Sunday, August 31, 2008
Thursday, May 8, 2008
Occupational Therapy’s Identity Crisis
"So what do you do?" is a handy question to ask when meeting people for the first time at social gatherings. The answer gives an insight into who that person is and provides us with avenues for further conversation depending on whether the response is considered interesting or worthy of follow up. My reply used to be "I'm an elementary school teacher". Some people found this interesting and pursued their line of questioning; to others, this answer maybe seemed too 'normal' a profession to warrant further comment. Whether people are interested or not, everyone has a strong conception of teaching as a profession. Most people don't have to think too hard to conjure up images of their favourite or most detested teachers in days gone past. Stories of chalk board erasers flying across the classroom aimed at disruptive pupils' heads or the teacher that could make learning seem interesting and dare I say it, fun, are fondly recounted at reunions of school friends. So like it or not, telling someone you're a teacher immediately provides people with conceptions and probably also misconceptions of who you are, what you're like, what you stand for etc.
Responding to the 'so what do you do?' question with the answer 'occupational therapist' probably makes some people wish they had never asked. When it comes to knowing what OT's do, people seem to divide into three groups: the majority have no idea at all of what an OT is or does - these people are then faced with the awkward decision of whether to pretend they know and then divert the conversation without being discovered or admitting that they don't have a clue what an OT is (I fell into the first category before beginning my OT training); the second group try to posit a definition of what being an OT entails - "so is that like helping people to find jobs or helping people when they are having difficulty doing their jobs" - which is a reasonable attempt considering the words of the job title; the minority of people break into a knowing smile and usually express some favourable comment about the work of OT's - these people, or maybe someone in their family or a friend, have usually experienced OT first hand.
For most people, the word occupation means 'job' so why wouldn't people think OT's are job counselors or career advisers? We don't have any popular tv dramas to publicize, or more accurately sensationalize and glamorize, the nature of our work. Lawyers have Ally McBeal and Boston Legal; medics have ER, House and Gray's Anatomy; teachers have Boston Public and Degrassi High (actually, did those kids ever go to school?); The police have CSI Miami, New York, Vegas and also Cagney and Lacey and CHIPS to take it back a few years. Even members of special intelligence agencies that investigate paranormal phenomena and extraterrestrial beings have their own tv show (The X-Files) even though this must be a pretty niche career.
Explaining to people what an OT does is tough. Launching into definitions of "enabling people to maximize their potential in valued activities" is vague. "Helping people to do, be and become" is even vaguer. When it comes down to it, unless a close friend or family member has had a debilitating illness, injury or condition, most people would not really understand why someone would need help with tasks and activities where the skills required for successful completion are normally regarded as second nature or just 'common sense'. OT's are keen to advocate and publicize their profession. On one level, this is out of necessity to compete for funding dollars, but also it stems from a passion for the profession and having first hand experience of its effectiveness. But the most convincing advocates, from my experience so far, are the recipients of OT services, the clients themselves. The experience of living with disability is a unique perspective from which to explain the challenges that everyday life presents. People with disabilities are likely to express the need for a profession that assists in remediation of every day life challenges in a more meaningful way that most OT's could. Maybe the time has come for a television drama based on the lives and work of OT's. After all, haven't Lindsay Lohan, Amy Winehouse - not to mention Britney - made rehab part of popular culture? Watch out for the new series 'Rehab' - coming to your tv screen soon.
Responding to the 'so what do you do?' question with the answer 'occupational therapist' probably makes some people wish they had never asked. When it comes to knowing what OT's do, people seem to divide into three groups: the majority have no idea at all of what an OT is or does - these people are then faced with the awkward decision of whether to pretend they know and then divert the conversation without being discovered or admitting that they don't have a clue what an OT is (I fell into the first category before beginning my OT training); the second group try to posit a definition of what being an OT entails - "so is that like helping people to find jobs or helping people when they are having difficulty doing their jobs" - which is a reasonable attempt considering the words of the job title; the minority of people break into a knowing smile and usually express some favourable comment about the work of OT's - these people, or maybe someone in their family or a friend, have usually experienced OT first hand.
