Please Help Me! PA to MD...opening a can of worms

[poopy06]

I really need some help here on my current situation...  I realize I will get bashed for this, and I apologize in advance, I sincerely do not mean to offend anyone.

I am a 32 year old woman and I have been a PA for 5 years; I have worked with my husband who is a physician.  Becoming a PA was a no-brainer at the time for me because I was so worried about having a good lifestyle and having time for children (who doesn’t?).

After 4 years, I was able to function completely alone; I realize that I was probably allowed more autotomy because I worked for husband.  I felt in a way that it was unfair as all of my friends struggled with their physician bosses, the politics of the hospital (well, I did struggle with this too; we all do), while I got to do more, have more flexibility, and basically, be the “physician”.  I performed all of the services for my hospital that were required of my specialty that would have been done by my husband, and people saw me “like a physician”.  They even stopped calling my husband for questions and then everyone started really relying on me, and I felt great that people had come to trust me so much.  My husband was so proud of me. He was able to start focusing on another hospital.  I had to work hard for that trust and all of my knowledge.  I even felt bad because my PA friends who were working hard as well were not even looked at with that kind of respect.  I started to feel that because my husband was a well-liked doctor, it was the only reason that I was able to obtain that kind of trust and respect (my PA friends would despise me for it, telling me I “was just so lucky”, “it’s all about who you know”, and “you just have what everyone wants”).  It was about this time that I started to feel like that if something were to happen to him or our relationship, I would lose all that I had worked for and would have to work under the same conditions that my friends were working under (no autonomy, they literally complained of not having any respect among their supervising physicians, not allowed to see complicated patients or dictate consults…my city is not that PA friendly… maybe I wouldn't be a happy PA)?   

It was then at this time that a friend of mine told me about a PA to MD program and that she was going to do it.  A year ago, I started the program too.  My husband thought that I was crazy but was supportive.  I really do not have a lot of emotional support from anyone and I have to admit, this wears me down.  This is the first time I ever ask for advice. 

 

My reasons for going for it were these:

1. I felt that, besides the other above reasons, that with as much autonomy that I had, I would be really unhappy if I lost that because I was so accustomed to it. 

2. I had always dreamed of becoming a physician, but never gathered up the nerves to do it because I was scared of the time commitment and sacrifice. When I decided to become a PA, I thought it was an easy choice because of the “lifestyle”.  If all I wanted was just a good lifestyle, then I wouldn’t even be thinking of medical school.  There was something more to it for me. 

3. After 4 years of being a PA, I started to feel frustrated that I would never become a physician because I functioned like one and I was doing fine

4. I had a strong desire to do it; I don’t want to do anything else besides medicine.

5. I am scared that I will be at the end of my life and regret not taking advantage of this opportunity. I mean don’t we all want to be the best we can be? 

*There are more, but these are what keep me going anyway* 

 

After a year into it, I am feeling guilty that I chose this path because of all that I have sacrificed so far and all that my husband has sacrificed.  I cannot believe that I feel so guilty for this.  I am questioning my decision making capabilities and my character.  I am thinking of quitting because maybe lifestyle IS all that matters.  I feel inherently guilty that when residency comes, I will be missing so much of my life for it.  I feel ashamed that I am not being a good wife, that I am taking my husband’s manhood by becoming a doctor and not doing all of the housework like before (my family has told me this, and I just believe it now. Women and men are different).  I feel like that there is something really wrong with me becoming a doctor, but that little voice in my head says that I will regret quitting. At the beginning, I was really happy and felt that I made the right choice.  

Also, quite honestly, I am scared that I will go through all of this and my husband will leave me and I will be alone, no children, no family because of all time I will spend in residency (the program is 3 years, plus 3 years residency, plus fellowship that I would like to do, which is another 2 years – I will be about 40 when I finish).  It is a real fear that I have that I cannot shake.  So many people have discouraged me that I believe I made a mistake.  Or am I making a mistake?  :(

 

Has anyone gone through something like this?  Can anyone give me advice? 

Do you know someone who is in a similar situation that could help me?   Is the gain of becoming a physician worth the cost in my situation?  Are there any PAs that are doing what I am doing or going through what I am going through? 

I cannot say thank you enough to anybody that can give me advice.  You don’t know how much I appreciate you reading this, even if just for emotional support.  Thank you and I am so sorry this is long :( 

 

[Guest Paula]

There is a long thread on this subject already on the Forum.  Search for it.  Your questions will be answered. 

