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Mindful Practice

Make it count

Wypych, K.A. MS, PA-C

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Journal of the American Academy of PAs: April 2018 - Volume 31 - Issue 4 - p 1
doi: 10.1097/
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I'm taught lessons frequently in my job, by my coworkers and my patients. I'm referring to life lessons, not lessons about medical care. Perspective-changing lessons. I am consistently amazed how easy it is in our world to lose focus on what's important and to create and sustain falsehoods in our lives. So unbelievably easy. Over the course of my career, with a large percentage spent in oncology, I've come to appreciate the fragility of life. I watched people face their own mortality, and that changed how I view my own life. At least for a period of time. The daily grind has a way of reloading personal blinders, propelling me through the busyness of my day.

Today, I was reminded of my humanity again, and, for some reason, it struck more deeply and in a more jarring way this time. I sat with a patient, Cynthia, who had undergone neck surgery earlier in the afternoon. I checked on her to see how she was feeling postoperatively. I'm not sure if it was the anesthesia, a genuine level of openness, or my ability to gain people's trust, but she divulged a large amount of information after I asked her how she was feeling. When she started to speak, I sensed that she needed to talk and that I needed to listen. I sat down on a footstool and gave her my full attention.

Though she was only in her late 40s, her bone metastasis was causing her pain, even more pain than her recent incision. She recited her medical history, how she developed colon cancer that didn't respond to several chemotherapy regimens and was now on “light chemotherapy,” for lack of a better description. Cynthia told me about her multiple lung metastases and resultant surgeries. She had been trying to get on a trial but wasn't sure if that was the best plan for her as she “felt okay.” Why start taking a new medication that had the potential to make her feel terrible? I felt I had walked in anticipating her to say one thing and, instead, was drawn in by the truth of her story.

As she spoke, life was illuminated as tenuous at best. One of the biggest myths of this world is that we have tomorrow. Each day, each moment we rest assured that we will work, socialize, rest, sleep, and repeat. We live under a false sense of security that we are guaranteed each day when really we are not even guaranteed the rest of this one. You and I are not promised even the next hour. Everything can change in a moment. Everything.

Patients with terminal cancer know this already. They face their impending mortality with each sunrise, though I rarely think of this during rounds. Instead, I think of vital signs, labs, and examination findings. We are pressed for time and see what we need to see. As I left her room, I thought, “Whose life view is more accurate? My fabricated sanctuary built on the premise that life as I know it will continue indefinitely? Or Cynthia's view of her own mortality and the importance of her quality of life?”

Each moment needs to count. Every instant is one that I can use to better my quality of life and to fulfill my purpose. How am I spending that currency? Am I a good steward of my life? Does the way I live and the quality of my life reflect the truth that I may not have any more days after this one? Am I wasting them? Cynthia taught me that today is the day that we have. Today is the only day that we have. Grab it with both hands. Make it count.

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