The Lymph Node Mystery

I was feeling nauseated, so I lay down on my bed, closed my eyes, and tried to think of something—anything—besides the nausea. That’s when I noticed discomfort in my left groin area. Naturally, I did what any rational person would do: I palpated it. And, surprise, I found a lump. Suddenly, the nausea was no longer my main concern. Anxiety about this mysterious lump happily stepped in to take its place.

The next day, I checked again, hoping it was just some bizarre dream. You know, like when you dream that your teeth fall out, and the first thing you do when you wake up is run your tongue over them to make sure they’re still there. Unfortunately, the lump wasn’t a figment of my imagination.

The nausea persisted, and I felt fatigued, which, of course, made me wonder if these symptoms were somehow related to the lump. Being the responsible adult that I am, I went to work anyway. After consulting with some coworkers, I decided to allay my subtle (but persistent) anxiety by visiting the health clinic.

I saw a physician assistant (PA) who told me it could be an infection but that we should rule out cancer. (Because, of course, cancer had to be on the menu.) She palpated the lump herself and, for comparison, felt the other side of my groin. While I could make a joke here about how this was the most action I’ve had in a while, I won’t—lest I offend the overly woke.

Next, she ordered an ultrasound. When I arrived for it, a young woman introduced herself as a student and asked if she could observe. Despite knowing the ultrasound would involve my groin, I said, "Sure, why not?" Because awkwardness is just part of my charm.

After changing into a gown and lying down on the table, the ultrasound tech—someone I know from work because I have an office just down the hall—came in with the student. Nothing says “bonding with coworkers” quite like having them scan your groin.

A few days later, I got the results: not one, not two, but three lumps. Fantastic. The PA emailed me:

“Based on your labs and the ultrasound, there’s a possibility the lymph node swelling is due to an inflammatory process. However, I’d like to exclude lymphoma or metastatic disease. I’ve ordered a CT scan of your chest, abdomen, and pelvis for further evaluation and placed a referral for a biopsy with general surgery.”

Fun times, right?

Naturally, the first thing I did was check with my insurance to assess the financial damage. My share of the ultrasound? $500. Fine, knowledge isn’t free. The CT scan would be $800, and the biopsy? Around $1,500, give or take—because why not keep the suspense going.

Not thrilled about dropping that kind of cash, I decided to email my PCP for a second opinion. My pitch? Let’s try an antibiotic first and see if this lump vanishes on its own. His response was reassuringly bureaucratic:

"Dr. Kovas has reviewed the results and your concern. He states he believes it would be beneficial to move forward with the requested testing to rule out malignancy. Thank you."

In other words, “Nice try, but no.” Fine. On to the CT.

The CT scan came back unremarkable, which, in the medical world, is actually a good thing. Translation: the lumps weren’t caused by cancer elsewhere in my body. My PCP reviewed the scan with me, and I even got to see images of my internal organs—fascinating stuff. I reviewed them with my readers here. 

Next up was a visit to the surgeon, who also had to "cop a feel." (At this point, I’ve lost count of how many people have touched my groin, but it’s definitely more than my girlfriend—though I’m not confirming or denying anything for the sake of Google’s content rules.)

The surgeon explained that the swelling could be from an infection or one of a hundred other things. My ears perked up at the mention of antibiotics potentially solving everything without the need for a biopsy. But then, to my dismay, he added, “In my experience, the swelling usually doesn’t go away with antibiotics, and a biopsy is still needed.”

We agreed to try the antibiotics first and wait for three weeks. I asked the surgeon if waiting would be a problem if it turned out to be cancer. “No,” he replied casually, as if we were talking about the weather.

I read on Google about a needle aspiration that could be done at the bedside. I was hoping this would be the case—simple, just the doc, easy, go home, done. Find out it’s not cancer, and get on with life.

