LPH

Many people have asked about my physical therapy experience in SW Virginia. It has been so many that I have a scripted response: I feel that I learned a lot professionally and culturally, but was not really challenged in terms of my physical therapy skills. I practiced the skills I learned over two years of PT school, but did not really have discussions around clinical reasoning or evidenced-based practice. Both of these are pretty important to becoming a master clinician. All that being said, I still appreciate my experience there. I witnessed with my own eyes the low priority of exercise in that rural community, the need for education, and I was exposed to many low level and highly involved patients.
Plus the staff at Lonesome Pine are truly really great people. Each of them has their own character but they all work well together and are a part of each others lives, as expected in a smaller community. I am very happy to have been a part of that for just two short months.

LPH - a 60 bed hospital. 6 ICU beds. 6!!!!!!!!

some time in coal country

during the first few weeks in Big Stone, i frequently noticed men dressed in dark jumpsuits with orange or yellow bands around each extremity. i thought, man there are a lot of firefighters around here. but the dark soot on their faces enlightened me. of course, these were coal miners. an industry that to me seemed antiquated and almost not real. even after 8 weeks being in coal country, i still don't know a lot. but i'm going to share some thoughts anyway.

my awareness of the presence of the coal industry...well...it was slow. in addition to the faux firefighters, there were several odd chutes that would cross over a road or highway. one was surrounded by a royal blue cylinder that had such a low clearance, i didn't think a semi could pass. one reason for my apparent blindness was that Big Stone had no coal. their mountains were rich in their beauty rather than rich in fossil fuel. but many residents worked or had family that worked in the near by mines. a patient recommended that i read a novel called Big Stone Gap, the first of a trilogy of books, set in the small town. the focus of the book was not coal, however the author did describe a little bit of what a mine would look like. a mine can penetrate a mountain as far as 5 miles with some areas only being big enough to crawl on your belly. as the tunneling grows, the roof has to be reinforced to prevent cave ins. one day i had a patient who's occupation was "roof bolter." i don't know anything about roofing, but i remembered about the mines. his job was to place the bolt after a machine had drilled a hole in the roof. being the deepest in the mine possible and operating a machine that drills...its obvious why this is considered the most dangerous job in mining. aside from morbid threats, miners also face knee pain, back and neck pain and the obvious black lung.

i learned to open my eyes and ears to learn more about mining culture. as my mother and i drove into Kentucky over Black Mountain, we could look back and see a mountain face, destroyed by strip mining. a chunk from the side, just gone. farther into Kentucky, you could see how little towns were there only for the coal industry. it seemed that every other car had that image of a coal miner on his belly window sticker, "i've got friends in low places." but at the same time, ive been told that the industry struggles, as cleaner, more environmentally friendly sources of fuel are becoming more popular.

barns

life in southwest virginia would not be complete without its barns, old and new. here are my favorites.

this old barn is on Powell Valley Road, another favorite drive that connects Big Stone to Norton with minimal use of the four lane. i also used it a couple times as a jogging route, the beautiful scenery attempting to distract from the hellish hills that stretched on for miles.

this barn, we passed on a daily basis to drive from the four lane to east stone gap and then on home. and i just liked it. when the purple rav 4 was not parked out in front.

carl

for at least the first four weeks of our stay, we had a bunny that would frequent our backyard. we noticed him one afternoon, and then every afternoon, munching on dandelions. because we figured it was the same bunny, we deemed him our pet and named him Carl. after midterm, the heat and humidity picked up and we didn't seem him as much, and then not at all. maybe he went to summer in the Hamptons or sought higher elevations more suited to a bunny.

other little day trips

Natural Tunnel State Park features a tunnel naturally formed over millions of years and big enough to house a railroad. Its just a quick, steep hike down to the bottom or you can opt for the ski lift ride. We also enjoyed the olympic-sized pool in the park.


The Virginia Creeper Trail is a popular activity near Mount Rogers. It is a path built along an old, never completed railway that extends from Whitetop Mountain near the border of North Carolina all the way to Abingdon, VA. We rented bikes and took a shuttle from Damascus up to Whitetop to ride the 18 miles back...but thankfully downhill.

Little Stony Falls is a group of waterfalls near Coeburn, VA, just a short drive from Big Stone. You could also hike 16 miles from High Knob past Bark Camp Lake to get a view of these falls. From reading, it seemed like a great path to hike for a day, camp and then finish off the next day. This is one thing I never got around to doing, because of time, but also due to reports of many downed trees left from the winter's snow. The same day that we visited the falls, we had come from Cave Springs Recreational Area (of which I do not have any photos), which along the hike has a cave where the temperature drops 20 degrees. Unfortunately, this hike was also cut short by downed trees.

cracker's neck

you might have figured out that i have already left beautiful SW Virginia. but i have a few other stories to tell and places to write about, so i will be playing catch-up. this first entry is about one of the first places we went to go for a run and ended up being my favorite place in the entire area. how could you not love a place called cracker's neck? it was a short distance down east stone gap road and it was one of the few areas that was flat. a large expanse of valley, filled with homes, trailers, farms, and overall beauty. when we first drove out there on our second day in big stone, we parked next two a couple boarded up buildings which i found out used to be an old country store. we ran past many small churches, one road that looked like suburbia and a lot of fields filled with wild flowers.in the mornings before work, i would run from the trailer to crackers neck, get as far as time would allow, and turn around to come back. one friday morning, i had run to my turn-around point and began to trot back when i noticed a dog at my feet. dogs chased me all the time especially in crackers neck, but most of them ran the expanse of their property and gave up. or if i sped up, they would stop and stare as if saying, whew no way! this young dog would not give up, and ran with me all the way to the point where i turn onto a larger road. i figured it would stop then, but no. it continued to try and follow me. i tried yelling at it, running a bit back in the opposite direction, but nothing deterred it. time was starting to be against me and my need to get ready for work. so i just kept running. it continued. as i approached the cemetery before east stone gap, i realized i was going to have to keep this dog following, so i could drive it back home on my way to work. it ran with me for 25 minutes until we arrived at the trailer. after a quick shower, i loaded it in my car and drove it back to the spot in cracker's neck where it had joined me. it was an adorable dog, all white, with black over the eyes and ears. but i had to let it go and drive away. i saw him again one morning, but hid, not wanting to risk another follow and return.

