Ten Minutes

Today was the first day we were examined on our competency for conducting well-patient histories on patients. The patients were either upper year students or health professionals that actually do this for a living. I practiced and practiced my history taking and I got to a point where I remembered all the points, sounded calm, did the history within the time allotted (ten minutes) and I felt pretty confident. Not over-confident, I just knew that the test day would all turn out ok and I am a fairly competent person when it comes to having conversations with people.

Oh how wrong I was. Maybe it is not as bad as I made it out to be and maybe it is just the overcritical perfectionist in me rearing its ugly head but I feel like my history taking exam did not go as well as I thought it would. I felt really awkward and was trying my best to mask it with a smile that I hope did not look plastered on my face. And I am desperately hoping that my nervousness during the interview was not translated by my body language and make me seem non-empathetic or distracted. It also probably didn’t help that the patient saw fear in my eyes because this was my first patient history exam! I stumbled on some words and had to apologize for certain word-bumbles and I felt like the entire time the patient was looking at me like I was crazy. Or maybe it was a trained judgemental eye. Or maybe they were supposed to act like a brick wall that I was going to have a conversation with.

Within a few seconds of meeting someone you definitely get an impression of whether or not you like them and that is all you have as a health professional to make a good impression – this point was really driven home with me today. I was planning on taking a deep breath before walking in the room but all of a sudden the ringer went off and everything moved too fast! Copious amounts of adrenaline was coursing through my body and my heart was beating so fast! I almost forgot completely how the entire interview went or what I said! I guess that is why they videotape you during these assessments so you can see where you need to improve for yourself. Thank goodness that they do not do that for our first history taking assessment – that would be so embarrassing to watch!

The one thing I hope I have on my side is my self-awareness during the patient history: if I had a word-misstep I acknowledged it and moved on to the next question. Also, I tried not to let my initially awkward beginning taint the rest of the interview. I feel like by the end of the history taking I was a lot more professional and composed. And hey, by second year this stuff will be old hat!
So my plan is to take a deep breath, listen to some tunes, let things play out as they may, finish my labs today and have a good session of moksha yoga!

Fibulas and Tibias

After a restful Thanksgiving weekend I am back to school and enjoying the short four day week I have. A lot of the coursework covered so far has been review of classes I took in university like biochemistry, anatomy, osteology, physiology, math, physics and medical anthropology. Math and physics has been really useful for biomechanics…finally vectors can be applied to my daily living! And I would like to state the irony that the class that is helping me most in anatomy practicals right now is not actually university anatomy or even any science courses…it was the osteology course I took within the department of anthropology!

Everything I encounter that is new or foreign is in my technique, orthopedics and clinic classes. This week there is an exam on well patient history taking and next week is the first technique exam for postural assessment and spinal landmarking – we don’t learn how to do adjustments before January.
Despite a lot of class being material previously covered there is often really cool tidbits of information that are super cool. Here is one of my favourites:

Wolfe’s Law: if stress is applied at a certain location of a bone, that bone will lay down more bone matrix in that area to make it stronger
Wolfe’s Law applied to real life: A little girl was born without a tibia (lower leg bone), so even before she could walk they took her fibula (the other lower leg bone on the lateral side) and put it where the tibia should have been. The result was a fibula that turned into a tibia!!! How cool is that?

can you define chiropractic?

What is chiropractic? Can you define it with one word? A sentence? Isn’t it amazing how it can be so hard to describe what a chiropractor does? One of the themes reoccurring in our ethics class is that there are so many different paradigms within right now.
The Canadian Chiropractic Association says: “Chirorpactors practice a drug-free, manual approach to health care that includes patient assessment, diagnosis and treatment. In particular, chiropractors assess patients for disorders related to the spine, pelvis, extremity joints, and their effect on the nervous system. Chiropractors are also trained to recommend therapeutic exercise, to utilize other non-invasive therapies, as well as to provide nutritional, dietary and lifestyle counseling.”
The World Federation of Chiropractic says that chiropractic is: “a health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the functions of the nervous system and general health. There is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation.”
As chiropractic students, we are encouraged to make sure that we can give our own definition to chiropractic. Some chiropractors take a more philosophical approach that talks about an innate intelligence that people have that can heal the body. Another approach is the evidence based model of chiropractic, which is what is taught at my college and has a heavy focus on scientific evidence for treatment. This diversity in chiropractic practice has a disadvantage in that you never know what you are going to get when you walk into a chiropractic office for an initial appointment. I am slowly working out my own definition of chiropractic, which I am sure will be continually shaped by my education and experience over the next four years. So far I define chiropractic as a healthcare profession that specializes in musculoskeletal disorders and promotes a holistic, drug-free approach to wellness. With all this philosophical discussion about chiropractic I understand why they recommend we take arts classes!

