In this heartfelt episode of The Healing Journey, Dr. Kate Oland sits down with her mentor and friend, Dr. Carol Beckel, to discuss Carol’s personal experience with a total knee replacement. The conversation weaves together professional insights, personal stories, and reflections on change, healing, and the importance of community in healthcare.
Show Notes: Ep. 6 – Healing from a Total Knee Replacement
Host: Dr. Kate Oland
Guest: Dr. Carol Beckel, Director of Clinical Education (now Dean of Health Sciences at St. Louis Community College)
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Ep. 6: Healing from a Total Knee Replacement
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Dr. Kate Oland: Hello, and welcome to this episode of The Healing Journey, healing from a Total Knee Replacement. In just a few minutes, you will hear my conversation with one of my favorite mentors and professors, Dr. Carol Beckel. But before we play that interview, I need to pause for a moment to honor a man who has profoundly shaped my life.
My work and the way I understand healing, many of my friends in fascia are grieving right now. We learned on Friday that John Barnes, the father of myofascial release, took his last breaths here on earth. John was a physical [00:01:00] therapist and licensed massage therapist, who early in his career began noticing something that wasn't being adequately explained.
Were treated by the traditional medical model, the role of fascia. As a continuous, responsive and deeply influential system within the human body at a time when fascia was largely dismissed or ignored. John trusted his clinical observations and his intuition even when his ideas were met with skepticism and criticism.
Beginning in the 1970s, John started developing what would later be come known as the John Barnes approach to myofascial release. Through decades of hands-on clinical work he observed that sustained gentle pressure rather than forceful manipulation. Could produce profound physical and emotional changes.
His work [00:02:00] challenged prevailing beliefs about pain restriction and healing, and required patience, presence, and deep listening Qualities not always rewarded in our fast paced healthcare systems. In his book, healing Ancient Wounds, John tells the story of the first time he witnessed a patient spontaneously unwind during their treatment.
The experience was unfamiliar and unnerving to both of them, yet the patient reported feeling remarkably better afterward, rather than shutting that moment down. John stayed present. He listened. He held space and that moment became a turning point, not only in his clinical work, but in the evolution of myofascial relief itself.
Over the next 50 years, John continued to refine his approach, treating thousands of patients, and ultimately dedicating much of his life to [00:03:00] teaching through intensive seminars and courses. He trained hundreds of thousands of practitioners across the disciplines. Physical therapists, occupational therapists, massage therapists, physicians, dentists, and even mental health professionals spreading an understanding of fascia that science is only now beginning to fully validate.
But John taught more than technique. He taught us to slow down to take care of ourselves as healthcare providers. To honor the inseparable relationship between body, mind, and emotion, and perhaps most importantly, he taught the value of presence, grace, and remaining in a state of constant curiosity. These principles changed my life, truly turning it upside down in a good way from where I was just five years ago, [00:04:00] and I know I am far from alone.
John touched countless lives, both directly and through the ripple effect of those he taught. While I grieve that I will never again see his face share in his sense of humor or feel his therapeutic touch, I know this. He passed his torch long before he left this world. That torch now lives in every practitioner who believes in a more human, compassionate.
An integrated approach to healthcare. John, you are already deeply missed, but your work will live on from all of your friends and fascia who remain here on this earth, we wish you peaceful rest, and we will continue to look for signs of you as we walk forward on our own healing journeys. Thank you.
. So today on the Healing Journey, I'm so [00:05:00] excited to welcome my guest, Carol Beckel. Carol, welcome to the show.
Dr. Carol Beckel: Thank you.
Dr. Kate Oland: So Carol, I wanna give the audience a little bit of our history and Yeah. So I met you for the first time, almost I, gosh, a little more than 20 years ago when you were just a brand new little baby professor.
Dr. Carol Beckel: Yes.
Dr. Kate Oland: Yep. Yeah. At St. Louis University. And um, man, that was funny. You brought some energy with you. You know, now that I've been a professor for a few years, I remember that first year energy and it is very different than the fifth year.
Dr. Carol Beckel: Yeah. Well, there is something to only being 10 years older than your students.
And I, I have, I felt that then like, oh, this is the closest in age I'm ever going to be to students.
I'll
keep getting older. They'll still be the same age.
Dr. Kate Oland: Kind of like that quote from, what is it? Dazed and Confused about high school girls. I keep getting older, but they just stay the same age, but from a professional perspective this [00:06:00] time.
Mm-hmm.
Dr. Carol Beckel: Yeah. It, uh, that those first few classes in particular, I probably have more friends with and more connections. Not that I don't now, but it's a bigger age gap. So it's where they're at in their life and their journey as they're exiting. College is much different than what mine was when I exited college.
Okay. So the, the 2003, 4, 5, 6 classes, I still have a lot of. Contacts, um, more so than just Facebook acquaintances. Like I, I connected with people out in the community more from those early classes. So,
Dr. Kate Oland: and I have loved staying friends with you. You know, you as someone who's been practicing for almost 20 years, especially early in my career, I had little voices in my head.
Don't worry. Not that kind. But I had little voices from Carol and Cheryl and Mark, you know, and Gretchen, if I did something right in my head, you were like giving me a PO on the back. And, [00:07:00] you know, that's something that I, I think is a common phenomenon. When you're a new grad,
Dr. Carol Beckel: you do have distinct faculty.
Mine was, of course, Cheryl. I mean, Cheryl's voice lingers in a lot of people's minds. Um, so to be, to be in that category of excellent faculty is helpful. I think being funny is what helped my mind or my voice stick in a lot of people's minds that I would at least bring you to content in a humorous way.
Dr. Kate Oland: Yes. And you know, one of the things I loved being in your classroom as a student was hearing your clinical experiences now, before you became a professor. Tell us a little bit about what, uh, your career path looked like.
Dr. Carol Beckel: I practiced for 10 years. Um, I did five years at a community level hospital where I had the opportunity to do acute care rehab, skilled nursing.
Um, as little outpatient as I could possibly get away with, because that was never my jam. Okay. I even did a, a preschool, three to [00:08:00] five. The hospital had a contract with a local school district, so I got to do a little bit of pediatrics.
Dr. Kate Oland: Hmm.
Dr. Carol Beckel: And after that I decided to join the home health branch of that organization.
And so I did home health full-time for five years.
Uh,
so I was full-time clinician for the first 10 years. Then I did one year part-time home health pt, part-time faculty member before going full-time in 2003.
Dr. Kate Oland: Yeah. I think I remember that transition. You were part-time with us, with my class for a little bit and then full-time and Wow.
So you went from, I didn't know that you had a little peds in your history, so you went from one stage of life to working with the opposite stage of life. Yeah. In home care.
Dr. Carol Beckel: Yeah. The middle aged people. They're fine. Like I, I never had the drive of, if you drove here and you walked into this clinic, you're probably, you're probably doing pretty good.
Uh, but
I like the preschool age, three to [00:09:00] five is amazing 'cause they have fantastic stories that don't really connect to reality and they get a little bit older and then they are two smart ay and they're too cool. And um, and then I love geriatrics 'cause they had great stories based in fact that you're, could not believe what people had in their life.
Like they're sitting there in a little hospital gown looking frail, and then they tell you their life story and you think, wow, let's get you back to some of that energy. So I, I had those two distinct ends were my areas of interest.
Dr. Kate Oland: I'm telling you, being in healthcare in general and just hearing, you know, being honored with some of people's stories is a big part of what I enjoy about our profession.
Yeah. Yeah. Yeah. And you told us some stories too.
. Well, how about, do you have a favorite home care story you would like to share today?
Dr. Carol Beckel: Uh, my favorite was, mm-hmm. Uh. I loved having students in home health.
Mm-hmm. And we were [00:10:00] prepping to walk into a house. And the nice thing about home health was every, every home was a different clinical setting, so you had to start over. And we got to the door and this particular student had poor correlations. He thought if you didn't have money, you had a messy house. I said, that is not a direct corollary.
