140 – OT and Pain ft Natalie Khan

Natalie has an amazing breadth of experience for such a young clinician. This ep we have a look at that experience and then funnel down into her interest and experience living and working with chronic pain.

Check out her work here:

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Automatic Transcript

Brock Cook 0:00
G’day, and welcome to episode 140. I have the absolute pleasure today of bringing in the lovely Natalie Khan to talk about her interest in pain and occupational therapy, how that actually works, exploring her how that interest came about her experience with it, and making some correlations with the ideal sort of occupation based practice model, and what’s currently happening in pain because, from my perspective, it’s extremely, extremely fascinating. And I think we can all learn quite a bit from how it’s happening. So enjoy G’day, my name is Brock Cook, and welcome to occupied. In this podcast we’re aiming to put the occupation in occupational therapy, we explore the people, topics, theories and underpinnings that make this profession so incredible. If you’re new here, you can find all of our previous episodes and resources at occupied podcast.com. But for now, let’s roll the episode.

Natalie Khan 1:08
Well, it’s true. To be fair, I don’t know that I’ve met a lot of people who have just become OTS because they wanted to be in it. Funny enough. My mom’s actually an OT.

Brock Cook 1:18
Oh, really? Yeah, you probably the first thing

Natalie Khan 1:21
you know, but it wasn’t like that. I think you probably actually have met her because my mom studied overseas. And so her degree wasn’t recognized. And so she’s only recently gone through JCU to get that she was one of the students who to get that, I guess recognized. But growing up I love but like, I was interested in what my mom did, but I was also kind of like, just don’t want to do what my mom does. And so, I don’t know, it’s probably a combination of there was a moment of I think I’ll finish school and didn’t want to do any further studies. I just wanted a gap here. My parents forced me to go to uni. So stallion Yep. Out of rebellion. I studied science to prove a point that uni is not for me, because I’m really bad at something.

Brock Cook 2:20
Seems like a logical way to go. Yeah, look,

Natalie Khan 2:22
look, it was obviously not not that. But it made sense. At the time. I was like, I’m here. I’m, you know, doing science. I failed, you know, as expected, because I’m not well, at the time, I think probably become better at those sciences. But at the time, it wasn’t really important to me. I was just kind of there for the uni experience can relate. Then I had some subjects. I think it was some of the healthcare subjects I had with OTs and kind of liked it. And I thought no, actually, I like what these guys do. But I’m not I don’t want to be like my mom. But I could be an OT. But I don’t want to be like my mom.

Brock Cook 3:08
And then I’m entitled struggle. Yeah,

Natalie Khan 3:11
put into it and was like, Yeah, I love what he does. So here I am I at now.

Brock Cook 3:19
Yeah, just like your mom. Just like.

Natalie Khan 3:24
Yeah. That wasn’t what I expected it to be. But that’s alright. Have you regretted it? So that’s,

Brock Cook 3:31
that’s all anyone could ask, hopefully. So once you finished becoming your mother, where did you move into? Like, what was your practice area? What was your passion?

Natalie Khan 3:44
Yeah, um, I guess through uni, you know, going through JCU one of the big things that we learn about is rural health and group practice. And that was something that really aligned with my values and what I wanted to do I, I, you know, had the plans prior to COVID I don’t know if you remember, because we talked about this a long time ago when you just started occupied? Probably not. But I had plans of going overseas and doing like some refugee pipe work.

Brock Cook 4:14
I do recall that actually.

Natalie Khan 4:16
I obviously, it was all planned out pre COVID You know, so

Brock Cook 4:22
COVID changed a lot of plans. Yeah.

Natalie Khan 4:25
But anyway, so I ended up I’ve prior to that. So I got into real work basically is what I was trying to get to I really enjoyed real work and I thought that was a good transition to you know, doing something like refugee type of work. And I seemed logical at the time I really enjoyed rural work and I think you know, the things that we learned at uni, I probably have a bit of a complex feeling like everything is my responsibility and I’m there to fix the world. And so you know, Remember, lecturers would say things like, oh, you know, not enough health professionals go out there and they need health professionals. And I was like, wow, they need me.

Brock Cook 5:09
Like, wait, I’m a health professional, I can do this

Natalie Khan 5:12
exam. Yeah, I’m gonna be a health professional and I can go. So I went out there and I stayed out there for two years. I did my Allied Health row generalist training, actually through JCU. I was out there. I loved it had the best time. Really, I don’t think I would have left if it wasn’t for the fact that I realized how isolated we were when COVID started.

Brock Cook 5:40
So just just for those that probably aren’t so familiar with the rural world, what’s the what would be the main differences between say what you were doing in a rural setting and what someone might do in a more Metro setting?

Natalie Khan 5:51
Yeah, so really, every day was very different. I guess there’s a combination of inpatient and outpatient work. We do anything from you know, your general older person presentations in hospital, you’ve got your, you know, your ortho surgical rehab presentations. We did hand therapy outpatient pediatrics, outpatient, your general community outpatient, palliative caseload, which was quite a big part of my caseload Actually, I didn’t expect it to, but turned out being that way. So it was really just very different every day, you know, you do outreach to different towns, and you know, overnight trips and going out into communities saw some interesting things. But it was, yeah, it was good. I think I like that no day was like the previous day. But I think, you know, towards the end of the two years, I kind of felt that I was just plateauing a little bit in my learning, because you see so much, you know, you see so many different things that, uh, you know, really different to the things that you usually seen. So you’d never really, I guess, you become really good at kind of knowing how to solve the problem, but never really good at actually knowing what, how to do something

Brock Cook 7:24
become that jack of all trades, but you don’t really have the time and the exposure to become the master of any particular area.

Natalie Khan 7:32
No, no. So you know, like, some conditions, you know, like, I guess you could have maybe two, two amputations or three amputations in a year. And that’s, that’s a busy year of amputations, you know, and so, and then you’ve got your hand conditions that you might see, you know, and you probably see the same condition to two or three times a year. So it’s just really tricky trying to, I guess, be really good at anything. And so I decided that that was probably, it was time to move on

Brock Cook 8:08
time for a change. I think for many people, I probably wouldn’t have heard that term rural generalist, I feel like it’s a very Australian thing. It is what it says on the box is invalid, it’s when you’re working in a rural area, and you become generally good at a whole range of different things so that you can meet the needs of a wider population without having essentially multiple, like in a metro, you’d have a therapist for hands, and you’d have a therapist in Powell care. And you’d have a different therapist, like you’d have a whole handful of therapists for the different areas, whereas in a rural area, I can’t remember what the population definition of rural I think it’s like under 20,000 In a town or something like that.

Natalie Khan 8:46
Oh, yeah, I think it’s something like that. We were definitely well below I think we had 1000 People in this some of the areas I was seven, I think 1800 people, so

Brock Cook 8:58
yeah, so generally, service, whatever it needs came up in the population, as opposed to being especially like a specialist, kind of having a specialist knowledge base in one particular area. Yeah, yeah. And what’s sort of the other sort of relatively unique thing with rural general stuff is just the area that you cover as well. Like, do you have any idea like how many like, what sort of how many kilometers How will the like, how are big an area you are?

Natalie Khan 9:29
I don’t probably don’t know the exact area. But oh, I mean, I could probably you could probably drive about two hours into most directions, I guess. And that was the area. I don’t know if that makes sense. But kind of the area that we covered and then that it was you know, someone else’s Dix district would start and that’s the area and you know, you I think you become really good at, you know, as a real general unless you become really good at just collaborating with those specialists, clinicians, so you know, you’ve got those major people at the metropolitan areas and call them you say, Hey, I’ve got another pediatric patient here. This is what’s going on. And I think to them a lot of times, it’s pretty straightforward stuff. And they’re like, oh, yeah, we see 100 of these a day, but it was a bit different.

Brock Cook 10:26
For us. Yeah. In those areas to you also in that was like rural generals and other professions as well as you. Yeah,

Natalie Khan 10:33
yeah. Sorry, everyone. Well, all of the Allied Health, actually even medical nursing, everyone’s everyone’s a real generalist. So it’s kind of the

Brock Cook 10:45
big family.

Natalie Khan 10:47
It is it is, but it was really nice. It was, it was great. I had the best time, you know, you get to know everyone really well, you get to work with all the team members really closely. And everyone knows exactly what everyone’s roles are. And so it’s makes it makes a really nice place to work.

Brock Cook 11:06
Yeah. And you mentioned earlier that you originally were planning to go and do refugee work. Where did that interest come from?

Natalie Khan 11:13
Oh, I think again, it’s probably, like goes back to me thinking that I can save the world. On my own. I, when I’ve honestly wanted to do that, I think since I was about seven years old. At the time, I thought I was going to be a doctor. And you know, that makes sense. That’s how you, you know, save people. I don’t know, I think it’s probably a combination of I think my heritage and my background and that my growing up in Brazil. For times, you know, mom used to take us, you know, just little things used to take us to the favelas, and we have to give all of our all of our toys away that we didn’t, you know, so that we didn’t use so just I guess, even though it’s probably in the grand scheme of things, a little thing, but I think it just started to instill some of those things. And that, you know, there’s other people out there who are less fortunate than us who need support. And, you know, my dad, he’s of Iraqi Kurdish descent. So he, he was a refugee himself. So I think, you know, probably all of those things just kind of came together and the need to help people out there. And, you know, I guess helping your people, you know, I guess, have your same background. And that doesn’t have to be, but I think it’s just

Brock Cook 12:44
it’s crazy, the thing you end up being sort of drawn to, I guess, yeah,

Natalie Khan 12:47
I think it’s just it’s to created a bit of a passion for me and working with minority groups, probably, you know, which is one of the reasons why also like rural health, and you know, like indigenous Aboriginal health, it just kind of all fits under that same bubble of people who are disadvantage, for most of the time reasons that are out of their control. And, again, me thinking that I can save the world.