But, he explained that they’d need to remove the entire lymph node because a needle aspiration wouldn’t provide enough cells. This didn’t thrill me any more than discovering the lumps in the first place. “So, what does that mean?” I asked, hoping he might mention something about a quick, simple procedure. He didn’t.

“You’ll need to go to the operating room. We’ll put you under, and I’ll make a five-inch incision. It’s deep, so it might be painful if you were awake. But I’ll get it out quickly—so it’ll be a very fast procedure.”

I couldn’t resist asking, “When you take it out, do you have to reattach the loose ends?” Surprisingly, he said it was a great question. He explained that the lymphatic system is like a web, so if one node is removed, the fluid just finds another route.

As of now, I’m done with the 10 days of antibiotics. The lumps feel smaller and no longer burn, which gives me some relief. But they’re still there, so a biopsy might still be in my future.

So here I am, anxiously awaiting my next appointment. The lumps may be smaller, but the humor I use to cope remains as big as ever. Prayers are welcome.

A Conversation With My Son

So, this is not respiratory therapy related. But, we all have families. And we all enjoy kids. So, here's a little conversation I had with my 7 YO a few days ago.

Son: "Dad, what does the F-word mean?"

Oh, keep in mind I have a teenage daughter. And my son will not say these words. He will only refer to them.

I said, "Ummmmm"

While I scratched my head in search of a good answer, he spared me. He said, "Does it have something to do with the S-word?"

"What S-Word?" I asked.

He sad, "You know: S-E-X."

I did not answer. After a short pause, he said.

"Say it day. Say the s-word."

"I said, "The s-word."

"No, say the actual s-word."

"The actual s-word."

"No. Say S-E-X."

"S-E-X."

"Dad, just say the word," he continued on, calmly, cooly.

"Fine," I said, "Sex." Pause for effect. Then I bravely added a question. I asked, "What does sex mean, anyway?"

He smiled, and said, "You know, it's short for sexy."

I won't remember you

"Hi, John! "How's it going?" The person says. I'm at Walmart. My mind races to find the gray matter where in my mind that brings forth a memory of this person. Nothing!

"Hi," I say, "How are you doing?"

"Great!" The person says."  Then she starts talking to me as though I know who she is and what she's talking about.

I am so guilty of this. My favorite part of my job is having conversations with patients. I've discussed many of these discussions on this blog. I am so willing to talk about God and politics even. I mean, you do so appropriately. But I have had such deep conversations with people.

So, this person is probably one of them. But there's so many of them. There's no way I can remember them all.

My wife remembers all her patients. She knows them all when she sees them. If she wanted to, if it weren't for HIPPA, she could entertain me with stories about people she meets. But not me. I don't remember.

That's just me. I just don't remember.

And it doesn't matter if you are readmitted to the hospital or if I meet you at Walmart. And it's even harder at Walmart because you won't have a robe on. There's a chance I might have a flashback if you have a robe on.

My 20 Year Anniversary

I showed up for work on November 10, and my boss says, "Today is your anniversary?"

"What?" was my feeble response.

"Today is the 20th anniversary of your first day of work here," she said.

"Do I get a cake?" I ruefully said.

"No!" she said, laughing.

Before I had this job I never had a job longer than a year. So, it's a pretty good accomplishment to last this long.

What has changed? 

When I started, there were senior RTs who always seemed to take the easy assignments. I was happy about that because I got to take exciting ER and critical care.

Whenever I had questions I'd tap in on their wisdom. When I wasn't confident, I'd have them shadow me. When I wasn't sure about myself, I'd ask them questions.

When they were thinking about retirement, I'd think, "How are we going to replace all that wisdom?

The answer: "You don't!"

"Who is going to fill your shoes?" I ruefully asked once.

"You!" One of them said.

"What? I don't know half of what you know."

"You are! You have no choice."

Gulp!

"Yeah!" she said. "That's, like, part of getting old."

