Living AnatoMe in Iceland!

I recently had the opportunity to bring the medley of anatomy and movement to a group of intrigued medical students in Iceland.

Iceland is a small country, and sometimes it feels like things are set in the ways that they’ve always been, so when I emailed the (only!) medical school here telling them about Living AnatoMe (LA), I didn’t expect a response. Months went by, and then one day, I received an email from a student who said my email had been making the rounds. I set the wheels in motion, rented a space, mats, did my outline, emailed the first year students with the dates and place and we had a little course ready! It was 6 weeks of 1 hour and 30 minute classes a week; the number of students that signed up and were able to come to my class were around 20 out of 45 first year med students.

I used the resources available to me from the LA  course outline but I also put my own twist on it.  I added so-called functional movements like squats, lunges, pushups and the like, had them explore their own anatomy through guided self massage and touch as well as posture assessments where i taught them about how to look at the body and notice anything out of alignment or even just noticing the way a particular body was held. We drew a scapula together identifying most of its crooks and crannies, mountains and valleys, as well as a full on yoga/Pilates class with music and sweat and of course relaxation in the end.

In the first class I introduced the planes and directions of the body and anatomical position in an alive and dynamic way and noticed straight away that this way of looking at those things was interesting and fun for them. Not only are these concepts new to the students but also the language is new, studying anatomy in English and Latin can be very daunting for people that have English as their first language let alone their second. We also looked at different students doing roll-downs and noted the lordosis and kyphosis (and scoliosis of some) and range of motion of the spine. At some point we did a Pilates side-lying combination for the deep lateral rotators complete with an intense piriformis exercise… I don’t think they’ll ever forget how it feels when the piriformis is firing and hopefully the facts around it like innervation, insertion and origin and piriformis syndrome were imprinted. I plan on fine-tuning and offering the course again next fall, maybe this time the medical school will show interest and allow me to borrow a spine or a pelvis to use for visual aid.

The opportunity to teach a living anatomy class appealed to me as a dancer and, in general, as a student of human anatomy and movement. Having studied dance and, later, Pilates led me to open myself up further to anatomical education, and teaching this class to the medical students helped me see ways to dig deeper into the material and understand how movement and anatomy complement each other in life and in pedagogy. We all are aware that we humans learn by doing and after doing teaching what we did is the best way to solidify knowledge. I learned a lot and recommend teaching LA not only because it helps you grow as a teacher but also because it gives you back so much. Long after having taught the classes I still get flashbacks or lingering thoughts and speculations that start to mold and form into deeper meaningful ways of teaching and looking at the human body. I strongly recommend the LA course to other movement and body instructors and practitioners who want to better understand the fundamentals underlying their craft.

About the author: Gudrun is a Pilates Instructor and engineering student in her native country of Iceland.

Long Call, Long Haul (part 3)

A three-part series describing the demands of life on the wards … and what you can do about it!

 

Part 3:  Make health work for you

For Jim, an accessible place to start staying healthy on the wards is food—for you, it might be food, yoga, social time with friends, staying away from alcohol or something else. Here’s the breakdown of what I find works for life on the wards, easily customizable to where you’re starting out.

For those of you just thinking about getting healthier, or for whom health goes out the window on tough rotations, I’ll steal from Weight Watchers and use a point system, of sorts. Think of it this way: each nutritious home-cooked meal, with veggies and whole grains and maybe some fish, counts as one point. Bringing a healthy lunch, making it to a yoga class or the gym, sticking to one beer (even on your days off!), seeing a friend outside of medicine and laughing about your job, getting a massage… each one of these counts as a point.  Can you get to three points a week? Maybe five? I consider three points a week victory over the battle with time that is month of floors or two weeks of night float. Five points a week is winning the war. Just take it one point at a time. Read More »

Long Call, Long Haul (part 2)

A three-part series profiling life on the wards… and what you can do about it!


Part 2:  What’s your health-type?

I am labeled, fairly I guess, by many in my intern class as a “health nut.” I bring breakfast – whole grain cereal with almonds in a little plastic bag – and lunch – an avocado sandwich, yoghurt, and a nibble of dark chocolate – from home every day. I won’t touch the cafeteria food or the greasy Chinese served at mid-day report. I live far from the hospital and close to my yoga studio, a deliberate choice, which means a 25-30 minute subway ride downtown rather than a walk across the street to my apartment. I’m vegetarian. I hosted a talk on Ayurvedic medicine for the housestaff. I’m going into integrative medicine. If I am a health nut, it’s not accidental. Read More »

Long Call, Long Haul (part 1)

A three-part series describing the demands of life on the wards … and what you can do about it!

Part 1:  The “life” of an intern

On July 1, 2011 the new ACGME rules on intern duty hours in hospitals took effect. Interns, though not residents, were no longer allowed to work 27-hour shifts as residents everywhere historically had done. The 80-hour work-week still applied, but instead of staying in-house overnight, interns were supposed to have ten full hours away from the hospital between every shift.

Also on July 1, 2011 I started my intern year at Mount Sinai Hospital in New York City. I had done routine 27-hour shifts during medical school, as a fourth year sub-intern in the Cardiac Care Unit (CCU) and as a third year on labor and delivery shifts, a standard part of the OBGYN rotation. And while these were something of a distant memory following a very chilled out fourth year filled with electives and one trip to Africa, I remembered them well enough. The slightly dizzy feeling of walking out of the hospital into the sun at 11am followed by a brief period of sleep-deprivation-induced mania; the great excuse to cram my face with my favorite pastry from the bakery down the street; and the 4-5 hours of slightly nauseated waves of sleep before getting up and having “a day off,” for me usually consisting of a yoga class and dinner before going to bed. Read More »

Physician, treat thyself (from time to time)!