I said, somebody may not have a lot of money and they will have a, a, a very clean house. Mm-hmm. Somebody has money, they don't always pay attention. I said, there's no direct corollaries between those things. So we were, I was trying to help 'em break out of some stereotypes. We walked up to the door and I said to, I said, I have one word for you.
And that word is cats.
Dr. Kate Oland: Mm-hmm.
Dr. Carol Beckel: And he said, I don't understand. I said, you will. I could smell ammonia.
Dr. Kate Oland: Yeah.
Dr. Carol Beckel: And
And the homeowner had seven cats. Anne had a broken basement window, so had a feral colony living in the home as well too, and just was not physically able to [00:11:00] maintain all of that.
And the student thought I was a psychic. I said, I am not a psychic. I just, I know situational things. And that was, that was one of them. But I enjoyed the opportunity for students to understand culture and mm-hmm. What you think is a normal home setting is your normal, that is not everybody's normal. Amen.
And you can't bring those expectations inside of somebody's home and make them feel bad. And I certainly had patients, um, that. Had significant OCD that was, uh, manifesting as a hoarder could not get rid of anything. Um, I had some abuse issues that we had to call the state about. And so you're really in their environment and I enjoyed the opportunity for students to say, okay, even if you never work in home health, you have to understand what the patient leaves your clinic or leaves the hospital and what they're, you have to watch for those signals of what's going [00:12:00] on in their life as well.
Dr. Kate Oland: Yeah. And I feel like, you know, about half of my career, uh, was home healthcare as well. Mm-hmm. So, you know, I think it's real easy for us to tell what I call quote horror stories now that, that might sound a little dramatic. Um, but you know, the other half of my career I've spent an outpatient. Now the type of person who goes to outpatient and the type of person who works in home care are usually very different types of therapists.
So a lot of my type A. Friends when I was working in outpatient with, oh, I can't believe you did that. I can't believe you went into people's homes. Um, and I mean, there is, at first especially, I think there's a little bit of adjustment working in someone's home. And then, you know, when you talk about some of your interesting encounters, I think, you know, the challenge of working in a home of a hoarder, it's pretty heavy.
I mean, I can't sit [00:13:00] down, I can't, where do I type? You know, do I just bring in my gait belt? Things like that. Um, and well,
Dr. Carol Beckel: and in the one case it was heartbreaking because she was really getting trapped inside this home. Mm-hmm. And I tried to, there were plastic bags lining the hallway. And this, the patient really needed an assistive device, but there was no clear path.
Yeah. And I called the physician because you really are an extender of the other healthcare team 'cause you're on site. And I said, here's what's going on doctor. And the doctor, uh, to her credit said, I had a feeling, I just had a sense that this I needed to understand so we can figure out. I said, I can help with mobility, but this patient needs some other assistance as well too.
They need some psychological assistance because this is not sustainable. Yeah. It wasn't particularly unhealthy, it just was, it was gonna just pile in literally and physically and, and keep reducing the amount of safe space, [00:14:00] um, that the person had to move around. So, um,
Dr. Kate Oland: and what a barrier, no matter what aspect of physical therapy or, or healthcare, you're in the psychological.
Peace is so important to consider. You know, one of my most challenging situations is helping someone who is a hoarder and a cat hoarder. And they logically understood why I was concerned about their health. Mm-hmm. And san sanitation of their home. They logically understood that. But they said, Kate, this is how I wanna live.
This is how I choose to live. And man, like where do you draw that line of, you know, I, something that I struggled with and thank God I only had to call the state once or twice in my career. 'cause I've always broke my heart because that's only bringing in pain. That's only gonna make a person feel judged.
Right. And not, and break the trust between the clinician and the patient. And quite frankly, I think the two times I've called the state, it didn't help. [00:15:00] Nothing good came of it, it, you know, but, but there is a point I feel like where we have to be professional and we have to protect ourselves and look out.
At the same time, and that can be so challenging. Yeah.
Dr. Carol Beckel: Luckily in this case, the patient had a niece who was very dedicated, and I, I called right away. I told the student, I said, you start the evaluation, I'm gonna make a phone call. And the niece immediately said, you're calling about the cats, right? I said, yeah, this is not sustainable.
And she was trying to catch 'em herself. I said, you need a professional. Mm-hmm. You need to call an organization who will set, um, traps that will live, catch these cats so they can be spayed and neutered and, you know, either return to a feral colony or maybe rehoused and get somebody to fix the window because Yeah, this is not, this is just perpetuating.
Yeah. So in this case, the, the patient had resources, um, she was unable phy physically or emotionally to, to make that decision. [00:16:00] But
um, yeah.
I only remember first visits, so I never know the outcome of the stories. I can remember my first exposure, those first impressions, and then I think, I don't really know what happened on these cases.
I know I treated them and we worked it out, but it's always, I can always talk about the first visit because that's where I got imprinted on what was going on with people, I guess.
Dr. Kate Oland: Yeah, and I mean, after you do it for a little while, you, you sometimes you can just walk into a home and, okay, here's what I got.
You know, I gotta, I gotta be tough. I gotta be tough, I gotta be soft. I have to be whatever. You know, you, you get a sense of what is needed to help handle that situation. So, Carol, I recently found someone on social media who is bringing so much humor to home care. Have you seen any of these, uh, reels or anything?
Uh, the guy who creates some of his name's, Dan cio, and I wanna, oh my gosh, you gotta check it out. He, he, uh, is, you know, he is doing some of those homemade reels where he's a home care therapist, but then he, Dr. Puts on a wig and he pretends like he's a, you know, home [00:17:00] care patient, you know. I found one of my friends from Home Care tagged me on a post and I just died and started following him.
I started messaging him, 'cause I wanna support this cause so I just wanna read this message. I said to him, uh, appreciating this content, and I asked him, you know, what is your goal? Like, you're doing something great here. What's your goal? He says, my goal for my content is to do what I can to support the fellow clinician.
Yes, with lighthearted comedy, but also with education for improving efficiency with the in the home, including the work that we do with patients, but also with charting. And lastly, an emphasis on helping to reduce healthcare burnout. It's rampant. The stats are high.
Dr. Carol Beckel: Mm-hmm.
Dr. Kate Oland: And so that's a big part of the message that I'm trying to spread my heart is with the clinician and I'm trying to do my part to help them to feel supported and give them strategies to make their job sustainable for years to come.
Yeah, that's great. [00:18:00] Yes. 'cause I mean, listen, home care, I, I don't know. I feel like home care is almost, especially in the PT world, a little bit of like the redheaded stepchild, you know? Um, I don't think it's a popular field.
Dr. Carol Beckel: Yeah. It's outta sight, outta mind for sure. Um, because you become their primary source of healthcare between the nursing staff and the therapy staff and the nursing aides.
So that team collectively is really focused on the patient. Um, and if you're keeping 'em outta the hospital, everybody's happy, you know? Yeah,
Dr. Kate Oland: yeah. Yes. And that, listen, we could talk for hours about what it was like being in home care during COVID, but that's not what I wanna focus on today. . All right. So Carol, after your home care stint, then you became our full-time professor at St. Louis University. What inspired that move?
Dr. Carol Beckel: I had, I had gone through a divorce and I was working full time and I loved taking [00:19:00] students in the clinic.
Dr. Kate Oland: Mm-hmm.
Dr. Carol Beckel: And I had, I, I wasn't really in good head space. I didn't really know what I wanted to do next. And my best friend in the world, we went to dinner and she said, what are you gonna do? Like, you're just, you're.
You're, you're sustaining life. You're, you're going to work. You're, but you don't seem that excited or that motivated.
Dr. Kate Oland: Hmm.
Dr. Carol Beckel: So I had been serving on the advisory committee for St. Louis University's clinical education team at the time, and I started to think about, you know, academics might be a route for me physically that might be a good move somewhere down the road.