Brock Cook 13:17
But I feel like that’s, that’s, like fairly common, not necessarily save the world, but like wanting to help people is, is a pretty common value held by people. Like I think that’s just one of those things that you’d be hard pressed to find someone that isn’t attracted to the profession that doesn’t have that value in some way or form. Like it’s just one of those things that’s very much associated with not even just OT, but like a lot of health related professions. It attracts people that want to help other people.

Natalie Khan 13:47
Yeah, yeah. I think probably, sometimes I think I’ve gotten better at it. It’s there’s been times where I think it was unhealthy. The levels of

Brock Cook 13:57
Well, the first part is admitting you’ve got a problem. Oh, yeah.

Natalie Khan 14:01
Yeah, yeah. Yeah. No, I think it’s a lot healthier. Now. I realize I can’t save everyone. But you know, it’s led me to where I am now. I think I just probably been a higher achiever for a while, not necessarily always academically, but you know, just from a I don’t know. Yeah, providing value to people’s lives is

Brock Cook 14:27
enough. I’ve still stand by the fact that I still think some of the best OTS aren’t necessarily the ones that are best in the books.

Natalie Khan 14:34

Brock Cook 14:35
I wouldn’t agree. i Well, I’m not saying that I was a good OT or emigrant it but I definitely was not good at the books. Yeah. I was much more practical person still am, but didn’t really even find my feet until I started placement and was actually doing things because that’s where I learned the most and that’s where I sort of went oh, wait, everything just clicked on one. I understand how some of this stuff works now, I can actually put it into practice.

Natalie Khan 15:05
I think it was pretty similar. I feel like after placement marks just like, yeah, I rocketed and I was like, Oh, wow, this is, you know, it’s all falling into place. And it makes sense.

Brock Cook 15:16
I did have, I did not enough have ever told the story on here. But I did have a ran into one of my old lectures, she’s not there anymore. So no one can look her up, did have one of my old lectures that I ran into at a conference once. It was the very end of the conference, everyone was having a few like adult beverages. And I remember talking to her, and I asked her I’m like, you know, what was your perception of me as a student? Because I didn’t, I knew I wasn’t a very good student. And she was just blunt. She was like, up until you went to placement. We didn’t even really know why you were there. And then you came back like this completely different person. And everyone was like, Oh, my God, what happened to me? And I just absolutely cracked up. And I’m like, well let the least I was on the right track. And I was aware enough to realize that was what was going on as well. Yeah, yeah. But it’s

Natalie Khan 16:07
funny. I think even when I was a student, I remember seeing a lot of people coming back from placement and just kind of going, Oh, well, yeah, really a different person to what I remember.

Brock Cook 16:18
It’s amazing how much people grow later on. In our course, it’s pretty much 12 months where the placement and like the difference that people can change, although the amount that people can change in that 12 month period is massive. Now obviously, for other courses, it’s it’s laid out differently. But I mean, everyone does the essential, essentially the same amount of placement. And I’m assuming everyone goes through some sort of similar transformation, as we slowly indoctrinate you into the profession. Yep, yep.

Natalie Khan 16:50
No, I grabbed Remember, it’s was? Yeah, interesting to see the differences that we saw.

Brock Cook 16:59
So then you’ve started another Instagram account, which is where I found I was like, wait a minute, is this the same person? The gram, yes. Talk me through it. Does that slit aesthetically, as I was saying, started, it’s amazing. And it’s super creative, and I love it. But

Natalie Khan 17:20
look, again, I think there’s there’s room for improvement. I’m trying still trying to figure out the aesthetics. But, basically, so I did a rotation and persistent pain. It was a bit of a journey of how I got there. But I think in my time there, I really realized how much misinformation is out there. About health in general, really, to, you know, just put it simply but persistent pain, I noticed that, you know, really a big, biggest part of my job was actually just trying to bring down those barriers of this is what you think painters, this is what it actually is kind of meeting them halfway. And so I just thought, you know? Well, you know, it’s probably it’s a combination of things. And then I thought, you know, I want to share those things with clinicians, I want to share those things, with anyone really who’s interested in those topics. And then it’s kind of just evolved into me sharing really short snippets of like evidence based articles and the findings of those that feel like the other thing with health professionals, you know, I think reasonably so you know, we spend all day at work, the last thing we want to do is come home and read a journal article, it’s boring, it’s usually not a really nice read. So I’ve been trying to, you know, really summarize things as best as I can, and then link the article at the bottom to anyone who’s interested in looking into things. And sometimes I’ve commented on, you know, the quality of the article, again, anyone who’s interested, but just trying to stay transparent and sharing those things. So that hopefully somewhere in the world, someone’s scrolling down their feed and going, oh, you know, that was 20 seconds of learning that I’ve just done. And that wasn’t a lot of effort and, you know, might make a difference to my practice, and then

Brock Cook 19:29
the seconds more than they had before.

Natalie Khan 19:31
Yeah, yeah. Hopefully open some thoughts about things and

Brock Cook 19:37
to how do you how do you make the jump from rural generalists wanting to work with minorities and then pain? Yeah, seems like a big stretch.

Natalie Khan 19:50
To be honest. I actually, it was a very logical next step. For me. It made a lot of sense, I think, you know, in a way, I guess you You could argue that people in pain, even though I think of stats is about one in four people in Australia have persistent pain. So it’s not exactly a minority group. But it’s a misunderstood group. It’s a very misunderstood group of people, I think, you know, really, it probably started. And I don’t, I don’t know if you know, this, or if other people listening know about this, but when I, in the rural world, you know, you’ve got your normal patients, your, you know, your pretty straightforward patients. And then you’ve got this other group of patients that’s kind of considered the big, they call them the forgotten. So they’re kind of those people that have really complex health needs, potentially would be doing a lot better if they were closer to a big city. But they’re just kind of got, they just seem like they’ve just been forgotten by the health system. And, you know, there’s just, there’s so much going on. And a lot of times, there’s huge barriers and getting people access, you know, you know, maybe they’re too unwell to drive to two hours to go to the next town, and was actually where I would have been about an eight hour return trip for some of the places where I was working. So it’s just too far to go, you know, to

Brock Cook 21:26
more complex, Elsa, yeah,

Natalie Khan 21:29
yeah, to, you know, go and see the specialists that you need to see, to get the care that you need, and the care that you, I guess deserve. And so, again, keeps coming back to the same to the complex of me thinking that I’m alone. And I wasn’t going to save the world. There was a few patients in particular that I had where they had complex, very complex health conditions. And part of that was persistent pain, which at the time, I probably didn’t really look at as a condition in itself, I just looked

Brock Cook 22:14
at it as it was, like a symptom of something. Yeah, it’s

Natalie Khan 22:17
a symptom of something else. And, really, it’s not related to me, that’s the doctors responsibility, but you know, they’re struggling with their occupational performance. So that’s, that’s my focus. So I didn’t really consider pain all that much. But, you know, we had a few doctors who, you know, a few patients in particular, they would present to hospital. And, again, the doctors didn’t really know those conditions. And so they would say things like, oh, you know, they’re just here, but they’re actually fine. They don’t, they’re not really, they don’t really have this in and they don’t really have pain, because I saw them do this, you know, I turned around, and then they said they have pain, but then they scratch their head with their arm, and they were able to do it fine, you know, that type of stuff. So it’s obviously they’re making it up, or it’s in their head. And, you know, initially again, that was, you know, a new ground, I didn’t really know that much about those things, the doctors, they were people that are generally respected. And so, okay, well, they came up there, right, I saw them, I saw the patient, they were doing those things, and they didn’t look like they’re in pain was when the doctor comes in, they’re in a lot of pain. And so led down to a bit of a, you know, okay, probably complacency of those things. But, you know, I think the really nice thing about being an OT is that you spend a lot of time with people compared to maybe some of those medical professions. You know, again, being an RA generalist, I saw this patient, this One patient in particular as an inpatient, and he’d be an outpatient, and he would come in as an inpatient again and see him as an outpatient. So I got to know him very well. And, you know, after a while, I was like, I don’t I really don’t think he he’s making this up. Why would anyone make anything like this up, you know, just kind of started really questioning? What those doctors and health professionals had told me why would anyone be making these things up? You know, like, you know, this person, particularly quite young, like, you know, what, why, you know, like, the just the there was, it didn’t make any sense to me why a young person would just choose to kind of give their life up and just pretend to be in pain. So, lead down a big bit of a very extensive rabbit hole of research and professional development and Looking at things differently, and joining interest groups, and all of a sudden I was the person that was kind of coordinating the multidisciplinary team, which is very questionable, given that I was a new grad. But anyway, that’s

Brock Cook 25:14
your the expertise you got.

Natalie Khan 25:18
In a very sad way, at that moment, pretend I had a lot more expertise in that than other people, because they hadn’t looked into it. Which, you know, arguably, I still didn’t know anything at all. But yeah, so it just really led to an interest in pain and learning about those things. So you know, when I came across pain, and I just, it really, it just made sense. To me, I think there was a lot of areas of OT that are obviously enjoyed being a real generalist, I was quite happy to do all the different areas of work and all the scopes of OT, yep. But nothing just made as much sense as pain did. I don’t know that.

Brock Cook 26:03
Completely. And then it’s, you said that you then did a like, off, you left the rural practice, you did a rotation through pain clinic or pain team? Yeah. Yeah. Was that did you find like, was that a an opportunity to I guess, learn even more? Or was more just to see how a dedicated painting like, what did you sort of learn going through that experience?

