My first mentee was a therapist who has been practicing since 2012. Abraham works in an outpatient clinic and is a partner in the practice. I enjoyed the conversation with him about the outpatient world in Kenya. He had the same views about trying to gain influence in the community, building referral with quality care, and the economic side of sustaining a business. He had very good communication skills, but having worked in the outpatient world he was more focused on efficiency and less on being thorough with questioning and understanding pathology. He made a lot of assumptions and when I forced him to dive further into the pain he ended up finding out the pain was not central low back pain like he assumed but actually thoracic pain. Had he continued with his exam under his assumptions he may have not even treated her location of pain. He reported in the multiple years of practice he never screened the thoracic spine so the rest of the session was education of thoracic exam examination and treatment. The patient left the session with no pain and new home exercises to address the source of her symptoms. Abraham is a smart man and to hear how impacted he was by this interaction was humbling. He told me that he plans to find a way to do another session next week and show how much he learned from this experience. He really took this experience to heart and said he now saw the value in being detailed and having strong clinical reasoning. I could not feel more proud of what he gained for this time together.
Mentorship session two was with the head of all physiotherapists at KNH. It was intimidating mentoring a gentleman 30 years older than myself and such a high role in the hospital. I began by just listening to his subjective and not giving input. However he did not ask many questions and left me with no understanding of what might be going on with the patient. I decided to ask him if he knew the answer to several questions and he did not know then so he ended up needing to do a second subjective evaluation. With these questions he was able to determine source of symptoms, red flag symptoms, goals, severity, irritability, and past medical history. The patient provided an X-ray with severe L5/S1 pathology. He is a prisoner serving a life sentence and this limited the treatment options for him. During the session he had two guards in the room. The objective exam was also very sparse so education was needed to help create an organized examination for someone with high irritability and severity. We decided to treat using lumbar traction due to limited tolerance to any other positions or intervention and severe radicular symptoms. After traction he was able to ambulate with full weight bearing on the effected leg with crutching which was a significant improvement from when he entered the clinic. After the session George told me that he was inspired by his mentoring experience. He said he has many therapists who graduated from this program on his staff and wanted to see what he could learn by joining. He said his eyes were opened today to how much he assumed when treating patients and that gathering more information can completely change the plan of care. He put himself on the schedule for mentorship next week because he said "this is exactly what he needs and wants to be better".
X-ray of second patient with pathology at L5/S1
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