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Attitudes on Mortality Change as Healthcare Career Evolves


An injury to a dear friend is a cause for some reflection on a career caring for others.

It was a difficult week in the neighborhood after our next door neighbors were in a major motor vehicle accident; one neighbor was in a coma and on a ventilator for a couple of days.

It is always difficult being the healthcare provider when friends or family are hurt because you care about the injured, and want to help them through a healthcare system that is oftentimes hard if not impossible to understand and negotiate.

When it is the anonymous people that you only get to know as you care for them, it is easy to keep your distance and objectivity as you interact with them in their care and treatment. When it is folks that have shared a path in life with you over decades, or a lifetime, it hits much closer to home. It is impossible at times to tease out all the subtleties that a member of your “family” presents as you share with them their illness or injury. This is very difficult and troubling for healthcare providers in my opinion.

Watching one of your best family friends - someone you have known for 20 years - lie motionless in a hospital bed, softly breathing on a mechanical ventilator brings you face to face with your own vulnerability and frailty as a human being. This is, in my experience, hard for physicians, PAs and other healthcare providers to face.

This episode caused me to reflect on how my attitudes about illness and injury have evolved over my life and my career as a physician assistant:

Bulletproof. There is nothing like the combination of youth, naivety, ignorance, and inexperience to make you feel invulnerable to the inevitabilities of life. Disease, injury, and personal loss are things that happen to others. Even our exposure to other’s suffering and loss only serves to strengthen our own sense of invulnerability. I can remember well what it was like to be a student on rotations, and my first years of practice as a PA, when I seemed immune to the inevitabilities of life.

Growing and learning. As we age, and become more experienced in medicine, we come face-to-face with losses that are increasingly personal and difficult to ignore in the context of one’s own well-being. Our patients die in our care, our friends and family begin to also get ill and some die, adding loss to our professional as well as personal lives. Through it all, though, I still felt “above it all,” and that these accidents and illnesses, while closer to home, were easy to rationalize as things that still happened mostly to others. However, with each difficult experience closer to home, doubt begins to creep in.

Maturity and reality. This is the phase that I’m in now. I have been practicing as a PA for over 30 years; I’m still in love with my job and the privilege I’ve had to be a part of caring for others in my community. I have directly experienced heavy loss and significant illness / injury over my career among both my patients and family. Having had some of the routine degenerative diseases that can be expected in the fourth decade of life and beyond, and recent devastating losses and tragedies in my immediate family, I realize that it is only a matter of time for the other shoe to fall for me. It is a sobering realization to come to the conclusion that due to genetics, fate, and an overwhelming number of things completely out of my control, it could be me lying in that ICU bed. And it could happen in the very near future.

Yet these thoughts make me realize how precious our loved ones are and how precious each life is that we save in our practice. I fortunately tend to deal with reality by getting my health screenings, taking my medications, exercising regularly, and maintaining a healthy weight. I’m thankful that my experience has positively shaped my psyche more than scarred it.

I deal with severely injured and ill people every day in a hospital environment, so I get a steady daily exposure to the frailties of life. Still, the inevitability of life weighs heavily on me, especially as I look at my neighbors lying in their hospital beds and facing the potential of permanent disability.

While it is too early to be sure given the nature of head injuries, it appears at this point that my neighbors are recovering. The road to recovery is going to be long and hard and yet it gives me a lot to reflect on, but more than anything, I’m thankful for my family’s health and safety at this point in my life.

Find out more about Stephen Hanson and our other Practice Notes bloggers.

This blog was provided in partnership with the American Academy of Physician Assistants.

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