Archive for tag: interns

This One Time, at Stroger

Dr. Yurasek and I scrubbed into the isolation unit, donned our masks, and needled an in-patient right in her hospital bed. I knew that shift would be different. It was only my third day, but it just felt different when I punched in that morning...and I was right!

2015-02-05_1Between our usual out-patient pain clinic cases at Cook County Hospital, Dr. Yurasek, the other morning interns, and I were discussing some of the more remarkable results achieved with auricular acupuncture. That's putting needles on ears, for the laypeople reading today. He told us about a patient in a wheelchair who rolled in with several bullet wounds and walked out the same day after the acupuncture treatment. We told him about patients whose pain level went from 10/10 to 0/10 after their acupuncture treatment. It was basically "one time at band camp" day at Stroger.

Dr. Yurasek was explaining that these types of staggeringly effective results are the reason that acupuncture has been making its way into the world of western medicine. Specifically, he said it was the "portal to acupuncture ecstasy." That's actually the start of an entirely different "one time at Stroger" story from last week... but we aren't talking about that one here.

The point was that with the obvious decrease in patient pain after a 10-minute needling and tui na treatment, it's hard to shut the door in the face of the acupuncturist who wants to treat the people. Let us into your hospitals! Share your space with us, MDs! We were all on board... but how would we get the administration to give us the time of day?

2015-02-05_2Then, the call came. The sixth floor had an in-patient in acute abdominal pain, and her doctor wanted the acupuncturist to come up and lend a hand -- a hand with a needle at the end of it. And, since they called Dr. Yurasek, it would be a big hand with a really, really big needle on the end of it. We all know he likes those 6-inch needles. I don't even near-faint anymore when he whips them out and drives them into a patient's leg. I still look at the other side, though, expecting to see the needle sticking out back there... I do still do that.

I had just hooked up my patient to the E-Stim machine and dimmed the lights in her treatment room, when Dr. Yurasek peeked his head in my room and said, "Let's go." Where were we going? I didn't know yet. He calmly said, "There's an inpatient on the 6thfloor in acute abdominal pain, and we're going up to needle her." Alrighty. If you say so, sir. I walk next to him, fumbling through the pockets in my white coat, knowing I probably needed to be bringing supplies or something.

Halfway upstairs he, very casually, mentions that the patient is actually in an isolation unit, and we'll need to take extra precautions. OK, ummm, is it too late to go back downstairs? What? Thoughts of bringing home some exotic virus (other than the ones I've already had) to my kids were flying through my mind.

2015-02-05_3Well, now I'm so nervous that I don't even know where I am. Where are we heading? East wing? West wing? Where's the lake? Finally, we make it to her unit. The nurses glance up at us like, hey, no big deal, go on in. She's through that set of doors, and then through that next set of doors... the ones with those red signs taped to the window. OMG. "Droplet isolation"! I don't even know what that means, but I'm nervous. Very nervous. We scrub in, the nurse finally steps in and helps us with our facemasks before we tied them on backwards, and basically pushed us through the next set of doors.

Well, too late to back out now. Here we go. Luckily I had needles in my pocket. Or he did, I can't even remember. The next 30 minutes were a blur, mostly because I was nearly passing out from the recirculating carbon dioxide in my facemask. How do people wear those for extended amounts of time? Clearly I was doing it wrong. First timers, right here.

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"Where's your worst pain right now," Dr. Yurasek asks the patient, who I definitely thought was unconscious when we first walked in, splayed out in her bed with the usual useless hospital gown covering her nothing. "My back, and my leg, all the way down to my foot," she says. Well, she's conscious. Great news for my burgeoning anxiety. Abdominal pain, back pain, she's got it all, but her back hurts the most right now. So, we treat her back pain. Cue the 6-inch needles into the ancient secret lock-and-key points now called "Gall Bladder 30" and Gall Bladder 34." Sciatic pain relief on the way!

The patient is in less pain and is visibly more relaxed in her body tension. She was in the middle of telling us a story, but then she suddenly passed out asleep. OK. As long as she's not dead, I'm going to make it. I run around like a crazy person in a crazy mask looking for a gauze pad so we could take the needles out, and finally, our job is done here. We walk back downstairs to the outpatient pain clinic and resume our day.

"How's your internship at Stroger going," people keep asking me. Awesome. It's freaking awesome. If you have the opportunity to intern at Stroger, and you're not doing it, you're missing out.

How a Clinic Internship Works

I get this question all of the time: "Do you acupuncture people yet?"

Yes, kind of, not really, I don't know what I'm supposed to say exactly. Do I put needles in people? Yes, of course. Should I? Well, that's where you've got me. Technically, I'm not a licensed acupuncturist yet, so I take that to mean that I can't charge people for acupuncture yet. Is it safe for me to needle people? Well, I do have my Clean Needle Technique certificate filed away somewhere....

2014-07-23_internDo I know what I'm doing? Can I help someone feel better? I don't want to be a pretentious jerk and assume the answers are "yes" here, but over the past year I've certainly had some good feedback. As a sometimes full-time and sometimes part-time student in the acupuncture program, I'm somewhere around Tri 5. I've completed a large chunk of the coursework, the whole observation phase in the clinic, and now I'm actively practicing on everyone who schedules an appointment with me in the AOM clinic on campus.