the LAST day of the last weekend

we drove away from the new river gorge a few hours later than we were expecting. we had called ahead to the Breaks Interstate Park to make sure that we could still land a campsite even after the office had closed. we had at least a three-hour drive ahead of us plus time to stop to eat. we finally turned off the main highway to head through Grundy and over to the Breaks. it was about 9:30, definitely dark. as we approached Grundy, the mountains narrowed and the mists rose. now, we were quite tired and a little loopy, but the drive through Grundy was surreal. i could tell this town was heavily influenced by the coal industry as we passed under many coal shoots crossing the road. it was so dark and misty that we could not see the mountains above us, but i wondered if they were still complete, or if large chunks had been cut out of them. as we continued the windy, ethereal drive, all of a sudden, a giant industrial tower with a wildly blazing fire emerged on the right. it looked like hell. i found out later it was a coke plant. we continued the drive through windy back roads, small enough to not require a yellow stripe down the center. we finally made it to the Breaks at about 10:30. and of course it was closer to 11 until we had finally chosen a campsite being as we are both type B. but our expertise arose as we set up the tent in record time with light from the car and one headlamp.
the next morning, we made breakfast, broke down and packed up, so that we could venture onto a hike. when i had been to the Breaks with my mom, i noticed that all the trails were one mile or less. that's boring. then i realized they were all connected and i found a loop that would take us down the canyon to the river and back up to check out all the overlooks. we went to the visitor's center just to make sure the trails connected and were open. "yes, they are but just be careful on the river trail...there is poison ivy." awesome. we remained optimistic as it was overcast and cool and the initial trail was relatively easy. we passed one overlook that i had been to with my mom and then headed down the Prospector's trail. we passed many impressive rock faces and Brittany had to wipe the drool from her mouth. we noticed that the trail was quite damp from a few days rain, but we kept on. when we hit the River trail, things got dicey. it was supér steep, and the path sat at an angle, so you felt like your outside foot could turn or slide down with every step. one wrong step would send you down a steep hill, probably not stopping until the river's edge. i took it really slow, but lost my footing every five steps. the other challenge of this hike was the spider webs. every few feet we could feel the thin and sticky strands hit us. i'd stop every so often trying to pull them off, not because i was worried about spiders, but because the sensation was like i was covered in the wispy hairs of a ghosts following me down the trail. at one point, Brittany walked right into a huge web with its spider in residence. i could hear the crackle as the sticky strands broke and stuck to her hair and face. i then saw the large brown spider quickly crawling up the remnants toward her face. i slapped it down to the ground and Brittany looked distressed, her blonde hair looking white and shiny on the ends. and then, the sun came out, and it got HOT. so we were dirty from the slick trail, covered in spider webs and now dripping in sweat on one of the most technical hikes of my life.
after over an hour, we finally saw a short path taking us to the river's edge. the narrow path opened up to flat rocks in the sun and a beautiful site of the river and canyon. it was the perfect spot to rest and eat lunch and do some swimming. unfortunately i had blanked on bringing our swim suits with us. i really wanted to get in and cool off. knowing that wet shorts for a couple hours would highly increase the risk for chub rub, i stripped down and hopped in. i knew from the amount of spider webs on the trail that we were the only ones around for a while and it was nice to cool off. i dared Brittany and she followed suit. well, sans suit. after our lunch and swim, it was time to continue. we hit an easier trail and then began the trail of death. it was straight up, no switch backs, and slippery. i did it as fast as i could, just wanting to get it over with. half way up, i had to stop, my heart was racing. we made it to the top to the overlook trail and were again dripping sweat. so glad to be at the top again, but missing the cool river below. we both agreed that it was one of the most challenging hikes we had ever done. if i were to do it again, i would definitely use trekking poles and maybe bring a swimsuit ;)

the LAST weekend

after rafting, with the new river behind us.

we had to do something big for our last weekend in SWVA. we decided that something was whitewater rafting in new river gorge, west virginia. ever since i moved to virginia (10 years ago!), i've wanted to raft in what are known to be some of the best rapids in the east. i LOVE whitewater rafting! i've rafted seven rivers in four different countries. but had yet to run the best rapids closest to home. we made the three-ish hour journey to lansing, west virginia, where we camped on the property of the rafting company. it was sort of a free-for-all site and as we entered the complex, the road was lined to the max with boy scouts. we sought an area elsewhere. if you've read my other blog entries, you'll know that Brittany and I have gotten a slow start in gaining our camping expertise. but there would be nothing but triumph in this final weekend. we set up our tent in 11 minutes (i timed it) AND i built a campfire! we did not need any brawny, facial-haired man nor a skinny catracho using plastic as kindling. we made a campfire! and then we roasted marshmallows.
the next morning after breakfast and an unfortunately long delay of our rafting time, we finally gathered (with the boy scouts) for our safety and instruction lecture. we set off with our helmets, life jackets and paddles on an old school bus up river. there were eight of us in the raft, plus our guide, Harley, who was a native west virginian that would have been cute if it hadn't been for the BO and bad teeth. Harley immediately chose the two big black guys to sit at the front of the boat after sizing up there biceps in comparison to those of Brittany and me. This reminded me much of my rafting in Perú and I realized this is just downright discrimination! It became apparent very early on that size did not matter. These guys had never rafted (did i mention i've rafted 7 rivers) AND they had no concept of the correct way to paddle and set rhythm. now, i don't need to be in the front purely based on the fact that i am just as good a paddler as any man. but its where all the action is!!! and i don't want to miss out on the best ride because i'm a woman. fortunately, karma visited us as the guys were each tossed from the boat at least two times. the last time it happened was in our most technical rapid. we had to get around two large rocks and we had to do it by paddling hard and together. the instructions were, if you fall out, just cling to the raft. we started down and i could tell we were not in sync. the guide commanded "all forward, dig in guys!" but it was too late. we hadn't made it around that first rock and instead slid up onto it. as the rushing water pushed our boat side ways into a hole, i thought for sure we would flip. i came close to falling out and even closer when Brittany came tumbling toward me from across the boat. thankfully, my shin stopped her. but i looked and the two guys were gone. then clinging to the boat. then mass chaos which seemed to last forever. the guide calling out for them to be pulled in to the boat ASAP as we were approaching our second large rock. i didn't mention that the people placed second in the boat were the girlfriends of these two useless guys. they were equally useless and the guide began to sound nervous, "get them in the boat NOW." after some confusion and, i hate to admit, giggling, the guys were pulled back in and the guide commanded, "anyone with a paddle, forward!" it was Brittany and I paddling full force, with the guide directing. we made it to still water and the guide said, "well, i've never done that one that way. interesting." this makes for a great story and it was definitely fun, but it still annoys me that it is my second crazy mishap in a rapid that i can attribute to poor paddling on the part of men.

