Focus Pocus

Intention was written on one of my ACMAS's last week.  For those who are confused as to what an ACMAS is, it is an evaluation of your patient encounter.  I have talked about these evaluations previously. The only word I have seen on an ACMAS since I left the campus clinic, is intention.

Dr. Roberts is a peculiar little lady.  She has been in practice for nearly 30 years or more and she has a knack for chiropractic (go figure).  Her ability to find a movement restriction by looking at the body is remarkable!  I still have no idea how she does this and to tell you the truth, it stresses me out!  My respect for her has grown throughout the last few months at the CIC.  Primarily because she has saved my sorry ass many times with patient care.  Not to make myself look bad (I hate that), but she really does step up for her flock when she is needed.

For instance, I have a patient at the CIC who doesn't like to be adjusted even though there is every sign present suggesting otherwise.  Every time I go to adjust a restricted joint, the patient tenses up because there is fear of getting hurt.  I assure the adjustment will be therapeutic and not injurious but still I get blocked by tense muscles.  Instead of plowing through the tightness, I decided to just try to relax the person by focusing on stretching and massage.  This seemed to worked well and I got the neck and upper back muscles to calm down.  I went back to the neck to see if I could get the segments moving I was interested in and I was blocked again!  Not good.

I marched down the hall to Dr. Roberts and told her the patient was blocking my impulses and the segment causing the patient pain was in need of a good adjustment.  She set up on the patient, adjusted the segment in a translational type movement and the patient was given instant relief!  I was amazed.  She told me that patients who block rotatory adjustments respond well to translational movements because they can't really block them.  Interesting.

She told me to have intention.  I took this badly, of course because I felt as if I have been trying hard to give adequate patient care since I have been there.  The remark wasn't about adequate patient care, it was about centering myself mentally prior to and during patient care.  Those who have worked with patients in this manner know very well that if your mind is elsewhere, the visit goes south quick.  I personally have an issue with this because I tend to get super exhausted from thinking so hard.  The simple remark to have intention was exactly what I needed to become a better student doctor.

I feel very fortunate to be given the opportunity to work with Dr. Roberts.  I know she can be harsh at times and sort of push us around, but I truly think she does it for our benefit and for the benefit of her large/loyal patient base.  If I were in her shoes, I don't think I would change much.  There is always some small details in need of tweaking, but for the most part, I think she does a great job.

Intention is a weird concept.  We have to use it during exam preparation and patient care, but in totally different ways.  The most challenging thing I have had to accomplish thus far is this concept.  Each day, it gets easier, particularly if I know what's heading my way.  Shooting from the hip and going in live has never been my strong suit, but it is Dr. Roberts' greatest attribute.

All for now