Meet Brie Marks

Brie is a PA, wife, mom to 2 kids, martial artist, musician, and my personal friend. We met at the DeSales PA Program when we were both in PA school. I’m honored to share her story today! 

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Brie had always thought she was going to go into trauma surgery after graduating PA school. For many years prior, she had always talked about working in critical care and trauma. However, she was 29 years old when she started PA school and already married. She and her husband had been discussing when they wanted to start having kids. Brie knew a trauma surgery fellowship would be an additional 18 months after graduation, so she would be 33 years old when starting to try to get pregnant and have kids.

Instead, Brie and her husband wanted to try earlier. So she was pregnant for all of her 2nd year of PA school! She graduated at 38 weeks gestation, took her boards at 39 weeks, and delivered at 40 weeks. Since she was now a new mom, this played a role in Brie’s job search after school.

Changing PA Jobs

Brie’s first job was in neurosurgery where she covered both neuro ICU and floor patients. It was a non-surgery position, but not a good fit for Brie so she left after only 6 months. This was traumatic for Brie as a new grad and new mom. She felt that it looked bad on her resume to leave her first job so quickly. She also felt the burden of providing for her family, now including her newborn.

Brie transitioned to pediatric psychology. She felt like it was great for her family life as it was flexible and had good hours. She stayed at this job until after having her second baby. While it was a great fit with hours that worked well having a toddler and newborn at home, Brie felt very removed from medicine and not where she wanted to be as a provider. She felt like she sacrificed her career goals for my family and questioned her identity as a PA.

Brie left her pediatric psych position and got a job in inpatient neurology. She loved her coworkers and working in an inpatient environment. Brie especially loved that she spent lots of time with ICU and high acuity patients. She had always been interested in critical care and had initially thought about critical care and trauma while in PA school, so she was happy to move closer to this specialty.

Then COVID-19 happened.

Brie and I live in northeast PA and felt an especially strong impact from COVID since we live close to New York, which was hit so hard. Brie’s hospital system told her that they were expecting a shortage of providers and asked if any providers would cross train to learn enough to pivot to cover ICU. Brie volunteered and transitioned into critical care. She was excited, because she thought this is what she always wanted. But the job didn’t work out. After one year, Brie left “in spectacular fashion” and took some paid time off between jobs.

Leaving her critical care position was very difficult mentally for Brie and forced her to look internally and face several questions, like “Who am I?” and “What am I going to do now?” For the past 15-20 years, Brie had always thought she wanted to work in critical care, but after finally getting there, it wasn’t what she had imagined. She was physically unhealthy and struggling from a mental health standpoint. 

Brie then started a job in plastic and reconstructive surgery, where she has worked now for the past 1.5 years. She likes it from both a schedule standpoint and from personal interest in medical specialty.

How to Navigate Leaving Your First PA Job

After only 6 months, Brie left her first job as a PA. She felt like there was some “bait and switch” after starting the job. There were job expectations that were not initially discussed with Brie. Initially she was told that the hours would be 7am to 5pm, but 6 weeks after starting, her employer told her that every third week she would actually need to arrive at 6:15am instead of 7am. Then she learned that sometimes rounds didn’t start until 4:45pm, so she left later than 5pm. Then she was told she would have to rotate into a swing shift. Next, Brie was told she would be taking call one week every month.

Logistically, Brie didn’t know how to make all of this work with having a newborn at home. At the time, Brie’s husband did not have any flexibility in his job and worked 12 hour days every day. Brie felt that as the mom, it was her priority to take care of their child and her responsibility to figure out how to make childcare work. She pushed the limits of the daycare hours in order to meet the changing demands of her employer.

This was especially tough in that it all occurred in the first few months of motherhood. Her newborn wasn’t sleeping through the night, so Brie was sleeping normal hours. Brie was also dealing with the struggles and difficulty of breastfeeding. It was hard to navigate being a new mom as well as a new PA, but made especially difficult when her job turned out not to be what she expected.

