Rotation roundup: Physiatry

I’m in the process of catching up on posts – I say “process.”  What I mean is “harrowing task.”

I keed, I keed.  Got a few things on my plate at the moment, not the least of which is waiting for interview offers from CaRMS, and not the greatest is trying to record some stuff for my annual disc.

But carry on my wayward son, and whatnot.

If you’ll recall, I was in Halifax a few months ago for a 3-week elective in physiatry and a proper debrief is a little overdue.  Halifax is a drop-dead gorgeous city and I couldn’t be more blessed to spend a few weeks there, soaking it all up.  The weather was lovely for the first week… then deteriorated rather rapidly as late fall turned to early winter.  Who knew rain could fall horizontally?

The where:   Nova Scotia Rehabilitation Centre

The good:  In a word, comprehensive.  As in, comprehensive care.  I absolutely loved being involved in nearly every aspect of care; when dealing with a new spinal cord injury, it’s not just a medical issue.  It’s a social issue – it can affect their ability to work, it can make their home unlivable, it can prevent them from driving a car… it’s incredibly complex and it requires the entire team to address all of the little changes.  Working so closely with the other professions was a real treat and everyone works together in a wonderful way.  It was eye-opening to attend so many family conferences.  And (okay I think I say this about every rotation) the patients are often really remarkable people.  Young people with traumatic injuries, middle-aged folks with multiple sclerosis… And don’t mistake me, these would be remarkable people without illness.  They’re in tough situations and the amazing progress they can make on the rehab unit is always a lovely surprise.  (Also, Halifax is pretty.  As earlier mentioned.)  Also, procedural stuff galore!  (Joint injections, Botox, etc.)

The not-so-good:  Again, these are tough situations.  Generally, the prognosis for many of the conditions the physiatrists work with are poor and progressive.  It’s not depressing so much as it is challenging, but it weighs on you when people (patients or families) are really suffering under ALS, spinal cord injury, whatever it may be.  As well, what progress they achieve can be quite slow and has very little to do with the medical care the physician provides.  Physiotherapy and occupational therapy are the big players in rehab, and we’re there to best support and enable them to do their jobs.  And while it’s great to watch someone recover their strength after a bout of Guillain-Barré syndrome, there’s none of that addicting cause-and-effect reward from medical treatment.  Again, not a bad thing, but something I missed.

The verdict:  A great elective, and I feel much more comfortable dealing with things like MS and SCI.  They’re not common, certainly, but I feel like it’s an important knowledge/skill set that I should be able to provide.

Thanks to the folks at the NSRC, had a wonderful time!

 – Atalanta

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