What you do is you add your own wisdom. You have your own experiences. You have your own wisdom from these experiences. You have wisdom from what you have read. You have wisdom from what you have heard. You have wisdom from your conversations.

This wisdom is there even if you don't know it. And you will be asked to share it, whether you're ready to or not.

Fortunately for me, I have done lots of research for the RT cave. I have spent lots of time reading science journals for articles I've written. That helps. But it's not always needed. Some RTs don't read that much and they're equally brilliant.

So, now I'm the senior RT. That's what has changed. The seniors I tapped into are retired. Now I'm the senior RT. This is not a role you seek out. It sort of just happens.

The RT Cave Is 10 Years Old

On October 13, 2007, I yearned to start a blog. I had no idea what to call it. I had no idea what I was going to write. I just wanted to do it. I just knew I wanted to write.

I worked night shift back then. I remember walking around the hospital. Everyone was busy but me and the nurses working in critical care. So, that's where I hung out.

I remember rolling ideas in my head for a title for my blog. I asked my CCU friends if they had any ideas. They did. But none of their ideas impressed me.

Finally, about halfway through the night, I said, "Well, folks, I'm going back to the cave!"

My eyes lit up.

"THAT'S IT!" I said. "I will call it the cave!"

I already knew I wanted respiratory therapy in the title. that way my blog would come up during any search for respiratory therapy.

I went back to the cave and decided to write. I had no idea what to write. I ended up writing this stupid article about the beeper. I read that post every anniversary date. And every year I think, "What a stupid post."

Sure, I've thought of deleting it. I have thought of editing it. But I don't.

It's kind of like saving your belt after you lose 30 or 40 pounds. You keep it even though it's worn out and useless to you now. You save it as a memento of what was and what is now not.

I wanted to write. I have always kept a journal. I started a journal when I was in high school. I did a diary before that. I just loved writing.

My dream was to be a published author. What I planned on was writing a book and getting it published. I wanted to be like Stephen King. I mean, I knew I wouldn't write like him, but I wanted to be published like him.

But I was unable to write that book. I was more of a columnist type of writer. I liked to write columns. But, I didn't have the confidence to publish what I wrote in the local newspaper. I say this even though the opportunity was there. I was asked to do it more than once.

But then something happened that I never anticipated: the Internet. It was there in all its glory. All I had to do was tap into it. And so I did.

I started the Cave. I decided to write something every day. My early stuff was shit. But, the more I wrote the better I got at it. I learned how to write pithy. I learned how to keep articles to one thought. I learned how to write for the Internet.

A year after I started this I received an email. It started with, "I love your blog." That email turned into my job at Healthcentral.com. I would write a weekly column for them for eight years.

That job came about just because I wrote. I wrote every day. And people must have liked what I wrote about. I know this because my blog was soon the #1 respiratory therapy blog not associated with a peer-reviewed journal. This is still true to this day.

But I did not make money on this blog. I just did it for fun. I did it to pay it forward, you might say.

There's this old saying that if you like to do something, and you do it and do it well, good things will come of it. I think it comes from the Bible. Well, one day I received that email. And, well, the rest is history.

I retired from Healthcentral in 2015. It was a hard decision. Now I write for Asthma.net and COPD.net. That's where most of my time is spent now.

But, this is my baby. So, you can expect for me to keep it around. If you have ideas what you want me to write about here, please do share. Like, if you have questions you want answered or whatever.

Anyway, it all started 10 years ago. It's been a great ride! It's been fun! I would like to thank YOU for making this so successful. None of this would be possible without YOU. THANK YOU!!!

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How to succeed in life

If you want to succeed in life, then you need to avoid people who are failures.  You need to avoid hanging around people who have negative attitudes.  You need to avoid people who incessantly complain about their work.  Because these people will never succeed.  They will never be better than what they are today.  

