Lesson of the Day: Change...Embrace It!

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I have been in the throes of hard-drive preparation for another assignment. There’s no easy way to describe the period of time in which the window opens for another assignment. It requires patience, perseverance, and trust that you’ll end up

• in the right place
• with the right people
• doing work you enjoy.

In the back of my mind, I replay the thought that I am really going to miss this assignment. I have made such good friends and enjoyed many new experiences. I have spent one of the best years of my life here. But I’m just not ready to settle down and go "perm."

Here’s how it works.

My recruiter sends me a list of the openings in the locations in which I am interested. I want to see if there were openings near my parents in Missouri/Kansas and also in northern California. The list reveals no current openings close to Mom and Pops in the Midwest. One option down, I concentrate on California.

My recruiter submits my information to several skilled nursing facilities (SNFs). It takes time.

This is when patience is a virtue. Some managers are on vacation; some SNFs are interviewing other travelers who have submitted their backgrounds before me. There are days in which you think you will be interviewed, and then days in which you think you will have an answer.

Then you don’t!

After 10 days of cat and mouse, I've made a decision.

Where Am I Headed?

I will travel three hours north and west of my current location and settle in a small fishing town right on the Pacific Ocean!!

The harbor, minutes from my new place...

I am thrilled! I have always wanted to live near the Ocean…

The beautiful Pacific close to dusk

and they want an OT who can start a new program.

I am their girl.

This appears to be a SNF that hasn’t had an OT for a long time, if ever. The thought of that generates all kinds of questions in my mind. Will they be open to what it takes for me to build a program?

I ponder these questions while sitting at the Fish House overlooking the Bay eating a hot cup of clam chowder and watching the fog set in.

Surreal. Sitting on the bay under the bridge at the fish house...

....and, then, instead of worrying about the "what-if's," I take a deep breath of the cool, salty air and simply sink into the moment.

Change...embrace it!

Lesson of the Day: Quit Perseverating About Your Illnesses!

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I arrived at work to find a full caseload plus 3 evaluations....(shuffle, shuffle, shuffle my schedule...okay, I can make this work...)

My first evaluation was Rick, barely 60 years old, who could recite every little illness he had ever had. I was amazed at how enthusiastically he recounted every ache and pain.

About Pain

A pain scale assesses intensity of pain on a scale of 0 to 10. These scales are at times accompanied by the continuum of smiley-to-grimacing faces. If you have a patient with cognitive issues, you can point to a picture of the faces and ask, "How do you feel?" They are more likely to be able to point to a face than rate their intensity of pain with a number.

If you have no pain at all, you're sitting at zero.

If you...

• Think you need to go to the ER
• Are unable to suppress a scream
• Are writhing in pain or spasms

you're sitting at a 9 or 10.

In between is "hurts a little" to "hurts a whole lot."

This guy, like many of my patients diagnosed with chronic pain syndromes, demonstrated absolutely no nonverbal signs of pain. He was smiling and talking nonstop when he rated his pain at 8/10, then,
...6/10 in another area,
...5/10 in another,
and...9/10 in another.

In my 15+ years of experience, men generally rate pain higher. (Am not sure why, but I'm thinking, "Could they ever make it through childbirth?")

So, I want to say two things...

First, I acknowledge that for each patient, their pain is real. Whether we as health care providers believe the intensity or not, it's real to the patient.
Second, there's a line of thought that says:  What you think about, you manifest into your life. If you think about illness all the time, if you think about pain all the time, you are more likely to experience it.

What do you believe? 
And what would you tell your patients? Or your family members? 

Let me hear from you...

Make Your Day Sweeter...

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Last week, I walked into a new patient's room. His lovely wife had set up the most beautiful tray to brighten his day... a china cup and saucer filled with coffee and cream (nearly unheard of in a skilled nursing facility except maybe in the doctor's lounge). Beside it was a china plate holding the most enticing sweet! I asked what it was.

"A florentine!" she said, and proceeded to tell me which boulangerie she had visited that morning. (Love the bakeries in northern Cal!)

The florentine she brought her husband was actually rolled with a light cream filling inside. I couldn't resist. Yesterday, I walked over and picked one up at the bakery.

It was...melt-in-your-mouth delicious!

So, imagine this:

http://allrecipes.com/recipe/milk-chocolate-florentine-cookies/detail.aspx

rolled and injected with a cream filling...

Yum! 

Lesson of the Day: Mr. Charlie Taught Us to "By-Grab-It!"

