I've been practicing as a PA for the past 30 years in internal medicine, family medicine, and urgent care, and like most of us, I've told hundreds—even thousands—of patients that they need to get this exam done and have that test.

Hemingway once remarked that every man's life is a novel if written down truly. In my experience as a health care practitioner, every patient has a short story to tell. Here is one of my own. The dull ache in my right lower back is all that's left of the searing pain that landed me in the emergency department at one of the local hospitals yesterday. The pain has faded, but the memory of the incident remains sharply etched in my mind.

It began just like any other day in my small community, and it ended with my gaining strength from God as I assumed my role as a provider of medical care.

It isn't like the Free World. Getting the truth out of patients is like going round and round with the questions, peeling a rotten onion.

Because Javier Gonzalez, a 6-year-old boy with spastic quadriplegia could not speak; and because his mother spoke no English, it was his 9-year-old sister Laura who answered my questions.

I had tried several times to explain to my parents exactly what a PA was, but between the language barrier (they spoke a kind of Italo-English indigenous to New York City in the 1970s) and the newness of the physician assistant profession, the inscription on the figurine ended up as "PhD."

Nancy was dying. Her body had been failing her in one way or another for many years.

In 25 years of pediatric practice, I have received only two direct phone calls from hematopathologists. One was 18 years ago; the second is now.