. So you will all have to wait until I make something worth sharing again to get an actual recipe post.

Instead, let's talk about cooking. Let's talk about the joy and peace of mind that comes from designing a recipe, committing to it, and perfecting it. Even taking a dish that was passed down, or a recipe found online and tweaking it to meet your own tastes lends a certain satisfaction to an "everyday-chef" that is sometimes hard to find in the fast paced lives we lead. Its a mental release - the way reading is for some and music is for others. While effort is required, it is certainly worth the reward.

Learning to cook well demands a certain passion for food in general. Personally, it took me a long time to get to this point. I was an extremely picky eater as a child. I didn't start gaining an interest in food until college, which my friends started pushing me to try new and different things. My world expanded, and it was good.

Getting older and wiser has only allowed my interest in food to change and grow. Learning to create the type of cuisine you grew up with is one thing. But being able to expand and experiment with new styles of cooking is even more exciting.

Not only does creating a new meal provide a therapeutic escape into creativity, it actually poses a challenge to eat better, more well rounded meals. Or, rather, it dares you to eat better. Putting effort into making something productive drives you to make something you can feel good about in the end. Making a meal that tastes good is only enhanced when it also happens to be good for you. I feel significantly better about myself when I make a good meal, both inside and out. Any anyone who knows me knows a happy belly equals a happy Jessie (same way a Snickers makes Joe Pesci turn into a party bro). 

Let's get up to speed

Its been a while. I admit I miss writing. I also miss sleep and structure. I've been working as an internal medicine PA now for 5 months; its gone by amazingly fast and I still feel as brand new as the day they let me off my training leash. My job is hard. Harder than I could have anticipated - and for that I love it. I am being challenged, truly challenged, and in the long run it will make me so much better. However, for now it makes me incredibly lazy on my days off and with Howie being on a completely different schedule its hard for me to stay strict with my own needs. The temptation of staying up with him to watch TV and sleeping until 11:00am on days off is too much for me to say "no" to. And since I no longer have homework and studying hanging over my head, I become a slave to my couch. Clean the kitchen? Eh, it can wait. Go shopping? I have a computer. Socialization is the only thing I can motivate myself to do, but even that is hard with my friends being on such different schedules. 

I've been telling myself its time for a change for a couple months now, and I've been mildly successful. I've devoted more time to wedding planning. I exercise 3 times a week ... though I miss having the motivation to work out 6 times a week... I send myself articles that I sometimes read. All in all, this is not where I want to be. I want to be productive and frankly I feel unproductive. So I have to find a way to hold myself accountable. I started this blog last spring. My goal: To revive my drive, to resume regular posts, to increase my work-outs, to read more medicine, to cook more meals at home, and complete wedding plans in a more timely/organized fashion. Once I do that, I have more goals to add, but I wouldn't want to bite off more than I could possibly chew so soon. Let's start small people! Here's to ambition and, hopefully, achievement! 

In Mourning

My hometown was paralyzed Friday, December 14th. I'm still feeling a bit paralyzed myself, grieving as I would someone I knew personally. This was an anonymous poem I received in an email and I feel I need to share it too.

"Twas' 11 days before Christmas, around 9:38

When 20 darling children stormed through heaven's gate,

Their smiles were contagious, their laughter filled the air,

They could hardly believe the beauty, of all that they saw there,

They were filled with such joy, they knew not what to say,

For they remembered nothing, of what happened earlier that day.

"Where are we?" asked a little girl, as quiet as a mouse,

"This is heaven." said a boy. "It's Christmas at God's house,

"When what to their wondering eyes did appear,

But Jesus, their savior, and the babes gathered near,

He looked at them and smiled, and they smiled just the same,

Then He opened forth His arms, and called them each by name,

In that very moment, was joy that heaven will bring,

Those children all flew into the arms of their gracious King,

And as they lingered in the glow of His warm embrace,

One small girl turned and looked right into Jesus' face,

Then as if He could read all the questions she had,

He gently whispered to her, "I'll take care of Mom and Dad".

Then He looked down on earth, the world so far below.