soon after that we approached the new river gorge bridge, which is the longest single arch bridge in the western hemisphere. its much cooler looking at it from the bottom vs. while you're crossing it. and although i did not have my camera in the raft, we stopped at an overlook and took some photos on our way out of town.
to be continued...

fun fact: did you know the "new" river is actually the second oldest river in the world? which is the first?

a little PT

well, i've hit the six-week mark here in Big Stone, which means i have only two left. its gone by really fast, the weekdays are busy and the weekends full of adventures (as you have seen). i haven't written much about my clinical experience mostly because i know many of you are not really interested in the physical therapy part of my journey. and to be honest, i wasn't feeling too excited about it by the time i reached midterm. i felt like i wasn't being challenged and that i was having to direct my own learning experiences by asking for feedback and voicing what i was ready to take on independently. fortunately, feedback is forced during the midterm eval, and i found out that my CI thought i was doing a pretty good job.
since then though, in the last two weeks, reasons i chose to come to a rural hospital for my clinical began to blossom. i evaluated a patient with a hand/wrist injury requiring desensitization therapy. if you're not a PT, then you probably don't know that most referrals for patients with a hand issue are going to hand certified specialists. these are PTs who specialize in the therapy of the wrist and hand (and entire upper extremity) because it is such an intricate animal. however, there are no specialists in this area, so these patients come to us. i was even learning a few tools probably more used by occupational therapists. next came a string of patients after MVAs and multiple surgical stabilizations of fractures requiring them to be wheelchair bound. this gave me the opportunity to practice a part of PT that has become very important to me. if i choose to go into an outpatient practice, i have vowed to never become a PT that ignores the basics, such as bed mobility and transfers. i think it is possible that in a high level sports medicine clinic, a PT may rarely ever have to address how a patient transfers out of bed. but i think on average, one will always be faced with patients where this is a critical matter of safety and becoming independent with one's care. whenever i saw patient enter the clinic in a wheelchair, i made a little self-reminder that i would address their mobility and transfers in my eval. and i had plenty of opportunities to do this.
on top of all the above, a patient with paraplegia came for therapy at the clinic. this i was sure was unique to being the only clinic in town. i'm thrilled to have the opportunity to work with him and be exposed to the different factors at play when someone is paraplegic. so after a slow start, this clinical actually has provided me with some unique experiences and provided me an opportunity to practice skills that form the foundation of my physical therapy experience.

a weekend with mom

when i first decided that i would be living for eight weeks in Wise County, VA, my mom expressed a desire to come out and visit an area of her home state that she had never seen. i had been compiling ideas of things to do ever since i arrived, and when i spoke to her last week she had only one request: let's go to Kentucky. and so we did. Sunday morning we began our drive toward Lynch, Kentucky (a chosen destination for obvious reasons) via Black Mountain, the tallest peak in the state. i had read on the internet that there was a small turn off at the state line where we could climb to the peak of the mountain where an FAA tower was in place. we drove about 1.5 miles and there it was. i said, should we turn around? but my mom's GPS device was showing only .3 miles back to route 160 where we had just been. we started down a dirt road and after a slow drive, i noticed the GPS said 3.1 miles to 160. hmmm. we decided to keep going. it soon became a very rocky path, with signs of recent rains washing away the rocks into uneven patterns and carving gullies into the edges of the path. we bumped down and farther down, much like i used to bump down the stairs on my butt as a child, taking care not to bottom out (pun intended). mom did a little side seat driving, directing me toward optimum paths free of drop offs while she clinched her seat belt. soon, an ATV/golf cart hybrid carrying a middle-aged couple came up behind us. i let them pass and used them as my guide down the mountain. i wasn't really nervous until the Garman showed no signs of knowing where in the world we were. we were just a bright blue cartoon car floating around in the blank green, hearing "drive to highlighted path" on repeat. we hoped that continuing to descend was a good sign, and i secretly hoped i wasn't going to have to test my nearly 10-year-old car further by turning around and climbing what we had just done. thankfully after about an hour of driving through unknown territory, constantly wondering if this road would just end or narrow or become a river, a highlighted pink route appeared on the GPS and we seemed to be driving toward it. all of a sudden, we popped out of the trees and onto a paved road. a road lined with pastel colored houses and manicured lawns. we were in Lynch, Kentucky. we realized we were actually on a side road and back tracked up main street to find the Welcome to Lynch sign (where we posed for a photo of course).
Lynch seemed slightly eerie to me. Eerie and odd. How could it not with a town motto of "Where coal mining is our heritage and bulldog and pirate legends live on." Pirates? Figures a town named Lynch would be crazy. I thought the homes that lined the streets in their Easter egg colors were quite quaint, but they were broken up by the deserted stone building, covered in vines, that at one point was a school as well as the abandoned coal shoots that crossed the road overhead. we were definitely in the heart of coal mining country and i wondered if the pastel facades served to lighten the gloom of this struggling industry.


