This story comes from a real-life experience. I was working in the Village of Garbage outside of Cairo, Egypt for a couple of years. I met another American PA who was living in Egypt. He had seen an article that I had written in the Physician Assistant Journal and looked me up.
Bill (the other PA) worked for an American company that employed both American and Egyptian workers. He was responsible for taking care of the American employees and an Egyptian physician was responsible for the Egyptians.
One day his Egyptian counterpart came into his office and said, “Hey Bill, I want to show you something.”
Bill walked with the Egyptian physician into his exam room. An Egyptian man was sitting on the exam table with his shirt off. Bill could see a large surgical scar going down the man’s belly and a small, red, granulated hole at the top of the scar that seemed to be oozing some fluid. The Egyptian doctor asked the man to arch his back and he did. When he did, the tips of a pair of curved hemostats came protruding out of the hole. To make a long story short, about six months earlier the man had a cholecystectomy. During his follow up with the surgeon, he showed him the new hole that had formed and the metal thing sticking out. The surgeon said something like, “Just ignore it. It will go away in time.”
There is not one specific story behind “Shrinking.” However, if you worked as a PA in most parts of the country during the 1980s and 90s, you would understand the point. You often felt invisible. In the early days, truly you were in the shadow of your SP and had no self-identity. We have come a long way as our hospital list providers by the alphabet, not by MD first.
The story behind Resusci-date takes me back to my Air Force days ( ca. 1994) my SP was spending his last shift in the ER before discharge. We were always doing practical jokes on each other. I had the ER shift just before him. The ER call room had a bathroom with two doors, one led into the call room and the other out to the hospital hallway (where anyone could enter). I took our full-size Anne resuscitation dummy and sat her on the call room commode. I then pulled her jogging pants down around her ankles and then took the end of the roll of toilet paper and wrapped it around her hand. The last thing I did was remove the overhead light bulb.
The next morning the nighttime staff (Dr. B had already left for the day) told me that he came up to the front desk about 3 in the morning, looking hung-over from sleep (it was a slow ER at night) and asked, “Who in the hell has been in my bathroom all night? I’ve walked in on her twice.” He had no clue in the dark bathroom, illuminated only by the light from the call room when you opened the door, that it was our dear Anne.
The above cartoon came to me when I was asked to represent the PA profession for a career day at a middle school outside Marquette, Michigan. The thing I remember (and this was 1993-4?) that the kids were so excited about the person before me, a veterinarian, but when the teacher (clumsily) introduced me, the kids’ faces were perplexed. I had questions such as, “Are you then like a nurse? a doctor?”
The inspiration for this cartoon came after I had a hard day in the ER (Air Force hospital ER) and the follow-up physician came in and congratulated me on a complex diagnosis. I think it was the time when a “migraine” patient was brought back and roomed. Her vitals were normal, including an oral temp of 98.8 F. She was sure it was a migraine as she had them before and she just needed Demerol. However, when I placed my hand on her forehead to do her ophthalmologic exam, she felt very warm to me. I went out and took the thermometer from the MAs and took her temperature myself and it was 103.5 F. She also had nuchal rigidity. To make a long story short, her spinal tap came back indicating viral meningitis. The MD who came on after me had the job of reviewing my chart notes before I left. He came in and said, “Man, what a pick-up. I would have just given her, her Demerol and booted her to the street thinking she was afebrile.”
I had admitted the patient. But then the next day, when I came to work, (and her husband was in the hospital by her bedside as she was quite ill) was furious when he found out that his very sick wife had only seen a PA in the ER. He put in a complaint against me for being a PA. My commanding officer (a gynecologist and hospital medical director) came down to my office and told me about the complaint. Then he asked me to write a letter of apology to the family. I had the look of this guy, in the cartoon, on my face and I said (which was disobeying an order in the Air Force), “Hell no! I may have saved the lady’s life and there is no way in hell I’m apologizing for ‘just being a PA'”.