Just another statement

[vector40]

Hi all,

 

I would very much like to hear any feedback on this one. Although I'm comfortable writing, I want to make sure that I'm communicating what I want to -- professionally, honestly, and without giving any leery impressions. In particular I hope I'm communicating that the PA profession is something I'm dedicated to, which otherwise may not be obvious in my application. I'm still doing some fiddling, but the basic idea is down, so please throw out anything that strikes you: good, bad, peculiar, off-topic, inappropriate, or otherwise. I haven't written a personal statement in... a long time.

 

*****************************

 

One Christmas, my father gave me a gift I hadn't expected: a self-help book about finding your career. It seemed to be a theme, and by New Year's I'd accumulated a small heap of job-hunting manuals and life-guidance bibles.

 

 

Since graduating, I'd picked up and skipped across the country, settling in the first city that looked new and hanging my shingle as an EMT. I'd immersed myself in the job until I was living and breathing prehospital medicine, and in many ways I loved it, but I still got weekly calls from my mother asking when I was going to find a real profession. It was a valid question -- no matter how much I enjoyed EMS, it was a dead-end career in an industry with real problems, and making it my long-term home would require more masochism than I had in me. Like many others, I loved the job, but it didn't love me back.

 

 

So I licked my proverbial pencil and worked through the exercises prescribed by the book -- lists and graphs and tables, all intended to help me understand what I truly wanted from a career. Some of the results were banal: like most people, I wanted a stable position in a respectable field, with reasonable compensation and the prospect of advancement. Some points were facts I knew, but had never articulated: I enjoyed working with teams of smart, dedicated colleagues, in an environment where I had a degree of autonomy but still felt like part of a whole. And in the end, with all the boxes filled and every aspect of myself unpacked, I knew that before I'd dedicate myself to a job, it would need to give back to me two essential things.

 

 

First, I loved the diagnostic process. On the ambulance, where our scope for intervention is limited, our main task is not healing the disease, but understanding what the patient needs and expertly facilitating his access to it. To make that happen requires an act of diagnosis: gathering a broad constellation of assessment findings, orienting them against a backdrop of clinical knowledge, and recognizing the pattern that emerges. Sherlock Holmes, the ultimate diagnostician, described his work as "observation, deduction, and knowledge"; medicine uses the same method, and like Holmes, solving that mental puzzle is my joy and addiction.

 

 

Second, I wanted to help people. "Helping people" is a medical cliché, and it meant nothing to me until I'd spent enough hours on the job interacting with sick human beings. Eventually, every EMT discovers that few of our patients are actively dying, and fewer still can be saved by our treatment. If the realization stops there, it leads to burnout, because saving lives is what we were promised at the door. But the smart ones discover that even when we deliver no drugs or staunch no bleeding, we can still make people happier. We can hold their hand, fluff their pillow, listen to their troubles, and fend off a few slings and arrows from an uncaring world. I was surprised to learn that I -- an unrepentant pragmatist in most aspects of life -- found real meaning in accepting my duty to help each patient as best I could. The idea of "duty" usually falls flat for me, but this time, I found I couldn't do the job well without it, and wouldn't have enjoyed it if I could.

 

 

So: diagnosis, and helping people. Medicine was the right field then, and the obvious answer was the traditional white coat of the physician. But at the same time, even with an outsider's view, I couldn't deny the warning signs. Too many friends and acquaintances, many with the letters MD after their name, had looked into my eyes and told me earnestly: "Don't be a doctor. Not now." The ongoing turmoil in American healthcare, combined with the unavoidable career expectations of liability, bureaucracy, and other obstacles, made that road seem particularly turbulent. My ego is strong and well-marbled with a stubborn streak, and my first reaction was to view it as a challenge; I knew that I could travel that path if necessary. But then I remembered my goals. Could I fulfill them without the distractions that route would entail?

 

 

The physician assistant, I eventually realized, could be the answer. Assuredly they diagnosed. They served in the kind of widely-varied roles that appealed to my inner desire to know it all and do it all, and had enough academic pedigree to sit at the table when it came to research, policy, and education. And after doing the legwork, talking to the right people, and spending time shadowing, I saw that it was a job where I could practice the fundamental craft of helping patients with a minimum of baggage.

 

 

Over than a year has passed since then, and as I've tagged each milestone and juggled the burdens of work, class, and more, I've grown increasingly confident in the decision. A role where I can practice medicine while serving people in such a direct way is rare. I had a small taste of it as an EMT, enough to learn what satisfies me, but in the end, I cannot imagine a better fit than the physician assistant.

[IdahoPA]

^This.

 

Generally when I read PSs, I help with grammar, point out the good things and suggest corrections for what's lacking.