Natalie Khan 26:27
Um, I think probably all of those things, you know, it was, I thought it was the best thing ever. I think, my, my supervisor, actually, we were talking about it just before I left, he said, I really creeped him out. Because I was I was, you know, when I was doing my training,

Brock Cook 26:44
we think for simple, so to say, I know, like,

Natalie Khan 26:48
we, we have a good working relationship. So it’s fine. But he said that, you know, I used to, because I used to sit in the in the room when I was doing my training. And I would just write quotes of what the other clinician said. Because I just, you know, and I explained to him, I guess, you know, English is my second language. And so wording things sometimes is a bit hard, you know, trying to find the best ways of saying things. And so just everything these people were saying, I was like, Wow, that’s amazing. And so I just write this quote, zap, it’s like, running, you know, chapter, sorry, in my notebook that just had all of the people in the room. Yeah. And I was like, wow, this is amazing. This is amazing. And then I’d go back over them and try and think about how I can, you know, use those sentences and put those things together. I mean, you know, that’s how I learned might have seemed a bit

Brock Cook 27:44
might have seemed a bit odd to them. But I have obviously worked.

Natalie Khan 27:49
Yeah, he said he did say he understands that why I did it. But I think at the time, he was probably just a bit worried that I was just going to randomly whip up quotes.

Brock Cook 28:00
Just randomly start recycling what someone said the day before.

Natalie Khan 28:03
Yeah, yeah. Obviously, I didn’t do that. I think it was just, you know, I didn’t have that context. When I was learning about pain. I was just kind of, were learning whatever I saw on the internet, and like, you know,

Brock Cook 28:18
I think it’s, it’s still a rel for OT, it’s still a relatively new sort of area. Like, I know, there probably wouldn’t have been much at all in the course, when you went through on on pain specifically. And even now, I’m not sure if there’s too much more than that.

Natalie Khan 28:37
I think there’s there’s one subject, I think, a haitch, who like to double Oh, to

Brock Cook 28:45
cover some of it.

Natalie Khan 28:46
I think it’s got a lecture on pain. Which it’s hard. I think it’s really hard, because I don’t think one lecture can really do it any justice. You know, I had a actually had a student that came through, spent a week with us. And they had just gone through that lecture. And they didn’t realize that it was the same thing. That what we were doing, and it’s not, you know, criticizing the lecture or anything like that at all. You know, I looked at it and it was exactly what we were doing. But I think it’s just it’s really hard to bring to really give the topic justice.

Brock Cook 29:27
Especially seeing it’s like I said, it’s relatively new, like I know, the pain team in Townsville, like it started because of a guy I graduated with was with the OT on the team when it started. So that was I want to say 1110 years ago, 11 years ago, like that’s when it began. And like even talking to him now he doesn’t work in that team now obviously, but even talking to him because he still has contact with a lot of people that still work in that area. He’s In a completely different state now, but still sort of stays in touch with, I guess, pain practice. He’s like the stuff that we were looking at back then like, it’s completely different now. Like, it’s just such an emerging areas still, like being so, so young for our profession, obviously, pain treatment has been around since. Yeah, medicine. But on terms of OTS involvement and what ot does in that field, it’s, it’s just the baby.

Natalie Khan 30:29
It’s really, I think that’s really quite sad. And to be honest, that that’s, that’s the case. Like, I understand, I think just in general, painters are really new, like, No, I would argue that a lot of health professionals no matter what degree they’re going through going necessarily, you know, they’re not up to date with the newest paint contemporary pain neuroscience. But I think it’s really sad that OT is not often seen as a role that should work in that era. Because, you know, to be honest, I think it, it, it just makes so much sense to me, that ot should be working in pain, you know, the really the basic model of care that they look at in pain is basically to say, okay, is new at first, but it’s basically a recycled Pio. But looking at people’s environments, or looking at all these different aspects and how it impacts their pain experience and their life and their ability to do things,

Brock Cook 31:37
but I feel like that might be more to do with how pain and how that people, how they look at pain has changed. Like, I feel like like you said before, I feel like for most of human history, it was looked at as just a symptom of, you know, an injury or something else. And if there was no injury that sort of could be connected with it, then like you said, people just thought you’re making it up, or I know in fields that I’ve worked in, I’m working in pain, but people who have complained of pain without any obvious, visible trigger for it, it’s often seen as either they’re drug seeking, or they’re just trying to get medication out of out of Doctor pharmacist case manager, whoever it is that they’re talking to. So there’s always been this sort of belief that pain is not necessarily like it’s a it’s a bio, biological, biomechanical, I guess, symptom, as opposed to a neurological condition? In some cases?

Natalie Khan 32:40
Yeah. Yeah. It’s, again, it’s a misunderstood condition. I think, you know, there’s that, you know, if it’s not biological, it’s psychological. And for, it means they’re making it up, you know, there’s just no in between, in a lot of people’s perceptions with pain would you know, and you mentioned the, you know, people going and being treated as drug seekers. And it’s really, again, it’s really interesting, I’m sure, you know, there’s always going to be people out there that that are potentially, you know, but most of the people that I saw in the clinic, they’re really frustrated. And, you know, I was, I would say humiliated about the fact that they’re being treated as drug seekers, you know, really looking at it as I don’t have another option. I don’t think, you know, like, the medical teams not really realizing, I don’t know how else to manage this. This is where I’m at. Yeah, yep. And I’m desperate, because I’ve got pain. But yeah, you treat me like I’m drug seeking. Yeah. I’m just trying to live a functional life and, you know, not be in so much pain that, you know, so I can go to work and do the things that I need to do.

Brock Cook 33:53
So within those, like you mentioned, that being sort of a recycled Pio how they’re looking at it. Can you explain, I guess, in layman’s terms, how that view, like, obviously, we talked about how pain used to be, like looked at as like a symptom? How is it looked at amongst those sort of people that work in that area? Because that might give us some insight into I guess how its treated differently.

Natalie Khan 34:17
Yeah, so they call it a biopsychosocial model. So I think they it’s used a lot in mental health as well. Supposed to be used in mental health. But although they’re looking at changing it for pain, and that it’s supposed I think they’re looking at calling it the psycho, psycho socio bio model, and that bio is being put at the back. That’s the you know, like, Guess it’s trying to really highlight that bio shouldn’t be at the front. Yeah. Really? Yeah, I mean, it makes sense. I just don’t know that. I like how it sounds.

Brock Cook 34:53
It doesn’t roll off the tongue as easy. Not gonna argue

Natalie Khan 34:57
that just do this for work. Um, but it’s, you know, basically looking at, I guess, the fact that there are a lot of contributors to pain. So looking at, you know, what, what’s biologically going on to this person? Are they, you know, is there anything sinister, I guess it’s you know, as soon as the pathology anything that we need to be aware of. And then they just been looking at, you know, what other contributors if we got to this, you know, pain experience. You know, we know that people who have had difficult upbringings and difficult life experiences, they can be more likely to develop what what they call a nervous system over sensitivity or nervous system dysfunction, which can make someone more prone to developing persistent pain later, what mental health is another one of those big things, different sexual experiences, how do we feel about a pain? What does this patient think about their pain? You know, do they think it’s this really horrible thing? And it’s gonna kill them one day? Because if they do, that’s probably, you know, not a really great headspace to be in, I guess, we, I say we, but I’m not working there anymore. So yeah, we’ve done two different rotations. But, you know, the the team really, a, they look at what are the helpful and unhelpful things that this person is currently doing to manage their pain? And a lot of times, and, you know, I think part of that is because it’s so misunderstood. A lot of people have mostly unhelpful ways of how they manage their pain. So people will develop, you know, on their own, they’ll do some trial and error, and they’ll find some really helpful ways of managing their pain. But a lot of people, I guess, especially people that end up coming through pain clinics, or managing it often really unhelpful in. I’ve got the word but

Brock Cook 37:08
now we just made it. Okay. Yeah. That reminds me of I remember watching a I think it was a TED Talk years and years ago, probably a decade ago. And I from memory, it was a lady named Kelly McGonigal. I think it was either her or her sister. They both did TED talks, and are very different TED talks, but she did one about stress. And the fact that there was at the time, she was involved in research that was looking at the fact that it wasn’t stress that was killing people. It was stressing about stress that was killing people was just sort of, I don’t know why that just triggered with what you were saying about, like being in that headspace. And it’s one of those things that even like in working in mental health, it was always tricky. That was always a hard part of working with someone depending on role electronics, support them to change their headspace was usually like, you know, step one. But it’s one of those things, it’s usually easier said than done. Because it’s like, if you don’t see any hope, or you’ve been trying to fix this, or manage it, whatever it is, for however many years and you haven’t made any progress. It’s very hard for me to then come in who you’ve never seen before. Okay, yep, no, that’s cool. I know exactly how this is gonna work. And we’re gonna try something different. And it’s gonna be awesome. And then again, I’ve had that before.

Natalie Khan 38:41
Yeah, yeah, it’s hard. It is hard. And I think, you know, a big part of it is, you know, how do they how does this person feel about change? And are they ready to consider change? And if they’re not, then, you know, there’s so I spend a lot of sessions just validating people’s experience. And the fact that it must suck to, you know, to have those experiences that that they’re having, and I think, sometimes it was interesting, actually, sometimes people would just come back the next time and just go, You know what, I feel so much better already. Because you’re the first person that believed me. And I was in pain. Yeah. chuckles really confronting, actually.

Brock Cook 39:23
That in that, like, no one else does it?

