Don’t look back in anger: Stories from the Upper Echelon

When you go to the tally office for your final clinic checkout, they’ll verify your clinic numbers and send you to a little-known office next door.

This, my friends, is actually typically the most time-consuming part of checkout.

The reason?  Because beforehand, they give you surveys to fill out.  These don’t take much time, but they have comments sections.  They’re supposed to remain anonymous–they even go so far as to tell you not to sign your name anywhere–but those comments are used as the outline for the Exit Interview [insert Dr Eckhardt’s voice booming “emmmbrrryyyooo” into his lecture mike].  We heard stories of some people being tied up in there for as long as 3 hours, but if there was space for comments I filled it, and my interview didn’t even take an hour.  That interview got me thinking back….way back…

Undergrad:  Ah, yes, undergrad.  The year 2006 was the last year in Parker’s existence that anything at that school would make sense.  After that, the school would not make a single good decision, but we’ll save that for later.

Undergrad rocked.  I learned more about chemistry in the first day of Mr Fick’s Organic Chemistry (O-Chem) class than I had in the previous 2 semesters of Gen(eral) Chem(istry).  Dr Perryman prepared us for no less than 8 future classes (we counted).

Tri 1:  The first trimester seemed to take the entire first year.  Dr G said they were going to put us under some stress, and he wasn’t lying.  I alternated between constipation and excessively soft stools for the first month.  My body scent changed.  I became sleep deprived.  I stressed out and subsequently turned inward.  I tried to write everything down.  I tried to hang on every word.  I tried to memorize every detail.  I literally drove myself nuts doing this.  Between the stress and an undiscovered gluten problem, I didn’t feel like I learned much new info at all.  It didn’t help that a still-busy massage practice encroached on my study time, and it often won.  So much for getting off to a good start.

I did learn, during this tri, how to say no.  I was still trying to adjust to all the new school demands, and my friends and family weren’t used to this yet; in fact, they didn’t really know what we were going through, so they didn’t know exactly how much stress we were under, and people made innocent requests that I simply couldn’t fill.  My plate was full–too full–and I learned how to push things back off when I felt overwhelmed.  I learned how to set boundaries and say no and not feel bad about it.

A piece of advice: palpate everyone!  You’ll be glad you got that practice later.  Oh, and you’ll probably have an Ipod (or something similar) by the end of the tri.  Ditto with a newer model cellphone.

Tri 2:  This trimester was all about tests.  Sure, we had plenty of tests in Tri 1, but we had more in Tri 2, more than practically any other tri.  They weren’t nice tests, either–Gross Anatomy, Biochem, Biomechanics, Microbiology, etc. Braham made the tri bearable.  Cadaver dissection was awesome.  There was an art to it.  I learned something, and I surprised myself: that I can dissect a cadaver, without fainting, and that it’s a blast.  The characteristic smell of a cadaver lab has faded from memory, but I’m sure it’d come snapping back should I ever step foot in one again.  I also learned that it’s good to cover up from head to toe, including a hat for the hair and disposable booties for your shoes.  I won’t say much more but let’s just say that Gross Anatomy got its name for a reason.

Main learning opportunity for Tri 2: how to cram for finals efficiently.  You see, this trimester’s final exams were about 80-90% old test questions verbatim, and they let you keep your old exams to study to boot.  So studying for finals was actually kind of a no-brainer.  Oh, and keep palpating!

Tri 3:  Finally, you get to adjust! Or so you’d think.  A lot of the classes are a continuation of subject area exploration begun in Tri 2.  You have Physio 2, Public Health (which is basically a continuation of Microbiology), Gross Anatomy 2, complete with a continuation of the cadaver lab, etc.  You have some blasts from the past like Philosophy 2 as well.  Newcomers on the scene are Neuroscience and an actual adjusting class.

Do not, by any means, think that just because you pass Diversified you’ll be a competent adjuster.  You’re not actually trying to adjust.  Yes, that is going to freak you out, as you imagine yourself 8 years down the road, after having had all this training, and you still don’t know how to adjust.  Well, that has happened; unfortunately, that’s not an unrealistic scenario.  Parker does indeed have a reputation (not only among its own graduates but also among field docs who graduated from other schools) for graduating students that don’t have a clue how to adjust.  So, carefully, start honing your skills on other students.  You didn’t hear it from me; I’ll deny I said it.

