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Clinical indecision

Ochs, Suzanne Ogilvy, BSN, MS, PA-C

Journal of the American Academy of PAs: October 2013 - Volume 26 - Issue 10 - p 1
doi: 10.1097/01.JAA.0000435010.40093.6b
Mindful Practice

Suzanne Ogilvy Ochs is an emergency department PA at Anne Arundel Medical Center in Annapolis, Maryland.

Tanya Gregory, PhD, department editor



Doors closing. Doors closing.

A female robotic voice says this after each stop on the Washington DC Metro.

It has become a mantra in our household to indicate the completion of a task or the end of a big event. Doors closing.

Now it might apply to my tenure in healthcare, which began as a nursing assistant in 1958, then moved into nursing, and finally to my current status as a physician assistant. Back in the 1950s and '60s in Norwalk Hospital in Connecticut and also at Johns Hopkins School of Nursing, we used mercury thermometers, never wore gloves for anything, and transported patients in real oak wheelchairs.

Doing the math, by this year, I have been in the health field some 55 years. Currently I work as a PA in a busy emergency department. I am the oldest member of the team, older than all my compadres, older than our current building, “older than God,” as one of my colleagues likes to remind me.

The decision I face now is whether to stay certified or give it all up. I want a firm diagnosis (like CT might give to appendicitis) to guide me. As I approach 70 this year, are the doors indeed closing? At what point do our doors close?

Folk singer Pete Seeger, now in his mid-90s, is still singing on street corners protesting the latest absurdities of our world. Maya Angelou writes poetry in her 80s. Picasso painted into his 90s.

I estimate I might have 10 mentally active years left to write, garden, and dabble in watercolors. I do not like to sit. I keep up a 100-year-old home with my retired and sometimes reluctant husband—painting, cleaning, emptying gutters, gardening, washing endless windows, wood chopping (he does that), and, most recently, tending chickens. It kills me to hire anyone for anything, so we do it ourselves. (New England bones.) Work is one of the anchors of my life. It seems I squeeze a lot into a 24-hour day as I have to get it done because soon my shift starts. Without the motivation of my work schedule, will I lose my sense of purpose and roll into a ball of ennui? Become a couch potato with increased body fat?

Some young docs in our ED probably won't be unhappy when I vacate the scene. I am the age of their grandmothers. I am computer-challenged and patient-slow. My productivity stats generally “need improvement.”

Yet I still come home after a shift and look stuff up. I still get excited about medicine and find the work amazing and challenging. Daily I witness poignant examples of the beauty and resiliency of the human spirit. To love your job after 50 years is a gift. And knowing that I am doing something “good” has enriched and focused my life.

As the doors open in the Metro, the same robotic voice says, Doors opening. Doors opening.

There is the adage: when a door closes, a window opens elsewhere. Maybe it is time to see if this happens.

PAs are starting to age. As a profession, we have almost hit the 50-year mark. I notice many gray heads and white beards at PA conferences. Clearly, I am not the only one grappling with clinical indecision.

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© 2013 American Academy of Physician Assistants.