Natalie Khan 39:25
Yeah. Yep. And that that made such a big difference for this person. When really, you know, we just we spoke for an hour, that’s all we did. They told me their story. And I just

Brock Cook 39:38
that’s pretty common though. I’ve I’ve heard that similar kind of thing and from many different OTAs in many different practice areas. And I feel like in reflecting on it a few times that it’s possibly something to do with like we were speaking about earlier about, you know, a certain type of person is drawn to the profession and they want to help people they want to you individually save the world in your case. But so when people come late, we’re almost cast into these roles as fixes. And that’s not necessary. I mean, previously, yes, in a very medical model health profession, or very medical model health service, that’s kind of what you are you people come to you, they don’t have the answers, you have the answers, you give them the answers, they get better. Whereas I think more and more we’re working, or the professional ot in particular, is pushing towards a more sociology, sociological basing of what we do. And that doesn’t fit. That’s, that’s the bit that I’ve always well, I’ve never been able to come consolidate, with ot being a medical profession, quote, unquote, is because we’re moving away from that sort of direct, prescriptive type medical model. And I feel like areas like pain, like as an a practice area of pain, are really highlighting that benefit of our profession, and what we can do. And the fact that the pain clinicians that I’ve spoken to their models, their practices, their even the way they view health is so aligned with mental health, yet they practice so differently. I’m like, That’s what everyone needs to be doing.

Natalie Khan 41:36
Yeah, yeah. It’s yeah, I don’t disagree. It’s, it’s definitely it’s exactly that I think we have a No, I think OTAs. You know, I think I posted about this recently, as well, you know, there was a survey done in the US. And they looked at how many OTAs worked with an A biomedical model. And it was like, a ridiculously high number, I don’t know, I want to say 70 or 80%. of people that they serve, they basically they looked at who uses a bottom up and who uses a top down approach. And most OTS actually use, you know, bottom up approaches. So, you know, very medical approaches, I think part of that is just that, you know, it’s sad, because I think we have so much to contribute by looking at things differently than other other professions, but at the same time, because we look at things differently. And I think we’re always taking us seriously. And so we almost have to compete, and kind of knowing what I know, things to you know, and I know, I know, all this lingo, and I know this stuff, and I’m an expert in something. And so I think, you know, that really leads to OTS then moving away from really what should be at the core?

Brock Cook 43:04
Yeah, I feel like those systemic pressures, even speaking with people from other countries, and completely different health systems, they’re all there. They’re all feeling that same pressure, especially as new grads. I, I feel for new grads, it’s it’s hard, especially when you you don’t have experience, or you don’t even have, like a strong experience in being able to, I guess, hold your own when it comes to try to maintain sort of your occupational role. Yeah, I mean, I was I was exactly the same when I was a new grad, I just sort of conformed with what was going on. Because I’m like, What do you want to do when you’re new grad, you want to impress whoever you’re working with, because I want to do a good job. And I want people to say, Hey, that guy is a really good at or that goes really good it. That’s what you want. You don’t want to like start rocking the boat and pushing boundaries, whereas nowadays, that’s exactly what I want to do.

Natalie Khan 44:03
Yeah, yeah. Yeah, I agree. It’s exactly that. And I think sometimes, you know, the, the problem is, then I think so is that sometimes OTS can be looked at a little bit negatively by teams, because they’re like, Oh, I asked them? And they said, No. And those OTS are so unhelpful, but I think it’s because OTS are starting to push back, I just don’t know that we really know how how to push back yet in a way that other disciplines understand. I’m pushing back because there’s a better way of doing this.

Brock Cook 44:35
I’ve had that conversation a few times recently with a couple people that I do supervision mentorship with around, not just flat refusing to do like, because that’s a very common thing is someone will send a referral to an OT with what they want as indoor walker or do a functional Hill do or whatever. And I’m like, how about you? Refer to me and I use my tertiary degree that’s equivalent to your tertiary degree. And I use my clinical reasoning and I work out what that person needs. You just refer to me for like, why is it? Do you think that this person needs it, I’ve noticed that, you know, not coding at home, or they’re not doing this or whatever it is. And then I’ll work out what assessments and stuff needs to be done. But I feel like that’s a medical model, it’s a similar, like we’re talking about, like that clash between how ot really wants to practice and a system that really wants to do it the other way around. So it’s, I can kind of understand why it’s happened because like you were explaining before, with the top down, bottom up, like we want to, we want to start at the top and sort of work our way down, they want to start at the bottom, find the problem work our way up. In that way you meet in the middle is generally where that assessment stuff takes that takes hold. So I think that’s why you’re getting referrals or why OTS are often getting referrals for specific assessments is because it kind of is a bit confusing. If you’re a profession that’s always looked at, assess, assess, assess, find what’s wrong, and then you know, eliminate the problem kind of thing, then having a profession that kind of does it in their eyes sort of asks about would be confusing. It’s like, oh, okay, if they’re not going to look at the problem, then maybe that’s they just start with the assessment. They don’t. Not many other professions that I’ve ever worked with, understand that we don’t start, we don’t go from like problem to assessment, like, we’ve got this whole other thing of like occupation and roles and all that sort of stuff above that. And I think that’s where OTS need to be really confident in one owning that that’s us, like, that’s where we fall, it’s that that’s our bread and butter, but also being out confident enough to explain it to someone that doesn’t like hey, like, understand you, like there’s something going on with this person. Here’s what I see, I know, you referred for a mock of say, for example, but here’s why I don’t think that might suit based on what I’ve seen from my lens. But instead of that, I’m gonna do this and go from there. Like, it’s, I feel like we come out of uni sometimes, and we’re a little bit precious. We just expect that, you know, I’ve done for years, people should know what I do.

Natalie Khan 47:33
But at the same time, it gets old having to, you know, what you’re doing having to warrant your presence in the room, almost, you know, like, there’s both sides to it,

Brock Cook 47:44
you know, and again, like, the specifics of that are going to be dependent on like, your, the team you’re actually talking to is because you’re gonna get some teams that you might have to explain it a couple times, and they just get it. Yeah, and then you’re off to the races, whereas you’re gonna get some that just no matter how many times they hear, they’re just not gonna get their head around it. In those cases, you might have to find like, a different sort of worker, and you might have to go, Okay, I’ll just tag this referral for a mock up, and then I’ll go on to my assessment, or whatever it is. Yeah, it’s, it’s, it’s definitely a tricky workaround. It’s something I’ve, I’ve been in enough support for quite a few people that are going through similar type things. It’s, it’s a very common trait, or key experience. Yeah, it’s a very, it’s a shared experience that many of us have shared. Yeah. So what’s the ultimate goal was piety, aiming to eventually work in a pain team or cure the world of pain or

Natalie Khan 48:48
cure the world of pain? Look? What don’t, I don’t I don’t have an exact goal at the moment, I guess, you know, leaving the pain service, I was really keen to, I guess, keep a foot in the pain world. So I’ve started doing my postgraduate in pain at the moment, clients. So it’s only just started so I don’t know that I that I know too much just yet.

Brock Cook 49:20
First up, but

Natalie Khan 49:23
yeah, I don’t I don’t necessarily think that, you know, I mean, there’s nothing wrong with working in a painting. I don’t think I think that’s awesome. But I don’t necessarily think that you have to be based in a pain team to provide good pain care, you know, I think it’s a really nice area and that you know, you can really apply it to a lot of areas of OT you know, you could guess, currently working on inpatient wards. What I’m doing at the moment. Use it all the time. You know, you can use it in any department department. Again, you can use it in hands, you can use it in, you know, you can use it in pediatric, even.

Brock Cook 50:13
Like you said, wonderful.

Natalie Khan 50:15
Yeah, yeah, I think it’s, you know, there’s, it’s, it applies to a lot of areas, I think I’ll probably, you know, either go, depending on what the world is doing, I’ll you know, might go back rural and look at doing some of that work over there. You know, pain is one of those things that’s really quite poorly managed, again, in those groups that are disadvantaged, especially people of color, Aboriginal people, even African Americans. There’s a lot of research around how those people are generally provided a lot poorer pain, service seven years, just the general stuff like medication from doctors, I think they’re more often seem to be drug seeking or non compliant and things like that. So love to, you know, do something in that area. Or, or maybe I’ll end up going overseas and doing the refugee stuff, maybe I’ll get to apply, you know, apply some of those things out. I don’t really know exactly what that will look like, but I guess I’ll see where see where life takes me.

Brock Cook 51:28
I love that. A free. I’m gonna have to live vicariously through you.

Natalie Khan 51:34
Um, well, well, yeah, I live vicariously through other people all the time. I think, I don’t know, you know, I probably, you know, with my background, and having moved around a lot. I don’t know that I could ever imagined myself just being in the one place forever. It’s just wherever life takes me, you know, Googled pain clinics overseas. And I found a whole bunch of countries where they’ve got planned clinical work, I guess, you know, I could do that. I don’t again, I don’t really know what it will be yet.

Brock Cook 52:09
We’ll just see what happens. See where the wind takes you?

Natalie Khan 52:13
Yeah, yeah. See what happens? What opportunities come up and

Brock Cook 52:21
they kind of start becoming the IT world expert in pain? Oh, look, I

Natalie Khan 52:25
don’t think so. There has to be. I can see it now. Now, if if it happened,

it would only be because there’s not that many. Okay, isn’t?

Brock Cook 52:35
It got to start somewhere?

Natalie Khan 52:37
And look, I’m definitely by no means an expert in anything related to pain. You know, I think it’s something that I’m interested in. But I’m definitely 100% would not consider myself an expert. Even once I complete it. Once I complete my postgraduate study, I’ll still probably be like, oh, yeah, I know, something’s about pain.

Brock Cook 53:02
Do you find it’s one of those things? I think I already know the answer to this. But I feel like it’s possibly similar to mental health in the way that you can learn all you can about it, like all you want to out of books and that sort of stuff, but then working with the individual in their experience is like I could work with the same people with the same diagnosis for the rest of my life. And every single person would be different and present differently and experience it differently. And I would have to do different things with them. I suspect it’s very similar to that.

