Archive for tag: clinic

Fueled by Caffeine and Dreams

I'm recovering from near brain-death. In case you missed it, last weekend (Friday, Saturday, and Sunday) a group of us took boards: Physiotherapy, Part II, and Part III. I wish I could say it was 3 days full of fun-filled magical awesomeness, but I think you guys know me well enough to know I'd be lying through my teeth.

We all survived the weekend, in large part due to the support we gave each other. Julia was my right-hand this weekend. She made me study when I didn't want to, go over questions, and made sure I got out of the hotel room on time (and didn't get lost too badly getting back and forth from the hotel). Ricky and Alid were the humor for the weekend. The four of us (including Julia) and two of Alid's friends from Palmer, went for dinner after PT. I honestly thought we would be kicked out of the restaurant, we were laughing so hard. It was just what I needed to keep me going another day.

It was great to see the smiling faces of people we've taken tests with before from other schools, and also of each other. Kind words of encouragement were given by so many. Leslie, Bryan, Julia, Alid, Theresa, Ricky, Roshaun, and Dave: My huge thanks to you guys for keeping me going this past weekend -- even if you didn't realize that's what you were doing.

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Image Source: www.etsy.com/listing/181470539/

It was a weekend fueled by caffeine and lack of sleep. We learned how little sleep we could survive on, how many questions we could answer in a short period of time, and how much caffeine was required to take an exam at 7:00 a.m. We were laughing at each other and our test-taking strategies, how long it took to finish certain exams, and how much we were stressing about something really and truly out of our control.

Boards are interesting, because you've been studying for them all along. There's really nothing to "cram" for, and yet we cram every time. Of course, it doesn't hurt to refresh memory on what we've not seen for a couple of years even. Part I, last year, was a test of the basic sciences. While these were more clinical, the basic science stuff just doesn't go away. There's always something that didn't get covered, that we haven't heard before, or that we've never seen. There are questions on every test that make no sense, and like all standardized test, more than enough opportunities to overthink something. I've always been baffled at how any exam in medicine can be made into a "Multiple Guess" test -- when everything we do in medicine is completely essay.

But, we survive. No! We endure. And however the scores come out, they come out. We'll take them as they come.

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Image Source: www.flickr.com/photos/thomas_r/8225164573/

In other news, clinic is in full swing. At the HEC NUHS Student Clinic, we are BUSY. We've been seeing sports physicals and regular patients -- several every day. As the term gets underway for the SPC students, we'll be seeing less of some sports physicals, and more of others. I believe we're serving at least 3 different sports teams now -- so there will be no shortage there.

I'm finishing up a quarter for the Master's program at UWS. Finals are this week. Hard to come back and tackle that after last week. But I'm SO looking forward to two weeks off with no pressing studies. Next quarter with them starts in a few weeks with Sports Nutrition and Fitness, Gastrointestinal Imbalances, and Oxidative/Reductive Dynamics and Energy Production. Sounds like a party.

Have a Great week, Everybody!!!!

Welcome Back Everyone

Photo of colored pencils"Don't you love New York in the fall? It makes me wanna buy school supplies. I would send you a bouquet of newly sharpened pencils if I knew your name and address. On the other hand, this not knowing has its charms." -- You've Got Mail

I always loved this quote. It reminds me of growing up and going to get school supplies in the fall. Things were a WHOLE lot different then. The seasons changed; things got a little crisper, a little clearer, and somehow a bit calmer.

Welcome Back, Everyone!!!!

I must admit, the last 5+ weeks have absolutely flown by. I honestly don't know where the time went. Between break and the first two weeks of clinic, it just kind of vanished. *poof!* I learned something new over break: singular tasking. I know; you must be asking yourselves. "What is she talking about?" I am a notorious multi-tasker. It annoys people to no end how I'm always doing multiple things at once. But, I made a concerted effort, to simply sit and do one thing at a time over break. It was weird; I will admit. But it was also interesting. I tried to relax, focus on what I was doing (or not focus on what I was doing), and it almost became meditative for me -- no matter what task I was involved in. I'm hoping to do more of that in the future.

We're back in clinic and we've got a new classmate that's joined us from Lombard. (Your loss, Lombard -- Leslie is great!) And we've also been joined by a new crop of now 8th trimester students -- some of which started out in our original class, but have been 5-track students. It's good to be back together again. I'd forgotten what a good crew we were. Next week will be the first week that we're all seeing patients together, but during the preliminary workshops and orientation, I can tell that they're all going to be amazing!

