Apparently I never posted my paper...

English 250

Matt Beth

            As the “baby-boomer” generation nears the age of retirement, the demand for physical therapists is increasing at an exponential rate. Physical therapists, diagnose, comfort and rehabilitate individual’s who have either had an accident that has impaired their movement or if an individual’s movement has been impaired due to aging. When a patient goes in to see their physical therapist the diagnoses that they receive are more often than not negative and hard to hear. Given these situations, physical therapists must deal with the delivery of their news with great care and tactfulness. Across the board in the medical field, including physical therapy, a balance between professionalism and understanding is crucial in successfully delivering negative diagnoses and prognoses.

            Clearly, a medical professional isn’t going to approach his or her patient saying, “You broke your foot and you can’t walk for weeks! That sucks man!”. A certain level of professionalism and bluntness must be kept when conveying such news.  When discussing this topic with a family friend who was also my former physical therapist, Brian Schmit, he had this to say “The best way we do this is to make sure they are involved in the process and lay everything out for them so they are engaged with their plan of care.” (Ryndak). He went on to describe how he likes to be blunt about every part of the process of treatment and that in doing so, the patient is much more driven and hardworking. Brian also stated that a big part of what his talks consists of forming goals with his patients. Setting out a plan of action leading to an end goal is also conducive to a positive mindset. Without a positive mindset and consistent hard work, it is extremely difficult for a client to rehabilitate back to 90 – 100% normal functioning (which is what a physical therapist’s goal is to reach). In an article entitled “SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer” six different oncologists came together to describe the methods in which they deliver “breaking bad-like” news to their patients. While obviously having cancer and having a torn anterior cruciate ligament are two very different ailments, the same core concept of bluntness and goal setting can be seen even in the extremeness of oncology, as well as across the medical field. The oncologists wrote “Patients who have a clear plan for the future are less likely to feel anxious and uncertain.” (Baile, 8) which runs parallel with what Brian Schmit and I had discussed in our interview.

            While having professionalism and being blunt are key factors to successfully delivering negative diagnosis, one must also have a certain level of empathy. Empathy in its simplest form is one’s capability of understanding and sharing the feelings that another person has. This is a crucial characteristic for a physical therapist because without it, the therapist would come across as cold and uncaring, thus driving a wedge between the therapist and patient and leading to a negative attitude towards the recovery process. Empathy is one of the strongest ways to form a connection or bond with another human being, which is half of the job of a medical professional. In the article mentioned earlier “SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer” the six oncologists also pointed out the importance of support and understanding. In the process that the doctors describe, they broke it down to the smallest finite details such like body gestures to show understanding which is exemplified by the quote “Maintaining eye contact may be uncomfortable but it is an important way of establishing rapport. Touching the patient on the arm or holding a hand (if the patient is comfortable with this) is another way to accomplish this.” (Baile, 5). While having empathy and being understanding might seem simple or common sense, Carol M Davis would argue otherwise. Davis is a professor in the department of orthopedics at the University of Miami and has received multiple awards for her work in physical therapy and human socialization. In her article “What is Empathy, and Can Empathy Be Taught?”, Davis tackles the fact that most people struggle with the concept and implementation of  empathy. She continues on to say that empathy cannot be taught but rather must be learned by one’s self and it comes from within. By having no way to truly learn empathy and the concept of empathy being as ambiguous as it is, a physical therapist’s delivery becomes much more complicated and must be approached with great care, in order to not come off as cold or uncaring.

            With the proper blend of direct information and understanding and compassion, the unpleasant task of delivering a undesirable diagnosis and/or prognosis becomes easier not only for the medical professional but the patient as well. When delivering the news,  one should be honest and upfront about all information regarding the client’s situation, it is after all their body and they have the right to know all the details. It is also extremely important to set goals after delivering all the details. This leads to a positive mindset and the patient is prone to be hardworking in the road to recovery. Throughout the process, providing support and comfort for the patient is crucial, no matter the how extreme or minute their medical situation is. If all three factors can be achieved, bluntness, goal setting and support, the patient will be in the best position possible, mentally and emotionally, to start down the road to recovery and rehabilitate as fast and as well as they can.

I used sources from my annotated bib for my works cited

·      Ryndak, Nathan M. "Interview of a Physical Therapist." Telephone interview. 13 Mar. 2014.

·      Davis, Carol M. "What Is Empathy, and Can Empathy Be Taught?" What Is Empathy, and Can Empathy Be Taught? Physical Therapy Journal, Nov. 1990. Web. 12 Mar. 2014.