Natalie Khan 53:39
Yeah. 100%. And I think, you know, really, from a clinical perspective, a lot of times, I would spend so much time just talking to people exactly about, you know, what those things look like for them, and just really exploring things. And sometimes it’s really hard, I guess, you know, when we’re looking at that biopsychosocial model, and you identify all these factors that make them more prone to having persistent pain, or, you know, some of those unhelpful links and behaviors and, you know, just trying to figure out which ones of these are potentially causing more harm than the others and then you just start exploring those and you know, looking at, you know, obviously, sometimes you look at exploring those and sometimes you just go straight into let’s just, you know, not even focus on these, let’s just actually shift focus and look at what are your goals and as we work through the goals, we might come back and explore some of these things. But yeah, I can show

Brock Cook 54:43
on to how I like to practice in mental health. I love it.

Natalie Khan 54:47
I think but you know, like, you definitely you could not say, you know, Oh, yep, you’ve got arthritis. Let’s do this. Yeah, you need to do five minutes of this every day. And then I After two weeks, we do 10 minutes of this, you know, it just it would never work like that. Because, you know, and one of those quotes that I used to write down. But I just again, I just thought it was great was that, you know, when when people came through, and they said things like, I’ve got arthritis or you know, I’ve got fibromyalgia or whatever their diagnosis might be actually spending time with them and going, you know, oh, you know, I That’s really interesting. I’ve worked with a lot of people who have fibromyalgia in the past, I know that it usually can look quite different for different people, and it can really impact people very differently in their lives. I’m really interested to know how your fibromyalgia has impacted your life and tell me more about that. Or, you know, even just acknowledging the fact that a lot of people have very different symptoms of fibromyalgia, can you tell me about what those are, like? Just don’t think those were things that I would ever, especially when I was doing hands, you know, I’d go, Oh, yep, you’ve got arthritis, I know everything about arthritis. I’m a new grad who has been working for two years. I know exactly what we can and can’t do. And this is a process of you know, and I think it’s working and pain is really making me realize that that is not how I should be practicing at all, but again, what you know, what contexts do we kind of have to know? To do better? We don’t know, you kind of know whether that should be something that you learn at uni, but there’s so much that you’re supposed to learn at uni? Or that we just hope that clinicians eventually find that out? And, you know, a lot of people wouldn’t so then are you just, you know, was it perpetuating that cycle of unhelpful pain things? I think, you know, if anyone who who I’ve worked with in the pain clinic would listen to this, they’ll probably laugh about what I’m gonna say next. But there’s a there’s a video we would often watch with, with our clients, which was by Peter O’Sullivan, he’s a big physio in the pain world. And, you know, they, there’s a lot of studies that have found that, you know, lower back pain is actually an I Can can’t get this word, right. I think it’s isogenic. Conditioning. So I think that’s the word. Hope I haven’t got it wrong, because that’s, that’s embarrassing. But basically, it’s a it’s a condition that’s generally like, it’s caused by healthcare institutions and health professionals. Because of how we treat people, because of how we look at scans before because of how we describe people’s backs, as you know, like not we as OTs, but you know, doctors, they don’t want to point fingers, but

Brock Cook 58:07
the healthcare system,

Natalie Khan 58:10
people that the people that look at scans, will, you know, sometimes just say, really unhelpful things to people. Again, again, I can put my hand up and say, I’ve done that. And I’ve had, you know, people come to me again, within the handset and who had arthritis in their hands. And I was like, Oh, yes, I know about arthritis. It’s a wear and tear condition. What that means is, it’s the generative and it’s just gonna get worse over time. And looking back, I feel so bad that I ever said that, but that’s kind of what I took from uni. That’s what I learned. Which is completely not what arthritis is, at all. Because that’s what I took away from it. And so that was the information that I probably passed on, you know,

Brock Cook 59:02
that it becomes a self fulfilling prophecy. Yeah. And you

Natalie Khan 59:05
know, if I don’t tell people that then it’s gonna they would have heard it from their neighbor or from someone else who I had free will Yeah, I had a grandma one. She had arthritis. And this is what happened to her and yeah, it just becomes this thing of Yeah. self self fulfilling prophecy. As you put it, that’s that’s exactly what it becomes sometimes. Sad.

Brock Cook 59:32
Do you think that because I have this sort of inkling that pain, like obviously, it’s it seems like a very good fit for it. Do you feel like it’s an area that OTS can be really occupation based in working with that population?

Natalie Khan 59:50
Yeah, yeah. 100% I think that’s what I really enjoyed about it. It’s so holistic, and you know, I think especially having I work in areas where even though I was a real generalist, there was still some restrictions, you know, I wouldn’t, you know, I wouldn’t necessarily have an outpatient, because it’s up hospital outpatient. In your, so your role is preventing hospital admission. So I wouldn’t necessarily go and help them with that, and I, that gardening, that’s not really my job. Whereas I feel like the really nice thing with pain has been that really, what it’s whatever the patient’s goals are. And so, you know, sometimes sometimes that was actually interestingly, there was a lot of people who just wanted to walk. And that was not a physio referral, you know, not necessarily could be a physio referral, but it was really, you know, because we worked in a really good interdisciplinary team, sometimes I would work with people on their, you know, just their goal of walking, obviously, if they, you know, if there was problems with their gait or other complications, then physio would get involved. But it was, you know, whatever they want to do, I want to be able to cook, I want to be able to make my own breakfast, I want to be able to be intimate with, you know, my partner. Yep. So, very different, you know, people wanting to be able to engage in their schoolwork, and, you know, I guess, from younger patients, but yeah, very, whatever their goals are, I want to be able to do work and get home and, you know, have enjoy my afternoon rather than being in so much pain that my days kind of come to an end I want, you know, work life balance.

Brock Cook 1:01:45
I guess it’s one of those. It’s one of those sort of areas where it literally impedes or works its way into affecting absolutely every little tiny part of your life. It’s not like, you know, if you break a leg or something like yeah, okay, that’s gonna affect some things, and it’s not going to affect other things. Whereas pain, it doesn’t see, I mean, I don’t know a huge amount about it, but it doesn’t even seem to discriminate with regards to where the pain is felt, it still seems to have an impact on, like, everything, everything people do.

Natalie Khan 1:02:26
It’s interesting, actually, because I don’t, I don’t often share this. I’ve kind of hinted at it on my Instagram, but I haven’t really shared too much about it. But when I actually when I was at uni, I started developing persistent pain. And then looking back, I don’t really have to try to figure out what started it, but it was, there was, you know, last year of uni, there was a lot, a lot going on, and a lot going on for me outside of uni. And I think potentially, I had an overuse injury initially, and kind of went away and then came back went away. And so I didn’t really couldn’t really, you know, I was like, oh, yeah, I’ve got an overuse injury. And me being really smart. I’ve done a placement where I did some hand stuff, it was my hands. And I was like, Oh, yes, this certainly this. And this symptom means this, I think, you know, this is what I have diagnosed myself, I had carpal tunnel. And then my other hand started hurting. You know, it was like, oh, like, trying to focus on what are the symptoms, and then, you know, after a while, I was like, I think I’ve got carpal tunnel my other hand too. So I’m obviously you know, getting quite frustrated at this. And then I diagnosed myself with something else, I was getting cubital tunnel symptoms when I you know, rest of my elbows on tables and things like that. And I’ll talk to clinicians, you know, like, I didn’t just self diagnosed, I should probably add that to next that’s probably not very, like a very healthy, good path. You know, I spoke to other health professionals spoke to him therapists. I was like, these are the symptoms I’m having, I think this is what I have. What do you think? And, you know, have a look at my hands and they’ll go yep, that’s definitely what you’ve got. And then a fluctuated went on, went away for a bit. And when I was working, really, it came back. And I was just got so bad, you know, I was just trying to get to, you know, your point in terms of impacted everything in life. I literally, I got to the point where I honestly didn’t feel like I could do anything with my hands at all. And it was so frustrating. And so, you know, I’ve always been a very independent person and there were a lot of things that I had to you know, like go got I got really bad actually. It’s probably not even that long ago now, heading about a year and a half, two years now. So not even that long ago. Yep. But it got, it got very bad. You know, like I would, if I did groceries, sometimes I would leave things in my car, because I just physically did not feel like I could carry those inside the house. And so things would stay in my car for ages that I didn’t feel I could take out. And there was a lot of, you know, housework that needed to get done, you know, lucky or, you know, with my partner, so he he took care of a lot of things for me. Not that I wanted him to but anyway, it was it was that was just kind of how things were at the time, and it just, it impacts everything. It was, yeah, I don’t think I had ever, I think that’s probably, you know, I would be lying if I said that. That didn’t also contribute to me, you know, really being drawn towards persistent pain. I mean, I started learning about it. And all of those things before all of this before, you know, before we got really bad. But I just yeah, anyway, long story short, I was still very convinced that it was a biomedical problem that needed a biomedical fix, because I know about persistent pain, I’ve been researching it. And that’s just not me. And I’ve got a biomedical problem, and it needs, you know, a fix, and I didn’t really want surgery, you know, got carpal tunnel releases, because I had a few patients that had those releases. And they weren’t, they didn’t always say that their symptoms were better. So I’m like, does that, you know, does it really helped? splints tried all of those things?

