I am a physician assistant, and I have been for nearly 10 years. I have worked in health care for 15 years. All the while I have tried to balance family and career with the daily struggle of cystic fibrosis. Work-life balance can be extremely difficult to navigate, even without a chronic illness. Add CF to the mix, and a career in medicine can almost seem unsustainable.
Medicine has many positives. It has proven to be rewarding, as I have affected many peoples' lives and provided a great life for my family and me.
When I was younger, I was advised not to enter this field, but no one could have talked me out of it. I realize now that my health has declined during my career. I am now almost 40 years old, and I have had many years to reflect on my career. I was recently asked whether I would make the same career choice knowing what I know now. Honestly, I can't say for sure but I can share my story.
Like many cystics in early adulthood, I was a wanderer without any clear direction in life. The nature of a chronic and progressive illness leads one to think that there is no future, and thus, I didn't feel a need to prepare for and embark on a real career. That changed during my early twenties, when therapies became better and made a longer lifespan possible. So I started to think about what kind of career would make me happy and fulfilled. Where did I turn? To health care, of course!
Growing up in and out of hospitals, they had become a comfortable environment. One gets used to the mixture of cold sterility and warm empathy. I felt that I could give back to all of those who had helped me, and I wanted to bring my unique perspective and empathy to patients. So I decided to become a physician assistant. I burned the candle at both ends, working and going to school for six years before that came to fruition.
When I was finished, I felt a level of accomplishment beyond what I can describe. However, my family had begun to notice the decline in my health and stamina, and made sure that I heard about it. I was oblivious, or naive, continuing to work at a frantic pace out of some need to prove to myself -- and others -- that I was good enough.
I took pride in being a great PA, especially in emergency situations. There is really no feeling like actually saving a life, knowing that your contributions, small or large, directly affected someone and helped to heal sickness or prevent death.
This has all come at a cost. At the root of a health care career is irregularity; the hours, the length of shifts, the pace. Most people work 12-hour shifts. As a result, my treatments and sleep become erratic, and exercise became an afterthought. The frequent exposure to viruses and bacteria haven't done me any favors either. These risks have led to more frequent exacerbations with less rebounding of lung function. I knew that health care would have some impact on my health but I was unaware of the extent. Looking back now, that kind of thinking seems short-sighted and naive. Hindsight is 20/20, I guess.
Since becoming a health care worker, my lung function has decreased by almost half. It's astounding to see the regression on a chart. While this cannot be due only to my career choice, it has compounded the natural decline of a person with CF. Even when faced with this truth, I still feel an obligation to continue practicing medicine, for my patients, for my family and for me.
This is the choice that all cystics will have to make if they are thinking about a career in health care. Are the risks worth the rewards? I cannot say for sure, and surely the experience will be different for everyone. I do know that I have very much enjoyed affecting the lives of my patients, but I now feel a much stronger obligation to stay healthy and happy for my family and me. So I am left with the bittersweet taste of being a physician assistant. Another livelihood may have allowed me my health, but I doubt that I would have felt the same level of accomplishment.
If you're out there considering a career in health care, please protect yourself by wearing masks and limiting your exposure. Make your treatments and exercise a priority, and try to find a work schedule that accommodates them. It can be done, but one needs strict guidelines to reduce the risks of working in health care with CF. I hope my story will serve as both a cautionary tale and inspiration to aid those who may embark on this career.