This article breaks down what empathy really is and how it can and should be used in our everyday lives. Empathy is a clearly an important contributing factor in delivering bad news to a client and their loved ones, which is why I added this article

·      Baile, Walter F., Robert Buckman, Renato Lenzi, Gary Glober, Estela A. Beale, and Andrzej P. Kudelka. "SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer." The Oncologist. N.p., Aug. 2000. Web. 12 Mar. 2014.

         This article goes over the step-by-step methodical process of a oncologist delivering negative cancer diagnosis’. This will be a good article to use to compare and contrast to they way physical therapists deliver news that is of a lower caliber.

·      Fallowfield, Lesley, and Valerie Jenkens. "Communicating Sad, Bad, and Difficult News in Medicine." The Lancet 363.905 (2004): 312-19. Science Direct. 24 Jan. 2004. Web. 12 Mar. 2014.

This article also shows how certain professions deliver unpleasant news in the medical field. This will also work well in my research paper for comparing and contrasting methods

Graduate Research

I went to the poster presentations and met a woman named Elizabeth Boyer who told me about her and her partner's (Timothy Derrick) research on the effects of forefoot and hindfoot strikes on one's knees. a forefoot strike is landing on the front of your foot when you stride, and hind foot striking is landing on your heal (more common). Her research shows that if you use a forefoot strike, it is better for your knees though if you don't gradually make the change from hindfoot to forefoot, it will lead to injury

Research Paper ideas

My only idea so far for my research paper is investigating the best/most successful ways of delivering negative medical diagnosis to patients (since I'm going to be a physical therapist). Other than that, I'm lost.

Textual Rhetorical Analysis

English 250

Matt Beth

            For as long as we all can remember, there has been a constant juxtaposition between the proper rehabilitation techniques of heat vs. ice. Lenny Bernstein, a journalist for the Washington Post, attempted to tackle this issue in his article “Ice, heat or a little of both? How do you recover from a hard workout?” Within his piece he interviewed two local professionals to compare and contrast their views on recovery practices, letting the reader formulate their own opinion on what practices are best based on the juxtaposed views.

            Bernstein begins his piece as any writer does, with a brief intro covering the background of the topic and the methods through which he will address the issue. He explains how the classical form of rehabilitation has always been icing the post workout areas, though the science backing this method may be flawed. He then introduces the two individuals that he interviewed: Robert Gillanders, a physical therapist and spokesperson for the American Physical Therapy Association, as well as Steve Hays, an impressive marathoner and a high school track and cross country coach.

            Bernstein then moves to the actual body of his article, comparing and contrasting the two view points trough a series of 3 questions. The first is “Your athlete or client has just completed his hardest workout of the week. What is your advice about recovering quickly and effectively?” Gillanders ultimately responds saying that if he had to choose, heat would be the best option, claiming that it allows for hydrostatic pressure and certain stretching needed for recovery, whereas the cold just postpones the healing.

Hays however suggest a combination of heat and ice, alternating on 10-minute cycles. He explains that he uses this method in an attempt to gain the benefits from both methods. The following two questions just divulge deeper into how the men interviewed came to use their respective methods and if they have any exceptions for methods.  

            Ultimately, I think Bernstein successfully and objectively gave the reader a good idea of the variation in methods and the reasons, athletic professionals have for their methods. One of the major ways that he accomplished this was by the format and organization in which he represented the information. In his article, he wrote each main question that he asked in bold and then had each person’s respective responses directly following it. Prior to writing out each of the interviewee’s responses, he listed their name in bold. This made the article very reader friendly and made a clear separation in the different points of view. In articles with medical content, it is very easy to quickly lose the reader and bore them. I mean lets face it, anatomy and therapy isn’t the most exciting thing ever (unless you are a complete nerd like yours truly). Bernstein does a fantastic job at keeping his piece simplistic and easy to follow through the structure that he used.

            While I did think that Bernstein did a great job of giving a general and objective view of the issue of heat versus ice, I did draw an issue with his article, which was the credentials of the people he interviewed. As I stated earlier, Gillanders is a certified physical therapist and a spokesperson for the American Physical Therapy Association, whereas Hays is simply a High school coach and a marathon runner. I think this discrepancy in credentials discredits Hays’ information a lot and ultimately diminishes the argument that he makes. Were Bernstein to interview someone with a higher level of credibility, I think his piece on the variance of therapy methods would have been stronger and would have given the reader more information to consider.

