Archive | May, 2012

Montezuma Castle: An Arizona Cliff Dwelling

30 May

A little history…  In 1906, President Roosevelt declared four sites in the U.S. the first National Monuments.  Montezuma Castle, near Campe Verde, actually has no connection to the Aztec empire that is its namesake.  This cliff dwelling, which was inhabited by the Sinagua people for over 400 years, is nestled in limestone along banks of Beaver Creek.  From Tucson, it was easy to catch this monument en route to Sedona.

 

 

 

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Butterflies of the Desert Botanical Gardens

28 May

Delicate, vibrant, and a symbol of change, butterflies delight me!  I could have spent all day photographing these whimsical creatures in the butterfly garden of the Desert Botanical Gardens in Phoenix, Arizona.

Give me your tired, your poor, your huddled masses, and your illegal border crossers…

26 May

With this post, I am bringing back into focus one of the key themes of this blog: exploring new professional practice. Although I have written posts on learning the logistics of travel PT, this is my first to catalog new perspectives I’ve gained from my clinical/professional experiences. Although this post focuses on my experiences with healthcare and illegal border crossers, I love my work and I respect those I provide my services to– regardless of their circumstances, social status, origin, etc.

Despite my years living in central Texas, my first professional exposure to the issues of the U.S.-Mexico border has been here in Tucson. Seeing the dark green clad Border Patrol trolling the hallways and parked beside hospital beds has become nothing out of the ordinary. But with growing experiences and conversations, I feel more and more like a five year old whose reply to every statement is, “But why?” On any given day, the glaring perplexity makes me want to give America an open-palmed slap on the forehead and say, “Are you for real?! This is crazy!”

So let’s get a few things straight about the lingo. When I interviewed for my travel assignment, I was delicately told I would work with a significant population of “undocumented immigrants” to primarily assist with discharge planning. Okay, an interesting choice of nomenclature, I thought. Up on the hospital floors, you hear “border crossers” mostly. Without sounding too insensitive, I don’t understand why we must mince words. These folks are illegal immigrants. (As a side note: Not all border crossers are Mexican. People from many countries attempt to use the U.S.-Mexico border as an illegal gateway.) They are crossing the border with no respect for a (failing) immigration system or the laws/regulations of our society. Although my opinion is a common one, the public’s opinion is quite varied. There is a mix of distain (of the “free ride”), frustration (with a flawed U.S. system), and sympathy (for those who “surely are fleeing a place where they can’t get the care they need—how sad!”). I can understand and have personally experienced each of these feelings during my time here. But, instead, let’s look more closely at the ass backward approach to healthcare for those injured during their ill-fated border cross.

While attempting to cross the border, many get injured. Most often these injuries occur by trying to scale the fence (I mean, really, how likely is that plan to be successful anyway?) or when running away from Border Patrol. Frequently we see spiral fractures of the tibia, trimalleolar fractures, etc. So these folks are brought to our hospital and receive all kinds of diagnostic testing and medical consults for their injury. They occupy our hospital rooms, watch cable, and receive good care. Then they get orthopedic surgery. Some with external fixators placed, some with internal fixation, almost all with a weight bearing restriction. Who pays for these services? America does. Then comes the “PT eval and treat” order. We provide our skilled services for evaluation, assessment, patient education and discharge recommendations for durable medical equipment. Who pays for these services? America does. We communicate with the physician, the case manager, the social worker. They want to know our recommendations for mobility to be able to cross back to Mexico. But in the next breath we are told, “Well, they are a border crosser, no funding, so we can’t get them anything.” Crutches are usually the only guarantee. They want to know what type of vehicle they can mobilize into for transport back to the border, and if they can safely walk (or hop) back into Mexico’s custody since U.S.’s Border Patrol cannot physically cross the border with them to assist. The orthopedic surgeon gives the patient discharge instructions. Some state a follow up is required in a few weeks—a follow up for which some patients have in fact attempted to re-cross the border. It’s a bitch when this time your external fixator gets caught in the fence (true story). This last bit makes me want to slap some ortho docs in the forehead. Where is the awareness to their patient’s situation? Where is the responsibility to the patient to make reasonable recommendations for follow up? Where is the social responsibility to the U.S. to not encourage abuse of our systems?

Given this scenario, the greatest frustration amongst the physical therapists I work with is this: Why is it that a U.S. and/or hospital system will pay for thousands of dollars of medical and surgical care for illegal immigrant (who choose to climb the fence, who are running away from being caught for something illegal) but then refuses to see it through and provide assistive devices that cost less than $100 to ensure their safe mobility?

