Rehabilitation Medicine (JOINT journal entry)
August 22, 1998
Saturday
Dear everyone-on-my-generic-on-line-journal-of-internship mailing list,
Hello! This installment of the journal is about my 2-week rotation in the Department of Rehabilitation Medicine, which happens to be my specialty of choice. Duh? For people who do net know about this young field, Rehabilitation (a.k.a. Physical Medicine & Rehabilitation, PM&R or Physiatry) is called the “quality of life” specialty. Physiatrists (like me in the future) treat patients who have had spinal cord injuries, trauma/accidents, stroke, burns, arthritis and other joint/musculoskeletal problems, and generally any kind of disability. These patients are referred to physiatrists after the initial injury has been managed by, for example, an orthopedic surgeon or neurologist. The physiatrist’s job is to make them better, to help them “live” instead of just “exist”. PM&R deals mostly with long term management rather than diagnosis and the immediate treatment. Physiatrists prescribe exercises, medications, braces and splints (known as orthoses), artificial limbs (prostheses), and physical modalities to help the disabled (differently-abled, to be politically correct). Physical modalities are heat, cold, ultraviolet rays, etc. – which is why the field is called “physical medicine”. PM&R can also deal with non-operative orthopedics – for example, a patient with scoliosis can be treated with a body brace if the scoliosis isn’t too bad; if the spinal curve is severe, the patient should be referred to an orthopedic surgeon to straighten the spine with a metal rod implant. Physiatrists head the “rehabilitation team”, composed of physical therapists, occupational therapists, speech pathologists/therapists, nutritionists, nurses, respiratory therapists, social workers, psychologists, and whoever else involved in making the patient better. No emergencies in this field, which makes its practice generally limited to office hours. Meaning, if I become a physiatrist, I’ll have time for my many other interests 😀
Attesting to the light (“benign”, in med lingo*) schedule of this specialty is the fact that we only had to be at the out-patient department (OPD) every other day. On the other days, I was free to play the piano, go [window] shopping (!), have lunch with high school friends (Donnaville and Valerie, who are both in med school too), bum around, and – oh yes – study. On some “free” days we had lectures and the like, which we were required to attend also.
PM&R is the last rotation before Internal Medicine which is a 10-week “core” rotation for us – if you don’t know Internal Medicine, you don’t know the business of being a doctor. That’s how important it is. Right now, I’m in the 2-week OPD part of Internal Med, after which I go into 8 weeks of ward work (in-patient) and emergency room stuff. I don’t think I’ll be coming home for that whole 2 months, so that journal installment will have to wait.^ Until then, take care of all of you.
– Future Physiatrist
Notes:
* benign = light rotation; malignant = busy, difficult rotation; can also be applied to people. A benign person is what American medical culture calls a “white cloud”, so when they are at work it is a relatively easy shift. A malignant person is the equivalent of a “black cloud” in the USA – when the person is at work, all craziness happens during that shift.
^In 1998, internet was accessible through a dial-up modem – i.e., it was not ubiquitous. I did not have reliable access to the internet and my email when I was away from home.
This journal entry was written in 1998. I decided to pursue Rehabilitation Medicine in the previous school year during clerkship (probably in late 1997 or the first quarter of 1998), and after I had rotated in the department during that year. That decision-making process is for another blog post.
I am wondering why I chose to use “Physical Medicine and Rehabilitation” (PM&R) in the text, instead of “Rehabilitation Medicine”. The Philippine term is “Rehabilitation Medicine” while “PM&R” is used in the USA. I did not know at that time where I was going to do residency, however I did have a whole bunch of education material about PM&R that I received in the mail from the American Academy of PM&R because I asked them for information about the field.
Yes, I actually signed it “Future Physiatrist” in 1998… and here we are, the future, on a blog.
JOINT is the Journal of INTernship, a series of email messages to family and friends (“journal subscribers”) written during my yearlong medical internship from May 1, 1998 to April 30, 1999. Internship is one of the requirements before taking the Philippine Physician Licensure Examination (also known as the Medical Boards). Journal entries were edited for clarity in January, 2020. Read more about it in the first blog post, Introducing JOINT.