He saw and wept for all hurt, and all the deep sorrow,

He closed His eyes and He outstretched His hand,

"Let My power and presence re-enter this land!"

Then He and the children stood up without a sound.

"Come now my little children, let me show you all around".

Excitement filled the space, some skipped and some ran.

All displaying exuberant joy that only a child can.

And I heard Him proclaim as He walked out of sight,

"In the midst of this darkness, I am still the light."

The Social Network

Social media has been on the rise since the '90s. Starting with MySpace, progressing through Facebook, and  continuing with Twitter and Instagram. I, for one, never participated in MySpace; Facebook was my first venture into social networking when it was still restricted to college students. Since then I've joined LinkedIn, the professional network, and I dabbled in Pinterest for about a week before calling it quits (I didn't really understand it and didn't want to deal with it after my interest fizzled).

Three days ago, however, I joined a new "club:" Twitter. At first, I didn't understand it. I wasn't interested in joining these millions of networks not knowing who was going to bump into my account. However, my interest grew insidiously from recommendations from friends and siblings, so eventually I caved. And, to my own surprise, I am hooked. Within 24 hours I found myself incessantly checking statuses and searching for new people to follow. So far my collection includes various sports analysts, Chelsea soccer, Barcelona Soccer, Giants Football, Paula Deen, Snooki, some of the Kardashians, Brit Brit, Ricky Gervais, Aziz Ansari, E! News, a bunch of friends, and more. Needless to say, I rarely find myself bored these days since there are always new tweets and instagrams to check up on. No wonder this has caught like wildfire and sucked me in with it!

While I'm completely in love with twitter, it has caused me to once again reflect on American culture. Aside from the friend who urged me to join, most others have had that "why would you do that?" response when I've shared with them my new obsession. But is it really that shocking? Just as facebook was (and arguably still is) a means of instant procrastination with a sense of social belonging, twitter offers that same gratification. Even Pinterest, which I still don't buy into, is loved by many, many of my friends... social belonging is fulfilled by pinning to your friends boards, its a wonderful means of procrastination, and it triggers pleasure centers in your brain looking at pictures of delicious goodies, beautiful places to visit, or creative projects you're dying to try... albeit this is more of a network geared towards girls since you can post an unimaginable amount of the above mentioned goodies, travel sites, or DIY (do-it-yourself) projects.

Twitter offers all those same feelings of social ties, but adds the sense of actual interaction with your favorite celebrities, politicians, sports announcers, sports teams, athletes, organizations, etc. What could be better than watching the X-Factor and feeling like your hanging with Brit Brit as she tweets through the entire show about her feelings regarding the contestants? Or how about getting a play-by-play of your favorite soccer match while at the laundromat? Or getting to hear the sass of your favorite comedian throughout the day? It's instant entertainment at any given moment. Plus you get to add in your own 2 cents whenever you feel like it.

Now, I'm not a spokesperson, but I imagine this is what any advocate of twitter would argue and then some. However, I will admit I waste an incessant amount of time these days waiting for my job to start so I had to entertain myself with something and twitter happened to find me at the right time. And because of that, I felt the need to share with you what I've learned about this bit of American culture gone wild: it can be quite addictive.

Happy PA week!

The end of PA week has come and I felt it was time that I contribute to promote my profession. I'm a Physician Assistant, which means I am a trained graduate of a masters program in medical education, I've passed a national certification exam, and I am licensed by the state to provide medical care to patients in almost every medical specialty, including diagnostic testing, managing patient care, and administering treatment to patients. I work as part of a team with medical assistants, nurses, and supervising physicians. Want to know more about how PAs are providing necessary medical care in today's society? Here's a great video on PAs: I'm a PA

Here's a link to my page on PAs, Health, and Medicine where you can find even more information about this great profession. 

Willkommen zum Oktoberfest

{Welcome to Oktoberfest}

Fall is back! Well, I supposed it has been unofficially fall for over a month now if you count fall as the start of the school year. You could say this is the 4th week of fall if you go by the NFL's calendar. However, you could be true to the solstice and only admit to it being the end of the first week of fall; nonetheless, its undoubtedly the time of year that indicates a select few things to celebrate. First: football, second: Oktoberfest style beer, third: football...

