It’s not All about you…

I forget frequently of how often it is not about me… and by extension, it is not about you either.  As is human nature we take all interactions personally with a strange self-importance to their substance.  But it is rarely about us.

We forget the 8 things that the patient did over the weekend that could have affected their outcome, and only lay importance on the TherEx we gave or the joint mob we did on Friday afternoon. We rarely consider the random activity the patient did, the medication effects, the visit from the favorite sister, the mother-in-law that just moved out of their home… no, it was us that had the most impact on them.

And the patient believes it too.  Because we mention

Scientific Reasoning in the Clinical Examination – An Intro

Are you tired of seeing “stuff” like this? (I mean who’s he even talking to??)

Or maybe this? (Uhh…

Tell me a story: A metaphor for understanding analogies

Start here, with this TEDtalk-

I like to use a story or analogy to explain things to patients.  It helps me come into their world and attempt to contact them on their own turf.

It’s not that patient’s are dumb, and can’t understand concepts or facts and figures. Stories are just a great way of conveying information. Adriaan Louw points out that when we are little children we have stories read to us (Aesop’s Fables and the like) that illustrate points, morals and teach concepts. You listened to the story and you got the point to that story, so it starts very young.

When you are on a cruise or on a bus or meeting people for the first time at a restaurant, why do you tell stories?

Think about it…

How do I help my patient get better? It may depend on many things, the disease, injury, co-morbidities, etc. And in many cases it can be hard to ignore big factors that “stand in the way” of recovery. Some patient’s are just tough. Complex. Hopeless.

Of course, we make sure to keep a mask on. We attempt to prevent our patients from seeing

Poor Posture Equals Pain, Right?

Img Cred: India.com

If you’ve been anywhere near a peer reviewed Journal in the past years you are well aware that the idea of positions equaling pain has been fully debunked (Eyal Lederman, Greg Lehman, Todd Hargrove, SportsDietPain ) The concept of poor posture = pain is still widely used (I won’t even list here…) but it is not backed-up by pain science.

Or is it?

Poor posture can indeed increase the chances of pain. Now, posture is a state.  An act.  A positioning of one’s self. Psychology tells us that if we stand tall with a smile then we will feel more powerful and be a more agreeable person.

“Kahneman writes about test subjects given a pencil. In one set of tests the subjects are asked to hold the pencil between their teeth horizontally. In another the same subjects are asked to purse their lips around the eraser end of the pencil. Then the subjects were shown cartoons from Gary Larson’s The Far Side. Those in the first group, with the horizontal pencil, were more likely to find the images funny than the second group, with their lips pursed around the pencil’s eraser end. What’s going on? The researchers concluded that clenching the pencil horizontally yielded a “smile,” with cheeks pinched back and the outer edges of the mouth turned upwards. Those holding the pencil’s eraser end in their mouths yielded a “frown.”” – The Observer

So our body position affects our perception of reality.  And pain is perception of stimuli as well.

It makes us feel better to have “correct” posture. (recommendation: spend 20 min with this TEDtalk)