A First

My first-ever Journal of Orthopedic and Sports Physical Therapy issue arrived in the mail! It looked so foreign in my hands. It felt like a revered document from another time, although I wasn’t sure if it was the past or future.

In my past, I’ve seen dozens of physical therapists receive a journal copy in the mail. Some tuck their copy into their work bags, or haphazardly throw their copy in the backseat of their car. Others simply leave their copy lying around in the clinic. This small token of our profession seems to be taken for granted by some.

Not for me, at least not yet. The arrival of the JOSPT came with a huge sense of wonder: I’ve joined their ranks. A year ago, I would’ve done anything to be in the position I’m now in. And now, here I am with a JOSPT in my hands, on the way to becoming a full-fledged PT.

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On Competition

Competition within a physical therapy program irritates me because it isn’t healthy, and it isn’t necessary at this level of education. My physical therapy cohorts are all hard-workers, they all care about mastering the material to hopefully become great physical therapists.  However, there are a few that are overly competitive.

I think it’s childish to see a guy walk up to one of the more timid girls, immediately declare that he received an “A” on the last exam, and bluntly ask for her grade.  It might as well be phrased, “Are you dumber or smarter than me? And can you say it loud so that everyone can hear?” I’ve also heard people guessing who in the program would drop out. How much more mean-spirited can you get? This isn’t a zero-sum game: a classmate’s good performance isn’t detrimental to you.

Competition to drive your own performance is all well and good.  But at the doctorate level, most people I’ve encountered are driven by their own goals.  Not by an insecure want to validate their intellect.  I can only speak for my program, but my cohorts go hard.  The diligence and hard work I’ve seen has surprised me.

I would like to see everyone make it through the program. It took hard work to get in the doors, and I can already tell it’ll take hard work to get out. So it would be a shame to see someone falter. During orientation, a professor talked briefly about how there’s no more competition: we’ve already made it into the program. It confused me at the time and now I understand why it was addressed.

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Opposed to Adipose

There are many scholastic benefits to dissecting a cadaver. But I’ll leave that for another day. For me, the greatest and simplest lesson from the gross anatomy lab experience is this: obesity will kill you.

From day one of lab, it was evident that adipose tissue (body fat) can accumulate almost everywhere and creates a myriad of problems. It invests every crevasse of the body: from your cheeks to your feet. It can get everywhere and anywhere. I wasn’t surprised that there was an unhealthy amount of fat on the anterior wall of our cadaver’s abdomen. I wasn’t even surprised that we had to dig through a thick layer of fat to expose the coronary circulation on our cadaver’s heart, which plainly suffered from cardiomegaly.

I was surprised to find that a thick layer of fat was on almost every abdominopelvic organ we extracted. The adipose tissue not only made every dissection session an arduous and painstaking process, it must have affected every body system when our cadaver was alive. Even if you only accounted for the fact that the fat abnormally distended every available fossa in the body, it’s pretty substantial.

As I said, if nothing else, it has made me more disciplined about working out. If I donate my body to science and it ends up in an academic cadaver lab, I don’t want to hear, “man, look at all that fat.”  Or, “there’s fat there? Well, what was I expecting?”

I want to hear, “man, this guy was so muscular and lean and attractive and rich!”


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Our Social Lives

Social life in physical therapy school is odd. I feel like I’ve known the people in my program for years. In reality, I just met them this summer.

My friends who are physical therapists warned me that PT school is like a black hole. You get lost in it. And it’s really hard to understand unless you’ve been through it yourself.

I’m in class with these people all day, every day. And when I’m not in class, I’m either studying with them or worrying about how I’m not studying with them. Even when we’re relaxing, we’re still talking about something funny that happened the other day in class or lab.  It sounds trite and stupid but it’s really hard to talk to normal people when you’ve been entrenched in this type of environment. This theory was very evident a few nights ago.

A group of us went out for a few drinks and significant others were invited. You know how sometimes you can really “hear” yourself talk when someone unfamiliar with the topic is around? A group of us were talking about dissecting the perineal region, and I realized how disgusting that sounded when I saw the look of suppressed, judgmental horror on a classmate’s wife’s face.

What? You’re not down with perineal skin and hair on your exam gloves?

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Today Was A Good Learning Day

Today, a lot of gross anatomy concepts clicked in my mind. Gross anatomy is a plethora of information. It is a steady sea flow of knowledge; when you’ve become accustomed to the force of one wave, the next comes crashing upon you.

Today, I feel like I’ve begun to master one wave. For example: all of the tributaries to the superior mesenteric vein and inferior mesenteric vein are part of the portal venous system. This makes sense because the liver acts as a filter for blood coming from the gastrointestinal area. Duh. I laugh at myself because it’s such a simple concept but it took me two days to actually realize that I’m being peppered with factoids pointing to the same thing — that the venous return in the mesentric veins ultimately drain through the liver. And it was really my first “ah ha!” moment in physical therapy school. Now that I have that overarching concept in my mind, it’s much easier to digest (see what I did there?) the details on that subject.

The only problem is that tomorrow we will be hit with even more information that requires a certain level of mastery, and then the day after that, and the one after. But maybe it’s the small victories that matter most.

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Formaldehyde Makes Me Hungry

I get super hungry after every cadaver lab session. In our normal schedule, the end of cadaver lab is the beginning of our lunch break. But even if I get out of the lab early, or if I’m in there in the evening after a long study session, formaldehyde makes me hungry.

It’s a weird sensation. You’re standing there amidst a sea of dead bodies, and all you can think of is how much you want a slab of ribs. It’s most confusing when the bonesaw is being used and you can smell burning muscle and adipose tissue. Talk about an omnivore’s dilemma…

In terms of learning, I don’t think it’s personally beneficial to have cadaver lab before lunch time. I can appreciate that the program directors want anatomy lecture early (while everyone’s minds are fresh), and then want practical implementation of that knowledge directly after. But some days I find myself so hungry that I just “want to get on with the damn dissection so I can eat.”

Today, unfortunately, was one of those days. Our cadaver lab sessions are patrolled by a mix of physicians, practicing professionals, and their teaching assistants. The physicians and other practitioners are excellent.  They show you exactly how to dissect your body, while sharing clinical knowledge and expertise that you can’t get from reading a textbook or looking at Netter’s. The teaching assistants are a mixed bag: they do more grunt work with dissection but each of them has a different opinion on what a hard-to-identify structure is, so oftentimes you’re left more confused. “That’s the accessory hemiazygous vein,”  one says. “No, that’s an intercostal vein,” another will overrule when asked for clarification independently.

The help my lab group has gotten has almost exclusively been from TA’s. Today, a former surgeon came over to assist us. It was great because he helped me understand all of the structures and tied clinical relevance into everything he was saying. But the downside was that the dissection took twice as long because he brought over another physician to confirm his diagnosis, due to one of the structures being abnormal. Then this retired surgeon brought over all of the TA’s for a mini-inservice. Then he called over some of the other  lab groups for more lengthy explanations.

So, it was great to have individualized clinical instruction. It’s something that I dreamed about before starting PT school: a freakin’ former surgeon walked me through a dissection for an hour. But at the same time my stomach was telling me, “Dude, we need to eat. Now!”

I know that it’s really short-sighted. From now on, I have to appreciate and absorb any knowledge that’s being imparted on me — no matter how much my daily needs make me want to hurry the session along.

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Races and Shoulder Impingement

I shot a local cycling race recently. It was actually a very cool event, but the physical therapy nerd in me marvelled, “gosh, those kyphosis-addled, shoulder impingement patients are moving mighty fast!”

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