A SISTER'S INSPIRATION. A THERAPIST'S PROVISION. A STUDENT'S INNOVATION. A PATIENT'S REHABILITATION

Last week I mixed things up. I left CHAD. This may or may not be a surprise to some. I loved my CHAD posting, but my love was fickle and conditional. I loved my days with Sam when we were out in the villages MacGyver-ing up treatment plans and adaptations for patients in the remote areas of Vellore. I struggled, a lot, through my days when I was simply an amateur photographer posing as an occupational therapist. Although I loved seeing the village life, and was challenged to capture it in time, I didn’t come here for that purpose. I once again felt the chains bind me. Last Friday I had had enough. I changed my posting to OPD (Out-Patient Department) back at the hospital. I had spent some time observing there, and this blog will give you a brief overview of life in OPD. My return to OPD was not just as an observer, but as a student therapist.

My mentor in OPD was Alok. It has been a pleasure getting to know him as a friend, and this week provided the opportunity to get to know him as an occupational therapist. I have had a variety of OT mentors throughout my stay here. All have provided me with different perspectives, different insights, and different learning objectives; however, only Alok provided me with patients and “carte blanche” regarding treatment. He would introduce me to a patient, brief me on the diagnosis, explain his therapeutic reasoning behind treatment, and the ask me to take over with suggestions. This was how we tag-teamed the week that way.

He may not have known it, but by tossing me at a patient Alok was forcing me into a completely new place of discomfort. A place where growth happened. I had flashbacks to my first day of campus clinicals where I felt like I didn't know what I was doing and yet needed to treat a patient—only this time I had no way of communicating with my client. So I wiped the sweat off my hands and got to work.

My first patient was a burn patient. She was a young woman from West Bengal who had been burned a year and a half ago and was at CMC for some reconstructive surgery and therapy to increase bilateral hand function. It was her hands and arms that were our focus. I was drawn to her. She was quiet, shy, and worked incredibly hard. She never questioned anything we asked her to do. She never said anything was too hard for her. She never said she was tired of doing an activity. (I need to be more like her.) When Alok asked me to find some activities for her, I did my best to hide my blank stare. I had very little idea of the resources that were available in the clinic for hand function. I was handicapped.

After my initial shock wore off, I set off to find some equivalent of theraputty. What I found was play-dough that had seen better days. The fact that it crumbled into pieces when I squeezed it made me think that it probably wasn't going to do much to help me. I scurried to another corner of the room to find something else that might work. In stuffing my hand in my pocket, hoping to find some inspiration there. My hand hit a piece of paper. Perfect. Paper cranes. We would make paper cranes. And so we did. And she loved it. In fact, it was an activity she asked to do with more regularity.

Her paper cranes.

Although we hit upon a winner, we couldn't just fold paper for four hours. My initial handicap become my saving grace. Because I didn't know what resources were available, I came up with an activity to do and then set out to find the materials to accomplish the task. That evening I found the supplies to make play dough and made a batch for OPD. This also became an activity of choice for my patient. She was sent home with a small amount and practiced making jungle animals when she wasn't at the hospital.

An elephant

By the second day at OPD I had my sea-legs under me and was ready to get creative. I was handed a stack of newspaper to use as a resource. I had no idea what I was going to do with it, but figured that if I could find scissors and glue, we could come up with some to challenge her hand function and engage her in interesting activities. I had my patient sculpt with her dough while I stalled for time. Click! The light came on. My sister makes pretty awesome felt dahlias for clips and broaches. I didn't have felt, but surely I could come up with a way to make them out of newspaper. And so we did. It challenged her, but she stuck to it and was proud of her accomplishment. I was a little bit proud of my accomplishment as well. My client’s thumb to first finger opposition had increased ever so slightly over the past two hours and she didn't even realize it.

Cutting news.

The finished product.

My sister had inspired me. My mentor was receptive to my odd, out-of-the-box treatment activities. My patient had increased hand function. And I had the opportunity to get innovative and make a patient smile.

(Side note: Attempting to speak in Tamil to patient will also elicit a smile... often laughter as well.)

Working on wrist extension with a patient who hadn't really been too excited about showing up for therapy. After he learned this game, he went home and taught his twin daughters how to play. He brought in their game to show me, and was eager to drop any of his exercise activities to play again with me. He was tricky at it too! 

He won... more often than not. I loved being able to communicate to him through this activity. It was our common language. And we laughed a lot.