REHAB: THE DAILY SCHEDULE.... MORE OR LESS

I am writing this post, and those hereafter, from a very different place. Well, at least geographically speaking. My physical being is now stateside, but I’m afraid that large portions of my heart and mind are still lingering on the other side of the globe. Last Friday marked the one month anniversary of my return to Washington. I could try to explain why it has taken me over a month to finish out this blog, but frankly, the details are not really that important. What you need to know is that 1.) come hell or high water I will be completing this blog, 2.) it may take me a while and a few posts.

The last six weeks of my fieldwork posting in India, were spent at the Rehabilitation Institute at CMC. This facility is located across from the CMC College Campus at Bagayam. My commute to work every morning was a simple ten minute walk that I generally took with Charlie. The two of us would stumble through the rehab campus turnstile at around 7:55am every morning and quickly discuss whether or not we were to meet in the chapel, library, or the separate gyms. You see, to us it seemed that nearly every morning started in a little different way and we were never quite sure what day started in which way. Monday morning the whole rehab staff would meet in the chapel for prayer and devotions followed by a lecture in the library. The order was reversed on Fridays, and every other day of the week was devotions at 8am in our respective gyms. However, this schedule seemed to change on us without warning. Either that or we were just never awake enough to figure out the schedule by the time we arrived on campus.

 

The entrance to the Rehabilitation Institute. A virtual tour will be given in a subsequent post. 

After devotions, or the lecture depending on the day, I would traipse on up to the first floor OT gym where I had been assigned a position working with patients with spinal cord injuries. Our early morning patients were generally getting ready for therapy by the time we made it to the gym. I would seek out my patients and note their progress, while stopping to exchange greetings with other patients who had become more than just familiar faces to me. For the next two hours or so, or until the ten o’clock tea break, I would engage my patients in as many activities I could conjure up to help them gain independence in their lives. Sometimes I would be out hunting down a car to practice car transfers with, other times I would be found covertly sticking tiny little beads into play dough for my patients to dig out for increased fine motor function. Or, sometimes I would duck out to scavenge cheap, random items to MacGyver a patient’s wheelchair into a safe and effective mode of transportation. Every day was different, and in every day the mundane was somehow transformed into the monumental.

 

My Patient Zero practicing upper body dressing with a button hook and epic levels of determination. Don't mind the spoon. I generally don't involve eating utensils in my clothing donning/doffing sessions! 

Patient Zero out on a little morning adventure to increase wheelchair mobility over various surfaces.

At ten o’clock the patients would file out and shop would close up while at the therapists rendezvoused at the rehab canteen. Because I was often too lazy to rise early enough for breakfast, I was generally famished by this time and eager for a hot dosai and tea. If luck was on my side (or perhaps if it wasn’t???), I would also be fed a bull’s eye, half-cooked omelet- Sunil style, or some other random morsel. Or all of the above. Out of politeness I never argued, but let’s just say that sometimes I left the half-hour tea break wondering if I would ever need to eat again.

The next two hours would be spent much like the first two hours of the rehab day, only this time with the second set of patients. While the early session patients were in occupational therapy in the mornings, their counterpart had been hiding out with the physios. After the tea break the groups switched places. Bottom line: all patients at rehab received six and a half hours of therapy a day, either with OT or physio. At twelve thirty we would send our patients back to their rooms for lunch and a rest while we ourselves found food and rested. The lunch break was from twelve thirty to two- enough time to run down to our favorite juice shop for a cool drink (or three) and catch up on emails or finish other work/research.

 

Shaving coconuts! One of my late morning patients (C6 SCI) working on handling an adapted straight razor prior to using it on his face. 

Once he cleanly shaved the coconut, we went on to shaving a balloon. If he could shave the balloon without popping it he could then move on to shaving his face. His determination for perfection was incredible. I have many lessons to learn from this man. 

The afternoon is where things started to get tricky. If I haven’t confused you yet, just hold on… I’m about to tie your brain in a knot. Monday afternoons, from two to four-thirty, PMR 1 patients had rounds. This meant that the PMR 1 therapists and patients would meet in the recreation hall and discuss patient progress, complications, etc. with the whole PMR 1 medical team (doctors, nurses, social workers, therapists, etc.). While PMR 1 patients were in rounds, the PMR 2 patients would be in therapy, either OT or physio depending on which session they had attended first that morning. If they had been in OT first that morning, they would be found in OT that afternoon. On Tuesdays and Wednesdays from two to four-thirty, all patients could be found participating in the therapy session which they had first in the morning. On Tuesday afternoons from three-thirty to four-thirty, everyone would break up into totally different small groups based upon their injury and/or native language for small group session activities. On Thursday and Friday afternoons the patients would participate in the therapy session which they had attended secondly that same morning. (Example: If a patient had OT from eight to ten and physio from ten-thirty to twelve-thirty, then when they returned at two they would go back to physio.) This was true of all patients… except for PMR 2 patients… on Fridays. On Fridays the PMR 2 patients had rounds at ten-thirty, so their afternoon session would be whatever was supposed to be at ten-thirty on a “non-round” day. Confused yet? One last thing, on Mondays as Fridays from eight to nine in the morning there were classes held for PMR 1 and PMR 2 patients respectively. These classes were divided into traumatic brain injury and spinal cord injury groups. And you wondered why Charlie and I never seemed to know what was going on when we walked through the turnstile every morning… The schedule took a few weeks to figure out. And just when we thought we had it figured out, it would change on us. Or maybe we never really figured it out.

 

The First Floor OT gym in full swing. 

Patient Zero and Raja (his lead therapists) discussing treatment sessions for the day.  Behind them is the schedule of who comes to the gym and is seen by which therapist at what time. I lived by this board in the beginning. 

Regardless of who was going where at what time, by four-thirty I was generally ready to get off my feet and let my head settled down a bit. This was often accomplished by wandering over to the canteen for a cup of tea, or setting up my computer in the library to check email, research, or write. Or both.

The Rehabilitation Institute operates on a perfectly orchestrated schedule and regardless of whether or not I was able to figure it out, I learn so much more than just how to manage a funky schedule. More on my lessons learned in the next post to be covered in my next post.