Tour de Frick

I didn't do much this previous week.  I have to be honest.  What did I do? 

I'm working on my inservice project for the clinic, a school requirement.  I'm doing the project on nutrition in physical therapy- just kind of exploring the roles that proper nutrition can play in overall health and healing.  It has been interesting thus far.  Eat your purple vegetables, guys.  Phytochemicals are important.

I took on a fuller role at the clinic this week.  Friday, I filled in for a sick PTA and practically took a whole schedule on my own.  Uff-da.  I'm still struggling to be efficient with my paperwork time, but I'm doing alright.  I missed one day with a killer migraine, independently taped a patellar tracking issue (Doug, McConnell taping is great), used MTI stuff on probably four lumbar evaluations, and dazzled a patient with my knowledge of the foot and ankle (again, thanks, Doug, you're making me look good out here).  Unfortunately, the same patient had the most disgusting feet I have ever worked with.  Manual therapy became a test of how long I could hold my breath, and the smell from my hands is still on my cart and laptop at work.  It is atrocious.

I had a patient suffer a heart attack (not on my watch), but therapy is looking a lot different.  She can't do much now, and the doctor has basically given up on her.  It's a shame for a lot of reasons, but she was making soooo much progress... it's really hard to see her now, really unable to do a lot of the things she had progressed to in the last week.  That's been the rough one to deal with.

Overall, I'm continuing to feel more and more like a real therapist.  Granted, I have a ton to learn, and I'm okay with that.  But I at least feel like I belong here now.  And not a moment too soon- I am nearing the end of my time in Marshall.

Being so close to the end of my rotation, I realized that my "bucket list" needs addressed.  I have yet to catch a Northern Pike.  I have yet to see a loon.  I haven't made it into the Northwoods yet.  And I hadn't ridden the Camden Trail, either.  Until Saturday morning.

Given my recent travels and knowing I needed to take things easy, I decided to stay home this weekend.  So, I chose to sleep in, eat a good breakfast, get a workout in, and spend the day in a local coffee shop.  Well, after breakfast, I was watching the Tour de France.  I enjoy cycling quite a bit- it's kind of like running, except with wheels.  Stands to reason that I should like it.  Anyhow, after watching for 45 minutes or so, I remembered that I had yet to ride the Camden Trail- a 30 mile round trip from Marshall to the local state park.  So, I got up, turned off the TV, put on a helmet, and set out.  

Literally that impulsively.  Time from decision to execution:  7 minutes.

Time from execution to regret:  10 minutes.

Time from regret to considering quitting:  10 minutes.

Time from regret to stubbornness overriding regret:  10 minutes.  So, 30 minutes in, I was on the opposite end of Marshall from where I had started, and I was completely committed to completing the ride.  Unfortunately, the first half of the route is uphill and into the wind.  To make matters worse, the nuts on my seat are so old that I couldn't loosen them to adjust the seat height, so I totally lacked any mechanical advantage at all.  Plus, no aero grips, so my upper body was suffering from supporting myself on the handlebars.  

A couple of times, I think I actually stopped moving on the way out into the 15 mph wind (yes, I'm aware that it isn't significant, but it felt significant while also pedaling uphill).

After 69 minutes, I had reached the 15.2 mile mark.  I took a moment to make sure my tire pressure was good, and turned back for Marshall.  Now, bear in mind that I was moving downhill and with the wind.  The trip that took 69 minutes out required only 47 minutes to complete going the other way.  Not a bad negative split.  Anyway, my quads, glutes, and calves are still sore and I felt like a moron.  But I also feel awesome.  Because I crossed something significant off of my bucket list.  And, sadistically, I kind of want to do it again.  I think with a good bike in the future, I'll be able to complete some solid rides.  

Now, next weekend will be my last to travel.  I'm hoping to address the remainder of my bucket list in the Brainerd area.  

Until next time.

 

Lions, Tigers, Bears, Badgers, and Gophers- Oy.

What a week/weekend, ladies and gents.  What a weekend.  As the woman working at Stillwater's Valley Booksellers told me, "You don't see fifty states by sitting at home."  I now believe I am up to 18.  So, a long way to go, but lots of life (hopefully, God willing) yet to live.

So, where to begin?

How about the clinic?

It was a shortened week, but probably the most exciting one so far.  My CI has upped my independent case load to about 55% of what a new graduate would be seeing- so, about 4-5 patients a day.  I have found that my engagement, interest, effort, and energy have all improved when I am the one in almost complete control of a patient.  I'm starting to feel like I really, really like what I'm doing.  Probably the most significant moment where this played in was seeing my first patient through an entire course of treatment.  I evaluated her, developed a plan, and discharged her this past week.  She is a very friendly lady, an EMT in a nearby county who was referred to us with carpal tunnel syndrome.  During the evaluation, I realized that her symptoms didn't match.  I put her through a series of tests to determine whether or not she may be suffering from a condition called thoracic outlet syndrome, in which the nerves, artery, or vein (and often a combination thereof) leaving the neck gets trapped somewhere in the shoulder, thus causing numbness in the hands.  When her radial pulse disappeared upon turning her head, I confirmed my own suspicions.  We informed the referring physician, who said he would order a nerve conduction study, but, in the meantime, asked that we treat her as though our working diagnosis were correct.  After some nerve milking, nerve flossing, postural and scapular strengthening exercises, she reported no symptoms and feeling better than she had in months or years.  The two of us could scarcely have been more excited when I discharged her.  She felt better.  I had done something right.  It was a good tradeoff.

As exciting as the week was (and believe me when I say it really was), Saturday alone was an adventure.