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Have you ever had a week of days where it's a victory just to get through each day? Last week was just that...No one who works in healthcare can consistently feel compassionate, patient and giving all the time.

During those hard-to-take moments, when we really wish we could go home, take a walk, eat a pint of sorbet or just take a nap, all we can do is

"By-Grab-It!"

Do any of you know what that means?  I tried to define it on Google, and all I come up with is a description of some new technology. My family members know what it means.  Whoa, do we know what it means!

A crusty, old WWII vet tobacco farmer in my home state introduced this word to my 6 siblings and me; he turned out to be one of our greatest life-lesson teachers.

MR. CHARLIE.

Mr. Charlie was the sole survivor of his company during the Battle of Normandy, shot full of shrapnel. In what we thought (in our youth) was a ripe old age, he stood 5'2" tops in his bib overalls and  flannel shirt. And he moved faster than most men a quarter of his age.

The man was a machine!

If you needed something done, Mr. Charlie had it done before you could blink. He finished his tobacco harvest long before all the other farmers and headed out to help his neighbors.

We were lucky recipients of his time and wisdom, though, at the time, we didn't necessarily see it as such!  You see, he always seemed to show up late in the evening, 10 or 15 minutes before it was quittin' time. Right before we planned to head in to the house to finish homework.

The dogs would begin to bark. The slice of headlights would light the starry sky in the otherwise black night. His truck tires would crunch down the snow-covered, quarter-mile lane.

Mr. Charlie would hop out of his truck as if he had downed a double espresso. The door to the stripping room would fly open. Now, what do you think that means?  Sound naughty?  Well, it's just the place tobacco farmers call the place they remove the leaves from the tobacco stalks.

We'd turn to greet him as we stood in line at a long table covered with tobacco plants, stripping cured tobacco leaves off the stalk, grading and separating them by quality.

"Well, Byyyyy-Grab!" he'd exclaim, closing the door. His weathered and whiskered face taking in the sight of us. His wide smile revealed shiny, pink gums. Not one tooth. "It's a good night for strippin' some tabaccer!"

Inside, we would groan, knowing it would now be at least another hour, or two, until we'd feel the warmth of the house and be able to sit down to finish our homework.

What's with the "by grab?" we'd ask each other early on. We never asked, and he never told.

But...what happened over time is that it became a verb.
           -
verb \bi-'grab-it\  sink your heels in and don't look back. Just get 'er done. As in, "You're just going to have to by-grab-it. Tough it out!"

Then, it morphed into an adjective.
                   -
adjective \bi-'grab-it\  an attribute characterizing perseverance, strength, initiation and reliability all rolled into one. As in, "He's a real by-grab-it kind of guy. He gets the job done!"

Today, 9 years ago, Mr. Charlie left this earth. When I attended his funeral, I was struck by the impact this sprite, tough, little man had on our lives. He still comes up frequently in conversation and so does his life lesson.

Mr. Charlie taught us how to keep on going, even when you want to quit:

Continue to put one foot in front of the other, even on the worst of days...

Keep moving...

Keep your head up...

Look only to the next step so you're not overwhelmed...

Keep going until you're DONE.

Nike said, "just do it!" Mr. Charlie said it even better.

Every day last week, that seemed to last 120 hours each, when fatigue and impatience were itching my skin, I thought about Mr. Charlie.

I sunk my heels in...

....and just By-Grabbed-It.

Introducing....My Recruiter

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So....here's the good guy who made the last year possible for me.

Tony Leber from Med Travelers

Tony has been a recruiter with Med Travelers for two years. Before Med Travelers, he recruited travel nurses for InteliStaf Travel (Medical Staffing Network) for 2 years.  Prior to MSN, he started his career at Martin Fletcher working as a recruiter for permanent placement RN’s.

Here's what sets Tony apart.  He called me on a fluke when I was working an assignment in the Midwest, and he stayed in touch. He never bugged me so much that I avoided his calls. (Once you travel, you start receiving weekly calls from numerous recruiters, some of whose calls you consciously let go into voice mail.)

Once Tony started looking, he found a perfect assignment. An assignment that was not listed. He called companies until he found a location within less than 30 minutes from where I wanted to stay.

He has checked in with me during the assignment. He answers phone calls nearly immediately. I haven't had to call him often, but I know if I need anything, he would be there for me 100%.

Tony has taken great care of me, and I appreciate his professionalism!!

Because I am more than willing to share a good thing....if you're looking for a great recruiter to help you through the process, give Tony a call!