 

Otherwise, seek professional counseling since your self esteem is taking a beating. 

[poopy06]

Thank you very much for your reply :)

I searched for it on your forums before I posted, but I couldn't find anything particular to what I was going through. Can you please direct me to that thread? I would be extremely grateful! I didn't see anyone that had actually started a program. I apologize for posting something so personal and long. Thank you :)

[MT2PA]

Out of curiosity, and I'm sorry this isn't related to your question, but didn't anyone question you working with your husband?  It seems like there should have been....idk...some hesitation about that situation.

 

There ARE PAs who end up going the MD route after practicing. I don't think it's super common, though, and while they may have moments of regret or wondering if they made the right choice, I can't imagine they have *quite* the specific feelings you are experiencing.  I feel like there may be some cultural issues at play here if you think you are 'taking your husband's manhood' by becoming a DR or that you should be able to have a career and do ALL the housework.  I genuinely think this may be a unique experience for you.  I can't name a single woman in my PA class that would ever feel that they are taking away their husband/bfs/etc manhood, nor a man in my class who would ever think his wife is taking that from him by working at a similar level in the same field.

 

Only you can help yourself now.  You have reasons for wanting to pursue the MD.  Did your family/husband never support the plan?  If not, at some point you decided that your wants and needs were more important than their opinions.  Only you can decide if you can overcome those feelings of guilt.  And if you have a husband who will leave you for pursuing your career....well, I'll keep my opinion on that to myself.

[Reality Check 2]

I too question the ethics of working with one's spouse in a supervisory medical role.

This seems too close for comfort with a lack of objectivity as a given.

 

No one from my class 25 years ago became a physician. 

One had a spouse who went on to become a physician and that became awkward with "why didn't you become a PA?".

 

Only you can decide if becoming a physician is worth it. It is a great deal of invested time, energy, money and time away from family.

 

I might have done it 20 years ago before kids but could not imagine at this juncture in my life having to repeat schooling and go through residency.

 

Plus, my family could not handle it financially.

 

Best of luck to you - follow your heart and your gut. Just be good at what you decide to do and give it your utmost.

[poopy06]

Thank you so much for your time and replies... I really do appreciate it, you have no idea :)

Just to clarify, at first my husband was not really supportive (with house work, etc) but now he is... He still thinks it's not the best choice but he supports me anyway. My family has never been supportive... I'm sure it's because I was raised in a very traditional family; my mom stayed at home while my dad worked. My mom never had a career, and my parents' seem to reflect that I shouldn't "compete" with my husband.. I asked my husband what he thought and he said it wouldn't bother him, but I still feel guilty. Probably because that's what I was raised with. It didn't bother me at the beginning but now it does...People can get to you sometimes no matter how hard core you are. Like a rock being eroded by the ocean over time I guess...

As for the husband-wife dynamic between us at work, i guess We should've thought about that before I started to work with him. I couldn't get a job right away after graduation so I worked with him and then years went by, and it was convenient for both of us. It never got brought up, believe it not... I guess that was the real mistake. There are several people I know who do it here, and everything is okay with them.

[cbrsmurf]

Reading your well-formulated essay, it boils down to this: Are you OK with spending the rest of your life wondering "what if?"  

 

If you are: stay a PA

If not: go to med school

[MT2PA]

Thank you so much for your time and replies... I really do appreciate it, you have no idea :)

Just to clarify, at first my husband was not really supportive (with house work, etc) but now he is... He still thinks it's not the best choice but he supports me anyway. My family has never been supportive... I'm sure it's because I was raised in a very traditional family; my mom stayed at home while my dad worked. My mom never had a career, and my parents' seem to reflect that I shouldn't "compete" with my husband.. I asked my husband what he thought and he said it wouldn't bother him, but I still feel guilty. Probably because that's what I was raised with. It didn't bother me at the beginning but now it does...People can get to you sometimes no matter how hard core you are. Like a rock being eroded by the ocean over time I guess...

As for the husband-wife dynamic between us at work, i guess We should've thought about that before I started to work with him. I couldn't get a job right away after graduation so I worked with him and then years went by, and it was convenient for both of us. It never got brought up, believe it not... I guess that was the real mistake. There are several people I know who do it here, and everything is okay with them.