My day started at 5:00 AM with a red grapefruit (shockingly, sweet and not at all bitter), some almonds, and some English Breakfast tea, as well as a difficult decision.  I grabbed a Wichita State t-shirt and my Royals cap, then started questioning whether it was a good idea.  I thought that wearing my Kansas apparel would make me an obvious tourist and a target for... well, I'm not sure what, but I questioned whether it was a good idea.  And kept questioning for about ten minutes before deciding to go with it.  I left home a little after 5:20.

My first destination was a little town of about the same size as Marshall, and, ironically, the third option on my clinical request list that was submitted for this summer- Hudson, Wisconsin.  So, realistically, I could have ended up there almost as easily as I ended up in Marshall, but God had a plan, and here I am.

Getting there didn't seem like a bit deal.  I took two lane highways almost all the way into The Cities (you don't call them the Twin Cities up here.  Just "The Cities"), but when I merged onto I-494... I started to get a little stressed.  Never in my life had I seen a highway with three directional options- East, West, and North.  Did I want to go North or East?  I knew I didn't want West... what to do?  While the traffic wasn't much worse than I-135 on a busy day in Wichita, I took a deep breath and went East.  Good choice.  I got where I was going.  I crossed the St. Croix River (quite a sight, honestly) into Hudson a little before 8:30 in the morning.  I made a beeline for Target with one thing on my mind:  I wanted a Wisconsin Badgers polo.  And I found one.  Along with a sale on trail mix.  My favorite kind, too, the Chocolate Cranberry Crunch.  So I got a bag of that, as well, and continued along my merry way, north through Wisconsin for a few miles.  And it was beautiful.  I doubt the entire state looks like that, but it was absolutely gorgeous.  After fifteen minutes driving north, I re-crossed the St. Croix across a cool old bridge into the peaceful little tourist town of Stillwater, Minnesota.

I parked the car and took a few pictures, then turned around to see how to approach the little riverside shopping district.  I was a little hungry and the first thing to catch my eye was my favorite sort of place- a coffee shop and book store under the same roof.  So, I made a beeline for The Daily Grind Espresso Cafe (not to be confused with the one in Marshall), where I ordered a coffee and walnut scone, both of which were just about the best of each I had ever had.  The woman working the counter in the bookstore, seeing my WSU shirt and KC Royals hat, called me over to the counter and informed me that she was from Wyandotte, KS and had attended K-State.  We chatted briefly before I started exploring.

Now, let me tell you all that if a runner lived in Stillwater, they could expect to have prolific thighs and glutes.  There were some seriously steep hills in town, but they allowed for views like this.

Probably the greatest highlight of Stillwater was the Stillwater Farm Store.  I would have spent quite a bit of money on gifts (and myself) if I had money to spend.  There were a great deal of items ranging from candles to food to birdfeed and feeders to pet goods.  However, the best part was feeling a soft, damp feeling against the back of my life, and turning around to find a British Labrador named Cash pressing up against the back of my leg, freshly bathed, holding his ducky in his mouth, and wanting very badly to play.  I knelt to oblige him, when his friend, Cooper, came to play, too.  I spent longer than I care to admit on the floor of this store with the two dogs, playing with them and their ducky.  I'm in quite a few other tourists' photos, I think, playing with them, but I don't mind.  I like dogs.



I think the sign was what Cash was thinking at that moment.  Dogs love anybody that will play with them, right?  That wasn't the only cool sign they had, though.

Not that any of you fall into that category.  Anyway.  I stopped into another coffee shop to use their restroom shortly thereafter, and was wowed by the atmosphere.

Inside of an old industrial building on the river, Tin Bins was a pretty happening spot.  Should I ever return to Stillwater, I will be going here.  The temptation exists to return next weekend, too, though I doubt I will, as it is the annual Lumberjack Days.  There will probably be too many people for the little town, and besides, I don't know that I want to make a three hour drive in consecutive weeks.  

Anyhow, to continue the story, I again heard someone calling to me, and met a lady from Garden Plain.  She had lived in Stillwater some thirty years now, but was a WSU alum whose brother was a survivor of the infamous plane crash over Colorado in the seventies.  We chatted for a while before I continued my day.  There were some cool bookstores and kitchen stores and boutiques and such in Stillwater, and some neat old historical buildings.  Had I not made other plans for lunch, I would have tried any one of the several tempting options along Main Street.  However, Como Zoo and Conservatory called my name.

I made it there completely stress-free.  The struggle, though, was finding parking.  I circled the park for longer than I will openly admit on this blog before finding a parking space, but I made it into the zoo.  It is a very small zoo with no set admission price- just donation-based.  But boy, was it crowded.  I made the joke to a father with three small children that I didn't have any kids- I was just an agoraphobic facing my fear.  He corrected me promptly, reminding me that agoraphobes are afraid of open spaces; enochlophobes are afraid of crowds.  Well-played.  Anyhow, after another KC family complemented my choice of hat, I continued on into the zoo.  The first thing I saw was something I don't believe I have ever seen before- harbor seals.

They were awesome.  My favorite animals at the Sedgwick County Zoo (which I miss dearly) are the river otters.  Seals are like otters on steroids.  I watched them for quite some time, but moved on eventually because of the crowd.  The next thing, again, was something I had never seen- sea lions!  Of course I thought of this:  

I also laughed pretty hard at a guy wearing a shirt that said, "Guns don't kill people.  George R.R. Martin kills people."

I also learned that zebras are, in fact, black, with white stripes.

Other animals included polar bears, tigers, lions, caribou, Dall's Sheep, giraffes, ostriches, lemurs, arctic foxes, wolves, and an anaconda.

I met a family from Newton, KS in the rainforest, where I also saw a Bill Maher lookalike.

Worth noting is that the spider monkeys seemed every bit as interested in watching people as the people were interested in watching them.