Lesson of the Day: ENJOY SMALL BREAKTHROUGHS

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It is 6:30 pm. I am getting ready to leave work, dead tired. I hear Joan's voice at the door.

"This is it...right here. This is where we're supposed to be."

I swivel around on my stool from the computer where I'm feverishly trying to finish the mountain of rehab documentation that never goes away, and in wheels Joan with Monty in tow. I will stop heaven and earth for those two.

Something amazing happens when the 3 of us are together.

Joan came to our nursing facility when her dementia and other medical conditions became too much for Monty to care for her at home. Monty drives 45 minutes one-way every evening to have dinner with Joan. I don't want to say too much about them because "Mont" has given permission for me to interview him about 'dedication'.

Joan rarely remembers my name, but she will call out to me from 30 feet away. Sometimes I am Mary; other times, Carol. The one thing that is consistent is that she associates me with Mont because I go to the dining room almost every night to tell them goodbye.

So, my plans immediately change. I will not leave work at 6:30. I put Dean Martin in the stereo and sit down. Joan is very communicative tonight; much of the sentence structure doesn't allow for understanding a train of thought, but her affect and her enthusiasm are what is important to enjoy. Monty does such a great job of allowing Joan to just "be." 

Joan lets me clip and clean her nails. I'm the only one, Mont says, who she will allow. We listen to Dean sing "That's Amore."

As they turn to leave from our brief visit, Joan begins to speak in full sentences, reflecting accurate information about her sisters, their age differences, and her early adult life in Germany as a singer for Armed Forces Network.

Then she talks about when she and Monty met. She looks up at Mont and says, "We will be together forever. Really, forever."

Amazing.

Monty and I look at each other, pleasantly shocked!  I lean down to Joan and look her in the eye.

"Joan, you are just wonderful!"

Her face lights up with an expression I really can't describe. What she says next, with a sincere and emotional tone, touches me deeply.

"I love you."

This conversation lasts only five minutes. Its impact continues.

Isn't life better when we are aware and grateful for small breakthroughs!

Photos: What I Love about being a Traveler

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Just back from a great Saturday in Half Moon Bay, California, with an early evening stop in Sausalito as I head home. I've enjoyed the presence of some great friends here I would never have experienced if I had not taken this assignment.

That's one of the many things I like about being a traveler!

My running trail on Saturday....the coastal trail above the Pacific...

When the conditions are perfect, hoardes of surfers hit the waves...

Live starfish in the rocks of Half Moon Bay

Surfers heading home...

This location is my friends' secret spot for a glass of wine and a million dollar view of the base of the Golden Gate Bridge. On clear days, they tell me, you can see colorful barges heading in and out of San Francisco and a great visual of the bridge. Last evening, it was foggy, surreal and, oddly, comfortable...

I've loved this assignment!

OTs Out There: Please Help These Students With Their Survey

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It's an overcast morning in northern California, and the flecks of rain are suspended in the air, it seems like....60 degrees. In the midst of the heatwave across the Midwest, I am grateful to be in such a beautiful place. So, before I start work...

OK, guys, we received a letter in our rehab department this week from some students at California State University. I am going to type the text of it because I'd love for you to considering taking their survey. Here goes:

To A Fellow Occupational Therapist,

We are 2nd year occupational therapy students at California State University, Dominguez Hills. We are currently conducting a quantitative research study on spirituality - which has been approved by the IRB - under the supervision of Eric Hwang, PhD, OTR/L and Yan-hua Huang, PhD, OTR/L.

The goal of our study is to see if there is any correlation between an occupational therapist's personal sense of spirituality and how he/she applies/addresses spirituality in his/her practice. If you have a moment, we would like to invite you to participate in our study by taking an online survey.

There are 30 questions that should take no more than 10 minutes to complete. As an additional incentive, not only will you be helping us extend current research on spirituality and the role it plays in OT practice, but you will also be entered into a drawing for a $30 Visa gift card! Just email us at otspirituality@gmail.com and we will send you the link to our questionnaire.

Also, please feel free to pass this information along to other practicing therapists you know. We greatly appreciate your time and effort in contributing to this important study.

With sincere gratitude,
Melissa Baylor
Maribel Cervantes
Enffie Chen


Thanks, in advance, for helping these students receive a great response!

Tre

What to Consider: IF YOU'RE A WANNABE TRAVELING THERAPIST

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No life lessons today.  Just some recommendations in case some of you are considering a medical, nursing or rehabilitation travel assignment.

