On my second day of pediatrics fieldwork, a 10 month-old baby puked directly down my shirt.  I'm sure some of you know this, but there is nothing like the feeling of formula vomit nicely congealing in your bosom.  Makes for a lovely smell, too - especially when you have nothing else to change into and 5 hours left in the workday.

This, among many things, led me to wonder why so many people want to work in pediatrics.  It's not like I haven't been vomited on before; with 5 nieces and nephews and an illustrious babysitting career behind me, I've certainly been there.  Bodily functions don't bother me.  Yet somehow, the Bra Meets Puke incident really solidified my decision not to work with kids.

Why do so many people seem to want to work in pediatrics?  The majority of my class seems to be headed in that direction - though it has changed since we entered school.  I understand the basic reasons for choosing pediatrics: just loving kids, wanting to help them, enjoying the schedule of one who works in a school...but does the good outweigh the bad?

It's not that I don't like children; I love them and want some of my own when the time is right.  I just find it harder to work with children with developmental delays or disabilities.  It's more upsetting to me that a child is starting out at a disadvantage.  It seems unfair, somehow.  At least with adults, they've been able to (hopefully) live a part of their life without having to worry about sickness or disability.  You only get one short, whirlwind childhood.  I wish a lot of the children we OTs see didn't have to spend such a big part of theirs playing catch-up, or stuck in therapy, or struggling to relate to their peers. 

In the same way a St. Jude's commercial tugs at your heartstrings more than another hospital's might, seeing a child struggle tugs at me a little bit more than an adult.  I doubt I'm the only one.  So why do so many of us work in the school, the early intervention center, the home? 

Maybe it's because when a child succeeds, the victory is that much sweeter. :)

Now, normally students love watching videos in class because it means it's not a lecture and they may not have to take any notes.  Sometimes, videos are genuinely enjoyable and you as viewer and student are able to get a lot out of them.  Unfortunately, the percentage of times I've benefited from the videos in my OT classes is somewhere around 20%.

I'll admit it's highly entertaining to watch the other 80% of these videos.  The clothing and hairstyles are just atrocious.  Usually the music is pretty bad, too, in that ‘I can't believe people thought this was cool' kind of way.  There is also the occasional use of outdated terminology; let's just say I've heard the term ‘mongoloid'.  While all of this is hilarious in its own way, it's also frustrating.

I frequently think about what a person who didn't know what OT was would think if they saw one of these outdated videos.  They would think we did arts and crafts all day!  Also, the information being provided is in some cases incorrect now that more research has been done and new strides made in the field.  More than once, I've been watching one of these videos only to have an instructor say: "Ignore that part, it's wrong."  How is inaccuracy helpful to me or anyone else?

So this is my call to everyone out there - and I mean everyone - to start making new videos!  If we want people to understand and respect our profession, we have to present it better than a few dusty VHS tapes from 1982.  New and engaging videos would also prevent a large number of TBIs, because students would no longer be banging their heads on their desks.

Okay, I know that was a bad joke.  But seriously, guys, our videos are terrible.  To finish this out, here is one of the more enjoyable OT videos I've found:

http://www.youtube.com/watch?v=oSM2rrIKdNs

When I decided to return to graduate school, I asked my sister what it was like.  She assured me it was easy and I would breeze through it.  Clearly, she did not attend school for Occupational Therapy!  You'd think a master's degree in Finance would be difficult, but for her, it wasn't - she obviously got the lion's share of the mathematical brains.

So, the first time I saw her after starting graduate school, she was startled at how tired I looked.  She not-so-politely inquired if I was going out and partying too much.  I not-so-politely laughed in her face.  Going out?  That was a mystical concept, like Atlantis or Shangri-La.

The reality is that OT school isn't easy - especially not as a short graduate program.  To outsiders it seems like a sort of ‘lightweight' profession.  They don't realize that because we treat the entire person, we have to know about the entire person.  We have to learn and incorporate anatomy, physiology, psychology, human development, cognition, and many more.  We also have to be incredibly flexible, creative, and patient, not to mention know how to talk to those we treat and their families.  We're pretty well rounded people!