In the conservatory, I learned that in Japanese gardens, every stone takes upwards of an hour to place, as every attribute must be considered and the most beautiful location and angle must be selected.  Although, after walking around the seemingly nonsensical layout for a while, I realized why some of the game maps for the Pokemon series look the way they did.

Anyway, my visit to the garden and zoo showed me that my selection of Kansas apparel wasn't a bad thing.  To those that cared nothing about the Royals or Shockers, my clothes weren't even noticeable.  I was just a guy in a gold shirt.  To those who cared, it was an invitation for connection.  So, that was kind of cool.

After the zoo, I went to a little location I saw on an episode of Diners, Drive-Ins, and Dives- Kramarczuk's.  I was blown away.  The service was remarkable friendly.  I ordered a six-varenyky mean (Ukrainian pierogis) along with a Ukrainian kale and sunflower side salad.  The cashier told me that two of my varenyky appeared to have been "rough-housed" and only charged me for four of them, plus the side salad.  And it was all good.  I would have taken pictures, but I was too hungry to, and besides, I think it is silly when people do that.  I also think pictures in mirrors are silly, otherwise I would show you all my new Wisconsin Badgers polo, which I look pretty sharp in, if I do say so myself.  I plan on wearing it to work tomorrow (under threat of being fired by the clinic manager and having rotten eggs thrown at me by patients).

After lunch, I decided to check out the University.  It wasn't far.  It was also the worst decision of my life.  Free parking doesn't exist in Dinkytown or on campus, and I could find nowhere to park in order to explore campus or to find out where the visitor center was or compose myself after an ill-advised turn the wrong way on a one-way street.  I eventually parked illegally at the post office just to breathe for a little bit, then decided to leave.  Already under stress, the road I needed was under construction, so my directions were worthless.  I took an alternate route, I-94.  Ten or twelve lanes of traffic.  And a traffic jam- though the locals would probably hardly call it that.  It looked like Kellogg at rush hour- and it was about 5:00 on a SATURDAY.  Once traffic started moving though, it really wasn't particularly intimidating.  The speed limit on the highways in the cities was only 55, so it wasn't really too nutso.  Eventually, I made it to Eden Prairie, where I stopped for dinner and some much-needed relaxation at Barnes and Noble. 

However, I noticed people staring at me in the mall.  I wasn't sure why until I stopped into a restroom.  Apparently, somewhere along the way, as a result of the stress I was experiencing during my drive in The Cities, I had ruptured blood vessels in my eyes.  I looked like some kind of an addict with my bloodshot eyes.  No wonder.

Anyhow, after some time in the mall, especially the bookstore, I felt much better, and continued uneventfully the rest of the way home.

So, with about three weekends left here in Marshall, I intend to take one more excursion, and I think it will be north for a more outdoorsy experience.  Not sure which lake I'm headed to, but I plan on some hiking and fishing.  No more big city experiences for this guy until I have to drive through Omaha (possibly at lunch hour, if the current plan holds) on my way home.

Until next time, ladies and gents.

In Which Jameson Starts an Internet Rumor

Well, I must be honest.  I had a fairly nondescript week.  Except for the whole Independence Day thing.  So, this will be a fairly brief update.

I've been vastly more independent in the clinic this last week.  I'm beginning to feel more confident, and my CI and I had a discussion in which we sort of ironed out some of the concerns I had with my own technique and that sort of thing, and things are going very well.  I don't yet feel ready to be an independent clinician, but I do feel like that is a possibility at some point in the future.

Saturday saw me visiting a coffee shop and going French style for breakfast- a slice of quiche and some (a lot of) coffee, as well as some time spent writing.  In the afternoon, I took a trip to yet another state park, the Upper Sioux Agency State Park near Granite Falls, MN.  It has some history, being a former government location for the Sioux, an old vocational school, military housing, and even (supposedly) an old chief's tomb.  It provided some views that were a bit on the unique side for the part of Minnesota I have been in so far.

However, for the first time since I have been up here, I didn't feel totally safe.  I also knew that my fears were completely unfounded- there are really no animals in this part of the state that I need worry about.  No cougars, no bears, no moose, no wolves, not even any feral hogs.  Venomous snakes are extremely rare.  It was also the first park I have ventured into that was almost totally bereft of other visitors, which I found very unusual.  That is undoubtedly the source for my fears.  It made me reflect quite a bit on how so many of our fears are totally unfounded- we worry, worry, worry, only to come to a place where we realize we had absolutely nothing to worry about.  Although, occasionally, our fears are not totally unfounded.

Sunday was a far more laid back day.  After church, I watched the beginning of the Iceland vs France Euro match, which turned out to not really be much of a soccer match, but rather a bloodletting.  I lost interest in the first half and went to my books, reading a decent chunk of CS Lewis's "Surprised by Joy."  Later that evening, a fellow intern at Big Stone came over for dinner.  I had prepared some country ribs in the crock pot along with some pasta salad, corn on the cob, and Bush's beans.  And, of course, some peach crisp.  Which was marvelous.  We had some good, meaningful conversation, centered mostly around our shared faith.  It was welcome, to be sure.

Monday was also fairly laid back. I went fishing and caught a handful of bullheads, but nothing worth keeping.  I also had a tail-less woodchuck come and visit me.  He probably sat a good three feet from me for some length of time, not seeming to mind my presence in the least.  It is this reckless nature I dare say probably led to the loss of his tail.  It was not the only close encounter of the rodent kind I had, as previously, at Upper Sioux, I had the pleasure of being within five feet of a tiny little rabbit.  He also didn't seem to care that I was there.

