1 HIGHLIGHT A LETTER FROM THE EDITOR: Breaking the Ice About Breaking My Arm Alison Maciocia, PA-S, Editor-in-Chief

The saying, “you didn’t come this far to only come this far,” has definitely held true for myself this past year. I was one of the forty students in our B.S./M.S. program that entered their didactic year last summer in 2017. The transition to and challenge of PA school was difficult for me, and the proverbial fire hydrant nearly drowned a few times. However, over time I learned, adapted, and figured out different ways to retain information and study for exams that were new to me but helped immensely. Unfortunately, in February I fell and badly fractured my humerus. If you know me, you know I am always trying to find the bright side of any situation and uplift those around me; but at that time, I felt like there was nothing I could do to remain a PA-S and that my world was crashing down. After coming to the realization and accepting the fact I could no longer attend class and be part of the class of 2019/2020, with the help and guidance of Dr. Lowy and all of our wonderful staff in Cunard, I withdrew from Wagner College with the intention of redoing the Summer and Fall on independent study/foundation overview to officially start again in the Spring. By withdrawing, I had given myself the time I needed to heal from surgery as well as the best chance of recovering and gaining full function back in time to start again this summer. It was surreal to go from learning how to diagnose and treat patients to becoming one. I am extremely fortunate to be where I am today. I had an amazing surgical and physical therapy team that essentially got me extremely close to where I was before the injury even happened. I also had and still have amazing support from my family, peers, and professors which motivated me to work harder at rehabilitating myself and to keep going so that I could come back to didactic year. I know I am going to be a PA one day, and while it would have been easier and probably a little less hectic to give up and switch majors, I held onto the fact that I did not go as far as I did in pursuing my dream to let a bump in the road stop me from becoming a PA. So now, I find myself in quite a unique position where I am sitting in on the didactic Summer and Fall semesters. Having gone through this portion of didactic year and already having gained a great deal of knowledge and experience, going through it a second time will reinforce everything I do know and make me a better student, leader, and future clinician. I am so excited and proud to be a PA-S at Wagner College, and I am very thankful for have been afforded this opportunity to join the class of 2020/2021 as well as become the editor in chief of ​Highlight​. As my first “Letter from the Editor”, I would like to thank Alexander Pennise, PA-S for making ​Highlight what it is today, as well as Evan Melillo, PA-C, Karlina Nguyen, PA-S, Jenna Frisolone, PA-S, and Ariana Volodarsky for shaping the PA-SLA to where we are now. I would like to recognize our outstanding faculty for all the hard work they put into running our program so smoothly, and especially for being there for me when I needed them all the most. I want to extend my congratulations to my past class for completing their didactic year and wish them the best of luck on starting their senior year rotations. In addition, I extend my best wishes to our graduate students as they begin their last year of rotations and start working on their thesis presentations. To my new fellow didactic class, thank you for welcoming me with open arms and I look forward to sharing this journey with you. I was in your shoes a year ago, and I understand how terrifying yet exciting this whole process is, but I hope in some ways I can help to make this year a great experience for you all. To the pre-PA sophomores, congratulations on finishing up your freshman year of college, that is an accomplishment of its own. To our new pre-PA freshman, welcome to Wagner College and welcome to our PA family.

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FEATURED IN THIS ISSUE:

1 Letter From the Editor (page 2)

2 New PA-SLA 2018-2019 Staff (pages 4-5)

3 Extra: Officially Juniors (page 5)

4 Highlighting PAA: New 2018-2019 Executive Board (page 6)

5 Extra: Sarcoma Awareness Month (page 6)

6 Extra: The Student’s Inside Scoop on the PA Admissions Process (pages 7-8)

7 Highlighting Didactic Year: Double H Bonding Trip (page 8)

8 Highlighting Transitions: The Summer of Change (page 9)

9 Extra: Art in Medicine (pages 10-11)

10 Highlighting Freshman: Advice and Tips from your Upperclassman (pages 12-13)

11 Highlighting Thesis: Learning Hands-Only CPR (pages 13-14)

12 Highlighting Clinical Anatomy: Going to Cadaver Lab (pages 14-15)

13 Extra: Officially Seniors (page 16)

14 Paper People: A Retrospective View on Didactic Year (pages 16-17)

15 Highlighting Double H: Create the Moment, Make it Matter (page 18)

16 Highlighting Summer Camp: The Sunrise Day Camp (pages 19-20)

17 Highlighting Summer: Senior Edition (pages 21-22)

18 Extra: Officially Graduate Students (page 23)

19 Highlighting Botswana: Pula! (pages 23-24)

20 Extra: Clinical Case (page 25)

3 HIGHLIGHT NEW PA-SLA 2018-2019 Staff President​: Alexander Pennise

Alexander Pennise is a Senior PA Student who is very involved on and off campus. He attributes his passion for leadership to Troop 60 in Victor, NY where he received his Eagle Rank. He has worked with his local community at home to organize important fundraisers and events. This background has helped him to work in many leadership positions at Wagner, including his current position of President of PASLA. He envisions PASLA to be focused on their mission to further publicize the PA Program and be involved in the local and international medical community.