Mm-hmm. So at the time, you could get a benefit of three credit hours. You could get up to six credit hours covered of tuition. That benefit is no longer available.
Decided, I actually went down to St. Louis University's career services and I did testing to figure out what I was really supposed to be when I grew [00:20:00] up.
I wasn't supposed to be in science. I could tell you that.
Dr. Kate Oland: Well, you are always an educator. Educator first and foremost. Always.
Dr. Carol Beckel: Yes. Uh, PTs are natural educators. Yes. So I tested high on that and or being a docent at a museum, I could have also gone that route too. Um, Ooh, that'd be different. Yeah. Well that sounded like a lot of walking and standing, which I already knew that was not probably, uh, so I started, uh, graduate courses and then a part-time position opened up on faculty and a person who I had worked with at the hospital knew me and honestly went in and told the department chair at the time, oh, I know this person who's very anal retentive and organized.
Those two top qualities that were promoted at the time and Oh, and really good with students. Oh, oh. And that
Dr. Kate Oland: and
Dr. Carol Beckel: that. Yeah. That, but I was organized, so, uh, I got my foot in the door with that when [00:21:00] the position converted to full-time. And I will say I had great support from the agency I was working for.
'cause I went in and I said, look, I wanna take this job, it's gonna pay me less.
Mm-hmm. And I
qualify for benefits and where the clinical job allowed me to work part-time, I could maintain my benefits. And they knew that I was gonna move on and, and I am so thankful to that supervisor who understood where I was going and was very supportive.
Uh, it was not shocked a year later when I said, guess what? Now I can move full time.
Dr. Kate Oland: Yeah.
Dr. Carol Beckel: So I move full time, uh, took a pay cut, which when I tell students that they think I was crazy, then I got full tuition. Um, I could take six hours a semester and have it covered. And that's how I finished my, my two graduate degrees.
Then was, was through working.
Dr. Kate Oland: So remind me, what are your, okay, so when you were working back in those days, I think [00:22:00] you had a bachelor's to be practice Bachelor's.
Dr. Carol Beckel: Yeah. At the time when I graduated, there were some master's programs, but there were more, uh, a high number of bachelor's programs like St.
Louis University.
Dr. Kate Oland: Mm-hmm. Mm-hmm.
Dr. Carol Beckel: So you either had a, a Bs, or an ms. Um, and then. When they converted to the DPT, those, those went away and, and they went to a singular degree. So when I was hired, we already knew in academics it was moving towards, you either had to have your DPT and a care specialty certificate, or you had to have a terminal degree in EDDA, PhD, something like that.
So I only, I only had a bs, I was the last person hired at SLU with a singular BS degree. And then I had to hustle up. So I started in 2003 full time. I graduated with my master's in higher education in 2004. [00:23:00]
Dr. Kate Oland: Mm-hmm.
Dr. Carol Beckel: And then started my PhD in 2005 and took me a while, but I finished in 2012 so I could meet the qualifications because I was not.
And your PhD in education? My PhD is in educational studies with an emphasis in curriculum.
Dr. Kate Oland: Perfect for your, for your role, right? Yeah. You could not have a more perfect education to be the clinic. The clinical education coordinator, is that your title?
Dr. Carol Beckel: Yeah. Director of clinical Education. Mm-hmm. Thank you.
Director of Clinical Education.
Dr. Kate Oland: For those listening who aren't in the field, um, a lot of healthcare professionals, uh, during their education, they have to go out and do clinicals or some, what are some other terms they use for that?
Uh,
Dr. Carol Beckel: uh, they preceptors. Most are calling them clinicals of some sort.
Dr. Kate Oland: The clinical for me, when I was a PT student, I was paying full-time tuition, but I was full-time working in a [00:24:00] clinic, partnered with a physical therapist who was a volunteer educator for me in the field. Is that a good way to describe that, Carol?
Dr. Carol Beckel: It sounds crazy, but yes, that is, we're actually not allowed to pay clinicians. That's part of the accreditation.
Um,
Dr. Kate Oland: other people. I didn't realize
that.
Dr. Carol Beckel: Yeah. It says there cannot be a financial reimbursement directly to clinicians. So you can offer courses, you can offer resources, you can offer, uh, like we have offers for opportunities to be lab instructors.
That sometimes helps a company say, well, we'll let the clinician go do that, and it's not time off.
Mm-hmm.
It's just of their work. And so you can do collaborative, um, structures like that, but you can't, it can't be paid. It can't. Pay people directly, which is different. I think we've never expanded much in Europe because there's an expectation of direct payment to the clinicians.
So, wow.
Dr. Kate Oland: It's just a little different. And I remember when I [00:25:00] was a, so I've had several of your students shadow, or not shadow with me, I guess I've precepted them. I've been the clinical, I've been the clinical instructor for several PT students through slu. And I remember this, and this may not be true anymore, but I remember they said, oh, if you're a clinical instructor, I think I had some on-campus benefits.
I could get an ID that would allow me into the gym or things like that. Are those still benefits that are out there?
Dr. Carol Beckel: Uh, they keep refining it now. Mm-hmm. It's more about online tools and access.
Dr. Kate Oland: Oh. And
Dr. Carol Beckel: we just don't get a lot of clinical faculty that will do the paperwork to get it. But you can get some discounts on, uh, different events certainly have a online access then to the library resources, so that's beneficial.
But we probably only get like 10 to 15% of clinical faculty that will. We'll engage in that process and you have to do it annually, which is kind of a pain, but it's usually something. And now they can do it anytime a year. We used to have one entry point a year, [00:26:00] and now it's a rolling. So if you get to a point where, oh, I really could use access to a university library, then you can sign up and have access.
Dr. Kate Oland: I'm such a nerd. I've had so much fun accessing the library now that I, you know, that, that I work at slu. That's been a fun benefit for me. For sure, for sure. Well, so Carol, you entered this realm of being full-time, and let me tell you, it's, you know, as an adjunct instructor for a little, for a hot minute, I thought I wanted to be full-time academia and, you know, it just never, never worked out for me.
But I certainly, I love, I love being in the classroom. In fact, I remember talking to you my first year, I remember saying, and. You probably remember this 'cause you made fun of me. But I said, Carol, I cannot believe they are paying me to do this job.
Dr. Carol Beckel: Yeah. I would've made fun of you for that.
Dr. Kate Oland: You did. You told them.
Made fun of me. You told me I was being cute. Now, as I reflect on that time, I will tell you, I think that first year for me being the class a nerd that [00:27:00] I am, I felt like I was getting paid to be a student. I had to relearn.
Yeah. Yeah. Anatomy
and physiology. My favorite. My favorite at a and PI really had to relearn the content before I taught it.
So, you know, after paying a lot of money for my education, it really did feel like a dream come true here. I was getting paid to learn high quality information from a mentor. I have to throw this out there. My mentor, Brian Elliott, he has been phenomenal. He helped, he held my hand figuratively as I walked into that classroom, and it made it a lot less.
Anxious for me, there was definitely plenty of anxiety, but having a supportive mentor really was a key to my, uh, enjoyment of this job.
Dr. Carol Beckel: Yeah. Yeah. The nice thing is there's always other faculty that have more experience and so being able to tap into that and learn from those [00:28:00] individuals, and some of them were my faculty when I was in school there, so it felt like an, an easier transition because I knew some of them and they knew me.
Dr. Kate Oland: Mm-hmm.
Dr. Carol Beckel: I asked them all to forget my, what my grades were. I'm like, if we could just forget how those, some of those classes went, don't know that I ever really passed exercise physiology. Um, yeah. But it, that was a tough one. That was real tough. Yeah. To then be on the other side with those faculty and learn and all of them have different processes and then start just like being a clinician, figuring out, okay, I see how you're doing it and I'm gonna take this piece and this piece from this other person, and then make that my own.
It is, it is a, a learning curve in those first couple of years for sure.