Eventually, I went and got a nerve conduction study done. And it came back, fine. There’s nothing wrong at all. And it was it just kind of clicked. But you know, I think I was I was very lucky. In that, that was one experience. And that the fact that, you know, when it came back negative, it just clicked because I learned all this other stuff about pain. I was like, oh, okay, I know what this is. You know, my partner was really eager. And he was like, you know, it’s Don’t Don’t worry that we’ll explore other options. It could be other conditions, I found out about these rare diseases that people can have. I was like, no, actually, I don’t think we need to look into any of those things. I think. I think I know what this is. But I think it ultimately came down to stress. You know, came back to too many stresses at the same time. And you know, my body just kind of went, you need to stop doing things. And I didn’t want to stop doing things, and I kept pushing myself. And so it would go, let’s make your dominant hand hurt. Because that’s where you’ve had your previous overuse injury, you know? And then it would, you know, and then I’ll go, oh, no, I can’t do things. I’ll use the other hand. And so and well, we’ll make both of you. And it’s how I was forced to rest, basically. But then it was really hard to then get back into into doing things then because I kind of felt that you know, can’t do anything with both ends. But anyway, we got there. We got there eventually. I didn’t probably sell Sarah pies. I don’t know if you’re supposed to do that. But you know, it worked.

Brock Cook 1:08:52
Every therapist does.

Natalie Khan 1:08:54
Yeah, look like my hands are fine. Now. Again, I was very lucky. I think in that it would probably be you know, looking back, it would be what they call neuro plastic pain. I think in that, you know, you’re looking at pain that has no specific physical origins. Yep. But yeah, it just, yeah, I

Brock Cook 1:09:23
got to hear your opinion because I have a similar thing, not necessarily with pain. With depression, like your story, you’re the part of your story where you’re like it just clicked I very much relate to in that I was experiencing these symptoms for so long. And then it was just all of a sudden I can’t even remember at the time like what happened but all of a sudden, it was like, oh shit, this is depression. Like how did I not see this? But one of the processes that I went through immediately after that was like, I work in this area. How the hell did I not see this? I had all this guilt. isn’t like I must be a shit clinician, like if I can’t even see this like in myself. Yeah. Is there any not necessarily like that same process? But was Was there any? I guess almost like I guess impostor syndrome type thing that you went through? Once you’ve sort of realized like, oh, wait, this is something that even something that I’ve been looking at for a number of years.

Natalie Khan 1:10:27
I don’t think it was quite bad. But um, you know, I think it would have made me realize it was a big slap in the face of the fact that I did not believe what I was preaching to my patients. You know, in that this was before I was worked in persistent pain, it was rural generalist, but, you know, I had those patients, and I was kind of trying to explain to them these different things that can happen. Somewhere deep down, I think I was still like, okay, but you know, it’s not that bad. Just like, it’s fine. Just that I think that was a big slap in the face when I kind of realized, actually, their pain is real, you know, I, you know, I think before then I my perception of pain. I don’t know, maybe this is what I took from uni, and not a bad reflection on uni at all. But you know, there’s that there’s that thing that you learn, I think when they teach you about pain, that pain is always true. It’s a personal experience. It’s always true to the individual. And it’s always true to the individual. And what I took from that was

Brock Cook 1:11:41
just in their head.

Natalie Khan 1:11:42
If they say it’s true, we pretend it’s true. The customer kind of thing. Always right. That’s what I took from.

Brock Cook 1:11:51
Yeah. Sure, yeah. Anyone that took that message? I was definitely see how you would Yeah.

Natalie Khan 1:11:58
Yeah. Like, I didn’t take from that, that everyone. If they say they’ve got pain, they probably actually. Yeah, yeah. What I took from it was, okay, we pretend that we believe them. They say they’ve got it, and we can’t prove that they don’t have it. Yeah. And so when I, when it clicked, I went, Oh, it is real. It is real, and it sucks. And it’s debilitating. And it’s frustrating. And, yeah, I don’t know, maybe my ego is too high, and that I didn’t think I was a bad clinician.

Brock Cook 1:12:39
It’s, it’s interesting, because I went through that as well, sort of, after I’d got over myself and gone, I, you know, everyone, no one would see it coming. And when you’re that close to it, you don’t see it. And then I went through that slow what’s pretty similar to what you just described, then of, I now feel having experienced it, or having recognized that this is what the experience is, I can now understand better what the people I’m working with are going through and what they’re actually experiencing, even though you might be different presentations and different experiences. I just feel like I can now be a more effective voice for these people, because I understand more what they’re going through. Which I know it sounds stupid, but no, it sounds sort of cliche, but I feel like I’ve been there so I can be a better clinician, I can be a better service to people. I agree. realm.

Natalie Khan 1:13:40
Yeah. 100%. I agree. I think it made a huge difference on the type of clinician that I was able to be. Because Funny enough, I don’t Yeah, anyway, it’s not my only, you know, that hasn’t actually looking back hasn’t actually been my only pain experience. But I just the other things just didn’t impact me as much. It was only once it came to the hands that I was like, Oh, I can’t do anything at all, you know. That’s when it you know, became frustrating. But as with the other stuff, I didn’t know, there was medical, I came up with the you know, doctors came up with medical diagnosis, which now I know aren’t really that much of a thing. But at the time was I Googled it. Google says it’s real. So it’s real.

Brock Cook 1:14:30
Go. Yeah, yeah.

Natalie Khan 1:14:34
Sorry, I forgot where I was going with that. But it’s yes.

Brock Cook 1:14:39
No, that’s right. Yeah, it’s, um, I don’t want people to think that. Like I’m saying that you need to have experience something to be a good No, no, but I think what the message should be is that like, you need to listen to the people you’re working with more about their experience than whatever they’re referral says, yep. Yeah, that’s a much more important aspect of working with people is the people funnily enough, then whatever some other health condition is written on a piece of paper.

Natalie Khan 1:15:13
Yeah, no, I 100% agree, I think. Yeah, I don’t think we listen to people well enough, you know, especially, you know, within certain settings or voted or specific settings, I would argue it applies to every setting I’ve worked in except for pain. I don’t actually think we listen to people, you know, probably mental health would be one way you would as well, because you’ve got that ability, I think,

Brock Cook 1:15:40
Well, I think it’s getting there. I still don’t think it’s good enough. Yeah.

Natalie Khan 1:15:43
Okay. I think pain was that was the, that’s been the first time that I’ve worked somewhere where I actually, you know, work within a team, first of all, that listen to two people, when I felt that I had the capacity of listening to someone because there was a, I think that’s probably what it comes down to. Because there was a therapeutic benefit to listening to people in the fact that maybe there’s a reason why they’re telling me this random story again, and again. And there’s a reason they’re telling me about that one time their grandchild did this, maybe it’s because they’re actually lonely, you know, there’s reading in between the lines, whereas I think in a lot of other roles of OT, I didn’t really get to do that. I never really listened to people. I’ve, you know, I listened I listens to the home environment, and they’ll start talking about the neighbor, and I’ll go, okay, but remember, what about your shower? Or your shower?

Brock Cook 1:16:39
How many steps do you go down to visit the neighbor?

Natalie Khan 1:16:43
really riveting stuff? Like your home environment? Let’s talk about that. Or your goal is to do gardening, or you mean toileting? Yes, yes. You know. So it was very, it’s hard. And it’s hard within those areas. Because, you know, there’s, there’s a clinical need of why you’re in that role, because you’re serving a purpose of, you know, the flow of guests, the hospital and those things, that I think that’s been the one thing that I’ve really taken away from, you know, pain is just listening to people, no matter what it is about, and, you know, sometimes, you know, you’ve got patients, sometimes people like to talk, and they probably like to chat a little bit too much. But, um, I mean, I just, I give them more of a chance to talk

Brock Cook 1:17:31
sometimes even that, not what they’re saying. But the fact that they’re saying that kind of stuff, like sometimes even that gives you information or insight into what’s going on.

Natalie Khan 1:17:40
Yeah, yeah. And I don’t think I realized that previously, I was like, Oh, they’re getting distracted. Yeah. Whereas now, I look at those things very differently. But certainly, you know, if they told me they’ve got pain, if they told me they’ve got whatever symptom they’re experiencing, I’m, I feel like, I’m probably I’m the number one advocate now. You know, I go to the doctors, and I’m like this, you know, their cast is on too tight. And they’re like, we thought we fixed it up too many times or anything like, I don’t care. They say it’s too tight. You know, we need to do something about this. Because at the end of the day, if they say it’s too tight,

Brock Cook 1:18:18
it’s too tight. It’s too tight. Yeah. Yeah, I feel like, like I was saying before, like our pain seems to be practicing in a way I wish mental health was, I think, OTs and mental health like getting there. But just the overall perspective of mental health is still very much similar to where pain started in that mental health conditions are looked at as this kind of modular thing that then just kind of attacks a person and our job is to get rid of it. Whereas instead of looking at, like the person as a whole and their experience, which is I think I t’s are slowly moving in that way, especially with more, I guess the popularization of more sort of narrative exploration tools like car wire and that kind of stuff. I do feel like OT is is definitely making progress forward with regards to that in mental health. With regards to the tools, are they similar tools for OTS would use in pain like do you use those sort of narrative exploration tools? And similar sort of I just ot type models, like you said, talked about PIO, or is it just like a very specific pain toolkit?