If you want to succeed you need to talk to people who have succeeded.  Any person who has succeeded will tell you this.  If you hang around negative people, people who are not happy with their jobs, then that is the attitude that you will pick up.  So if you want to succeed, hang around happy and successful people.  

That's not just something I'm making up, it's true.  If you hang around the failures, you're just going to become negative, and you are going to lose hope, and you are going to become apathetic about your job.  Once apathy sets in, chances of you moving up the ladder will probably be thrown out the door.  

Once you become apathetic and sit around the RT Cave complaining about this or that, or complaining about this person or that person, then you are going to trapped where you are right now.  If you want to succeed, if you want to move up the ladder, for instance, you will have to get away from these people.  You will want to rise above them.  

Don't hang around people who tell you you can't succeed because they didn't, because then you won't succeed.  You don't want to hang around people who are bitter.  Find the successes and learn from them.

If you want to be a writer like I am, you used to have to be ambitious and try to get some newspaper or magazine to like your writing.  One day I was sitting around trying to figure out how I could become a writer, and my wife introduced me to the Blogosphere.  I started writing.  At first I wrote to no one, as I has no audience.  Then people started discovering my blog, and they realized that I had something interesting to say.  

Then one day I received an email from a producer.  She said, "I love your blog.  I love the way you write in a pithy manner, and how you describe your profession accurately, and how you write about asthma.  I love how you write about smart people and stupid people.  I think you are a great writer, and I want you to write for me."  

I responded to this email, and now I have been successfully writing about asthma and COPD since 2008 for healthcentral.com.  I love doing this.  To me, it's not work: it's fun.  I have succeeded.  You can too.  But you will have to take advantage of opportunities, and you'll have to stay away from the complainers, or at least not listen to them. 

I'm not even saying you can't complain, because Lord knows I do.  I'm honest about my job.  However, I talk about it in a generic way, without blasting any person.  I might honestly discuss a situation that isn't going well,  and I might even disagree with doctors and bosses, but never at the expense of respect.  

People do things for a reason.  Doctors order useless breathing treatments because that's what they were taught, and telling them they are "idiots" will not solve anything.  Many doctors even admit that they order 'useless" treatments because they have to in order to get patients admitted.  

You might look at me and say, "You are a small town respiratory therapist and you have a couple blogs, but you are not successful."  To that I say, "It depends how you define success.  I define success by how satisfied I am, and I'm very satisfied." 

This is who I am to a tee

Here's my personality to a tee:

Peaceful Phlegmatic:  The watcher:

• Easy Going:  I got written up once for being too relaxed at a code
• Quiet:  I speak only when there's something worth saying (although I do fail on occasion)
• Comfortable clothing: Large and loose.  Comfort comes before looks.
• Light on their feet:  Never wear coats, boots, pads, etc.  
• Blends in:  Humble, and don't like being in the spotlight
• Steady worker: I get my work done and do it well (yet I do cut corners)
• Flexible:  I don't care when I work, and am more than eager to come in when called.  

Strengths:

• Steady:  Keep going forward
• Reliable:  Will get it done in a timely manner
• Consistent:  Will do it the same every time 
• Curious: Always thinking and looking for new answers
• Observant: They look, they see, but they do not speak
• Empathetic: They care about people's feelings
• Good listener:  I'm all ears. Would rather listen to you than hear me.
• Calm:  Again, I've been written up for being too calm.
• Witty:  I'm pretty much as my blog might indicate.
• Kind:  Easy to get along with
• Has few enemies: I even get along with the arrogant and condescending
• Low Key: Humble

Weaknesses:

• Dislikes change:  Hate it.  I just want to keep things the way they are.  I'm very conservative.
• Uninvolved:  I come up with ideas, but it's up to others to sell them.  
• Avoids conflict at all costs: Conflict to me is trying to keep all the people in my life happy.  Sometimes I can't keep both my boss happy at the same time as my wife, because one wants me to work, and the other wants me to be home with the kids.
• Super stubborn when pushed:  Very much so.  I hate stupidity.
• Hard to get moving: Yes, I put relaxation, sleep and recharging before doing things that are monotonous, like frivolous breathing treatments, cleaning up after the kids, etc. I am very hard to get motivated.  Although, once I act, I do a great job. Funny thing is, when I attend meetings I generally vote not to change anything. 