As I fished on Monday, every hour, the local church belltower played out patriotic melodies.  I enjoyed that quite a bit, along with the weather, which only improved as the evening went on.  I went with my fellow intern to Marshall's 4th of July celebration, complete with a municipal band playing patriotic tunes and a local illusionist.  I did watch the fireworks display from my patio, too, and it was almost chilly.  Didn't seem much like the 4th, but I kept a checklist to see whether it really was or not.  See as follows:

Stereotypically American Things I Did July 4, 2016

-Watched documentaries on History Channel about America

- Wore red, white, and blue

- Ate excessive amounts of red meat slathered in BBQ sauce

- Said 'Murica at least once

-Said "Sun's out, guns out"

-Watched fireworks

Stereotypically Un-American Things I Did July 4, 2016

-Did NOT skip cardio

-Did NOT bench press

-Wore short shorts while not skipping cardio

-Used my bike as transportation

By a score of 6-4, it does seem that it was, in fact, Independence Day.

That was my week.  We'll see what the next one holds, as I am planning on a journey to parts east of here.  Stay tuned.

Also, in case you missed the title of this post, or weren't able to put two and two together, that bear track is an internet stock photo.  Let's see who reads all the way through this post.  

Thousands, Upon Thousands of Words

They say a picture is worth a thousand words.  Well, I have several for you today.  I also have a few hundred written words, probably.  And clinical situations involving words.  Among other things.  But where to begin?  Hmm.  I could start any number of places, really.  So, I think I'll start in the clinic for a change.

It has been up and down.  No shades of gray there.  For every patient where I feel like I know exactly what I'm doing, I get one or two that make me feel like I'm never going to be a good therapist.  I know that isn't necessarily the truth, however.  I'm not particularly efficient in documentation (I'll get there, the process is just very uncomfortable).  I am not especially creative most of the time (I have moments of brilliance).  And almost worst of all, I don't know what to do with personalities I don't mesh with.  We had some great instruction on the topic, and I know, in theory, why I don't mesh with the other party (usually). The problem is that I don't know how to work through/around it.  I have one elderly lady that will not speak to me.  No matter what I say, or how I say it, she won't speak to me.  She is perfectly sweet and friendly toward my CI, however.  I also a really hard time when a patient talks- and won't stop.  I am generally pretty good at slipping in the "let's do this exercise next... I'm sorry, what were you saying about your nephew?"  However, there have been a couple where they so dominate the conversation that I can't even slip that in there.  I don't want to be rude, but I struggle heavily with knowing how to redirect a 95 year old woman who cares more about the fact that she is getting new glasses than the fact that I am there to try and evaluate her as a fall risk.

That being said, I have some patients that I absolutely love and cannot wait to chat with- even if we don't speak the same language.  I took a tip from our cultural competency class and always address the patient, looking them in the eye, even if they need a translator and don't understand a word I am saying.  I have had some of the best conversations of the whole trip with a patient from Guatemala- mostly through his son, serving as an interpreter.

I've also seen some unusual cases in the clinic... my CI evaluated a patient for vertigo who seemed, upon further questioning, to be suffering from low blood sugar.  After nearly vomiting and passing out during a Dix-Hallpike, I questioned him further to find he hadn't eaten anything in three days.  Come to find out at the follow-up visit, a bowl of oatmeal cured his dizziness that afternoon and he had been fine since.  Not exactly therapy, but proof that we, as a profession, need to be aware of pathology originating in other realms of wellness.

Now, what have I been up to?  Oh, not much, I guess.  After going home for the wedding of some very dear friends, I spent the ensuing weekend doing a lot of nothing- watching hunting videos on Youtube, reading, writing, hanging out in coffee shops, etc.  But this past weekend, I went on an adventure.  I went to Palisades State Park (near Garretson, SD)...

And Sioux Falls!

Now, Palisades was beautiful.  Those of you who are Facebook friends with me can see the rest of the photos there, but let me tell you a little of the story.  So, I started exploring.  Of course, I thought the park was quite beautiful.  I hiked for a while before all of a sudden I hear a loud rustling behind me.  I can't quite get turned around in time before I feel something soft slam into the back of my legs.  I yelled and tried to get a better view of my assailant, only to find that my assailant wasn't an assailant at all... it was Bailey.

She was super friendly.  She had been vaccinated in Moscow, Idaho, so for a minute, I was worried about how she ended up with me on the trail.  The phone number, though, was a local one.  So, I hiked on, with my new friend loping along beside me, occasionally dashing off after a squirrel or going for a brief swim in the river, but always returning, tail wagging and asking for attention.  She proved to be a good trail guide, though.  At one point, I encountered this guy.

While I am no Trey Harrison, I was quickly able to determine this snake was not venomous.  The problem was, I wasn't sure what kind of snake it was (my first thought was kingsnake, but correct me if I'm wrong), or if it would be aggressive at all.  So, I stood for a bit, trying to decide what to do, when Bailey got impatient, ran forward, and began pawing at the snake.  He slithered off into the underbrush, leaving the trail totally clear.  Bailey turned back toward me, wagging her tail, and looking rather like she was smiling, obviously quite pleased with herself.  Onward we went. 

In the end, Bailey was with me for about an hour and a half, a good portion of which I spent walking through the campground trying to see if anyone would claim her.  No one did, so I left her at the park office.  The head guy (whatever the term is... I somehow don't think Park Ranger applies to state parks) wanted me to take her.  I would have loved to, but aside from the fact that she obviously belonged to someone, I had no place to keep her.  So, after parting ways with my new friend, I went on to Sioux Falls.

