“Our own group has been a little off this morning; we’re missing Willy, our PA.”
That was Dr. Crepeau’s response to my blubbering, slightly breathless, explanation for why I was seemingly two hours late to rounds. It was my first day at Mayo Clinic for an epilepsy elective, and it was nothing short of a disaster. I had been misplaced from the coordinator’s student list and lacked the forethought to realize this meant I had no instructions for where to find anyone from the neurology department. It was thanks to an angel from radiology who recognized the helplessly lost expression on my face and wandered with me, in my gold trimmed loafers and satin emerald blouse, throughout the hospital until she could track down an epilepsy attending on my behalf. I was deposited in 5D, the epilepsy monitoring unit (EMU), feeling like a child who had wandered and gotten lost at Disneyland. Dr. Crepeau collected me from the nurse’s station. She looked a little amused, made a comment about a Willy who normally “handles some of this,” and took me to get changed into OR scrubs. I was to watch neurosurgery drill holes into the skull for an ongoing stereo-EEG case. Epilepsy was a rare neurology subspecialty that had the privilege of spending time in the OR for electrocorticography. In the midst of changing, I realized I had lost my coffee cup to the maze of the radiology department (I would never find it again). To top it all off, this was the second time in my medical student career that I had ended up in an OR with dress shoes on. My ankles were cold and my face was warm.
The second day, it all began to make sense. I finally met Willy, whose real name was actually Ejerzain, and my first impression was of his cheeky smile. He had a relaxed and easy-going demeanor, despite being a cornerstone of keeping the epilepsy service in motion. When I asked for any reading recommendations for the rotation, he immediately sent key articles to help navigate the subspecialty, a primer for EEG, and a quick, personality-read on all my epilepsy attendings at Mayo Clinic.
“Dr. Crepeau loves dogs; you could include that into your patient’s social history.”
“No one can beat Dr. Noe at chart digging; she’ll know details about the patient from notes from 15 years ago.”
“Dr. Hoerth is very nice; he loves to teach students and he’s faculty at the medical school.”
It was with Willy that I’d round on the EMU list every morning. He effortlessly weaved through the entire interprofessional team, checking in with the nurses and getting any overnight events from the EEG technicians. Willy seemed to know nearly everyone by name. If the nurses were struggling with disrespect from patients, he was first to know. If the EEG techs were having technical issues with a trial of the new EEG software, he carefully listened to their concerns. He remembered many of our patients from his time in clinic, recalling the nuances of their lives and quirks of their seizure semiology. He seemed to be the thread between all levels of patient care, from technicians to physicians. When I learned more about his own journey in medicine, it became clearer why this was the case.
To summarize his own 30 second autobiography, Willy was born in Mexico, came to the US at three years old –and unknown to him– he was an undocumented migrant. At fifteen, he applied for immigration status, but family issues resulted in him becoming the primary income responsible for covering rent. While Willy worked several rough jobs, it was nearly impossible to complete his high school education, so he pivoted and obtained his GED instead. He kept working, taking classes at community college and university while he tried to save enough money for tuition. In 2011, he was able to go back to school and become an EEG tech. He eventually got his green card, a whole twenty-four years after he applied, had his first child, and decided once more that he wanted more than his current position as an EEG tech. As a nontraditional applicant, he felt that medical school would take too much time to complete and take time away from raising his daughter. He successfully became a physician’s assistant in 2019.
Willy had worked in epilepsy from both the perspective of an EEG tech and now as a PA. He knew intrinsically what it felt like to work on both sides of the interprofessional team. His experience was the key contributor to being the glue that held the department together. When he wasn’t teaching me or helping me do my best on my elective rotation, I got to see the motorcycles he loved to work on, hear about the woes and triumphs of his teenage daughter, and listen to his endless stories of working in epilepsy. I distinctly remember one of my favorite moments with him. We were playing a game we called “Is that a seizure?” and Willy did his best to absolutely confuse all I knew about seizure semiology. He gave me curve balls of patients with frontal lobe seizures and strange, albeit stereotyped, presentations. Every video had a story that accompanied it. Every moment was filled with laughter and knowledge to be gained. Willy was a fabulous PA, but he was also much more. And I write this article in dedication to all the PAs, and Willy, our PA, who improve the lives of patients, physicians, and everyone else in the care team every day.
Natalie Nabaty is a medical student from the class of 2025 at UACOMP with so many passions she struggles to juggle them all. Between playing guitar, dancing traditional Assyrian line dances, and studying global health, writing is a skill she is happy to refine while in medical school. She graduated from ASU with a Bachelors in Biology and a minor in Psychology. Her special interests include migrant health, global neurology, and medical humanism.