While I clearly am a football fan, that is not the focus of this post. This last Friday we went to a mock Oktoberfest celebration at a quaint German restaurant which got me thinking about what my favorites are, especially since Howie goes crazy for Oktoberfest style beer annually at this time of year. For those of you who know me, you know at least one of two things: (a) I'm not a huge beer person, and/or (b) I'm a huge beer snob. Both are true. I don't always drink beer, but when I do I prefer the good stuff (props to who knows where that line comes from). I don't really do light beers (no Coors, Bud, Miller, etc) unless there is nothing else to drink and I'm not into very hoppy "man" beers. If I can taste the bitter aftertaste in my nose, it's a no-go. So here goes:

5. Blue Moon (by Coors - US of A)
Disclaimer: This beer is making it to the list only because it is my go-to bar beer.
I am well aware this is not an super high quality beer; its the generic "girl beer." With that noted, it was too difficult for me to confidently decide between the runner's up for this spot so Blue Moon is the pick because of the frequency with which I drink this beer. It is a wheat beer - my favorite style. In fact, almost all the beers on my list of acceptable beers to drink are wheat beers. This style is light and fruity in flavor with a smooth finish. Runner's up: Hoegaarden, Sam's Summer Ale, Pumpkin Wheat, Schneider Edel-Weisse.

4. Delirium Tremens (Belgium)
A new beer on my list, Delirium Tremens is quite a treat. Similar to a wheat beer (jury is out on the official classification) it's light in color and smooth in finish - but you don't need a lot of this as the alcohol content is pretty high for a beer.

3. Oktoberfest (by Sam Adams - US of A)
I didn't choose the title of this post without reason. Oktoberfest style is definitely my second favorite in every way. Crisp, full bodied flavor perfect for the season. I'd even accept other brands of oktoberfest. But I do wish it lasted longer than 2.5 months out of the year, as does my boy since its at the top of his list too (see below).

2. Hopfen Weisse (by Schneider - German)
I'll admit, I've only had this beer once - but it's that good. Since you've probably figured it out, Howie is the driving force behind my beer snobbism by exposing me to these fabulous finds. After hunting for a specialty beer store, we hit the jackpot only 5 miles from where we live. This is the type of store that you walk into where the walls are lined with over-sized bottles of specialty beers and you get to select as many or as few of exactly what you want. That is where we found this little gem. It's a wheat beer so its that golden honey color, on the fruity side, with the smoothest finish you can find in a beer. The flavor is so unique and the aroma is just as enticing. I might be drooling thinking about this one.

1. Franziskaner Weissbier (by Spaten - German)
This has been my favorite beer for a while now, though the Hopfen Weisse might take over after I try it a few more times. Howie introduced this as a surprise one time while visiting my family (he and my dad have a tradition of trying new beers and styles as often as they can). It is a wheat beer; I'm sure you are surprised by this. The flavor is full and on the sweeter side with a very smooth finish. If you like wheat beer, this is the best it gets.


Howie's Picks: 
5. Dos Equis Amber
4. Delirium Tremens
3. Guinness
2. Oktoberfest (Sam Adams specific)
1. Schneider Edel-Weisse 

Fulfilling a dream

While at the Big E last week, I was able to live a dream: to ride an elephant. Really my dream was to ride any exotic animal. I made an attempt at the Bronx Zoo to take advantage of the camel rides, but when I got to the Asia exhibit, there were only 4 year-olds in line causing me to bail out of my mission. However, as we walked by the elephant rides at the Big E my excitement could not be contained and I convinced my friends to join. Here are some commemorative pictures of the event for your viewing pleasure:

Culture of a Train Town

I've been waiting for a hot summer day to share this piece of creative writing with you all, and its arrived right on time - the summer solstice is here!

It’s hot... It’s humid. The air melts onto my face and neck within seconds of being out of the AC’d building. My skin simmers as I drive home from work – a five minute commute. I don't mind my sticky skin, as my hair blows wild around the car. The sunshine touches everything, beautifully painting the day in color. The trees and grass are still at their greenest, the heat of the pavement sways upward and the people splatter pinks, yellows, and blues across the canvas of the afternoon. Every moment is a moment to memorize, a moment to live in. 