Emotional needs:

• Peace and quiet:  I sacrifice sleep every morning and get up at 5 a.m. so that I can get my 2 hours of peace and quiet.  This is my recharge time.  
• Feelings of worth:  I just want people to show that they respect me.
• Lack of stress:  I say all the time I hate stress.  If any change is going to amount to any degree of stress, than I am all against it.  
• Sleep:  Most people like me are teased because we are seen as big sleepers.  I do not sleep well, but I must get plenty of it in order to prevent stress.
• Respect for who they are:  I expect this a lot.  Generally, any conflict in my life resolves around this.  

Truly, there's not much else to say about me.  However, you'd have to add that I'm a thinker, creative, and I like to be organized (although not at the expense of relaxation).  These other traits, however, come from my secondary personality: melancholy. Melancholy people tend to be creative and thinkers. 

I cannot change who I am.  I think the most difficult thing for any young person is learning who they are, and then accepting who they are.  This is me.  Respect it.

Recommended read: Personality Plus by Florence Littauer

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The main difference between working nights and days

I was told by a patient that when I work nights I tend to pace, and when I work days I become more involved in conversing.  After thinking about this, I realized it's true. 

At nights I'm tired, so I don't really feel like conversing.  Plus when working nights I work alone, and I carry the ER beeper.  So this makes me fear that my beeper will go off at any time, so I'm always in a hurry to get done.  At nights I tend to provide less therapy and focus more on getting tasks done. 

At night elderly people don't have their hearing aids in.  At night some get irritated when you wake them, or are groggy.  At night there are fewer opportunities, and less desire, for conversation. 

During the day people tend to have hearing aids in, and they are awake.  During the day you are more awake, and more likely to feel like conversing.  Yes, during the day I converse more and pace less. 

This is one of the main differences between working nights and working days.

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The priorities in my life

Being it's the holiday season and all, I've decided to take a time out here to write a little about my self.  Here's your chance to get to know me if you don't already.

God:  I fear him, and for good reason.

Wife:  I fear her, and for good reason.  She is the most special person in my life, my best friend, and the reason I am what I am today.  Seriously, I could not do this without her.

Kids:  They give me purpose and make sure I look at the grander picture as opposed to what's right before my eyes.  I find my kids absorb a majority of my non-working time.  And, for the record, I have one kid in each age group:  one teenager (14), one adolescent (9), one toddler (4) and one baby (2).  So if I seem distant or invisible at times, just think of how many practices and events I attend with my older kids, and catering to the needs of my younger kids.  Parenting is a lot of work, although it's very rewarding.  Still, it provides little time for the things down on this list.

Work:  I'm a respiratory therapist and I love my job and the people I work with.  Surely there are flaws in this profession, but it does allow me time to do this and to meet some wonderful people.  So I am thankful for that.  Plus it's a good job for an asthmatic, of which I am.

Other people:

• Friends:  I'm not really a social person.  I do not like crowds, even if it's all family members.  Yet if you invite me out to dinner I'll probably accept.  
• Fellow bloggers:  It's amazing how many people I've met on the Internet who've become my good friends.  I do have to admit I haven't given you guys as much attention as I'd like to due to the other priorities listed above -- i.e. kids.  