Vice President of Alumni​: Karlina Nguyen

Karlina Nguyen is a Graduate PA Student at Wagner College. After graduating with her Bachelor of Science degree in physician assistant studies this past May, she is very excited to continue serving on the executive board of PA-SLA as the Vice President of Alumni. Karlina looks forward to strengthening the connection between current students and Alumni and is working on new ways to involve Alumni in the PA program.

Vice President of Interclass Communications​: Victoria Drumski

Victoria Drumski is a Junior PA student, currently in her didactic year. Victoria hails from Central CT and is the Vice President for Interclass Communications. Victoria hopes to strengthen the communication between each class and to advocate for the program on and off campus. She's excited to begin working with the incoming freshman and all returning students this coming fall!

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Vice President of Public Relations​: Jenna Frisolone

Jenna Frisolone is a Senior PA Student at Wagner College. She is the current Vice President of Public Relations for PA-SLA and is in charge of the PA program’s social media and publicity through mediums such as Instagram, Facebook, and the Wagner PA website. Jenna loves being part of the PA-SLA because she feels it makes her a better team player.

Extra: Officially Juniors The class of 2020/2021 has officially entered their didactic year! With a total 41 students in the class, as a whole, they are very excited to tackle didactic year together!

5 HIGHLIGHT H​ ighlighting PAA: New 2018-2019 Executive Board

By: Alexandra Berwick, PA-S

Hello Everyone,

My name is Alexandra and I am so honored and excited to announce that I am the President of the PAA for this upcoming school year. This year, I have the honor to work alongside ​Vice President Leanna Aronoff, ​Treasurer Lauren Joseph, and ​Secretary​ Daniella D’Acunto.

When granted this position, I had already started creating new ideas that we could instill and other ways the Wagner PA program can give back to the community. I am very excited to meet the new incoming freshman, help the sophomores get excited for their didactic year, and overall, create a better representation of what the Wagner PA program stands for. Again, thank you to those who granted me the opportunity to represent the PAA here at Wagner.

Extra: Sarcoma Awareness Month! On July 9th, some Didactic students sported yellow in support of July being Sarcoma Awareness month.

6 HIGHLIGHT Extra: The Student’s Inside Scoop on the PA Admissions Process

By: Karlina Nguyen, PA-S

Being in the graduate phase of the PA Program, I can not help it but I keep imagining the moment of our white coat ceremony where my classmates and I will finally get our long white coats with the label of ​PA-C​. As I am grateful to be where I am now, I look back to my journey of getting into PA school. I can remember how nervous I was through the whole application process, but nothing beats the nerves I had during the most important part of it all – the interview.

Looking back, I wish I had someone to tell me the “​do’s and “don’t​s” of the whole interview process. Even as a PA student now, prospective PA students quite often ask questions of how interviews work, what is asked, and just simply what to expect. So here is an insider scoop of how the Wagner PA Interview Process works:

When you walk into the room, expect to see a faculty member of the program with one or two didactic year students. They will have papers in front of them that are filled out during your interview. Now, do not get nervous so quickly yet. Breathe. There is no “official rule book” for an interview like this, as I am sure you may have searched up some websites and books for a “how-to” process in guiding you on an important day like this. Instead, here are some tips that you may want to keep in mind during or for your interview.

1. Dress professional! Probably a given, but you would be surprised what professional means in different perspectives. Ladies, no dresses that are above the knee and no stilettos. Gentlemen, make sure you do not forget that tie and white button up. Definitely no jeans! If you act professionally, that is a plus.

2. Do not let your nerves get the best of you. The interviewers already know that you are nervous, in fact they probably could smell it off of you as you shake their hands when you walk into the room. It is normal to be nervous, but do not let that stop you from showing them who you are. This is your chance to shine and show what the application does not necessarily show. Take your time answering questions. Let yourself think. Do not rush.

3. Do not be arrogant, but do not undermine yourself. It was always hard for me to speak about a strength of myself, but so much easier to speak about my weaknesses. You want to sell yourself and show what you are made of, but do not want to sound arrogant or full of yourself. However, you do not want to sell yourself short while highlighting a weakness. Instead, find a way to speak about your weaknesses, but show how that may have brought a new strength in your personality. Two negatives makes a positive right?

7 HIGHLIGHT 4. Ask questions. Do not forget that just because you are there for an interview, it does not mean that you can not ask them questions. You are interviewing for this program, along with others, so you should be weighing the pros and cons. Feel free to ask questions! Be interested in what you are applying for. Ask the students in the room how far they are into PA school, or ask them what was hard about transitioning, etc. Ask the staff if they are a professor, or if they are practicing. Start a conversation. Do not just be a robot and answer the questions.

5. Lastly... Just be yourself. I am sure you have heard this before, and the reason you have heard it plenty of times is because it really is the key to the interview. You are there to show who you are just like how you are doing everyday, so you should act like yourself. You may feel intimidated by the questions, but answer them as if you are replying to a conversation. Like I said earlier, do not be a robot. Converse. Show you are capable of being professional and able to have a conversation. Be flexible. Show that you are capable of fitting in the PA profession.

