The Teacher is a Student

Being a teacher is second nature for a clinician.  It is part of the medical profession to guide students and mold them into their best potential as health care professionals.  When you ponder on it, it is a big deal, a huge responsibility.  It is one thing to change the life of a patient, but it speaks volume if you are able to guide a human being become the best nurse, doctor or therapist there is.  You are not just changing the life of one person, but maybe a whole community.  

I did not really expect to become a mentor when I first worked at the Philippine General Hospital.  I just wanted a job.  But I guess the job came with the description of becoming a teacher to physical therapy students as one of its biggest duties, since PGH was a “teaching hospital”.  To be honest, I was already scared to work in one of the busiest hospital in the country, and to top it off, I had to be a role model for a bunch of teenagers with ideologies untainted by the real world and an imperfect system-zits and all.  

I think, it is second nature for me to be afraid of things that are different from the ordinary.  Every time I set foot in ICU, there is that fear at the back of my mind that anything can go wrong, and I think that is fine because I can be on guard and on my toes all the time.   A single beep of an alarm can set me off into random thoughts and my brain just goes into clinical thinking mode: Why is that damn alarm on the monitor going off?  (Now, just imagine any clinician in the presence of a constant and annoying chirping of a broken smoke detector…I personally won’t stop until I take care of what is making the sound go ff or until I smash that thing into silence).  And to place trust on other people in taking care of your own patient, that is something else.  It requires judicious thought and constant practice to make sure that the student and myself are both ready for whatever may happen at any given moment- chirp or no chirp.    

Before I accepted a student to teach here in the us,  I questioned my abilities of becoming a supervisor because I felt that i needed to learn more, that what I knew was not enough. Until I was given no choice to be a CI. 

I guess I had to teach what experience taught me, so as the other theories that my former mentors taught me as well. In reality, I am still learning along with my student. And I learn from doing what I am supposed to do; and from people around me who are good at their job.

I want my student to be successful.  I do not want him or her to feel inferior.  We all had the same starting line, the only thing that sets me apart from them is experience, just a few years ahead, but otherwise, we were the same.  It just so happens that we do not exist in same timeline: I was a few years ahead, which is why they come to me for guidance.  

I also like to think that I am a successful therapist, otherwise, I am not worthy of becoming a good teacher to these kids.  But then again, I am also a student, who is also in constant search of answers and still discovers many things every single day, along the way.  I say to my protégés, “It is hard to teach someone who already knows everything.”  If you accept that you are also a student, then there is no limit to your growth and learning.  

I want to say, with confidence and at the same time, humility, that I had a very extensive training as a supervisor.  Pardon the little shade to the American Physical Therapy Association (APTA) but the preparation that we had to go through as clinical supervisors at PGH was miles away from the two-day clinical instructor certification course provided by APTA.  I feel that after my stint as a PGH staff, I deserved an acronym after my name or some bragging rights that I walked in the line of fire to teach clinical interns at PGH.  

We were not thrown into teaching the moment we became staff.  We needed to observe how everything worked, first as a therapist, then as a supervisor.  Afterwards, we had to go through a series of workshops after office hours in order to feel more competent once we started our teaching journey.    

These, on top of helping create an instructional design or basically a curriculum, on how to evaluate and implement the training program of the department.  This was almost a week-long training, brain-storming and discussing the path we would set for the students at the start of every school year which involved numerous presentations, arguments, excel spread sheets until we come into a conclusion what would be the best way to impart our wisdom and knowledge.  I felt that I could be a school principal after many hours of this training crash course.  

The way I describe them now does not even give justice on how anal and extensive we were in teaching these students.  All I can say is that they were graded objectively.  If a supervisor was really way deep into the program, he or she can never have bias in grading a student because every single criterion was accounted for and had an equivalent mathematical equation.  This was when I realized that for so many years of avoiding Math (because it hates me and I hate it back), I had to deal with it in real life.  

One of my mentors told me that as supervisors, we may have the tendency to want our students to be a “mini-me” version of ourselves, which I usually see myself doing with any student.  This boils down to the issue of trust.  Do I trust this individual in changing, or maybe even saving the life of a patient?  The answer is, in one way or another, “yes”.  I should trust them eventually, so they can grow.  It’s like parenting, however, we do not share the same genes, only the same foundation.  But like any parent, your child is somehow a reflection of yourself.  That’s why you want them to be successful.  But it is good to be reminded that they are also their own person.  They are individuals with different passion, thoughts, ideas and background.  To save me from being a controlling tiger parent-slash-CI, I always tell my students, at the start of rotation: “you will hear different opinions and ideas about a particular topic, but as long as the basic idea is correct and safe, you take what you think is best for the patient and keep it.  Consider that you have learned two different outlooks that you can choose from.  When you know which one is better for you, then you learned something.”  

Most of the students that I have handled back in the Philippines are my good friends now. My co-workers are sometimes amazed at how many people I know and how much connections I have around the state and even across state lines.   I consider my experience as a clinical instructor to be a bridge in making connections professionally.  And eventually, personally.  Our bond has grown deeper and beyond the clinic borders.  

And in an imperfect world, not all students are successful.  And as a CI, I also felt that I failed.  There was a time when I met someone, who had enough maturity to learn that the profession was not for him and learned to embrace that fact, even though it was painful.  Unfortunately, this happened when he was under my guidance.  

At the start of every rotation, I would always tell myself that I should make a student fall in love with the hospital setting.  Most of them do, except this one.  One day, just out of the blue, he suddenly decided to quit because he felt that he was a letdown.  

In fact, he confessed that he actually despised being a therapist, which eventually led him to quit PT school, altogether.  He only needed one year to graduate but he has turned the corner and had this epiphany that the medical profession was a path he did not wish to continue pursuing. To be honest, I felt like I was the one who let him down.    Even though he reassured me that I had nothing to do with it, as a teacher, I felt that it was my responsibility to show him the right path, and the next would be up to him to take it.  

As a consolation, I somewhat convinced myself to think that his exposure to the real physical therapy world had made him realize that it was not for him.  It was not until after that he had his feet in the water when he knew that it was cold, deep and sad.  For me, that water is life.  For him, he was drowning.  I want to think that I saved him from that.  

I wish him the best and hope that he will eventually discern what is truly meant for him.  The last time I checked on him, he pursued his career in the arts and is now a brand new parent.  I was sincerely happy for him.  I just hope that he did not despise his short experience with me as a therapist because I would like to believe that we had made a difference in the life of at least one of our patients.  And I hope he saw that too.  

Students come and go.  As time goes by, they become your equal and colleague.  As a teacher, it’s very reaffirming to learn that they become successful in their profession and somehow you are a part of that success.  If you are lucky, they will come back, in one way or another, and say thank you.  For me, that is more than enough.  

A friend of mine has one simple advise to her students at the start of each day, which best describes the acute care physical therapy practice: “Don’t drop anyone, don’t kill anyone”.  I would like to borrow that advise and add a little something into it: Don’t forget to breathe because it’s hard to drown, then, make a difference in someone’s life (It can be your own).”  

The PGH staff clowning around during the Philippine Physical Therapy Association Convention

January 25, 2021