I turn left onto my street, the main street. Its a train town. A speck on a map, a location people often confuse with being somewhere else – it’s that small. This one main street is always a bustle in the afternoons: Kids on bikes, teens window shopping, workpeople on the go, townies sitting on the outdoor patios of the restaurants that speckle the neighborhood. Young adults and old adults jogging with their dogs, a group of boys in the park playing football. Most characteristically, the rumble every fifteen minutes of the trains to and from the city marks the passage of time. Though small, this town is certainly alive in itself. You can see how its nestled into the world. The sidewalks are uneven, the streets are composed of potholes, the store fronts are mismatched, all evidence of a town that has lived for years and aged quaintly nourishing those living here.  

Driving down this busy street is comfortable. I am home. Passing by the townies, the children, the dog walkers and joggers, I know here I am safe and at ease. Ah, this town. A train town. It’s at its best in summer. 

Tweaks to a famous life-stage theory

We're grown-ups, how did that happen? And how do we make it stop?
(Props to who can name where that quote came from)


This one is for all of you psychology geeks out there. I've been having jitters for about a month or two... Life is changing and I fear I'm entering a life-stage crisis as I like to say. The last semester of PA school is underway, I'm in the middle of planning my wedding, I've started to job hunt, my board exam date is booked, and my quarter century birthday is on it's way.

So lets talk psychology. Everyone has heard of a "mid life crisis" and ironically, when you Google search, there is also a quarter life crisis -- which refers exactly to the time frame I'm in right now. Furthermore, the famed psychologist Erik Erikson developed and proposed a sort of counter-theory to Freud's approach that describes life stages that correlate with certain ages and with specific psychological barriers that must be overcome to continue to the next stage. His 8 stages of development are as follows:

1. Trust vs. Mistrust: 0-1 years, highly related to the baby's relationship with the mother; separation anxiety usually starts during this stage and the baby must learn to trust the caregivers

2. Autonomy vs. Shame and Doubt: 1-3 years, coincides with toilet training, child learns that he/she has control over his/her body and actions

3. Initiative vs. Guilt: 3-5 years, associated with preschool, children learn to assert control over their environments

4. Industry vs. Inferiority: 6-11 years, associated with elementary education, children learn to how cope with new challenges independently, such as homework and responsibility at home

5. Identity vs. Role Confusion: 12-18 years, this coincides with middle school and high school when teens start learning about themselves and who they are/who they want to be, this is highly affected by social influences (peer pressures)

**6. Intimacy vs. Isolation: 19-40 years, young adults learn and need to form loving human relationships and bonds while also finding a sense of security in adult hood (via career, education, relationships, etc)

**7. Generativity vs. Stagnation: 40-65 years, adult lean and need to find ways to be productive, whether it be having and nurturing children or creating a positive change that will benefit others

8. Ego Integrity vs. Despair: 65-Death, older adults reflect and acknowledge their accomplishments to find a sense of fulfillment

The first word in the stage name, trust, autonomy, initiative, etc, is the attribute the individual attains if successful, and the second word, mistrust, shame, guilt, etc, is that which the individual learns if unsuccessful. I have written these descriptions in the positive light in which the individual is successful during that stage (i.e. in stage 2 if the child learns he has control over his body, he feels a sense of autonomy, if he fails and does not learn this self control he learns to feel shame and doubt).

Stages 6 and 7 have been starred and I bet you can guess why. Intimacy vs. Isolation (stage 6: young adulthood) correlates with a "quarter life crisis"... however, I personally like to call what I'm going through a "life-stage crisis" because over the span of 20 years, I'm sure individuals can feel a sense of uncertainty at multiple and various points along that time frame. Yes graduating and getting a job is one, but what about marriage? Or buying a house? Or having a child? All these can happen at different time points and still cause feelings of "crisis" because they are each big life changes. And while Erikson's theory doesn't specifically refer to crisis, his description of the stages account for the crisis by suggesting there is a certain conflict to overcome, in this case finding security.

