{"id":8992,"date":"2016-07-12T09:28:33","date_gmt":"2016-07-12T16:28:33","guid":{"rendered":"http:\/\/depts.washington.edu\/medex\/?p=8992"},"modified":"2016-07-12T09:28:33","modified_gmt":"2016-07-12T16:28:33","slug":"it-makes-you-really-truly-love-medicine","status":"publish","type":"post","link":"https:\/\/familymedicine.uw.edu\/test\/it-makes-you-really-truly-love-medicine\/","title":{"rendered":"It Makes You Really, Truly Love Medicine"},"content":{"rendered":"

N<\/span>ot many people<\/span><\/strong> come to the MEDEX physician assistant training program from a background of medical examiner investigator. Working for King County and Snohomish County Medical Examiners, Al Noriega responded to scenes of death, working alongside law enforcement to assist the pathologist in determining the cause and manner of deaths. \u201cAny traumatic or violent death, suspicious death or unattended death, we would be called out to investigate,\u201d Al says.<\/p>\n

Now part of MEDEX Tacoma Class 3, Al is also grateful for his military background in this path leading him to prepare for a future career as a physician assistant. \u201cI often think that the military led me to a program like this,\u201d he states. \u201cEvery day that I spend here I realize this is where I should be. This is where I’m meant to be. There’s a reason we’re here, and it\u2019s to help people.\u201d<\/p>\n

Al Noriega enlisted in the Navy when 18 years old and went to boot camp in San Diego. He was trained there as a corpsman at Balboa Naval Hospital before being sent to his first command at Marine Corps Base Camp Pendleton, CA, to serve with the US Marines. Later, Al was assigned to work at Naval Hospital Camp Pendleton in the intensive care unit, where he received much of his medical training that he used in the Navy.<\/p>\n

[smartslider3 slider=48]<\/div>\n

After that tour of duty, Al was stationed onboard the USS Carl Vinson<\/em>, a nuclear powered aircraft carrier out of Alameda near San Francisco. He did several cruises in a four-year tour with the Navy before getting out of active military duty.<\/p>\n

Upon completion of his first tour in the Navy, he started working as a civilian medical assistant. \u201cI did this while attending school and serving in the Navy Reserves.\u201d<\/p>\n

E<\/span>ventually Al transitioned into an entirely new career direction<\/span><\/strong>\u2014that of a forensic pathology assistant for the Kern County Sheriff\/Coroner in Sothern California. After two years, the lure of a job brought him to Seattle where he also worked as an anesthesia technician for the University of Washington at Harborview. By day, Al worked in the operating room assisting anesthesiologists and at night as a full time investigator for the King County Medical Examiner\u2019s office. After receiving a promotion, he eventually resigned his position at Harborview as an anesthesia technician.\u00a0\u00a0 \u201cI worked my way up to training investigator, then lead investigator,\u201d he says, \u201cwhich is a job I had for several years.\u201d<\/p>\n

The pull of the military remained strong, so in 1998 Al went back into the Naval Reserves as a reserve corpsman. \u201cI was affiliated with the VR-61, which is an air wing squadron based out of Naval Air Station Whidbey Island, WA,\u201d he said. \u201cWe provided logistical support to all branches of the military all over the world. After September 11, 2001, we were flying a high volume of missions with most of the deployments overseas in support of military operations. It took me away from my family and my work.\u201d<\/p>\n

During this time in the Naval Reserves, Al was assigned to a dual role of hospital corpsman and aircrew member for a medium-lift aviation squadron that provided logistical support missions moving small groups of individuals and supplies in support of Operations Iraqi and Enduring Freedom. \u201cWe would transport almost anything and for any service in support of these operations.\u201d<\/p>\n

As an aircrew member, Al worked on the maintenance and readiness of the aircraft in addition to his role as corpsman. \u201cWhen I wasn’t fueling or maintaining the aircraft,\u201d Al recalled, \u201cI was maintaining medical records, providing shots, or working with the ship’s personnel on their health and well-being.\u201d<\/p>\n

Clearly, Al enjoyed his role in the US Navy. \u201cI loved it,\u201d he says. \u201cI love serving my country, and I also liked working at the medical examiner\u2019s office. So I tried to do both, to juggle both.\u201d<\/p><\/blockquote>\n

In time, the frequent deployments became too difficult for family life and his civilian career. So in 2008, after a total of 13 years of service with the US Navy, Al turned his full attention to the private sector. \u201cI still miss it,\u201d he says, referring to the Navy.<\/p>\n