I, along with many of my PT colleagues, will tell you that it doesn’t take an Oprah “a-ha!” moment to see that this is a ridiculous system and misappropriation of U.S. / healthcare dollars, physical resources, and clinician time. A fellow PT posed a novel concept: As military personnel are frequently trained in medical care and triaging, why isn’t Border Patrol utilizing a medical triage where these injured folks can be stabilized with essential care and returned to their country of origin for further medical intervention? We can provide care to meet the emergent, basic needs all humans deserve. But must we provide medical care that many of our own American citizens cannot afford or do not receive?

Strolling through Tucson

20 May

Tucson has mapped out a walking tour of the city which was reminiscent of following my beloved Boston’s painted sidewalk line, “The Freedom Trail”, but without as many interesting historical sites here.   But despite my walking tour snobbery, this was a nice way to catch a glimpse of the city (although I didn’t quite finish it… so perhaps I missed something absolutely amazing).

Sentinel Peak (a.k.a. “A” Mountain).  In 1915, University of Arizona fans celebrated a victory by white washing a huge “A” on the mountain.  The tradition remains with a permanent red, white, and blue “A”.

The Arizona Superior Court of Pima County campus is speckled with traditional Spanish architecture and Sonoran landscaping.

To date, my best local meal has been at El Charro Cafe.  Pairing mouth watering spinach/artichoke/mushroom enchiladas and a cerveza brewed locally by Barrio Brewing Company in a dining space peppered with cultural zest, makes El Charro heaven.  This warmly colored restaurant, established in 1922, proudly distinguises itself as “the Nation’s Oldest Mexican Restaurant in continuous operation by the same family”.

The historic Hotel Congress was built in 1919 and is where the infamous bank robber John Dillinger was captured.

St. Augustine’s Cathedral

A creative, vibrant arch covering an outdoor stage on the Cathedral’s grounds.

What is it about the great American tourist trap?

16 May

Plunked on the side of the interstate where the desert sand whips and tumbleweeds roll is Rooster Cogburn’s Ostrich Ranch.  Its sun-battered roadside signs spark interest, luring me toward the exit.  Surely a magnetic force field sucked me into its vacant dirt parking lot… what other logical explanation is there for a grown adult partaking in a random desert version of a petting zoo owned by the fictitious True Grit US Marshall?

I easily entertain the notion that one particular Miniature Sicilian donkey is most definitely smiling at me and has to be the Donkey from Shrek.  After all, why wouldn’t Rooster Cogburn himself have the REAL Donkey residing in his park?

Like an elementary school girl, I timidly extend my hand with a ration of pellets to the cluster of Fallow deer.  What was Bambi’s girlfriend’s name anyway?

I’m pretty sure it was the Ostrich Rancher extraordinaire (and most definitely not the infamous Rooster Cogburn) who taught me the secrets to duck and lorikeet feeding.   

And then there were the ostriches.  Despite the wondrous picture painted of these (really creepy when up close) creatures, I am here to refute that image.  Case in point: the sign that reads “Yes! Ostrich bite!”  Although they don’t actually have teeth, they have sharply snapping beaks.  And freakishly long necks with which they aggressively lunge forward to snatch pellets from your sensitive, much slower fingers.  No wonder there is a disclaimer freeing Mr. Rooster Cogburn and his associates from responsibility for any ostrich nips.  Good thing my fingers were a less easy target than those of the not-so-lucky kiddos nearby. 

Have you secretly enjoyed a tourist trap as much as I enjoyed this one?

(The material of this post is simply my personal anecdote.  I think everyone should consider having their own unique experience at Rooster Cogburn’s Ostrich Ranch.  And don’t hate on ostriches.)

Back on the Blogging Radar

10 May

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I didn’t realize how long I had been off the blogging radar! When on an acute care PT schedule which is free flowing and often without a traditional “weekend” of two consecutive days off, time escapes you. With only one day off for every 5 worked for several weeks, not only have I lost time to play tourist, local explorer, outdoor adventurer, I have also lost my daily routine. Losing track of the mundane laundry, bills, errands, etc. to a whirlwind of workdays starts to affect the work-life balance.

And, thus, the blog has suffered. Rest assured, loyal readers, I have lots of fun experiences, photos galore, and perspectives on local healthcare up my sleeve! (And a schedule with three “real” weekends in a row coming up!)