My personal and professional history into neurology and occupational therapy

I grew up in Christchurch, New Zealand. What has regularly fed my interest in this area has ultimately been my mother. My mother is a registered nurse and has spent over a decade working in and studying neurology. While I spent the majority of my life being surrounded by nursing textbooks and diagrams of the brain and central nervous system and neurological assessments on the walls of our bathroom I did not show much of an interest in these matters until I was 16.

Growing up I loved connecting with people, finding out what is important to them and hearing their side of things (whatever that may be). And above all else, I loved to study - to learn. When I find out I am lacking information on something I feel uncomfortable. If someone asks me something and I do not know the answer, I make it my business to be honest, admit my gaps in knowledge and then learn so I can appropriately answer their question or refer them to someone whose knowledge and experience is far greater than mine. The more I learn the more I realise how little I know.

However, due to personal circumstances and my own personal humanity, I realised I didnt want to just tell people information and watch them struggle to understand. I felt that my personal history made me qualified to pass it forward. Then when I was 16, in the space of a fortnight I was told by three independent sources that I should study to become an occupational therapist. First, who I greatly respected throughout highschool was my physical education teacher, the second was the pastor of the church I was attending and thirdly a computer programe. It was one of those government endorsed career quizzes that asked questions then gave you a top three. My guidance counsellor had us take it three times, and every time, my number one was occupational therapy.

I spent the majority of my last year in highschool in the library or classroom. I had this invisible push to put myself into OT school, and it motivated me in a way that is hard to describe. To my joy, I passed all my high school courses with flying colours and got accepted into the school of occupational therapy. At 18 I moved to Dunedin knowing absolutely no one but being thoroughly excited as to what awaited me.

My first two years at tech were a steep learning curve but highly enjoyable at the same time. My openness to learn and seek constructive criticism grew more and my excitement to see my skills in the classroom used in practice was like a carrot constantly dangled in front of me.

My foray into neurological conditions started in my first year with my first placement, at an urban primary school. This I discovered was where the health system met with the education system and linked hands in a way. I learnt first hand the functional implications of cerebral palsy, spina bifida, hydrocephalus and a few others eg autism, learning disabilities etc. I quickly became acquainted with the speech therapist there and they took me under their wing along with my excellent supervisors.
My second placement was a longitudinal practicum where I visited a community agency once a week. The conditions were the same as my first placement except the client group were adults.
My second year had to be the most hectic period I'd ever experienced in my life. I had two placements that year as well completing six papers for each semester. The first practical was at a busy hospital with a large acute OT team and I was frequently moved between the medical, orthopaedic and neurological wards. Learning in this fast paced environment was rewarding and a lot of my first year naivete's and fears were put to the test. I was very uncomfortable at the beginning of the placement as the experience was like having to bungee jump blind folded. But then, I love bungee jumping. It was a healthy kind of uncomfortability. As my spiritual convictions tell me, its like being pruned. Painful but at the end of the day it was for my own benefit.
Later in the year I was placed at in an outpatient rehabilitation clinic in the city. I took what I learned from tech and my acute placement and applied it again. In this placement I learnt a huge amount about degenerative diseases in particular multiple sclerosis, parkinsons disease and motor neurone disease. I also closely worked with those who were recovering from a stoke (Cerebral Vascular Accident) as well as traumatic brain injuries (TBI). At this point, strokes began to fascinate me. I enjoyed listening to the clients and their stories and working with them in making goals and planning intervention with them. My supervisors hooked me up with some excellent reading material and by the time I went home for the holidays I started reading my mum's textbooks and paying closer attention to the weird pictures of brains in our house.
My fifth placement was with a community occupational therapy team, who although were based at a hospital spent the majority of their time with clients in their homes. Here was my first experience with clients who had multiple (and very complicated) diagnoses. This work environment was also the first time I worked at an interdisciplinary capacity. While the medical model definitely felt like a taboo compared to working in the hospital, the relationships with medical colleagues were still extraordinarily strong as well as with other allied health professionals. Making the house fit the clients (and their family's) needs to become a home was very important. Intervention was very often compensatory due to the level and type of disability. During this time I familiarized myself with the Maori model of health and began to agree with its points especially when involved with the social and spiritual needs of the clients and their importance.

I am pleased with the amount of learning I have achieved since high school. Though I have cried a lot at my own frustrations I have also smiled a lot. I still love talking to people - that will never change. I have also learnt when to be quiet, and to know that that in itself is therapeutic, not just for clients but for myself as well.

My growth into this richly contextual work is ever widening. Multiple sclerosis and cerebral vascular accidents still remain a special area of learning for me. And for this blog I wish to focus on the ever complicating nature of the stroke.

My goal is:

• For you as the reader and explorer of this blog to understand more about this diagnosis and its functional implications in life.
• To gain a further understanding of the role of occupational therapy in stroke rehabilitation.
• To allow an avenue of professional development in the form of reflection, prior to my registering as an occupational therapist next year.