Wednesday, July 22, 2015

Achieving Maximum Potential

Singing deer head
Way back at the beginning of my second year of medical school, Dear Husband was the only one who could come to my white-coat ceremony. While I was waiting alone in the bustle of happy families for him to arrive from a wedding that ran long, I bumped into a doc who turned out to be a developmental pediatrician. When he found out I wanted to work with special-needs kids, he gave me his card and recommended I spent a week at Camp CAMP, helping Children with developmental disabilities Achieve their Maximum Potential. So the next summer, after taking my first board (do you notice a pattern developing here?), I flew down to San Antonio for a few days of training and a week of acting as a one-on-one volunteer counselor for a camper. I made sure she was dressed, toileted, ate, swam, canoed, went to arts and crafts, and got ready for bed. It was exhausting, which is part of the point: Camp provides typical summer fun to campers and respite for their parents. Camp takes all comers, even if they require two counselors (mostly area high schoolers and college kids), and integrates everyone into all activities to the best of their ability and interest. At Camp, even campers on ventilators get in the pool and go down the slip-n-slide.

This year, because I had (finally!) finished my core rotations, I was eligible to return as a health care volunteer. These folks are responsible for administering medications and handling any medical issues that arise, from sunburns to seizures. I chose continuing medical education weeks with lectures in the mornings in order to receive course credit from my medical school. The first week I attended, campers had medical diagnoses ranging from diabetes to cerebral palsy to respiratory compromise. Campers at my second week fell on the autism spectrum.

Talented and dedicated med staff!

Every year, every week, and every day at Camp has a theme. The days are always the same: Monday—Tribe Color Day, Tuesday—Pajama Day, Wednesday—Wacky-Tacky Day, Thursday—Crazy Hat/Hair Day, Friday—T-shirt Day. This year the theme was Storybook, and my first week’s theme was Harry Potter. The campers were organized into “houses,” the secretary dyed her hair red so she could dress up as Mrs. Weasley, and one day they organized a camp-wide “Trip Down Diagon Alley,” complete with Butterbeer. (I understand it consists of root beer, cream soda, and vanilla ice cream; I’m sorry I didn’t get to try any.) My second week’s theme was Dr. Seuss. I joined the Poetry Club: over the week the campers each wrote and decorated a booklet of poems, and on the last day we went on a Dr. Seuss-themed scavenger hunt for the Cat’s Hat and Dr. Seuss’s least favorite word. (Can you guess what it was?)*
Is it a flag pole or
a Truffala Tree?

The first couple of days were a crash course in medication administration, a completely new subject for this green medical student. In charge of half a dozen young men on Week 1, I administered medications 8 times a day, and if I wasn’t giving meds, I was prepping or documenting them. I learned how to inject insulin, crush pills, use a G-tube, and give a nebulizer treatment. On Week 2 I had fewer med times but more campers, a dozen young women who all took their pills orally with water, juice, or applesauce. That week I joked that some people come back from vacation and shake sand out of their clothes, but I was going to be shaking Miralax out of mine.

By Week 2 I felt comfortable enough with the Camp routine to help orient the new crop of HCVs. Maybe I was too comfortable, because one evening I failed to check the name on the bag with the name tag on the camper in front of me and gave the right pill to the wrong camper. My first medication error. I was figuratively sick to my stomach; the camper was literally sick to her stomach, which may have been the unfamiliar pill or the 14 cups of water she had drunk that day. The head nurse talked it over with me later, acknowledging my feelings and then counseling that I let them go. No great harm was done, especially if I used the experience to learn how to avoid making *that* error in the future. The nature of being a clinician and a human being means that I will surely go on to make other errors in my career.

Quidditch: basically Calvin
Ball with brooms
Despite the heat, I had a blast at Camp—which is good, because it was the closest thing I had to an extended summer vacation. My favorite moment from Week 1 was the absolute joy of one of my campers when his house (team) won a round of Quidditch. Apparently that was only the semi-finals, because then he came bounding down the hill again to share that they had won—again!

Another episode that made a big impression on me happened during Week 2, when a large young man on the spectrum threw an epic tantrum over not wanting to take his medication. Now, I completely sympathized with him. It requires a great deal of emotional energy to swallow pills every day of your life. He had reached his breaking point, but he did not have the skills to deal with his frustration and anger in socially acceptable ways. So he yelled, charged at his counselors, overturned trash cans, and tried to swipe everything off the counters in the mess hall. He made a fearsome picture. Being young but well trained, the staff at Camp activated a protocol for such “behaviors” that involved a few counselors providing him space to vent as he wandered about the grounds. At one point he came up to our med table, threw his arms around a camper in our tribe, and sobbed into his shoulder about not wanting to take his meds. It turns out the two had interacted earlier in the week; despite our first impression, the young man was actually a sweetheart, as we got to see later.

It's a snitch!
Between weeks on service I explored nearby Kerrville, Texas, which you can read about in these posts: one, two, and three.

I rather doubt my future residency program will excuse me for a week of vacation next summer, so soon after starting (July 1, 2016), but hopefully every year after that I can return. These are my people! And Camp is a very special place on earth, where campers and volunteers can achieve their maximum potential.

Wheelchair-accessible chapel.

*The word was orange, of course, because it has no rhyme!

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