Your Favorite PT: Using History to Understand His Story
It’s okay to NOT be okay.
In all honesty, recent events have been heavy. As a clinician, I’ve struggled with maintaining my composure as the world around me seemingly crumbled. There are feelings of anger and hurt from a multitude of situations that were blatantly unjust. A healthcare worker like myself sleeping at home and brutally murdered? An innocent man with a knee to his neck killed over $20? Watching helplessly, I witnessed a horrific 9-minute video that left me numb. As uncomfortable as it makes me by saying it, I am all too familiar with these type of wrongdoings against people that look like me. However, this time was different. The entire world was watching.
I drew a line in the sand.
After hearing responses to the deaths of Breonna Taylor and George Floyd from my peers and different media platforms, I realized I needed to know where the people in my life stood. In my eyes, you either viewed these killings as being right or wrong. Any attempt at justifying these deaths, in my eyes, was unacceptable. After finding myself in hour long discussions and debates about racial injustices, I was forced to face a reality I had often rationalized in my own way. I was faced with numbers and statistics that outlined a culture of systemic racism that was much bigger than the murders of Breonna Taylor and George Floyd. I somehow ended up giving testimonies of a lifetime while explaining my personal experiences that were very unsettling to hear out loud.
Silence ensures that history repeats itself
I knew what I experienced was not right. Those in my community have always spoken up about these issues. Our protests of being ill-treated were continuously met with rebuttals as many of our white counterparts failed to acknowledge relevant parts of black history that were not taught by the education system. I was met with statements like “slavery has been long gone”. “Schools are no longer segregated” and “my parents came here from another country with nothing but the clothes on their back and they became successful, why can’t you?” There are plenty of remarkable stories of families coming to the U.S. to fulfill what they considered the ‘’American Dream.’’ This dream was rudely interrupted for African Americans in so many ways. Even something as grandiose as the US economy, was built off the enslavement of Africans. We had to persuade the country that a proudly boasted confederate flag is a reminder of how the South's slaveowners valued their wealth over my ancestors’ freedom.
After a little Windex, the window is a little clearer now
It wasn’t clear why I never questioned the other side of the story when learning about this country’s history and how it pertained to me as an individual. In retrospect, I am more “woke” to the discrepancies of what was taught in grade school. I ask now, what happened to the people who were outwardly against de-segregating schools? What happened to the bankers who refused offer home loans to blacks? What happened to the whites that felt an African American could not drink from the same water fountain as them? What about the nearly 5000 people lynched between 1882-1968 as a way to oppress black people after they were freed from slavery? People that were on the wrong side of history didn’t magically disappear just because we had anti-discrimination laws passed 55 years ago. If you were born then, you haven’t even reached retirement yet. I ask my peers. What side of line were your parents on? If you don’t know, find out.
We’re here. Now what?
I am angry. I am hurt. I am disgusted. However, I am so proud of the support I have received and seen abroad. I have had friends reach out to me to openly express their stance on racial injustice and to let me know they are here for me. I have had my work organization as a whole take a stand and construct actionable steps to tackle a concern of systemic racism. I have had coworkers organize and create department wide conversations that not only aim at identifying problems but, brainstorm how we can do our part to address this matter. For the first time in my life, I feel my struggles as a person of color are being recognized as a topic that is important to both individuals inside and outside of my community. Countless people are refusing to let this be a fad or allow the amount of news coverage guide their efforts.
I became a healthcare practitioner to help my family in times of need, such as assisting my mother after surgery or advocating for my uncle after he sustained a stroke. Over the years, there have been efforts to address racial and ethnic disparities in healthcare. Did you know that black people between the ages of 45 and 54 die of strokes at a rate that's three times greater than their white counterparts? Did you know black women and white women get breast cancer at about the same rate, but black women die from breast cancer at a rate 40% higher than white women? My call to action for you is to educate yourself and advocate for those in need who are at risk of falling victim to systemic racism.
5 Things Every DPT New Grad Should Know: Advice from a Fellow
1. Chase experience, not letters
Would you spend $50K on a car you couldn’t drive just to say you have it? All letters are not created equally, proceed with caution. It’s so easy to get caught up in adding accolades to your name especially when you’ve spent your graduate studies seeing the alphabet soup your instructors acquired listed behind their names. It has been engrained in you that the more titles you have, the more you’ve accomplished. I recommend setting a goal and thoroughly researching all that goes into getting there. It may be residency training or even taking things to the fellowship level. Whatever your reason, don’t lose the forest for the trees. Treasure these experiences and make the most of them. Never lose sight of your purpose for seeking training in the first place.