The price for being well rounded (and well educated) is that as a student, you might have to stay home more.  You might have to pass on a Thirsty Thursday outing.  You might have to leave early.  You might have to schedule fun into your planner like a doctor's appointment.

Does this suck?  Yeah, a little bit.  But scheduling fun just means that when the time comes, you better make sure you capitalize on it.  Here are a few ways that you can have fun and increase your camaraderie with your classmates at the same time.

• 1. After big exams, plan some sort of celebration. This can be a trip to the bar, a meal out, or just a picnic somewhere on campus.
• 2. Plan group happy hours. Many bars are happy to accommodate groups and negotiate reasonable prices for a few hours of open bar. These can double as fundraisers - just tack a few more dollars on to the price and put that extra towards your goal.
• 3. Holiday parties! You're never too old for these.

When you're not hanging out with your classmates...well, you're on your own.  I'm sure you can find something to do, but if not: http://www.thingstodo.com/.

10. Realizing that there is only one male in my class (estrogen fest, commence!)

9. The 115 slide PowerPoint lecture on funding sources for assistive technology

8. The day I almost chopped off the tip of my left index finger in a freak bagel accident and could only think about tendon lacerations and what kind of hand therapy I would need

7. Trying to cross Broad Street in a manual wheelchair

6. The burn lecture (or, the pictures in the burn lecture)

5. The first time I received a copy of a certain professor's anatomy notes

4. Realizing that I am stuck with the same 31 people for the next two years

3. Realizing that when those two years are up, I'm going to miss these 31 people horribly

2. The first day of cadaver anatomy

1. The first day of fieldwork

But I have a confession: I strongly dislike group projects.  I know I'm not alone in this.  Everyone's been down the dark road of a dysfunctional group project.  You do your part, and inevitably there's someone who doesn't do theirs, does it poorly, does it wrong, or appears to never have learned how to express themselves in English.  That leaves you scrambling to patch it up and make it presentable - and then the people who did nothing received the same grade as you when you did twice as much work.

This was the nightmare scenario I was envisioning when I was assigned my first group case study.  I was readying myself to be the person who made it all work in the end.  I cleared my calendar for the night before the due date.  I battled flashbacks from high school and middle school.  I stalked people who had dropped the ball in groups past over Facebook, glaring disdainfully at their pictures.  I was ready.

Fortunately, I found that my classmates are smart, articulate, responsible people.  There isn't one person in the bunch who is lazy or not invested in the program.  Everyone is just as neurotic about getting things right as I am.

That led to a whole new set of problems, though.  Now we are all so focused on our hypothetical patients that we spend hours debating what is the right intervention, the right goal, the right meaningful activity...I vividly remember my first pediatrics case study.  It took use three hours just to agree on goals.  The funny thing is that we were probably all correct in the goals we wanted to use.  A lot of the time there isn't just one right answer.  That's part of the beauty of OT.

We did brilliantly on that case study.  And about a dozen group assignments later, the lowest grade I've gotten on any of them is a 92.  I suppose I can't complain...but now I worry that when I get out there on my own, I will have a hard time figuring out what to do without my panel of 5 other talented OTs to contribute!

So is this group work breeding cooperation or codependency?  Probably a little bit of both.  As long as it results in the best care for our patients, it's a risk we'll have to take.

I have to say that the single most annoying thing about being in the OT field (at least for me) is...THE QUESTION.  It's that constant obligation to explain what an occupational therapist is and what our job entails. 

After I began my program, Thanksgiving was more hellish than usual because all of my relatives had a sudden curiosity about what I was in school for.  I guarantee you that none of them even knew what my undergraduate degree was in, but they wanted answers about OT.

Finally, after the fourth uncle and ninth relative overall asked me The Question, I gave a classic response.  It's still my favorite.  I put down my drink, pointed at my 91-year-old grandmother's chair lift in the stairwell, and said, "THAT!  I do that."

No one else asked The Question that day.  Perhaps they sensed my irritation.  The real kicker was that for each of the nine times I was asked "So what's OT?  Like, what do you do?", I gave a different answer.  That's the nature of OT.  It is so broad and so focused at the same time.  I could've spent the entire holiday explaining it to just one relative.

