So we finally got our medical clearance and started work on Friday, when we really should have started on Monday. And we have just had our first full week of clinic, 6 days to be exact. The clinic is extremely laid back, the patient load is currently very low too. But I think it has been the best thing for our learning experience. We come into this situation after 2 years of didactic learning and in reality only a few weeks of primarily observing in the clinic. Very little examination, medical screening, documenting, basically decision making etc was required previously. Mark and I were very nervous to get our first patient, especially considering his/her life had just been turned upside down via a suicidal leap from his apartment building. Intimidating to beginners, but it has been an experience I'll never forget. Not to mention the language barrier which is of course complicating matters. We were literally handed the patient and told to come see them if we needed help. Well, we seem to have pretty much managed on our own besides a very tough love lecture our CI gave the patient when he just wanted to sulk in bed and not participate in rehab. Since SCI patients require a massive amount of time to treat, it is somewhat deceptive that we have primarily only had 1 patient. We always seem to keep busy though. We spend about 3 hours a day treating our primary patient, a couple other hours observing and helping with our CI's (clinical instructor) patients, about an hour documenting and reviewing SCI when there is down time, take a solid hour for lunch and that's our day. Much shorter than a typical American day. We are told that we only need to be in clinic from 9-3 but we have gotten there at 830 every morning and don't usually leave until 3:30 or sometimes 4:00. We actually were the last ones on Friday, they had to kick us out. I originally thought they were giving us a short schedule because we are students and wanted to give us a light load. But since we come earlier than expected and leave later as well, we come to realize that there mornings consist of "rehab meetings" which are half patient related have social...it's quite similar in the afternoons as well. So, I think we are pulling our load in the clinic and I know for a fact we're making their lives even easier than they already are. I love socialized medicine ;) And considering that Sweden has one of the lowest infant mortality rates in the world and the US has one of the worst (for developed countries) it isn't necessarily inferior. Collectively, it is actually seen as much better than the US system...the people are healthier, they have a much bigger emphasis on prevention and education. Sure, you might have to wait 3 times longer for an elective procedure but hell, most of them won't even need the procedure. And if the patient has money, they can speed up the process and go to one of the semi-private clinics in Sweden. So in reality, the wealthy can still get relatively rapid care, and the less fortunate get reasonable care in most cases. Wheras in the US, the old, the extremely poor, and the insured get most of the good healthcare. Medicare and Medicaid have quite a few loopholes however and they frequently get the shaft too. Especially where elective procedures, medications, and long-term care are concerned. And the estimated 40-45 million Americans who don't have insurance and must pay out of pocket, well...they only get care when its life and death. No preventive screenings, only an ER trip when they have a stroke or heart attack or massive bowel impaction or whatever. The little things get skipped because they don't have a choice, they can't pay a few hundred dollars a year for an annual physical, or see a psychologist or nutritionist for their massive obesity problem, etc etc etc. So what happens then? 1/2 the country gets very good care, 1/4 get reasonable care with loop holes, and 1/4 get emergency care and end up paying for it the rest of their lives. Whereas in Sweden 100% of the population gets good care, regardless of ability to pay...assuming you have paid your exorbitant taxes. But hell, medical insurance in the US is exorbitant and so are the copays for many elective procedures...so the cost comes out in the wash. And when we talk about cost...that's a whole nother issue. The US spends something like 3 times more per capita on healthcare than Sweden. Yes there is some great research and clinicians that come out of the US, and I am very proud of that fact. But that doesn't mean our system is broken for the masses...it doesn't give us an excuse to sit behind our pensions and employer subsidized insurance premiums and cross our fingers. So, what are we going to do to make it better? That's a whole nother debate...but that's the first step. Let's just debate it, lets converse and analyze and propose and see what we can come up with. It won't be perfect, but it can be better.......Not sure where all this came from. Would love to chat with anyone who has a retort to my points, because I'm sure they are inherently flawed. But, no one can argue the fact that something has to change in America...change is a must for any country. We are reaching our breaking point...it's time to try.
Back to clinic, whew!! My day's have never gone by so fast. Although my experiences with SCI rehab are very limited, I have a strong inkling that this could be a very strong potential career path. Watching a patient crawl out of suicidal despair with our help, fight through disappointments and successes, and slowly develop hope and mobility is something that is hard to describe with words. The first time our patient stood on his own, and to see the look in his eyes...it took everything I had to shut off the faucet. I actually had to turn away and pretend I was coughing to pat my eyes dry. We still have our good days and our bad days, but this week it has become clear to me how beneficial physical therapy/rehab in general can be. Without the day to day clinical contact, most of these patients wouldn't make it. They have to relearn to do everything that you and I take for granted. From getting dressed, to using the bathroom, sitting, standing, walking, using a wheelchair or assistive device properly...the list could go on and on. You tell them to get out of bed and sit in the chair next to their bed and they look at you and say...how? How do I get out of bed? That must be a mind job for the patient because it is for me. I'm not talking about old people either. These are people that were as healthy or even healthier than we were 2 weeks ago. We have one teenager that was hit by a car that played very competitive sports his whole short life, and now he is a quadriplegic with 1 arm. All he wants to talk about is sports, bipedal sports that is. Sure, there are opportunites for WC sports, even for patients with quadriplegia. But I don't think its even completely registered that he'll never walk again...much less sprint or play semi-pro soccer, or whatever. But he is so excited when I stop by his room to chat and talk about America or sports or whatever. It is amazing to me how happy he can be, all things considered. It gives me so much perspective into my own life to work with these patients. It's only been 6 days and I've only helped treat 4-5 different patients, and most of those just assisting other therapists or doing very simple things with them...but its already changed me. It has given me a wider range of emotions that I carry with me daily, perhaps that's not always a good thing. I think I'm more keenly aware of the amount of suffering, sadness, and despair there is in the world but then I cherish each step, each breath I take...I relish each morning I wake up. And if something does happen to me or my loved ones, its giving me perspective to handle adversity...which is of course inevitable in this world we live in. Well, I'm on Mark's computer since mine crashed so I guess I'm going to run...thank God I still can.
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