PDA

View Full Version : Cross Country 46 - Shuttle bus terminal lounge


Barrett Dorko
02-04-2006, 05:58 PM
It’s been a quiet week in Cuyahoga Falls…

Whatever understanding we might have of war comes from imagining and affirming the presences that give war its inhumanity.

James Hillman in A Terrible Love of War

Before I left Tulsa and headed west toward Oklahoma City on Thursday afternoon I was warned several times to watch the sky. High winds and hail were moving in that direction and one guy even described to me how Route 44 acted like a funnel eastward for the tornados that regularly threaten this region, and I-44W was my proposed route. “Keep the radio on AM,” said one young woman. “They’ll warn you sooner than anyone else.” She was smiling sweetly, and that really affected me more than anything else – or maybe it was the prospect of 120 miles of AM radio. Talk about scary.

As it turned out, I never saw a raindrop or even much of a cloud the whole way. I turned on an oldies station after a while and sang along with the FM signal for fifty miles. This is my version of a courageous act. As it turned out, the high winds that had an effect on me were far, far away.

I’ll admit that I’ve been missing him more acutely lately. My son’s difficulty getting to the computer from which he can send email has resulted in no messages for a couple of weeks. Now the phone service from Baquba is unreliable and he understandably saves that time for Melissa as he can. On this last trip especially I felt detached from the reality of his life in Iraq, but the high winds in Chicago changed that, as you’ll see.

Alex sent us a power point slide show earlier this month. It contained images and commentary and I’ve only looked through it about a hundred times. He had one of his men take a photo of him as he returned from hollering at an Iraqi citizen for following his convoy too closely. He took several quarters of Arabic while at Ohio State and knows how to say, “One more time and it will be a shame for you!” which he says “sounds a lot tougher when you say it in Arabic.” The look on his face would scare anyone no matter what language was used, and I am strangely relieved to see that he’s learned how to do this so well.

My departure from the Oklahoma City airport was delayed by almost five hours on Friday and I discovered that I wouldn’t be able to catch a connection to Cleveland until Saturday morning. They told us that high winds off of Lake Michigan had delayed our plane in Chicago and this is where I simply planned to spend the night.

I know that once he returned from sharply warning the Iraqi with his fierce demeanor (to say nothing of his weapon) Alex would return to the command vehicle. It's good for making it down those roads but not so good at accommodating tall Buckeyes dressed in armor on a hot day. He spends long hours crammed into the back on the radio to his men and peering through binoculars for an enemy provided cover by the local citizenry and for explosive devices already covered by the road beneath him. By comparison, after I left Tulsa I just had to look up occasionally and endure some talk radio. Not quite the same thing.

As fathers and sons do, Alex and I share a number of things, and an appreciation for the performances of Tom Hanks is one. In The Terminal Hanks plays a foreigner trapped in an airport because of a conflict on another continent. He searches for a place to sleep and in one particularly funny scene he’s shown trying to get comfortable on airport lounge seating. He fails spectacularly before he pulls out a screwdriver and gets to work modifying it completely.

I arrived in Chicago just before midnight to find many, many others who had been similarly delayed, and we all had the same idea; find a room for the night. Unfortunately, I began my search a couple of hours too late. At 12:30 AM I found myself in the shuttle bus terminal lounge, three heavy suitcases beside me and nothing but rows of hard plastic seats for a bed. It occurred to me that the word “lounge” didn’t actually describe this place though the word “terminal” seemed about right. I thought of Tom Hanks. I thought of Alex, and then I decided to simply endure the night where I was. Dismantling the chairs wasn’t an option, so I folded my large body in a variety of ways throughout the night and waited out the darkness, hoping the high winds wouldn’t keep me from returning home for very long.

Another movie staring Hanks that Alex and I both like is Cast Away, and I’ve written in the past of how it is a perfect metaphor for the work I’ve come to do. This is pretty much a solo performance by Hanks but anyone familiar with the movie would also recognize that “Wilson,” a volleyball fashioned into a head complete with hair and a face composed of Hank’s own blood and sweat, is also a major character. Alone in a dangerous and unforgiving place, Hanks creates this silent partner and then begins to talk to him. Subsequently he survives. Clearly, Wilson is something inside of himself that inspires and directs him. Only by pursuing this internal conversation does he create and endure and eventually succeed in escaping those things that keep him from returning home.

One of the slides sent by Alex is of a simple wooden rack the soldiers construct to hold their gear. For everyone else it’s just a small body with arms and legs but my son has added something else, something that should remind him of who he is aside from the constant warrior he’s become. Perhaps because of this he’ll return to us and find it possible to look at the world without the suspicion and aggression that keeps him safe and will become again the man his mother and I raised rather than always the one this war has created.

