Same Material means Less Friction

A lesson in physics and cultural competency.

A middle aged female patient comes in with carpal tunnel syndrome, and the OT decides to treat here with a static wrist splint. I'm watching from the side, because at the time, I was practicing how to mold my own paddle splint (which was and is still going terribly...). When it came time to start making her cast, the patient says that she won't be able to take off her jade bangle. She had put it on in her younger days and after two pregnancies, her wrist had grown and now the bangle no longer comes off. She tells the OT that she's fine with going home to have her husband brake the bracelet off with a hammer, but the concern was that it would be done in an unsafe manner, potentially causing further harm to the patient's wrist. My preceptor is called in to help take it off.

Like a boss (and he literally IS the Boss of the clinic), he strolls in to look at it. He brings with him a small plastic baggie, like one of those small snack sized ziploc bags (without the zip), and soap. First, he wets the client's hand with soap and water and then proceeds to place their hand into the plastic baggie. The edges of the baggie are slipped underneath and around the jade bangle. Now that the baggie is pulled over the bangle, with an edge that you can pull on. The hand is positioned in supine (yes, anatomy terms will be used on this blog) and soap is applied to the volar side of the hand (that is now covered in plastic). The bangle is now positioned between two plastic sheaths. Then he starts to pull on the edges of the plastic baggie with his hands on the ulnar and radial side of the wrist.

After a few minutes of suspense and skillful tugging with my preceptor, he could not roll the bangle off the client's wrist. And so her wrist was wrapped in a towel and the patient was given a hammer. A good tap broke her bangle so that the OT could continue to make her splint.

Later my preceptor summarizes that experience for me with the phrase: Same materials cause the least friction. Forget sandpaper! The finest wooden chairs are rubbed down to smoothness by another plank of the same wood. (Don't quote  me, you can quote my preceptor.) The plastic-jade-plastic sandwich he had made was his attempt at gliding the jade along two identical materials, which would mean the least friction. I'm no carpenter, but I can see the logic behind his theory.

So much texture... Kind of resembles how rough my placement is going so far. >_<

That phrase resonates with me at the moment because as I am having a lot of difficulties adjusting to my placement. Specifically, it is the relationship with my preceptor that has been the most challenging. We are not made of the same material (both culturally and clinical experience wise) and so, there has been a loooooooot of friction. I'm definitely taking notes on how to best approach this situation from the perspective of developing my cultural competency. Communication breakdowns due to cultural differences in the way certain words, actions and mannerisms have all occurred. And in this setting, the student is the one who needs to compromise and adapt. In theory, I should be able to do it. I am trying to constantly remind myself that no matter how harsh the training, he is trying to guide me to become a better therapist. Even if I am not going to choose to work in this area in the future, I do value and respect his expertise. But there's no doubt that our differences are clashing. Big time.

It has come to the point where I find myself asking the question: Am I doing things the hard way by not recognizing what I can't change about myself? There will always be friction between some materials... Especially when the other party's approach to the issue is so different. How much harder should/can I try, how much effort am I not giving now and have to find, to make things smoother between us? ... ...