Back in civilian life, Al continued his work for the medical examiner\u2019s office, and in 2008 he accepted the position of Chief Investigator for the Snohomish County Medical Examiner in Everett, WA. Al attributes his medical training as a US Navy corpsman for his entry into that profession.<\/p>\n

A<\/span>l\u2019s training as a corpsman<\/span><\/strong> provided him a foundation for efficiently yet thoroughly gathering crime scene information like medical history, medications, and injury patterns. From that information, he generated a report for the forensic pathologist, who then examined the body while looking at the medical records and history to make a determination as to whether the death was a homicide or suicide, accidental or natural. Al mentions that every forensic scene is different, and consistency is key in every scene. \u201cWe investigated drownings, hangings, vehicle accidents, overdoses, gunshot wounds and homicides.\u201d<\/p>\n

[smartslider3 slider=49]<\/div>\n

To hear this, one\u2019s mind conjures up the intrigues of television crime shows like NCIS or Law & Order. But Al reports that reality is a lot harsher. After having kids, Al\u2019s mind frame changed. \u201cAs death investigators, one sees a lot of the worst sides of life and death. And after becoming a father, it became more difficult to see some of these troubling things on a day-to-day basis. After over 15 years in the field of forensic death investigation, I told my wife, Jenny, that I thought I was done with death investigation.\u201d<\/p>\n

It was during that same time that Al reflected on his job satisfaction as a Navy corpsman. \u201cI always enjoyed the time I was in the military when I treated patients,\u201d he recalled. \u201cThey came in with a problem and I usually could help them out.\u201d<\/p>\n

Al discussed the possibility of medical school with his wife. \u201cBut when you do the math, it would have been too many years for a person my age.\u201d He thought about the physician assistants he\u2019d worked with in the military, specifically one of his most inspiring supervising officers\u2014 Mr. William Lussier\u2014 the first PA with whom Al worked. Al would go on to work with many other PAs both in the navy and civilian sector.\u00a0\u00a0 \u201cThese guys were good. And the PAs in Snohomish Country and King County were all just remarkable too. They were very easy to speak to and communicate with.\u201d That’s when Al turned to his wife, a full-time dentist who encouraged him by saying, \u201cBy all means, do it if that’s what you\u2019d like to do.\u201d Together they decided, \u201cLet\u2019s do it!\u201d<\/p>\n

T<\/span>he MEDEX Tacoma training location <\/span><\/strong>was the right choice for a couple reasons, the most important one being the military relationship. The MEDEX Northwest UW Tacoma campus has the largest number of military veterans across all four of the MEDEX sites. \u201cThe cohesion and camaraderie that a lot of military folks share is something that’s indescribable and very important to me,\u201d Al says. The Joint Lewis McChord Base is within 12 miles of the MEDEX Tacoma site, and Naval Base Kitsap in Bremerton is 30 miles away. Proximity to both was a consideration with the establishment of the MEDEX Tacoma location in 2013.<\/p>\n

Al recently completed his didactic year of the UW MEDEX PA Program and is embarking on his clinical year placements in the wider community.<\/p>\n

He refers to the first year with MEDEX as \u201cvery challenging. It included a lot of complex material to learn. I have three little girls, and a very busy wife who runs her own dental practice and the house as well. I knew it was going to be tough but, without a doubt, it was more than what I anticipated. The subject matter is very interesting and it’s challenging stuff. But what is most challenging is the time management of trying not to go so deep into topics that you don\u2019t have time to cover what\u2019s relevant for now\u2014 just learn what is needed first without spending too much time on certain things that aren’t essential to know at this point in time.\u201d<\/p>\n

Al heaps high praise on the MEDEX faculty. \u201cThey\u2019ve been phenomenal!\u201d he says. \u201cThey put in the time and effort and made themselves available to help us. They were very, very proactive in trying to encourage us how to best utilize our time.\u201d<\/p><\/blockquote>\n

Al stated that his fellow students of Tacoma Class 3 are also encouraging and willing to help out each other. \u201cIt’s a really unique and wonderful group of fellow students and friends.\u201d<\/p>\n

Come September, Al will begin his four-month family practice preceptorship. With three little daughters, he\u2019s hoping for a placement close to his home in Seattle. \u201cMy wife would be very happy about that. She\u2019s the real champ in my book as she\u2019s carrying the majority of the load for our family.\u201d<\/p>\n