Natalie Khan 1:19:30
It’s probably a bit of a combination of things. There’s definitely a lot of it is a probably what you’d call a more of a pain toolkit. That’s actually what we call it. That there’s obviously you know, I’ve done collars with people before and things like that, which I was so excited. I was like, I can do a cow. It was great. But yeah, it’s a bit of a combination. I think, again, you know, at the end of the day, It comes back to that. What’s What’s the main, what are the main, you know, unhelpful things are the main things contributing to this person’s experience at the moment, if that’s going to be, actually, we’re just going to work on your communication skills with your partner, so that you can reduce to improve that relationship, and then we’ll go out the other stuff, then that’s where we start. So that’s, yeah, that’s, it’s been a really nice thing, being able to work like that, I’ve really appreciated that. But what I was going to say, I think, you know, one thing with, with my painting experience, that I was really, that I really, you know, grew so much from probably more in the, in the aftermath of it all, but learning about mindfulness and meditation, you know, looking at, or watched a few different things of, you know, Buddhist monks, that spiels about things. And I, you know, I guess, you know, you said that in mental health, sometimes you guys would look at, you know, mental health as this thing, and it’s our job to remove it. And I think, you know, really sounds cliche, and I’m definitely not saying everyone’s pain experience works like that, you know, obviously, I’ve had a very different experience, given that, biologically, there was actually nothing wrong with, you know, with my anatomy, or nothing that I’m aware of anyway. And it’s, I believe, and again, I’ve come to these conclusions myself, that it was just a, you know, but no, see plastic pain. But looking at living with pain as my old friend, that sounds very cliche, but you know, I think, really, that’s my relationship to my pain experience. Now, I very, you know, lucky in that, in the grand scheme of things, I didn’t have time for as many years as other people had. And because I had that background and understanding and knowledge was, once it clicked, I was able to do the right things, which, if I didn’t have that knowledge, it probably, I would probably be still going through the same thing and not getting the care that I need, because there’s a lot of unhelpful things out there. But because I think, you know, all the I don’t know if you want to call it early intervention, but because I was able to do those things sooner, yes. Thinking about you know, things in terms of neuroplasticity, I think I just, there was a better prognosis from that, like for me, so I basically don’t really have pain at all anymore. But there are moments when they will I went, I’ll get pain in my hand

Brock Cook 1:23:00
old friend comes back to visit the old prints comes back.

Natalie Khan 1:23:03
Yeah. And that’s, that’s how I look at it now. Because I’ve come to realize I am not good at good at realizing when I’m stressed. And I’m not good at realizing when I’ve taken on too much

Brock Cook 1:23:14
consciously. But apparently, your body is very,

Natalie Khan 1:23:17
my body is aware, but I’m not I just you know, I’m so good at pushing those things away. And, you know, having, you know, just handling the life’s things, and you know, just moving on with Lifeline and never really acknowledging feelings and emotions are nice things. And my body just tells me and so you know, I’ll get pain. And then I’ll kind of look at my hand usually for a few segments and go, Oh, why is that hurting now? And then I’ll realize and like, actually, I’m really stressed right now. And I didn’t realize that I was as stressed as I was. And usually it doesn’t take long of me acknowledging this, and then thinking of it, then it’s like, do I really need to be stressed about this? Probably not, you know, maybe can I look at it differently, doesn’t take one the pain goes away, and then it comes back next time? Over dumpings it’s been interesting, but I think you know, it’s cliche looking at it as an old friend, but that’s,

Brock Cook 1:24:18
again, that’s something that very much relates with mental health practice.

Natalie Khan 1:24:21
That’s It’s been exactly how it’s how it’s been. It’s just you know,

Brock Cook 1:24:26
I think a lot of with a lot of health issues for lack of a better term. It people have found it really helpful to and this is something I talked about with students not enough I talked about you guys but nowadays is being able to externalize things helps people process them. So being able to, you know, call your your pain, essentially another person like being able to externalize it, being able to refer it to refer to it as something other than you part of you Yep, helps some people, not everyone, but for quite a lot of people in my experience that helps people process it. Same thing happens with with mental health. That’s why, you know, there’s nicknames, like the blackdog, for depression and stuff like that is because it allows people to refer to the experience they’re having. But not, I guess not cemented as part of their identity. And that, like we were talking about earlier with that sort of positive mindset that helps with that, if you’re not identify like, I’m not a depressed person, I’m a person who has depression kind of thing, you’re able to separate it. That helps the mindset very, like massively and like, like, we it’s common knowledge, hopefully, by now that,

you know, the

mind is a very powerful muscle. And if it’s pointing in one direction, it’s hard to change it. It’s interesting, yeah, to be positive, even better.

Natalie Khan 1:25:59
Because I think a lot of times in the pain setting. Pain clinicians don’t actually like people referring to things as different things. Because sometimes it can, I guess, it can, you know, people D associate with those parts of their body, and sometimes that can cause further pain problems, and that they no longer actually see that hand as belonging to them or that foot. It’s just something that’s just dangling. And it’s not part of you. So we don’t actually recommend people interesting, separated from themselves. When I, which is I think, why, for me, and I don’t know, probably someone else would argue against that. But I think that’s why for me, you know, looking at it as my old friend, I know that it’s part of my body. You know, I think that’s it’s just important that Yeah, to make that differentiation,

Brock Cook 1:27:01
rather than doesn’t sound like you’re separated the body part, though. More just the experience.

Natalie Khan 1:27:07
Yeah, I’m not but someone else could go. Oh, it’s that friend again. That’s coming to you know, yeah. Again, stupid risks are it’s that stupid thing. And it’s actually quite unhelpful. Looking at things like that. Yeah, from it’s to me, it’s from like a neuroplasticity and like, nociception. perspective? And I guess, yeah, it’s cool. Without the ins and outs of it.

Brock Cook 1:27:41
in mental health. It’s, that’s not usually a concern, I guess. People if people are just sort of dissociating. They’ve already disassociated by the time I see them.

Natalie Khan 1:27:52
Yeah, yeah, I think it’s trying to think of mindful, I’m not gonna say the wrong thing. But when when people have cast on, you know, like, you break your arm. And I don’t know that it’s the right word. But I think it’s the neural pathways, they actually find that there’s a weakening in the strength of neural pathways, if you’ve got a cast on for multiple weeks and weeks on it, in the fact that you know, your proprioception and that restoring that arm on that foot is going to be a lot worse, because you haven’t used it for a while. And so, you know, basically, the body stops communicating as effectively with that part of your body. And so I think, you know, a big part of this associating that part and going, Oh, that’s that thing. I don’t want that thing that can contribute to neuropathy. Yeah, that well, that’s, that’s the that’s the thought process and

Brock Cook 1:28:46
make sense. Of

Natalie Khan 1:28:49
those. Yeah, I don’t know that. That’s the that’s really simplified. And that’s probably not really the best way of putting it. But anyway, for the purposes of this,

Brock Cook 1:28:58
I mean, it makes sense. The brain controls everything, like pain, something a lot of people don’t understand, you can feel free to correct me if I’m wrong, but my understanding is, I’ve heard multiple people say like, you might feel pain, like in your wrist, but that’s not actually where it is. You’re feeling it in your brain, essentially.

Natalie Khan 1:29:21
Yeah, we, you know, I even now, not working in pain I often talk to people is, you know, really painters is a protective mechanism. It’s your body’s you know, it’s your brain law. You usually say your body because people don’t like hearing brain because then they think I’m telling them it’s all in their head. It’s a very, it’s a very touchy topic, actually talking about pain to people because there’s so many preconceived ideas. You know, but I would often say things like, you know, it’s your body’s trying to make accents of the situation and deciding if this is threatening or not. And if there’s credible evidence that may be threatening, usually pain is produced. And, you know, often very often use the example that, you know, for example, right now, you know, I’m sitting here looking at you, this is probably more of an example for you, because you’re the person that usually interviews people. So, you know, I’d say things like, you know, I’m always in this clinic room, I feel pretty safe here. I’ve met you before, and you seem like a pretty, pretty nice guy, you know, I’m not I don’t feel threatened. But otherwise, you know, I’ve got a door behind me, if I really needed to escape, I feel pretty safe. You know, my body’s probably more on a, you know, rest and digest state rather than, you know, fight or flight. Like, in theory, I would hope that that’s how you’re feeling as well. But you know, and then then, you know, I say, you know, I’m probably making very generalized assumptions here, because I don’t know exactly what it’s like for you. But potentially, you might be sitting here right now going, what? Who the hell is this girl is talking to me about pain? You know, how does she know she has no idea what it’s like, this chairs really uncomfortable. The drive here was really annoying. I had to park on the other side of the road, there’s really bad parking here.

Brock Cook 1:31:22
You’re describing my day?

Natalie Khan 1:31:25
You know, how much longer am I going to have to sit here for? Is she going to tell me it’s all in my head? You know, those things unusually, at that stage? People kind of start nodding, and you’re like, yep. So even just with something as simple as you sitting in this appointment with me, your I guess, fight or flight system is activated a lot more than than mine is. And so that’s, that’s an indication that, you know, things are probably just overdrive a little bit. That’s kind of how how we

Brock Cook 1:31:55
have a really good example.

Natalie Khan 1:32:00
Yeah, again, actually, that was not a quote, I came up with,

Brock Cook 1:32:03
um, I write that down, I’ll quote you.

Natalie Khan 1:32:07
That was, that was, but you know, you come up with a lot of different ways of explaining things. And sometimes you explain something and you think, you know, I don’t know if you’ve heard of it. Explain pain, it’s like,

Brock Cook 1:32:21
I don’t know much about it.

Natalie Khan 1:32:22
There. It’s by the, without advertising too much. The neuro institutional noise group, I don’t know what it stands for, keep forgetting your something group. Basically, they provide professional development opportunities to teach people about pain and how to explain pain. But, you know, you find, you know, you learn all the stuff, and then you try and explain that to someone. And sometimes it works really well. And you go, yeah, we’re gonna use that exact example again, and then sometimes, it just does on almost seems to have made things worse. We’ll try that one. Again. It’s a bit of a juggling act, I think sometimes, you know, providing the right information at the right time when they’re ready to receive it in the right, tailored in the right way. But it’s going to work for that person, you know, if it’s an older gentleman, who likes Carl motors talking about motors, or if it’s, you know, an electrician talking about, you know, both, you know, using kind of some of those examples.