Dr. Kate Oland: You know, this is my fifth year teaching, and I think in the last year or two, I've taken the approach, you know, that first year I thought I had to know everything. I had to know every answer, and I was gonna look dumb if I didn't have the answer.
Well, I got real used to not having the answers off the top of my head real fast.
Dr. Carol Beckel: So the, [00:29:00] it's just like having a student in clinic.
Dr. Kate Oland: Mm-hmm.
Dr. Carol Beckel: What do you guys think? Well, let's use your clinical reasoning and think through that. So it gives you a lot of time.
Dr. Kate Oland: Gives you a little time, but also it helps them to figure out their own thought processes.
Right. Right. Like, I like to encourage people to think, okay, where could we find this information of this question you're asking? That's something I like to do. But what I did this year, probably more blatantly than I have in the past, uh, that very first a and P lab, the anatomy and physiology lab that I taught.
I was like, all right guys, here's the deal. I love anatomy, I love teaching this course. I need y'all to know I don't have it all memorized anymore. I passed my test. Like I don't have to memorize it, you know? And if you don't, if you have a question, I don't have the answer to it. We're gonna figure it out together.
Um, and let's, you know, it's not, I've even used the approach a couple times, like, here, let's, let's look through this together. And very recently I had a student say, Kate, I thank you. You make, you are [00:30:00] more human to us. And that makes you more approachable.
Dr. Carol Beckel: That's
great. That's, I
want your students to feel like they can't ask you a question.
Yeah.
Dr. Kate Oland: That's one of the things I loved about the slew PT department. One of the things I loved the most was, you all had us call you by your first name. Mm-hmm. And I think that was intentional. I think that's an intentional thing in the department.
Dr. Carol Beckel: Yeah. It was about developing colleagues and not just students and.
It's shifting a little bit. We just have different faculty and I, and I go back and forth. There's different instances where that first name basis for some students, they have a hard time understanding what that means in a terms of a relationship.
Dr. Kate Oland: Mm-hmm. And
Dr. Carol Beckel: so trying to build that with not such a casual tone.
I tell 'em all the time, I'm like, don't start emails. Hey, just, you can call me Carol. But, you know, and so they practice that and they practice how to be professional and some of that is generational.
Dr. Kate Oland: Mm-hmm. [00:31:00]
Dr. Carol Beckel: I, you should start all sentences with a capital letter. I don't understand. Not ca I capitalize text and, and, but that generationally is not as important.
So when they can call me Carol, then I get very casual grammar and language sometimes. So there are pros and cons. There are times I use Dr. Beckel with some intentionality.
Um.
I teach juniors now, and I tend to go by Dr. Beckel with them because that's what they're coming out of from their undergraduate world.
So until they're really into the professional phase, once they're in the professional phase, I say, now you can call me Carol to train. I like that boundary. I like that. Understand. Oh, now we're colleagues and we're, we're working towards that. So it's, and I always say, I make my brother and sister call me Dr.
Beckel. But yeah, people, no.
Dr. Kate Oland: Well, so Carol, here you are, you're in charge of the clinical education for a lot of PT [00:32:00] students, and a little over a year ago you shared on Facebook that you were preparing for a total knee replacement. And this is something I really am excited to talk to you about on this show because as a pt, I've been practicing about 20 years now, and the little whatever, when it comes up in conversation.
You know, I have friends that are helping their parent go through a knee replacement. My, what I tell them is, you are gonna have to be so patient because this is, this is almost the most painful condition I've worked with throughout my entire career, and I, I would say it was the most painful condition if I had not had a clinical education experience in the burn center.
Yeah.
So burns are best level. That's
Dr. Carol Beckel: different. That's a different range.
Dr. Kate Oland: Yeah. Ooh, that's, that's a realm that I knew right away. I could not do that full time. The amount of pain I had to inflict on people to make them better was not for me. But so had I not had that experience in the burn center, I would be saying that total knees were the most painful condition I [00:33:00] worked with in my career.
And there's no sugar coating it. It's a, it's a brutal surgery. I got to observe a total knee replacement when I was a student, and holy cow, that. Very quickly turned into a construction zone. That operating table felt like a construction zone.
Dr. Carol Beckel: Yeah. With
Dr. Kate Oland: hammers and saws. And you knew all of this mm-hmm.
Preparing, yeah. For your procedure. What was that like?
Dr. Carol Beckel: It, it had been a long time coming. Uh, I was diagnosed with juvenile rheumatoid arthritis, or now it's juvenile idiopathic arthritis at two and a half. My knees were always my most involved joints, so I really could not remember a time of not having pain in my right knee.
So that was, that was the premise. And at times the left knee is painful, but it was always the right knee and there was no particular injury. I wasn't in a car accident. I didn't fall. It just was bad. So [00:34:00] in my head, I always knew that was coming all through PT school, I knew it was coming. I had a chance to observe a total knee replacement, and I nearly passed out, so they asked me to leave.
So I knew it was, and I understood why there was so much soft tissue pain because they put your, your leg is in such an extreme position to expose the ends of, um, the femur in the tibia. Mm-hmm. That there's nothing but bruising and, and swelling after that. And I had done years of, you know, immediate post-op care when I was working at the hospital.
I didn't have many patients in rehab at that time with just a knee replacement, unless unfortunately other complications had come up. I had seen a patient come out of a total joint replacement that had stroke-like symptoms. So I knew I had seen all of that. And then I'd seen patients at home who, mobility wise, they couldn't go straight to outpatient.
And what that looked like now that they're, you know, not getting the same care that they got in the hospital and the pain [00:35:00] medication is dropping off. Mm-hmm. Yes. So I knew all of that and I knew in talking to patients, I hadn't seen a lot of patients in outpatient, but knowing with patients, they always made the decision when that joint was becoming so disruptive to their life that they were out of choices.
Dr. Kate Oland: Mm-hmm.
Dr. Carol Beckel: And I knew, I had an appointment with an orthopedic surgeon February of 2024. I had been getting injections with a PA in the, in the practice for about two and a half years. And at first it was great. It would last for three months. Great relief. And then I got down to two months and then I got down to a month.
And then it was really not effective. So I knew when I saw the PA in November of 23, I said, I'm ready. Yeah. So by the time I got there in February of 24, I had started walking with an assistive device. So I started with a cane. [00:36:00] I went to a crutch, I went to two crutches, and the orthopedic surgeon immediately looked at the x-ray and said, there's no doubt, when do you wanna schedule this?
You know, we're scheduling three months out. There's nothing, nothing left in that knee. Mm-hmm. You're absolutely a candidate for this. So I felt vindicated, at least that I had, you know, I wasn't in there too early, and I, uh, wasn't past the point of of return, and I knew what I thought. I knew what to expect.
Dr. Kate Oland: Going into it. Oh, you thought you knew what to expect, so let's,
Dr. Carol Beckel: yeah. Yeah. And I, I did all the prehab. I went mm-hmm. I did, I got measurements done. I had was on a strengthening program because my gait had gotten really wonky, which is why I put myself on crutches, bilateral crutch, or both crutches on both sides.
Dr. Kate Oland: Mm-hmm.
Dr. Carol Beckel: Because I didn't wanna have any worse of a limp going in. Uh,
Dr. Kate Oland: what was that like for you, Carol? Because I mean, uh, the first day you [00:37:00] carried that cane or crutch to the office, did ask. Well, well, the first day
Dr. Carol Beckel: anybody saw me with anything was at our big February meeting with about 16,000 PTs that combined sections.
And it was in Boston, and I took a trekking pole. I thought I'd be cute, and I was, it had to match your outfit. Yeah. I, how many PTs walked up to me and said, you know, that's not really offloading. Your gate is terrible. What? And I didn't go, I didn't go through any of the vendor floor. I would figure out how many programs I could go to in one hallway.
Like I was making significant decisions based on pain. And I went from that to a straight cane to the crutch. And I, you know, I've seen so many patients, my mother included, she wasn't my patient, she was my mother. She would not walk with an assistive device because people would think there was something wrong with her.
