In healthcare, we are invited to the most vulnerable moments in people’s lives, and our job is to make these experiences better for our patients. As a Physician Assistant, I realized I would not only be intellectually stimulated and emotionally challenged, but I would also have the opportunity of increasing patients’ quality of life every day. I would have the responsibility to diagnose and prescribe, and the flexibility to have more time with patients, pursue another specialty if desired, and work intimately with a Physician collaborator to exchange ideas and ensure the best possible patient care.
I remember back to my high school days as an intern for a local hospital. I was holding the soft, aged hand of a woman four times older than me who was confused and agitated by the white walls and constant beeping of the hospital room, and wanted to go home. I sat with her and recognized the outward manifestations of Alzheimer's, with its plaques and tangles strangling her most recent memories, but leaving childhood memories alone, for now. I tried to stimulate memories of her childhood and young adult years, but she appeared even more anguished. I finally saw a commercial for Campbell’s soup and asked if she enjoyed chicken noodle soup. I saw a smile grow on her face, and she seemed to be staring into another time, when she was cognitively unshackled and physically free. She said, “I used to make the best chicken noodle soup...”.
This woman’s clarity declined rapidly, but I realized although I didn’t cure her disease, I was able to direct her into a momentary clarity and sense of joy, which was so often stolen by Alzheimer’s. This experience with this woman, and many other experiences I had during a hospital internship in my senior year of high school, both ignited and reinforced my commitment to working in the healthcare field.
To begin, I became a Certified Nursing Assistant and started a job at a nursing home / rehabilitation center. I continued to enjoy bonding and working with patients, but I was overwhelmed as I was responsible for changing, washing, and dressing almost 20 completely dependent patients. I was furious that these expectations were so unreasonable, and that it negatively influenced my ability to provide high quality care. I worked through my breaks and still did not have time to provide essentials, such as mouth care. Although this job was not always enjoyable, it taught me about staffing and resource constraints inherent in healthcare and taught me how to manage my time to accomplish tasks and advocate for my patients’ care.
In college and beyond, I was exposed to a global perspective on healthcare in the homes and hospitals of South Africa, stone churches in Haiti, and even the family clinics of Brooklyn, NY. I visited private and public hospitals in South Africa, seeing firsthand how economics influences the distribution of resources and personnel. In a Muthi Market in Durban, I saw rows of herbs and animal bones, and heard a traditional healer discuss how her practice, more attune to local culture, was more effective in treating alcohol addiction than the sterility and isolation of a Western style hospital. In New York City, working as a health intern for the International Rescue Committee, I advocated for language services for new refugees, realizing just how critical communication was to offering high quality care, especially in the absence of a shared language. In Haiti, I assessed and treated patients with vitamins, antibiotics, and pain relief, realizing that I may be the only provider our patients had ever seen and adapting my care and treatment considerations to that fact. Traveling reinforced the realization that healthcare delivery and patient goals are influenced by the context patients live within.
I stopped feeling challenged as a CNA, so I became an EMT. Starting on my first call, I discovered the rush of adrenaline and race against the clock, gathering information and assessing patients. It is a great privilege, and a huge responsibility, to respond, and adapt rapidly, to births, deaths, and everything in between as an independent provider. I am responsible for determining if my patient needs Advanced Life Support, medication, or transportation to a hospital with special resources. I am continuously exposed to the presentations for a variety of conditions, including the ashen color of a patient with a pulmonary embolism and even the smell of a urinary tract infection, experiences which could never be garnered in a textbook. I love learning from my co-workers, and the challenge of the unexpected.
As an EMT, I do not have the knowledge or scope of practice to determine the cause of patients’ symptoms, formulate a treatment plan, or prescribe medication for most conditions. The desire to diagnose and prescribe medications has directed me to the PA profession instead of a career as a RN. However, one of my favorite aspects of emergency medicine is direct interaction with patients. Increased time with patients is the primary reason I chose to pursue a career as a PA instead of a MD. I also value the flexibility of being free to change specialties with relative ease, as I believe adjusting to a new specialty would be both challenging and enable me to be a more versatile provider.
Healthcare is more than a job, it’s a lifestyle, with its extensive hours, sleepless nights, and great responsibility. Even with these sacrifices, I have never doubted that being a Physician Assistant is the job for me. There is no other job that offers the same intimacy with people, ability to make a difference, or opportunity to face unanswerable questions. Through dancing with women with dementia, using Narcan to rapidly rouse an unconscious patient, and gently placing a sheet over the cyanosis and limp features of death, I feel like I can make people’s lives, and even deaths, better. It is a great privilege to be a part of the healthcare world, and I hope to continue to gain knowledge and skills to be able to offer patients more as a physician assistant.