Highlighting Didactic Year: Double H Bonding Trip

By: Joanna Barretta, PA-S

In May, as we finished our sophomore year, a group of upcoming didactic year PA students went on a trip to the Double H Ranch in Lake George, New York. The Double H Ranch is a summer camp, co-founded by Charles R. Wood and Paul Newman, for children with life threatening illnesses. It provides free specialized programs and activities that serve as year round support for children and families. The main goals of this camp are to let kids be kids, to have fun that is safe, and to empower children by making each and every activity possible for them. The day that we visited and volunteered at the Ranch was an eye opening and rewarding experience. We split up into groups to paint lifeguard chairs and wash the camp shuttles. Just by doing these simple tasks, we were able to see and feel the impact it made on the workers, families, and campers. We watched a video of the amazing work the Double H Ranch does throughout the year and it made us realize how lucky we were to experience the magic of the Double H Ranch. This rewarding service trip also served as a great bonding experience for the students and staff. We are looking forward to visiting the Double H Ranch again next summer and are amazed at the work they do.

8 HIGHLIGHT Highlighting Transitions: The Summer of Change

By: Connor Lampasona, PA-S

From freshman and sophomore year to now in the PA program, many parts of daily life have changed - all for the better. The first aspect which drastically changed are my time management skills. The freshman and sophomore year of the PA program taught me excellent effective planning skills, but starting junior year made me realized they needed improvement. Starting didactic year, much more time needs to be spent studying. You need to learn, memorize, and understand the material in ways that can not only help your for tests, but also help you down the line when you have a patient in front of you. While you must make sure you fit study time into your schedule, you also need to balance it out with a little bit of fun. Balancing the two can be difficult, but working very hard and doing well will (and is) call for reward. Another big change for me was changing what I wear to class. Freshman and sophomore year was casual wear, while junior year is business professional everyday. Our program puts a large focus on professionalism, so dressing the part every day now will make it much easier later on. I personally adore this change because I can look amazing every day while doing what I love! The professional phase of the program has also changed how I write notes for class. In the pre-professional sector, I wrote my notes strictly in a notebook. Now that there is so much more information in class you need to learn, I find myself typing everything on a laptop to keep up and stay organized. An important tip for using a laptop is making a google drive and separating all of your classes into their respective folder which gives a sense of structure and makes it easier on you when it comes to your next exam. The greatest change from the pre-professional to professional phase is my outlook on the PA career. I knew how amazing being a PA was before the professional phase, but the professional phase has enhanced my passion for becoming one. Until you are in it, you will never realize just how incredible the field is. You know so much, you do so much, and you have so many opportunities - something you just cannot fully grasp until you start. These are just a few of the plethora of aspects that have changed from the pre-professional to professional phase and I could not be happier! Dealing with change and loving it is the key to success in living out this wonderful dream of becoming a PA-C.

9 HIGHLIGHT Extra: Art in Medicine Matthew Donovan, PA-S, is a current Wagner College student in his didactic year. He has enjoyed creating art in various forms to showcase his love of medicine. The following are some examples of his work:

Depicted to the left:

Coronal cross section of the human heart

Depicted to the right:

Bacteriophage

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Depicted to the Left:

The Large Intestine

Depicted to the right:

The different vertebrae of the spinal column

11 HIGHLIGHT Highlighting Freshman: Advice and Tips from your Upperclassman

By: Thomas Behar, PA-S and Kaitlyn Ross, PA-S

C​o​m​m​u​te​r​ S​t​u​d​e​n​t​s D​o​r​m​i​n​g ​S​t​u​d​e​n​t​s

Hello! My name is Thomas Behar, I am a Hi! My name is Kaitlyn Ross. I am currently second-degree PA-S currently enrolled in the a didactic year PA-S here at Wagner College and didactic portion of the Wagner College Physician am the Resident Assistant for the 14th floor of Assistant program. Before becoming a second- Harborview Hall. I have lived on campus since my degree physician assistant student, I became a New freshman year and have worked as a RA for first York State EMT and certified Surgical Assistant year students for the past year. Enrolling in college which has allowed me to garner skills of time and moving away from home can be a little management, planning, and organization that have daunting given the additional responsibilities of ultimately helped me succeed throughout the PA living on your own while adjusting to the new program thus far. As a commuter student living on rigors of the college course load. To be successful, the South Shore of Staten Island, I have you need to find a balance between enjoying your discovered certain habits and organizational tasks newfound freedom while maturely managing your that have helped me with time management, time to perform well in the classroom. After minimizing stress, and staying focused on my guiding my first group of freshmen residents studies. I am pleased to share with you my tips for through their first year of college, I am here to commuting students that I hope will guide you in share some tips that can make living in the dorms a becoming a successful student! much more enjoyable experience!