For most people, the word occupation means 'job' so why wouldn't people think OT's are job counselors or career advisers? We don't have any popular tv dramas to publicize, or more accurately sensationalize and glamorize, the nature of our work. Lawyers have Ally McBeal and Boston Legal; medics have ER, House and Gray's Anatomy; teachers have Boston Public and Degrassi High (actually, did those kids ever go to school?); The police have CSI Miami, New York, Vegas and also Cagney and Lacey and CHIPS to take it back a few years. Even members of special intelligence agencies that investigate paranormal phenomena and extraterrestrial beings have their own tv show (The X-Files) even though this must be a pretty niche career.
Explaining to people what an OT does is tough. Launching into definitions of "enabling people to maximize their potential in valued activities" is vague. "Helping people to do, be and become" is even vaguer. When it comes down to it, unless a close friend or family member has had a debilitating illness, injury or condition, most people would not really understand why someone would need help with tasks and activities where the skills required for successful completion are normally regarded as second nature or just 'common sense'. OT's are keen to advocate and publicize their profession. On one level, this is out of necessity to compete for funding dollars, but also it stems from a passion for the profession and having first hand experience of its effectiveness. But the most convincing advocates, from my experience so far, are the recipients of OT services, the clients themselves. The experience of living with disability is a unique perspective from which to explain the challenges that everyday life presents. People with disabilities are likely to express the need for a profession that assists in remediation of every day life challenges in a more meaningful way that most OT's could. Maybe the time has come for a television drama based on the lives and work of OT's. After all, haven't Lindsay Lohan, Amy Winehouse - not to mention Britney - made rehab part of popular culture? Watch out for the new series 'Rehab' - coming to your tv screen soon.
Wednesday, April 16, 2008
OT Joke
Five healthcare students sat in a room: a medic, a pharmacologist, a nurse, a PT and an OT…
It sounds like the beginning to a joke, but alas it’s not (skip to the end of the article if you want a joke!). It was, in fact, the situation I found myself in last week. And was this meeting of prospective healthcare professionals from an array of disciplines a spontaneous get together? Of course not – we’re all far too busy for meetings not scheduled into our curriculum! During our mini-summit, we all lamented at the fact that while we worked towards a common goal – best possible patient care – rarely, if ever, did our academic worlds coincide.
If truth be known, part of the reason I was in the room was the lure of $100 for taking part in this interdisciplinary problem-based learning research project and the promise of a free pizza meal. Along with this considerable draw, I was also intrigued by the prospect of getting a snapshot of what working with future colleagues would look and feel like. And my conclusion is: the future is bright.
Our task was to discuss a case study of a patient who had a diagnosis of lower back pain and post-partum depression. We received some initial information and then more details were revealed by the facilitator as we asked pertinent questions. It was a bit like a more sophisticated version of ‘Twenty Questions’. My trepidation in being unable to convey the OT perspective slowly subsided as a few key concepts jumped out at me as we were introduced to the case. The main concept that struck me was ‘role’ – this lady was a wife, a mother, an employee (and the list goes on). I begun to get excited when I realized that ‘role’ was a very ‘OTish’ concept and just by mentioning this word, I felt that my place at the table was justified.
Discussions hadn’t progressed very far when the pharmacology student turned to me and boldly declared, “I have to admit, I don’t really know what an OT does”. Suddenly I felt the pressure of four sets of eyes looking in my direction all expecting an eloquent and succinct explanation of the occupational therapy profession. And I’m sorry to admit that I didn’t do a great job of providing them with the answer they were looking for. I began to explain it by comparing OT to PT – an attempt to provide a meaningful context - but I soon tailed off with that approach when I realized that I didn’t truly know what PT’s do and there was one sitting right in front of me (awkward!). Then I changed my tact to utterings of “support people to resume or reintegrate into meaningful activities after the onset of illness or injuries”. Although it made sense in my mind, I could tell I wasn’t doing a lot to help them visualize what OT’s actually do.
Returning the following week after doing some research into potential OT interventions for this case, I think I managed to enlighten my team a little more. There were a few surprised mutterings and impressed looks as I reeled off a number of potential OT interventions. The medical student said he would often refer patients to OT’s in his action plans (or whatever the medics call them) but like a road you feel may suddenly terminate over the crest of a hill, he had no idea what actually happened when they arrived in the OT department – he just assumed they rehabilitated…somehow. My hypothetical action plan seemed to cover most bases: it involved biomechanical, rehabilitation and psychosocial approaches. The others were surprised that OT’s could delve into mental health issues. I felt satisfied, maybe a little smug if truth be known, that I represented such a diverse and holistic-thinking profession.
