Mountains and Valleys of CEI, 2020

This post is dedicated to our Clinical Education Team. This all-star squad is made up of Dr. Nancy  Mulligan, Dr. Alice Davis, Dr. Shelene Thomas, Dr. Stacy Carmel, Dr. Denise O’Dell, and Dr. Laura LaPorta. They navigated our first clinical experience with admiral perseverance and continue to work hard in the face of adversity for future clinical experiences. In addition, Addison Rodgers, the student clin-ed representative for our class, continues to serve with excellence. We thank you all for your commitment to our education!  

Last month, my peers in the class of 2022 and concluded our first clinical experience, where we were mentored by a physical therapist who served as our clinical instructor in various clinics and hospitals scattered across the United States. As you can imagine, the experience was complicated due to… unprecedented circumstances. Yet, despite last minute unavailability of sites, alarmingly rising COVID-19 statistics, and record wildfires, adaptable professors and clinical instructors and creative travel arrangements made it possible for everyone to arrive safe and prepared to begin their first clinical experience.

My clinical experience took place in rural Virginia. In just one weekend, I traveled from Denver to the east side of the Appalachian Mountains, which served as a frequent vacation destination growing up for this Hoosier. I felt pieces of home as I began to drive through the winding deciduous forest as the leaves boasted the shades of a fall bonfire, filling me with gratitude at every turn that I got to spend my favorite season among such nostalgia-inducing beauty. At the same time, I felt nervous, rushed, and geographically alone. I never imagined my first time working with patients as an SPT would be with two masks and a face-shield between us. I had only practiced on two bodies since March, due to our precautionary lab trios that served as a quarantine bubble from my 79 other peers. I was suddenly in a long-distance relationship, again, after establishing a blissful routine with my partner in a snug rental in Denver for the past two months. I did not know a soul within a 120 mile radius of this small town. I was eager for this experience, but simultaneously uneasy about how it would play out. As I was having this inner dialogue in my head, the late Tom Petty sang through the speaker of my  Suburu:  

“Some days are diamonds, some days are rocks. Some doors are open, some roads are blocked.”

I found deep comfort in the familiar tune in that moment. I was reminded that there are  highs and lows, diamonds and rocks, mountains and valleys in everything we do in this life. I reassured myself I had the tools to make this the positive experience I had worked so hard for. I found comfort in the thought that despite being so far away from my classmates and professors for those few weeks, in the midst of a pandemic, we were all in this together.  In an attempt to connect us and provide a platform for our voices, I asked my class about their personal “mountains and valleys” from clinical.  

The Valleys – the tough stuff, the learning opprutunities, the lows, the rocks:

  • “Meeting a patient with terrible chronic pain, who was hurting her entire appointment. She cancelled the rest of the week…it was a reality check that not every patient will feel better after one session.”
  • “Watching a patient with Huntington’s Disease get worse instead of better throughout my time there”
  • “I felt alone at times. I had not been hugged for a while. But one day there was a big cockroach on my wall, and I smushed it with my Doc Marten. It was disgusting, but I proved to myself I did not need anyone to come and save me.”
  • “I found self-care challenging. The first week I just wanted to kick my feet up at the end of the day, which is exactly what I did. I was neglecting to reflect, exercise, and rejuvenate. I joined a yoga studio (within social distancing guidelines) and discovered that committing to showing up on my yoga mat regularly was the form of self-care I needed all along.”
  • “There was a shock-factor to the overall health-literacy of the population. We are in such a bubble with PT students. It was also sad to see people in so much pain they could hardly move.”
  • “It is difficult not knowing how to proceed with more complicated cases.”
  • “I saw a lot of college students with back and neck pain, pointing to endless hours on Zoom as the culprit. It was too relatable…”
  • “Wildfires.”
  • “Subtle reminders that we never know what the person in front of us is dealing with. It was a reminder to me that we should try to be kind to all those who we encounter.”
  • “It was hard to bear witness to the realities of being a healthcare professional, like calling emergency services, addressing pain in my patients, and accepting that I cannot fix everything.”
  • “Hearing the frustration of my patients as they work through their pain, discomfort, and injury.”
  • “Feeling inadequate during times where my skills were not where I felt they should be, or not being able to understand/ participate as much because we haven’t gone over that material in the program yet. This was both humbling and sad in a way, as it allowed me to really comprehend and see how much the pandemic is impacting our education and the clinical care we will be able to effectively provide to our future patients. “

The Mountains – the good and the great, the highs, the “this is why I’m here,” the diamonds:

  • “Watching my patients grow and express pride in their progress.”
  • “I felt so supported by my CI. The staff was all there for me when my ballot was tampered with.”
  • “Exploring the hidden nature of Kentucky, playing at the climbing gym, making slow dinners, and reading books.”
  • “I was my CI’s first student, and he gave me a lot of autonomy with treating patients. We had so much trust between us – I built so much confidence and started to really believe in myself.”
  • “I loved getting cookies, cupcakes, and treats at the office. We dressed up on Fridays too. I worked with a patient who was non-verbal at the start of therapy and began to speak during the later weeks. Also, I played patty-cake with a three year old and they showed my their rock collection.”
  • “My clinic was always one-on-one patient to PT which resulted in getting to know patients more. Everyone was excited to have a student there and they always let me watch interesting sessions like vertigo, prosthetics, and post-op.”
  • “It was great to finally practice the techniques we have learned. I got to work on a lot of manual techniques, which was amazing.”
  • “I was in home health, and loved getting to know the patients including their families, pets, house, and hobbies. Their openness, vulnerability, and grit are so special!”
  • “I was in Maine, and loved the community. My patients gave me great hike and restaurant recommendations, which I loved to explore on the weekends then talk about it with them the next week.”
  • “A patient with PD who I had been working with on neuro re-education gave me a hug at his last appointment and told me to keep working hard and he would really miss me! It was cool to really experience effective change in patient care when using the things we are learning.”

My clinical experience ended up being refreshing and informative. It reminded me of my “why.” It was marked with diamond days, like the day I ran my furthest ever (thank you, sea-level oxygen levels), the day a patient brought me a detailed list of her favorite fly-fishing spots in Virginia (sharing your secret spots is a big deal in the fly-fishing world!), and the day I spent hiking through Shanendoah National Park with an old college friend. And of course, there were rocks – like the solo road-trip that seemed to last forever but was crammed into a weekend, and the discouraging feeling when a patient expressed their right to not be treated by a student.

Now that we are back in classes, we are seemingly barely holding on to the in-person component and constantly having to be prepared to slip. We are counting down the tests and practical exams left until our long-anticipated winter break. This general stress is combined with individuals fighting their own battles. Yet, there is still joy. For instance, Dr. Shelene Thomas spends the beginning of every zoom-class playing her favorite tunes. This small tradition serves as a great example of playing the hand you’ve been dealt; she coordinates her virtual class with grace, empathy, and transparency. It reminds me of how the song “Walls” settled my anxious thoughts on my drive to my clinical and how I am always surrounded by “hearts so big.” 

Overall, I am thankful for my professors and classmates who I can lean on in my valleys, but celebrate with on my mountains. Our class boasts an overwhelming triumph of learning in any environment as we discover who we want to be as therapists.

By Suzanne Peters, along with my peers in the class of 2022 

The “mountains and valleys” concept was inspired by the beautiful scenery we got to take in across the United States.

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