Generativity vs. Stagnation (stage 7: middle adulthood), which correlates to "mid-life crisis," is really just a continuation from finding security, for after you gain security the next goal is to be productive in that role. If you have nothing to show for your hard work and effort at the end of the day, or if you feel like you have nothing to show or you don't know where your work is taking you, that can lead to feelings of crisis. Though I'm not at this stage in my life, its important to keep in mind now that I'm currently laying the foundation for what is to come, so I better give myself a nice set up so I can be successful in the future.

What does this mean for me right now? I guess I need to get some "security." Since I've identified the feeling, and now the problem/solution, the next step is putting it into action and continuing to keep my goals in mind while taking one step forward at a time. The important thing is to avoid letting the feeling take over and paralyze progress, because the feeling is simply a feeling - it is of no real value. To keep it simple: this too shall pass.

*Note: Any supplemental information about Erikson in this post is from my good friend wikipedia. 

Baby Bamboo

This weekend I had a bit of a "moment" causing Howie to be on a mission to have us have a great bonding day together, especially since we haven't relaxingly hung out together in a couple of months due to law school/clinicals/etc. We ended up having a very nice, low key day: watched our townie Memorial Day Parade (I love my town), had a couple margaritas outside at the local bar, went food shopping for goodies, and then went to see the Avengers that evening.

Let me preface our food shopping trip with this statement: every time I go food shopping I spend at least 3 minutes pondering whether or not I want to purchase a baby bamboo, baby orchid, or baby money tree plant... depending on what is on display when I walk in the door. This pondering habit has been going on for at least 2 years but I can never rationalize the decision to commit. So I usually just longingly look at the little plants and then move on to my regular agenda.

Our First Plant! 

This day, however, I already had two margaritas before we decided to take the 2 block walk to the grocery store. As soon as we walked in, without even thinking I blurted "Wait! Howie, can I have a baby bamboo??" I leaned over to examine all the little ceramic pot designs. "Don't you want a baby bamboo plant in our house?" Sarcastically he replied, "Of course, I'd love a baby bamboo plant, Jessica. Why don't you pick one out?" As he was replying in his you-are-out-of-your-mind voice, I hear a lady behind us start giggling at our little interaction. Embarrassed, I ran out of the way as Howie handed me one of the little plants saying, "Just get the bamboo, Jessica." In all honesty, she really could have been standing there waiting for us to get out of the way, in which case she witnessed the whole thing, and if you know how Howie and I interact it really could have been quite comical.

Later that night I realized I have no clue how to take care of a plant, let along a baby bamboo. So, I started googling as per usual. News Flash: Apparently those baby bamboo's aren't even from Asia! The indoor baby bamboos, aka, the ribbon plant, is from West Africa! Anyway, I did my proper research and now its time to take bets how long I can keep this little one alive! Wish me luck!

*Here is primarily where I got my info, if you choose to follow my footsteps and get your own baby bamboo :) I did also supplement by browsing multiple search hits, but this particular site just seems to sum it all up neatly. 

Hello again

Its amazing how good it feels to come home after being away for a length of time. I've been gone for 10 days and I have yet to leave my bed for more than 2 hours at a time. The persistent rain encourages this behavior, but its just the relaxation I need right now. So lets take some time to chit chat.

I left Sunday night to pop over one of my besties' house to prepare to leave for our trip Monday morning at the crack... actually before the crack of dawn for what we hoped would be warm, sunny Ft. Lauderdale, Florida. While most of the time it was quite hazy, we all got some color (some of us more than others...) and we all had a great time. I'll soon be adding a couple "Places to go" type posts with some more trip details. We spent four days in hazy, humid Ft. Lauderdale, met up with my home girl from Villanova for a day (Holla Jenniferrrrr!), relived all of college in one night, went sailing, had the largest margaritas on the planet, and enjoyed being sandy at the beach. We arrived home at 11:30 pm Thursday night sleepy and tanned/burned.

