• Samantha McPherson

Le Pub Scientifique – Reflections on Reflections

I was lucky enough to be able to attend the international zoom – Le Pub Home Brew – where the Neuro Orthopaedic Institute (NOI) did their first online get together to enable pain brains to still chew the fat despite the world being on lockdown. I wholeheartedly recommend.

For the uninitiated into Professor Dave Butler – he is a pioneer in pain treatment in physiotherapy. He teaches all over the world, is the author of multiple key texts with best bud (and one of my personal faves) Lorimer Moseley and has published countless research in the field of pain. He has a brain the size of a planet and personality to fill the galaxy.

Dave has changed so much in our thinking around treating patients that have suffered with pain – particularly pain for a long time. As a physio that has grappled with patients in pain for over ten years, this research and shift in practice has given so many a great deal of hope!

One Saturday Morning I started with a Bloody Mary/Quarantini….*

As I settled into my makeshift at home desk with some boozy tomatoey goodness to listen to the man himself, I was not prepared to have such a revelation about my own professional life. Dave’s honesty regarding the waves that occur to a clinician throughout their career – he has also considered being a barista – are simply lessons that help us to develop, become critical thinkers and better practitioners.

He described his professional life as waves – ups and downs of confidence, wins, losses and new thinking. A hugely reassuring account from a physio of many years. He encourages constant reflection as a way of learning. Simple questions that seemed to reach out from the small screen and poke me in the face!

· What elevated my thoughts – pushed my buttons – made me sip and reflect..????

· Why was that word, term or thought so impactful?

· What does this tell me about me as a physio?

When did we learn how to learn?

Much like a proverb designed to clear the mind – this question of ‘were you ever taught how to learn?’ blew my mind. Here I was teaching my patients all this stuff, but were they learning it? How could I tell??? ‘Knowledge is constructed by the learner not the teacher’.

This little mind conundrum has already changed my practice. My patience for my patients has increased dramatically and I am seeing them more as a learner on a pain journey. This could not be further from what I was ‘taught’ at physio school…

Reward the process

Some lovely advice included encouraging patients to self-reflect. To feedback to me what they experienced since their last session with me, also that we should reflect at every step – rewarding a positive emotion – rewarding the process, not just the outcome. Which seems like a life philosophy if I’m honest, a sort of ‘be here now’ ethos. Understanding as a practitioner and as a patient that dealing with persistent pain means celebrating the small wins daily provides a positive and tangible treatment plan that I am totally onboard with.

As pain and bodies and rehabilitation and wellbeing are all processes and journeys there is a lot of talk about how we talk. The language health professionals use and the subsequent explanations that our patients give can be deflating at best and damaging at worst. Sadly, how to use language constructively is not widely taught to health professionals. Though I suspect that this will change.

Where on earth will I go now??

Relatively speaking, I’m only on my 4th wave and I do so hope I have many waves to go! I am starting to dream my next wave up! I’ve always been somewhat obsessed with language and had my father not put his foot down, would have been a journalist in a former life (please don’t fully judge the writing in the post- we had cocktails at breakfast….). I think that the next ‘professional need’ will be linguistics for physiotherapy. Our words are so powerful, our training on how to use them is not. It seems to be learned via experience and mileage. But I don’t wish life experience to be the limiting factor for delivering information, reassurance and changing misconceptions for patients. I’m going to reflect (sip) on this and perhaps create another post another day.

For now, in these weird times, I am grateful for staying connected, being able to still help patients, and for a Saturday morning well spent with a group of fun experts, the legend himself and the WhatsApp chats that ensued after we enjoyed the Le Pub Home Brew. I look forward to the next!

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