Other things:  

• Country:  I love being a U.S. Citizen.  I love the document that makes it all possible, and I believe the principles that established it are rock solid, not ever changing.  Principles do not change, and people should remember that.  I wish more people would take note of that.  
• Exercise:  There is not excuse for not finding time for this.  It is the string that makes everything else in your life work.  When it's not done, things just don't work as well.  
• Respiratory Therapy Cave:  It allows me a place to organize my thoughts about the profession I'm wrapped in.  My blogs are really the only things in my life I have complete control of. 
• Hardluck Asthma:  It allows me a place to organize my thoughts about the disease I'm wrapped in.  
• Baseball:  Justin Verlander, Cabrerra, Prince -- nuff said.
• Politics:  It amazes me how many people don't care.  I do.  
• Beer:  Peace; relaxation

You may have noticed I've placed all the above in order of priority.

Here's how I became a good student

In High School I was a bad student. My teachers always told me I could get good grades if I applied myself, but I never did. Well, it's not like I was sitting around watching TV. That wasn't the case at all.

It seemed like at the start of every Semester I'd say something like, "This Semester I'm going to study hard and get good grades." Yet, I'd start to study and my brothers would decide to play a game of football. They would need me to make even teams. So, I'd end up playing football. By the time I got to my reading it would be after the sun went down and I was too tired to focus.

In retrospect, I am glad I spent time with my brothers. Yet, I wish my parents would have helped me organize my time better.

I got C's and B's without trying much. In my first two years of college this trend continued. I made some friends real quick and they acted like my brothers, always dragging me away from my studies.

In fact, my Freshman year in college I think I actually got D's in math and English. I was a poor student who would go out and party on some nights I should have been studying. I was a poor manager of my time.

However, my room mate and best friend named Frank at that time got all A's in everything. He would party with us too, but when he wasn't doing anything he'd discipline himself and study his butt off while I would sit around watching TV.

He even went out of his way to improve the scope of his learning and read as much as he could possibly absorb. In class I would take a note here and there, but Frank would write down everything. Then, when he was back in the dorm room, he would rewrite all of his notes in a separate notebook.

This was a lot of work for Frank. But it paid off. Frank was well respected by my classmates and teachers because he was such a hard worker. He ended up graduating top of our journalism class, and ended up the Editor and Chief of the newspaper.

After we got our Associate's degree in journalism I moved on to the Advertising program. Frank decided to pursue a career in journalism, so he transferred to the University of Indiana. I never heard from him again until the advent of the Internet and email. By this time, however, I decided I needed to become a better student if I was ever going to succeed. So I started reaping the rewards of having a great former room mate like Frank.

I don't know if Frank ever had a great IQ or not. The truth was it didn't matter, because, he was just a hard worker. He was a great organizer. He made very good use of his time.

I'll give you an example of something Frank would do that others would not. During our first year working for the student newspaper the Editor and Chief would get stories from the student reporters and she would peruse them quickly after they were edited and publish them. As a result, there were usually some errors or flaws in the published paper. I would guess 90% of newspapers are published in this matter. It takes a lot of time to make a perfect paper, and since life is busy most people don't take that extra step.

When Frank was Editor in Chief, on the other hand, he took the extra step. He wanted to be the best reporter/ editor he could be. Frank would literally stand in the copy room and read EVERY single word in HIS paper. He wanted every paper to be the best. He settled for nothing less. And, every paper was the best. So now, not only did he get the best grades and have the respect of everyone, he also had the best newspaper ever made at Ferris.

Finally Frank and I graduated with our Associates degrees in Journalism from Ferris. Frank knew exactly what he wanted and he transferred to the University of Indiana to pursue journalism further. I also remember him saying one day in passing he thought it would be cool to be a lawyer some day, but I don't think he really said that thinking he'd actually do it. I said in passing I wasn't sure journalism was for me, and thought that my real calling was probably respiratory therapy, "but how do you go from journalism to respiratory therapy?" I said.

I graduated from Ferris with a Bachelor's in 1993 in Advertising. After Frank left my grades went up some, but I still think I graduated with a C. Then, after working as a journalist for three months I was fired. Journalism simply wasn't for me. That was when I realized I had taken the wrong path. Little did I know then I would end up using these skills in the blogosphere.

