Welcome to Chicago
When I arrived in Chicago, alone for good after dropping off my things up here with Hugh several weeks prior, the traffic overwhelmed me after existing in sleepy northern Florida for so long. Sometimes it still does. The unexpected one-way streets and turning-lane only's, the strangely marked, vague lanes full of cars patiently slogging their way through rush-hour traffic test my limits as I try to smoothly navigate the mazes of down-town. This place is nothing like the organized mesh of Manhattan, the easily understood right angles of D.C, and far from the laid-back and unkempt mess that is Florida's roadways. I panicked about finances, as did all the fellows when we got here, and began driving for Uber. Ironically, I made the same average hourly wage driving for a ride share app, as I did working at the fellowship which required a Master’s degree in Physician Assistant studies. I certainly would not recommend learning the roads by Ubering fares around, but you can survive, and I have been thankful for the flexible second income. Lower Wacker Drive will long be the nemesis of myself and many others, but I'm getting better at it.
I came here exclusively for an Emergency Medicine PA fellowship, there are a lot of things that I want to be good at doing, emergency medicine being one of them. When people ask what brought me to Chicago, I've noticed that they expect an answer which alludes to the area, friends or family, a significant other, etc., and seem slightly surprised to hear none of those were the reason. I have always thought it was normal to go where you needed to in order to get the job done and accomplish goals, even if that meant leaving your creature comforts and loved ones behind. This may be the military mindset echoing in my head, and honestly it's nice to see that so many people are here because they wanted specifically to live here. I would certainly believe it if anyone told me that they came here just for the food, everywhere you look are adorable corner-cafes and hole-in-the-wall diners patronized and run by stylish hipsters amidst unique decor and lush potted plants.
Indoor gardens are huge here. I mentioned this observation to a stranger the other day, who pointed out that we live in a concrete jungle devoid of green, so everyone must keep plants indoors for their own mental health. I had a few plants when I lived in Ohio, which became quite a few more while living in Florida, due to the pristine greenhouse conditions there making it easy to grow nearly anything. Because of that I had arrived with personal jungle in tow, ready to continue my fostering of plant life the way I intended to foster my medical knowledge and skillset.
As far as fostering a medical skillset, actively working with my own patients has taken much longer than anyone here anticipated. There are four of us PA Fellows, each happy and excited for this opportunity, who all quickly discovered just how cumbersome the journey towards clinical practice can be. We were offered positions in late September, and immediately asked to apply for our Illinois state license, with hospital credentialing paperwork to follow. Easy enough, this should all be done by January. That information soon expanded into the knowledge that it takes upwards of eight weeks for the state to process a license, because there are only four technicians managing all the medical applications for the state, from nursing assistants, to pharmacists, to surgeons. That is a lot of work for four people.
We then discovered that we would need a Drug Enforcement Agency license in order to prescribe in Illinois, but in order to apply for that you must first wait for your state license, then apply for your Illinois Controlled Substance license, and only then can you fill out the DEA application. We also learned that taking part in an emergency medicine fellowship functioning at different hospitals, means lengthy paperwork for the emergency medicine group we are working for, and also separately for each of three hospitals we will see patients at, as they all have their own rules and procedures. Currently, we are now on month five of the credentialing process, month two of the fellowship, and inching ever closer to clinical practice. Today is Sunday, and on Tuesday we will all be at the Advanced Practice Professional Sub-Council for one of the hospitals, after which we hope to go on to New Provider Orientation and then training shifts at that hospital.
While waiting, we have been keeping as busy as possible by attending lectures organized for us, along with the EM Medical Residents weekly educational conference. It has all been incredibly educational, and I am very grateful for the condensed knowledge presented in these sessions. Additionally, we have been shadowing in the ED so that we can at least learn the flow of patient at each site. Now that our application packages are complete and on their way to the council, the trauma center has graciously extended temporary privileges. They have allowed us to take turns working shifts on the weekends in order to become more acclimated to the flow of trauma patients. There has been a lot of evolution because the fellowship is new, but today one of the surgeons said that we were welcome to be in the OR to observe most procedures if we were interested and I was elated. I couldn't feel more fortunate than to have stumbled across a fellowship that allowed me time both in the ED, and the trauma operating room. Tight finances, obstacles, weather, relationships and circumstances aside, I continue the mantra in my head of why I came to Chicago, and staying focused on the fellowship.