 

I'm struggling to find the right words for this one. If you'll excuse me and assume that I'm not trying to be mean just for the sake of it, you come across as:

a.) a slacker who had to be prodded by his parents into a "real" job. Not really a great first impression. (Also, a bit insulting to those who are EMTs.)

b.) one who got the inspiration for such a change from a self-help book DESPITE the fact you were already in the medical field as an EMT (and we never hear what made you become one in the first place)

c.) arrogant, egotistical and stubborn. Those last two you pretty much directly stated. And I'm fine with ego; I actually mentioned it in my own PS. But whereas mine lent strength of character, your use of it makes you seem "above it all."

d.) someone who isn't a team player at all, or one only when it suits you to be. And I'm really bothered by the fact "duty" means so little to you. In a profession, you can't pick and choose what you want to do...you have to take the bad with the good, esp since you wouldn't be the head honcho. Maybe it's because I'm former military (where that word means something), but some adcom members are, too.

e.) extremely entitled. You even demand that the profession "give back to you two essential things."

 

Your 4th and 5th paragraphs are good. I like that you differentiate the cliche of helping people. (Something I did as well, oddly enough.) I like the summation leading into your 6th paragraph. The rest, as far as I'm concerned, should be scrapped. While it may be true, it seems very negative and it makes the PA field sound like an acceptable second choice.

 

You seem smart and, unlike many, you are able to write. Unfortunately, your skill doesn't seem to be doing you any favors.

 

If you choose not to re-write this, can you please come back and let us know if you were successful or not? Thanks.

[vector40]

Thanks a ton for the thoughts, guys. It sounds like I may have had an outbreak of overhonesty -- not for the first time! Everything down there is 100% true, but this is an application after all, not a therapy session...

 

I think that I felt like, faced with my application, a few questions really presented themselves that I had to answer. Namely:

 

- I have clearly dedicated myself to EMS and continue to be very involved in it; so why am I leaving?

- Given that, why a PA instead of MD or something else?

 

What do you guys think? I could simply avoid those questions, but because my application screams "EMS" but not necessarily "PA," I feel like it's going to be out there anyway -- particularly since it's essentially what the prompt is asking. (Otherwise I wouldn't have spent so long talking about me-me-me!) And I'd hate to make up a pleasant but fake explanation instead of the truth.

 

I do a ton of writing and other carrying-on about topics like our duty to the patient, functioning as part of an overall system of care, and so forth, and I guess I imagined someone reading this with that understanding -- but unless they already knew me they obviously wouldn't! I suppose it might be different if the statement is read last, but I can't count on that...

 

I also think I've become too used to discussing EMS with others on the job -- I've forgotten that not everybody is so intimately familiar with the challenges of this field, and the usual critical remarks may not come across in the right light. I'm gonna go through and reorient everything with a little less prehospital cynicism.

[vector40]

Very nicely said.

[mackjacks]

- I have clearly dedicated myself to EMS and continue to be very involved in it; so why am I leaving?

- Given that, why a PA instead of MD or something else?

It might help you sound more positive if you write/brainstorm along the lines of "EMS has been great, I have learned A B C, but I feel that it is lacking X Y Z that I've found I can get in the PA profession."

 

Why PA instead of MD? I really don't think you should say that your friends have told you not to do it. Figure out what matters to you: is it the lateral flexibility, less time in school, less debt, not having to move to wherever you'd match for residency, etc? and tell them. You could say something like you have observed MD friends put their lives on hold for 5 year residencies, missing best friend's weddings and children's first words, so you appreciate that PA school is a 2 year commitment leading to the ability to find a position that will allow you a more flexible schedule or something-explain what you have learned, not state what they have told you. Or you have watched MD friends become frustrated over the stagnation in medicare reimbursement as their practice expenses continue to mount, so you do not want to take on the increased loan debt medical school would require. I told schools that I want to own a house by 30 and be settled into my career and community with most/all of my loans paid off, and if I went to medical school that wouldn't be an attainable goal, and also that I think I want to go into primary care and if I did MD I might feel pressured to go into a higher-paying specialty. Honest, practical, got me in.

[vector40]

You guys have been absolutely stellar. If I'm a PA in a few years, it'll be because of your help. Beers all around?

 

I hope you'll keep up the trend of honesty -- here's draft number two. Basically redone, just a few lines and ideas carried over. Please rate perceived douchiness on a scale of 1 to 10, where 10 would be a guy who hosts a show about internet videos.

 

 

*******************

 

When we became EMTs, they told us we were going to save lives.

 

 

Well, not in so many words. I suppose it was just an assumption we all had, reinforced by the nature of the training, which emphasized the recognition and treatment of life threats.

