“I got you man, hang tight! They’re just around the corner,” I lied. The moped lay several meters from the pair of us while a friend called 911. I had basic First-Aid knowledge so my first thought was to “stabilize the head,” but The Red Cross training did not prepare me for this. The blood sank between my fingers, carrying bits of brain matter that stuck to the hair on the back of my hand. His body convulsed with random twitches and his crossed-eyes looked through mine. My face was solid. I knew I would be the last person this old man would ever see; I couldn’t show him the terror that I felt. As he drifted away in my hands the ambulance arrived. An EMT got out and told me “It’s okay man, you did everything you could’ve done.” In my head I thought, “Did I?”
As a young adult midway through my college career, I felt the angst of not knowing my destiny commonly shared amongst my peers. Having someone die in my hands put my life into perspective as this was my first connection with a patient, and something told me it would not be my last.
PA shadowing in the Emergency Room and Surgical department opened a new door for me. As rapid as the physicians, my PA, “Shawn,” met patient after patient; suturing ripped stitches, directing nurses and attendees through a cardiac arrest, resetting ulnar fractures and making their own diagnoses.
One of my shadowing experiences brought me to “Ted”, a 45-year-old, heavily obese man who had his leg amputated due to a diabetic neuropathy. Ted had been in the hospital for 130 days while the surgical team treated the infection that persisted around the amputated site. Shawn informed me that they had taken the risk of infection by cutting below the knee, where if they had cut above the knee they predicted Ted would have been able to go home much sooner. I did not understand why they had taken this gamble, but Shawn told me that they thoughtfully took into account the patient’s quality of life. He explained that an amputation above the knee requires more energy for maneuverability, and since Ted didn’t exactly have the BMI of a ballerina, they deduced that this procedure would allow him to move easier on his own with less effort. I can not say Ted was my most exciting shadowing patient. As a Medical Scribe in the ER I’ve met prisoners who had given themselves enemas or swallowed four pencils, victims of motorcycle crashes and schizophrenics who thought the moon was the Death Star. But meeting Ted taught me the most important aspect of PAs that sets them apart from other professions, which is the quality of care they are able to provide.
The encounter with the moped patient taught me early on the importance of “cutting below the knee” for each patient. While I reflect on that night, there may not have been anything different I could have done. Perhaps just being there with him in his darkest hour was enough. A hand to hold or someone to tell him that I’m doing everything I can to help, and mean it. I think that’s what real quality care means, which is the standard a patient should expect when they see me in the back of the ambulance or in the hospital.
Teaching and learning has always had a place in my heart. Experience as a summer camp director and substitute teacher shows the parallels it has to being a PA. It’s their responsibility to teach their patients about healthy practice and treatment plans while speaking to the level of the patient and keeping the patient’s best interests in mind.
When I started school at Arcadia University, I endured the long, hard hours that came with being a varsity college athlete and some of my grades suffered because of this time-commitment. I took action with these poor grades and retook them later on in my college career and received much higher marks. I do not believe in settling for less and felt myself losing the potential I sought for when I started my college path. I decided to transfer to the University of New Hampshire and as a result my grades improved and I participated in more extra-curricular activities such as Army ROTC, intramural soccer and part time work in the Emergency Room.
“We are a leader amongst leaders,” one PA told me. Throughout my education I could have been consumed by college’s temptations, but my mind was focused. I could have been a follower, but I was different. Empowered with compassion to help others the Army ROTC program taught me to solve problems, certifying as an EMT taught me to trust my skills, and shadowing PAs on weekends taught me teamwork and compassion. Striving to set myself apart from others required a lot of self-confidence, and as a PA I’m going to need it the next time somebody tells me, “It’s okay, you did everything you could’ve done.” I’ll be able to say, “I did.”