So, I'm going to meet the team. This was deflating enough.
But the visit will (in addition to the RN, I'm assured) be with a PA, a physician's assistant. A PA. I've been in health care for 10 years now, and I have clocked not a single positive experience with a PA. Not for my own health care, because I would never-not-ever go to one if I had a choice of an MD or NP. And I've had horrific experiences with PAs in the ICU.
It's a terrible bias, and I'm sure this PA is lovely and competent. And not a physician. And not a nurse. My bias is unfair, and I haven't met every PA in the world.
Many, many physicians and nurses (NPs, CNSs and RNs) share this bias. An MD (and DOs?) goes though an educational process that should more accurately be called hazing. Only the strong survive it, and the longer their training, the worse the hazing. The process of school, internship, residency, fellowship...weeds out the weak, and the stupid, mostly. The process does not select out for "psychologically impaired," "alcoholic," "asshole," etc. But four of the five pulmonologists I've asked (either directly or not) about my pectus is an asshole to a chunk of people. (Sometimes enough people that the word "notorious" is not a bad stretch.) The fifth one I asked spontaneously, because he's been practicing forever, and he's cute and adorable and sweet and knowledgeable and he told me that my pectus doesn't affect me.
So. Clearly "cute and adorable" aren't priority characteristics in a physician for me. (Although my PCP is, which I consider to be a nice bonus.)
An NP (or CNS) is a nurse with a master's. A NURSE first and foremost. An NP has a bachelor's, and the majority of them do time as an RN, and then go on to the three-ish year master's. That includes clinicals, so patient face-time. (MDs do clinical time from internship on.) There is hazing here, too, but less severe and more cultural than structural. It would be better for us this hazing were structural in the sense that we call that first year a nurse residency. (It's rare.) This process weeds out the weak, the uncompassionate and the unethical, mostly. It doesn't select for "intellectually brilliant," or "psychologically stable," "alcoholic", etc. I am far more likely to trust a nurse I just met than trust a physician I just met.
Just as it's rare to meet a truly stupid physician, it's rare to meet a truly heartless nurse.
(It's a little bizarre to be a nurse and say that. Because that's not a characteristic I think about in myself.) (I'm in my head, and I think I am very often an asshole.)
A PA has a bachelor's degree and three years of doing....something, I don't know what. I don't even know if they talk to patients in that time. Having two bachelor's degrees, and a handful of credits towards a master's makes me "better schooled" than any of them. It's hard not to think of a PA as being someone who couldn't cut medical school either due to lack of brains or hard work. And at the same time, this person maybe had ideas like one PA who said to me, "Why didn't I become a nurse? The bedpan factor." As if a) that is even remotely an accurate way to distill my career choice and b) he wouldn't ever deign to sully himself with such menial and disgusting work. So what does that make a PA? Stupid? Lazy? Entitled? Arrogant? Deer in Headlights? Prissy? Weak-stomached? Did I mention prissy because I'd like to say it again: Prissy?
I'm not excited to go meet my new PA. I have not had good experiences with them.
She's probably lovely.
I'm being unfair. I'm sure her GPA is better than mine. (No, I'm not.) Or that she can be trusted. Maybe. I'm sure she's a nice person who wants to help people. And somehow, I'm supposed to trust her to explain how they're going to rip my sternum up out of the divot in my chest. Hopefully, she's just going to tell me what the surgeon said. She better damn well have taken notes.
I will try and not ask for her transcripts. And a resume. And her SAT scores. I will try (but I cannot guarantee) to not direct all of my questions to Dr. J's RN. Yeah, I'm not gonna guarantee I won't do that. Because I haven't met any of these people, and I will still trust the nurse to tell me true things.
I have to be okay with it. If I want to move forward in December. I'll be okay with it. I'll talk with Dr. J on the phone. Maybe Skype. I've never used Skype.
I'm disappointed. It's fine.
I cough every day. All day. All the time. I have to take some type of medication for neck pain at least every other day to deal with the muscle aches from the cough. I try an alternate tylenol and ibuprofen so that my liver and my kidney take turns getting hit.
I cough. All. Day. Long.
Not real happy. Mark will help me to be polite to the PA. I'm sure she's very nice.