Unfortunately, the more I think about it, you working for your husband might be part of the problem with the feelings you're having.  Even when you had a career as a PA and autonomy, he was still your SP.  If you had experienced the independence of working as a PA separate from your husband you might have a better feeling now for how having your *own* career will feel.

[ventana]

Life is about decisions

 

you are very fortunate to have this one

 

a question - why do a fellowship?

 

Why not just to IM or a 3 yr res and then transistion right into a job at 1/2 time

 

residency after the first year is not all that bad.....

 

 

 

 

When i turned 40 I finally emotionally realized "I was too old to ever go back to school"  I was done with formal education, and I am comfortable with it.  I have a 2.5 yr old kid at home, my wife can stay at home, and I work my tail off at 2 jobs.  It allows my son and wife to be home, and I am helping my family.  I would rather be the one staying at home, but the income potential for me is far greater then my wife (and I am in a perfect setting)

 

 

 

 

So, these are all great questions you are asking, and only you can answer.....

 

BUT realize 3-4 year Med school doesn't sound that bad, and only the first year of residency is bad (from what I see)

 

you can be a full fledged doc in 5 more years (one of which will really stink)

 

 

 

I would finish what you started..... as long as the family unit stays intact

[Rosslyn]

It sounds like you're in a really tough place, but honestly, at the end of the day YOU are the one who has to live with this decision, not your parents. If you want to be a doctor, then continue on your path. Your marriage survived PA school (and possibly his trek through med school), if you continue to work on it, it could make it through med school. Your dream is important, as important as your husband's and I hope that he feels the same way.

[True Anomaly]

Thank you so much for your time and replies... I really do appreciate it, you have no idea :)

Just to clarify, at first my husband was not really supportive (with house work, etc) but now he is... He still thinks it's not the best choice but he supports me anyway. My family has never been supportive... I'm sure it's because I was raised in a very traditional family; my mom stayed at home while my dad worked. My mom never had a career, and my parents' seem to reflect that I shouldn't "compete" with my husband.. I asked my husband what he thought and he said it wouldn't bother him, but I still feel guilty. Probably because that's what I was raised with. It didn't bother me at the beginning but now it does...People can get to you sometimes no matter how hard core you are. Like a rock being eroded by the ocean over time I guess...

As for the husband-wife dynamic between us at work, i guess We should've thought about that before I started to work with him. I couldn't get a job right away after graduation so I worked with him and then years went by, and it was convenient for both of us. It never got brought up, believe it not... I guess that was the real mistake. There are several people I know who do it here, and everything is okay with them.

 

While it seems that part of your feelings stem from how you were raised, as others have pointed out at the end of the day it's YOUR life and YOUR career- and if your husband supports it, then you should do it.  

 

My wife is a physician who also does ER- there is no way she could've been a PA because she's very type A and needs to be the one in charge- she would've had a very unhappy career being second banana to a physician as a PA.  We don't work at the same hospital- and I've discussed before with my medical director that if she ever came to work where I did then there would have to be special considerations made so that she wasn't working directly with me at the same time- just something else to think about with your current professional dynamic.  Although knowing my wife, even if we worked together she would be just as strict with me as she is with the residents she teaches

[PACdan]

This is a weird syndrome.

 

PAs get a few years into practice, really hit their stride, and all of a sudden start daydreaming about medical school and Doctor-dom. I guess it makes sense in a way... You're getting comfortable on your own, your patients see you as comparable to the physician, you're confident in your management of the pts., and then BOOM the "I'm doing the exact same thing as the physician...why am I not one?" hits. I think this moment of existential crisis needs to come before PA school. The reality that PAs will being doing the same work as the physician in many arenas, for less pay and lack of the "doctor prestige"...or what remains of it.

 

I would posit you this: If you're working "at the top of your license" as I've heard members here refer to it and if your patients are deferring their questions and management to you instead of the physician (husband); should you not run with that type of recognition to help bolster the PA profession? Why jump ship just when you can really maximize what a PA does?

 

I wouldn't worrying about lying on your death bed and regretting not going to medical school. I don't see most people shaking their fists at the sky while lamenting not getting one degree or another. Most people tend to reflect on whether they were a good person, or if they helped their family, friends, and fellow humans, and if they made a mark on the world. If as you say you're helping your pts. immensely in the capacity of a PA, do you think taking four years away from that is then going to greatly expand the amount of help you ultimately render during a career?