Atop the wooden rack my son has placed a volleyball with a palm-print face and I know he has small conversations with it each day. This is so like Alex, and I know it will help.

I thought of this through the night in the shuttle bus terminal lounge, and now I welcome whatever hardship my life might offer.

These things remind me of my son.

Diane
02-04-2006, 06:54 PM
Barrett, coincidentally I just read your essay "Waiting." You were talking about waiting during treatment, quoting Natalie Goldberg.
In Wild Mind: Living the Writer's Life, Natalie Goldberg explains the difference between waiting and procrastinating; "Waiting is something full-bodied. [Having] worked on something for a while you are wise to step back. Waiting is when you are already in the work and you are feeding and being fed by it. Procrastination is pushing aside or putting off. It is thinking the moment is tomorrow... it is a cutting off [that] diminishes you."
You go on to say, "In therapy, there are many opportunities to sense the power of waiting." Sounds like life is presenting even more opportunities at the moment.

Hope you don't have to wait very much longer.. six more months? something like that?

Barrett Dorko
03-04-2006, 02:19 PM
Diane,

The promotional line in The Terminal advertising was "Life is Waiting."

Not sure when Alex will be home for good but a short visit will happen soon.

In my experience, many therapists have very little capacity to wait for anything to happen of its own accord once they put their hands on another. If nothing happens within a second or so they feel compelled to coerce the system in some way. Many find the few seconds it occasionally takes for the unconscious expression of correction to occur dreadfully boring or frought with anxiety. I'm sure more than a few can sense their boss breathing down their neck. Others worry that the patient will question their immobility and why "they aren't doing anything." Still others can literally feel their productivity number dropping.

This is the world of physical therapy today - broken, academically inert, lurching toward meaningless classification systems and terrified of any suggestion we've been massively wrong about many things for decades.

Other than that we're doing okay.

Diane
03-04-2006, 04:52 PM
I consider those moments of waiting after initial contact very productive. I have made an inquiry (knocked on the door) by contacting the skin on the body, and I sit back patiently and wait for the patient's brain to acknowledge me somehow. I am still and expectant; I know it can check me out through its "peephole".. if I check out OK, I'll know it through a palpable change (the patient's nervous system will come to the door). The next step is a conversation. The door can never be opened, for it is the skin, But the patient's nervous system and mine can feel each other through the door. If it's a successful conversation I will have managed to introduce all the possibilities, and the brain will have eagerly carried out all the recommended "renovations" inside.

I don't know what the answer is re: the wasteland part.. I think PT could stand to lose delusions, come of age, be an active deconstruction force, marry current research with old tradition, upgrade its ability to help people... all that, but only individuals who can see themselves doing that are going to be able to do it, by breaking away and letting go of the dysfunction and illusion that is shot throughout the operating culture of PT, which apes the culture that surrounds it. I think our Querencia school is a start. Where did Nick go?

EricM
03-04-2006, 05:31 PM
As I'm reading this I've been asking myself, what if? What if, in the beginning, physio had started out as Barrrett suggests? How would things be different now?

On the Simpsons last night, Homer fell backwards over his garbage can and 'cracked' his back leading to relief of his back pain. He decided to market his 'spinal cylinder' and compete with the chiropractors in Springfield. His practice was doing so well that the chiros became worried and stole then destroyed his can. Unfortunately I missed the ending so I don't know what happened next.

If we had started out on a different footing, would there still be those using spinal cylinders to get them through the day?

None of us would have much to talk about.

eric

Barrett Dorko
03-04-2006, 07:35 PM
Eric,

At Butler's workshop in Chicago three years ago he had that episode set up at the break. I tried to find my own copy then but eventually gave up. Now I find I could have taped it but apparantly I don't watch enough TV. Drat! I mean Doh!

I like your question and hope a few others will answer. I've another:

What sealed our fate?

nari
03-04-2006, 11:11 PM
I can't speak for North America; in Oz there was one event which 'sealed our fate'.
When doctors woke up to the existence of PTs, probably in the 40s and 50s, they wrote what they wanted done, how to do it, and how many times a week.
Autonomy arrived in the mid 70s, but the meme for what the doctor wants done lives on, albeit in subtle ways. A PT makes a decision to treat according to evaluation, but not all PTs trust their evaluation......

I don't think PTs realise this.

Chiros never had to follow orders. They just treated, wrongly or rightly.