That preceptorship will be followed by six one-month rotations designed to expose him to a wide range of medical areas including surgical, inpatient, behavioral, and emergency medicine.<\/p>\n

A<\/span>l stops to reflect for a minute<\/span><\/strong> on his path to MEDEX: \u201cI think my way of getting here was very unconventional. First the Navy, and then I was so entrenched in forensic pathology. I already had my career down, and this is like a third beginning. I could have stayed in familiar fields and not done something different. As it is, I’m older than most of my fellow students. But it probably doesn’t matter how or when you get here. It\u2019s just that you’re here and the MEDEX faculty recognized the potential in all of us.\u201d<\/p>\n

After spending some time with Al, it\u2019s easy to see why he was selected to join the MEDEX family. He\u2019s a mission fit.<\/p>\n

One of his main reasons for wanting to become a PA was \u201cto give back.\u201d From an early age and throughout his careers, Al has observed people who could not comprehend the specifics of their own healthcare, often to their detriment. It started with his own mother, who spoke only Spanish. \u201cI remember going to the physician’s office with my mom and having to translate. I had a sense that my mom could have walked out and not understood what was going on.\u201d<\/p>\n

Much later while working in the medical field, Al would recognize this behavior again. \u201cWhen I worked at Harborview, people would nod and leave. They\u2019d say they understood, but you could tell they were scared and had trouble focusing on what was going on.\u201d<\/p>\n

\"C-Al<\/a>
Al Noriega of MEDEX Northwest Tacoma Class 3<\/figcaption><\/figure>\n

All this drives Al\u2019s vision for his future practice. \u201cOne of my goals is to be a really effective communicator and help people not only with treatments but also with comprehension about their medical illnesses or conditions. I want to be able to make certain that when patients leave the office they understand what’s going on in their body and they have an awareness of their treatment options. The diagnosis and outcome may be good or it may not be good. But I want them to feel that I have effectively explained to them what’s going on with their body\u2014 how they can improve things, how they can recover, how they can get treatment, and how their medication works.\u201d<\/p>\n

Given that Al is bilingual, he\u2019s hoping for rotations that make use of his Spanish-speaking skills. \u201cMy mom is from Spain, so I grew up speaking Spanish to my mom and English to my father. I learned both languages simultaneously. I look forward to communicating with Spanish-speaking patients, and hopefully, providing them with greater understanding of how things work.\u201d<\/p>\n

As someone who spent a good number of years in the US Navy, Al found it unsettling to walk away and return to the civilian side. \u201cThere was always that apprehension that maybe I won\u2019t be able to do it,\u201d he mentioned.<\/p>\n

Yet it\u2019s clear that the military provided Al with the foundation he needed to succeed throughout all areas of his life. He\u2019s clear that these skills are transferrable for medically trained veterans wanting to make the transition to the PA profession. \u201cConfidence, accountability and responsibility\u2014with those tools and the right work ethic, one has what it takes to do this if this is really what you want to do. It’s a lot of work\u2014a lot more than I had anticipated. But it has proved to be worth it already. I haven’t completed the program yet, but I couldn\u2019t be happier to be here and I\u2019m incredibly humbled by the possibilities it offers.\u201d<\/p>\n

We remind Al that he\u2019s already made it past one of the toughest parts of PA school\u2014the didactic year of the two-year PA program.<\/p>\n

\u201cYeah, well, one of the things that MEDEX pounds into you is that the learning doesn’t stop here,\u201d he says with a big smile. \u201cThis is just the beginning, and I recognize that now. We\u2019re just scratching the surface. There’s so much to learn, but I think that this makes you hungrier. It makes you really truly love medicine! And the more you understand it, the more you love it.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

With a combined experience of 13 years as a US Navy corpsman, Al Noriega developed a civilian career as medical examiner investigator. His military medical training informed this second career, but the stressors of that job carried an expiration date. Now, at age 47, Al is embarking on his third career as a physician assistant. He has a particular passion: to see his future patients leave with a full understanding of their own role in their healthcare.<\/p>\n","protected":false},"author":1,"featured_media":8994,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[22],"tags":[],"class_list":["post-8992","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-veterans"],"_links":{"self":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/posts\/8992","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/comments?post=8992"}],"version-history":[{"count":0,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/posts\/8992\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/media?parent=8992"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/categories?post=8992"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/tags?post=8992"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}