 

I get that people say "I always dreamed of becoming a physician", but I don't know if I completely buy it. I dreamed of becoming a cartoonist, an FBI agent, an astronaut and before that, the President. As I grew and experienced life, my goals, interests, and dreams changed. The doctor often gets put on a imaginary pedestal and then she/he can be quite difficult to get down. We are biased to think of becoming a doctor as the ultimate goal in medicine. Yet if your goal is to maximize the care you can provide for others, ask yourself if this is achievable as a PA. If the answer is absolutely not, there is no way this goal can be accomplished as a PA, then I would assume you have your answer. Any other motivation is self-edification.

[EMEDPA]

keep up the med school route then do a 3 yr residency. I really wish I had. I am very type A and it has taken me almost 20 years to finally be happy as a PA working in solo situations making all the decisions. I looked at going back several times, most recently 6 years ago and again 3 years ago and life always got in the way. carry on, you will be glad you did. If I lived any closer to erie, pa or there was another west coast bridge program I would probably still go in my late 40s.

[dholmb]

I’m not a PA (yet) and don’t have a family or kids (yet) so I probably don’t know what I’m talking about, but here are my thoughts.

 

It sounds like one of your main reasons for going to medical school was not because you didn’t like your job, but because you thought the only reason you had respect and autonomy was because of having your husband as your SP. I doubt that’s the case. I would bet your coworkers respected you because you are a good PA. I don’t know what the culture is like where you worked, but I can imagine that if you were a lousy PA then people would gossip and be equally if not more hard on you.

 

I’m sure you could find another job, independent of your husband, and do great.

 

Medical school is stressful and it’s not going to get any easier. That being said, the second-guessing and doubt must add even a darker cloud to the whole experience. I would recommend taking a step back, making the decision, and then going on with your life while trying not to bring all of those fears with you into the future.

 

Also, don't forget, the grass is always greener on the other side. There are so many PAs on this forum that wish they had gone to medical school. That being said, I’m sure there are plenty of docs who wish they hadn’t gone to medical school and instead been able to spend time more time with their family etc. 

[poopy06]

This is a weird syndrome.

 

PAs get a few years into practice, really hit their stride, and all of a sudden start daydreaming about medical school and Doctor-dom. I guess it makes sense in a way... You're getting comfortable on your own, your patients see you as comparable to the physician, you're confident in your management of the pts., and then BOOM the "I'm doing the exact same thing as the physician...why am I not one?" hits. I think this moment of existential crisis needs to come before PA school. The reality that PAs will being doing the same work as the physician in many arenas, for less pay and lack of the "doctor prestige"...or what remains of it.

 

I would posit you this: If you're working "at the top of your license" as I've heard members here refer to it and if your patients are deferring their questions and management to you instead of the physician (husband); should you not run with that type of recognition to help bolster the PA profession? Why jump ship just when you can really maximize what a PA does?

 

I wouldn't worrying about lying on your death bed and regretting not going to medical school. I don't see most people shaking their fists at the sky while lamenting not getting one degree or another. Most people tend to reflect on whether they were a good person, or if they helped their family, friends, and fellow humans, and if they made a mark on the world. If as you say you're helping your pts. immensely in the capacity of a PA, do you think taking four years away from that is then going to greatly expand the amount of help you ultimately render during a career?

 

I get that people say "I always dreamed of becoming a physician", but I don't know if I completely buy it. I dreamed of becoming a cartoonist, an FBI agent, an astronaut and before that, the President. As I grew and experienced life, my goals, interests, and dreams changed. The doctor often gets put on a imaginary pedestal and then she/he can be quite difficult to get down. We are biased to think of becoming a doctor as the ultimate goal in medicine. Yet if your goal is to maximize the care you can provide for others, ask yourself if this is achievable as a PA. If the answer is absolutely not, there is no way this goal can be accomplished as a PA, then I would assume you have your answer. Any other motivation is self-edification.

How long have you been practicing as a PA? How do you stay satisfied knowing that you have no opportunity for career advancement?  Maybe that answer can help me a lot.   Because I really do want to help people. I just think, though, becoming a PA, a MD, a RN, a plumber, a truck driver, a hair stylist is all a personal decision.   They all help people.  I don't think it is that simple, with all due respect.  (I am not trying to upset anyone, really).  If you are still in school now (I am guessing that you are, since you have PA-S 2016), there is just no way of knowing until you get there, in my defense.  It is just really difficult to project how you will feel; your dreams change, like you said.  What do you think the ultimate goal in medicine is for you?  I think that varies for everyone, which makes this decision difficult for me. 

