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A lesson in empathy

Icenhour, Laura

Journal of the American Academy of PAs: January 2015 - Volume 28 - Issue 1 - p 1–2
doi: 10.1097/01.JAA.0000458873.16678.8d
Becoming A PA

Laura Icenhour is a first-year PA student in the Wake Forest School of Medicine PA Program, Winston-Salem, N.C. The author has disclosed no potential conflicts of interest, financial or otherwise.

Tanya Gregory, PhD, department editor

Reviewers: Alexandra Godfrey, MS, PA-C; Jill P. Grant, MMS, PA-C, MS; Laura A. Katers, PA-C; MS; Ellen D. Mandel, DMH, MPA, MS, PA-C, RDN, CDE; K. Patrick Ober, MD; Harrison Reed, MMSc, PA-C

On the most unforgettable day of my life, I went to the ED, my parents by my side, convinced that the tingling in my legs and feet was the result of something minor. “It's probably just a nerve problem,” I explained to the doctor, confident in the medical knowledge I had as a 20-year-old college student. The physician, a young resident who appeared to be no more than 5 years older than I was, explained to me that my symptoms would “probably reveal a lesion in my brain. It sounds like multiple sclerosis [MS],” he told me. I remember laughing in response. I was completely unconvinced that from my symptoms of loss of balance, difficulty raising my legs, and lower extremity neuropathy, this new young doctor could correctly diagnose a disease I had only really heard about in older people. He did say there could be other causes for my symptoms and ordered tests to rule out other possibilities, such as vitamin B12 deficiency.

I spent many hours in the ED that day. Blood work and an MRI were done, and then I waited. As I lay there, I remember thinking that the only thing that separated me from patients who were “actually sick” was a curtain. And then, after what seemed like an eternity, a team of physicians I had never met approached my bed. At that moment, I knew the news they were there to deliver would change my life forever. The resident was right. A large lesion of demyelinated neurons was centrally located in my corpus callosum, as most manifestations of MS are.

I don't remember much after hearing the diagnosis. I didn't cry. I just stared blankly, shocked and in utter disbelief. I didn't understand. “I'm only 20. I've always been so healthy,” I said. I vaguely remember a physician trying to convince me to stay overnight in the hospital. I asked him if I would die if I didn't stay, and he explained that I would be okay but that I needed a high dose of IV steroids to essentially “calm down” my brain, and that I would have to start treatment immediately. But I didn't care about this at the time. I refused. I was traumatized.

I remember small scenes from my experience in the hospital. I remember my mom crying and my dad holding my hand. I remember how understanding the physician was when I wanted to go home: rather than trying to convince me otherwise, he helped to arrange a home health nurse to come to my house and start an IV that I could administer myself over the course of 5 days. But most of all, I remember the ED resident. He did his job. He diagnosed my problem correctly, just from listening to me and ordering the tests he thought would best confirm his hypothesis. And then he did more. He found me, hours later after I had received the diagnosis of MS, and walked in to ask how I was doing. I remember thinking about how much he must care to go out of his way to locate one of his many patients that day. Among the million questions, thoughts, anxieties, and fears I remember from that day, I also remember feeling human. That ED resident's action had shined a light on the hardest day of my life.

When I remember that day, I don't remember the medical terminology, the test results, or the details of my disease, but the thoughts and feelings that ran through me as I tried, frantically, to digest all that had been thrown at me. How would we afford to pay for the great expenses sure to follow? Would my parents be okay? Would I still be able to finish college? Would physician assistant (PA) school still be an option for me? Honestly, I didn't spend much time trying to answer those questions. I quickly realized that my only limitations would be self-inflicted and chose to let my positive interactions with medical professionals drive me to where I am now, preparing for my first round of examinations as a PA student.

Today, I feel fortunate that I can look back at this experience and see how valuable it will be when it comes time to treat my own future patients. Because I personally know how it feels to receive bad news from a medical provider, I will be better able to empathize with their feelings and their fears. Because I learned how to hear, accept, and then move past the bad news, I will be better able to help my patients do this as well. At first in that ED, I pretended to know what I was getting myself into. I felt that I was educated enough and strong enough to incorrectly self-diagnose, and then listen to a life-altering diagnosis, absorb it, and move forward immediately. And then I realized I was simply human. The emotions and tears I have experienced through my own medical journey will help me to better communicate and empathize more deeply with my patients as a practicing PA.

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© 2015 American Academy of Physician Assistants.