Our students have separated into the two different clinics. For those that aren't familiar, we have two clinics in Florida -- a more student-based clinic at the Caruth Health Education Center, and a more public-based clinic in Pinellas Park. Our student-based clinic treats students, faculty, and staff for NUHS and St. Pete College. Our public-based clinic treats people from the public, but also some faculty from NUHS and students and faculty from St. Pete College. We're BUSY!!!!! It's been really odd having lost half of our classmates. It's a lot quieter when the 8th trimester students aren't in the office, but also, everyone that we've been around, every day for the last 2+ years (depending on when they joined us), isn't around any longer. It's been very different.

That having been said, I LOVE the crew that's I'm at the clinic with now. Everyone is fantastic. They work VERY hard, and we all seem to work very well together. Even though we've already been here for 4 months, it's still a period of adjustment, especially as we get more and more responsibility. I'm looking forward to seeing how things go.

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(Image source: www.indiamadisetti.com)

While we've been working in clinic, we've also been trying to study for boards. Most of us are taking Parts II, III, and Physiotherapy this coming weekend. It's a LOT to study. This is the first time that I've felt extremely unprepared for boards. I think it's because too much of a good thing is just too much. I've got more board study materials than I had for Part I -- probably triple the amount of materials. We were told that there is such a thing as over-studying for boards. I don't feel like I'm there yet; I have quite a ways to go. Here's hoping I make more headway before Friday. I'm pretty nervous.

But, we will go, and we will fill in bubbles and say prayers and hopefully things will work out.

As things get closer and more boxes are checked and things crossed out, I get more excited, and a little bit more scared. But it's all a great adventure.

Have a great week, everyone!

Life's Kaleidoscope

The trimester is coming to a close, and I can honestly say it's flown by. We're all scrambling to meet deadlines in the clinic: this many of this, that many of that. It hardly seems that about 12 weeks ago we were terrified we'd be horrible at this. Truth be told, I didn't think anything about deadlines and numbers and paperwork (OK, well I did think about paperwork a little bit). That's probably why I'm scrambling now.

The last couple of weeks have been discussions about who is transitioning to the other clinic, and some talks about where we'll end up. Half of our crew is moving to the other clinic. It's unlikely that I'll see them very often. Perhaps we'll have seminars or training sessions of some sort, or get together outside of school (although we don't do that now). But in a few weeks, there will be another big transition for all of us. Some of us have been together, nearly every day, for about 3 years. This will be something really new.

Newness. It reminds me of my theory about Maslow's Hierarchy from last week. Incidentally, I've been working some more on that, but I'll spare you all the details. I had the pleasure to discuss it with two of my fellow interns today, the concept of new ideas. We were talking about my theory, and about other theories -- things in medicine and science that seem to have been left behind. We were discussing the idea that there are no new ideas.

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Image by http://mladavid.deviantart.com

Mark Twain said:

"There is no such thing as a new idea. It is impossible. We simply take a lot of old ideas and put them into a sort of mental kaleidoscope. We give them a turn and they make new and curious combinations. We keep on turning and making new combinations indefinitely, but they are the same old pieces of colored glass that have been in use through all the ages."

I grew up not far from good ol' Mark Twain's stomping grounds, but between you and me, his writing always made me crazy. No matter how much I tried, I couldn't understand the dialect he wrote. I'm not sure that I agree with Mark; it seems we're discovering new things all the time. From god particles to medicines, we strive and learn how to change, adapt, and understand the world around us.

If the last 12 weeks in the clinic have taught me anything, it's that we have no standard approach to treating anything. We have to be willing to come up with new ideas, or at the very least, new applications for old ideas. For every patient that comes in, even if they have the "same" diagnosis, what works for each one of them is likely to be something completely different.

I'm fairly certain that our discussion today came to the conclusion that there has to be something new. There has to be a pursuit of Science that crosses boundaries into new territories, that bypasses the need for a randomized controlled trial of everything, and simply embraces discovery for the sake of discovery, and implementation for the benefit of the whole. Perhaps we're all idealists. I see no problem with that. Being idealistic just promotes my love of the field and my hope for making a difference.

Neil deGrasse Tyson, in his series "Cosmos" said:

"To make this journey, we'll need imagination, but imagination alone is not enough because the reality of nature is far more wondrous than anything we can imagine."

OK, Neil. I'll take that one to heart. The greatest theories come from crazy idealists.

I wish you all many great new discoveries. May your kaleidoscope always look just a little bit different.

Another Week, Another Blog Posting

How are everyone's midterms going? I'm on break from the master's program. I had finals last week. I'm glad to have a couple of weeks off to catch up on a few things, including all the reading that I didn't get done during the quarter. My pile is still astronomically large. We'll see how much I can get done. I figure if I don't get it done before classes start there again, it's probably a lost cause.