 

I really appreciate all of your thoughtful replies and help, it really does help me and I have been thinking about this from a different perspective, which is what I was hoping for. Fresh perspectives really, really, really help me.  

The more I think about, 5 years is really not that long (in the scope of life...I mean, I am 32 now), and I feel so much better about it.  

Ventana, I wanted to do a fellowship because I currently love my specialty and I might have a shot at doing it close to my home because I use to work with the program and they know me really well (I know I can't completely rely on that, but the worst that could happen is that I don't get in and I can work as a hospitalist, which I think I might be happy with)  but yes, it does add time and a little bit more uncertainty.  I will have to think about that more.  

[PACdan]

How long have you been practicing as a PA? How do you stay satisfied knowing that you have no opportunity for career advancement?  Maybe that answer can help me a lot.   Because I really do want to help people. I just think, though, becoming a PA, a MD, a RN, a plumber, a truck driver, a hair stylist is all a personal decision.   They all help people.  I don't think it is that simple, with all due respect.  (I am not trying to upset anyone, really).  If you are still in school now (I am guessing that you are, since you have PA-S 2016), there is just no way of knowing until you get there, in my defense.  It is just really difficult to project how you will feel; your dreams change, like you said.  What do you think the ultimate goal in medicine is for you?  I think that varies for everyone, which makes this decision difficult for me.

 

I think what you came here for is validation for a decision you already made. You're already in the first year of a PA-physician bridge program, as you stated. 

 

I do have to point out that asking me how long I've been practicing as a PA and then affirming that you understand I am still student by virtue of my signatures, in the same posting, is a passive-agressive means of implying that I cannot possibly know what my ultimate goal in medicine is. This however would be an incorrect assumption on your part. I know I will not pursue medical school after I finish studying to be a PA. Now I may add an exception in there, such as a miraculous 9-month bridge to MD or something, but barring that, absolutely not. I will practice as a PA for the entirety of my career. I made the decision between MD and PA very thoughtfully. So yes, there is a way of knowing before you get there. I did my due diligence.

 

Now of course any job can be beneficial to others. But stating that no opportunity for career advancement exists as a PA? I do not believe that is true. Or have you exhausted all reasonable attempts at advancement and met with only stubborn resistance? It seems from your original post that you have not encountered many actual barriers in practice. Have you sought leadership positions and been denied? Have you tried to implement some change and been rebuked for being a PA? What career advancement do you believe will be available to you as a physician, that you desire now as a PA? Department head? Chief? Program director? Money? Prestige? Are these hypothetical concerns or realized ones?

 

I understand that more avenues do exist for those with MD/DO degrees, but they are by no means guaranteed. What if you fail to attain them as a physician, will you still be okay with that?

 

You seem indecisive. And while you may get people telling you one way or the other, I'm neutral. I think it's good to have some perspective on the counterpoints. But I'm only providing my thoughts on the subject, as it was something I weighed heavily before entering school. Either way, it's a situation where you need to be confident in your own choices.

[Guest Paula]

What PA to MD program are you in? I'm guessing it is one of the off shore schools.

[winmy]

I will share my own experience , it may/may not be useful to you. Depends. A lot of people have indicated to you that the most important factor is you.

I went into PA school after carefully evaluating the time and money for PA vs Med school. I was pregnant in my first year and I ploughed through my very demanding program successfully.

 Fast forward to graduation, I got a number of good opportunities and yeah, I started to have those feelings too.

 

By the time I decided to sit for the MCAT, I had 3 little children to care for. I can be quite determined but I suffered loss of a family member about a week to the exam. So it changed my priorities completely. It practically rescued me for lack of a better word. If I had gone back to Med school, I would be in residency by age 40. Not bad at all. So you are still very young.

 

You must decide which is more important for you, becoming a physician or having those other things that you have to let go of to go to med school/residency. Because, try as we may, we cannot have it all.

 

Do I wish to go to Med \School now? Not at all! Do I wish I had? absolutely not! I am in my own very happy medium and I wish you the best.

 

[rad PA gal]

In ten years you will be ten years older period regardless of whether you go to med school or not.

As such, in ten years, do you want to be an MD or will you be happy being a PA?

For me, life is all about having no regrets.

I'm 54 and applying to PA school.  In five years, I'll be five years older.  This will be my fifth career.  

Yes, I'll be 59 in five years.  And a PA-C in that time as well.

