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The Winter of My New-Found Reality
By Ronald A. Roiz By the time you read this I will have begun my spring thaw.
I made it through my first Chicago winter relatively unmarred. Despite the wind tunnels and icy patches, it has been manageable navigating the different pathways on my way to work. During this chilling period, I have gained more insight into my actual orthotics capabilities, how my patients can drive self-improvement, and my desire not to encounter the "real world" quite yet.
 Once I reached my six-month mark, I was given increasing autonomy. Even more recently, our already understaffed department was further strained when one of the orthotists left for an extended vacation (no, he did not die or get fired). I received the brunt of the work. With more patients came more responsibility, and of course a greater chance for mistakes. Triumphantly, I can say that I handled the burden well...that is, as well as one can while scrambling around a hospital like a headless chicken with an AFO in one hand and a clipboard in the other. The more tasks that were put before me the more I would get blown from one project to another and another. It was a downward spiral as I trudged on, attempting to take on the responsibilities of an orthotist with many years of experience. As I took on these additional responsibilities, a seemingly obvious idea became painfully apparent: you can be thoughtful and have good results even with little experience, but to be efficient you need years of practice so every project does not take an eternity—especially when the task involves correcting impressions of little feet that do not stop kicking.
So at this point I would like to take a moment and pay homage to the many clinicians out there who have spent their time running around and have realized that perhaps it is better to take steady, confident strides forward rather than frantic scurries back and forth.
Another character-building task this winter was caring for a person who at first seemed frosted and rigid. The challenge initially presented to me was fairly straightforward—shoes! What ensued was a trialing endeavor to accommodate a person who was detail oriented and a bit nervous about her healthcare. This patient challenged me to employ my biomechanical understanding to evaluate her deficits and, furthermore, to employ tact, rationale, and clear communication when her anxieties about my recommendations challenged my knowledge base. Because of her desire for precision, I was forced to break free from my prior mold to reach a higher level of skill and accuracy.
After several days of working on the same problem, I achieved a product that was done to the best of my ability. I came up with a solution to a functional deficit; I was able to satisfy a person who had been dissatisfied with other aspects of her care; and, perhaps most important, I got to interact with a kind woman who had a string of bad luck and just wanted things to be done right. In a world when time constraints allow you to be good enough, it is nice when you are challenged to be excellent.
After enduring some months of heavy snowfall, howling winds, and ice-covered roads, I am beginning to realize that at times it is nice to still be in a sheltered state of learning without the responsibility of bearing the full force of the elements. I am content to let the seasons change naturally, not to be too courageous when it is really hairy, and not so inpatient that I do not enjoy the state I am in. I will let my challenging patients encourage my growth as an orthotist and will continually ask questions of those wise ones who have "seen it all," when I clearly have not. By simply going through the motions and constantly modifying my outlook, there has been much growth in terms of my comprehension of the practical aspects of this profession that I did not gain from school. With my perceptions and understanding morphing daily, I hope that my view of the real world is real enough when I complete my residency and go out on my own.
Ronald A. Roiz is a resident at the Rehabilitation Institute of Chicago (RIC), Illinois. He is a graduate of the MSPO Program at the School of Applied Physiology at the Georgia Institute of Technology, Atlanta, Georgia, and will be sharing his experiences as he completes his residency. 
Table Of Contents - April 2008
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