Since then, I've thought about how I can be a good educator to those who don't know what OT is.  Here are my top 3 strategies for answering The Question.

1. Quote the OT Practice Framework, if you can figure out WHICH is the current and accepted version of it.  Then break it down for the person into laymen's terms.  Give an example or two.

Example:  "Well, the professional jargon is: engagement in occupation to support participation in context.  What that really means is that we try to help people recover their health or be as independent as possible by using activities that they like in a place that's familiar to them.  That way, they want to do what you're trying to teach them and it's easy for them to do at home on their own.  So, if I'm working with an older person who is recovering from a stroke..."

1. If you're interested in a specific area or are already employed in a certain segment of the field, talk about that.  If you do early intervention, talk about the children you see, the deficits they have, and what you do to help.  If you do hand therapy, talk about the injuries and problems you deal with and the types of practices you use to alleviate them.  It's easy to talk about what you are most interested and experienced in.  However, be sure to let the other person know that what you're describing is just one area in a very broad field.

1. If you're short on time and/or patience (you know it happens from time to time), offer a website or some other source of information.

Example: "Listen, I'm really short on time right now, but if you're curious, you can go to the Occupational Outlook Handbook online.  If you just Google that, you'll find the site and you can do a search for occupational therapy.  It's a really good resource because it's how the government defines different kinds of jobs.  It can tell you more than I can right now!"

If you're curious what OOH says about us, here's the link:

http://www.bls.gov/oco/ocos078.htm

I've also suggested AOTA or Wikipedia.  One of my professors is experiencing a sudden fit of the vapors at my endorsement of the W-word, but Wiki is something that people know and it generally contains articles that are easier to understand.  People may not follow through and look at the websites I recommend, but if they really have any interest, they'll probably continue to seek the information.

There you have it, folks.  Now you're armed and ready with answers to The Question.  Since I'm feeling indecisive this week, I don't know what I will regale you with next.  Stay tuned...

Note: This blog was originally posted without its ending! Please re-read to find out how Andrea went from a PT student to a Transition Counselor and Job Coach to an OT student! --Jessica LaGrossa, Web editor

So, I'm sure you're all wondering how I got here.  It's a salient and personal question.  I will do my best to answer it in excruciating detail. (If you understand that reference, then you know where I'm currently attending school.)

I was born at the very end of 1983, on December 27, which means that I'm constantly robbed of birthday presents and celebrations and missed every educational cutoff in existence.  It also means that my parents considered naming me Joy Noel, which would have been terrible (apologies to anyone out there who is actually named this).  Thankfully they came to their senses, and here I am, Andrea Lorraine.

I was always a tomboy.  I had no time for dolls with the notable exception of my One True Love, Mr. Larry.  Yes, I named my androgynous childhood doll Mr. Larry.  I have no idea why, but let it also be known that my first goldfish was named Popcorn Princess Gummi Bear the Third.  Clearly the creative talents were just bursting forth in me from the get go.

But as I was saying, I was a tomboy.  I preferred mud and worms and sports.  My parents were fine with that, though my mother would often ask me when I returned home from playing if I had left any of the street/field/backyard behind.  The answer was usually no.

I discovered early on that I had a talent for soccer.  You wouldn't be able to tell if you looked at me now, but at one point sports ruled my life.  I was soccer.  I wanted to be on the National Team.  I don't know that I ever would have made it, but it was a nice dream and I was pretty darn good.

When I was 16, I tore my ACL in my left knee during a summer league practice.  At the time it seemed catastrophic, but it was actually the beginning of my journey to the world of occupational therapy.

What followed was surgery and 8 months of physical therapy.  It wasn't supposed to take so long but a horrible bout of tendonitis around month 4 set me back.  A few cortisone shots later I was able to get back in gear and was finally cleared to return to sports in March 2001.

Those 8 months in physical therapy made my career decision for me, or so I thought.  My therapists were amazing people.  I never would have recovered and gone on to achieve even more without them.  The timing was convenient; I began to look into colleges that had physical therapy programs.

I found one, incidentally at a place with one of the best OT programs out there, as well.  However, at the time I had no idea what OT was.  I blazed into college and jumped in head-first, thinking my life was completely on track.