The whole experience of working as part of an interdisciplinary team was invigorating and exciting. I would go as far as saying that I can’t wait to work in an environment where there is constant exchange between different disciplines. Maybe it won’t be as relaxed and responsibility-free as this little taster experience, but it will certainly be dynamic and interesting.
This experience coincided with ponderings over my progress through the Masters program so far. For better or worse, I feel like I am steadily acquiring the lingo of OT’s and healthcare. I also feel like I can view situations through an ‘OT lens’ (I love this expression – it’s like a special prescription for glasses; I might try asking for it when I visit the optometrist next time). I am getting the “What” of OT – I just don’t quite get the “How”. When it comes to thinking of realistic plans and actually implementing them in real life situations, my mind goes a bit blank, the furrows on my brow deepen and my cognitive cogs start to churn. Oh well, I’m only a quarter of the way through the program and only have one fieldwork placement under my belt out of six and the placements are where the real and lasting learning happens.
And now for an actual OT joke (I totally plagiarized this from another OT blog so I take no credit or responsibility for its funniness/lack of humour, delete as appropriate):
Q: How many Occupational Therapists does it take to change a lightbulb?
A: None. We’d teach the lightbulb to change itself.
Hmmm…maybe we shouldn’t give up our day jobs quite yet.
It sounds like the beginning to a joke, but alas it’s not (skip to the end of the article if you want a joke!). It was, in fact, the situation I found myself in last week. And was this meeting of prospective healthcare professionals from an array of disciplines a spontaneous get together? Of course not – we’re all far too busy for meetings not scheduled into our curriculum! During our mini-summit, we all lamented at the fact that while we worked towards a common goal – best possible patient care – rarely, if ever, did our academic worlds coincide.
If truth be known, part of the reason I was in the room was the lure of $100 for taking part in this interdisciplinary problem-based learning research project and the promise of a free pizza meal. Along with this considerable draw, I was also intrigued by the prospect of getting a snapshot of what working with future colleagues would look and feel like. And my conclusion is: the future is bright.
Our task was to discuss a case study of a patient who had a diagnosis of lower back pain and post-partum depression. We received some initial information and then more details were revealed by the facilitator as we asked pertinent questions. It was a bit like a more sophisticated version of ‘Twenty Questions’. My trepidation in being unable to convey the OT perspective slowly subsided as a few key concepts jumped out at me as we were introduced to the case. The main concept that struck me was ‘role’ – this lady was a wife, a mother, an employee (and the list goes on). I begun to get excited when I realized that ‘role’ was a very ‘OTish’ concept and just by mentioning this word, I felt that my place at the table was justified.
Discussions hadn’t progressed very far when the pharmacology student turned to me and boldly declared, “I have to admit, I don’t really know what an OT does”. Suddenly I felt the pressure of four sets of eyes looking in my direction all expecting an eloquent and succinct explanation of the occupational therapy profession. And I’m sorry to admit that I didn’t do a great job of providing them with the answer they were looking for. I began to explain it by comparing OT to PT – an attempt to provide a meaningful context - but I soon tailed off with that approach when I realized that I didn’t truly know what PT’s do and there was one sitting right in front of me (awkward!). Then I changed my tact to utterings of “support people to resume or reintegrate into meaningful activities after the onset of illness or injuries”. Although it made sense in my mind, I could tell I wasn’t doing a lot to help them visualize what OT’s actually do.
Returning the following week after doing some research into potential OT interventions for this case, I think I managed to enlighten my team a little more. There were a few surprised mutterings and impressed looks as I reeled off a number of potential OT interventions. The medical student said he would often refer patients to OT’s in his action plans (or whatever the medics call them) but like a road you feel may suddenly terminate over the crest of a hill, he had no idea what actually happened when they arrived in the OT department – he just assumed they rehabilitated…somehow. My hypothetical action plan seemed to cover most bases: it involved biomechanical, rehabilitation and psychosocial approaches. The others were surprised that OT’s could delve into mental health issues. I felt satisfied, maybe a little smug if truth be known, that I represented such a diverse and holistic-thinking profession.
