Last night I worked with my next amazing PA. EPMG has a roster of impressive, bright PA's that bring a lot to the table, including their absolute willingness to teach, impart wisdom, pearls and other delights that bring me to a new level of excitement about becoming a PA. I was lucky to get this rotation, and I am thrilled being there. I count down the days, not because I am looking towards the end, but because I am sad that it is going to end.
My first two patients were easy ones. I made the DX, and it was quite simple. Reassured them they were not going to die, and off they went, hopefully relieved. Since the rest of the ED was hopping, I felt a bit like a good luck charm. Ah, the joys of being naive. ;-)
My third was a young woman who was placed in a hall bed. Ah...not a good thing for anyone. Complaints of N/V, general exhaustion. Her history reveled that she had missed her last period. Further questioning also indicated that her mom had died less than a year ago, from HIV. No smoking, drugs, ETOH herself-mom contracted HIV from a boyfriend a few years ago and the disease progressed rapidly.
She was living in her moms house, taking care of her brother who was younger than she was. Simple math showed that her brother was a minor when her mom died, herself just barely into adulthood. Dad was long gone. She had no other relatives that were involved in care of herself or her brother. She had insurance, and worked at a nearby fast food restaurant supporting them both. She was an example of an upstanding citizen.
And indeed, she was 6 weeks pregnant. I sat next to her, and told her the news. I asked her if she considered this a good thing, and she nodded yes. The supervising PA ordered the rest of the tests, and all came back fine. She was given prenatal vitamins and we spoke a bit about good prenatal care, and the importance of this. Her boyfriend was steady, a good guy, looking for work. When I gave her the results of the ultrasound, her bottom lip trembled slightly, but the joy on her face was not able to be disguised.
She was scared, but happy. She clearly realized that this was major, life altering event. A beautiful girl by anyones standards, she somehow emanated that internal strength and courage that some just have and can draw on at the right life moments. She was drawing on it, and it was doing her well.
When it came time to discharge her, still in her hall bed, I hugged her and told her that I knew her mom was watching. She said that she thought her mom probably knew and wanted it to happen. She said her mom was a great woman, a wonderful mom, and she missed her a lot. I got her email address, probably the first and only time I will ever do so with a patient.
Another patient that I will never forget, another flower added to my lifes bouquet.