Mom and I also had other adventures to the Breaks Interstate Park and Cumberland Gap. Check out the photos below.

The Breaks Interstate Park


The Breaks, called the Grand Canyon of the South


Cumberland Gap, a view of three states: Virginia, Kentucky and Tennessee

HOTlanta

when asking around for things to do on the weekends in the area of Big Stone Gap, someone alerted me that Atlanta is only about 4 hours away. I immediately emailed my friends Carlo and Stef to see if they had any weekends for a visitor. Stef was planning on celebrating her birthday a few days early on July 10th, which marked the halfway point for my clinical, so I decided it would be perfect.
there is more than one way to get to Atlanta. i chose the straighter shot, but which also traversed the mountains of North Carolina and northern Georgia. it was slower going, but it was beautiful. I could equate it to the eastern/Appalachian Mountain version of driving the small mountainous road through towns like Ouray and Montrose, Colorado. Curvy roads and mountain passes, broken up by cute small towns that are vacation spots for local citizens. Unfortunately, two massive thunderstorms hit during my drive and it took nearly 6 hours to reach my destination.
but once i was there....well what can I say? Un finde lleno de travesuras. I ate Cuban food, danced to Latin music, met a lot of new people with interesting and diverse backgrounds. i hit up both an H&M and a Trader Joes. it was exciting but at the same time odd to be in a big city again. staying out past midnight was a change since my move to SW Virginia. shoot, seeing asian people was a change since my move to SW Virginia. and after my weekend dose of cultural diversity and city night life, i returned to the mountains.
monday morning it was raining, and a heavy mist was moving across the valley. it reminded me of the book the Mists of Avalon. its a King Arthur tale from the perspective of Morgaine who is a priestess at Avalon that is shrouded in mists, only lifted by those who know how. There, you are cut off from the rest of the world and only have knowledge of the outside through dreamlike visions. and thats how i felt on monday. i had penetrated the mists again, and i was again cut off, living amongst a people who really don't have a grasp on what goes on on the outside. and when thinking back on atlanta, it seemed like a blur.
that being said, i do enjoy and appreciate the life here. its quieter, slower paced, the scenery is incredible. but i think my trip to Atlanta made me realize that, at least while i'm young and unattached, i yearn for the diversity and the excitement that a big city offers.

fourth of july

since my last fourth of july was spent at Isla Amantani in Lake Titicaca, dancing around a bonfire, wearing traditional Quecha dress, and sipping a drink of coca leaves, pisco and milk, i figured i should probably do it up American style this year. and thats what I did. we grilled hamburgers and made various accoutrements to compliment them. not just various. too many. cabbage salad, breaded zucchini, red velvet whoopie pies. are you surprised?
after stuffing ourselves, we headed out to Bulitt Park, a regulation size football field/track used by the local high school in Big Stone. here are the benefits of living in a small town: we drove up to the neighborhood around the park, and although the streets were filling with cars, we found a spot, walked to the park, plopped down, watched fire works, got up and left. no traffic problems, no unruly crowds. and this was no po-dunk fireworks display. it was actually quite impressive and i was very satisfied with my independence day. grand finale

tonight's top story

something big was coming to town. real big. it's all that anyone could talk about for weeks. the radio gave daily updates about its arrival. and no it was not the president's caravan, a popular music group, or even a museum exhibit. it was a 1,300,000-pound generator headed for a new power plant under construction in St. Paul, Va. it had made its way all the way from Japan to Louisiana, then on to Knoxville where it began the last leg of its journey through the mountains of Virginia. it was bound for the new power plant via Route 58 from Cumberland Gap through Pennington Gap and then through our little town of Big Stone Gap. it was destined to make its 200 mile journey only from the hours of 8 pm to 5 am at a max speed of 10 mph. its size would take up an entire side of what everyone here calls "the four lane," which says to me that when this four-lane highway was first built in this area, it was a pretty big deal. and now they were going to block it with this 650-ton monstrosity. no wonder everyone was talking about it. well, that and this was wise county's news event of the summer. like you've probably already guessed, not much goes on around these parts.
when the day finally came for it to pass through Big Stone, we decided we had to see what all the hub-bub was about. we had heard that due to an overpass or bridge on the four lane, the giant generator was forced to pass through the main street of Big Stone Gap. we drove up around 6pm and people had already started to gather. lawn chairs, a tent set up with people selling food, musicians playing on the small stage in the park. they were turning it into a town event. police and firemen were posted along the main street blocking it from traffic and rigging a crane to lift the cabled stop-lights to a height that would allow the generator to pass. some even had to be taken down as you see above. as the evening wore on, more people began to gather and speak in hyperbole about the generator. i heard it took four hours for it to pass one house up near pennington. you know, 100 men walk along side it as it travels down the road. i heard this is just the first of four others. you know, it hasn't left pennington. it won't get here until after midnight. this last one was not an exaggeration. and so after soaking up the crowd, i returned home around 9pm.
the next morning, we got on the road to head to the clinic in Norton. the four-lane was partially blockaded with cones as we entered our on ramp with a gathering of equipment on the shoulder that said WIDE LOAD. is this it? no. it couldn't have only made it this far all night. it doesn't look big enough. once we got to the clinic, it was confirmed. that was the giant generator (that didn't look all that giant) and it had only made it a few miles outside of Big Stone after getting stuck for a few hours at two locations. on our way home that evening, it was still parked, causing a bit of a traffic jam as people pulled over to take photos. if you want to see the generator itself and hear more, check out this video from the local news.