My first CEU course was with an instructor I’d consider a Renowned Professor with an amazing background and resume. He covered at least 50 different manual therapy techniques in a two-day course! I left the course in awe and ecstatic about the extensive list of “skills” I now had in my toolbox. I knew for sure I’d be ready for a manual therapy certification by the end of my first year as a clinician.
Fast forward a few months and I probably had only used 5 of the 50 after returning to work. This wasn’t quite how I had envisioned my CEU money being put to work. I realized I was pursuing the glamour of being a manual therapist without understanding what goes into it. The course instructor wasn’t at fault, he was brilliant. It was people like me who wanted to become an expert overnight without respecting the process that made courses like this common practice. To this I say, take the time to take charge of your own learning experience. Review course objectives and syllabuses to make sure the timing is appropriate for you and where you are in your career. Find therapists you look up to and ask their opinion about upcoming courses. They may have insight to what the course offers and if it’s a good fit for you. There’s nothing worse than being all hammer and no nail with your skillset.
2. Attack Your Failures
When you fail and yes, you will, use it as a learning experience. If you don’t learn from your mistakes, you can’t blame anyone but yourself. If you can’t accept the fact you have failed, you’ll never put the energy into making sure you don’t make the same mistake again. Hold yourself accountable, but don’t beat yourself up about it. Own it! Replay the situation, talk it out with someone and give yourself at least three other ways you could have handled it. Sounds cheesy, but why treat it like a bad date you want to move on from when it could be a major turning point for your career. I’ll never forget how confident I was about treating low back pain. All of my patients were getting better or at least in my eyes they were. I then experienced my first session of didactic work with the residency program for treatment of the lumbar spine. The mentor, an Alligator of the Swamp, who had been a PT for over 20 years, posed questions for which I had no answers. I was embarrassed and felt exposed. In retrospect, this was my moment. It kickstarted my journey. The concept of “imposter syndrome” or “faking it to you making it” holds true, but it requires putting in the work to actually make it over the hump. You’ll eventually get to a point where your failures carry little burden when stepping on the scale, no longer weighing you down.
3. Don’t conform to Toxic Environments
Being a new graduate, you’ve come out of school hopefully with only a few bad habits, if any. As a new grad, you now have the choice of starting on a clean slate. You have a choice to establish a strong work ethic, virtuous morals, and unfailing empathy for your patients. When backed into a corner, always side with what holds true to who you are as a person and what you believe in. As a new grad, you will be impressionable, but you can also be the change for the better. If you find yourself in a toxic environment that does not seem salvageable, don’t be afraid to find a situation that aligns closer with who you are. You’ve now entered the realm of why it is important to interview the organization you are working with at the same time they are interviewing you.
4. Contrary to popular belief, you graduated at the perfect time
You may feel cheated by not having the traditional graduation you’ve come to anticipate over the past 3 years. In actuality, you graduated at the perfect time. You are coming into healthcare at a time where there is no clear expert on this evolving pandemic, as it is still being understood.
- Nevertheless, whatever specialty you decide to begin your career in, you will be affected in one way or another by patients recovering from COVID-19. -
Why not prepare ahead of time to learn and educate yourself on how patients recovering from this condition will be in dire need of our profession in their recovery. You’ve spent countless hours of didactic coursework targeted at understanding the why of vitals and critical lab values that may influence a patient’s clinical presentation. You have the opportunity to apply this useful information to practice without having to undo the mistakes of downplaying it in daily clinical practice. As your more experienced colleagues struggle to adapt to a new normal by being placed out of their comfort zone, you may find yourself being relied upon for input more so than expected if you put the work in to do things the right way, the first time.
5. Make Networking Meaningful
Once you graduate, your life will never be the same again. Make networking meaningful. Pay it forward. Take students as a clinical instructor and keep up with their progress after they’ve left you. They’re your student for a few months and could potentially be your colleague for decades. Try to have all relationships end on a good note. I recall starting a new job and attending a CEU course my organization was hosting only to find that my boss from my days as a clinical assistant in a city 4 hours away was an attendee. Thankfully, our relationship had been great, and she had nothing but good things to say about me to my new coworkers and boss who was in attendance. Networking can exist in so many different ways. You too may have been a clinical assistant. You will also meet people at conferences and places of employment. Either way, cherish these relationships, you never know how they may come full circle. Like-minded individuals in the PT world always seem to cross paths. It’s inevitable. Finally, once life hits you and you are no longer dealing with the day-to-day school regime, you may find yourself becoming your old self again. This is a good thing. Accept it. Embrace it. Share it with the world.