● Start to meal prep the night before! Depending ● Keep a schedule and stick to it! Planning and on your schedule, you may want to pack a being organized is incredibly important! I meal for lunch and or dinner. Figure out foods utilize the Google Calendar app on my phone you like eating that will not spoil if left out and to schedule out my day down to the minute. be sure to utilize the microwave in the You can organize your week by setting aside commuter lounge or in Hawk’s Nest to heat it specific study times, laundry days, club up. meetings, and even some down time for a ● Know bus and transit times! If you are taking much needed nap. public transportation, know what time to leave ● Do not merely be a student; become a well your house to make it to school with some time rounded individual with a robust résumé! Join to spare to you never have to rush around. clubs, organizations, sororities/fraternities, ● If you are driving, when you get home at the intramural sports teams - the possibilities are end of a day, check that you have enough gas endless! in your car for traveling to and from class for ● It may be cliché, but communication is key! the next day. You will be living with a roommate that you have most likely never met before coming to college. You may have different interests,

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● Make sure to leave your house early enough to habits, and daily routines, so if you are having have a few extra minutes to park and walk to issues with your roommate, talk to them about class. Sometimes, the lot can be very full! it! Do not let your concerns or frustrations ● Keep a spare pair of clothing in your car or build up over time to the point where you backpack. You never know if you are going to cannot stand each other. accidently spill coffee or get a stain on your ● Attend your RA’s programs and community outfit. It is also important to keep a more builders! Not only will you form a stronger professional outfit on hand in case you need to bond with your floormates and make more change for a meeting last minute. friends, but you could also learn valuable ● Pick out clothing for the next day the night lessons and skills to utilize in college and life before! It takes a minute or two but saves time thereafter. the the morning when you are tired and do not ● Always lock your door! I have dealt with a want to be fumbling through your closet for a number of cases where residents have come nice outfit. back to their unlocked rooms and had their ● Charge phones, iPads, and or laptops the night Xbox, TV, or MacBook missing. Better safe before, especially during exams! You never than sorry! want to show up to school with any of these ● Never be afraid to ask for help, whether it be dead. To be safe, you can keep spare wires in from a teacher, your RA, Public Safety, or any your backpack in case you need to charge up office on campus. These are all resources you between classes can and should take advantage of to make your ● Make friends that live on campus and get college experience the best it can be. involved! Join campus and be involved, ● Get out and explore NYC! Wagner offers a because the college experience is what you free shuttle to the Staten Island Ferry every make it! 30 minutes!

13 HIGHLIGHT Highlighting Thesis: Learning Hands-Only CPR

By: Leanna Aronoff, PA-S

As days before departure dwindled down, one graduate thesis team raced to complete their pilot study. With the coming medical mission trip to Botswana, Africa looming overhead. This group worked tirelessly to put together a pilot study that would predict the outcomes of their goal for Botswana: to teach Hands-Only CPR to healthcare providers. With a lack of training and experience, many healthcare providers in this developing nation struggle to maintain beneficial practices that will decrease the rate at which Basic Life Support needs are met. Students put together an informational session paired with practical instruction in efforts to effectively teach this program to other providers. To test this lesson, the Graduate team held a session with the Wagner PA Didactic students to test their initial hypothesis. On Thursday, July 12, 2018 the session was held by the Graduate PA students of Wagner College to present the Didactic year students with an informational lesson on performing Hands-Only CPR as a part of their thesis study. The lesson consisted of a multiple choice pre-test followed by a physical test of the actions that should be followed prior to and during CPR. The physical test required them to perform and explain the steps they would take if a person were to be unconscious requiring CPR. After completing both tests individually, the students were given a written lesson with the information read and explained to them. After completing the lesson, they were asked to repeat both the written and physical exam in order to compare their results from before and after attending the lesson on the correct procedure.

Highlighting Clinical Anatomy: Going to Cadaver Lab

By: Jonathan Twiggs, PA-S

I would like to start by thanking all the men and women who donated their bodies to the continuation of medical health studies. It is not an easy thing to learn simply by words, and going, seeing, and doing helped facilitate the learning process. My name is Jonathan Twiggs and I am a PA-S in the Wagner College PA program. Thanks to the joint efforts of Wagner College PA and New York Presbyterian Weill Cornell, I had the privilege of continuing my clinical anatomy education at New York Presbyterian Weill Cornell’s cadaver lab in Manhattan. The knowledge and visual information I acquired there will have long lasting effects on me. I have personally never been to another cadaver lab, so I have nothing to compare the experience to, however from my experiences at NYP Weill Cornell, I can tell that this is the caliber at which all labs should be operated. I appreciated that there was a place for us to safely leave our property, and everyone was warm and welcoming. Our instructors were very knowledgeable, each one was a master

