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Barrett Dorko
17-04-2007, 03:07 PM
It’s been a quiet week in Cuyahoga Falls…

True story: I wakened quite early this morning, carried my luggage to the car, took Buckeye for a walk and then fell asleep in my recliner. I dreamt that I wakened suddenly on a plane. I was in a window seat and we were taxiing toward the runway. Looking around, I tried to remember boarding but couldn’t. I had no idea where I was headed.

Today, I’m headed toward West Virginia. The flight will be short and my time in the hotel long. I will be alone until tomorrow when I begin to set up the table at the front of the classroom and deal with the person hired from Kelly Services to help with registration. Before then I don’t imagine I’ll engage in any actual conversation.

About 8AM I’ll begin. “Good morning. I’m Barrett Dorko and this is Manually Managing Pain sponsored by Cross Country Education. I’d like to welcome you to wherever it is I am today.”

I’m on the treadmill a lot these days. These devices vary from one hotel to the next but most contain a display that shows where you would be on a quarter mile track as you progress. As it happens, I was the best quarter miler on my ninth grade track team. I remember coming in third several times in meets with other teams, and these were my best finishes. It was hard to recruit anyone else to run this race, and though the effort required to sprint this distance is considerable, I’m not certain that that was the main reason so few tried it. I think it was something else.

On a treadmill things can get dreamy, especially if you listen to music as I do. These days I start to Celestial Soda Pop by Ray Lynch and go on to repeated recordings of Home by Marc Broussard. I try to finish with I’m Alright by Kenny Loggins. The images each brings to mind are distinct and compelling for me, and they make the run more like a dream than anything else. And it’s a dream I can control.

The image of the track before me contains a long straightaway that I know would be the furthest distance from the spectators. I remember how quiet it was there, how the only thing you could hear were the sounds of pounding feet and labored breathing. There I always felt completely alone. The effort I expended during this portion of the race would determine how I might finish; not necessarily ahead of anyone else, but how strong. Sometimes I chose well, sometimes not.

I think it was the far side of the track that my teammates were avoiding though we never spoke of this. It was a scary place, and there wasn’t any music to distract you, comfort you or encourage you.

These days before I teach I imagine myself there again.

rfairbanks
17-04-2007, 05:48 PM
Barrett,

I have always been drawn to "the far side of the track". Growing up I read stories, both fictional and biographical, about people who excel in part because of the time they spend there. However, I suspect that many of our patients would prefer, as your teammates did, to mingle in the stands. Yet their pain forces them to stay on the far side, isolating them from their colleagues at work, friends and even family.

Should one of our goals be to help them return to the stands, or help them embrace the far side?

Rich

Diane
17-04-2007, 06:05 PM
Should one of our goals be to help them return to the stands, or help them embrace the far side?
I think the answer to that is "yes (http://www.amazon.com/Far-Side-Gallery-Gary-Larson/dp/0836220625)".

Barrett Dorko
18-04-2007, 03:53 AM
Rich,

Thanks for the reply.

Diane,

I've in the past referred to myself as "the Gary Larson of physical therapy." I know I wrote a column about this somewhere here.

I’ve written in the past about how it’s thought that while emotional pain may bring us together, and by extension, might respond well group work of various sorts, physical pain separates us from others. The novelist and poet John Updike said this of pain’s ability to isolate us: …Pain… shows us what seriousness is…And shows us too, how those around us cannot get in; they cannot share our being.

Maybe the discomfort and loneliness on the far side of the track taught me something about pain that helped me understand my patients. I have a sense as well that my nearly instinctive rejection of group exercises and generic protocols of care for painful problems has something to do with that running.

Diane
18-04-2007, 04:16 AM
My sense is, once patients know how to deal with their pain (once it is back inside their "locus of control", and they are less scared of it) the more tolerance they develop for finding themselves on the far side, because they know they aren't usually too far from the stands most of the time after all.

Barrett Dorko
19-04-2007, 02:24 PM
Diane,

I agree entirely.

At the moment I’m seated in a cavernous ballroom in a fine hotel in Lexington Kentucky. This room could contain 75 students easily and I’ve taught classes larger than that on a number of occasions.

Today there a total of four students on the list of those expected. Some combination of factors, not the least of which is my lack of popularity in Kentucky, has resulted in the possibility that this will be the smallest group I’ve instructed in my career. When I saw that this was going to happen I was at first a little shocked and panicky. Now, sitting in this enormous venue alone I feel, well, silly.

This is truly “the far side of the track” for me today, and I can’t help but think of this story (http://www.washingtonpost.com/wp-dyn/content/article/2007/04/04/AR2007040401721.html?hpid=topnews) that Sebastian found and provided for us on the Manual Magic (http://www.somasimple.com/forums/showthread.php?t=3407) thread.

I can hardly compare my skills to those of Joshua Bell’s, but I know that today I’ll put everything I’ve got into the teaching of this work. The fact that I’m being almost completely ignored doesn’t change that.

Jon Newman
19-04-2007, 02:33 PM
Only 200 more meters Barrett. Then the pause that refreshes.

Jon Newman
20-04-2007, 04:46 AM
So how did it go through the second turn?

Barrett Dorko
20-04-2007, 05:09 AM
Ya know - it wasn't bad. Once I got over the initial feeling things went about as usual. I slightly altered the emphasis, but I ordinarily do that anyway.

Tonight I'm in Louisville. Those 12 people in tomorrow's class will look like a mob.

Just returned from dinner with Chance Mobley, a student from 2 years ago and a contributor here.