            I really enjoyed reading Lenny Bernstein’s article “Ice, heat or a little of both? How do you recover from a hard workout?” and thought it was a very important and well-written piece. It was perfect; in it’s simplistic nature, for the average reader and those who may not have a lot of background information on the controversy. With his intended audience in mind, I think Bernstein did an excellent job but for anyone digging deeper into the information, I think his sources could have been stronger. Either way, Bernstein successfully completed his goal of delivering a general outlook on the ongoing debate of heat versus ice for the readers of his articles.


http://www.washingtonpost.com/lifestyle/wellness/ice-heat-or-a-little-of-both-how-do-you-recover-from-a-hard-workout/2013/04/16/59ea8116-a388-11e2-9c03-6952ff305f35_story.html

Visual Analysis Essay

http://www.medicalook.com/systems_images/Skeletal_Muscle_Fibers.gif

English 250

Matt Beth

            The image that I chose is a diagram of a strand of muscle, which is intended for anyone in the medical field or anyone who intends to be. It shows the viewer just what a major muscle group is composed of, what each individual part looks like as well as labeling all the parts to educate the viewer on such things. I found this image on a website called medicallook.com which is dedicated to breaking down the human anatomy and its various ailments into easier information to understand. Medicallook.com is updated often and has been updated already in 2014, keeping the information up to date and current.

            In the diagram, all the major parts are displayed and labeled. The image includes a bone, a tendon and the actual muscle, which is sliced in half to show the various fibers, blood vessels and bundles with their respective connective tissues within the muscle. An easier way to think of this is by thinking about a long strand of muscle, a bicep for example. Within that single strand, there are multiple more strands called muscle bundles, which are wrapped in connective tissue. Within these bundles are more strands, which are called muscle fibers, each of which are also wrapped in their own connective tissue.

            As a physical therapist, clearly I have to know a lot about the human anatomy. My job will always revolve around know the in depth knowledge and manipulation of the human body. Muscle and tendon issues are arguably the most common problems that physical therapists have to treat. Because of this, diagrams such as the one from this site become incredibly useful in understanding the client’s infirmities. For example, a muscle strain or sprain is the over extension or tearing of the either the tendon or the muscle fibers, both of which are displayed in the diagram.

            I feel this picture as             a whole, represents the common core of all physical therapists, and any medical professional for that matter. Within this relatively simple picture, you can derive so much information. You can tell what a proper muscle should look like, the function of each piece of the muscle, certain issues that could result with the muscle and so much more, as long as you know what to look for. This is very similar to any medical profession, especially physical therapy. As a physical therapist, you’re not always given a clear idea of what exactly is wrong with your patient and furthermore, how to best treat them. For example, a patient may come in, complaining they have sharp pain in their lower back. Generally the person wont have any physical signs of the injury on the surface level and the physical therapist will then have to feel with his hands and take in situational information to properly diagnose the person. Thus, each physical therapist has to draw upon what they already know and look for the tiny details to decipher the true implications of the person’s ailment, much like how one must take in all the small details in the picture to know the total amount of information that it provides.

            So how do you find these tiny bits of information for the diagram? Well certain parts are easier than others. Clearly it shows how a normal muscle should look, fibers making bundles, which make the entire muscle. That doesn’t take a whole lot of thinking. But the functions and possible injuries take a little more work and a bit of background knowledge. The functions of the fibers and bundles are to contract and relax for muscle movement, made simple by the shape and positioning of each strand. The formation of these is also precise to strengthen and protect the muscle. This info can be derived based off of inference and prior knowledge on the subject matter, much like how a physical therapist performs their work (by inference and prior knowledge). Figuring our possible injuries is found the same way. If these fibers we to be severed or over extended, the muscle will not be able to contract and function as it is supposed to. Injuries such as these are what we know as sprains and strains.

            As a whole, I feel like this diagram of a muscle not only pertains to my future career field but also represents my future profession as a whole. A lot of information can be derived from this single image, which runs parallel to the techniques physical therapists must use to successfully do their jobs. 

Summary reflection

English 250                                        

Matt Beth

In my Portrait of a Writer essay, I wrote a lot about how I thought my major strengths were in narratives and poetry. Since a summary is clearly neither of those styles of writing, I was very skeptical about starting this assignment. I’ve never really been a huge fan or writing academic pieces, especially one’s where I couldn’t include my opinion at all.

I think in general, I completed the assignment well. I believe I got all the criteria into the essay that I needed as provided an informative overview of Alan M Jette’s article “Diagnosis and Classification by Physical Therapists: A Special Communication”. Were I to be able to add my own thoughts and stance on the topic, I would have been able to drive a stronger argument and generate more to write about rather than adding “fluff” which I feel really diluted and diminished the quality of my essay.

I know we have plenty of other academic writing left for the rest of the semester and I can’t say that I’m really looking forward to them. However, after writing the summary, I have began looking at these future pieces as more of a goal, rather than just work that I have to do. I have seen where I struggle and get frustrated in writing academic texts and it is now my goal, as the semester moves forward, to fine tune and correct the parts of this writing style that I struggled with so much while writing our summaries.