After having made it through another holiday season of family gatherings and cocktail parties, I thought I had been asked every possible ‘first year of medical school’ question in existence: What kind of doctor do you want to be? Are you interested in what you’re learning? How’s the stress level? Do you like your classmates? – and the like. But over dinner with an old friend last week, I was finally confronted with a new and thought-provoking one: How has learning about the body changed the way you live? Read More »

living anatome for Better Living & Learning

As a first year medical student, I made a promise to try to do yoga at least once a week. Not only did I fail to keep that promise, I think I only did yoga three times that entire year! As I progressed through medical school, I could not help thinking about this ever present question; don’t I deserve to treat my body with the same respect as I would recommend to my patients? Seems like a simple concept, yet surprisingly medical schools around the country do not seem to regard this as important. It’s not necessarily that medical schools lacks the resources or that medical students are unwilling to participate in self-care. Self-care just always seems to end up at the bottom of the to-do list. Read More »

LA feature: Pilates Style magazine, “Anatomy Lessons”

This profile of living anatome in Pilates Style magazine is short, sweet & to the point!

My favorite quote is from Carrie, eloquently stating the LA mantra:  “It’s paradoxical, but there is not much emphasis on self-care in the education of a medical student… But I believe all medical professionals have an obligation to maintain their own health. We can’t communicate with patients effectively about the importance of exercise and eating happens if we can’t practice what we preach!”

Read More »

Learn by experience (not just lecture!)

I came to medical school ready and excited to learn.  I felt that the knowledge was right there for the taking – I just had to go to lecture, listen, read, and the learning would happen.  However, while slogging through the dense biochemistry pathways and memorizing the names of all the muscles in the hand, I began to get the sense that there was more to learning than effort and following the rules.  It was not until I was well into my clinical rotations that I was able to truly appreciate that much of learning happens through experience.  I don’t remember the Raf/MEK pathway, but I can tell you the possible reasons why a 24 year old man may have liver failure – I had to figure out the answer to that question in order to help a patient.

As I’ve gone through residency and fellowship training, the notion that you have to create an experience in order to learn something has become more and more entrenched in my thinking about education.  That sounds nice, but how does one actually create these experiences?

Read More »

Bye-Bye Back Pain!

My back’s been bugging me lately. I figure my life is kind of like a doctor’s — I see clients for several hours a day, am constantly on my feet, and have started to feel a tightness in the low back that sometimes aches. Similarly, all my physician friends have been telling me how tight their low backs feel after long shifts at the hospital. This one is for you guys!

Recently, I realized that I have been relieving that compressed-back feeling in the wrong way: I kept arching my low back (think cat-cow from yoga), or twisting side to side in a futile attempt to get the tight, painful feeling to go away.

Then I discovered a little trick for low back decompression that helped immensely:

Stand facing a wall and place your hands on the wall, lower than shoulder height. Walk your feet back a few steps, flex your hips, and lower your back into a flat, “tabletop” position (so that your back is perpendicular to your thighs). If this position is difficult, slightly bend your knees. Think of your ischial tuberosities (sits bones) reaching back toward the wall behind you. Now think of letting those sits bones turn upward towards the ceiling. You will probably feel a lengthening in the hamstrings; you might even feel a stretch of your lumbar spine. Breathe in, and breathe out. As you exhale, think of your femur heads dropping back into the hip socket. Think of space being created between your lumbar verterbrae. Breathe again, and decompress.

Staying in this position, think of your sits bones changing position, from pointing towards the ceiling to reaching toward the floor. In reaching them toward the floor, find a place where your tailbone drops and becomes heavy, forming a tucked position. Breathe deeply and allow your quadratus lumborum to lengthen (remember your QL extends between your iliac crest and your bottom rib).

Now bend your right knee, and let your left sits bone reach long behind you. Then switch, bending your left knee, and letting your right sits bone reach back. Feel the fascia along your back and gluteal muscles release. Breathe deeply and switch back and forth.

Doing this stretch daily should help you feel some relief – enjoy!

About the author

Priti Radhakrishnan is a Pilates teacher at Kinected, in New York city. In addition to her journey as a Pilates teacher, Priti has worked for nearly a decade as an attorney fighting for access to affordable medicines for patients living in poverty in the developing world. She loves to combine therapeutic Pilates with her experience working in clinical and low-income settings: her dream is to ensure that Pilates is available to everyone, regardless of economic status.

Watch your back!

“Let’s face it”, I told my sister earlier this year. “At the rate your shoulders have been elevating, they will be past your ears by graduation.”

“Not fair”, she retaliated. “I’ve been working hard. Med school is no cakewalk!”

No one says that the path to becoming a doctor is easy. So those of us who work in the movement world often worry about our friends in the medical arena. As Matt McCulloch, a Master Pilates Trainer in New York City, says: Watching students progress through medical school calls to mind a “reverse evolution,” as their thoracic spines become increasingly rounded and the students subsequently lose a few centimeters in height (and he should know, he met his wife while she was in med school!). Between studying, heavy pockets on white coats, and leaning over hospital beds, White Coat Kyphosis has become today’s norm.

There is a solution: watch your back.

I put this solution to the test earlier this year. I gave my sister 3 simple tasks to do to ensure that her spine remained erect, and that her shoulders stopped rising like lava bubbling out of a volcano. The tasks involved paying attention to 3 parts of the body: Read More »