Despite this, Brie was very worried about leaving her first job so soon and being blacklisted from one of only two hospital systems in her area. She felt trapped and like she had no choice but to say yes to all of the changing demands of her employer. Brie struggled with needing to say no to some of these changes, but also wanting to give a little and work with her employer to find something that could work for both of them. How firmly could she push back without destroying her career which she had only just started?

In the end, Brie says that it came down to asking herself “What am I willing to put up with?” and “What are my hard boundaries?” Brie and her husband also had to discuss at what point would Brie leave if she and her employer couldn’t figure something out? Was she willing and able to leave? For Brie, taking call was not something she was willing to do and was the final straw before leaving.

Changing expectations and clinical responsibilities can often happen after starting a new job. It’s important to remember that the employer is often not doing this out of malice, but is trying to keep up with changes in healthcare, patient loads, hospital-wide demands, etc. However, it’s very difficult for the employee to have to deal with sudden changing expectations. 

Employees feel very location-dependent depending on family structure, kids’ schools, spouses’ jobs, etc. They might not be able to easily move to a new area to find a new job. PAs often want to work in a specific speciality, but may only have 1 or 2 employment options if they work in a small community. They can feel trapped into staying and feel like they have to say yes to everything their employer asks. 

Navigating Leaving Your Dream Job

Brie had always thought she wanted to work in critical care. Everyone Brie knew had known that was her dream for many, many years, even before starting PA school. This made her feel especially embarrassed when her “dream job” in critical care didn’t work out, and she left after one year. She felt like she needed to tell people she was leaving but didn’t feel like she could tell them why. 

Brie was afraid that people wouldn’t think she was smart enough or that she couldn’t do hard things. She was afraid people would think she wasn’t good enough. 

A huge part of Brie’s identity was wrapped up in being a medical provider. Not just any medical provider, but the one who wanted to take care of the hardest patients and the highest acuity patients. She wanted to be the one to do all of the difficult and skilled procedures. She wanted to be the provider representing the health network

Brie thought people supported her and had her back, but learned the hard way that they didn’t. She realized how little others she worked with cared about what she was doing. She realized no one was paying as much attention to her as she thought and that she had “main character syndrome.” Brie was the main character in her own life, so a majority of her focus was on herself. We can often extrapolate this into thinking that we are also the main character in other people’s lives. But other people often pay us much less attention than we initially give them credit for. Brie learned that the identity she had built up was only in her head. 

We want to be important and integral to our team, our health system and to our patients, but it’s important to not be co-dependent. We want meaning in our work and we want to matter. Brie now finds meaning from her interactions with her patients. She says that’s the reason to do medicine. Beyond that, she doesn’t put meaning into her work. A bad-ass PA who can do all the things and handle the most difficult procedures is no longer motivating to Brie as her identity anymore. 

Where is Your Identity?

Becoming a PA is an all-consuming quest. From pre-recs to clinical hours to getting into PA school to PA classes to rotations to the boards. Our whole lives for years can be wrapped up in the quest to become a PA. But what happens after you’ve achieved your goal?

There is a continual shift and growth. We can assign a certain worth or respect to certain specialities in our heads. As PAs, we can get trapped into thinking that our worth is determined by our job. It was an arduous ordeal to get here, so the high acuity, sexier specialities are often equated to being better and cooler than lower acuity acuity specialities. But we’re all still PAs, just in different settings. 

Your worth is not determined by your work, but society places so much value on what we do and what we produce. As PAs, we’re often friends with lots of medical people – it’s the nature of our work, schooling, the trauma of being in medicine, and also socioeconomic factors. But there are other people out there! We should befriend non-medical people and learn what else is in the world. 

Brie noticed that people in high acuity specialties are often very unhappy, and they wear it as a badge of honor. “I’ve suffered more than you have suffered, so I am worthier.” These providers can hate what they do and feel miserable, but it’s their identity so they keep doing it. 

This is an important reminder that there is more to life than what we do, even if it’s a calling. PAs are felt called to medicine and called to take care of people. It gets tangled up in the fabric of our identity. But something will happen where medicine treats you poorly, and then you’ll feel lost. You can’t figure out who you are outside of medicine. You question how you exist in the world if this isn’t your purpose?

