These are my people

If you follow me on facebook, you know I am back in Denver (where I went to graduate school) for the week. The past four days have been nothing short of perfect. I have gotten to catch up with some of my best friends, eat delicious meals  engorge myself in copious amounts of food and drink, catch up on some sleep and get ready for my 4 day conference tomorrow. It has been great to be back in Denver, but I am realizing now, more than ever, I made the right decision in moving back to Portland.

Denver was never home to me. That being said, I have some fantastic memories with some of my lifelong friends here in this city. Several times throughout graduate school, I had to sequester the longing to return to Portland, as it was not productive. I thankful for my education and truly believe I received the best at University of Colorado, but I knew my time in Denver was going to come to an end following graduation last May.

The past few days I have enjoyed several cups of joe across from those same people I used to spend countless hours studying with until our eyes blurred, brains were maxed out and felt like the life was sucked out of us. These people were my lifelines when we got our asses kicked for three years by a doctorate degree.  These people form the foundation of my knowledge of physical therapy management. We share the same skill set, same theories on practice and same bias of our professors (now colleagues).  It is these people whom I can call at any hour with questions and they will talk out what they might do if in my situation.

It is good to be back. It is good to laugh so hard that I pee my pants. It is good to eat until I cannot take another bite. It is good because I am in some of the best company I could ask for. It is good to know I have friends who I will always have something in common with- for we are therapists. We come from the same DNA of compassion, empathy, the art of healing and knowledge of the incredibly complex human body. We share a desire to help humanity; despite the ever imperfect healthcare system. We love each other because we have been through it all together. These are my people...

Last days of summer 2011

Graduation Week 2012

White Trash Bash up close

White Trash Bash 2011

Flag football League Champs

Stampeed Country Bar- Tradition

Boundaries at work

Today has been one of those days... One of those days when each of my patients requires a little more of me than I have to give. Last week, one of my patient's passed away. Though I am no stranger to loss, this was particularly hard for me. I had treated this lady one day prior to her passing. One day she is working with me to improve her transfers in and out of bed and the next, she is gone.

Today, I had two patients breakdown in tears, one confess he had suicidal idealizations and the another admit to binging due to depression. At the end of the day, I know my limitations. I am there to listen. To redirect when possible, add prospective where I am able and most importantly validate their concerns. I am not superwomen, nor do my patients want me to be that for them. I am confident in my pre-established boundaries and know if I want to do my job well, these boundaries must remain.

But what happens when the compassionate, type A problem-solving side of me wants to fix all their problems? What happens when my MO for all my life has been to assist people with working through various problems (and in the mean time created unhealthy codependency patterns/relationships)? What happens when the face I am listening to is pleading for mercy from life's circumstances?

That was today. And now it is tonight. I was true to myself and my boundaries today, but I left work feeling like I wish I could have done more.  That being said, I also know if I would have tried to fix these individuals, I would perpetually be chasing my own tail. But I know I can be a shoulder to cry on and have two ears to listen. And that is what I did today today

A broken and flawed system

I have found that at the end of the day, my capacity to "pretend I am interested" severely diminishes. Today, I blame my job. All day I work with patients who come from all diffent backgrounds. Each of them need and require something different from me.  Some just need someone to listen to them and validate their pain. Others need manual intervention that only a skilled therapist can provide. Others need advice on further medical treatment they need/should seek.

At the end of the day, I am spent. I have given all of my capacity to demonstrate how much I care and value them, first as an individual, second as a medical diagnosis. I often leave work wondering if I should have given more? Wondering if I could have asked just one more question, would I have gotten to the root of their concerns.

On a day like today when I completed 7 evaluations, I feel exhausted. I am tired of listening, tired of scrambling my brain to determine what might be causing their shoulder pain, hip pain or back pain.  I am tired of being pressed for time and worse, not getting paid for the time I have to put in order to document all the things I did find wrong with said patients well after they leave.

Our medical system is broken, we know that.  What an average American may not know, is what medical providers are being forced to do to break even (we are not even talking about making a profit). Patient time is cut so we can squeeze in more patients because we are not being reimbursed for the care we provide. This not only leaves patients feeling like they are rushed through the system, but it leaves providers feeling like they weren't adequate in providing care. It's truly a lose-lose situation.

And yet, on nights after days like this, all I can think about is going back tomorrow.  I love my job. I love my co-workers and I love working for a hospital system that provides specialized care to individuals regardless of their background or diagnosis.  I love my profession and the direction it is headed.  And those are the things that keep me coming back for more.

For better or for worse...

In my line of work, you literally see everything.  In the course of one day, I can guide an athlete back to running for the first time following a major surgery, I can work with a patient to decide which assistive device would be best to meet the needs of their declining functional mobility and I can spend an entire session helping a husband cope with his wife's diagnosis of a neuromuscular disease and a prognosis of 3-5 years, at best, of declining function until she passes away.  I have days where every patient seems to be making significant progress towards their goals and I have days where every patient is losing ground.  My role is part PT, part psychologist and part mentor.  I am always being watched; watched by patients, my co-workers, my supervisors and by students aspiring to be therapists.

This week, I have been struck by the importance of choosing a mate whom you would do absolutely anything for... despite their physical abilities, their mental capabilities or emotional status.

I have been working with an older gentleman following a routine shoulder replacement who happens to be the primary caregiver for his wife.  Today, he brought her in to meet me.  Within seconds of meeting her, I realized why it is difficult for my patient to schedule appointments, why it is difficult for him to spend time in the pool doing therapy and why he is lagging behind in gaining range of motion. She has been living with Alzheimer's disease for the past 10 years and his rehab cannot be his priority.

A second patient whom I just met today, was recently diagnosed with Parkinson's Disease. His wife accompanied him for the session.  This was my first time meeting them, so I was careful to watch every movement he made so I could begin piecing together my assessment of his physical capabilities. About 2 minutes into our session, his wife completely broke down, citing his decline in function and recent diagnosis as the reason for her tears.  We spent nearly the next 40 minutes discussing expectations as the disease progresses and what my role would be in their care.  The patient was also having a difficult time, but it was clear the burden of care had landed on the wife.

And this got me thinking.  So often, we live in the present.  And I am all for that, as I have a tendency to be an "ultra-planner" and try to plan out every detail of my life.  But all to often, I am so concentrated on my present needs (wants) that I forget God's plan.  I get frustrated that I am still single and I "have it out" with God because I (selfishly) feel like he is withholding happiness from me by "keeping me single". And the men I have dated lately, have certainly been fantastic people, but not the one for me. Its like I have tried to make them fit into my life, despite all signs pointing to them not fitting. Like a puzzle piece that is so similar to another, that if jammed in with force, it can fit in another's spot.

And then I am reminded of these patient's and their spouses.  I desire to be with someone that no matter what changes, I will continue to honor him "for better or worse, in sickness and in health".  There is a reason those lines are recited at weddings.  Its not for the first few years of marriage; its meant for years 40, 50, 60, etc.  They were written so that when one spouse suffers a traumatic brain injury that leaves them a changed man, his wife remains by his side.  Those lines were written for my patients; when a mental disease robs someone of their character, that same character that made you fall in love in the first place.  Those are when those words carry the weight of gold. And that is why I am going to wait... wait for the man I would do anything for, despite any physical, emotional or mental changes that could possibly happen!