Friday morning Howie and I left at 8:00 am to head down to Philadelphia for my brother's graduation from Villanova. We had a jam packed weekend there as well: We met with our priest, we met with our new wedding coordinator at our reception venue, we ate lots of meals, had a siblings night with the college seniors and a keg, attended the Engineering Recognition Ceremony, attended the Baccalaureate Mass, and attended the Commencement Ceremony Sunday before finally returning home after a 4 hour drive, which should normally be 2 hours. Whew! What a week!

Yesterday morning I woke up in my own bed with the rain pouring down and the sky darkened by the clouds. Perfect sleeping weather. As you can imagine I took advantage and stayed in bed most of the day watching brainless tv: aka reality shows on E!. 

Remembering a mission: The flights and arrival

May 13-14 – The flights

            We flew Royal Air Maroc from JFK International Airport to Casablanca, Morocco. We were each given blankets, pillows, and eye covers for sleeping – free of charge. We were served a hot dinner after we took off and breakfast just before we landed. As expected, it wasn’t a comfortable night’s sleep. We arrived tired, and trucked along following Nana, our classmate from Mali. She had worked out a deal to have us spend some complimentary time at the airport hotel in Casablanca during our 15 hour layover. We had spent time relaxing, sleeping, and eating.

            We took off for Bamako at 2:00 a.m. on what seemed to be a clear night. As we continued on our 3 hour flight, the weather took a dramatic turn. The wind cause the plane to rock and the downpour was torrential. There was a bit of terror in our eyes as we landed – the bumpiest landing I’ve experienced on a pitch black night. Nana assured us “it’s always like that, it’s because it’s too hard to see the runway in the rain and there aren't that many lights.” I guess this was the norm here. 

           By the time we arrived we were hungover from exhaustion only to discover we couldn't communicate with anyone. It was a zoo trying to use one individual - Nana - to do all our translating while trying to find out what happened to our luggage. Not only were all of our personal luggage and medical supplies completely soaked through, but a few bags never made it on the flight. We were all crazed running around trying to put leaky bags on the luggage wagons, each weighing 50lbs dry, and to keep track of exactly what we were missing. As a plan was finally developed about getting the lost bags, we shoved into a bus with what we had, sitting on top of each other, and began the trek to our volunteer housing…

      

Remembering a mission

Now that I am officially done with my clinical year of PA school (YAY!!) I can jump back on the posting bandwagon. I've decided I'm going to make the next series of posts into story time. This week commemorates the 1 year anniversary of a trip I took with my classmates to Mali, West Africa, to donate medical supplies and volunteer our clinical services. Over the next several days I'll be uploading bits and pieces from the journal I wrote while I was there to share what we did and what I experienced. 

May 13, 2011

          It is the Friday morning of our departure... Friday the 13th. I'm patiently waiting for the arrival of my parents, who will take me to lunch and then the airport. I'm about 90% packed but still feeling very overwhelmed. As I'm looking at my bags while sitting on my couch "taking a break" I'm getting more and more nervous. What I'm nervous about, I'm not quite sure. Perhaps its that I'm going on this 10 day journey during which I will have little to no contact with my parents or fiance. Perhaps I'm worried about the food - I'm a picky eater, I have a GI condition, and I'm petrified of being sick the entire trip (Because of this, I've resigned myself to the fact that I'll probably lose 10 lbs and will be surviving on dry cereal and peanut butter). Perhaps I'm afraid of flying after recent political events (namely, the death of Osama bin Laden). In an effort to combat these fears, my fiance matter-of-factly rattled off statistics about the un-likelihood of plane crashes over the phone (he left for Texas last night to visit his parents). Unfortunately, this does not help me.

            In reality, I know it all boils down to the unknown. I'm stepping far out of my comfort zone and the 
honeymoon excitement phase is over (hopefully it will come back when we land!). Deep down, my "logical" brain knows I will be just fine and that this will be an absolutely wonderful experience - but it’s my "unlogical" brain that feels the stress and the desire to just stay home and sleep for two weeks after finishing our last didactic semester of PA school. One thing I know - it will be an awfully big adventure. 

I love lunch

Lunch is my absolute favorite meal of the day. I not only enjoy it the most, but its also the most satisfying for my belly. Why is lunch so great? I'm glad you asked.

