Lightbulb Experience

[SportsMed09]

---

Members don't see this ad.

Would people on this forum be willing to share what moment in time or what experience made them say, "This is the field for me"? A specific patient who made it click, or some injury that you rehabbed, or simply the science of it, whatever. I'd like to know how others got into the field. Me personally as a student, i think the science of it is interesting, and though I've only shadowed a physiatrist for a day, I thought it was REALLY cool, and something I'd love to do for a "job".

 

[rb72md]

It was September of 4th year med school, I was doing an ID rotation and trying to decide between IM/ER/psych. We had a consult patient who had been transferred from a rehab hospital to the acute care hospital for medical complications, he was 19 or 20 and had a spinal cord injury from a horrible body surfing injury. Poor kid was quadriplegic. Had multiple admissions to the acute hospital from local rehab hospital due to infections etc. At the moment I went to do the consult, there was a physiatrist there from the rehab hospital and I observed his interaction with the patient. It was like waking up from the tough decision of picking the field I hated the least to seeing something I actually LIKED in medicine. It was great. It was personable, not based around a single organ system, comprehensive...
and I knew right then that it was for me.

 

[TRAMD]

Always loved neurology, muskuloskeletal medicine and my free time. As soon as I first read about physiatry I was hooked.

 

[axm397]

I really loved neurology when I did my 3rd year rotations but always wondered where those patients went after the stroke was correctly diagnosed, etc. I also had an interest in pain management but didn't like my Anesthesia rotation (early mornings, hot ORs with nasty surgeons telling you to put the table up and down, and I actually liked interacting with patients). the pain fellow at my med school was a PM&R grad and she first introduced me to the field of PM&R. I then went and spent a day at the JFK "PM&R day" during my 3rd year - and confirmed my interest. I set up rotations at JFK and Kessler and just LOVED it. I especially enjoyed my SCI rotation with Dr. Kirshblum. Prior to that rotation, I had never met a physician who was that compassionate and humble. He would stop and talk to patients who weren't even his, answer questions from family members and staff, push patient's wheelchairs to therapy sessions, etc. etc. He just went that extra mile to show patients he cared - and the patients loved him for it. I felt like I finally met a role model and a physician I can truly look up to - and decided that rehab was right for me. It really has been a series of confirmations since then - from interacting with fellow physiatrists at AAPM&R and AAP meetings to interviewing for my pain fellowships.

I think you do have to have a streak of independence in you to be able to handle the "no one knows what I do" situation. I actually enjoy teaching my patients and friends/family about what I do and what the field is all about. It's like you're a member of a secret club - the patients are usually really happy after I share what they think is very valuable information. Many patients go back and forth between their PCP and various specialists with no satisfactory resolution of their issues. To learn that there are other options for their rehab-able issues - they are really happy. I take pride in my profession and know that I have a set of skills that will serve my patients well. fellowship will only add to that skill set.

So a long winded answer to your "light bulb" question.

 

[rehab_sports_dr]

I had two lightbulb experiences:

1. When I was just starting medical school, I was recovering from a torn PCL in my left knee, and was training for an Ironman distance triathlon. I went to the main knee orthopedist at my medical school, and asked him about help in getting back to Ironman shape. He was very kind, but his consultation was limited to telling me that I was not a surgery candidate.
I went to medical school thinking I would do orthopedics sports medicine, but that made me realize that there was a big gap between the decision whether to surgery, and helping plan the rehabilitation program for the vast majority of athletes who don't require surgery.
I shared my experience with a classmate of mine who had been a physical therapist before medical school, and he recommended I learn more about physiatry.
That's when the lightbulb went on, and I never looked back

2. When I was in my last year of medical school and doing my medicine internship, one of my patients was admitted with some complications of diabetes. Her admission was very short, and when we were discharging her, I was concerned that we were sending her home to an environment that was suboptimal, and that she would likely rebound with further complications. When I expressed this concern to other members of my medicine team (and they were a very good team), it became apparent that they were not really designed to make sure that a patient was discharged to a suitable environment- they were really designed for management of acute crises.
That was my second light bulb moment that confirmed for me that the rehab model was the method of practicing medicine with which I was most comfortable. My experience as a physiatrist has confirmed this- we are really the docs that take care of the little things that prevent problems from occuring or reoccuring, and that is a very satisfying way to practice medicine.