asheville, camping, and the hike from hell

brittany and i had discussed a few ideas of things to see in and around southwest virginia while we were here and one of our priorities was asheville, north carolina. asheville, being only a 2 hour drive from big stone and a haven for locally grown food, hiking, hippies, and all around small-town-in-the-mountains fun, had obvious appeal. plus brittany had never been there. we decided to camp, not only because we enjoy it, but because its just plain cheap. after the clinic closed on Friday at noon, we packed up our already prepped meals, camping and hiking gear and set off south through tennessee to north carolina.
the camping experience was, in my opinion, much more successful than our last adventure in Shenandoah over labor day weekend. that weekend, we struggled with the set up of our borrowed and very odd-shaped tent, underestimated the melting of ice in the cooler which then turned pre-made fajitas into soggy tortilla mush...which we THEN burned in attempts to dry them out over the fire which we only started after borrowing lighter fluid from a neighboring camper... novices indeed. this time we were more prepared. we brought my small propane gas grill. beat that nature. we kept all bread type ingredients far from the cooler. we did a dry run of tent set up before we left virginia. we were not going to look like idiots this time. and indeed, things went well. we got a space in our first choice campsite, we set up the tent in 20 minutes and turned the knob on the grill to get the fire going. we hit one snag when brittany mistook the bug spray for cooking spray and doused half of our pre-cut veggies in deet. she managed to salvage most, and our dinner, minus the one mushroom i had to spit out, was much more satisfying than the burnt mush fajitas to which i previously alluded. we even managed to make s'mores and then pack up fast as a thunderstorm rolled in. what comes after novice? competent? although i do admit that as the rain poured down that night, i was saying a silent prayer that our tent would not collapse as we slept.
the next task for the weekend was to hike Mount Mitchell, which happens to be the tallest peak east of the Mississippi River. now, you can just drive to the top and walk up to the tower built to look out over the expanse of the North Carolina mountains. but then what can you say? I drove Mount Mitchell? No no. Online we found the details of the summit hike which began at a remote campground 5.7 miles and 3600 feet from the top. With printed copy in hand and camelbak stocked with water and snacks, we set out on our immediately climbing, tree-covered path. And it just kept climbing. No ascents and descents, no passes, no flat ground, just up hill...for three hours straight. additionally, this hike had none of the views that made mount rogers so spectacular. we were deep in forest for the entire climb, which gave us no sense of how far we had to go and no ability to visualize our target. but luckily, my print out gave detailed descriptions of the path: the types of trees we would meet a long the way, boulders to look forward to, signs of nearing the summit. After an hour of climbing in silence, I pulled out this little paper and began to read aloud about the type of forest we were in and how the trees were changing as we increased in elevation. The paper also revealed that we had already made it nearly half way. Then, silence. and more climbing. possibly some moans behind me. after another 45 minutes, i whipped out the paper again. more trees, a virgin forest to be exact. find that and we'd be at another milestone. we were starting to get tired of trees. another 45 minutes, no virgins, just endless climbing. please, next milestone, PLEASE. we finally made it to an area where "a horse trail will combine with the path." we were nearing the last 1,000 foot climb. we had missed the virgin forest. "as the trail flattens and puncheon is laid down to keep your feet out of the mud, you will know you're near the summit." puncheon? what's puncheon? after another steep 30 minute climb, EVERYTHING was puncheon. is this keeping our feet out of the mud? oh no, here it is. this is puncheon. no, THIS is definitely puncheon. we were also instructed to look out for a boulder on the right and a cave on the left. that rock looks big enough to be a boulder. where's the cave. no cave. ok. keep climbing. didn't she say this would flatten out? hey, that could be a boulder. still no cave. this is definitely puncheon. finally, after another 30 minutes and angry grumbling, we passed exactly what we were hoping for. people. especially one woman who said, you're almost there. the trail began too look more used and had some signs about the flora around us. and at last, we emerged from the trees to find...another steep, yet paved, hill to climb to the tower overlook. ughhh. we trudged up, salt from dried sweat caked on our faces, dirt on our legs, we passed the loafer and izod clad, complaining of the burn they felt climbing that paved walkway. if they only knew. we refueled on peanut butter sandwiches and fruit and begrudgingly began the descent. This took an entire hour less than our climb up because at many points we were nearly running down the mountain, due to the slope as well as the desire to be the hell done with this hike. when we made it back to the car, we agreed, the first stop would be for ice cream.
as this entry is already too long, i will be brief about our time in the actual town of asheville. we stopped by the town each day, sometimes just to walk around, others to eat. it's not how i remembered it. its bigger, with a more concentrated downtown that i had imagined. but its just one of those ideal places. you could have the city, night life and great food if you wanted that. or you could be at peace in the mountains, walk around the campus of the nearby university, tap drums with the folks in the park. if i could find a salsa club and some people to speak spanish with, i think i'd be set. our last morning after a stop at a farmer's market, we went to brunch at a restaurant i had spied online. Tupelo's Honey Cafe = Incredible. They use locally grown and organic ingredients and put a fresh spin on southern cooking. You'd think i'd pulled that from their website. We had fried green tomatoes and goat cheese grits, followed by sweet potato pancakes served with peach butter and maple syrup. As if that wasn't good enough, they serve complimentary warm biscuits with blackberry jam. In my book, it was a great ending to an fun weekend in Asheville, NC.