1. You can eat whatever you want. You want pancakes? That's acceptable (brunch really is lunch, people just like to add the br- for a sense of security when ordering breakfast foods, but as you can see, I don't discriminate at lunchtime). You want an omelet? Have at it. You want a sandwich? Yum. You want a burger? Okay. You want a salad? Go for it. You can get away with eating any type of food at lunchtime. I don't think burgers for breakfast fly, and in order to eat breakfast for dinner you have to preemptively plan a brinner (however, brinner is totally enjoyable when in the proper mood, holla Scrubs).

2. It's in the middle of the day. The the part that lets you know you're halfway through your work and in a few short hours you'll be at home ready for dinner (hump-hour of the work day, as it were.... which makes Wednesday lunches the best lunches ever...)

3. You can eat (somewhat) guilt free! Unlike dinner, after lunch you still have 8 more hours of daytime to work off what you ate! Yay! Have that brownie for your lunch dessert... its only 1 pm.

4. Lunch is social. You still have enough energy to actually want and be able to talk to people while enjoying a good meal. Breakfast is always too rushed, and by the time dinner rolls around on most nights of the week you are already pooped. I guess it could be just me... but it takes a lot of energy for me to be social during dinner hour.

5. Lunch is just awesome. The world would be a sad place without lunch.  

Intro to an Engagement

If you've read my last couple of posts you know I just completed my pre-cana, which therefore spills the beans that I'm engaged. With that said, you can safely expect to read about the woes of my wedding planning here over the next many months. Here is my launching pad for this theme.

August 20-23, several years ago - The meeting

It was orientation at Villanova. I can't recall which day exactly it was, but at some point during these first couple of days we had our very first floor meeting. In the common room of St. Monica's 4th floor we gathered. My roommates and I sat in a corner next to the table and waited. The room filled and finally Regina, the RA, got us to focus. We were to introduce ourselves, state where we were from, and give a fun-fact. To this day when meeting new people in a group I still try giving fun facts... it became that ingrained in me during my time at Villanova. Regina threw a ball to someone to get things started. Things barely began rolling before two boys walked in late. There were no seats left so they sat on the table next to me. I was quiet and listening attentively as the ball was passed. However, the one kid kept trying to make comments in my ear. Excuse me buddy, why are you talking to me? Instead of saying this, I gave a nervous smile and diverted eye-contact. He continued to try talking to me until finally the ball was in my hand.  

"Hi, I'm Jessica, I'm from Connecticut, and I'm a Giants Football fan." By the end of that sentence my face was bright red and I couldn't get rid of the ball fast enough. With such nerves, how could I remember what I said that day? Because my now-fiance tells me that statement was the reason he kept talking to me from then on...  mostly because of his disdain for the Giants, but also because of intrigue that I used that as my fun-fact. 

After a year of friendship, I finally realized I had feelings for this kid who had been my buddy all through freshmen year. My roommate, Katie, ratted me out eventually and so Howie, who already had some interest, and I started the awkward transition from buddies to boyfriend/girlfriend. We had our ups and our downs. We studied abroad in separate countries, we lived in different cities, we were interested in different professions, we had different groups of friends. We grew into ourselves and learned from eachother. Our best qualities rubbed off, and we started breaking down the worst qualities. Some days we were vinegar and oil, other days we were two peas in a pod. Our bond was unconditional.

December 20, 2010 - The engagement

We had been living together at that point for 6 months, I was halfway through my didactic year of PA school; he was working in the city. It was Christmas time, and therefore there is a cheesy proposal story that comes along with our engagement. Unfortunately, Howard would murder me if I shared it, so we'll save walking that tight-rope for another day. The point is, this was the day my life as Howard & Jessica really became Howard & Jessica. 

Since my engagement, part of me has been a bit upside down. I have no experience with even attending weddings and few close contacts to draw information from about how to plan a wedding. If you know me, you know my mother and I often don't see eye to eye, which can be straining. I also have a tendency for neurotic tantrums (often dealt with by Howie) in times of great stress. Essentially, the "getting engaged" part was easy, its the "after" that is the mysterious, challenging, and exciting.