My adventures there were actually not so adventurous, probably.  I had lunch with a local celebrity (a meteorological whiz, let me tell you).  Then, I made an excursion to the South Dakota Peach Festival.  Judging by the line of cars, I would have thought this was a pretty big deal.  As it turned out, it was darn near a waste of time, unless you

      A)  Had little kids that would have been able to enjoy the countless inflatables

      B)  Came hungry, as there were tons of tantalizing food truck options

      C)  Had lots of money to spend on crafty things ranging from scarves to peach preserves

That being said, I came away with a bag of trail mix and free peach cobbler and peach ice cream.  Not a bad haul for a 45 minute excursion.

Later that afternoon, I visited Downtown Sioux Falls.  It started raining almost immediately, and I took refuge in Duluth Trading Co.  One free coffee, a few manly books, and a wide variety of items necessary for complete manliness ogled later, and I decided Wichita needs one.  I'll be starting a petition soon (complete with hashtag).  #ictneedsduluth

After the rain stopped (and after sitting in the Duluth front window with three employees and a friendly old man, watching some pour soul's Volkswagen convertible filling with water, all of us drinking coffee and discussing what a shame it was), I continued along.  There were a great many shops and restaurants I wouldn't mind re-visiting, should I return.

Next, I visited Falls Park, the highlight of the trip, I think.  It was a really neat set of waterfalls, which formerly powered the Queen Bee Mill, a key player in the commerce of a developing Sioux Falls.  There was even a restaurant, the Overlook Cafe, in the park.  It would have been a great place to grab a bite to eat, but it wasn't quite dinner.  So, on I went.

After grabbing dinner and a few grocery items, I returned to Marshall, which, I realized, I haven't posted any photos of.  So, here are a couple.



 This is a statue dedicated to Marshall's birthday...

And this is the 9/11 Memorial that gained national headlines a few years ago.  I'll let you look it up if you really want to know more.

Anyhow, that's my update.  I feel I've exhausted my words... so... until next time... La revedere.

An Update

Hello all!  It has been a little while since my last update, but part of that could be because not a whole lot of any real interest has occurred.  I still feel somewhat obliged to provide you with an update, so that you are aware I have not fallen off the face of the planet.  So, here goes.

When last I left you, I was about to go to Cottonwood Lake to try my luck at walleye fishing.  A nice lady who was walking by with her grandson told me her neighbor had caught several decent walleyes on the other end of the lake and told me how to get there.  I was about to pack up and go when I had my first bite.  And soon thereafter, lost the fish.  This game continued for some length of time- several bites, followed by lost fish, which activated the competitive streak that resides within me.  After awhile, I finally hauled in a handful of my bait-robbing adversaries- bullheads.  They eat as good as anything, so I took them home, cleaned them (with significant difficulty), and fried them up a few days later for dinner.  This, however, is almost unheard of in Minnesota.  Patients and coworkers are shocked and I might even go as far as to say disgusted to hear that I would eat bullheads.  Nearly everyone has asked me if I have ever heard of walleye, and why, if I had, I would ever eat bullheads.  Upon explaining that I love walleye but that I find nothing wrong with catfish, the locals are equally shocked upon discovering that bullheads are, in fact, merely a small species of catfish.

Speaking of patients.  I have been enjoying the caseload that I share quite a bit.  I now see maybe 3 patients a day somewhat independently- with my CI observing and offering advice here and there.  I've really started enjoying working on functional balance with elderly patients.  I was reminded why I'm doing what I am doing by one particular lady in the local retirement community that laughed at me when I told her I wanted her to stand on an Airex pad while playing catch with me ("You realize I'd have to let go of my walker, right?")  The excitement she exhibited when she was able to do so (with my CI lightly holding a gait belt) was energizing.  The next treatment, I held a can of tuna in one hand to simulate a high shelf, and suggested that my other hand, at waist height, was a countertop.  With confidence, she started moving the tuna can from shelf to countertop and back, absolutely beaming all the while.  As she left that day, she took my hand and told me I was crazy, but that she loved me and knew she was in good hands.  If I barely stumble through the rest of this rotation, that makes the whole thing for me.

I've also found that the "pretzel" exercise that our very own Mike Rogers introduced us to very early on is somewhat of a novelty- but a very highly valued one.  Same can be said for progressing 4-Way Ankle exercises with a resistance band by adding a toe curl.  I'm excited to see how the two posterior tib patients I'm seeing respond over time.  Don't worry, Doug, I'll throw the TC manip in there soon enough.  The dorsal glide has already had some results.

Away from the clinic, I rented The Force Awakens the other day.  I'd give a movie review, but the DVD drive on my laptop has apparently stopped working, so I was unable to watch it.

My latest wilderness adventure was Lake Shetek State Park, the site of a Lakota raid on a settlement near the lake.  I believe twelve settlers, including women and children, lost their lives, and the rest survived by hiding in a slough, now called Slaughter Slough.  The twelve deceased were buried in a mass grave which is now marked by a very large, though very plain monument.  The original site of the cabin at which the first lives were lost is also marked.  The foundation has sunk deep into the earth, leaving a fairly deep impression in the forestland that almost serves as monument in itself without the added historical marker.

What has been interesting to me is the number of bird species I have seen in Minnesota.  There are the expected- cormorants, a variety of ducks (teal, wigeon, wood duck, mallard), plenty of shorebirds (including a Green Heron, which I had never seen before), etc.  There are several species of flycatcher, I've seen evening grossbeak (not a species I've seen in KS), bobolink, yellow-headed blackbird, a flock of cedar waxwings, pine siskin, goldfinch, and more species of swallow than I ever realized even lived in the continental US.  What I have not seen are snakes and turtles.  I've also noted that the deer are considerably larger than what we have here.

Oh!  And note I said "here."  Like, the 316.  Wichita.  I am back.  Briefly.  I was honored to be a part of a terrific wedding of two people I care very deeply about (you know who you are).  So, that means I had to make the journey back- all 8.5 hours.  And you know what?  I wasn't even bored until the stretch between Omaha and Topeka.  Why?