Dr. Kate Oland: Yeah, yeah. And
Dr. Carol Beckel: I said, mom, anybody with two [00:38:00] eyeballs can see there's something wrong with your gait. You know, walker or no walker. You're not really faking anything. And it, it took a lot. But I was honestly Kate in so much pain that it became risky and I thought, I'm gonna fall. It's gonna give out. It just, it felt like it had no stability.
It felt like the femur, tibia, and they were, there was no structures left. Hmm. Um, he goes, it's, that's why it felt so unstable. So once I got into it and I could move better, I thought this is just part of the journey then to get there.
Dr. Kate Oland: So what I'm hearing is, you know, in your mind you have all this knowledge and experience mm-hmm.
But even with all that knowledge and experience, you were still concerned about looks,
Dr. Carol Beckel: oh, of course. You're still a human being.
Dr. Kate Oland: Everybody is still concerned.
Dr. Carol Beckel: Degree, and you're still a human being. Look at, look, when you walk around a hospital or healthcare facility, how many people walk with [00:39:00] deviated gait that you know, okay, that's, you shouldn't be on a device.
Mm-hmm. Like I'm looking, watching you stand up and you're unstable and you should be on a device. And I would, I wanted to at least be able to have a a as typical as possible gait pattern going in. Because I felt like, okay, that's gonna help my recovery on the backside if I don't have to rework, you know, glute medias being so weak or gastroc being so tight or whatever.
Mm-hmm. If I could normalize my gait and offload it, then I could put up with the crutches. And it was interesting 'cause in the semester I talked to the juniors in, in professional year one students about, okay, I am like now I'm, now I'm using this crutch and here's why I decided to use this crutch. And you guys have seen me walking and it's declining.
And I said, that's, it's not easy to do. I don't want you to think that this was an easy decision. It's, it's a real humility check. Um, [00:40:00] but it was the right decision. I would make it again in a heartbeat, uh, to be in a better shape for the surgery.
Dr. Kate Oland: One of my biggest challenges in my career, and I think a lot of PTs will.
Uh, uh, identify with me on this is convincing someone to use their assistive device to use their cane or their crutch or their walker. And I know that it, man, I know that it makes people feel old, and I know it makes people feel ugly, and I know it makes people feel vulnerable. Those are all things no one wants to feel.
But man, when when you're on the flip side, when you're on the therapist PT side, you know that that feeling of ugly or incapable or vulnerable is gonna be a lot easier to deal with than a broken hip,
Dr. Carol Beckel: right? You know, but it still allow
Dr. Kate Oland: me, and I hate to use scare tactics, I hate to use scare tactics, but sometimes that is really the kind of [00:41:00] communication you need to use to help someone understand how important it is to be able to stay upright, safely, and supported.
Dr. Carol Beckel: It made the difference between me continuing to do my own activities of daily living, like grocery shopping and getting in and outta my car. It made that all tolerable so I could keep doing everything myself, whereas without crutches going to the grocery store and target were becoming miserable.
Yeah.
Uh, which isolates and that's not a great place to be in preoperatively.
Dr. Kate Oland: Yeah. Did you ever get one of those electric, did you ever use the electric scooters when you were out shopping?
Dr. Carol Beckel: No, that one I couldn't do.
Dr. Kate Oland: Okay.
Dr. Carol Beckel: It was my boundary and I, I could walk in, I could get a cart, I'd put the crutches in the cart and I would use, I would use that, and I did get, I did get accessible parking because I had to be realistic about, I'm gonna need this after surgery and I, I need it [00:42:00] now.
I'm at a point where I need to conserve the steps, and it's that balance. I wanna be strong and I wanna be healthy going in. But I'm in pain, so I, I and I, I never took more preoperatively than two Tylenol in the morning and Meloxicam.
Mm-hmm.
So I never had to get any heavier medication than that. So I, I did other modifications.
Um,
Dr. Kate Oland: Ooh, I love that point. So what you're saying is you were using those assistive devices in part to help, uh, you meet your goals of keeping the pain medication or Yeah. Not taking pain medication, but controlling your pain as conservatively as possible. Yes. Through medication. Yes. Oh, I like that. I like that.
So, as you were heading into surgery. You know that that's intimidating. And I kind of wanna, I, I wanna tell you a little story. Part of what inspired this conversation today, Carol is one of my former home care patients. This, you know, [00:43:00] I spent five years doing home care, full-time living in the city of Boston.
Mm-hmm. And I, which is a whole, that's a whole trip compared to doing, uh, home care here in the Midwest where I'll put a thousand miles on my car in a week, where I think in a year I didn't put a thousand miles on my car in Boston. It's totally different
Dr. Carol Beckel: in St. Louis.
Dr. Kate Oland: I'm sorry, say that again.
Dr. Carol Beckel: Easier parking in St.
Louis though.
Dr. Kate Oland: Oh, don't, don't. Yes, yes. Well, so when I worked in Boston, one of the really cool things about doing home care there was I met people from all over the world. People literally come to Boston from all over the world to get healthcare. Um. I had, so I have so many really interesting stories. But the one I wanna tell you right now has to do with a physician, gosh, I can't remember where he was from originally.
I can't remember. But he intentionally set up his knee replacement to be in Boston. This man was an orthopedic surgeon [00:44:00] himself. Oh, wow. He did not wanna have this surgery in his hometown.
Dr. Carol Beckel: Mm-hmm.
Dr. Kate Oland: Yeah. So his, uh, med school buddy, he, he flew to Boston to have this surgery. And I got to work with this gentleman, I think two or three times.
Um, and IWI didn't, right at first, I didn't come out of the gates and ask him this. It was like I had worked with him for a hot minute before. I was like, all right, well dude, I gotta, I gotta talk to you about this because he was gonna go back to work. I said, now is this experience gonna change how you practice?
Dr. Carol Beckel: Mm-hmm.
Dr. Kate Oland: And he said, absolutely. Number one, and, oh God, I wish I, I wanna tout this to the rooftops. Number one. This man, this very kind man, humble man said, I had no idea how much pain I was putting people in. Mm-hmm. All right, so y'all, if you're going through a total knee replacement, please know that that physician has no idea how much pain you're in.
The people who understand the pain you're in are the people who are putting you in more pain to help you get better. And those are your physical therapists, your occupational therapists, [00:45:00] right? So he had no idea. He said, I wish every one of us could go through this of, that's not practical, he, but right.
And then he said this. So there, there were two points. Number one, he had no idea how much pain this caused patients. Number two, he said, I will never do another bilateral knee again. And for those of you who don't know what that means, uh, doing bilateral, a surgeon, doing a bilateral knee replacement means replacing both knees at the same time.
Holy cow. I've only, I've worked with a handful of people who I've done both done at the same time. And that's brutal. It is brutal.
Dr. Carol Beckel: I had a physician do that once, and the, the patient had 20 steps to get to their house and they'd never, the physician never asked the patient.
Dr. Kate Oland: And I think, listen, I, I get it.
Why he didn't ask that their mindset is so different from a pt, let alone a PT who's done home care.
Dr. Carol Beckel: Mm-hmm.
Dr. Kate Oland: And this is where I feel like we could, if we all could communicate more, I don't, and listen, that sounds so [00:46:00] simple, but trying to get the communication improved between all the different professionals would help with a team approach.
And I think we're working towards that. Um, so
Dr. Carol Beckel: I will say surgeon was very upfront and, and knew I was a PT and said, you're gonna hate me. Mm-hmm. For six weeks. You're going to hate me. You're gonna question this. You're gonna think you made a terrible decision. Keep working. And, and get through that and it will get better.
And you won't hate me in a year. And I actually see my surgeon tomorrow. It'll be the plus one year. 'cause I ended up having my surgery in August of 24. Mm-hmm. Um, but I, yeah, I don't hate him. I'm, I'm so happy. And I've seen him like a couple other times in this, in this first year, uh, for regular checks.