Do what you need to do so that you'll have no regrets -- that is my philosophy   :  )

[LT_Oneal_PAC]

I will say this, of the half dozen or so PAs who later went to med school that I met, none regretted going to med school

[electric130]

If you do not think that going to medical school will interfere with any other major/important goals for your  life then why not go through with it?  I had some of the same feelings you did a few years out of PA school, wondering why I didn't go through with medical school.  With my increase in confidence and experience I began feeling like I had sold myself short. I also graduated from PA school fairly young at age 26.   13 years later I can say that I am happy I did not act on those feelings, I am happy being a PA and I was at a crossroads of having children at age 29 or going back to medical school and spending the next 7 years in intense study between medical school and residency.  For me I knew I would not have children and go to medical school, I knew I would spend too much time away and wanted to work part time while my children were young.  I also decided I did not want to wait until I was in my late 30s to have children.  I continued working as a PA, had my children and worked part time as I had planned.  I am now close to 40 and my husband and I will likely both be financially independent and possibly retired by age 55.  (my husband is career military).  I enjoy medicine but the extra debt and time away from working would not have been worth it for me.  I have many other interests and continue to enjoy working part time as a PA and raising my children.  Now in your situation if money is not the issue and you do not need to take on a large amount of debt and you are comfortable having children while in residency or even later then that is awesome, lots of people do that and it works out just fine.  Also I would not feel like it is all on you when you have children.  My situation is a bit different, with a spouse that deploys it really is all on me a lot of the time. Hopefully if you do have children before you are done with your training you would have a lot of support, but as a mother of 10 years I just have to say having children changes a lot of things.  I can honestly say juggling a career with children is much harder than I imagined it would be.  Definitely worth having both, just not exactly what I expected.  Good luck to you!  Since you are already in the program it may be best to just plow through....you will likely not regret it, it is a huge accomplishment. 

[EMEDPA]

something to consider- you can throw as much of your life into your career as you want. there are PAs who work 100 hrs/week and docs who work 20 hrs/week. there are docs who have kids in residency and do cush fp residencies in which yr 2 and 3 are only 40 hrs/week. I personally worked with a doc who had 3 kids during a 3 yr residency and she graduated on time with her class. I also work with a pa who frequently works 12 hr shifts 26-27 days/month. life/career are what you make of them...

[poopy06]

Thank you all so much for your thoughts. Ive never been so ambivalent about a choice I was making, because I always thought that everything would turn out okay no matter what. It's so crazy how we are actually alike in many ways. I actually lost someone in the beginning of November and I didn't even consider that I may have been stressed because of that.. It does change my perspective immensely. But you are all right, I appreciate all of your perspectives ... Thank you again

[ColoradoIMCardsPA]

As a PA with some years of experience practicing alongside doctors, you have a much more realistic idea of what the life of a doctor is really like. Compared with med school applicants with just about any other background, you actually understand what it's really like. If you've seen what it's like to be a doctor, and still want to be a doctor, then go to med school.

[kittryn]

I really need some help here on my current situation...  I realize I will get bashed for this, and I apologize in advance, I sincerely do not mean to offend anyone.

 

***ETC ETC ETC***

 

Has anyone gone through something like this?  Can anyone give me advice? 

Do you know someone who is in a similar situation that could help me?   Is the gain of becoming a physician worth the cost in my situation?  Are there any PAs that are doing what I am doing or going through what I am going through? 

I cannot say thank you enough to anybody that can give me advice.  You don’t know how much I appreciate you reading this, even if just for emotional support.  Thank you and I am so sorry this is long :( 

 

sooooo....you're afraid of being a really good PA bc if your doctor-husband dies or leaves you, you'll (you think) lose all the good stuff you've gotten so far.

 

but you're also afraid to become a doctor and "emasculate him" (WHUT??), and then he'll leave you.

 

I will be very happy to solve your life for you (but it'll cost you - a lot - PM me).

 

you want to be able to see around corners and you can't. if you don't know what you're doing, don't do anything. or keep going. it doesn't matter. if you make a mistake, so what? we all do, and we still manage to muddle through somehow... 

 

relax, take some deep breaths (often), try to keep it in the moment, and also try to be grateful for all your good fortune.

 

finally - and not to be mean - but it's a little condescending to assume that "all the little PAs" who do not share the same privileges you have are miserable. I mean, we ARE, but...(lol).

 

good luck -