Experience

I'm not yelling, but I need to put this part in caps:  YOU SHOULDN'T EVEN THINK OF BEING A TRAVELER IF YOU ARE FRESH OUT OF SCHOOL.

You could be put in ethical dilemmas you never dreamed of due to your lack of experience. Get some experience in the field, then travel in the setting in which you've become experienced. 2 years is good. You're a baby therapist until then.

These buildings benefit from experienced therapists who have the experience to make a positive impact.

This is to OT's, since we have a crazy shortage: It is likely in many locations that you will be the only OT.

Newbies need mentorship! The buildings need a confident expert!

Skilled nursing facilities (SNFs) need you to have knowledge of contracture management and wheelchair positioning. You shouldn't consider skilled nursing unless you can take a wheelchair apart and put it back together, eye a resident and tell your co-workers what size wheelchair width (s)he needs without pulling out a measuring tape.

I've heard of OT's who say,  "I don't do wheelchairs!"

I say, "Shame on you."

Research

Do your homework!

Go onto the state website for any state in which you wish to travel. If you want to go to a state that takes months to get a license (like California), start the process on your own before you contact the recruiter. You can negotiate their reimbursement of the license.

In my case, I took a fun trip to California in December 2009 to get the required Live Scan fingerprints completed. I pulled everything together by March 2010 (not in a hurry, since I was not at that point mentally ready for the change), and I received the license in early July 2010. By the end of July, I was feeling an itch  that had to be scratched (though I loved the therapy team at the building in which I was working). I was certain of my assignment in California by mid August 2010.

For me, it was all about the recruiter. I was working for a different travel company two years ago when I received a call from Med Travelers. The recruiter presented me with an opportunity to work with them in Fall 2009, but I chose another option and ended up in Kansas City.

It was while working in Kansas City in Spring 2010 that he called me again, and this time, I knew I wanted to work with him. He had been so professional, so patient. I want to highlight this recruiter sometime, so I won't say any more, but to keep it simple, working with Med Travelers has been a very positive experience!

Gut Feeling

Test your gut feeling when you talk to each recruiter. Trust your intuition! The one with whom you feel most comfortable and trust the most is your future recruiter.

It doesn't matter if they aren't paying quite as much as the other guys, believe me!!

My first recruiter from another company was a guy who always seemed to be on the beach or rescuing puppies. He didn't return calls. He didn't do squat to provide options for my next assignment, even though the pay was stellar. In the end, it wasn't worth it.

Most travel companies, in fact, offer very similar packages. So, beware the ones who offer you the moon, the sun and the stars!

Details

Ask recruiters for names of therapists on current assignments so you can interview them. Make a list of things you need explicitly written into your contract. For instance, make sure you write any planned vacation time, reimbursed travel or guaranteed hours per week into your contract.

Make sure you clear all tax questions about living and working in different states with the company with whom you wish to work before you start, especially if you own a house and will not occupy it.

...and FYI, your assignment needs to be greater than 50 miles from your home of record, or your per diem benefits (lodging/food) are taxable.

If you stay in the same assignment for over a year, your per diem benefits become taxable, which is why I am leaving my current beloved assignment after September 7.

If you wish to get relocation reimbursement, keep in mind that it will come out of the same pot of funds from which your weekly salary is paid.

For example, if you want full reimbursement for driving cross country and staying in hotels for 3 days, you'll end up with a slightly smaller salary on a weekly basis over the course of a 13-week contract than if you took a smaller sum. It depends on what you want, just be aware.

The Interview

When you interview with your particular assignment, ask:

• Why they have an opening
• How long it has been since they had a permanent OT
• How long their current traveler has been in place
• The size of the building For example, if you are asked to be the only OT in a 150-bed building, you should know you are going to be absolutely swamped, doing documentation after hours and probably crying when you drive home on Friday nights. Just ask!
• Don't be afraid to ask about the building's issues (every SNF has some issues)...

I can tell you that if you have solid experience promoting joint integrity and postural stability through contracture management and positioning programs, they will want to snatch you up.

Granted, that is not all that you will be doing. It's likely you'll have a variable caseload of Medicare A, HMO and Medicare B patients. If you have questions about this, send me a comment, and I will outline it for you.

Due Diligence

If you want to be a real star, go onto the Medicare website and check out the skilled nursing facility for which you are interviewing.

From this tab, type in the name of the building and check out the number and type of deficiencies (aka "tags") the building had from the last posted state survey.