But he was right. And I appreciate him admitting that, that he knew as much as he could, having not experienced it. Mm-hmm. He was at least listening to patients [00:47:00] and understanding what it was like as best as he could with, again, without that first person experience.
Dr. Kate Oland: Yeah. I think that listening piece, any healthcare professional, if we can make our patients feel heard, it can really help ease some anxiety.
So why don't you talk about that? What did it feel like emotionally getting ready for the surgery?
Dr. Carol Beckel: Well, I had a little glitch 'cause I was supposed to have it done in May of 24. And I, they kept saying, they're like, don't get sick, don't get infected. And the blessing of a pandemic was, I knew how to stay away from people.
Mm-hmm. And I woke up one day and I had a sty in one of my eyes. And it wasn't going away. And it wasn't going away. And I finally went into the eye doctor and they said, you're gonna have to go on antibiotics to get rid of this oral and eyedrops. And I, so I started it 'cause I was like, there's, and the surgery is supposed to be the next week.
And I called the surgeon's assistant and she said, do you have to take them orally? And I said, well, they're telling me [00:48:00] yes. She said, we're gonna have, we can't, you have to be 30 days free of antibiotics. And I merely cried and I said, look, I, I understand that. I said, but if I'd have showed up next week with this big old goopy looking eye, you also weren't going to do the surgery.
She goes, that's right. We weren't. Yeah. So then they couldn't get me until August. And I ended up, I got another, like, I had mites in my eyelashes. I did another round for my eyes and then, oh no girl cracked tooth that needed a root canal. And that was another round of antibiotics. So in hindsight, it's probably very good.
I didn't have the surgery when I did, I never take antibiotics and I had a series of like three antibiotic. So I did, I went into pandemic mode then for the rest of June and July. I didn't go out places. Um, I would wear a mask when I went out and I still did my shopping and stuff, but I, and I was in pain.
I was so sad. Mm-hmm. And just, I thought I had the whole [00:49:00] summer to rehab and now I was gonna get it. And then three weeks later the semester was starting. So, um, that was challenging.
Dr. Kate Oland: Mm-hmm.
Dr. Carol Beckel: But again, if I'd have had a cracked tooth and they had to do a root canal that took two hours after I'd had a knee replacement, I'd have been.
Horrible pain sitting still for that long. So
Dr. Kate Oland: it would've been a problem. Yeah, it all worked out. Um, well, so you had those hiccups. Mm-hmm. It's the day of the surgery. Were you done? I was so excited.
Dr. Carol Beckel: I they nurse anybody smiling this much, I said, I am done. I, the knee kept just getting worse and worse and I was exercising as best I could and was using resistant bands to keep my muscle.
But the pain, just nothing was really controlling the pain. Um, so day of surgery, uh, my brother and a very good friend of mine took me and they laughed. They're like, you were just like the happiest looking person. 'cause I thought, we're here, there's nothing Now. I am [00:50:00] clean. I am clean. We've done all the testing.
I'm ready to go. Um, and as I was getting the nerve block put in, in my leg, I heard somebody hollering in pain and she was mad at the nurses and stuff, and the PT in me thought, oh, I should probably try to help her. And I realized, I'm like, I'm just gonna go to sleep. There's not, I'm sorry ma'am, there's nothing I can do for you right now.
And then that was it. I, I woke up and was just, I don't remember a lot of the surgery day. I asked my brother, I said, did I eat? He goes, yeah, you got a Turkey sandwich on white and then complained it was dry 'cause
Dr. Kate Oland: mm-hmm. That sounds like hospital food. I bet that was an accurate review.
Dr. Carol Beckel: Yeah, it was an accurate review.
And I told the nurses overnight, they were so great, they were right on my pain medication. And I said, isn't it? I said, I've tried to be awake when you come in. And they laughed. They're like, you're not awake. We've had each time, um, so did inpatient. Or not inpatient, did one round of pt, up and down the steps, basic [00:51:00] exercises.
One round of OT got dressed. Um, and then I went home and I thought, okay, I understand what the knee pain's going to be. Uh, I know the swelling. I, I know what I have to do to try to control the swelling and I've gotta move it no matter how it feels. I gotta move it. And I just have to, you know, be okay with that.
And turned out the harder part was nerve pain, and that was what I was completely unprepared for, which is not uncommon and it's part of the risk. Um, but I had terrible, terrible nerve pain, um, from the perineal nerve. So like from the knee down, I had to stop wearing the TED hose, which that messed up my, you know, controlling the edema regime.
Um, and I, it was more aggravating for me to have that. Than the knee pain. Um, but I had a phenomenal home health pt. [00:52:00] I got home health for three weeks. I don't know how I got that, but I did not complain about it.
Dr. Kate Oland: Yep.
Dr. Carol Beckel: Um, and she sat me down and she said, I know you're a PT and I know you're an educator. And she goes, I'm gonna talk to you like a patient, which was exactly what I needed.
And she said, this is a traumatic surgery. She goes, I've seen the surgical report. You were in there for two plus hours, which is a long surgery, and that you're gonna have pain and you just have to be right on the pain medication and right on the ice and right on the exercise, she said, but it's a no joke surgery.
And hearing that as a patient was very reaffirming. Yeah. That what I was going through. She wasn't surprised. She wasn't upset that I didn't have a hundred degrees of flexion right outta the gate. She goes, that was a ludicrous idea. She was very funny. She's like, why did you think you would have that? I said, I just thought I should be at 90 degrees before I left the hospital.
She goes, no. That's not, it's not a thing. That's nobody's goal. You know,
Dr. Kate Oland: we can get those preconceived notions in our head. And I think some of that is, Hey, my goal is to get this [00:53:00] person to the best possibly I can before they go. So now if it's for yourself, you want yourself to be the best possibly. And yeah, sometimes you, when you were working with patients, sometimes you could and sometimes you couldn't.
'cause Carol, what I like to tell my patients is that every body is different. Your body's different from mine, et cetera, et cetera.
Dr. Carol Beckel: Yeah. And I think just the years and years of poor mechanics in that knee, I was, I thought 120 was what I had to get to. And I was barely at 90 degrees before I finished home health.
And I thought, okay, well it's only 30 more degrees. How hard could that be? It turned out it was impossible. Uh, where,
Dr. Kate Oland: how, where are you at now, Carol?
Dr. Carol Beckel: I graduated outpatient PT and I went, I. I was an outpatient PT from September till November, so
Dr. Kate Oland: mm-hmm.
Dr. Carol Beckel: Quite a long time. Mm-hmm. And we had three weeks where my top [00:54:00] number was 114 degrees.
Mm-hmm. I had full extension, I had full extension very quickly, which everybody was very happy about. No contractor. I could get my knee nice and straight, but after three weeks of 114, I, you know, uh, my friend Karen, who is my pt, she said, I, I think that's it. You know, what can you not do at home? And I said, I can do everything at home.
I was nearly back to doing step over, step on the stairs. I had a little bit of a catch, um mm-hmm. But I was getting it done. I had the strength back. Um, I did have to do quite a bit with my foot because I had nerve pain. Mm-hmm. I had sensory loss, I had some loss through the myotome, so some muscular loss
Dr. Kate Oland: mm-hmm.
Dr. Carol Beckel: That I've gotten the muscular back, I've gotten most of the sensation back and the pain. Finally by January or February I could stop taking the Gabapentin, but I had to take that for longer. They anticipated for three months and I took it for about six months.
Dr. Kate Oland: Is the theory that that peroneal nerve [00:55:00] got irritated, moved, shifted, inflamed, something and that's why you had that?
Dr. Carol Beckel: Yeah, I, it's weird because it's not, 'cause I asked him, I said, I'm not upset. I know this is one of the risks. I'm just trying to figure it out like, did you have a strap? 'cause I thought, well, maybe they had a strap to hold my lower leg in a flex position. And he said, no, we don't use any kind of a strap. We just position and put weights on your feet and mm-hmm.
