Pebbles, ponds, and ripples

In a rich southern drawl she exclaimed over the telephone, “A physician assistant saved my life!” To say that I was startled by this revelation would be an understatement, considering that her response wasn't at all connected to why I made the call. To make a long story reasonably short, I had been sent several emails from my alma mater, asking that I call a special number to give information to them about me so that it could be included in a new, updated alumnae guide. “We need your help!” the email said. “A brief telephone call will ensure your listing is completely accurate and up-to-date.” I don't have much attachment to my college and I was pretty sure that buried in this friendly request for information was going to be another request to buy the guide. However, after several very user-friendly, almost apologetic emails from my college, I was feeling guilty. What the hey! So I called.

After answering several preliminary questions, I was asked: “Do you have any advanced degrees?” I felt a quick moment of pride when I said, “Why, yes. I'm a physician assistant,” a reply which triggered the above-described elation. All of a sudden, a call that I had made very reluctantly had morphed into hearing a story of a life and death struggle. How could I not ask her what happened?

Apparently, she was having nonspecific symptoms that were ignored and/or minimized by all the people who saw her and she felt that nobody was listening. She then described a clinical encounter with a PA (I didn't get the details) who spent time listening to this woman talk about her symptoms and what she had been through thus far. To this woman's surprise, the PA asked her some questions that no one else had asked or if they had, had not listened to her answers. My college-directory friend added, “The PA then said that there was one test that had not been done and she was going to do it.” This is when the story got quite confusing but ultimately ended with this unbelievable conclusion, “I had a brain tumor; and the PA made the diagnosis!”

We didn't get into any more specifics in our conversation, although my “PA-ness” made me want to tuck into a discussion to learn more about this remarkable story. But it was neither the time nor the place and I was glowing enough just listening to this elated – and obviously healthy woman – tell her amazing unsolicited testimonial.

I am a constant collector of vignettes about the world of PAs; many of which have been inspirations for my editorials in JAAPA. I view these personal stories similar to dropping pebbles into the pond so that I can follow the ripples to see where they go. PAs and their clinical encounters are also stories – some just introductions, others with many chapters, and inevitably, some with only the final page. Although it is truly pushing the analogy to think of each PA's clinical contact as a pebble, we do cause ripples in our patient care, our relationships with colleagues, and with the passage of time, greater participation and influence within the American healthcare arena.

I hope I never stop wanting to remember and hear about how we change other people's lives, hopefully for the better. Who would have thought that a reluctant telephone call could reveal that the life of the person at the other end was saved by a PA! The ripples caused by a decision made by a colleague I would never meet nudged up against me that day on the phone as I heard the happiness and gratitude of a changed life. I'm sure you've dropped pebbles in the pond but have you thought lately about where the ripples might have gone? JAAPA