Nari

christophb
04-04-2006, 01:06 AM
As a young therapist, I was kind of "born" into the meme of the profession. Kind of like the fish not knowing it's in water. So it's hard for me to pick out the "sealing our fate" bit. All I can know of it is what I read here. If I never stumbled upon the likes of you I might never have questioned the environment of PT. At best I would wonder at times why I felt so uneasy in the clinic.

If I were in the right clinic and saw the right patients for manual therapy I doubt there would be an issue. Usually, when things didn't work out as we were told they would in school I would ask myself "what if I am just a bad therapist" or "maybe I am using the wrong techniques, or doing the techniques incorrectly, or at the wrong time, on the wrong patients, maybe if I held the stretch longer, or went at the joint from a different angle, or identified some imbalance in the muscles, or saw the scapula deviating, or blah blah blah"

The what if's never really helped me then, but reflecting now I can ask, what if I never met Barrett, or Diane, Nari, Jon etc? What if I never became so dissatisfied with the current model? I wonder how many PT's are dissatisfied with it. I meet plenty PT's and physicians who are as happy as clams with the way things are. I might realize the value of "what if" but do they? Should they? Will they? Are they deluded? Am I?

Chris

nari
04-04-2006, 01:39 AM
Chris

Life's full of what ifs :) If I'd known back before Uni about my interests now, I wouldn't have touched physiotherapy. But one doesn't know, as years unfold, how things can change.
I agree that many PTs are perfectly happy with the status quo, seriously believing/understanding that their interventions are the factors that lead to improvement in a patient. My age-old dilemma has always been:
They would have recovered anyway, given time.
This is certainly true for some, not for others. I consoled myself that I could do something for the others. Probably that is what kept me sane...or what my perceptions of my own sanity are.

Delusion depends on where one is standing. I think some PTs are definitely deluded, working with a false sense of security that they really help people get better, even if only for one to two months, by their interventions, eg electrotherapy and exercises.
Some think I'm deluded and out on the fringes of caregiving, ignoring all the wonderful RCTs and other so-called EBMs.
Some actually think my understanding of processes in the business of treating patients is great; but it's not for them. They are quite happy with status quo.

Back to 'what ifs'..if I hadn't abandoned physiotherapy for 10 years and stayed being a research technician instead of returning to physio...who knows.
I could still be removing thymuses from tadpoles for urea assays and extracting DNA from rat livers. I might have been a PhD in biological sciences and writing esoteric papers in Nature. Or ended up selling encyclopaedias.

Who knows!?

Nari

Bas
04-04-2006, 02:16 PM
Ever since someone introduced me to the concept of mindfullness, waiting (for ANYTHING) has become a very interesting and enriching experience. I still have many occasions where I am not mindfull and get antsy and cranky....Especially waiting for PTs to wake up and smell the brain and nervous sytem...

Barrett Dorko
04-04-2006, 06:24 PM
I’ve been thinking quite a lot about this “sealing our fate” issue since I asked the question. This is what’s come to me so far.

PT’s rise to prominence in rehabilitation began with our role in response to the polio epidemic. It was amazing work done by dedicated therapists, but this specific entity (the polio virus) led to a problem dominated by weakness that to some extent could be resolved with effort. PTs choreographed that effort to great effect and were rightfully raised up as a lynchpin of rehabilitation. Unfortunately, effortful movement was attached to the profession’s presence and usefulness. We literally became what we did and not who we were.

Despite the subsequent success of alternative approaches to neurological disorders by Bobath and others our own lack of interest in neurology generally has allowed us pretend that the lessons regarding effort post-polio are still relevant. They aren’t, of course.

So, I think the very thing that accounted for our rise has also led to our downfall.

Diane
04-04-2006, 09:46 PM
So, I think the very thing that accounted for our rise has also led to our downfall. The rise and fall pattern of professions, peoples, nations, the Roman Empire.. the seeds of the inevitable demise are present from the beginning.

I'm glad we are reinventing our profession here on somasimple. Do you think we'll need a new name for it? Or should we keep the ones we have?

Barrett Dorko
04-04-2006, 10:24 PM
Diane,

A new name? Can you imagine the paperwork?

In case any of you out there who know me need a laugh I thought I'd tell you that I just got a letter from one of last week's students telling me that I needed to take a Dale Carnegie class in "How to win friends and, well, you know. Can you see me there?

