“My older brother Adam revealed for me my calling to medicine. We were best friends, and one grade apart — we did everything together. And I watched him start to struggle with substance use, anxiety and depression when he went away to college.”
PA Parins started her journey to becoming a PA at the University of Wisconsin-Madison. After earning her undergraduate degree and then her PA master’s degree, she practiced in a variety of specialties — cardiology, orthopedics, rheumatology. “And then I found my home in internal medicine, with an emphasis on behavioral health,” she says. “I loved it so much, because it struck me as an area where you can take care of the whole person.”
She began practicing in an integrated behavioral health clinic, which took referrals from emergency rooms, patients who did not have regular primary care providers, individuals struggling with severe mental illness, substance abuse disorders, chronic pain. She explains, “So often in medicine we try to separate out physical health from mental health, when in reality they overlap substantially and each one affects the other. Our clinic made it a point to integrate behavioral health into all primary care visits.”
In 2016 she joined the University of Wisconsin Madison PA Program Faculty where she was able to take her passion for holistic patient-centered care and integrate these concepts into her students’ education by developing curriculum on patient-centered communication, trauma-informed care and health literacy. During this time, Adam continued to struggle with alcohol addiction, anxiety and depression. He had a back surgery and was prescribed chronic opioid therapy, which progressed into misuse, and addiction. “I watched him struggle with opioid use disorder, anxiety and depression. I watched him self medicate. He told me when he took opioids they took away all of his pain and all of his worries. My family and I tried everything we could think of to help him, but nothing worked. I felt helpless, as a sister, and as a PA, watching the Adam I knew and love disappear.”
Tragically, PA Parins’ brother Adam lost his battle with substance use disorder. “The pain from grief took my breath away, and brought me to my knees. The days and weeks that followed Adam’s death changed me profoundly; I left my internal medicine practice, and wondered how I could help patients when I felt so broken”.
Just a few weeks after Adam passed away, her PA students began their addiction medicine module. “Although it was so painful to talk about losing Adam, I knew I wanted to do it. I talked with them about his journey with mental illness and addiction, about what it was like being on the other side of this. People struggling with addiction are still labeled as noncompliant, manipulative due to the manifestations of their brain disease. They are written off and disregarded at times. I want to teach students to meet patients where they are. Ask hard questions, listen; really listen. Then show up and keep showing up. Our patients with substance use disorders need to be shown respect and given the same care and treatment for any other disease.”
“Watching how Adam was treated by the medical community motivated me to speak up. I needed to do something with my pain, otherwise I thought it would eat me alive. Our patients deserve a future without stigma, isolation or fear. I want our PA students to be equipped with the skills to break down barriers, and treat every person struggling with this chronic disease as a human that deserves respect. For patients with addiction, there is an us-versus-them mentality. This needs to change. This started a big push for my healing,” she says.
PA Parins began volunteering at a student-run free clinic for medically underserved, underinsured patients. “I loved it. It was an opportunity to help people and learn to love medicine again.” She explains that during her time at the clinic, she started to realize some of the gaps that exist with regard to patient education and health literacy. “It started to gain momentum wherein eventually I helped our students develop a standardized after-visit summary that optimized health literacy for our patients.” She now serves as the co-medical-director of the Salvation Army MEDiC Clinic. “The roles reversed— my patients and students helped me heal and find my purpose. I can continue forward. I can keep going.”
PA Parins joined Madison Area Care for the Homeless (MACH One) as part of their street medicine team providing direct care to the most vulnerable, unsheltered and insecurely housed patients in Madison. “Providing face-to-face nonjudgmental care during the pandemic is a gift. Every time I hand out naloxone, I think about how the same medicine could have saved Adam’s life.”
PA Parins was chosen to be curriculum content expert at the University of Wisconsin-Madison to develop motivational interviewing curriculum and addiction medicine curriculum for a HRSA Grant.. “I decided to move forward with my education and training and pursue the doctoral degree to gain more skills as a PA educator, as well as study healthcare advocacy and executive leadership. The focus of my research will be on other ways we can train students to help patients struggling with substance use disorders.” Her doctoral project focuses on how motivational interviewing can improve outcomes for people with substance use disorders, even if the counseling is given by students. She says, “It is really cool to see — seeing that they are as effective as some of the other clinicians in this skill. This really opens avenues and creates a synergistic relationship, where both health professionals students can be really important change agents in their patients’ lives.”
Most recently in her journey, PA Parins began working on the addiction medicine hospital consult team at University of Wisconsin Hospital, as their first Addiction Medicine PA. “This is my calling. It is an honor to help patients when they are at a crossroads – many know they want to change and want help, others are still ambivalent. Having the tools to help at that crucial moment is profound.”
She says, “When you are honest with your patients, they know. When you approach someone with unconditional positive regard and respect, they feel it. It makes a difference. That is a gift I received from Adam — that everyone deserves unconditional love. ”
