One of my favorite stories about how small the physician assistant community is involves Alison,* a PA I will never forget.

One night during my pediatrics rotation, I was approached by a PA named Alison. I had seen Alison once or twice during my rotation, but we had never formally met.

Alison walked up to me and said “I need you to do me a favor, can you remove the wound packing from my patient in the other wing?”


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Being an enthusiastic student, I said “Of course!” and then immediately looked around to run it by my attending, who was nowhere in sight.

I didn’t know what to do. Was I even allowed to leave my pediatric post? Did my attending need me for something else? Doing what most students do, I tried to handle the situation as best I could. I ran over to the other wing, quickly removed the packing, and ran back to my desk, faster than a pediatric heart beat.

Alison was full of questions when she bumped into me again. “How’d it go? Is he still taking his meds? What did you find on exam?” 

I froze. I hadn’t asked the patient any of these questions. I didn’t know Alison had wanted me to actually do a history and physical examination on the patient. I took her packing removal request in a completely literal manner.  “I’m so sorry!” I apologized profusely. “I didn’t know you wanted me to see the patient!”

“Of course I did!” chirped Alison. “I thought you would find his case interesting! I also thought it would be a good way to teach you about wound care!” 

I stood there, feeling like an idiot. Alison had wanted me to do one thing and I didn’t do it right. 

While in the midst of apologizing profusely, and telling Alison I would go back and see the patient, my attending came back and asked me to go see a patient that had just arrived. Alison looked at me and said “It’s okay. I’ll see him myself!”  

As I watched Alison quickly walk off down the hallway, I couldn’t help but feel horrible that I wasn’t able to help an extremely nice person on a very busy night.

I didn’t get the chance to see Alison for the rest of the rotation. I was partially happy because I was still embarrassed by the situation, but I was also sad because I wasn’t able to prove to her that I could actually be useful. 

Two months later I was on my OB/GYN rotation at a completely different hospital. While I was finishing lunch, I looked up to see Alison walking into the other end of the cafeteria. I sat there deliberating whether or not I should go over and say, “Hi.”

Determined Jillian said do it. Mortified Jillian said run the other way. Mortified Jillian won that day.

Sixth months after the second run-in, I was on an interview for an ED position that I desperately wanted. It was local, the ED had a great reputation, and I found the position through a recruiter. When I went for the interview, I met with the recruiter, who discussed what we would be doing that day, and who we would be meeting. 

As we walked down a long hallway he was throwing hospital facts and numbers at me, and I tried my best to listen. We slowed to a stop in front of a door and he rapped twice.

“The ED director could not be here today, so you are going to interview with our new lead physician assistant!” The recruiter opened the door to reveal a large office with a shiny oak desk. And there was Alison, sitting grandly in a chair behind the desk.

“Hello, Jillian!” She beamed as she walked around her desk to shake my hand. “It’s a pleasure seeing you again!”

I am happy to report that I did get the job.

I like to tell this story because it is a reminder that mid-levels interact in incredibly small circles. You might have times during school that you want to snap at someone or be lazy when they ask you to complete a task.

Remember to be nice to everyone at all times and do your tasks to the best of your ability, because there is a very good chance you will see them again one day. As it was in my case, you never know if they are going to be the one responsible for your next job.

Jillian Knowles, MMS, PA-C, is an emergency medicine physician assistant in the Philadelphia area. 

*Name has been changed