In any case, aside from the profession being in a tremendous amount of turmoil and distress and how it got there despite our initial bright promise, I have another question:

How does a 55-year-old man tolerate a hard plastic seat that ends at about L2 through the night without pain? I'm the man so I can vouch for that part.

nari
04-04-2006, 11:48 PM
Yes, Barrett, I can see you in a Dale Carnegie class paying close attention. ;)

I've advocated changing the name of our profession for some years and there have been some interesting threads on that topic a couple of years ago.

How does someone tolerate a hard plastic chair all night?
A glib answer is he has plenty of padding; his own body air bag.

As that is not the case here, it's an excellent adaptive potential.

nari

Bas
05-04-2006, 01:40 PM
Barrett, you and I are the same age, and from my experience: I have no pat answer to your question about the plastic seat. I am sorely lacking ANY padding.
I know the seat you speak of, intimately. It can be found at any airport....I tolerate its existence, but interrupt my relationship with it very frequently. I leave it often for my own benefits, ignoring its needs completely; only to return to it briefly for my selfish purposes (resting my sorry behind). I don't allow it to control me or my body, and make sure I stake my claim to independent movement. I clearly express myself: "I can live without you!" Clearly, my assertiveness training is paying off.
We will never be friends, regardless of how many Dale Carnegie courses the seat and I take. The seat remains rigid and immobile. Hey, that sounds like that recent student....

Barrett Dorko
05-04-2006, 02:31 PM
Bas,

Your approach is certainly reasonable and obviously works. Ideally, we can create a system that is tolerant of the stresses placed upon it, and often this includes sitting on surfaces specifically designed to keep us from sleeping. I had to sleep. When I teach I notice that many students are pretty good at this as well. Impressive.

Being the rather obsessive person I am I've been looking into Carnegie's career. The word "rich" appears a lot, and I've not seen a single reference to his training that doesn't promise riches for those who apply his principles. Despite Carnegie's reputation for charity I can see no indication that he gave away any money that he actually needed personally and they didn't call early twentieth century industrialists "robber barons" for nothing. They melded machinery and people and turned them into revenue streams. Perhaps Carnegie's genius lay in his ability to convince his workers he respected and cared for them - and for all I know he did. But his continual interest in and appreciation of others isn't necessarily what everyone else can do without faking it a great deal of the time. Doesn't sound healthy to me.

I am truly interested in others when they show me something that is interesting to me and I don't feel that turning my patients into my friends and admirers is either appropriate or therapeutic. I would say the same of my students.

I have met many PTs who seem convinced that if their patients "like" them that they have done their job. I'm not exaggerating. Having accomplished that, these same therapists never read a book, hunt down an article or follow the amazing discussions easily found on the Internet. These therapists also look for teachers that don't challenge anything they've been doing and are especially happy with nothing other but joyful acknowledgement of their existence by an instructor who doesn't end up teaching them much of anything.

I'm not one of those guys, and the word "rich" will not be found anywhere in a description of my career.

Think these two things are connected?

Barrett Dorko
05-04-2006, 06:19 PM
I'm wondering how many of you noticed that I managed in my last post to confuse Dale Carnegie with Andrew Carnegie. Since Andrew was the industrialist who actually hired the Pinkertons to shoot his striking workers I presume he didn't have the same attitude toward others that Dale did. Still, it was an honest mistake and may lead toward something I've yet to write.

As Emily Litella used to say on Saturday Night Live after making precisely this kind of error: "Never mind."

Diane
05-04-2006, 08:21 PM
Do you mean, Roseanna Rosanna Dana played by Gilda Radner?
I'm not familiar with Emily Letilla..
Never mind..

Barrett Dorko
05-04-2006, 08:31 PM
No, I mean Emily. Radner portrayed her too. Very hard of hearing, she would be confused about what was said and get going on a rant only to be stopped and corrected eventually by another character who had grown quite annoyed with her. I recall her carrying on about "eagle rights" for a while only to discover someone had actually said "equal rights."

She'd smile sweetly and say, well, you know. I can still hear it.

Jon Newman
05-04-2006, 08:31 PM
Hi Diane,

Here's a link for Emily Litella (http://en.wikipedia.org/wiki/Emily_Litella).

Barrett, hilarious.

Diane
05-04-2006, 11:40 PM
I remmber now. I thought she was Roseanne.. (never mind.. :))

Jon Newman
25-12-2007, 01:15 AM
I really planned to add this link (http://www.overcomingbias.com/2007/12/procrastination.html) to Barrett's thread titled Waiting (http://www.somasimple.com/forums/showthread.php?t=1752&highlight=procrastination) but I can't add to that thread anymore. This was the next best thread as Diane references it in post #2.

The new year is coming.