The whole experience of working as part of an interdisciplinary team was invigorating and exciting. I would go as far as saying that I can’t wait to work in an environment where there is constant exchange between different disciplines. Maybe it won’t be as relaxed and responsibility-free as this little taster experience, but it will certainly be dynamic and interesting.
This experience coincided with ponderings over my progress through the Masters program so far. For better or worse, I feel like I am steadily acquiring the lingo of OT’s and healthcare. I also feel like I can view situations through an ‘OT lens’ (I love this expression – it’s like a special prescription for glasses; I might try asking for it when I visit the optometrist next time). I am getting the “What” of OT – I just don’t quite get the “How”. When it comes to thinking of realistic plans and actually implementing them in real life situations, my mind goes a bit blank, the furrows on my brow deepen and my cognitive cogs start to churn. Oh well, I’m only a quarter of the way through the program and only have one fieldwork placement under my belt out of six and the placements are where the real and lasting learning happens.
And now for an actual OT joke (I totally plagiarized this from another OT blog so I take no credit or responsibility for its funniness/lack of humour, delete as appropriate):
Q: How many Occupational Therapists does it take to change a lightbulb?
A: None. We’d teach the lightbulb to change itself.
Hmmm…maybe we shouldn’t give up our day jobs quite yet.
Friday, March 28, 2008
The Healing Touch of Tango
It's so refreshing to read articles like this once in a while. Just when I'm starting to get lost in the maze of learning experienced by OT students (I'm generalizing hopefully - it's not just me is it?) and lose focus, I am reminded about the power of occupation. This is another article by Tasleem Rajwani, the author of 'Salsa as Medicine' (mentioned on this blog a few months ago). I wonder how many amazing and inspiring stories there are like this out there just waiting to be written.Click the link below to read the article:
http://salsavancouver.net/articles/healingtango.html
Friday, January 18, 2008
Guinness and Anatomy
For me, studying anatomy was like becoming a Guinness drinker. As a beverage, Guinness is big and scary. It is not something to take on with a light heart and without full considerations of what you’re getting yourself into. It is seemingly straightforward at first (how difficult can a black and white beer be?), but as soon as you taste it, you discover its depth. As time goes on, you begin to appreciate the subtleties of consuming Guinness – the correct angle of poor (45 degrees if you’re interested) and the optimal serving temperature (5-8 degrees Celsius apparently). The first few times, the taste of the beer may seem overwhelming, but its intriguing and multi-layered taste makes you want to come back for more. You persevere and after a while, its complexity which once seemed unlikable and unconquerable becomes the reason you begin to like this new flavour. Everything at last begins to fit together and make sense. While appreciating the tumultuous journey you have taken together to become friends, in the end you see Guinness as a straightforward and honest pint – it’s just black and white after all! Guinness and Anatomy: for me, as they like to say in South-East Asian markets, “same same, but different”.Not coming from an anatomy background, I felt like the man in the parable who tried to build his house on sand. Like him, I would keep trying to build, but with limited foundations, my knowledge kept slipping away. However, I was intrigued from the start and inspired by the teachers who seemed to fully appreciate the beauty of every muscle, nerve and artery. We were also very lucky to have cadaver specimens to practice on which ironically really brought the subject alive. I am eternally grateful to those good souls who graciously dedicated their bodies to the scientific cause. Without them, it would have been pretty tricky to figure out how the body really works. I remember the first time our class went down to the ‘wet lab’. I think on the whole we looked apprehensive and those of us who had not worked with prosections before were probably wondering how we were going to cope with the experience. As the door to the huge specimen fridge was opened for the first time, I heard someone ask if they should move out of the way so that someone behind could get a better look. “It’s ok, I’m fine where I am, thanks” came the reply. This was partly the way I was feeling too, though intrigued to see at the same time.