Main knowledge gained in Tri 3?  This was the tri in which I learned how to take serious, efficient, effective powernaps between classes.  Despite the bright fluorescent light overhead and people talking and milling about all around me (sometimes even trying to get my attention) I learned how to make a pillow out of my afghan, put my head down, and will myself (successfully) to go away for 10 minutes.

Tri 4:  Hope you enjoyed Tri 3, because it was kind of a break.  Finally, they’re nice to you, figuring you made it through Tri 1 and 2 and now you’re now “in”.

Top secret: the other reason they go easy on you in Tri 3 seems to be because they’re apologizing in advance for the buttkicking you’re about to receive this trimester.  Yes!  Let’s take Tri 1’s volume of material, plus Tri 2’s testing battery, and there you have it: Tri 4.  Let’s take the most important–and also time-consuming–classes and put them together in the same tri (despite the fact that we have several other trimesters to choose from).

Tri 4 is not a cakewalk, not that any part of chiropractic school is.  It’s your first hands-on adjusting lab, and you do it in the clinic, with staff doctors, which is cool.  You learn a few more things, too.  Now, don’t get your adjusting hopes up yet, though; you get to adjust 8-10 whole times during the entire trimester, which does not a manual medicine expert make.  But keep practicing.  Call it “deep palpation”, wink-wink, nudge-nudge.

What did I learn this tri?  Near the end of the tri, I was slowly starting to realize that I could no longer ignore the evidence that the school is pretty much just money-hungry, with questionable (at best) intentions and priorities.  Up until this point, I had been a benefit-of-the-doubt kind of person.

Tri 5:  Ahh yes.  For me, this was a party tri.  Not that I partied all the time (I didn’t).  Hell, not that I even went to the official Tri 5 party (I didn’t).

But I loved the classes and (most of) the profs.  Some people hated this tri.  I don’t know why.  Maybe it’s because it’s the halfway point–we’d already been there so long and we were so beat up and burned out already and yet as far as we had come, we had just as much more to go, and there just didn’t seem to be any light at the end of the tunnel.  Hell, we were wondering if the tunnel was even going to end.  But no, I enjoyed it.  I loved having Perryman and Dr G again.  I loved Brown’s Wellness class and–call me crazy–Guest’s Lab Dx class.  I loved Pearson and I think we had Strader again for something.  I also loved Thompson (finally, I could move bones with confidence!).

The drawback was that I had to adjust Gonstead (and only Gonstead) in the adjusting lab, but what the hell.  Neither my lab partner nor myself liked it, so we did as best we could and got signed off anyway. Hall (not Marty) is also a cockbite–you’ve been warned.

Lesson learned this tri?  Find outside seminars!  They’ll preserve your sanity, your motivation, and offer some important clinical application you just plain don’t get at school.

Tri 6:  If you did not have an emotional breakdown at least twice a week, you simply were not registering vital signs in Tri 6.  This tri was a complete downer, which could usually be traced back to a combination of Bodnar’s Business class (i.e. crappy insurance and Medicare guidelines that reduce us to glorified PTs without the good PR or MD lapdog status–and thus healthy referrals) and Student Clinic (paperwork, paperwork, paperwork, all of which reinforces Bodnar’s depressing class material).

Suddenly, the dreams of helping ADD/ADHD, autism, pregnancy, ear infections, and everything else, get dashed and (temporarily, hopefully) replaced by treatment plans that are “transparent and defendable”, meaning that you pretty much treat only back pain, neck pain, and headaches.  They strip you and tie both hands behind your back by conveniently omitting the “neuro” part of neuromusculoskeletal and leaving you to compete with the PTs for that sliver of patients.  Activator class is cool but boring.  You now have some afternoon classes and morning labs, so that really messes with your chi.

Don’t discount or blow off Communications.  It’s actually very important.  Instead, blow off Philosophy 3; it’s completely pointless.

BTW, Kearsing is not nearly as much of an asshole as people think he might be.  By the time everyone got to know him, they liked him.  His PT class, even if outdated, is still very good.  Tri’s 4 and 5 left you with exhaustion; Tri 6 you’re starting to feel a bit brazen due to the burnout.

