Archive for tag: clinic

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!

Hey, Everybody! Welcome Back!

Two weeks of break isn't anywhere near long enough. It seems like just about the time that I get into a new groove of being out of school, things start up again. But, this time -- it's different. I'm an INTERN!

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My intern badge

Last week was the first week in Student Clinic. We went through procedures and charting info and a bunch of other things. I think it's going to be AMAZING! Dr. Harrison (our clinician) has taken the time to explain so many things to us already. It's a whole different world, now. I don't know what I thought it was going to be like, but it's different. And I think it's going to be great. I started out this week as a secondary, and I see my first patient on Wednesday.

Break was wonderful. I was able to take some time off, do some volunteering, and work on some projects. I feel "lighter" -- having been able to accomplish some things that I hadn't had time for thus far. That having been said, I'm still behind. That's not tremendously surprising. I'm making lists and slowly getting things done.

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Sunrise over Tampa Bay

The Master's has been ongoing. My classes right now are in Botanical Medicine and Immunology. I've learned so many fascinating things. Last week I got stuck in researching zonulin and tight junctions. I've been trying to pool together all of the locations that contain tight junctions in the body, so I might be able to link proteins and chemicals that disrupt the tight junctions with disorders that occur at those locations. I have to stop myself sometimes, from going too far down the rabbit hole with some of my research -- because I'll get so engrossed that I forget about everything else. Sometimes I have to stop myself at the point of too many questions. It turns out that some of the ones that I came up with last week (according to my professor) don't currently have answers. I guess I'm not the only one with questions.

I'm looking forward to the Tri mixer -- whenever that will be -- and Wednesday with my first patient. I'm secondary on patients before then, so that will be interesting as well. Mostly, I just want to say how excited I am to be here.

Welcome back, everyone! I'm glad you're here.

We Made It - Week 14

We made it! Well, almost. It's week 14 -- which means there's only one week left. This week and next week are finals. This week is mostly practical finals, but I have a few written as well. Acupuncture, the practical, was over the weekend. We also had the clinical entrance exam for physical therapeutics. We have to pass that exam, in order to progress to the clinic and treat (using those modalities). We were all pretty nervous -- because we're all anxious to get to clinic.

After next week, I'll be in Tri 8. Tri 8. (did you hear that sang angelically and see the beams of sunlight streaming down onto those two words?). They did. We've been talking about schedules and who will take what shift -- and how nervous some of us are. I'm not nervous -- at least that's what I'm telling everyone. I'm anxious to see what all we'll end up doing. What most people don't know is that any of the St Pete College and NUHS students can come to our clinic for free (and their immediate family too). We're really hoping that we see a lot of people -- that need all kinds of help. We do more than MSK -- just to let you know. I'm really hoping to get some functional medicine and nutrition patients as well.

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So, after the "festivities" of the next 2 weeks, we have break. Break (did you hear the angels again?). This will be the first break that I've actually had since Fall of 2012 -- not because we didn't have a break, but because I was so busy. I worked, moved, studied for boards, worked -- and now, I finally get a break. I'm so excited! What will I do? I am going to a festival, the first weekend of break -- and I'm really looking forward to it. I haven't been to one here in about 4 years. I'll be volunteering as a Medic (only requires CPR certification), and I always have an amazing time. I also still have Master's work to do (which starts back this week), and random stuff around the house -- projects, prospects, and purpose. I'm trying to stay focused on finals and studying, but the allure of "free time" is haunting the back of my mind.

So, I figured you all needed to see something new around the area, so I went to Gulfport. I don't know why I haven't taken you all to Gulfport before -- it's only a hop, skip, and a jump from my house. While most people spend their nightlife in Ybor in Tampa or in Downtown St Pete, I tend to go to Gulfport. My favorite karaoke bar (O'Maddy's) is there -- where on random weekend nights I might be found singing Pink, Bonnie Raitt, or Evanescence. Really, Downtown Gulfport feels like a really small town right on the beach. There are some little shops, open air bars/restaurants, and a beach. It reminds me of the little beach towns in movies from the 50's and 60's.

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Gulfport Casino

So, featured in the pictures today is the Gulfport Casino -- right at the center of Downtown Gulfport. Here's some history about it: Then And Now: The Gulfport Casino Ballroom. The Casino, as it stands now, was built in 1934 -- and architecturally it fits into the time -- beach-Craftsman era. They host all kinds of events there now -- including ballroom dancing. If you're in town -- before or after you come by the school, I recommend stopping by. And if you see me at karaoke, I might even sing you a song. I know that I'll be spending some time there over break. I'm really looking forward to it.

So, I'll see you guys after break. Good luck on finals. Enjoy the time. Next Tri means big, big things.