Story of Self: A PA Week Reflection
Posted by Rich BottnerComment

Rich BottnerI’m a PA student, but I’m not a likely person to be authoring an article about the PA profession.

I grew up in northern New Jersey in a family with deep entrepreneurial roots. Both of my grandfathers came from overseas and started their own businesses decades ago. That tradition was passed down to my aunts and uncles, my distant cousins and my parents. In fact, it wasn’t until junior high school that I began to have an appreciation for the fact that most people actually worked for someone else.

My father was no different. He had a small retail establishment in the basement of a local supermarket where he sold furniture, toys, electronics and jewelry. Through years of hard work, blood, sweat and tears, this man became a pillar of our community and a cornerstone of a federally funded redevelopment project in our town. What began as a small shop grew into one of the largest independently owned and operated businesses of its kind in our region.

I followed the family tradition and in my father’s footsteps. I started my first business when I was 14 and sold it before I was old enough to drive. By the time I graduated from Babson College in Boston, well-known for its entrepreneurial education, I had started and sold four additional companies, and had just launched another that would occupy my professional life over the next three years.

While I always had an interest in science and healthcare, I viewed it as something I would read about in the Sunday paper, and not something I would ever be a part of. That all changed on Martin Luther King Jr. Day in 2010.

How I came to join the PA profession

It was a cloudy, bitter cold winter day in Boston. A fresh coat of snow covered the streets. I began my day by heading outside to shovel our walkways. After about an hour in the frigid temperatures, I came back inside to thaw my stiffening limbs. A familiar noise was echoing throughout my apartment. There were almost two dozen missed calls, text messages and voicemails from family members on my cell phone. A bitter chill, more paralyzing than the weather I had just escaped from, went barreling down my spine. Something was wrong.

I quickly noticed that my dad was the only family member who hadn’t contacted me. I immediately called my mother, and so began my metamorphosis from businessman to self-proclaimed healthcare gamechanger.

My father had been at the gym, as he was almost every morning, when he suddenly collapsed. Paramedics were called to the scene, and he was rushed to the nearest hospital. He presented with altered mental status but was able to communicate that he was having one of the worst headaches of his life. An emergent CT scan showed a profuse and very serious hemorrhage. He was stabilized as best as possible in the emergency room and transferred to the neurology intensive care unit.

I booked my ticket and was on the next flight to Charlotte, N.C., where my parents had recently moved. I had been a volunteer emergency medical technician for eight years and had spent considerable time in hospitals as a result. But nothing could have prepared me for what I saw at Carolinas Medical Center.

After weather delays and a missed connection, I finally arrived at the hospital more than 24 hours after my father first collapsed. I entered the building and worked my way through the maze of long, brightly lit corridors and elevator banks to the neurological ICU.

I finally arrived at his bedside, but I couldn’t bring myself to look at him. Instead, I shared eye contact with my mother, sister, aunt and uncle, who were all somberly embracing each other in the corner of the room. I joined them. Then I turned around to take in the scene that was right out of a movie.

My father lay in bed with the occasional disorganized movement I now know as spastic paralysis. His head was shaved and a tube drained fluid from within his skull, something I now know as an external ventricular drain. He had a tube in his mouth, something I now refer to as intubation. The temperature was a kind of cold I had never felt before.

The paint on the walls was a pale white like I had never seen. The smells of the hospital ICU were pungent and unfamiliar. The life-support monitors rhythmically chirping were one of the few signs that beneath his skin his organs were struggling to keep him alive.

As many patient families do, we stayed at the hospital around the clock. Clinging to hope. Waiting for a change. A sign. An improvement. But as many patient families also experience, sometimes it’s better to let go. After two weeks of sleepless nights, deliberations, research, and discussions, we decided to remove my father’s life support. Two days later, he passed away at the age of 57.

To call this entire experience “bittersweet” is odd to some and confusing to most. But to me, it’s an appropriate way to sum up a series of powerful and life-changing emotions. Bitter for obvious reasons, yet somehow thought-provoking and stimulating at the same time.

While the situation with my father was gut-wrenching and sad, we got through it with the help of a wonderful medical team—a group of providers who explained everything to us until we understood it all. Their passion for medical care was palpable every time they walked in the room. For these people, taking care of the sick and their families was not just a job; it was obvious that it was their passion. This was something I couldn’t relate to after the 10 years I had spent as an entrepreneur, yet it was a feeling I yearned to have.

Ready to make a difference

Flash forward to today: I’m beginning my second year as a PA student at Quinnipiac University. I’m more excited, passionate and enthusiastic about healthcare than I ever could have imagined. I’ve been able to work in multiple clinical settings and attend regional and national conferences focused on improving patient outcomes.

We are on the dawn of a new era in healthcare, and it’s an opportunity to re-energize and rally support around our profession, which will ultimately lead to more efficient and effective patient care.

This is not just the story of my father, whom we later found out later was self-treating his undiagnosed hypertension with maximum-dose aspirin. This is the story of a person lost in the complexities of our medical system. This is also the story of my 40-year-old patient, an uninsured single mother of five children left paralyzed after an automobile accident who may walk again, if she can pay for physical therapy. This is the story of my 29-year-old patient who committed suicide because there were not enough beds at the local psychiatric hospital. This is the story of my 50-year-old patient who logged hundreds of days in the intensive care unit with diabetic ketoacidosis because she didn’t have transportation to pick up her insulin or the financial stability to pay for it.

Our healthcare system continues to deteriorate. Some have fought actively for change, but many have waited on the sidelines for just the right moment to take a stand, to push for improvement, and to be the voice for those who have none. We have reached that moment. Our profession is in a unique position. This is our time. Children shouldn’t have to go through what my sister and I did, but the reality is that most will. When it comes time for my children to make those decisions for me, I hope they do so with the support of a compassionate medical team practicing in a fair, navigable and selfless medical system.

Rich Bottner is a PA student at Quinnipiac University where he is the president of his class, an Urban Health Scholar, and a Paul Ambrose Scholar. He also serves on the National Leadership Council of Primary Care Progress.

See also: The Beginning of a Beautiful Friendship?

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