I ended up taking a year off. Then I got this exciting job as a hotel desk clerk. I did that for about a month before I decided I better get my life in gear. Here I was with a Bachelor's degree making less than $5 an hour.

So I signed up for the RT Program at another school in the area. I didn't want to go back to Ferris because I thought people would wonder about me if they saw I was still there five-six
years after I already got a 4 year degree.

So now, in 1995, I found myself in the RT program. I thought I would be the oldest person in the class, but I was not. It turned out that most people who go into the RT program are older people -- housewives, former construction workers, asthmatics who failed at other things, moms and dads of asthmatic kids, former alcoholics, and a few kids right out of high school.

This time around, though, I knew I could not fail. I had to succeed. So, while I was still a front desk clerk, I borrowed someones anatomy and physiology book and medical terminology book and studied them every night I was working. I wanted to have some core knowledge before the RT program started. I was not going to fail. I couldn't fail. I needed a paying job with medical benefits (I had asthma you know, and I was about to be kicked off my parent's insurance). I knew I could not fail this time. I could not go to school another four years and not get a job in return.

So I decided to take the route Frank took. Instead of hanging out with my friends I stayed in my apartment studying. I never missed a class. Keep in mind here that I know for a fact I was not good at retaining what the teacher was saying in class. So, for that reason, I would sit there and write my ass off nearly every word the teacher said. Then I'd go home and type my notes on the computer and organize them that way. Usually, by the time I had this done, I had most of the stuff memorized. But I would still at least try to peruse my notes for each class as often as possible. If a teacher discussed old material, it was right there handy too. And, whenever I needed to study, it was all right there neat and organized.

Also I should add that every moment I had open I was pacing my living room or sitting on my bed studying my notes. I had to do this because I didn't trust my memory. I don't have a 150 IQ or book smarts where I can read something once, or listen to one lecture, and have it memorized (or even understand it). Many times when I left class I had no clue what the teacher even talked about, but I had the best notes ever. I'd go home and sort things out, maybe review the topic he was talking about in one of the RT books, and voila, it would all make sense. That's basically how I studied.

By the time the test came around, I never studied 24 hours prior to the test. I made sure I had all the information in my long term memory by then. Then I would take the test (or quiz) and do pretty well usually.

There was one test early in the RT program I got 98 questions out of 100 correct. The highest grade under me was a 63. So, needless to say, I blew the curve. I didn't say anything, but since there are only 10 people in our class, it didn't take long for them to figure out who the "culprit" was. So, after that, everyone wanted me to study with them. Oh, and they all wanted copies of my notes. I could have sold them but I never did. I actually enjoyed studying with my classmates -- or tutoring actually, and that actually made studying easier. For some reason when you teach something you retain it better.

Again, I am not smart. I do not have a high IQ. In fact, I actually know my IQ. In 1985 when I was at the asthma hospital a psychologist performed 2 IQ tests on me and I think I scored somewhere around 105 or something like that. See, I'm no genius. But I read something in an IQ book once that a persons IQ does not determine ones level of success. Success is determined by how hard a person works. If I learned nothing else from Frank's success, that was it: I learned how to succeed. And, in 1997 I graduated tops in the RT program for that year. I did not have a 4 point or anything even close, but I still did pretty well. So, you can say, I earned the respect of my teachers and fellow students by working hard like Frank did years earlier.

My point here is that if you want to get good grades in the RT program, or any other program for that matter, you have to work hard. You have to sacrifice your free time and study. And you can do this knowing that once it is all said and done, and you have your job in whatever career you are pursuing, you will have all the free time that you want.

I lost touch with Frank for the next 20 years. Recently, when I found his emial address, it was on the home page of a law firm. In a recent email duscussion we marveled at how we both ended up changing to the career we talked about that one night. Frank is now a well respected lawyer, and I'm an RT.

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