Closing Plenary: PhyzTalks

Building a Scholarly Muscle: Hormesis and a Growth Mindset
Irene Estores, MD
As a physiatrist in academic medicine. I am expected to do excel in the areas of clinical care, education, and research- an academic triathlete. The first two came easily for me . The last one I had to train hard for. I will share my early experiences of being sponsored and mentored in research and a recent experience with submission for a substantial research grant, highlighting the importance of reframing my mindset, pushing my limits, and giving myself to grace to rest and recover after this effort . That was the most challenging task I've done as a clinician- researcher. I learned two key lessons from this experience. First- a growth mindset silences the impostor’s voice in our heads. The work starts there. Second- hormesis. As physiatrists, we are familiar with this concept as applied to exercise physiology, and we can use the same principle to build our scholarly muscles.

Survivorship in the Face of Neuroendocrine Tumor: The story of Three Physiatrists Dealing with a Rare Disease
Paul Jett, MD, MBA
The story of three Physiatrists who practiced in East Tennesse and North Carolina that became closely connected through their mutual and rare diagnosis: Neuroendocrine tumor (NET previously known as Carcinoid). Unfortunately, our colleagues Dave Hogarty, DO and Kevin Bailey, MD have both passed as of 12/31/21 and 9/11/22 respectively from complications of this misunderstood cancer. I would like to honor them by sharing their stories and how we became connected and have fought together in joining hands via a national nonprofit call The Healing Net Foundation (HNF). My talk will also touch on what "quality of life" means from a patient centric standpoint as well to describe the provider turned patient experience including survivorship and psychosocial issues.

From Teacher to Student: What I Learned at 2023 Fourth Grade Career Day
Erin Kelly, DO
This past year was my first year as an attending. I was staying where I trained and was excited to still have the mentorship of those who taught me while blending my training of rehab and palliative care. I knew the job would entail giving lectures to PM&R residents, faculty and staff members to inform them of what I can offer, but what I did not expect was being invited to lecture to community members on different occasions. One was speaking at a Philadelphia Elementary school career day. I don't have kids and always envisioned career days given by family members of the kids in the class. Would they really want to hear from me? But my motto so far for the year was to say yes, so after I did, I was given a list of questions ahead of time to answer during my presentation. Did my job require a degree? What kind of classes did I take to prepare? What do I like about my job? What are some things I don't like about my job? At the end of my presentation, I started taking questions, but they were repeats that the students didn't catch but needed to fill out. After repeating a few times, I asked if anyone had any questions not on the sheet. More hands raised and it turned into an interview that was the hardest one up until this point of my medical career. First question: "Do you remember your first patient?" I was speechless. Unfortunately, I did not. There were more hands to call on and more questions to field. " How many people have I helped?" Again, speechless. I pulled out a calculator and ran some numbers multiplied by 10 and figured at least 10k. Really? Even I was impressed. Next question. "How do you handle peer pressure when you are trying to save someone?" Another great question. "What do you do when someone is dying?" Wow. I left that day not as the teacher but as the learner. I thought back to my palliative fellowship where we had reflection rounds, a space to process anything regarding patients that passed away over the last 2 weeks. I was never one to journal but now I wish I did so that I could look up my first patient. The action of journaling in the moment never seemed helpful but now the ability to look back and reflect provides an opportunity for growth. This first year was an interesting year. Clinic duties came naturally but there was always more to learn between more skills, insurance denials, wRVUs, metrics to meet, and understanding the academic medicine faculty requirements. It sometimes became overwhelming but what allowed me to push through any feelings of burn out was that connectedness to others and willingness to still learn. Why was I saying yes to things? Because I need to experience it myself to form my own impression.

Laughter Is The Best Medicine: What Performing Stand-Up Comedy Has Taught Me
Mitchell Prywes, MD
A decade ago, after 25 years of private practice in PM&R, I decided to enroll in a stand-up comedy class. The instructor, a professional stand-up comedienne, promised the 15 strangers assembled that she could teach us to create a "tight 5" minutes of comedic material over the next 8 weeks to present to an audience at the Ridgefield Playhouse in CT. The experience was transformational. It led me to opportunities and invitations to perform at comedy venues and medical/health related conferences…while not quitting my day job! In this PhyzTalk, I will share my personal insights, which include how writing and performing stand-up comedy can be a creative vehicle for self-exploration, connecting with an audience, and promoting effective communication, while having a lot of fun in the process. Laughter truly is the best Medicine!