C1 to sacrum

I can’t believe that it has been two weeks since I have written! The time has been flying by and I am in the full swing of classes. Lots of classes – like 12! At first it seemed really unorganized and I really had no idea what sort of schedule was starting to develop but after two weeks there is a sense of routine which helps me mentally prepare for the upcoming week and organize myself a bit better. We’ve started on landmarking in technique class, so I should now be able to locate C2 (and determine where C1 is from this point), C6, C7, T4, T10, L4, L5 and the posterior superior iliac spines (PSISs) and from these landmarks determine the location of all the other vertebrae. To help me out I’ve decided to invest in a spine model (it has yet to acquire a pet-name), complete with a pelvis, and occipital bone! Besides practicing landmarking on my new spinal model (by putting a pillow on top of it and palpating for the spinous processes) I have the hope that just looking at a spine everyday will a) help me learn by osmosis b) motivate me to study! Labs started this week which is really exciting. It was a dry lab, meaning we studied the bony spine and shared a spine between the 5 people at our table, which was still review for me since I have taken osteology and forensic anthropology but it was totally new to most of the class. This is one of those moments where taking arts classes really benefits a science based program! It was slightly morbid though since we were in the same room as the cadavers were in and had to use the stainless steel tables they were lying on as our working surface (they were covered of course, so it was a very respectful environment). I think it will definitely take longer to get used to the whole cadaver situation. I think the best way to think about it is that I am grateful that people have donated their bodies so we can learn more about anatomy. At the school there are some really great tutorials that have contributed to the hands-on portion of our education. We have a tutorial bi-monthly that involves dissecting a case study in a small group setting led by a tutor and another lab that is bi-monthly where we practice our clinic skills like how to take a patient history and conduct yourself during an initial consultation. In all of these tutorials we are split into smaller groups (based on the first letter of our last name) and everyone is pretty involved so you get a lot of peer-based feedback on how to improve which I think is the best way to learn. This week I also had my first observership at the school clinic! It is a course requirement to spend 6 hours each semester observing a clinician either at the school clinic or one of the external clinics. So I got all dressed up in my clinic clothes and tried to act like a grown up for 6 hours :p It was an amazing experience though, and a great insight to what I will be doing in my internship year. It has seemed really busy, but in actuality the pace is still really mellow. I’ve been trying to do all the fun stuff I can before things really pick up, which should be soon I am hearing. For example, I’ve gotten really into Moksha Yoga (a type of hot yoga) lately, I find it really helps decrease my stress and anxiety…plus it is warm in the rooms and reminds me of being in Brisbane last year!

1st and 2nd day

Wow, today was BRUTAL. Five straight hours of lecture then a two hour break and two hours more. On little sleep I might add. That won’t be a problem tomorrow as tonight I am exhausted!
Even more lecture tomorrow to look forward to.

As we sat through 3 hours of histology I focused my attention on the chiropractic table sitting at the front of the lecture theatre – it has been there ever since we started – it is teasing us as we review every organelle of the cell and basic biochemistry concepts. It is a constant reminder that we actually are at chiropractic school, not university, and one day we will learn how to do chiropractic adjustments! However, even though we are reviewing the basics, the professors make sure to add a chiropractic spin to everything we learn/re-learn and constantly remind us that this is not normal university class this is a professional program. It keeps me a bit more optimistic about the grueling hours of class – instead of being bored from learning about the cell for the millionth time, I am trying to understand it more from a teaching perspective. If I was in clinic and I had to explain the cell to a young patient, what metaphors would I use, how would I make the concept easy to understand? From that angle, listening to the professor talk about how the cell wall was a castle fortress and the interior a factory was easier to listen to and absorb. I’m not just a kid anymore just trying to pass the course, I’m preparing a strong foundation for my career.

Besides having deep insightful moments in class (haha) I am absolutely exhausted and clutching my travel mug with a death grip like most of my peers. This week will be a re-definition of what is normal for the next four years. My new normal is not getting a lot of sleep, being in class/lab for 8 or so hours a day and cherishing every nap I have the chance to take. And since the other 200 or so people in my class will be re-defining their normal as well, it makes it that much easier to change.

Orientation Week

Every morning we have some lectures delivered by the staff at the college or inspirational chiropractors they invited to talk to us about their experience as a chiropractor. Most of the lectures were very motivating and all of them provided us with undoubtedly important information. The underlying theme was that we all need to identify ourselves, not as 20 something university students but as chiropractic students, who represent the college, and even the profession of chiropractic, which, I would like to add, is a healthcare profession that undergoes constant scrutiny. How I conduct myself on a daily basis, my social networking, how I behave at social outings, reflect on all these things. It was a bit of a shock to the system really. A weekend of rest and then the race begins.

Hello!

I am a first year chiropractic student and I want to share my experiences – the fun, the stressful and the boring – with anyone else who is considering the profession or applying to school. I wish that something like this existed when I was trying to decide what to do with my life so I hope it is helpful. I’ll also be sharing the interesting things I learn in lecture and lab as time goes on. Enjoy!