mount rogers, highest in Virginia

Most people warned me that there is not a lot to do around Big Stone Gap, Virginia. Even when calling in search of housing, one realtor told me that "I better bring some fun, because there ain't none here." But when you love the outdoors as much as I do, there are plenty of things to do. This was evidenced in conversations with my CI, who also likes to be outside, that went something like this: there's this great hike...and this state park...and this camping site....and its an easy drive to Asheville...and..... Now it seems like there is almost TOO much to do, and there aren't enough weekends to do it.
This saturday though, we hit one site that I really wanted to conquer: Mount Rogers. Not only is it the tallest peak in Virginia, but its along the Appalachian Trail and is high enough that the temperature is 10 degrees less than the Gap. This was a blessing as the high on Saturday looked to be 91 degrees. To get there, we drove east towards Abingdon, which is known to be a cute little town, almost metropolitan in these parts. We then crossed under 81 and made our way through Damascus, which is known to be the friendliest town on the AT, and it looked the part. Restaurants, bike shops, outfitters, campgrounds, everything that a trekker could want. It also is a starting off point for the Virginia Creeper Trail, 35 miles of bike trail that goes from White Top Mountain through Damascus to Abingdon. Save that for another weekend. Past Damascus, we drove up switchback after switchback until, nearly nauseated, we made it to Mount Rogers.
The hike began with an open meadow, filled with dozens of butterflies, and a cool breeze that blended perfectly with the warm sun. We couldn't have asked for better weather. After about a half mile, we hit the AT, which was much more challenging than I imagined, not a smooth path, but instead lots of rocks to clamber over. The majority of the trail is above the tree line, with open meadows, bright green grassy hills, dotted with charcoal gray boulders. Aside from the pine trees in the backdrop, I could have been in Ireland. We climbed up one of the boulders to get a panoramic view and eat our lunch. As we sat and enjoyed the breeze and the view, we saw a group on horseback, cowboy hats and all. As I caught sight of the dog running amidst the horses and their riders, I then thought I might have been in Wyoming. Both Brittany and I remarked that this was a unique Virginia hike as it was not tree covered and you could actually see the expanse of the Blue Ridge all around you. This Western girl was in heaven. The path led us past many AT trekkers, some walking, some napping in the shade. We finally made it to the spur trail that led to the summit. This became immediately covered in trees, unfortunate for a summit trail. Actually most about the summit trail was unfortunate, namely it ended with no demarcation that you had just reached the highest altitude in the state. Instead, a tree stump with one last blue blaze was the indication we had reached 5,700 feet. A little disenchanted, we turned around to head back, but were quickly reminded of the amazing beauty of 90% of the hike. I feel like I cannot do justice to the beauty of this hike. Hopefully the photos help.

the best friend festival

apparently every year, the city of Norton, VA puts on a Best Friends Festival. from the Wise County chamber of commerce website, i could not ascertain what exactly the festival commemorates or celebrates, except well, best friends. this year's theme was "There's no place like home" obviously taken from the classic Wizard of Oz and confirmed by the cardboard cut outs of Dorothy, the Tin Man, Scarecrow and Lion that were up on a hill advertising the festival. There were events daily starting off with one called Paint a Trash Can on Monday and ending with a pancake breakfast Saturday morning. We did not attend either of these, but we did check out the Tuesday evening farmer's market, which really should be called a gardener's market, and the Emerald City Celebration on Friday evening. This was actually no joke. There were several trailers of fair food, at least 3 moon bounces, a couple of rock climbing walls and a stage set up for music. We took a lap up and back the closed-down main avenue of Norton and decided we had enough time enjoying best friends and returned to the Gap.

the baby blue palace

When we found out that we could potentially live in a trailer during our stay in rural southwest virginia, i knew it would make the experience complete. and as soon as we confirmed that it was not located in a park and would have wireless internet installed before our arrival, we were set. as we drove along the road, looking out for our home for 2 months, we passed a mixture of large mobile homes, run-down trailers complete with car parked in front yard, and beautiful homes of the foundationed sort. i realized when i arrived that i would be spoiled with this double-wide beaut. i know it doesn't look like much from the outside, with its flat facade and porch in dire need of a paint job. but its clean, inside and out, houses a washer and dryer, and has two rooms sizable enough for a full bed, a dresser and a desk. and aside from the cat-laden floor mats and throws, it is virtually knick knack free (minus one life-sized ceramic cat that sits behind the tv stand).

what it does NOT have is a dishwasher nor the water pressure in the kitchen sink to wash one single crumb off a plate. only slightly more awkward are the accordion-type doors which separate the bathroom from my room and give Brittany "privacy" in her bedroom. the other door to the bathroom is typical, except that it doesn't stay open except with the help of a cat-shaped door stopper. and every time you open this typical door to exit the bathroom, the accordion doors flap from the displacement of air. but B and i knew we would be living in close quarters, and are laughing at these inconveniences instead of fretting over them.
to end on a positive note, the trailer is very comfortable to come home to, especially the central air on a humid day.

my first day

after much anticipation, i finally started my clinical. i arrived at 8 am and received a tour of the larger than expected outpatient physical therapy clinic. they have pretty much everything you could need, modalities units, high low tables, even paraffin. my clinical instructor (CI) is originally from this area, however graduated from VCU, and is now the only PT for this hospital. due to that, this outpatient rotation will also include acute care coverage on the floors of the hospital. today was not necessarily very exciting. my CI seems quiet and laid back, which means i mostly observed. there are other people on staff including PT assistants and technicians. i am very aware of my accentless speech and my lack of a desire to talk someones ear off. sure i'm friendly, but boy to these people talk.
we spent much more time than expected over in the ICU and on the floor, although my CI says this should be only about 20% of the clinical. i don't mind doing work in the hospital. our program only allows one acute care affiliation, so i feel like this is bonus experience. after a year, things definitely needed to be refreshed, but i think its coming back fast and i will feel really comfortable with acute care after this affiliation. but today definitely had some interesting moments on the floor, from the inmate with several stage 4 ulcers to the patient s/p ORIF that only wanted to walk to go have a smoke, i feel like i'm not that far from Richmond and MCV.
will hopefully have more to report about outpatient by the end of this week.