Well, driving through Iowa was pretty great.  Good radio station, for starters.  Secondly, I-29 from Sioux City to Council Bluffs follows some really pretty country.  Also, there is something to be said for leaving at 6 AM.  It didn't feel like traveling ate up my whole day.

Well, anyhow, that brings you up to speed.  I return to the relative cool of SW Minnesota tomorrow (high of 77).  I look forward to bringing you an update of hopefully hauling in a nice Northern sometime soon.  That's really why I'm in Minnesota, right, to catch pike, not anything about an education or anything.

Hopefully you can detect the sarcasm in the above statement.  If not, my blog is perhaps not for you.

Until next time, God Bless, and enjoy this picture that holds no real significance.

First Impressions

Good morning all!  I hope your Memorial Day is off to a good start, hopefully with coffee and a cinnamon roll or something.  I revisited my childhood with a bowl of frosted flakes with a banana.  Not that you care, but you chose to read this blog post.

Anyhow, when last you heard from me, I was preparing for the long trip that would put me in my summer location of Marshall, Minnesota.  I have since arrived.  And you know what?  I like this place.

On the trip up, I took a little side trip out to a friend's farm in rural Norfolk, Nebraska.  It was an absolutely gorgeous area, tucked back in massive rolling hills.  As I stood out on the little pond dock they had, I could hear cock pheasants crowing all around me, and soon began to see a few.  The family that hosted me were incredibly kind hosts, and I am super grateful for a place to stay over.

The following morning had me on the road.  After a stop for chicken livers at Cracker Barrel in Sioux Falls and a detour along Highway 23, I found myself on the campus of Southwest Minnesota State, checking into my apartment.  There were a few bumps along the way- a bad smell in the apartment when I first arrived (nothing some Glade couldn't fix), an AWOL trashcan (maintenance brought it approximately Wednesday), and wifi that wouldn't work for a few days (finally got that fixed, too)- but overall, I have been very pleased with the apartment.  We have a kitchen, a washer and dryer, and free cable, with an inordinate number of channels.  I have been more glued to the various sports networks and travel-related shows than I care to admit.  Note that I say "we"- I have two roommates.  Both are interning with the Schwan Food Company, which is headquartered here in Marshall.  I get along pretty well with both, though we are all three pretty different.

The clinic I am working in is great.  I work five days a week with somewhat variable hours (10-6:30 on Mondays, 8-4:30 on Tuesdays and Fridays, 9-5:30 on Wednesdays and Thursdays), and a variable patient load.  Last week, we spent about half of our time in the clinic, and about half the time at a local retirement community.  The caseload has ranged from farmers with bad backs to a young lady born without ACLs.  The people here are incredibly friendly, and I have thoroughly enjoyed working with them.

Now, of course, Minnesota is a great state to get outdoors.  I have done so.  There are miles of biking paths around here, and I have spent quite a bit of time riding around.  I haven't seen a ton of wildlife- some 13-lined ground squirrels (the famous Minnesota "Golden Gopher," for those of you wondering), and what appear to be very runty prairie dogs compared to those we have back in Kansas.  I believe them, however, to be more intelligent and ritualistic than their Kansan counterparts, as I found about 30 of them surrounding my car one afternoon in what appeared to be some sort of ceremony.  I'm still not quite sure what that was about.  I also encountered a partridge while hiking, which flushed directly in front of me and nearly gave me a heart attack with the racket it made whilst breaking cover.

Oh, yes, the hiking.  I visited Camden State Park yesterday.  I fished in Brawner Lake for a few hours, catching a handful of largemouth bass that were too small to be worth bringing home.  Besides, apparently the dam was breached a year or two ago and they lost a large portion of the fish population, so they are asking for catch and release only with bass.  Fair enough.

Anyhow, after a few hours of relatively fruitless fishing, I decided to try out the hiking trails.  The trails varied from rolling prairie to woodlands, and I certainly knew I wasn't in Kansas anymore.  Bellwort, waterleaf, and phlox were everywhere. The whole trail was surrounded with beautiful purple flowers.

They smelled heavenly, too.  I'll try to do a better job taking pictures.  I forgot to bring my camera yesterday.  Those are courtesy my little cellphone.

Today, I'm cooking some BBQ in the slow cooker and sharing a meal with my roommates, and hopefully venturing out to another local state park.  Hopefully I'll bring home my first Northern.  That's a picture I would be happy to take and post for you all.

Stay dry back in Kansas.  Keep praying that I would remain centered on what God has called me up here to do.  I'll see you all soon.

The Threshold

I'm sitting at my kitchen table with a bowl of oatmeal (with blackberries- my favorite) and a cup of coffee.  It is absolutely beautiful outside with the sun coming up.  It's a cool morning, by May standards, but it promises to be a lovely day all the same.  Worth noting is that Kansas is currently cooler than my summer home in Marshall, Minnesota.  And unfortunately, my summer home is part of the reason I'm not paying as much attention to the lovely day as I should be.

Packing and cleaning are stressing me out.  You don't realize what you can't find until you start looking for it (to this, you are undoubtedly saying, "No, really?  Why am I reading this guy?").  You also don't realize how much trash you harbor until you start  moving trash out of a room in order to find things that you actually need.  I'm also seeing time as a commodity right now.  Seven to eight hours of work over the last couple of days are all I've been able to put into my bedroom so far, in part because of other important things I've needed to do, such as moving furniture, beginning pre-marital counseling, and getting my finances set for the summer.  I've also tried to give myself some rest and relaxation- this is, after all, my only week "off" before starting my summer clinical internship in Marshall.  So I think I'll try my luck fishing this morning/afternoon for about 3 hours or so.  Hopefully I don't pay in stress sweat.  I still have a lot of things to pack, a box of books to locate (likely misplaced after last summer's clinical), and a bicycle that needs checked out by someone who knows what they are doing.  I'm somewhat apprehensive about how much money I'll need to put into that sucker, but it will be a ride (hopefully) this summer that will save gas and make for easy entertainment.  Not that I won't already have plenty to do.  But sometimes, a mindless, outdoor activity is what I need to recover, and I have no lawn to mow or garden to tend.