Tri 7:  The burnout gives way to “we don’t give a shit anymore”.  And you don’t.  And, you’re not afraid to say so.  All frontal lobe inhibitions are simply gone.  You simply don’t care anymore, because you’ve been through the wringer already.  This tri should be great; after all, the classes are (a lot) easier, testing schedule is (much) lighter, and you’ve transitioned from the junior high that is Tri 6 Student Clinic to the High School equivalent of clinic: outpatient.  You’re one of the big kids now.  Yes, depending on your staff doc, you just might get treated as an adult, maybe even with respect.  But the truth is, even though Tri 7 should rock, it doesn’t.

Contrarily, it’s actually an emotional beating, to use an upper tri student’s consoling words at the time.  And here I was thinking it was just me.  No, it’s not.

What brings Tri 7 down is clinic, because you typically start off with zero patients.  And as a lowly Tri 7, your staff doc’s priorities are the Tri 9’s in your pod, because they’re close to graduating.  They get all the new patients off rotation, they get fed all the exams, etc.  Meanwhile, you get jack, and you’re left wondering why you’re waking up with clenched teeth every morning.  Relax.  As hopeless as it looks, it will pick up for you and you will get through.  The only other part that sucks is, you still have a full class load, so your only available clinic time is 3-7.

Here’s a suggestion: don’t go home at 3p every day when you don’t have patients.  Instead, clock in and stay.  Study.  Get your Grand Rounds case type written up while it’s still fresh.  Look over the material from the day’s classes.  You’re gonna have to study anyway, might as well get clinic time for it.  Trust me, you’ll thank me later when you don’t have to come back after all your requirements are done and sit and do nothing because you didn’t put the time in now while you have it.

What I learned this tri: be in your pod if you can, in front of your staff doc.  That way, when someone is needed to sub for a PT or an adjustment (or even–eek!–a new walk-in patient), you’re right there, ready to go, and picking you is a no-brainer.  (Yes, admin recently sent out a memo prohibiting this.  See, whenever too many people finish on time, the school gets disappointed that they don’t have enough students paying full tuition to go through a 10th trimester and they start arbitrarily throwing you curveballs, hitting you where it hurts most.  Lay low for a few weeks and then gradually start disregarding the “rule”, which is not, by the way, an official policy in any of the clinic handbooks.  Eventually, no one will notice.)

Tri 8:  This tri is much better.  Classes still start at 7am, but you have about half the class load this time around, and except for 2 2-hour morning labs, you can treat patients pretty much any time the clinic is open, because you otherwise don’t have any regular classes scheduled during clinic hours.

Also, if you were smart last tri (and this one) you hung around during your staff doc’s rotation day and with any luck you picked up a patient or two, so maybe you’ll start Tri 8 with a patient or a handful.

So, not only do you have to study even less, but clinic is at least starting to look, well, not bright, exactly, but at least less grim.

Learning opportunity for this tri: I learned (at the beginning of the tri as my patient load started picking up) how to schedule efficiently.  You’ll quickly learn who your most reliable patients are; give them first pick of the times.  Schedule everyone else around that, filling up the times immediately before and immediately after first.  Schedule your least reliable patients at the end of the day (you have a lot of M-F 9-5 patients and those end-of-the-day slots are in high demand for you).  This way, should the unreliable patient cancel with short notice (or just plain not show up without calling), you get to go home early without having anyone else to wait around for.  I wouldn’t put an unreliable patient at the beginning of the day; otherwise, you hurry to get to the clinic by a certain time, only for that patient not to be there.

Also, as the tri goes on, patients will drop back on frequency, whether it’s because they’re getting better and no longer need to come so frequently or they decide it’s not working as well or money gets tight and elect to drop back or drop out altogether.  Get additional people in there, whether off rotation (although never count on this) or having your own people in mind (preferred).

Two classes not to let get away from you: AK and Rad Positioning.  They’re not hard and it’s easy to forget about them, but if you do, they’ll sneak up on you and they’re impossible to cram a couple days before.

BTW, you probably won’t start feeling super-good about your clinic numbers till the second half (or possibly the very end) of Tri 8.  By the end of Tri 8, most people feel like they’ve hit their stride and they’re in their game, but don’t feel bad or panicked if you don’t feel this way.  Many people get practically all their numbers in Tri 9.

