Fresh out of Roseburg High School in 1998 and volunteering with relief workers in Nicaragua amid the devastation wrought by Hurricane Mitch, John Roth decided on a career in medicine.
Fluent in Spanish, he worked as a medical interpreter for health care teams dispatched by Mercy Ships, a global nondenominational Christian charity.
"I was the voice between the doctors and the people, and I had to be very aware of how they interacted," Roth recalls.
That role inspired him to become a physician assistant -- a profession with growing responsibilities in a health system facing the dual challenge of expanding access while containing costs.
Roth is one of 927 students set to get diplomas from Oregon Health & Science University this year -- from schools of medicine, nursing, dentistry, and science and engineering. Pharmacy students graduate from a program run jointly with Oregon State University, and 33 physician assistants, including Roth, will graduate Aug. 9.
Roth began his final clinical stint as an OHSU student Monday at Salud Medical Center, a Woodburn clinic run by the Washington-based Yakima Valley Farm Workers. Salud serves a predominantly Latino and Russian immigrant population, providing care for uninsured patients on a sliding fee scale.
After graduation, he plans to work in a clinic like Salud, treating the medically underserved.
"That's my goal," says Roth, 27, who received a student leadership award last week for his work advancing diversity and multiculturalism at OHSU.
Physician assistants, or PAs, are trained to practice medicine under the supervision of medical doctors. They examine patients, make diagnoses and order and interpret lab tests and X-rays. They suture wounds and cast fractures. In rural or inner-city clinics where a doctor is present only part time, PAs often are the mainstay.
Roth enrolled in OHSU's physician assistant program because "I would get a good medical education and still practice medicine without having to go to school for the next eight or 10 years."
Physician assistant is one of the nation's fastest-growing health jobs, the U.S. Department of Labor reports. Median annual pay was $75,000 in 2006.
Roth spent his senior year in high school as a foreign exchange student in Panama. Living with a host family, he immersed himself in Central American history and culture and became fluent in Spanish.
During the next decade he returned again and again to the region, visiting every Central American country except Belize.
First he fell in love with Central America, its music, language, culture and food. Then he fell in love -- with a young Nicaraguan woman he met near the end of his first visit.
Maria Esmeralda is now Roth's wife. They married in August 2001 in Managua. Roth returned to Oregon while Maria waited for her visa, which arrived the morning of Sept. 11, 2001, as the World Trade Center towers collapsed and airports worldwide shut down.
The couple eventually moved to Corvallis, where Roth graduated from Oregon State University with degrees in public health and international studies.
But it was the Nicaraguan relief work in the fall of 1998 that set his life course. Hurricane Mitch had drenched Nicaragua with a week of torrential rains, causing severe floods and landslides. Roth drove a beat-up pickup over nearly impassable roads to deliver sacks of rice and beans to people who had gone for days without food.
In one village, Roth came upon a boy yelling frantically and waving for help in front of his house. Roth followed the boy inside and found his mother in labor, about to give birth, with no doctor in sight.
"I caught the baby, and everything went fine," Roth says. "When the doctor came, he helped me cut the cord."
Roth was just 19.
"It's been an adventure," he says. "And it's just beginning. I love that."
Don Colburn: 503-294-5124; firstname.lastname@example.org
©2008 The Oregonian