Having been told at the start of the course that we (OT’s and PT’s) go into more detail in our Anatomy studies than the Meds and Dents, it should have been no surprise that preparing for the exam was tough. The ‘bell-ringer’ is quite the experience: 80 stations, each with a specimen, a radiograph or surface anatomy photo tagged for identification. One minute per station, then the buzzer sounds and everyone breaks their intense inspections, scrambles down an answer and moves on in unison to the next challenge. I was totally unprepared for this type of examination at the midterm. In retrospect, speed-dating may have been a good way to get ready. I can’t think of anything else where you get a short time to make your acquaintance, make the best possible effort to understand exactly what is in front of you before being ordered to move on by a buzzer. At least the bell ringer is civilized enough to have rest stations; one whole minute of pure luxury, a chance to sit down, compose yourself, contemplate life, before…BUZZ and you’re back into the game. My slight angst with the whole process was eased as I arrived at my first station which happened to be a photo of the Governor of California’s back, but in the Terminator days rather than his current Governator role. So muscle-bound was Mr. Schwarzenegger’s back, I actually had difficulty identifying which muscles were which. Studying for the exam was all-consuming. One of my study partners had remarked her husband had romantically stroked her tenderly on the hand a few days earlier and all she could think about was which dermatome was receiving the sensation. What dedication to anatomy studies!
So in OSCAR-esque spirit, here are this year’s Anatomy Academy Awards. The award for having the biggest name for the smallest feature goes to Flexor Digiti Minimi Brevis. The Darwin Award for possibly being a casualty of evolution goes to Plantaris (due to being one of those muscles that is getting smaller and may evolve out of the human body in time). The award for inconsistency goes to Palmaris Longus for not being present in all people (draw your fingers and thumb together and flex your wrist to 90 degrees. Can you see a tendon popping out by your wrist – that’s the Palmaris Longus. If it’s not there, you’re like about 30% of the population that don’t have this muscle.) Palmaris Longus also wins the award for the muscle sounding most like a cheap Mexican resort. The Arnold Schwarzenegger award for the coolest name goes to Buccinator (Supinator was one of the nominees). The award for the best supporting muscle goes to the Pectoralis Minor (an unexpected decision as Teres Minor had been widely tipped to win this award). And finally, the Student’s award for the most functional muscle goes to the Brachioradialis (which is dubbed as the ‘beer-drinking muscle’). Without this small but purposeful muscle, drinking a smooth pint of Guinness would be a lot harder.
Sunday, December 30, 2007
Thought provoking movie
So here's another movie suggestion (can you tell I have more time on my hands now that term has ended?). It's called 'The Diving Bell and the Butterfly'. It's a true story and adapted from a novel by the same name. It's an extremely well written and filmed French flick with a great soundtrack to match. I'm going to put my reaction to this film in the comments section (commenting on my own blog - sad?)so as not to ruin the storyline. I would love to know what other people think about this movie. So don't be shy to comment on my comment. Movie website and trailer link: http://www.thedivingbellandthebutterfly-themovie.com/
Friday, December 21, 2007
Army OT's
At the beginning of the year, we attended a Rehab Expo. It was pretty inspiring to see the array of amazing designs and devices that exist out there for people with disabilities. Curiously, one of the exhibition booths at the Expo was a recruiting stand for the Canadian Army. One of my classmates went up to the booth and asked if the army employed OT's. The women looked blank - the sort of "shall I admit that I don't really know what an OT is or should I just wing it" look. Recognising this expression, my classmate filled her in on the ins and outs of a job that would seem essential in the rehab of injuries inflicted during service. The women replied that she thought the army employed PT's but not OT's. If anyone knows whether the Canadian Army employs OT's, I would be interested to know. Maybe this is one of those areas where OT is not deemed essential enough to put funding into, but wouldn't all an injured soldier want to do is return to "normal living"? That could be a tough proposition without the help of an OT. Anyway, this little YouTube clip below shows the American Army have figured it out.
Wednesday, December 12, 2007
Inspiring documentary
I saw this great documentary on CBC the other day. It was part of The Passionate Eye documentary series. The program follows Dr. Jack Kessler who is leading research into nerve regeneration using stem cells. Dr. Kessler is particularly passionate about this as his daughter has a spinal cord injury. Obviously a huge controversy is sparked off when the words 'stem cell research' are mentioned, but for those of us in rehab, this program is inspiring and makes it seem like important developments are just around the corner if only the moral/ethical/political issues can be resolved - don't hold your breath for that one though. There's a link to a trailer of the documentary below but try to get hold of the full program (er, not quite sure how, contact CBC?). There's also a link to a discussion board which opens up some of the issues touched on by the documentary. For anyone interested in spinal cord injury, this documentary is fascinating and inspiring to watch.
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