Tri 9:  Where had this tri been all my life??  There are no more academic classes, so you barely ever see the main campus or even that whole side of the street, except to park.  No more 7am mornings; I tried not to schedule patients before 9.30.  I really preferred 10am, if it worked for them, because it pretty much kept me out of rush hour completely.  I didn’t mind staying late, because afternoon rush started before 4pm and if I had any afternoon patients at all, even one at the earliest afternoon time slot (3pm, and I almost always did), I was going to end up stuck in afternoon traffic.  Best to schedule some more patients and resign myself to staying the whole day, and not leave till 7p when traffic has a chance to clear out.  Nah, this tri is a sleep-in, study-free, get-your-life-back kinda tri.  You get to pick up the odds and ends that got let go and neglected during the last few years.  The carpet mysteriously gets cleaned, the car gets fixed, the dogs get their shots, you dust, you vacuum, you clean out your closet and take carloads to Goodwill and other charities.

Try not to spend much money, though; this’s the last tri you get any student loan check, and remember that it takes 3-4 months to get your license and be able to start practicing.

Unfortunately, by this tri (when I would’ve had time to start massaging again), the preceding trimesters had all but killed my massage practice and I had to devote so much time to school in Tri 3-7 that I really didn’t have time for any massage clients and so I had referred them all to other therapists and had barely any left by Tri 9, so supporting ourselves doing massage therapy is going to be trickier now without the client base.

However, I’m more human again.  The burnout and brazen-ness I had felt before is gone and my lost inhibitions have been found again.  I’ve returned to the status of a civilized being.  Hint: even if the State Fair falls in Tri 9 for you and you think it’s a moot point and useless with only about 7-9 weeks left till graduation, go anyway.  Some people get all their recruit numbers in Tri 9, a good chunk from the fair alone.

A Sidebar Extra: During the long, arduous process of checking out of Tri 6 Student Clinic (a fiasco I won’t revisit, but let’s just say that we were supposed to be out by 1pm or so and we weren’t able to leave campus till 8pm), a fellow student Josh and I came up with various songs that should go on a soundtrack CD dedicated to Parker.  Well, I had also been thinking of something along those lines (as is a way of life for me), and the soundtrack CD turned into a double CD set.  The listing would be as follows… (this list–unlike most of my lists–is in order, for the most part)

CD 1
1. Bon Jovi – “Mister Big Time”
2. Our Lady Peace – “Tomorrow Never Knows” (Beatles cover)
3. Republica – “Ready To Go”
4. REM – “Shiny Happy People”
5. Duran Duran – “Too Much Information”
6. Crystal Method – “Busy Child”
7. Scorpions – “Winds of Change”
8. Pink Floyd – “Money”
9. Smashing Pumpkins – “Bullet With Butterfly Wings”
10. Hoodoo Gurus – “Axegrinder”
11. Don Henley – “Sit Down, You’re Rocking the Boat”
12. The Who – “Won’t Get Fooled Again”
13. James – “Born of Frustration”
14. Meat Puppets – “We Don’t Exist”
15. Alan Parsons Project – “Eye in the Sky”
16. Tori Amos – “Crucify”
17. Twisted Sister – “We’re Not Gonna Take It”
18. Pink Floyd – “Another Brick in the Wall, Pt 2”
19. Rolling Stones – “19th Nervous Breakdown”

CD 2
1. Don Henley – “Dirty Laundry”
2. Information Society – (Why are we) “Still Here”
3. Dire Straits – “Settin’ Me Up”
4. Pink Floyd – “Us & Them”
5. Hanson – “Where’s the Love?”
6. Jackson Browne – “Runnin’ On Empty”
7. Eurythmics – “Would I Lie To You”
8. Rolling Stones – “Between a Rock and a Hard Place”
9. Queensryche – “Anybody Listening?”
10. Gloria Gaynor – “I Will Survive”
11. REM – “Draggin’ the Line”
12. Fleetwood Mac – “Don’t Stop Thinkin’ About Tomorrow”
13. Mike & the Mechanics – “All I Need is a Miracle”
14. Pearl Jam – “Alive”
15. Pink Floyd – “Run Like Hell”
16. Eagles – “Hotel California”
17. Third Eye Blind – (Can I) “Graduate”
18. Tom Petty – “Don’t Come Around Here No More”
19. Queen – “We Are the Champions”

Yep, that about sums it up.  So in case you’ve ever felt alone in your confusion, frustration, incompetence, insignificance, etc, take at least some comfort: you’re not.

Somebody make that CD, make several copies and slip them under key admins’ office doors.  Heh…


2 thoughts on “Don’t look back in anger: Stories from the Upper Echelon

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