This will fulfill your due diligence, as you may be able to discuss clinical issues and determine what programs you may be able to initiate or assist with to improve quality of care.

Again, trust your gut.

When I interviewed for my current post, I was rock solid after an hour talk with the regional director of ops that I would love this building. In addition, I found she was the only other OT in 15 years of practice that clinically problem-solved the same way I did with long-term care patients.

Wow! She has turned out to be an incredible ally and peer.

If you're hesitant to be alone, travel to a location where you have friends or family. Don't be afraid to explore! That is the great advantage of going various places...it's a big, wide, wonderful world.

Tre

P.S. If you're thinking of traveling and have questions, write me!  I'd be glad to help you through the process.

Lesson of the Day: ENDINGS = BEGINNINGS

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The theme today was endings, or it is... beginnings? I think it's both.

An absolutely stunning, petite woman was admitted for rehab just before I went on vacation. While I hoped that she would be well enough to go home before I returned to work, I was secretly pleased yesterday when I turned the corner at the nurses' station and set sight on Rita's serene smile.

She's bald and less than 85 pounds. Her baseline? Thick, black, luxurious hair and 110.

She's fighting her cancer with a vengeance. And she has four daughters doing battle alongside her. You could say, in fact, that at times, they are doing battle with her.

"Ma, maaaaa, take another bite! Just one more..."
"Ma, it's time for your exercise."

There have been moments in the process when her grip on the armor lessens, and I see fatigue. Fear. She has confided that her girls are afraid she is going to starve to death because of how the cancer affects her ability to eat and eliminate waste.

Rita is primarily concerned about her adult children: "What will they do? They have already given so much of their time and energy. They have their own lives to live. I'm afraid they will burn out."

Yesterday, she had a procedure done to drain fluid off her abdomen that set her back five paces. Her stomach pain throughout today was at times intense.

I spent a few extra minutes with her to provide a Reiki treatment, a Japanese technique for stress reduction and relaxation that also promotes healing. I knew this would allow her to relax and manage her pain more effectively.  I have integrated Reiki into my OT practice for years.

If you're curious, check out the International Center for Reiki Training.

In the middle of the treatment, she popped up for a moment, rolled from her back to her left side and picked up what looked like a thin, green pocketbook off her tray table. When she snapped it open, it was a photo album that her granddaughter had made for her, a complete collection of family photographs of her with kids and grandkids interspersed with Bible quotes .

She pointed out each family member, and then, her finger stopped on a gorgeous, sophisticated woman.

"This is me with hair."

I focused on this woman who I already felt was beautiful without hair.  I suddenly realized the severity of her loss. Literally, physically, emotionally. It was more, of course, than just about hair. 

"You know, Rita," I said, "has anyone told you how perfectly your head is shaped?" (It really is.)

She smiled. "Quite a few."

"Well," I said, "I think you look great with very little hair!"

And she replied, "I think I might keep it short...even though it is going to be gray now."

I told her about a friend of mine who did that in her late 40's, went gray. Quit coloring. She looked stunning.

I also told Rita that she is still the same Rita that had hair, that weighed a little more, that had the energy to cook for her big family. The same Rita. That Rita had not extinguished. She was still right here in my presence.

The crease between her eye brows deepened, and a tear welled up in her left eye.

"OK."

An ending; a beginning.

Later that day, Eileen arrived. When I knocked on the door to introduce myself, an aide was guiding her out of the bathroom. As she pushed with a walker, I observed a bobbing and weaving pattern unlike the more characteristic symptom of Parkinson's Disease, the tremor.

During her evaluation, I had to concentrate deeply on 2 things. 

First, I had to focus on the movement of her lips to understand her, because her speech was barely audible.

Second, I had to follow her lips, as her head and upper body weaved back and forth rhythmically. The only time they stopped was when she took a deep breath. I was exhausted from concentrating by the end of our session, but this time with her was one of the highlights of my day.

Eileen was lovely!

As we tested strength, balance, and cognitive abilities, we made a list of all the activities she cherished the most. After all, as an occupational therapist, it's all about returning people to the highest level of function so they are able to engage in life!

A short time ago, Eileen had been walking 9 holes weekly with a ladies golfing group. "We can swing golf clubs during your balance retraining!" I told her. She had been a voracious reader, but macular degeneration had limited her sight, making her central vision blurry.

"Are you open to audio books?" I asked her.

"Absolutely!"

"Perfect!" I'll bring the application tomorrow for the State Talking Book Library in Sacramento. You'll be going through a book a day in no time."