For the next year, I'll continue along in this internship, enjoying the opportunity to test out treatment strategies, hone my diagnosis skills, and figure out if "patient consents to treatment" actually belongs in the "A" or the "P" portion of the SOAP note. I'll do intakes; I'll form diagnostic impressions; I'll pow-wow with Dr. Cai, Dr. Stretch, and any other clinician I can find. I'll needle patients; I'll moxa their cold feet; and I'll do as much moving cupping as my forearm strength permits. If you're really special, I'll do tui na and I'll gua sha you afterward. Want some herbs? Sure, we have raw, granules, or patent pills. Right this way!

While the patient visits are the most important and most fun parts of the clinic internship experience, the clinic lottery is the part that causes the most anxiety among the interns. "Will I get my same shifts next tri?" "Which clinician will I work under?" "Which interns or observers will be on my shift?" All of these panic-stricken questions and many more can be heard all over campus right now -- the infamous Week 12 clinic sign-up and resulting lottery has arrived!

Photo of Stroger buildingSure, interns get to sign up for their preferred shifts and locations for clinic internships. We AOM students have the luxury of choosing the on-campus Lombard Whole Health Center clinic or driving to Stroger (Cook County Hospital) in Chicago for an off-site experience. My 45-minute commute is plenty, so I try to keep it simple and stick to the main campus. There we all are, fluttering around the sign-up sheet in the clinic lounge room, which is busting at the seams on a regular day, elbowing the interns who are actually trying to sit nicely and write SOAP notes that day.

If all goes well, there is a nice white empty slot shining and waiting just for you on the day and time that you've decided would be perfect for your upcoming trimester. In reality, someone else probably agreed and already signed up for that one. In the end, many interns are able to secure an acceptable shift and everyone survives the sign-up week. Some lucky individuals end up in the clinic lottery, where randomly drawn numbers allow devastated interns to play a sort of game-show rendition of "This will be your life next trimester."

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In my two years at NUHS, we haven't lost anyone yet! The sign-up process can be stressful for some, but by the time the next trimester rolls around, we're all just excited to start treating our patients and working with our clinicians to hone our skills. I have one more year of this endearing learning process, and then it's out into the real world for me (again). No more clinicians to ask questions of, no more easily accessible chiropractors down the hall to consult with on orthopedic issues (thanks, Dr. Anderson!), and no more half-days of work! Maybe this whole clinic deal is pretty great after all....

Choosing Your Intern

You've made the first move. You've called to schedule an appointment in the AOM clinic. Just as you think you're almost done with this first critical step, the receptionist throws a massively important, yet completely unexpected, wrench in your plan. "Which intern are you looking to schedule with?"

Oh. My. God. What do you do? Which name do you say off the top of your head? As you feel the pressure mount in those two seconds of silence on the phone, your brain quickly scans the names, personalities, general skill levels, and specific competencies of every student you know at NUHS.

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It might not seem like a big decision to some, but for many patients, your intern will make or break the entire appointment. I've heard it all in the halls of the clinic, "He got a D on that Point Location Exam, so I don't want to schedule with him!" "She's the only one who follows up needling with tui na every week--I want her!" "I only (or, I don't) want my best friends seeing me with my pants down." If you're bringing sensitive people--the elderly or young children--then even appearance might matter. If I scheduled my kids with a super-tall bearded man, they might run outside and hide by the swans!

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If you haven't thought about which intern you will choose for your first or next acupuncture appointment, here is a handy guide to help weigh your options. No, I'm not going to provide a rating list of each intern in clinic this trimester, complete with names, pictures, and assorted blasphemies or accolades. Instead, I'm going to walk you through the options that may or may not be important to you in your decision-making process.

  1. Do you want your friends to see you naked?
    Most of us don't mind in a medical setting, but if you get stage fright in this arena, consider it a factor. If you can't relax, then your acupuncture treatment can't be fully effective.
  2. Do you want to build a long-lasting relationship with just one intern?
    Don't select someone who's graduating at the end of the trimester. Many of us are part-time, which means that we will be a regular presence in the clinic for a year or more.
  3. Are you only concerned about having the most informed, top-of-the-class intern right now?
    Then go ahead and choose that fabulous intern who has the most experience with add-on extras--if you can get into her packed schedule!
  4. Should your treatment philosophy match your provider's?
    I think so, and I consider this when scheduling an appointment myself. Do I get a good feeling from this person? Do they ooze positive energy? I come to the clinic to build my qi, not to have it stolen.

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Image source: www.visualphotos.com

Now for the great part--there isn't one intern who fits every criteria! This is wonderful news, because it means that a variety of options exist for each patient who walks through the door. Each patient is different, and each intern is different. If you've tried acupuncture once, but just didn't get that great feeling, then try again with someone else! If you were lucky and hit it out of the park with your first intern, then stick with that person, or ask him or her for a referral for another intern who treats in a similar style.

Good luck, and happy hunting!