14 HIGHLIGHT anatomists that kept us engaged while respectfully transversing the body parts we were examining. I give credit to them because personally for me the veins, arteries, and nerves all looked the same on the samples. They pointed out all parts of the specific section of study, told us what the purpose of the structure was, what blood supply feed the structure, what nerve innervates the muscles, and what movement was performed by each muscle. It was very illuminating to see it all laid out in front of you in such a manner and the visual will definitely stay with me. I could also sense the pride taken by the cadaver lab in their upkeep in many ways, such as the lab technicians were always busy retrieving any extra tools the doctors needed as well as setting up and preserving the bodies we were examining. They walked around with a solution that not only kept the samples from drying too much, but also had a nice fragrance to it. I compliment them on their attention to these little details. I have a sensitivity to smell, and going in I was told by upperclassman that the smell was going to be horrible and you cannot stay in there too long. I was nervous going in that I would pass out or vomit! I am happy to report that thanks to the efforts taken by staff of the cadaver lab, that did not happen. As it stands, there actually was not much of a smell at all, one of the doctors informed me that the room actually gets vented and filtered every twenty minutes or so which keeps the auroma from becoming pungent and hard to bear. NYP Weill Cornell was an amazing place to visit. Getting there was not always as fun with occasional heavy traffic, but that allowed some bonding time between me and my peers as we were shuttled to and from the lab. I would also like to thank the shuttle drivers for getting us all there safely and in a timely fashion even with all the traffic. NYP Weill Cornell is at a pulsepoint of the city and the area is full of life and energy. After graduation, I hope to work there as a PA, being part of the team that helps keep that energy alive is one of my main reasons for choosing this profession. I believe that the cadaver lab along with classroom studies is fundamentally the best way to stimulate all different types of learning. I feel I learned so much in our sessions there, and I hope in the future we can possibly add even more. I hope the relationship between Wagner PA and this lab stays strong so that future generations of PAs get the chance to have the same experience I did. ​Thank you again to the Wagner College PA staff and NYP Weill Cornell for this experience.

15 HIGHLIGHT Extra: Officially Seniors

Pictured below, the class of 2019/2020 celebrated their last day of didactic year in May! Congratulations to the entire class, and good luck on your upcoming rotations!

Paper People: A Retrospective View on Didactic Year

By: Alexander Pennise, PA-S

A 21 year old male attends a small liberal arts college in Staten Island, NY. He is allergic to cephalosporins. He is from a small town in Western NY, upper-middle class with a close family, and has worked in a restaurant over the summer for the past three years (at which his aunt is the manager and one of his cousins has also been a server). He denies smoking cigarettes or using opiates and drinks socially [3-4 cups every two weeks]. He denies headaches, nausea, vomiting, dizziness, arthralgias. He has seen councillors before for depression/anxiety and has been prescribed medication, however, has elected to try therapy over medication. His vitals are within normal limits (BP: 120/65; RR: 18; P: 70; Temp: 98.0). He has a healthy body weight and composition with a BMI of 23.

The above paragraph is the medical history of, you guessed it, myself. For those of you medical professionals out there, you are familiar with the patient history, which is especially useful while conducting rounds. Clinicians have to take the information from a patient, present it in a way similarly to that above, and then understand how to take this information, diagnose the patient, and finally relay to the patient what is ailing them in layman's terms.

16 HIGHLIGHT Day after day, patients were presented to us in this manner. Reduced to dates and numbers and facts. Before evaluating these 'paper people,' we reviewed anatomy and physiology, added onto by the challenging medical physiology course so many before had warned us about. The most valuable thing I took from didactic year was not the rigour of the infamous medical physiology course, nor was it the countless hypothetical patients whose charts we analyzed. It was, rather, the ability to focus; every other obstacle mitigated by the fact that work was never going to simply disappear. To most, that might sound daunting and Kafkaesque, but think of it like this: if you are always thinking about whether or not the critics will like your painting, you will never be able to put your brush to the canvas. Now I am no artist, however, I think that the analogy is appropriate. And I am not talking about the finished piece, the painting when it is done, because that is another analogy… Recently, I brought this same idea to a group of other students in my graduating class, and we proceeded to debate the topic. We could not decide whether didactic year made us mature or whether didactic year happened to be at the same time as our maturation into young adults. I believe didactic year influenced me in a way that made me grow up. I put my brush to a canvas. I may not be able to see the big picture - I have an idea of what it is going to look like - but I am not afraid of what others will think of it. I know what I am going to do will be worthwhile, no matter how hard the work gets. We as PA students are going into the business of caring. Some people may argue that it is moreso a business of medicine, but I do not believe medicine would even exist without compassion. I am a fan of a podcast called 'Sawbones' (which I HIGHLY recommend), and it reminds me of the ludicrous things humans do just to make ourselves well! It is funny, informational, and sometimes sad. But if there is anything else that this podcast did while getting me through didactic year, it was that it was a constant reminder of the lengths at which people go to show they care. Although often mislead, the efforts of medical professionals and sages were out of hope that people might find a better life. So when I looked at these 'paper people,' I did not simply consider labs and signs, but I looked into historical cases or treatments. I did not want to lose my humanity in the facts and data. And looking back on didactic year, I do not look at the notes, nor the SOAP notes I had to create, but I remember professors becoming emotional about their lost patients and smiling for the hilarity of others. It was these moments of humanity that breathed life into those 'paper people' that burgeoned my will to continue - and trust me, my will was very depleted. Despite sitting many nights awake studying, sacrificing time with friends, family, and/or myself, I was offered a glimpse into how I might be moved by my future patients. And if professors continue to offer these precious moments with their students, then I believe that Wagner will continue to produce strongly compassionate PAs, as I hope one day to become.

