When the health is gone

I was sharing a few thoughts with a group of my students last week, just before they walked across the stage to accept their diplomas and enter the world of medicine. I remember the fear, excitement and energy that I felt at that moment, and it is always a thrill to see a future generation of PAs take their place in our profession.

This group of students was a particularly compassionate, dedicated group. Every class has its own personality, but this one was all about giving. The list of efforts they have supported is long, but here are a few examples:  giving time to volunteer for community charities, building homes for needy families around town, raising money for the children's hospital, hosting events to benefit underprivileged youth in local schools, traveling to places all over the world on international mission events. One of these students even gave the gift of life last year with a solid organ transplant to a total stranger who needed a new kidney.  

So, I was sitting at my desk trying to craft a few words of encouragement and inspiration to this very inspirational group of students. Part of what I ended up sharing with them was how to deliver health care, when the health is gone. I still find this to be the toughest part of the job.

I thought back to an adorable young girl I helped care for when I worked for a large hospital's cancer treatment center. I was young, remarkably inexperienced and ready to change the world. She was very young, 3 years old in fact, but unfortunately very experienced (too experienced) in health care matters. Her cancer was diagnosed at age two. As the father of a 16 month old daughter and a 4 year old daughter, I perish the thought of having to think about what her parents were going through when they got the news. So, this precious little child with the most perfect bald head and a great affinity for the Radio Flyer tricycle that we kept parked in the waiting room had run out of options. Standard therapies had failed, so an experimental treatment was her last hope. 

Without reliving the details, you can imagine what happened. She fought, her family prayed, her providers tried their best to work a miracle, and she died – at age 3. I can still close my eyes and see that little gal driving that tricycle down the clinic hallway lighting up every face she passed. I told my students that in her case there was no “health” left to offer. So all we had was “care.” I had nothing to offer her family, no words of wisdom to share. I had no knowledge of a higher plan in which a baby dies before her parents can even drive her to school for the first time. There is no more uncomfortable place that I can remember being than with that family after her death. I was a junior member of a large treatment team, so the chief oncologist did most of the talking, then left. I asked a seasoned social worker, who was well-versed in grief counseling, what I should do. I told her I wanted to hide, but I felt her family deserved more. She said, “Just be there. You don't say a word. You just need to be there.”  So, that's what I did. I listened, smiled, cried a little, and cared. 

Learning how to be with families at the most difficult times in their lives is the worst and best part of being a PA for me. I am proud of these students, and I know they are going to add a lot of talent to our profession. JAAPA