So I, who
Dr. Kate Oland: knows,
Dr. Carol Beckel: who knows? Just anatomically, like you said, every body is different and anatomically, wherever my perineal nerve came out. It was really prone to that. And I'm, I'm thankful I don't have any more loss. I'm thankful I don't work in a job where there's a lot of hot objects or sharp objects because there's times where I can't, I don't always, like, I was sitting next to a kid and the kid was kicking me and I had to like, oh, you're kicking my leg, but it's on the side.
And that's, that's gotten better. I, I'm trying to use B12 [00:56:00] to help, to regenerate nerves a little bit and, and be healthy about that. Yeah. Uh, so by the time I finished pt, I was a little sad, and I went into the doctor and I said, I'm only, I'm at zero to 114 degrees. He goes, that's fantastic. Why do you need more than that?
And as a kid, like a kid, I'm like, oh, well if you're happy then I can, yeah, I can be okay with that.
Dr. Kate Oland: Well, something I always tell people is, if you are happy, if you are doing what you wanna do, then that's, then we're good. You know, maybe it, so gosh, normal knee range of motion, what we consider normal is zero degrees, fully extended is normal.
Like 140 or 150 for someone without impairments. I don't quite remember somewhere. I mean, probably
Dr. Carol Beckel: if you're a baby.
Dr. Kate Oland: Right,
Dr. Carol Beckel: right, right, right. No damage you like 130 is a good adult range. Yes, yes. So 120 postoperatively is a, is a good thing. Yep. For me, I wanted to be able to cycle and so, mm-hmm. I needed a strong mid range.
Right. I didn't, you know, you don't really need full extension on cycling, [00:57:00] but you need 90 plus
Dr. Kate Oland: mm-hmm.
Dr. Carol Beckel: Cycle. And I was able to return to that, so I didn't, so we're good.
Dr. Kate Oland: So Carol, when you were picking out your outpatient therapy clinic. Because you are the clinical education director, how did you decide where you wanted to go?
Dr. Carol Beckel: That was very strategic. I went to student health, so I went on campus. This is gonna make me sound like, I think I'm more famous than, I'm not, I'm not famous, but to try to pick between all of our local clinical sites and then have them be able to say, well, we did Carol's rehab. Mm-hmm. I, I didn't want that.
And I honestly, when I started in outpatient, we had students out in the clinic. Mm-hmm. And I will let students work on me in any other way, but I, I'm like, I can't have one of my students, one be afraid to push me. Mm-hmm. [00:58:00] Or be a little too anxious to push me, you know? Right. Yeah. And so for me, going to student health.
I knew, and, and Karen did my work ahead of time, so I knew I would get the one-on-one attention. So I had that opportunity because they don't, they don't double book. And, um, she would something so
Dr. Kate Oland: you, you knew that business practice, that they did double book. That they worked one-on-one. And let me tell you, if I had to choose a place to go for outpatient pt, that's what I'd be looking for.
I don't want one PT working with five patients, period.
Dr. Carol Beckel: I think there's pros and cons and there's, there's different times. And I've worked with a lot of different practices and I think, I think there's practices for everything. I mm-hmm. I knew for me and knowing what I wanted to get the range that's hands-on.
Dr. Kate Oland: Mm-hmm. And
Dr. Carol Beckel: I didn't want a clinician to be in a position of, oh, we don't have enough hands-on time.
Dr. Kate Oland: Mm-hmm.
Dr. Carol Beckel: And to be honest, it was just the flexibility because Karen would teach [00:59:00] in the building and so we would talk, we'd be like, look, we're both here at three 30. Can you, we'll go down to the pro bono clinic.
And use that space at four 30 when all the other patient care is done.
Dr. Kate Oland: Mm-hmm. Um,
Dr. Carol Beckel: so I had an advantage that was, that was a privilege I had, and that's the one I went with because again, it, it really was trying to not offend anybody else. There's so many fantastic clinicians across, across the metro area.
I've got alum. Everybody wanted me. Everybody was like, oh, we're, we will do.
Yeah. That's why I'm not gonna go because I can't just pick one.
Dr. Kate Oland: Carol Beck. I do think you're a little famous physical therapist. There's not very many of us, and it depends on, I just had an interview with Fred LeBlanc who says, some people think he's famous and some people don't.
And that's okay. In my mind, you are famous. I have a couple PTs who I'm trying, who I'm in discussion with, getting them to come on the podcast. Um, and, uh, yeah, I had, I, you know, one of my [01:00:00] former clinical instructors, I said, oh, I'm gonna be talking to Carol Beckel about her knee replacement, and maybe you could come on and talk about your business model on the episode.
You know, so it's, people know Carol Beckel.
Dr. Carol Beckel: Well, it's a small audience, but I'll take it.
Dr. Kate Oland: Okay. That's right. That's right.
Dr. Carol Beckel: And I'll say I, because I was on crutches before surgery, I stayed on my crutches probably longer than most. I did not wanna limp. I said, I've been limping my entire life. I don't wanna limp.
And because that had become part of who I was. Nobody questioned it. And I kind of backed it up that okay, I Karen's like, just drop one crutch, try one crutch. And then I used one crutch part of the day, but I think that helped me to recover walking the way I wanted to walk. And I, I get a lot of people that will say that her PTs are like, I kind of forgot you had a knee replacement.
Yeah. Which is the highest compliment you can get. Yeah. When you walk by somebody and they [01:01:00] don't remember that, oh, you had a major surgery.
Dr. Kate Oland: Mm-hmm.
So I, for me, that's my pride point that I stuck with it and I committed to it. And that gave me the recovery that I, I really wanted, I didn't bail out on it early.
That's right. So you did it, you did all that work. You Oh. And it is so, so much work.
Dr. Carol Beckel: Yeah. It's, yeah. Yeah. Those three to four times sessions a day in the early month.
Dr. Kate Oland: Mm.
Dr. Carol Beckel: It's a lot. It's a lot to commit to. And again, I had the support, I had friends helping me. I had friends when I hit the two week point of wondering why, um mm-hmm.
So I, I had that privilege of having a lot of people around me to back me up and to support me and drive me till I felt like I was ready to drive. And, um, that makes a big difference. Not feeling isolated in it was very helpful.
Dr. Kate Oland: Yeah. I think anytime a person's going into any surgery, you know, um, there is a little bit of a psychological [01:02:00] component to it.
No matter how minor the surgery you're gonna be inconvenienced. And that's frustrating.
Dr. Carol Beckel: A hundred percent. Yeah.
Dr. Kate Oland: It's
Dr. Carol Beckel: hundred percent.
Dr. Kate Oland: And when you're stuck at home and it's a surgery where you can't, you physically are unable to leave the home. That's so isolating. So having that emotional social support in place is so important.
Yeah. Yeah. Yeah. Hey, you mentioned the pro bono clinic. Can you tell me just a little bit about that? Because I've seen the signs, but I just, I, that was not something that was around when I was a student. I'd love to hear a little bit more about that.
Dr. Carol Beckel: So the program and physical therapy has a pro bono clinic that runs Monday, Wednesday, Friday, and Saturdays.
Dr. Kate Oland: Mm-hmm.
Dr. Carol Beckel: Um, it is for patients that are underinsured or have gone through their insurance or some folks just want the convenience of actually just being on campus. Mm-hmm. And on our south campus, so we get some faculty and staff that have seen a physician and, and would like to see a physical therapist.
It's integrated with coursework. So [01:03:00] in the fall semester, the third year, students are doing all the work, which is fantastic. Um, they've come at it 20 weeks in the clinic. They get to do clinical practice. Then throughout the semester. We have patients with primarily orthopedic conditions and patients with primarily, uh, neurological conditions.
