Erin Rysavy is an alumnae from the 2001 Augsburg PA Program. Prior to that, she completed a B.A. in Biology at the College of St. Benedict. Erin received her Masters in Public Health from the University of Minnesota. She is the current president of the Minnesota Academy of Physician Assistants. Currently, she works for St. Cloud Orthopedic Associates. The following article appeared in the newest edition of MAPA’s newsletter, imPAct.
I was recently given the honor to speak at Augsburg University’s White Coat Ceremony. It gave me a chance to reflect on what the white coat means to me, and what a key role humanism plays in medicine! Although I am a graduate of the Augsburg PA program, they did not have this ceremony as part of the process when I was there. So I did a little Google research. Interestingly I found that the history of the white coat stems from the 19th century. At that time, there was great respect for certainty, in contrast to the quackery of medicine. During that time doctors mostly wore black garbs, representing formality, solemnity, and death. The white lab coat came to emphasize the more scientific approach to modern medicine, thanks especially to Joseph Lister, whose reproducible results helped researchers better understand how to prevent bacterial contamination. This color change also represented the “pureness”, and the dream that Lister had that bacteria could be successfully overcome; that pneumonia, appendicitis, or an infected blister no longer had to result in death. Today, many people, including Dr. Gold suggest that the white coat is viewed as a symbol of compassion and responsibility to not only take care of patients, but to care for patients.
I received my first white coat when I started at my first job as a PA in orthopedics. Although it was 16 years ago now, I can still remember the pride, nervousness, excitement, and sense of responsibility that came with it. Thankfully, I was paired with a physician who realized the importance of humanism. He really got to know people for who they were, and listened to their stories. He was straightforward, but had a great sense of humor. He encouraged me to make evidence-based decisions, be confident, listen, and be kind. I learned that I may not have all the right answers to patient’s questions, nor know what is causing their symptoms. And that’s where the art of medicine comes in; where warmth, empathy, and understanding outweigh hardcore facts. I sometimes tell people that their symptoms didn’t read the textbook. That their radiating leg pain is kind of a puzzle, and could be coming from a few different sources, but we can try injections to help us figure this out. And I’ve learned that patients come back if their pain doesn’t go away! I also often tell people I don’t know, or I can’t explain why they have so much pain. And it’s OK not to know! The doctor I worked with also believed that it was perfectly acceptable to do surgery on your own family members. While I worked with him, I assisted in surgery on my dad, my husband, and my grandma. As you can imagine, I gained a lot of respect for the importance of dignity, integrity, and always doing the best job I can do.
After 12 years, my first doctor partner retired, and I have had the opportunity to work with a new doctor, who also is extremely kind. Working with him, I have learned the importance of communication. Ask a question, pause, and listen. He speaks to patients in a way that takes their likely unspoken thoughts and concerns into consideration. For example, going through an x-ray that is relatively normal, he acknowledges that just because there is no arthritis, it doesn’t mean they don’t have pain. So, question, pause, listen, empathize, and communicate.
Through the years, I have learned the importance of knowledge and research, but probably more importantly the importance of compassion, integrity, and respecting others. Thankfully I have been quite healthy to this point, but I’ve experienced enough to have some empathy of what it’s like to be a patient or patient’s family. I try to put myself in their place and explain every step of what’s happening. For example, if I’m giving an injection, I communicate the process. I tell the patient, “it will just take me a few minutes to get the medication loaded up; now you’ll be feeling my hand”, and then I say “poke” just before I insert the needle. I never use the words big or long needle in the room if I don’t have to. I think knowing the steps helps make the experience better even if the shot hurts. I also try to communicate updates or changes. I know when my sister just had a C-section; they told me they would come to get me around 10am. They finally came to get me around 11am. What I wasn’t told was that there was a delay getting started, and that everything was going well. But for that hour, while my sister was being operated on by a brand new surgeon, I started to assume the worst!! Explaining and updating expectations makes a world of difference. Communication is key!
As Sir William Osler said, “The practice of Medicine is an art, not a trade; a calling, not a business.”
In our medical practices, we all have moments of feeling overwhelmed, frustrated, and afraid. But there are far more moments of excitement, connection, gratitude, and love.