Barrett Dorko
09-12-2006, 06:08 PM
It’s been a quiet week in Cuyahoga Falls…
On the elevator in my hotel in Houston on Friday I noticed some announcements and bits of information posted. The one that caught my eye was “Yesterday’s Weather.” I had to get out and didn’t take the time to read what it said beneath but felt that I didn’t really need to anyway; I’d been there the day before and I pretty much remembered what it was like. And then I began to wonder why anyone would care about such a thing. It stuck in my head and I told the class that I thought I’d found the hook for this week’s column.
As luck would have it, I found myself standing in the “A” line in preparation for boarding my Southwest Airlines flight for home later that day. Two men in front of me began talking about how the weather might be where they were headed. Then they began to trade stories about the weather here and there that they were familiar with, weather that they’d only heard of, different types of weather in far flung locations, snow removal problems in Detroit, early arriving coldness in central Missouri, the nature of wind driven waves as described by The Discovery Channel last month and other fascinating minutiae about our climate. I could feel my eyes start to cross.
My teaching might commonly be described as “arresting” to many of the therapists attending. Perhaps “disturbing” would be a better word. I don’t think that this is because they don’t understand me or that I’m not easy to listen to though I might be wrong about that. I think it’s because I speak about things related to manual management that no one expects. People arrive totally unprepared, and they have always assumed that chronic pain is driven and perpetuated by forces so vast, powerful, insidious and invisible that they can’t really do much more than blame these things for the failure of therapy to help much.
Therapists expect me to address the issues of secondary gain, malingering, laziness, the repetitive strain inherent to work, insurance policies and productivity mandates that severely restrict any sort of individualized care. Anatomically they wonder about irreversible connective tissue degeneration, pathology in need of surgical repair and painful disease processes for which there is no effective therapeutic intervention possible. I address virtually none of this. Instead, I focus upon the anatomy and physiology that we are perfectly capable of changing with our special knowledge and skill. I talk about understanding behaviors that can be changed rapidly and dramatically with a little specific education. Most of my students aren’t ready for any of this.
To me, the public’s general fascination with the weather isn’t so much about its variability as its absolute inevitability. Each day we are faced with something that has no interest whatsoever in our desire to change it. So, we admire it, complain about it, worry about its future expression and talk endlessly about the ways we’ve seen it change things. The famous line from Mark Twain, “Everybody talks about the weather but nobody ever does anything about it,” is true on several levels.
I think there’s a connection with therapists’ general fascination with the things in their patients and the profession over which they have no control. They talk about them endlessly, and when I’m nearby I can feel my eyes start to cross. Beyond boredom I grow annoyed and wonder aloud why my colleagues don’t put some effort into reading about the things they can change, things like our patient’s physiology and use. It’s not that hard, really.
But once a thing is controllable it becomes less interesting to many, I guess. After all, if they invented a weather machine I wonder how many would favor such predictability and controllable power over this thing that ordinarily gives us such a feeling of community. After all, the two men in my line had never before met, but they conversed continuously for over half an hour about their shared experience. Of course, I’ve seen women do this about shoes, but that’s a whole other column.
Perhaps the disturbing thing about my teaching is its implication that control over many aspects of those things we know perpetuate painful sensation can be had with a little understanding and unique care. In effect, I’m inviting therapists to leave the safety and familiarity of the herd; to forget about the weather for a while, especially yesterday’s.
I show them how to create an environment with their hands and a context with their knowledge and presence that sets them apart from a profession that dwells upon what can’t be changed yet discusses it endlessly and with a great deal of resignation.
Weather talk is “small talk.” None of what I say to my classes can be classified as that. What I speak of is unexpected and its implications are profound.
No wonder the disturbance.
On the elevator in my hotel in Houston on Friday I noticed some announcements and bits of information posted. The one that caught my eye was “Yesterday’s Weather.” I had to get out and didn’t take the time to read what it said beneath but felt that I didn’t really need to anyway; I’d been there the day before and I pretty much remembered what it was like. And then I began to wonder why anyone would care about such a thing. It stuck in my head and I told the class that I thought I’d found the hook for this week’s column.
As luck would have it, I found myself standing in the “A” line in preparation for boarding my Southwest Airlines flight for home later that day. Two men in front of me began talking about how the weather might be where they were headed. Then they began to trade stories about the weather here and there that they were familiar with, weather that they’d only heard of, different types of weather in far flung locations, snow removal problems in Detroit, early arriving coldness in central Missouri, the nature of wind driven waves as described by The Discovery Channel last month and other fascinating minutiae about our climate. I could feel my eyes start to cross.
My teaching might commonly be described as “arresting” to many of the therapists attending. Perhaps “disturbing” would be a better word. I don’t think that this is because they don’t understand me or that I’m not easy to listen to though I might be wrong about that. I think it’s because I speak about things related to manual management that no one expects. People arrive totally unprepared, and they have always assumed that chronic pain is driven and perpetuated by forces so vast, powerful, insidious and invisible that they can’t really do much more than blame these things for the failure of therapy to help much.
Therapists expect me to address the issues of secondary gain, malingering, laziness, the repetitive strain inherent to work, insurance policies and productivity mandates that severely restrict any sort of individualized care. Anatomically they wonder about irreversible connective tissue degeneration, pathology in need of surgical repair and painful disease processes for which there is no effective therapeutic intervention possible. I address virtually none of this. Instead, I focus upon the anatomy and physiology that we are perfectly capable of changing with our special knowledge and skill. I talk about understanding behaviors that can be changed rapidly and dramatically with a little specific education. Most of my students aren’t ready for any of this.
To me, the public’s general fascination with the weather isn’t so much about its variability as its absolute inevitability. Each day we are faced with something that has no interest whatsoever in our desire to change it. So, we admire it, complain about it, worry about its future expression and talk endlessly about the ways we’ve seen it change things. The famous line from Mark Twain, “Everybody talks about the weather but nobody ever does anything about it,” is true on several levels.
I think there’s a connection with therapists’ general fascination with the things in their patients and the profession over which they have no control. They talk about them endlessly, and when I’m nearby I can feel my eyes start to cross. Beyond boredom I grow annoyed and wonder aloud why my colleagues don’t put some effort into reading about the things they can change, things like our patient’s physiology and use. It’s not that hard, really.
But once a thing is controllable it becomes less interesting to many, I guess. After all, if they invented a weather machine I wonder how many would favor such predictability and controllable power over this thing that ordinarily gives us such a feeling of community. After all, the two men in my line had never before met, but they conversed continuously for over half an hour about their shared experience. Of course, I’ve seen women do this about shoes, but that’s a whole other column.
Perhaps the disturbing thing about my teaching is its implication that control over many aspects of those things we know perpetuate painful sensation can be had with a little understanding and unique care. In effect, I’m inviting therapists to leave the safety and familiarity of the herd; to forget about the weather for a while, especially yesterday’s.
I show them how to create an environment with their hands and a context with their knowledge and presence that sets them apart from a profession that dwells upon what can’t be changed yet discusses it endlessly and with a great deal of resignation.
Weather talk is “small talk.” None of what I say to my classes can be classified as that. What I speak of is unexpected and its implications are profound.
No wonder the disturbance.