Brock Cook 1:33:33
Yeah, yeah, I think that, that the point of them being in the right place to receive it is something that is fairly ot universal. I don’t think it’s something OTS think about very often, or not even just OTs, just health professionals in general, don’t think about where the person is, at that point in time on terms of the like, obviously, there’s some situations like probably palliative care, where sometimes it’s a little harder to you know, find the right moment. But for most clinicians, there are some times where you’re like, oh, this might not be the right time to explore this or venture down this road. We might wait until the next session and see how that’s going kind of thing. So

Natalie Khan 1:34:21
I definitely again, before working in pain, never something I considered. Like my goal for today’s session is ABC. No, that’s what we’re going through. If you have anything added, that’s what we’ll work through as well. But my these are my goals. This is what I want to get out of, you know, great, great clients since it really when you think about it.

Brock Cook 1:34:44
I think it’s a very familiar new grad experience. I think most new grads will like resonated with that and then going through that growth. I mean, that’s you only preps you so much before you get it out. And then honestly, that’s why there’s like a two year yearly in Australia. And so we classify that the first two years as new grad quote unquote. And then that’s what we usually see is my experience, you’ll see, after two years, a person will be a different person. And then after seven years, that person will be a different person. They’re the two big, I guess, Game Changing milestones that I would generally see in in New clinicians.

Natalie Khan 1:35:25
Yeah. Well, I’ll have to wait for my seven year transformation.

Brock Cook 1:35:32
I got a just yet. I just

Natalie Khan 1:35:35
wonder how what I’ll be saying by then

Brock Cook 1:35:38
fix the world or save the world by then.

Natalie Khan 1:35:41
Yeah, yeah, probably not. And I’ll probably be on the other side of it and going, Oh, I can never fixed.

Brock Cook 1:35:50
That’s growth as enthusiastic. One more thing I want to bring up. Because I’ve found it the other day. Your shop?

Natalie Khan 1:36:01
Oh, yeah. Yeah,

Brock Cook 1:36:03
it’s amazing.

Natalie Khan 1:36:04
Oh, look, it’s very small. I’m just kind of doing it

Brock Cook 1:36:09
for fun. So explain what is it? What’s the fall?

Natalie Khan 1:36:13
So it’s what did the summary of it Yes, is that it’s aesthetically pleasing? clinic posters for clinicians?

Brock Cook 1:36:25
They definitely, I can vouch I’m looking at them right now. They are very aesthetically pleasing. Oh,

Natalie Khan 1:36:31
thank you. Thanks, I try, I’ve probably, you know, have been a little bit have not been creating that many new things as I’ve wanted to, I’ve got to, actually online, I’ve got a whole bunch of things saved on my computer, haven’t uploaded them yet. I need to do that. But really, though, I think, again, you know, coming back to trying to save the world. I realize there’s a lot of, there’s not a lot of good posters out there. You know, crap. Versus a really bad and, you know, sometimes I’m not saying my posters are amazing, or anything like that at all. But most of them are really bad. You know, you can’t even I guess, if you had a private clinic, and you want a new clinic to look nice. Pretty hard to do that. Because I think, you know, usually the public world, we don’t really care too much, we have all of that which is on the wall unhealthy.

Brock Cook 1:37:31
The aim is to get a message across, and that’s where it stops. Yeah, we don’t care. These I would akin more to a piece of art that also some some of them. Others are just thought, but some of them also have a message, but it’s probably more like it’s art first, and then it has a message.

Natalie Khan 1:37:50
Yeah, yeah, well, that’s what I’ve tried to do. Anyway, really, the aim is that over time, and I’ll probably say, you know, take me a while to actually get to do that. I’d like to have a lot more pain posters and pain related things up there. Maybe some resources for clinicians, and you know, like, just, I don’t know, initial assessment and things like that. But people can just, they’re all you know, electronic documents, so you just, you know, go on there. And it’s an instant download,

Brock Cook 1:38:20
downloadable, and there’s some things that are also not in English, by the look of it. Your status, Spanish stages, stages of change and

Natalie Khan 1:38:30
stages of changes foundation, I think I did see a mindfulness one in German, just exploring, again, nothing, none of it. It’s just, it’s just a creative outlet. You know, again, realizing that there is no, there’s a lot of gaps, you know, things and sometimes, you know, I’ll message people that buy from me, and I’m just kind of like, what do you want to see, you know, but there’s actually, I don’t know, maybe I’m not looking at the right places, but I could not actually find any clinic room resources that are not in English, you know, in, in in, you know, Spanish and Portuguese and looked at German, I guess, you know, those

Brock Cook 1:39:11
notches. Seems odd, because I know, I like talking to some friends that work in the States. Like, for some, especially like, California and stuff, like Spanish speaking people are a huge percentage of the

Natalie Khan 1:39:28
things out there like I’m not, that’s not not completely right. But there’s nothing in this area, I guess, in the you know, there was there’s a lot of kids, children resources that are translated in Spanish because I was thinking about, you know, kids pediatric stuff for a while, but I think that looks like you know, people, a lot of people have done that. But yeah, it’s just, it’s just not the same quantity of things available. It’s probably all it is just I’m adding the things that I’ve created out there into the world. And if it helps one person, that’s great, you know, the other one has been, which, you know, I still have very weird feelings about how I feel about it. But I’ve, you know, had a few acknowledgement of country posters that I’ve put up. And I feel really funny about it, because I don’t feel like I should be, you know, putting those things out there because I’m not Aboriginal myself. And I’ve chatted to my partner about it. He’s hates Aboriginal. And he was like, no, no, and it’s fine. And I’m like, Okay, well, I guess if you say it’s fine, and maybe it’s fine, but, you know. So the way I kind of worked around that for myself is that I’ve just, you know, sent some of the proceedings have gone to charity, and, you know, kind of looking at some of those Aboriginal. Probably, you know, like, to try it trying to think of the word.

Brock Cook 1:40:57
I see this thing at the top that says, some some of the promises donated to the indigenous literacy fund foundation. Yeah, they go

Natalie Khan 1:41:05
charities, that was the right word. charities that that was sending things. Yeah. So we did the indigenous literacy foundation for a few months. And now we’re really I think I’m trying to remember, I think we’re doing a sleeping bags to the homeless.

Brock Cook 1:41:24
That’s the current high. Yeah, I think it’s a lot of thinking. I think I’ve seen that. Yeah, so that’s the one sleeping backpack. Yeah, yeah. It’s an Australian invention. Yeah. Yeah. I think they’re trying to roll it out in the States as well. But it’s yeah, there was actually an ad on TV for it the other day. That thing is amazing. And it like folds up into a backpack, and it folds down into a safe, comfortable sleeping. Like a kind of like a little swag, I guess for for people who are living on the streets. It was really cool.

Natalie Khan 1:42:00
Yeah, so that’s the one that we’re currently looking at donating money to. But you know, it’s a, again, it’s nothing huge or anything like that. So, you know, probably I’m not very good at selling myself and my but it’s, you know, I’m just, every few months when there’s a significant enough amount of that, again, still not that significant. donate the money over?

Brock Cook 1:42:27
Well, I think I’m gonna have to order some things for my office, because I’ve just moved office and there’s not much on the wall. Anyway, definitely see some of these things on my office wall.

Natalie Khan 1:42:38
Maybe you can tell me what things would be relevant. And then I can think of it from, from that perspective.

Brock Cook 1:42:44
We can we can brainstorm. That’ll be. You put some of your quotes on there. And put yourself yeah, Natalie.

Natalie Khan 1:42:57
We don’t know if anyone would want that. Maybe if I was, you know, famous.

Brock Cook 1:43:05
That’s the first step. First step to being famous.

Natalie Khan 1:43:09
Creating posters with my quotes, right. That

Brock Cook 1:43:12
works work. I’m sure it’s worked for all the people can work.

Natalie Khan 1:43:16
I guess, you know, people will be sitting in someone’s clinic room grandkid. And Natalie.

Brock Cook 1:43:20
This is Natalie person that I keep seeing in every clinic. Yep. So yeah. So where can people go to find all your stuff on your shop? Your Instagram? Where’s the best? Where can we send people?

Natalie Khan 1:43:33
Probably my Instagram, I think so. It’s the arc dot gram still gram. And then the shop is called the arc shop. So if you go on to the Grammys, you find the link in the bio there.

Brock Cook 1:43:47
Yeah, the links in the in the top and I’ll throw links in the show notes for all of this stuff. So if you’re looking for posters, definitely go and grab some go and have a look. They’re really cool. I’m definitely gonna autosol

Natalie Khan 1:44:00
otherwise, feel free to send me a message and let me know if there’s anything in particular that people would like I’m very open to ideas. Yeah,

Brock Cook 1:44:09
and then go and check out the amazingly flowing aesthetic of her whole Instagram page, which I’m very jealous of, because it just,

Natalie Khan 1:44:16
I feel like that’s really setting the bar very high.

Brock Cook 1:44:19
It is exactly what you’ve set the bar very high, because I’ve never seen an Instagram page where if you look at it as a whole, all the posts look like they’re just part of one massive picture. I think that’s I think that’s awesome.

Natalie Khan 1:44:36
Thank you. I didn’t come up with it myself. I just I don’t think I saw something similar somewhere. It wasn’t it wasn’t. It was like, you know, the following pictures. I was like, let’s just make it a

it’s funky.

Brock Cook 1:44:47
I love it. I’m a very visual person. I like that sort of minimalistic aesthetic. So I’m very drawn to things like that.

Natalie Khan 1:44:56
Thank you. Make sure I keep working on the estate So when people look at it actually looks,

Brock Cook 1:45:03
catches their eye and then they get those little 22nd snippets of learning and you’ve hooked them in then, yeah,

Natalie Khan 1:45:09
20 seconds of learning and if that makes any difference to their clinic clinical life. I think that’s really that’s all all that kind of hopeful.

Brock Cook 1:45:20
Perfect. Thanks so much for coming and having a chat.

Natalie Khan 1:45:24
Thank you. Thanks for having me. It’s been good.

Brock Cook 1:45:28
Good to catch up.

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Transcribed by https://otter.ai