the drive

this morning i left Roanoke and hit 81 south for the 2 hour drive to Abingdon where i would meet Brittany to caravan to Big Stone. I was making excellent time, 15 miles from the exit for Abingdon, when i came over a hill and was suddenly aware of the ominous dark gray sky ahead of me. here it comes. I was reminded of my recent trip to the river with my friend Genevieve as we sat out on a rock under the threat of rain. After an hour or so of only clouds, I looked up river and said, here it comes. Gen said, What? The rain? Can you see it?? Just then big pellets started to drop and we jumped up to take cover. Again today, i felt like i could see the rain before it hit, and boy did it hit. I made it to exit 19, but could barely see the sign pointing towards Abingdon. I drove 5 minutes towards town when Brittany said she had made it and stopped almost immediately off the highway at the Dunk 'n Deli. i turned around to meet her and upon walking in greeted her with, Are they deep frying the entire building?? We compared notes on the routes to Big Stone: 11, 19, 58, 23, 610, looked more like my next lottery pick.

We set off through the small town of Abingdon, which appeared cute and historic but it was all a little blurred by the heavy rain. We traversed along curvy roads, around mountains, down through narrow valleys. After about an hour, we passed by Norton, "the next town over" from Big Stone Gap, and according to Brittany, the smallest city in Virginia. From the highway, it appeared like it could have a cute "downtown" with brick buildings lining the main drag. After Norton, we climbed another pass that was shrouded in dense fog. I could see the guard rail to my left but nothing of what I was sure was a beautiful scene below. In fact, the above photo was taken from a scenic view point that I had no idea existed because I could not see it through the fog. Finally, we turned off the highway and found East Stone Gap. I'm not exactly sure why this locale deserves its own name and sign because aside from a church, there is nothing there. After heading the wrong direction out into the country for several minutes, we turned around much to our dismay, leaving behind cute homes in a beautiful valley. We drove back in the direction of town and in the passing of each run down mobile home, prayed that that one was not ours. Finally, we arrived at our blue double-wide destination. To be honest, its not much to look at from the outside. But it is clean and plenty big on the inside. But more on the abode later.

As i mentioned last post, i was on a mission to watch the US/England World Cup game. I had called ahead to a Mexican restaurant in Norton to ask if they had TVs and if they were showing the World Cup. The man answered, Diga. Sounds promising. After not understanding my question in English, he handed the phone off. Of course they had TVs, and of course they were showing the world cup. We arrived at Mi Finca to find that it not only had TVs but a patio and a recently acquired liquor license. We sat down in front of one of the HD TVs airing the already in-play game in Spanish. At the table next door, sat four Mexican men, all hoping for an English victory. After the game, I struck up a conversation with one of them and he inquired about why we were here and where we learned Spanish. Not the first afternoon in Wise County that I was expecting. More to come...

from the 'Noke

i made it to Roanoke with only one casualty. as i was packing....no, STUFFing my car full, the largest glass lid for one of my pans hopped out to make a break for it. however, it shattered upon landing. no big deal. didn't really use that lid anyway. and i wonder how many other items i decided to keep and haul on my back that i could say the same thing about. my sister, Betsy, suggested that as a part of this blog when I decide to ditch an item that i previously cherished but have now come to my senses that I really just don't need that hair straightener with four attachments that i haven't used since crimping my hair for an 80s party 7 years ago... that i should write about it, and maybe include a photo for the big decisions. well so far, the straightener, a pair of half working computer speakers, and one pillow have taken their place in circular storage, i.e. the garbage bin.

i stopped in Roanoke as a surprise for my uncle. some of you may know that my uncle was hospitalized for several months at the beginning of this year. he is home and on a gradual path to recovery under the attentive care of my aunt. my arrival fortunately coincided with his first outpatient physical therapy appointment. i was impressed with the ability of the PT to examine the entire body in an efficient manner and also with what my uncle could already do. i helped him with a few exercises at home, in exchange he taught me how to play backgammon.

tomorrow morning i set off for the gap, the big stone gap. i think i might start calling it that, although many people might start to think i'm living in a preppy store that makes medium quality clothing. i also have come down with a serious case of world cup fever, and after watching this mornings South Africa/Mexico match up, i know it cannot be cured. tomorrow the US plays England, which which looks to be a big match-up. whether it makes you recall that other important America vs. England contest in 1776 or that episode of Simpson's where the family goes to England and Homer rear ends the Queen, i think we can all grasp the significance of this game. so tomorrow, aside from the goals of finding this small town in the mountains, locating the trailer and the woman that owns it, Brittany and I will be on a quest to find an establishment that is airing the game. I've already google mapped sports bars in the area of Wise county. Closest one: Kingsport, Tennessee. It's going to be an interesting two months.

time to hit the road

becoming sentimental

i have been so busy with packing and getting my life in order, that i sort of forgot that i'm leaving. on my way to my friend's house to return her baking dish, i walked past the gardens overflowing with their summer bounty and through the small park behind my house. the cool evening air was a surprising break from the normal june heat, and the lightning bugs marked my path across the park with their intermittent glow. i walked up the road, stopping in at my favorite italian take out spot and then into the market on strawberry street. while paying at the register, i noticed the basket of infamous chocolate chip cookies, which i have often grabbed as a reward for finishing a test or as solace after a bad day. i realized that although i will be returning to Richmond, i will be leaving this blissful life in the Fan, where i can walk to meet friends, sit in the park and talk to neighbors, and enjoy a face-sized cookie just steps from my apartment. other than this small neighborhood of quaint row homes and beautiful gardens, there is not much else that makes me feel sad to leave this city.
and leaving it i am. tomorrow morning, my car will be packed and i will be on my way to living a nomad's life. first stop, the 'Noke.