17 HIGHLIGHT Highlighting Double H​: ​Create the Moment, Make it Matter

By: Jenna Frisolone, PA-S

I always knew Wagner PA had amazing things in store for me, but I never knew Wagner PA would take me to places THIS amazing. Double H was truly unexpected and extraordinary. The week at Double H has made me laugh, cry, smile and reflect more and harder than I ever have. I had the privilege of being a counselor at the Muskrat Cabin which was youngest boys, the age range was about 6-8. Not only were the boys the biggest inspiration, but as was my fellow cabin counselors. Every one of the counselors I worked with were so unique from each other. I believe it was our diversity that helped us all flow together so well. I swear you would have thought we all have been friends for years. I am thankful to say we have all kept in touch too! The campers though, those boys felt like little brothers to me. What I learned most about those boys was courage. Not only did the boys exemplify courage throughout their battles with their respective diseases, the boys also reminded me what courage it takes to be a kid in general at their age. And to do both at the same time? It seems like a level of bravery not many reach. Each day we had a schedule of events that ranged from pool time to arts & crafts to science experiments to high ropes course and of course to, the very necessary, nap time. Our day at the high ropes course was one I will never forget. One of campers was terrified of heights, a very common fear at such a young age, and the ropes course was as tall as the Adirondack forest. You could bet this was going to be a problem, and it was. However, the good news is, eventually the camper showed his courage, climbed up the ropes and, more importantly, had the best time of his life! With the sun peaking through the canopy of the trees all watched him climb higher. His fellow campers chanted his name saying “You got this!” . It was so sweet and one of the best memories of camp. Saying goodbye to my campers was one of the hardest things I ever had to do. I made a promise to myself to visit Double H again in my future as a volunteer PA, or even again while I am still a student here at Wagner. Double H is a magical and timeless place. I know those reading who will eventually attend Double H will experience what a joy it truly is and I am excited to read their experience one day.

18 HIGHLIGHT Highlighting Summer Camp: The Sunrise Day Camp

By: Faiz Abed, PA-S

This summer, I had the great privilege to attend and volunteer as a camp counselor at Sunrise Day Camp for a week. Each time I look back at my experiences there, I become overwhelmed with gratitude. I am so thankful for the life lessons I have gained from the kids and counselors alike at Sunrise, and though I was the one who was volunteering my time and energy, I cannot help but feel that it was I who gained so much more. For those of you who do not know, Sunrise Day Camp is the only day camp of its kind for children with cancer and their siblings ages 3½ to 16, provided completely free of charge. Sunrise Day Camp allows the children to reap all of the benefits that traditional camp provides while enabling the children to continue their medical treatment and enjoy the comfort and safety of their own homes at night. Their philosophy is an admirable one to say the least in that no child sick or healthy, is left out of fun, care, and most importantly love. Each day was an adventure from the start as groups of counselors greeted busloads of children who were anxious to have a day filled with friends and carefree fun. Their daily schedule was planned with various activities ranging from dance, music, arts and crafts, gaga ball, gym, free play, fields, and the ever-popular splash pad, all to keep the fun from stopping and the children’s minds off of their illnesses. With each subsequent activity, it was amazing to see how each child blossomed in their own right and how throughout the week, a camaraderie between the campers would form. It is that strong bond...that human connection that many of these kids crave that Sunrise Day Camp is able to give them. The sad reality for many of these children is that due to their frequent hospital stays, they seldom interact with kids of the same age making it very difficult for them to develop strong and meaningful friendships. It is very admirable and refreshing to see an organization whose aim is to provide children in such situations with the opportunity to make these social connections and ultimately give each camper back their childhood. I cannot truly say which of the experiences I had at Sunrise Day Camp were my favorite because I experienced something special each day. I will say that just getting to know each of the kids in my group (Rangers 4th: 8 year olds) and the other groups was truly a blessing. Just talking to all of them throughout the day, especially during lunchtime when the cafeteria was always booming with laughter brought me such joy. Getting to know what their favorite foods were, which athletes were their favorite, who can sing, who can dance, who can speak multiple languages, which camp activities they liked best (I liked