Take a deep breath, regroup, and push forward
It’s been about 2 months since our world as we knew it was rocked by a pandemic that has been sobering to say the least. My thoughts and prayers go out to those negatively impacted. After receiving an e-mail from my organization regarding the uncertainty of the year ahead, I thought this would be a great time to rally the troops. You are only as strong as your team. There is no need to beat yourself up about a situation that is out of your control. The bruises are not a good look on you. My “mama” always said, the one thing that can never be taken from you is your education. Whether you’re starting your career or are well established, you possess knowledge and skills that are intangible.
In with the good. Out with the bad
Sometimes your day just needs one deep breath to kickstart the release of any negative energy you’re harboring.
Go ahead. Do it.
Make it as awkward as possible.
Take a DEEP BREATH IN, IN, IN, IN and then a deep breath out.
If that was your practice round, feel free to show me the real thing this time around. I want to challenge you to try starting and ending your day with a purposeful deep breath.
“Use what talents you possess; the woods would be very silent if no birds sang except those that sang best.” – Henry Van Dyke
Preserve your identity
This is your test. Can you pull it together? In this moment, we all have a unique set of circumstances and an opportunity to be better versions of ourselves. If you’re following this and you’ve thrived under pressure before, let your light shine. As a healthcare practitioner, now is the time to prepare yourself for your role in this pandemic, both in the short and long term. How can your training up to this point prepare you for a new wave of impairments related to this pandemic? Why wait for someone else to figure it out for you? How would your approach to treatment of a patient affected by COVID-19 differ based on acuity? What special considerations can you implement for a patient with an underlying neurological condition? Chronic orthopedic conditions? History of cardiac disease? History of cancer?
Let’s be clear. You cannot advocate for any person or group without first learning how to advocate for yourself.
“The strongest oak of the forest is not the one that is protected from the storm and hidden from the sun. It’s the one that stands in the open where it is compelled to struggle for its existence against the wind and rains and the scorching sun.” – Napoleon Hill
With the loss of physical touch, your identity as a physical therapist may feel as if it’s been stripped from you, no pun intended. However, you can find other avenues of fulfilling this void by finding purpose in your days similar to your typical routine. If you’ve been given a different task within your organization, use this as a chance to learn a new skill or another aspect of your company. You’d be surprised how the relationships you build find a way to come full circle. You can’t sit back and expect your leaders to hold your hand--they have their own slew of problems they’re managing. Your patients are just that, your patients.
Become Your Patient’s Favorite Teacher
It’s always interesting how life comes full circle. One of my favorite teachers growing up was my kindergarten teacher, Mrs. Griswold. She had a knack for controlling her classroom and connecting with her students. Fast-forward more than 25 years later and being in a new city over 100 miles away, I ran into her granddaughter at my new place of employment who is now my coworker. I found myself filled with euphoria just hearing her last name. I was unaware of the effect she left on my life, but in retrospect, my love for school started with her.
“A good teacher can inspire hope, ignite the imagination, and instill a love of learning.”- Brad Henry
As said before, it’s easy to assume the best teachers are always the smartest or most accomplished, but there is something to be said about developing a connection with your students. Oddly enough, as a teacher, you may not even know the connection exists. Sometimes your explanation of concepts and ability to tap into different learning styles leaves an imprint that can never be erased. Mrs. Griswold didn’t teach me long-winded algebra equations or quantum physics, but she sparked a fuse for my desire to learn. If asked, my mom will tell you that I was never the kid that needed to be coerced into going to school or reminded to do my homework. She may even add that I didn’t need to be prompted to do my chores, but that may be a bit of a stretch. We’re all perfect. Right? It was worth a try.
Don’t Ruin Their Movie
I love when a patient tells me how great their previous course of physical therapy may have been and how much they adored their physical therapist (PT). I make it a point to ask what made them switch to a new PT and what did they enjoy about their experience with that particular therapist. You will often find that the therapist was able to get the patient to “buy-in” to their approach to treating their condition in one way or another. You may also realize what the patient recollects about the experience wasn’t necessarily the most up-to-date treatment approach or even anything remotely close to evidenced based practice.
Here lies, your defining moment.