Adaptive Gaming in Physiatry: The Unrecognized Importance of Video Games
Austin Scott, MD
During my third year of residency, I was contemplating on how I wanted my practice to look in the coming years. I started to think about how to combine my personal interests with my work, and realized that one of my personal passions of video games was being underutilized in our field. I reached out to The Able Gamers Charity to learn more about their mission and if that could overlap with my ideas. After several months of discussions, Able Gamers was gracious enough to donate the equipment to the Cincinnati area to help start the Adaptive Gaming Program. It started in May 2022 with the arrival of the equipment and training of myself, other residents, and therapists of how to hook up and use the equipment. In August 2022, I started a once monthly multidisciplinary adaptive gaming clinic with myself and an occupational therapist who meet with 2 gamers in a half day to try out and learn how to use adaptive gaming equipment. I modeled this clinic after the adaptive sports clinic at the University of Cincinnati that was already established. Our adaptive gaming efforts were quickly absorbed into The Bridge (local nonprofit) who helps with manpower and planning. We have had physical therapists, engineering students, PT/OT students, and medical students all join in this clinic to learn more! In December 2022, we collaborated with a local E-sports bar and lounge to start a monthly adaptive gaming night. In a similar vein to the clinic, myself and a variety of other residents, physical therapists, and occupational therapists meet with 3-4 families in a night to help reach more families and gamers. We also encourage families to return each month so that the gamers can meet other people who also want to play games. Our goal is to start a community where these gamers can gather in an accessible gaming lounge to meet new friends and socialize. Thus far, we have helped 20+ gamers in the Cincinnati area. The beautiful thing about being in a combined program is I have access to both the pediatric and adult population. We have helped children with cerebral palsy such as Brandon. A 12-year-old boy with CP who is now able to play Rocket League utilizing his fingers for the joystick and gas pedals that he can kick with his legs. We have helped adults such as Taylor, a former soccer coach who had a heart attack and subsequent anoxic brain injury who is now able to play Fifa with his family. This program has had a huge impact on the Cincinnati area in its first year, and it something that isn't routinely thought of when addressing patient interests. My goal during this presentation would be to briefly discuss how it started in 2-3 minutes, spend 1-2 minutes on what adaptive gaming looks like and current options on the market, 3-4 minutes discussing our evaluation process including patient stories with pictures/videos, and then 2-3 minutes discussing the future of adaptive gaming.

Pay It Forward: How the Good that Comes Around Can Go Around
Lisa Varghese-Kroll, MD
By my early 30s, I felt like I had navigated a few challenges. Moving to a new country in my senior year of high school; a decade-plus of medical training; and three years that my husband and I spent living 500 miles apart while I was in residency and he served in the Air Force and was deployed overseas. We were finally together again, but now he had started his residency, I was a new attending, and we had a baby that I had to effectively single-parent given his grueling schedule. Further, I sensed that I was headed for a major career change. Just three weeks after leaving private practice to start a new job in physician advising, I was diagnosed with thyroid carcinoma, and its treatment would require me to isolate from my toddler for weeks at a time. My experiences during this period revealed the critical importance of a support network, something it can be difficult to build in adulthood. When I emerged on the other side of my medical journey, it was clear that I needed to be part of that network for other people. While that did include obvious assistance such as providing meals or childcare to people going through similar crises, I had also had my eyes opened to the importance of access to reliable medical information. When I was diagnosed, we had the benefit of a huge number of medical school and residency colleagues and mentors to provide advice, share referrals, and debunk myths. I knew that was not necessarily available to the average non-medical person. Thus, I eventually launched a health and parenting podcast with the goal of providing some of that information to the public. Through the hard work of broadcasting for the past three years, I've felt like I have been paying forward some of the generosity I received during my own challenges. And who knows? My actions could be a tiny cog in the giant wheel of someone else's plan to pay it forward.