19 HIGHLIGHT gaga ball and arts and crafts) brought such a light to this place. I realized that these kids are camp... They are Sunrise... They are their own beacon of hope projecting an evershining light on their futures. It also dawned on me during my week that I was unable to discern the sick children from the well children... a true mark of how just allowing the children to just be themselves, let loose and have fun can have such a profound impact on their demeanor and overall health. These children have collectively taught me to truly live in the moment which has always been difficult for me to do as I, like many of my classmates in the PA program, am someone who is always planning for the future. I learned that these kids refuse to be defined by their illnesses regardless of the severity. No matter what, this Summer was theirs for the taking and they would stop at nothing to make this the best Summer that they, their siblings and friends ever had. As my time at Sunrise Day Camp approached its end, a sadness for my campers had befallen me. By this time, my campers had become my family where we would laugh together, play together, make fun of each other, and share stories of hardship and triumph. We shared what our aspirations were and motivated one another to always persevere so we can make our dreams come true. We shared a bond that would never be broken and gave each other the confidence to fight for our futures. My campers saw the sadness in my face and without any prompts said “We’re going to miss you french fries” (a nickname they gave me because my name was too hard for them to pronounce. Plus, who doesn’t love a good french fry). I smiled and nodded. I hugged all of them, and told them that I will miss them too. When some of my campers cried as the last day neared its end, I gathered them all and told them that they should not be sad especially because they get to meet all of my classmates from the PA program. When they still told me that they were going to miss me, I told my campers that the best way to manage these feelings is to keep an open heart and an open mind as my classmates really are amazing individuals as well. They trusted me, took my words, strengthened their hearts, said their final goodbyes to me and got on their buses. I often think of my campers and how they are doing. I knew they would be okay because these kids are special and they are strong. I know that we had a great week together, but I did not truly understand how much of an effect my being there had on them until the next group of counselors from my class began their week at Sunrise and told me how much my campers missed me. They wanted me to know that they were still laughing, still having fun, and still making french fries jokes. These kids are some of the most courageous, intelligent, witty, funny, and kind-hearted kids I have ever met, and each and every one of them will always have a special place in my heart.

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Highlighting Summer: Senior Edition

By: Michelle DiPaolo, PA-S

We did it! We have completed the hardest part of our educational path which included many sleepless nights, cups of coffee, hundreds of pages of notes. So now what? Luckily for us, the senior summer is not as demanding as the previous year and more fun because we get to practice our hands on clinical skills. The class is divided into groups and each week every group has a different schedule from the rest of the class that way the professor to student ratio in the clinical skills learning environment is quite low allowing for students to perfect what is being taught.

BLS For my group, our first class was BLS, Basic Life Support training, taught by Professor Epstein. BLS includes CPR techniques, AED usage, problem solving, and teamwork. We learned how to provide BLS when by ourselves and in groups in both medical and nonmedical settings. We used mannequins This class gives you an arm workout! Providing CPR requires deep compressions that tired us quickly, showing the importance of how important to take turns while providing compressions. An automated external defibrillator (AED) is a device used on patients who have fallen into cardiac arrest. This device gives very clear instructions on its use and definitely help save a life while awaiting for more medical personnel. Professor Epstein made this class fun and educational while also making each of us comfortable in our ability to perform BLS.

Scrubbing Scrubba-dub-dub we get to scrub in like the pros! We were allowed to fully scrub in on a surgery. How hard can washing your hands really be? Well, scrubbing can take up to 10 minutes and clean from underneath your fingernails all the way up to your elbows in a yellow soapy iodine. It is very important to take care while scrubbing to help eliminate passing an infection to the patient during surgery. After scrubbing in, we were had the privilege to witness a cystoscopy with stone removal, a procedure to remove kidney stones. Being in the OR, we were able to see the team dynamic. Some nurses were scrubbed in while others were just sterile to provide the most efficient environment for the procedure.

Prescription Writing Prescription writing is taught by Professor Rota. At first, it is quite intimidating but once you understand it, it is much easier. In addition, professor Rota makes it a fun environment by providing scenarios that go along with each prescription. Pediatric dosing is definitely the most challenging aspect because the prescription relies on the child’s weight so be warned, there is math involved!

21 HIGHLIGHT Casting and Suturing Little did I know that I had been preparing for casting since childhood while practicing paper mache with my mom. This too looks much harder than it actually is. A cotton layer is wrapped around the patient’s injury to prevent any irritation from the cast and then you have fun! You place the plaster into water until it is saturated and squeeze out the excess water. Then you start to wrap your patient ensuring that you are overlapping the plaster to prevent any weak areas. Once applied, you rub and mold the cast and wahlah! You have just casted your patient! Afterwards we learned how to suture external wounds. Pig feet are great for practice because it closely resembles human skin. Using a forcep and a needle holder we learned how to properly stitch. The techniques used are quite challenging at first, but once you get the fluidity of the movements they are almost calming and therapeutic. The following week we had suturing 102 with professor Tiburzi to build on what we had learned the previous week. Here we focused more on the types of sutures used during surgery and deeper wounds. Some use the same tool technique i described earlier but predominantly techniques using only the hands are preferred. We even learned a technique where you only use one hand to close the deeper tissues. After these classes, we all got our own suturing kits and pig feet and have been practicing at home!

Delivery This class was definitely the most excitement. First, we practiced how to perform a pelvic exam on the mannequins. Afterward, we were able to use the mom sim mannequin to prepare for us delivering a baby. We used cooking spray on our little bundle of joy and placed it inside the sim doll and then had one of us be the mother’s voice for the mock delivery. We learned the proper way to coach a mother on how to push and when they should and should not. There are also movements that are necessary to deliver the baby safely. We were all able to deliver our beautiful Pam covered baby boy and cannot wait for the delivery room.

