To my younger sister.

Dear Sister,

So you've decided to pursue a career in the medical career. I chose the word "career" for several reasons. First of all, the word "job" implies that you simply do that position to earn an income to support yourself and/or a family. The word "career" suggests much more commitment often involving much more schooling or education to achieve your goals, and generally tends to mean you aren't setting yourself up to get to a specific position. A "job" tends to have a set definition, whereas a "career" means more of a field of experience and expertise you will work in. As a PA, when someone asks you someday what that means you do, you'll smile and more than likely start listing various services you provide. Not because that's all you do. Far from it. You will say that because its easiest to understand, and it will encourage the other person to decide whether or not they want to converse further or just leave it at that. In fact ironically, as a PA your job will be pretty much the opposite as you explain to people, but culturally its the most appropriate response to a question so simply put and direct as you will so often get. I say its the opposite because you are simply saying you do those things to help them understand those are the tasks you most often complete, but that is not what a PA a does. As I'm sure you've seen with Mr. Tery, being a PA changes. Often. It is not a safe or secure job. Tery does not wake up prepared for the events that will occur and the patients he'll see each day, he instead wakes up mentally prepared to use the education, experiences and past knowledge he's received from training and reading to deal with whatever situations or patients he sees. There is no preparation, whether in a clinic or hospital. There is preparation for procedures, education preparation for your patients and what they can possibly expect, but not preparation for your day.
More often than not Dianne, your career as a PA will not be exciting. It is however, challenging. Instead of prepared, Mr. Tery is several very important things. He is comfortable, honest, educated, cautious, intuitive, sensitive, empathetic and wise.
Wise is last because it is acquired, not obtained. He had to work hard for years to become wise. Comfortable is first because as a PA his patients decide in the first three seconds of meeting him whether or not they are safe with him. In three seconds every person chooses to trust him or not, so he must be comfortable with them at all times, whether or not he is.
Next he is honest because after his patients have spent any amount of time with him, they know he is. Some PA's are more talented at this than others, use humor or identifying with their patients, but that bears no effect on whether or not they are honest. Comfortable or not, patients must know you're being honest. Tery has received not only the required education he needs, but so far beyond that it can't be measured. The varying degrees he has prove on paper he has completed the necessary classes and testing to be recognized for those positions, but they are only that. As he will earnestly tell you, he's "always learning." The hundreds of thousands of hours he has spent in surgery listening intently to the other nurses and surgeons, listening to conferences, attending classes, reading, looking at images, questioning his own conclusions and attentively listening to his patients cannot be measured. The best PA's in any setting are cautious. Not tentative, not reserved, not any similar word. They are cautious. Waiting in and of itself is only occasionally valuable. It is the protective and intentional aspects of waiting that carry the highest percentage of worth. Often time is inconsequential as a PA Dianne. It's inconsequential because you simply don't HAVE it. Time is working against you, you've got none left, or it is worsening your choices as the seconds pass. But caution, doing the most important things first, always keeping your patient's life, health, and comfort (in order) prioritized, doing what may mean hours of more work, dozens of pages of documentation or what is less than ideal, is what's needed. Your choices, wrong or right, will eventually one way or another disappear. If your patient lives they will always remember and wear your decisions, so doing what is best for them is what is most important.
Intuition follows after caution and always should. As a PA your choices should be affirmed by your intuition because you have the knowledge and experience to know instinctively what's right before you think about it, not the other way around. The knowledge and experience come first, before that they're just guesses that might or might not be right, and a patient should never trust that. Nor should you.
And Tery stands head and shoulders above each of those who wear his title in his field of expertise or peer group because he is empathetic. Not only are his patients almost always comfortable and trust him regardless of what he tells them, the procedures he performs, or how much pain they experience; with each one he chooses to leave his place of safety and identify with what they're going through, their insecurities and fears, and help hold them up. Dianne, empathizing is one of the most taxing, tiring and draining things a person can do. At the end of the day you alone have in a way gone through the same things they have. Not physically, but mentally and emotionally. You come home and have to take all of it off, and learn how to process through each thing while lumping it all together. It sounds weird, but for PA's who choose to empathize with their patients, that's what they have to do.
So at this point I'm sure your head is spinning. It's a lot, I know! Some of this you'll learn in PA school. The majority of it you do naturally, which is one of the most exciting things about watching you move forward in this direction, and the last let's say...34% is why I wrote this letter to you. It's both the most difficult aspects of being a PA you'll ever experience and the part that makes Tery Hursch stand out as the best PA I've ever met. His ability to choose daily to serve others at cost to himself has come from a lifetime of tough decision-making. To figure out what it takes to invest your life into what you're passionate about while still keeping it your passion each morning will never be easy. Life, what you do itself, coworkers, the difficulties of education and learning...everything tears at your passion.
Family, a loving husband, friends...are nothing compared to what happens when you realize your passion means sometimes watching someone you took care of die. Or participating in an abortion to save a Mother's life. Or having to be the one to walk into a room and tell a shaking, trembling seventy year-old man that his cancer results when he's still so in love with the tear-stained little bent-over woman who clings to his arm. There is no need to keep going because the experiences others have had do not define you. You and how you decide to handle your experiences define you. You can learn about all the drugs in the world and what they do, but until you meet your first patient who has used cocaine the entire time their husband was deployed overseas, it won't mean anything.
This is where I have several really, really important thing I want you to think about Dianne. Who do you want to come home to if you drive home crying? There are an unlimited number of nice men in this world, but to find a man who knows how to listen to your body language, set himself and all others aside to come alongside you every time, and a man who chooses to love you in a way that only loving God passionately could create, that is a man worth Dianne. One I might not kill. Is he willing to admit he was wrong? Be attentive to your needs and try to learn when you need space, how to handle when you yell in frustration or don't want to go to bed because tomorrow will be so tough? Those are things that will affect your effectiveness. Life is a challenge.
What about this whole passions thing? What really is a passion? I could look it up, but instead how about you figure out what your passion means. What it means to be passionate about people who don't want you to tell them what you have to. What being passionate means when you have to take a class you're terrified you can't pass. What your passion means when it hurts your family because you can't be with them. What your passion means when you watch a newborn baby take its first lungful of air on this planet. What your passion means when someone brings their beautiful three year-old son back to say a shy thank you, and there's tears in his Mother's eyes. What your passion means when you watch a person walk out with both limbs when you thought they'd never walk again.
No matter what you figure out, what you see, what you learn about your passion Dianne, some things will never change.
The light in your eyes when you get to serve someone is literally a picture of Jesus' face to those of us watching. The special gift you have of being sensitive to who you're helping is something God gave you to bring glory to Him. The sweet spirit you choose to have infects other people's lives in a way that makes MRSA jealous. The potential you have to brighten a room with your beautiful, sincere smile is unlike anything most people have ever seen. And your heart--passionate, fragile and delicate--is made strong through the unlimited, matchless love of Jesus alone.

Don't ever, ever stop fighting to be who God has called you Dianne. Find people who will encourage you to be more like Jesus. Choose every single day who you want to be. And if your oldest brother ever has kids, pay their way through college.
Proverbs 31:29-31
“Many women do noble things,
but you surpass them all.
Charm is deceptive, and beauty is fleeting;
but a woman who fears the Lord is to be praised.
Give her the reward she has earned,
and let her works bring her praise at the city gate."
Love you Dianne.

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