Martyrs in Medicine

People love a martyr. Martyrs pour their whole selves into their careers, because who else will do it if they don’t? But it’s important to step back and realize there are other people who can do this. You don’t need to take on more than you need to. It’s imperative to put boundaries in place. “The process of healing is figuring out how you contribute to your own suffering.” We can make things worse for ourselves.

The culture in medicine also propagates our own self-torture. We do it, but also complain loudly about it. And we do this to each other. We tell students they need to figure it out on their own and run the gauntlet of suffering in medicine because that’s what we did. 

Advice for New Grads

Brie tells new grads to expect that their first jobs won’t be their only jobs. In that first job, it’s important to learn everything you can. Also know that you will struggle, but try not to take things personally as you go through the learning process.

Nothing is permanent. Wherever you are, take what you can and gain the experience. Brie recommends to view your first job as a stepping stone. 

We can often wait too long to leave. But if a job isn’t working for you, don’t be afraid to leave. Future employers will understand if you say the old job wasn’t a good fit. When you do leave, be sure to do it as nicely, kindly and respectfully as you can. Brie also recommends to try to keep ties to your previous employer and colleagues because for better or for worse, medicine is a small community. 

Passions and Pursuits Outside of Medicine

Brie had to remind herself that there is joy and purpose outside of medicine. Brie enjoys her musical hobbies. She plays guitar and ukulele and also sing. Brie reminisced that music was one of the first things she gave up as a PA because she didn’t have time for them. She says that she loves having it back.

Brie is also a martial artist. She does Kung Fu, Muay Tai, and Jiu jitsu  6-7 days/week.  

Brie reminded us to pour attention and focus into ourselves, because we matter as much as our patients. Witnessing yourself doing something you thought you never could is a huge gift. It’s important to ask yourself if these are really your limits or if they are just self-imposed?

Brie strongly believes movement is medicine. Your overall sense of well being, mental health, and insomnia are all better with movement. 

More Than a PA

Brie describes the opposite of burnout as wellness and wholeness. She struggled with burnout and its effects during the peak of COVID while working in the ICU. She said she thought she was doing herself a favor by having an extra alcoholic drink, eating whatever tastes good, sitting instead of working out, and giving herself a break. But it actually made her feel worse. She was getting dopamine reinforcement with these negative habits, but it is not a way to live. 

Brie said she wasn’t being kind to herself creating a life that she had to escape from immediately. So she took a break from alcohol and sugar for awhile. After just 1-2 weeks, she started feeling a lot better. 

Changing habits takes awareness and intentionality. First, you need to be aware that this is not a healthy habit and not actually making you feel good. Then, you need intentionality to change it. You need to build integrity with yourself – don’t say you’ll make changes if you don’t really plan on doing them. Start with very small changes that you can actually do. Build evidence with yourself that you’re going to do what you say you’re going to do.

Brie thought being a critical care PA was going to be the pinnacle of her career, so she was initially devastated and spiraling when it didn’t work out. But now she says she is so grateful because leaving that job propelled her into the life she has now. Going through that helped her make the drastic changes that she needed to in order to become a more whole and healthy person.

Our habits influence who we are. We are whole people who happen to be providers and happen to have been called to medicine, but those are not the only interesting things about us. Our work and what we produce do not define our worth as a human being. All medical specialties are worthy of people feeling fulfilled. 

You can connect with Brie on Instagram at briemarks_pa

Brie has found her unicorn position in her sleep consultant work. Are you looking for your unicorn PA job? Check out episode 199 to learn how to custom design your dream unicorn job. Are you looking for someone to help you decide between two jobs or how to negotiate to create your unicorn job? Book a negotiation call with Tracy for specific concrete advice on your next steps. Are you looking for coaching support through a job transition, burnout or big life changes? Schedule a free 1-on-1 consult with Tracy to learn how she can help you understand your options and set up a coaching plan!