I explained to her that when we do OT, if a person cannot fully return to the activity they once loved, it is not lost forever. The activity may simply need to be modified.

Eileen paused for a moment during the evaluation. "Sometimes, I wake up in the morning ready to bounce right out of bed like I used to. I forget that I can't. I think it's time to load the clubs in the back of the car and take off.  Then, just getting out of bed is a reminder."

"Eileen, you are still the same woman who golfs with friends. You are the same woman who has helped so many children in your job. You are still the same person on the inside."

So many of my patients tell me stories like this. Someone with a stroke whose arm won't move will report that they dreamed they had full use of that hand or another will say he walked. It all feels so natural and "complete" in the dream state.

Some awaken dejected. Others are motivated by their dreams. Their reactions are usually consistent with their outlooks on life.

They will either see their current station in life as the end of the road, or they will shift through their former perceptions of what life was into a new and meaningful way of living . Living fully. Despite the obstacles.

Dr. Wayne Dyer wrote a small paperback called Living the Wisdom of the Tao. In it, he includes the 16th verse of the Tao Te Ching, part of which goes like this:

"...let your heart be at peace.
Amidst the rush of worldly comings and goings,
observe how endings become beginnings.
Things fluorish, each by each,
only to return to the Source...
to what is and what is to be. "

If a major illness or injury happened to you, would you choose to think your life was ending or beginning?

Endings = beginnings.

Lesson of the Day: WORDS OF AFFIRMATION

 I noticed a trend today. Appreciation!

I was greeted this morning by nursing facility residents with bright smiles, "ohs!" (new hair style - they all noticed, even the ones with dementia!) and sweet words ("We missed you, Tre! We're so glad you're back! How was your vacation?) I felt such appreciation!

Isn't that a great way to start the week!

There's a book I'd like to recommend. The 5 Love Languages by Gary Chapman.  In the book, Chapman introduces five ways in which people demonstrate their love for each other.

One of these is words of affirmation.

Receiving such sweetness from my older friends fueled a desire to pay forward positivity today. What "something special" could I note and share with each person in appreciation of them?

I understood more about Hank during his occupational therapy appointment today. I palpably felt his anguish as he opened up about a childhood rife with abuse by his mentally ill mother and social isolation at school.

This man, however, navigated through a miserable childhood into a meaningful life as an artist and teacher, father and friend.

By the time we parted, I realized that tatoos were Hank's route to a life of creative expression, friendship and empowerment. Every tatoo represented a significant moment or mark of friendship in Hank's life. Some of us may choose photos or jewelry or momentos to remember special events or beloved people.

Hank chose art...
...on his skin.

He morphed today from just a guy with tatoos to an authentic creative professional.

What I appreciated about Hank was his dedication to his art form and his contribution to the education of future tatoo artists. College degree in art, years spent teaching newbies in a seven-year apprentice program...

Seven years?! I had no idea....this wasn't just a two-week training session...

I gave him kudos. That's all I could do. He beamed.

Appreciation.

Shortly after, I sat down with a resident with dementia who had recently undergone inguinal hernia surgery. Earlier in life as a surgeon, Ron  had corrected inguinal hernias.

I explained to Ron that we needed to work together because his surgery and hospitalization had weakened him.

"What surgery?" he asked.

"Well," I replied, "you had a right inguinal hernia surgery last week."
He immediately touched his right groin area. I asked, "Dr. Ron, how do you fix a hernia?" And he launched into an admirable description of how to surgically correct it.

Wow.

In the healthcare world, we always check something called orientation. Do you know:

1) who you are
2) where you are
3) when it is; and
4) why you're there?

Dr. Ron was oriented only to who he was, yet he could retrieve from memory how to perform surgery!

Dr. Ron was not the same after surgery as before; something subtle had shifted in his affect. When I looked him squarely in the eyes at the end of the treatment to congratulate him on a job well done, his dull eyes locked with mine, and suddenly, it was as if they lit up. They sparkled...and then a smile emerged that I had not seen in quite some time.

My heart squeezed. "Dr. Ron, you just made my day."

He winked.

I wanted to talk a bit more about Dr. Ron's work. "So, tell me about the other surgeries you used to perform."

"Surgeries?"

The moment was lost.

Dr. Ron may not always remember what a difference he has made, but it didn't stop me from reminding him.

We all want to know that we contribute in some significant way. It's also up to us to acknowledge the contributions of others.

 Appreciation...pay it forward!