After 3 semesters, that spark was gone.  The feeling that had initially drawn me to PT was nowhere to be found.  Something was missing and I didn't quite understand what.  I did understand that I needed to change my major. 

Don't get me wrong.  I don't have anything against PT and those who choose do it, and I am still close to some of the people I met in that program.  It's just not my cup of tea.  Or, more accurately I should say that it is not my variety of tea; to extend the cheesy metaphor further, PT was the Darjeeling to my OT Hibiscus.  They're both important health professions, just with a very different flavor.

Fast forward to 2006.  I'm a college graduate with a bachelor's degree in Counseling and Human Services.  Yes, counseling.  I followed my heart and got one of those degrees that is flexible and applicable to just about everything, but also kind of useless all on its own.  All along I knew that I would have to go back to school for a master's degree; I just wasn't sure what profession I wanted to pursue.

I then got a job working for a company as a Transition Counselor and Job Coach.  I found myself working with students from 14 to 21 years of age, all of whom had disabilities and wanted and needed to plan for their futures.  Slowly, as I worked with each student at their jobs and attached pouches to wheelchairs, demonstrated how to use a folding board, and helped teach life skills, I realized that much of what I was doing was very close to occupational therapy.  I was giving these students what they needed to function independently at their jobs.  Suddenly, the missing piece of my physical therapy puzzle became clear.

I wanted something holistic.  I wanted something that sought to compensate or adapt as much as it sought to fix.  I wanted something that had real meaning to and lasting impact on a patient's life.  What I wanted was OT and it was such a relief to finally understand myself and my crunchy granola desires.

So here I am now, in my second year of school.  Do I still feel that OT is the right choice?  Absolutely - and I'm not just saying that because of the exorbitant amount of money my program is costing me (though that is a strong motivator).  The more experience I gain through fieldwork and other sources, the more certain I am that I made the right choice.

Are you bored yet?  It's okay, I know I got a little too serious and introspective there.  I promise it won't happen again.  Next time I'll talk about one of the most interesting and irritating parts of being in the OT field: explaining to other people what you do (or will do) for a living.

Hello, everybody!  Thanks for stopping by and checking out my blog.  I was delighted to be offered the opportunity to blog for Advance, a great magazine and resource for the OT profession.  When the chance arose, I read up on the magazine, checked out the websites, and investigated some of the other blogs.  I was very impressed and excited at what I found; all in all it's a great source of information that can bolster my ongoing education.

I was struck, however, by the fact that the one thing that was missing was the student's perspective.  OT is a rapidly growing and changing field.  For this reason, there is sometimes a disconnect between the clinicians that have been out on the frontlines practicing and recent graduates or current students like myself.  There is no doubt in my mind that what I learn in class now is very different from what was taught twenty, ten, and even five years ago.  That's part of the wonder and excitement of our field; it's always evolving.

So I'm here to try to cover a lot of ground: 

Current students, do you feel like you're at your wit's end?  I'm here to help...or maybe just commiserate.  I have an excellent mojito recipe.

Teachers and professors, have you ever wondered what was going on behind the blank stares of your students?  Sometimes it's not a whole lot (we're still young, let us have our moments)...and sometimes it's far too much.

Fieldwork supervisors, do you wonder how to benefit us more in the short time you have with us?  Once we get over our initial anxiety, we're really quite intelligent, we swear.

Practicing clinicians, do you feel out of the loop?  I sometimes think I'm more loopy than in the loop, but I'll do my best.

I'll try to accomplish all this in a combination of editorial style, anecdotes (which are hopefully humorous to someone other than just me), essays, rants, and whatever else tickles my fancy when I'm writing.

I also want to make this as interactive as possible.  If there are topics on your mind, please comment and let me know what you're interested in.  There are always new areas that need investigation and if I can dig out from under the avalanche of my schoolwork, I will be more than happy to explore them!

Up next, you guys will get to know me a little better when I relate my life story up until this point.  Brace yourselves.  Nah, just kidding, it's not that exciting, but it will contain incisive wit, hints of familial mockery, and brazen self-promotion.  Sounds like an HBO show, doesn't it?  Until next time, everyone. =)