So, again, picture painted, I'm sitting here, tired, and a little stressed out.  Beyond the prep work, there are unknowns out the ears.  Will I mesh with my CI?  What are the business standards at my clinic?  What kind of roommates will I be paired with in my university housing?  Will I find community in Minnesota?  Will my budgeting prove accurate (aka, will my funds last?)  But there was a little reminder that I didn't need to be so stressed.

http://solidjoys.desiringgod.org/en

I am far too focused on details that frankly just don't matter.  It may seem that they do.  But I'm not going to starve.  I'm (most likely) going to make it back to Kansas.  My focus shouldn't be on this experience as a weird vacation or even something I have been forced to do (I did choose the location, after all).  Even though Piper's blog doesn't necessarily speak directly into my circumstances, it is a reminder that I simply need to center myself.  I'm not seeking things that are above.  I'm merely seeking to keep my head above water.  There is a difference.

This summer, God has a plan for me.  I don't know what it is.  I would hope the plan is that I will treat a lot of patients, thus showing them God's healing grace; I will find a small community of believers that challenge and encourage me; and I find another individual that perhaps doesn't know God well whom I can invest in.  But those are expectations; and expectations of such a nature are dangerous.  What I should really be expectant of is that God will do with me as He sees fit.  My expectation should merely be that God will ask me to do something; in no way should I attempt to predict what that something will be.  All I can do is whatever the next thing God wants me to do is.

Today, that looks like listening to a Timothy Keller message while doing the dishes.  It looks like packing like crazy between fishing and running my bike down to get looked at.  It looks like posting this blog, which is an opportunity for the rest of the world to see the way I mentally process things.

I want to add, as well, that I will be continuing to update this blog over the course of the summer.  I will be posting at least weekly with photos, stories, thoughts, all sorts of things.  I might bring some physical therapy insights to the table.  I will hopefully be bragging about the giant Northern Pike I catch (a dream I have had since I was a little kid).  I will probably share what the Lord is doing in my life.  I will tell you all about my unusual\ experiences, ranging from weekend trips to dining experiences to probably some general commentary about where I am.  If any of that sounds interesting, or if it doesn't but you love me enough to read about it anyway, feel free to check out this blog.  I'll post links to Facebook and Twitter, so don't hesitate to check them out.

Enjoy your Wednesday, ladies and gentlemen.  Rest in Him, even when packing has you ridiculously stressed out.

On Easter

What are your immediate thoughts when you think of Easter?  Rabbits and tulips?  Eggs and candy?  The Crucifixion?  The Resurrection?  I cannot answer the question for you, I’m sure, but personally, I have thoughts of some combination thereof- and then some.  Here is what I think of when I think of Easter.

I think of Good Friday services, and the anticipation it typically started for a young child awaiting candy and the Easter Bunny.  I think of all of the treats- Reese’s Eggs (which I can no longer enjoy- peanuts are a migraine trigger), Robin’s Eggs, jelly beans, cupcakes, carrot cake, and lemon-blueberry pound cake.  I think of dyeing Easter eggs all manners of bright hues and fun patterns the night before.  I remember watching a cartoon version of the Easter story every year between the ages of probably 3 and 8 or 9.  I remember waking up with eager anticipation to see what the Easter bunny had done.  Usually, there was a large, brightly colored basket containing candy and stuffed animals and coloring books.  The eggs we had dyed the night before were hidden all over the house.  Usually, my grandparents would be there.  Often, they would go to church with us, an event that was preceded by dressing up for what would often be the only time in any given year for me in those days.  Generally, the other set of grandparents would arrive in the afternoon with a load of plastic eggs that were loaded with more treats, which we would search the back yard for.  We would have ham, potato salad, deviled eggs, and one of the previously mentioned desserts almost every year.  We generally watched “Ben-Hur” or “The Greatest Story Ever Told” as a family.  I loved it all- the bright pastels, the sweets, dressing up for church, the Easter story- all of it.  And to me, they were all parts of the same whole.

Easter is my favorite holiday, and I cannot, for the life of me, figure out why it isn’t as big a deal as Christmas.  Two gospels have the birth narrative.  All four feature the Crucifixion, after all.  Christ came to die for our sins, and to defeat death by coming back to life.  His purpose is the reason to celebrate Easter.  Now, that being said, there are many reading this that probably question me when I suggest that I want Easter to be as big a deal as Christmas.  Why would I want the consumerism and media circus that surrounds Christmas every year?  Well, I don’t, necessarily, but I suppose that just comes from a broken world struggling to process something it doesn’t understand.

As a physical therapy student, I have learned that TBI (traumatic brain injury) patients, in one of the early stages of their injury, are generally violent and agitated.  They are then confused and often inappropriate.  It often takes a great deal of time before their responses are appropriate to their circumstances, and even when their responses are “appropriate” to the circumstance, it may still not be correct.  The reason for this is merely that they cannot process the information in their surroundings.  They can’t process the information; they know that something is wrong with them, but they don’t know what.  They can’t figure that out; they’re in unfamiliar surroundings; they can’t attend to multiple problems at once.  Therefore, it is nearly impossible for them to figure out both what is wrong with them and what is going on in their environment.  It is easy to understand, then, why one might become angry or violent, especially when the part of the brain that serves as a “filter” is often one of the most affected by TBI. 