Do you dig up the roots and chop down the tree from the seed their favorite therapist has planted, or do you insightfully find another way to shed light on it? On paper, the latter seems very near common sense. In the real world, however, we may find this encounter to be draining and cumbersome causing us to go out of our way to convince the patient they were not receiving best practice. I personally, find it harder to point out the good in what could have been a less favorable way of delivering care. It is way easier to just create a new slate and just hit them with the facts! In reflecting on these situations, is it worth ruining fond memories for that person? If my 2nd grade teacher had gone out of her way to persuade me that Mrs. Griswold was a horrible person and was mediocre at best as a teacher, my tree would have succumbed as well. We as a profession, promote independence and accountability in healthcare. If your patient is on the path to “pursuit of healthiness”, don’t be the nail that flattens their tire.
Your gluteus maximus is innervated by the inferior gluteal nerve.
We get it. You’ve studied and have worked hard to become a specialist. Don’t fail your patients by not meeting them where they’re at, irrespective of their level of education. If your patient only understands 25% of what you explained to them, how much of that is converted to “buy-in”? I’m sure anyone who has worked in pediatric healthcare will agree that how you educate a child can be the polar opposite of teaching an adult, even when you have to inform both simultaneously. Of course, in that setting, it seems more obvious, but when you have a patient with a graduate level degree or a 10th grade education and/or may be at risk of losing their job because they can no longer perform it, it’s not so simple. Consider the person in front of you as a whole, not just an assigned diagnosis. In doing so, you may create a relationship that inspires them to see the light at the end of the tunnel, hopefully before the batteries in your flashlight loses power.
New Year… New Me
Or is it? Personally, I love this time of year. I know people get tired of hearing everyone’s New Year’s resolutions that will most likely fail, but what other time of the year can you get so many people to even consider making themselves better at the same time? There are some things that you must consider moving forward and now is the best time to reflect. It’s not so much about setting up a resolution, it’s more about reflecting on which systems did not work well for you over the past year and which made you more refined. What skills did you acquire? Did you implement them? Are you proficient at them? What diagnoses did you see for the first time? What did you learn from that experience? Did you fail at anything? If so, how can we ensure the same mistakes don’t happen again?
"Let go of the past, but keep the lessons it taught you." — Chiari Gizzi, Fearless Soul
Some say you should leave the past in the past, but if you don’t look at where you’ve come from, you might miss out on how far you have made it. Tread lightly and be careful not to stare, you may get enticed into making the same mistake twice. As you’re driving in the opposite direction of who you were at the beginning of last year, you may fail to appreciate that you have transitioned from steering your sedan over a bumpy, dirt road to now smooth sailing on an open road with very little traffic. Of course, there were times where you may have lost control of the wheel a little or made wrong turns, but you’re here. Take a moment to give yourself credit for your growth. It’s easy to overlook how much you’ve blossomed if you let your failures overshadow your gains.
We are not taking a stroll on the beach here. We are learning to adjust to weather changes that are both anticipated and fickle. Some days will be sunny with a 50% chance of showers, while others are nothing but heavy rain with a 0% chance of sunburn. Either way, our goal is to always perform at a high level. I mentioned earlier about reflecting on which systems did not work well over the past year. This concept of "systems" isn’t new at all.
“Goals are about the results you want to achieve, and systems are about the processes that lead to those results”— James Clear, Atomic Habits.
In fact, you may already have a few in place such as preparing your work clothes the night before, so you’re not surprised by a shortage of clean laundry or even food prepping to take the decision making out of your morning routine. In both circumstances, you had a goal that was able to be attained by establishing systems that increased your probability of becoming successful. These same habits can certainly be translated into your day-to-day pursuit of professional goals.
So where does this leave us today on our excursion of becoming The Rockstar clinician for most and The Alligator of the Swamp for a chosen few? It places us in a position of strength and gratitude as we take the time to balance our checkbooks, as my grandmother would say. Reflect on situations over this past year with the intentions of seeing how each one made you a little better as a person and clinician. Did you express empathy in times of need, like when a patient has lost a family member while under your care? Did you empower those that may have felt helpless before seeing you? Did you teach or learn from a colleague when given the opportunity? Did you Shut Up and Listen to your patients when they felt like they weren’t improving? Did you admit when you were wrong or weren’t the solution to your patients’ problems? Sometimes it’s not a clear cut yes or no. The growth comes from acknowledging these efforts and allowing yourself to mature as a clinician from them. Let’s start the year with a challenge of embracing these experiences collectively, personal and professional, to help strengthen our footing as we push forward into this new year.