We have some patients with some pretty complex conditions, um, that, that come in. So the students work in teams and there's always, uh, either a faculty member or a preceptor. We have, uh, three res, three residency programs. So that's part of the residency that they are also supervising the students. And then in the spring semester, the second year, students begin to do some of the work.
Mm-hmm.
Um,
some of the documentation they take on more and more as they get ready to go out into their clinicals. We have first year students who do some observation in their gross anatomy summer now. As well as in their spring semester, they can come in and observe [01:04:00] on Saturdays. Underclassmen can come in and do some observation as well too.
So it's been a great way to integrate clinical practice to provide, provide some community service. Um, some of our patients who have long-term declining neurological conditions that just they insurance doesn't qualify them for rehab. So coming in once every couple weeks or so and we can recheck their plan and update their program and advocate for equipment, um, it's been, it's a big lift.
Um, Dr. Barb Yam, I gave her all the credit on a huge lift with that, and we all contribute as much as we can to, to be part of it, but it's made a big difference for the students to have that ongoing patient presence, um, practicing their communication skills, understanding the, the psychosocial piece of physical therapy and mm-hmm.
How much it really can impact somebody's life to have, uh, any kind of decline or [01:05:00] change in their mobility.
Dr. Kate Oland: Yeah, those progressive neurological conditions are a beast. You know, those are some of my most heartbreaking stories. And in a couple weeks actually, we are going to have an episode on, uh, healing from K Crudes Field, KO's Disease, CJDA.
Uh, that's a disease that's come near and dear to my heart through some interpersonal experiences. So we'll hear about that. But I love that you at SL are able to offer that kinda support. 'cause people, especially those progressive neurological conditions, could really use all the help they can get. Yeah.
Now someone listening wants to learn more about how to get involved, whether they wanna volunteer or whether they wanna try to receive services. Where can I point our audience to get more information?
Dr. Carol Beckel: Uh, they can look at the PT website. I think the pro bono email address is on there. The
Dr. Kate Oland: Yeah. Okay. Okay. We will find a, I will find a link and put it in the show notes for sure.
Well, my famous [01:06:00] physical therapist friend Carol Beckel, you have some really exciting, uh, things coming up that, although it makes me a little bit sad, um, I'm really excited for you, my friend.
You wanna tell us what's next for the life of Carol Beckel?
Dr. Carol Beckel: Yeah, I will be starting a new position. Um, I will be taking on Dean of Health Sciences at St. Louis Community College and overseeing the health science programs. Nursing is a separate division, so they have their own dean. Um, and I'll be starting that on December 15th, so it was.
Not something I was looking for. A friend called me that works over there and spent the summer kind of thinking about and interviewing, and it's hard to step away after 23 years. It's hard to step away when you creep closer and closer to retirement, but it's also a good time. I was kind of thinking, I'm like, okay, am I gonna do this for another 10 years?
And I could do that. And I love the students and I love the job. This is an opportunity to do [01:07:00] something different and to really dive in to use more of my skillset coming outta my degrees and see students in education from a different lens. And as a lifelong St. Louisan, the idea of even more directly impacting on local healthcare since the majority of students are living in the St.
Louis area and will remain in the St. Louis area, is really exciting. Especially since I've had so much experience with a lot of different healthcare providers in St. Louis. It's um. It's an exciting opportunity. So I'm slowly wrapping up life at SLU and the benefit of being a three-time alumni is they won't forget me and I actually get to officially retire 'cause I'm old enough and I've been there long enough that I can retire and not just depart.
So I like that. Having a little bit of a connection there still.
Dr. Kate Oland: Yeah. And you know, like you said, 'cause I also, tomorrow is my final day on campus as an instructor and it breaks my heart a little [01:08:00] bit. But like you said, you know, uh, we got some new, new opportunities
where you and I are both trying to make the biggest difference we can with the time we got here on this earth.
But you and I will always be daughters of St. Louis University forever. Forever.
Dr. Carol Beckel: That's right. Forever.
Dr. Kate Oland: That's now, yes. I haven't been to a graduation since Beyondi was the president. Do they still say forever? Very emphatically. They
Dr. Carol Beckel: do Uhhuh. It's not the same as Father Beyondi. And, and Dr. Costello did a very nice job in his years there.
Um, he was as emphatic as possible, but there's something to a priest telling you something mm-hmm. That you're gonna do or be forever. That's a different level of gravitas than, um, a, a lay president who is not in the clergy. There, it's still emphatic and you still feel it, but I was, I was glad to have all three of mine pronounced as.
Daughter forever. I felt like it really [01:09:00] was binding when Father Beyondi said it so
Dr. Kate Oland: very
well.
Carol Beckel, I'm so excited for you in your new journey. I can't think of a person more qualified or more ready, more the more qualified with the energy you carry. I'm really excited for your future students, for your new colleagues.
You'll be sadly, sadly missed here at St. Louis University, but you're always gonna be a little voice in my head, a daughter of slew forever. Well, good.
Dr. Carol Beckel: Keep that in there.
Dr. Kate Oland: I'm gonna try my best. All right, Carol, listen, I have loved talking with you today. Thank you so much for your insights, for your time, and from all your students.
We appreciate you for being you. Thank you.
Thank you, Kate. I love watching you grow. Oh, thank you.
Well, we're gonna close out right there. Love you, girl.
Dr. Carol Beckel: Love you.
Dr. Kate Oland: . Wow. I did not prepare myself to get [01:10:00] silver clumped at the end of that interview, and yet, even though Carol and I had very different roles at St. Louis University, it became clear that we were both sitting with many of the same emotions. Both of us stepping forward into new chapters of our lives because earlier this semester, I also turned in my notice sharing that my life has taken me in a direction where I can no longer fully honor the commitment of being an adjunct instructor.
Now, while this role was technically part-time, it held my whole heart. I loved being in the classroom, connecting content to clinical application, watching bright minds light up as they made meaningful connections, and sharing the joy of learning with truly remarkable [01:11:00] students. When I finally worked up the courage to turn in my notice, it initially felt like breaking up with my dear friend and mentor.
Something along the lines of, it's not you, it's me. But in true mentor fashion, my friend and colleague, Brian Elliott, met me with kindness, support, and grace as I navigated this change, but then came the harder part. Breaking up with my students. I actually didn't tell them for several weeks. In fact, I waited for them to ask me which sections I would be teaching next semester.
It felt heavy telling them that I wasn't planning to come back. But no, not long after that, I realized I was also, in a way, felt like breaking up with my alma mater. The only place I ever envisioned myself [01:12:00] teaching. And it was around that same time that Carol shared with me that she too was moving on and that that brought me a lot of comfort because no matter where our paths lead, she reminded me.
That we will be daughters of St. Louis University forever. And just a quick update on Carol. I talked to her this morning and she did start her new job last week as the Dean of Health Sciences at St. Louis Community College. She said she had a great first week,
but then for me, came the final breakup leaving this job. The quietest and the most personal, one of all, letting go of the peace of myself that came alive at the front of that classroom. Though I spent only a few years teaching the relationships I formed and the memories we created will live in my heart [01:13:00] always.
I am profoundly grateful for them and these experiences. So as we head into the holiday weeks, I find myself. Deeply, deeply thankful for the life I've lived, for the mentors who guided me, the mentees who trusted me, and for the seasons that invite us to reflect, to release, and to renew. And speaking of the holidays, if you are anything like me right now, you might be getting a little tired of the same loop of Christmas music that we've been listening to for a few months now.
So along with my boys and the band Carbon Leaf, we want to leave you with a little gift. One of my favorite holiday albums, one that I've loved for over a decade now is Christmas Child by Carbon Leaf. It's Indie rockabilly inspired sound, offers a [01:14:00] fresh perspective on the season, and it never fails. To meet my spirit right where it needs to be.
Here's a sample of one of my favorite tracks, and if it resonates with you, I encourage you to explore the full album wherever you stream your music. Happy holidays, friends, may this season bring you connection, warmth, and just the right song at just the right moment.
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