Angela MujukianLadybruin24@ucla.edu
By 6:45 am, I have already left my house in Pasadena and am not looking forward to the bumper-to-bumper traffic on the 405 freeway to UCLA for the next hour. By 7:45 am I arrive at the Medical Plaza and walk in with my personalized stitched lab coat, my neat badge and of course my Hello Kitty pen.
It’s another day, new patients to see, and new medical terms to learn. I walk into Module 1 and greet all the doctors. And then walks in Dr. Raffi Tachdjian. If anyone has seen an episode of House then they would know at the Pediatric Pain Clinic, Dr. Raffi is House.
By 8 am, our first patient has arrived. We review their report, vital signs, and questionnaires and then go in to greet the patient. We sit with them for about 2 hours and discuss everything about them ranging from their past medical history to their social life and what they want to be when they grow up. We then do a quick physical examination followed by a "teenage-talk" where we kick the parents out. We then go back to the module to discuss the patient in further detail. Once we are back in the module it can get intense. I now have to explain to Dr. Raffi the usual "Plan & Assessment" of the patient and of course, he interjects with his comments if I have made a mistake. We then go back into the patients’ room, discuss with them what they have and how we are going to help them fix it.
What is actually interesting is that the Pain Clinic focuses on East-West Medicine & Complementary and Alternative medicine. So we are not just prescribing drugs to the patients but referrals to actual therapy like Physical Therapy, Iyengar Yoga, Hypnotherapy, and Acupuncture just to name a few. Dr. Raffi then gives the patient a gift, a musical CD supporting his Children’s Music Fund Charity; also happily noting that he made Track 10 on the album every time.
In the beginning, I thought shadowing meant that you were glued to the doctor you worked with and the most you would do was observe and learn from what they do. I was completely taken back, and on my first day of shadowing felt like I was an actual resident, doing what med students do, when in reality I’m a first-year undergrad.
It was a new experience being the youngest student in the entire clinic, watching med students consulting with patients not knowing that just in the next few weeks I’d be doing the same thing.
I remember filling out my first outpatient consultation report and Dr. Raffi telling me that I’d never forget this patient and he was right. What’s more intense is the first time Dr. Raffi asked me to go in with a patient alone and said, "Angela do you think you’re ready to take this one?" Moreover, I replied "yeah" with the most timid expression on my face. I could not believe that I was about to do what Dr. Raffi was doing just months ago and I was actually going to talk to the patients and ask the questions this time. It’s not an adrenenal rush, you’re not saving a persons life, you’re just having a conversation with someone who has trust in you, and you’re trying to find out what’s wrong with them by listening to them in order to treat them and cure them from their pain.
I remember filling out my first outpatient consultation report and Dr. Raffi telling me that I’d never forget this patient and he was right. What’s more intense is the first time Dr. Raffi asked me to go in with a patient alone and said, "Angela do you think you’re ready to take this one?" Moreover, I replied "yeah" with the most timid expression on my face. I could not believe that I was about to do what Dr. Raffi was doing just months ago and I was actually going to talk to the patients and ask the questions this time. It’s not an adrenenal rush, you’re not saving a persons life, you’re just having a conversation with someone who has trust in you, and you’re trying to find out what’s wrong with them by listening to them in order to treat them and cure them from their pain.
The funniest moments I will never forget at the Pain Clinic besides getting yelled at by one of the patient’s moms, was asking a 10-year old, "Does it pee when you burn?" He had a good laugh with that one and it just makes me feel that laughter truly is medicine.
One thing I learned from the clinic, is that even a simple laugh can go a long way into earning a persons’ trust. Dr. Tachdjian is a comedian in the making and does it with ease that makes patients really feel comfortable and he always says "You have to add some humor to it so it will be fun."
People are open minded when they come to the Pain Clinic not knowing what their continuous headaches or backaches are from or what is causing them to have pain. The majority of the patients come in with this chronic pain that sprang out of no where called Complex Regional Pain Syndrome (CRPS) used to be known as RSD (Reflex Sympathetic Dystrophy) that can be developed over time.
One thing I learned from the clinic, is that even a simple laugh can go a long way into earning a persons’ trust. Dr. Tachdjian is a comedian in the making and does it with ease that makes patients really feel comfortable and he always says "You have to add some humor to it so it will be fun."
People are open minded when they come to the Pain Clinic not knowing what their continuous headaches or backaches are from or what is causing them to have pain. The majority of the patients come in with this chronic pain that sprang out of no where called Complex Regional Pain Syndrome (CRPS) used to be known as RSD (Reflex Sympathetic Dystrophy) that can be developed over time.
The patients and their parents can finally make the connection and see that a small injury from the past like slamming their hand on the door or falling off the jungle gyms, or even a surgery when they were young, could come back later as CRPS when they begin to have sudden shooting pain.
A lot of these kids not only come in with CRPS but stress and anxiety on the chip of their shoulders. Dr. Raffi Tachdjian has started a Children’s Music Fund Charity and hopes to treat future patients with Music Therapy in order to relieve that anxiety and stress.
What is the purpose of the Children’s Music Fund one might ask? "The mission of CMF is therefore to provide musical instruments and MT (Music Therapy) to patients with chronic and life-altering illness, and to research the effects they have on health and well-being," said Raffi Tachdjian. When asked what inspired or caused him to start the Children’s Music Fund, Dr. Tachdjian explained, "There was an unmet need for Music Therapy, especially in the Pediatric Ward at the Massachusetts General Hospital where I did my residency. I found that by using the Guided Imagery provided by Musical Therapy, the patients get empowered in feeling better. What’s more, we often uncover hidden musical talent in these patients that are confined to the hospital or their beds for extended times".
When asked where in the near future do you see Music Therapy research going, Dr. Tachdjian replied, "In the future I see MT (Music Therapy) creating a library of sounds and song categories to treat ailments in a complementary and alternative medicine manner. We need research to see the response ‘immunologically’ to pain, stress, anxiety, when different types of music are played in different settings." The newest album out is called "Open Your Window" and can be found at childrensmusicfund.org.
Throughout this entire shadowing experience, it has not only opened my eyes to different types of illnesses but complimentary and alternative medicine as a new form of treatment. Music therapy is a breakthrough that not only helps patients with pain but also other conditions down the line like Autism & Asperger Syndrome.
If the patient can just get rid of their stress then that may trigger and prevent whatever is causing them to have pain in the first place. If I learned two words and nothing else from the Pain Clinic, it would be CRPS and its treatment Neurontin.
When Dr. Raffi Tachjian asks a question, it is my go-to answer every time.
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