Last weekend, my friend and classmate Julia, went to homecoming at the main campus in Lombard. I want to say, to everyone there in Lombard, thanks for taking such great care of her! She had glowing remarks for everyone that she met. There were meetings and events, information sessions, etc. She was able to meet Dr. James Cox (of Cox flexion-distraction fame), and many of our illustrious alumni.

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Dr. Strauss and Florida students with Dr. Cox at Homecoming

Julia was able to reassure us students about one of the issues that we find frustrating. We are always hearing that we'll not be able to find jobs or make a decent salary. Even though I've yet to meet anyone at school that's "in it for the money," we're all hoping that we'll be able to make enough to at least pay back our student loans, and maybe have enough for food. Even speakers that have come to the school (non-alumni) have commented that it would be tough for us to make a living.

The problem is, with all of my research, and all of the alums that I've spoken to and heard from indirectly, this is FAR from the case. Julia confirmed this when she spoke with alumni at homecoming. She said that everyone that was doing VERY well for themselves. People were not only successful and able to pay back their loans, but also contribute back to the school. It was inspirational for her that not only would we be out and in the community, but thriving. I'm glad she shared that with me, because I needed the inspiration as well.

We're finally starting to see the light at the end of the tunnel. It's halfway through 8th Tri. In a few months, we'll only be in the clinic. No more classes. No more random exams. No more quizzes, papers, or random presentations. It's been REALLY easy to lose track of time this tri. Alarmingly easy. I've been caught up with patients, in my own stuff, with the master's, and classes. I honestly can't wait for classes to be over.

I was asked today how I liked clinic. I've said this before, and I'll say it again -- I love it. I love the idea of being able to do this every day. Even with the challenging cases (my favorites), the idea of being challenged to learn all the time is exciting. I never know what I'm walking into, and I find that absolutely enthralling. I can't imagine any kind of job, ever, that would be anything like this. When I'm in clinic working, I am more than pleased with my choice.

Have a great week everybody!

The Student Physician

Nearly two and a half years, countless exams, memorization of facts and figures, pathologies, prescription drugs, and maneuvers that scare you to death -- and you think you might actually know "something" (but not everything). And then the first patient walks through the door and you realize nothing you could've possibly done thus far could have prepared you for what you're about to experience. Welcome to being a student physician.

Throughout my various collegiate undertakings, I've felt ignorant. There was never much of a point to thinking I knew everything or even all that much because I was constantly reminded that whatever bits and pieces I've pulled together meant only a drop in the bucket toward what's out there. I hate feeling ignorant. Maybe that's why I'm constantly reading and researching -- because I know that I don't know anything.

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Ricky in Radiology Positioning class
(Special thanks to Dave Aiello and Ricky King for this picture.)

Dr. Harrison, our clinician, brought up an excellent point last week (he has LOTS of amazing pearls of wisdom). He said that the stuff that we learn the best is the stuff that we're faced with. If there's a condition that we, a family member or friend, or a patient has, we WANT to learn about it. And so we learn those things the best. But when something is sitting right in front of you, there's this overwhelming need to know it -- right now. Sometimes that learning curve can be pretty frustrating.

Questions get asked. Tell me about your family. How are you feeling? What's going on in your life right now? Can you describe this or that sensation? As the physician, you're supposed to know, not only what it is they're talking about, but also how to put all of it together to make sense of what is in front of you. It's a complex task. Then you have to take the person in front of you, and figure out how to make them better, take away the pain they're having, help them cope with what's going on in their life, and help them re-enter their space of wellness. And of course, you hope that they're working with you on this. This takes skills they don't teach in school. We can take all of the interviewing skills sessions, basic and clinical sciences, and psychology classes and still not be able to put all of these "issues" into the complex Being that sits in front of us. So, as I sit here wearing my white coat, I can honestly tell you that nothing I've done over the last two and a half years prepared me for my first patient. Not a thing. Not even remotely. Of all the things I've learned, even over my whole life, listening seems to be the most beneficial.

One of my biggest fears when starting clinic, besides being worried I wouldn't know what to do, is that I would be stuck with pure musculoskeletal cases. I know, this is chiropractic and musculoskeletal would theoretically be a big part of most chiro's practice, but I wanted the hard cases. And I'm getting them. From complex vascular issues to hormone imbalances, I've had to do research in the first week on topics that we didn't learn in any of our classes. Before any physical exams, before any orthopedic testing, just doing the history, I'm learning so much. I love learning this way. Get a topic, find out as much as you can, and then apply it.

Pick up a copy of Harrison's Internal Medicine, and also a copy of the Textbook of Natural Medicine, and Textbook of Functional Medicine. All three of these will serve you very well. Even though these three are great resources, there are some things that still require digging. I love a challenge. Good thing I'm in the right field.

Have a great week everybody!