 

 

I worked on the streets for over a year until I realized the truth: few of my patients were actively dying, and fewer still could be saved by my interventions. At first, I found it disheartening -- what was I here for? -- and filled the space by chatting with them, perfecting the art of tucking in blankets, finding the right jokes to lighten their day.

 

 

The funny thing was, after a while it dawned on me that none of them seemed too disappointed that I hadn't plunged through a window to rescue them. Maybe I wasn't a fraud after all. I started to understand what all the veterans of this work learned a long time ago: even when we deliver no drugs or staunch no bleeding, we can still make people happier. We can hold their hand, fluff their pillow, listen to their troubles, and fend off a few slings and arrows from an uncaring world. And I was surprised by how much meaning I found when I accepted that as my job: recognizing a duty to help, however I could, each individual human being who became my patient. Because it seemed to me that everyone deserved to have somebody on their side.

 

 

As I worked, that's the kind of provider I tried to be. And as time passed, I started looking for ways to do it better -- because good intentions are one thing, but I saw that the smarter I was, the more I could help, and the better I could plug my patients into their larger course of care. So I kept learning, and eventually found myself teaching, and writing, and trying to help others be better too.

 

 

It wasn't long before I started to look beyond the immediate picture. Even when I provided perfect prehospital care (both clinical and human), often times the true problems lay beyond my scope. They were bigger than the ambulance. My friend *****, a long-time paramedic who now manages the AHA's ***** programs, explained his career jump in a way that resonated: "I wasn't satisfied with saving one life at a time." So I began sitting in at regional EMS council meetings, taking part in the ongoing discussions about the future of our industry, and helping promote systems of cardiac arrest and STEMI care with colleagues like *****. I watched with fascination the emerging new ways that prehospital medicine could elegantly intersect with primary and preventative care. I followed the research, because that evidence is what was driving the right kinds of change -- upward, not the other way -- and wished there was more of it. And I kept responding to sick patients, doing what I could to set the stage for their care, and hoping as I handed them off that the system would serve them well.

 

 

Finally, after several years, I felt ready for the next step. I knew that in order to get more involved in the areas I was passionate about, I needed a broader and deeper base of education and experience. I considered medical school, but I was concerned that with every moment of a physician's time so highly valued, I would lose the ability to connect with -- and advocate for -- my patients on a human level.

 

 

The physician assistant could be the answer, I thought. The midlevel role offered a combination of hands-on clinical care and high-level medical management, the prospect of lateral mobility, and the academic pedigree to really get my hands dirty in research, policy, education, and public health. And after doing the legwork, talking to the right people, and spending time shadowing, the fit seemed perfect -- it was a job where I could practice the fundamental craft of helping patients with a minimum of obstacles.

 

 

The many months since then have only strengthened my decision. Against a backdrop of classes and teaching, I kept transporting patients, and kept feeling like I could do more for them if I had more tools available.

 

 

Last February, I picked up an elderly man who'd fallen at his home after increasing weakness. I dropped him off uneventfully, but the next day I was back for another fall. When I was called there yet again the following week to find him covered in urine -- and learned that other crews had been here in the interim -- I'd had enough. At the ED, I spoke with the staff and explained the situation, pressing them to ensure that my patient wasn't simply sent back once more to an unsafe living situation.

 

 

I saw that patient last month for a minor complaint. He wasn't home; he was in a skilled nursing facility. He told me cheerfully how the ED had held him until they could convince him -- no small feat -- to move to a facility, then arranged for the whole thing, with no help from his family. And who'd turned the wrenches and pushed it all through, fighting to make sure he didn't slip through the cracks?

 

 

The emergency PA. That's when I knew I'd made the right choice.

[IdahoPA]

The first guy I wouldn't want on my team. The second guy I'd def want to know more about.

 

I'd combine your 2nd and 3rd paragraphs. I'd nix the latter half of your 3rd paragraph and the beginning of your 4th paragrpah and make those one paragraph.

 

"I worked on the streets for over a year until I realized the truth: few of my patients were actively dying, and fewer still could be saved by my interventions. At first, I found it disheartening -- what was I here for? Then I started to understand what all the veterans of this work learned a long time ago: even when we deliver no drugs or staunch no bleeding, we can still make people happier. We can hold their hand, fluff their pillow, listen to their troubles, and fend off a few slings and arrows from an uncaring world. And I was surprised by how much meaning I found when I accepted that as my job: recognizing a duty to help, however I could, each individual human being who became my patient. It seemed to me that everyone deserved to have somebody on their side."

 

The rest seems fine. Nice work! :)

I'll leave with some advice I received when I was wondering, "What are we doing here?" The man I was talking to said, "I'll make a difference when it's my turn." I've kept that in mind...sometimes we have to do the monotonous, unglamorous jobs until we have the right skills to step up.