Today was my first mobile clinic. This is where we pack up all of our stuff and drive out to a local village to treat people out there. This is for the people who aren’t able to come into our clinic but still may need our help. The clinic was about an hour away down a long bumpy dirt road. Once we got there we set up in a local building that is used for their town meetings. For physical therapy we bring a curtain and some pipes to make a private examination room. We also bring a portable table for us to do examinations on. Other than that we just wait until patients come in to see us. I quickly learned that out in the villages people are very unaware of what physical therapy is. As the med students examined patients they often would make referrals to us for musculoskeletal pain. The first patient that was referred to me did not speak any English. She was only able to speak Kekchi. Luckily we had a translator on our staff who was able to help. The patient explained that she had low back pain. When I tried to examine her she refused stating that she had physical therapy before and she didn’t do the exercises because she was afraid it would make her pain worse. No matter how much I tried to explain to her that exercising would help her pain she refused to let me evaluate her. It was a very frustrating case because I know there are so many things I could do for this patient whereas all she ended up leaving with was a dosage of Tylenol.
The next patient that came in was a patient Hillside has been seeing every time they go to that village. She came in with right knee pain, left ankle pain, right shoulder pain, and low back pain. I quickly discovered that the left ankle pain was due to a minor cut she had due to a fall on her way here. Her main complaint was her right knee pain. Previously another student had examined her and suspected a meniscal tear. Upon my examination I agreed. The last student also noted that they taught her how to wrap her knee with and ACE wrap and that she was sent home with it. When I asked her if she has been wearing it she said she wore it one time and it made her knee feel better. As I asked why she didn’t continue to wear it she just kept saying “I don’t know”. This became frustrating to me as well. She explained that she wasn’t wearing the wrap, she didn’t remember her exercises therefore she hasn’t been doing them, and she generally didn’t seem to want to get better. I gave her an actual knee brace hoping that it would be easier for her to put on therefore maybe she would wear it more often but right after I put it on, she took it off and said “I will put it back on when I get home”. This made me recognize that the reason she isn’t wearing the wrap may be due to a cultural issue where the woman don’t like to look unfashionable. All the Kekchi woman dress in similar attire and the brace may be considered unflattering.
By the end of the mobile I was very frustrated because none of the patients that I treated seemed to want physical therapy even though there was a lot we could do to help them. They simply came for a new dosage of their medication. In the end, I learned that sometimes you have to accept that a patient doesn’t want your help and their noncompliance is not going to improve. There is only so much you can do for those people.