Procedures We had learned most of our clinical skills with Professor Marchese in the previous fall semester so these classes were for a great refresher for us. With Professor Rota, we perfected our foley catheters, Intramuscular injections, and venipunctures. This class is especially fun because we get to practice the injections on each other. An intramuscular injection is an injection into a muscle. An example of this is the Tdap vaccine and is usually placed into the deltoid (shoulder muscle). A venipuncture is used to draw blood from a patient for testing purposes. This too we practiced on eachother and most of us were able to get it on the first try. With Professor Marchese, we reviewed other various clinical skills especially placing an IV. Again, we were all able to place one on each other as well as volunteers from the graduate students. We can all confidently say we are ready to provide whatever clinical skills are necessary while on rotations.

22 HIGHLIGHT Extra: Officially Graduate Students In May, the class of 2018/2019 graduated with their Bachelor of Science degree in Physician Assistant Studies! Congratulations and good luck on your last year of rotations!

Highlighting Botswana: Pula!

By: Karlina Nguyen, PA-S Pula (n.)- rain; the currency of Botswana; used to welcome somebody or something or to wish prosperity

This summer, our PA program added Botswana, South Africa to the EYH trips, and our graduate class was the first group able to go! Personally, being a graduate student of the program, I have never been so excited to be able to say that I would be able to go to Africa for a medical mission trip. Little did I know that this trip would have such a huge impact on me. For this medical mission, we focused on teaching, rather than seeing patients. This itself was different from the EYH trip to Guatemala, where we would see 200-300 patients a day. However, my fellow classmates and I believe that this trip reminded us of how important it is to be able to teach not only a fellow clinician, but also patients. On this trip to Botswana, we focused primarily on teaching clinicians, which consisted of physicians, midwives, nurses, and personal care assistants. Topics taught included ‘Hands-Only CPR’, ‘Neonatal Resuscitation’,

23 HIGHLIGHT ‘Maternal Health’, ‘Diabetes Education’, ‘Asthma Education’, and ‘Importance of Vital Signs’. We were also able to visit schools and teach some of these topics to teachers and students. The feedback we received on our lessons and demonstrations were great. Not only were the clinicians thankful, but the people of Botswana were thankful to see that we were there to help and educate their health providers. Simultaneously, we were able to explore the clinics throughout Botswana and saw that they have established their own clinics that would resemble a miniature hospital. We were impressed in seeing them exceed our initial expectation of how the clinics would be. We were fortunate to have the guidance of an organization called Love Botswana. Along with bringing us to the clinics, they were also able to teach us about the culture of Botswana – including properly greeting the villages and their proper handshake gesture. Thanks to them, the people of Botswana were so happy to see us, even simply just hearing us say hello to them. “​Dumela!​” Throughout the trip, we were told that we touched many people’s hearts. They were moved because we were traveling from across the world just to come and teach them. To them, that meant the world. We were told that while we may forget them, they would never forget us. However, Botswana’s love and culture really touched my heart! In despite of adversity, they are still filled with positivity and faith. Being able to witness this moment firsthand was a blessing. And that moment was when I realized what ​“Pula!”​ meant. The word “Pula” is a Setswana word which is used to represent three related meanings. The word pula means rain, which is rare in Botswana’s climate. Almost half of Botswana is desert terrain so having rain is scarce, hence its great demand. It is this reason that ​pula ​is the word that is used by them to wish others well. The presence of ​pula means fertility, water to drink, grass for animals, and so on. Therefore, overtime, Botswana developed “​pula!” as a cry to wish for life, fertility, progress and prosperity on the people and the land. I found this very touching, and I created my own analogy from it. Back home, we view rain as something that is gloomy and not necessarily prosperity. However, in Botswana, they managed to make something we look at as opposite to sunshine a word that represents prosperity. That itself reminded me that every bad situation can be not so bad when you view it in a different perspective. It is made to make you stronger somehow, someway. Along with the great people that I got to meet, that is the lesson that I was able to bring back home with me and will always remember. So, thank you Botswana. I came here on a medical mission, and went back home to find myself filled with answers that I was not even looking for. – Happiness can be found in the darkest of times, if one only remembers to turn the light on.

24 HIGHLIGHT Extra: Clinical Case

By: Oriel Rafaelov, PA-S

Do you have what it takes to solve a clinical question generated by one of our PA Students? Try your luck by answering the question below! Send your answer to ​[email protected] with your full name! We will recognize all those with correct answer in the next edition as well as release the answer and give out a new case! Good Luck

A 43 year old woman comes to the emergency department with a 5 hour history of RUQ pain, fever, nausea, vomiting, and anorexia. She says she began experiencing these symptoms shortly after eating at her favorite fast food restaurant. Her temperature is 38.8°C (101.8°F). Palpation of the abdomen shows voluntary guarding. Laboratory studies shows leukocytosis. Which of the following is the most likely diagnosis?

A.Acute pancreatitis B. Acute cholecystitis C. Appendicitis D.Peptic ulcer disease

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