So, using this illustration, I would say that society’s response to Christmas and Easter are akin to a TBI patient.  C.S. Lewis is quoted as saying “If we find ourselves with a desire that nothing in this world can satisfy, the most probable explanation is that we were made for another world.”  We are told in scripture that “the natural person does not accept the things of the Spirit of God, for they are folly to him, and he is not able to understand them because they are spiritually discerned” (I Corinthians 2:14, ESV).  So, we are surrounded by people that do not understand the world they live in.  They know something isn’t quite right, but they aren’t quite sure what it is.  Some respond with anger, violence, and a host of other wrongs and coping mechanisms.  Others respond with a response that seems appropriate (religiously or societally), but isn’t necessarily right.  To me, this is the reason that we have such hubbub surrounding Christmas, and to a lesser extent, Easter.  People recognize the importance of such events, but they don’t understand them, or the world they live in, so they respond inappropriately or incorrectly.

Now, for many people, Santa Claus and the Easter Bunny and elves and eggs and stockings and sweets may be one of those inappropriate responses.  Well, perhaps.  But there is another angle I would want to approach these things.  C.S. Lewis, in his Reflections on the Psalms, talks about a stage in the life of a child in which he is naively unable to distinguish the festive portions of these holidays from the religious.  In his mind, to whatever degree is possible, is yet uncorrupted by the confusion around him.  To the child, the festive portion is a direct result of the religious.  They are inseparable.  Without Christ dying on the cross, there would be no reason for the festivities.  There is no celebration without the sacrifice.  The eggs, candy, pastels, rabbits, and fake grass stuff that gets everywhere are all the inappropriate response of well-meaning people trying to celebrate an event that they cannot fully understand.  But just because it isn’t fully fitting doesn’t make it any less sincere.  It is all done in honor of the sacrifice.  I see no problem with this, or with the festivities around Christmas, despite the complaints of many.  The true problem, as Lewis also touches on, is when the celebration becomes the celebrated.  In essence, the gift-giving, the decorations, and the symbolism become the object of our worship rather than a mechanism for doing so.  The fact that this happens has led many to shun the festive side of these holidays, citing their detraction from the purpose of the holiday.  But as Timothy Keller says, in a sermon which I am struggling to dig up at present, if the only way you can gain freedom from idolatry is to separate yourself from the source of that idolatry, you have no freedom at all.

So, to me, like the child Lewis writes about, composing poetry about “chocolate eggs and Jesus risen,” we cannot separate the celebration from the purpose.  To me, every aspect of Easter points back to the Crucifixion and Resurrection.  Rabbits and eggs and baby chicks represent new life.  We have new life in Christ.  Spring itself represents new life.  Meals are a way that families connect.  Our faith is not meant to ignore our culture, and as a culture, we bond over meals.  Meals, in this case, that feature ham, potato salad, asparagus, carrots, deviled eggs, baked beans, carrot cake, and whatever else would be reasonable to consume at an Easter meal.  Which takes place in spring, I might add, meaning that traditionally, only things available in spring would be consumed.  And potatoes, carrots, and preserved meats (like ham) would have probably been reasonable spring fare.  But why the pastels and candy?  Well, as the color goes, possibly because they just seem to mirror nature.  I don’t think it is any accident that Easter falls during spring (unless you’re in the southern hemisphere, but I think it is fair to say that Christ was not crucified in the southern hemisphere- besides, autumn is equally beautiful, in my opinion).  Nature seems to celebrate with the bright colors of new plant growth, blossoms, and blue skies that break through the winter darkness.  Nature worships its Creator more purely than any sentient being ever could- it simply exists for His glorification.  The candy can be explained simply in that children love candy.  Why not give them some during an event at which celebration is in order? 

To sum up my stance, when I think of Easter, I think of the “commercial” or “secular” aspects.  I think of the strictly religious aspects.  I think of time spent with my family.  I think of spring.  Why separate them?  They are all parts of the same whole.  I wouldn’t eat all of the candy that I do in March or April every year if not for Easter.  My family wouldn’t have a big family meal without Easter.  I wouldn’t dye Easter eggs, wouldn’t hide them, wouldn’t develop an inexplicable fondness for bunny rabbits every spring if not for Easter.  Above all, I wouldn’t be forgiven or free without Easter.  I wouldn’t delve as deeply into the Gospels without the reorientation offered by the conscious reminder that it is Holy Week. I wouldn’t stand out in the inevitable spring chill singing the praises of my Savior before the rising sun if the Savior had not risen.  This time of year would mean nothing without Christ, so how can it be said that the festivities detract from the holiday?  I celebrate life as a result of his death and resurrection.  To me, there should be more at Easter.  No celebration could be enough.  Would you sooner let the day pass with no societal recognition?  Could it be that the media circus surrounding the holidays is being used by God to at least raise awareness that there were events that occurred on these days that a hurting world might take interest in?  I doubt many non-Christians would have ever heard the Gospel or set foot in a church if not for Christmas and Easter getting so much “secular” attention.  God uses events that may not appear particularly holy to bring about His purposes all of the time (Romans 8:28).  He even used the sinful pride of the Pharisees to bring about the sacrifice that would save all humanity.  Imagine how He can use a celebration, a joyful event!

So, I hope you’ll join me in celebrating this week.  Join me for some carrot cake cookies and malt eggs.  Let’s watch “The Greatest Story Ever Told” together.  Let’s go to Easter service together.  Maybe I can pull some strings and have some dyed eggs hidden around the yard.  Let us celebrate together, for the Savior of the World is risen.