I’m a Physician Assistant and I Play One on TV

Posted on Mon, Mar 06, 2017
I’m a Physician Assistant and I Play One on TV

By Kenneth Szwak, MHS, PA-C
I’ve never considered myself “normal,” whatever that means. Certainly not typical in the realm of medical professionals. I pursue creative endeavors equally as much as professional and athletic ones. I play guitar, have been in many performing bands, love heavy metal music, and have had more hair styles and colors than I can remember (which some my colleagues over the last 20  years would like to forget). While I don’t buy into astrology, I would seem to be the Gemini that my birthday indicates, and I cherish it, feeding both my professional and creative personalities. So, when I saw the advertisement in ACEP Now that “Untold Stories of the ER” was looking for new stories, I knew I had to apply.
Story Submission 

After I took the step of emailing the production company, several weeks passed before I received a reply, asking me to submit multiple stories for them to consider. I already had several cases in mind and racked the corners of my mind for more. In the end, I submitted 10 stories with about three that I thought were “can’t miss” cases that I was sure they would pick.
Several weeks later I received word that they wanted to work with me. You can imagine my surprise when I learned that they not only didn’t pick the cases that I thought were a “sure thing” but they chose the one I liked the least. In short, the case was regarding a patient who had hiccups for three days, which turned out to be a small bowel obstruction.
The next step was a Skype conference call to go over the details of the case with two of the show’s producers. From that, a script was produced, which was edited back and forth over the next few months. I wanted to ensure that the script held true to the medicine of the case, and the writers wanted to make certain changes to protect the confidentiality of the patient and add more flair to the story. In the end, the patient was written to be a young female circus performer in the ER with her boyfriend.
The Commute 

Filming each segment takes two days, and I was only able to get four days off, providing for what would be a whirlwind trip. I was flown into Vancouver along with my girlfriend. As I was technically working in Canada, I was presented with very specific documents I had to present at customs. The Canadian customs officer was quite unimpressed with what I was sure at the time to be the start of a promising career in TV. Once through, we had just enough time to get dinner and catch a Canucks game before heading to sleep for an early start.
Filming Day 1 

I had to be up around 5 a.m. on the first day of filming to meet my driver. No surprise there, of course they would send me a limo… or in this case, a minivan to carpool with one of the production assistants and several others to the set. The set itself was actually an old mental health asylum that was converted into TV and movie sets. I realized several months later the same location was used in the conclusion of one of the new X-Files episodes. Imagine that, me sharing the same location as David Duchovny and Gillian Anderson, albeit not at the same time. Surely TV stardom was just around the corner.
In all seriousness, I was blown away when I realized I had my own production assistant getting me coffee and a breakfast sandwich. I thought to myself, “Better enjoy this now, because it won’t happen when I get back to the ER.” The first day was spent doing a table read of the script with the actress who played the ER nurse and the actress who played the patient along with one of the producers and director. Table reads are actually great fun, and are exactly like they sound: A group sitting around a table, reading through the script, seeing what works, what doesn't work and making edits. It was a lot of laughs and brought me back to when I dabbled in drama in high school and college. I was delighted to be in the company of people who got my obscure references to old TV shows and movies like “The Prisoner” and “The Great Race.” I also found out that while this was my first time in TV, this was the first time the show worked with a physician assistant. After that, I filmed the scenes where I talked to the camera and worked with the art department to make sure that the X-ray and CT images looked correct. We wrapped up around 1 p.m. Afterwards, my girlfriend and I enjoyed a little of Vancouver, a very modern, progressive city with a great local restaurant scene – especially the oysters.
Filming Day 2 

The second day of filming is typically a long day and I was advised to plan on being there at least 12 hours. When I arrived, I again found my production assistant eager to grab me breakfast. I changed into my scrubs, and took a seat in the makeup chair. They needed a lot of makeup to make me camera friendly!
Actually filming scenes are even more fun than the table read. Edits are continuously being made to the script as you find some things aren’t working when you start filming. There are mistakes, goofs and laughter. There is a lot of collaboration to find out what works, and the director, Alan Harmon, was great to work with. I’m sure not all directors are the same, but Alan was easygoing and took my and other actors’ opinions into consideration. For example, they were concerned with the opening scene, where the nurse hits me with the chart and makes fun of my last name. They felt it was inconsiderate and wanted to change it. I said, “No, keep it! They make fun of my name all of the time in the ER. That’s just how we are.”
My other favorite moment was when the director pulled me aside to discuss how I was going to deliver a particular line. He said, “I want you to say this with some gravitas. I want you to think Pacino.” I burst out laughing and said, “Alan, there’s like three Pacinos. Do you want ‘Panic in Needle Park,’ ‘Revolution’ or ‘Scent of a Woman’?” After some thought, I knew which Pacino to try to emulate.
Through this experience, I learned how things are filmed: different filming angles, how to keep and how to film a person vomiting. The day ended earlier than expected after about eleven and half hours. I could tell the crew was happy we finished ahead of schedule, and I took that as an indication I learned my lines and came prepared.
Coming Home 

By the time we got back to the hotel, there wasn’t much time left in the day. My girlfriend and I again took to the city, enjoying fantastic food and libations at several places. We returned to our hotel at around 3 a.m., took an hour-long nap, packed our bags, and took off for the airport, leaving The Great White North behind us.
Epilogue: The Episode Premier 

I had been given a rough estimate of when my show would premier, but it changed a few times. The episode, “Hiccup Circus,” aired on TLC and Discovery Life 13 months after I filmed it. Watching with some friends over my house and again with colleagues at work, it was surreal to see myself on TV. I was amazed that I remembered so much from filming that I could pick out which scenes they kept, which ones they didn’t and which takes they preferred over others. I also learned that I don’t like the sound of my recorded voice. I had a good laugh when one of my colleagues texted me, saying a patient called the ER to ask if that was me on TV.
I more than enjoyed the experience, and hope to do it again someday. Until then, I’m still waiting for Hollywood to call me. I probably shouldn’t hold my breath?
Kenneth Szwak, MHS, PA-C, is the lead emergency department physician assistant and EMS co-director at Our Lady of Lourdes Medical Center, Camden, N.J. He is a graduate of Rutgers University and received his medical training from Drexel University. Szwak is a board-certified physician assistant and a fellow of the American Academy of Physician Assistants (AAPA) and Society of Emergency Medicine Physician Assistants (SEMPA). He services on the New Jersey State Society of PA’s Government Affairs Committee and Political Action Committee. Szwak has lectured to medical interns and residents, physician assistant programs, EMS programs, and has authored several peer-reviewed journal articles.

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