i hate packing

at first, sorting through 28 years of belongings was fun. i reminisced, i organized, i threw away. it was therapeutic. now it just won't end. i thought i would have one box of items from the kitchen to take to Big Stone Gap. now i'm 3 boxes and a couple bags deep. and its hard for me to part with things from the kitchen. i even bought new multi-colored spatulas and baked friendship bread and chocolate chip cookies in the last two days. but i had to get rid of my butter and eggs, right? riiiiight.
i miss the days of my life fitting into the back of my car. now only half of my life fits in the rear of my SUV (with the seats down), while the other half resides with my friends in Richmond. so maybe i don't hate packing. i hate stuff.

yard saling

i could be wrong, but i feel like the concept of a yard sale is purely American in its origin. let me just put all my used crap on my lawn and hope that some schmo wants to buy it is about as shameful as our other contribution to civilization, fast food. however this past saturday, I succumbed to the idea that one person's trash is another's treasure. then again, my stuff wasn't all trash, claimed my craigslist ad on Friday: "I'm not just selling junk people, I will be living out of a suitcase for a year, this stuff has got to go." so armed with pre-priced stickers and lots of small change, i sat outside from 7am to noon, watching people hem and haw over my belongings. Scott, those bike tubes sold in about 2 seconds. other hot items were any sort of jewelry, my John Williams CD, and the Nana and Bumba nesting tables...which I did NOT sell, but turned down a dozen times. all of my patrons were very friendly, with their good mornings and chit chat about the weather, and did not try to bargain prices too much. they ranged from little old ladies that could barely make it up my front step to young hipsters looking for cheap clothing and music. my last sale of a crate and barrel vase for five dollars rounded my earnings off at $100, which goes straight into my savings account for next summer's adventure. as a yard sale novice, i am pretty pleased with its success and if i come upon another time in my life when i want to rid myself of possessions, i may do it again.

cleaning house

It began with photos. I needed to begin the daunting task of perusing, disposing and organizing....my life. I would start with one corner of my room. To the right was my desk, which after two weeks and six exams, I did not feel like nearing. To the left, my bookcase, which although dusty, was seemingly neat. Atop it sat a bamboo box full of photos in disarray and I was aware of at least two other boxes filled to the brim with photos. Perfect. A stroll down memory lane is better than a trudge through tax returns. But it only began with photos. It soon became physical therapy binders, then toiletries and medicines expired in 2006, winter clothes not touched in the last two winters, CDs I'm almost ashamed to own...and yes Stephanie Shield Silvia Stout continued to take the garbage out.

Finally, I was back to square one: my desk. I first tackled a neon orange file folder, definitely from my UVA era, stuffed to the brim of not closing. I continued my purge of useless papers, including the Welcome to Bank of America folder from 2000. Shoved in the back I found a thick stack of papers and exams from previous schooling, obviously of which I was proud. Motor Learning Project: The Effects of Knowledge of Results on Rehabilitation Exercises. Wow. When we began this semester's Neuro Rehabilitation course with a section on motor learning, I vaguely remembered that I had taken an entire semester of that dreadful topic in college. I must have blocked out most of the experience. C+???? And I kept this?? I can only surmise that the class was challenging, not like a hard run on a humid day, more like pulling the splinters off a porcupine. Or that at one point in my life, I was ok with this average (gasp) grade. I laughed as I read in my own words the differences between intrinsic and extrinsic feedback. But I nearly hit the floor when I read, "However, studies have shown that although frequent and instantaneous KR enhances immediate performance, it is detrimental to long-term retention of a motor skill." Wasn't I just memorizing that (yet again) this past January? I think I may need a few more lessons on retention. I decided that, although according to my current standards that grade was certainly unacceptable, for some reason I kept it, and it stays. Next: A comparison of the Enzyme Alkaline Phosphatase and a Mutant Using Michaelis-Menten Kinetics, jigga-what??? Again, the 76% circled in red was at that point a grade to be proud of. But my experience in Bio Lab in my first semester at UVA is forever burned in my brain as one of the hardest courses of my life. Keep. Finally, a test from athletic training, 93%. That's more like it. The last group was a selection of tests from my Advanced Orthopedic Assessment course in grad school, taught by the renown Mike Gross, PT, PhD. The first test response began with the effects of lower limb amputation... I learned that? Before PT school? Enough to answer a question about it? Pressure ulcers? I didn't think these thoughts had been in my brain before last year. I also found the scoring sheet for the class's practical examination, where I had to perform an entire lower quarter assessment, 2 Mulligan techniques, and neural tensioning tests. Yes, I had remembered learning this material, but a practical examination?? No recollection. This puts two years of stress and pressure to get 95s on every written and practical examination into a little bit of perspective. I find it hard to believe that I will ever forget the nerves I felt preparing for my wound care practical, and how defeated I felt when my sterile field oh so gently grazed the non-sterile cart. Or how I had to fight back tears at the end of my final Rehab practical in the Nursing School because I thought I had done so poorly. Surely I must have felt this before facing Mike Gross. Surely. But now it is not even a distant memory, its no memory at all.

Over the past two years, I've been consoled and have consoled others during pre-exam stress that grades really don't matter, that you will never remember your grade on some insignificant test. Turns out, its true.

Sin Dirección

A few people have asked if I am going to write about my experiences in southwest Virginia this summer, especially with the news of my future two-bedroom trailer abode. I was hesitant, but since I am facing the beginning of an entire year without roots, I decided this may be an adventure worth telling. Thanks to mom for inspiring the title for this blog, which fit perfectly with an idea I had earlier today. I was chatting with my friend Percy from Perú and was explaining to him that I would be moving around for the next year. To say without an address in Spanish is "sin dirección," but I realized that this may give a false impression. Although I may be wandering physically, I don't think I have ever been a girl without direction.