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Barrett Dorko
25-05-2007, 05:12 AM
It’s been a quiet week in Cuyahoga Falls…

I wonder when it will begin. There’s no way that this additional travel and lecturing isn’t going to affect me in some way, and I doubt that it will be a positive thing. The physical strain alone to a man in the latter third of his life is going to take its toll and I remain vigilant but doubt that I’ll notice the first signs of this. I wonder when it will begin but I’m pretty sure it’s already begun.

I’ve heard recently of a new book titled Never Saw it Coming (http://www.amazon.com/Never-Saw-Coming-Challenges-Envisioning/dp/0226100324/ref=pd_bbs_sr_1/103-9374717-8174203?ie=UTF8&s=books&qid=1180047632&sr=1-1) by Karen Cerulo. The read line on the book cover is “Cultural Challenges to Envisioning the Worst.” A review states, “…it is hard to (imagine future disasters because) adaptive behavior hard-wired into human cognition is complemented and reinforced by cultural practices, which are in turn institutionalized in the rules and structures of formal organizations.” In other words, not only are we naturally optimistic about the future, our institutions encourage this, no matter how often we’ve been wrong and thus unprepared.

I speak a great deal about how certain cultural institutions have failed to help us live our lives with less pain and disability, not the least of which is any therapy program that doesn’t teach modern neuroscience. And if I sound cynical about our profession’s future as effective caregivers for a large percentage of our patients, maybe it’s because of what I’ve seen and heard in every corner of this country. I’ve not noticed any sort change in the knowledge base of my colleagues in the past three years and I can count on one hand the number of new voices heard here with any regularity. This is beginning to wear on me, and running on the treadmill isn’t going to enhance my resistance to it.

But I listen to a lot of radio shows while working outside or walking Buckeye and it’s amazing how one will relate directly to some writing I’m in the middle of. This week on This American Life (http://www.thislife.org/) a reporter recounted her experience of traveling for a while with the legendary George Burns (http://en.wikipedia.org/wiki/George_Burns). She says, “Despite the fact that this is almost precisely the same act he’s been doing for fifteen years, it sounds totally spontaneous, as if he’s making it up right there on the spot. In fact, the act doesn’t vary, but to George it’s an eternal work in progress, and every night he makes microscopic changes. This is how he’s been able to do it for so long.”

Hearing this today I actually grew a little hopeful - mainly because I’ve been doing the same thing with my own act. With any luck (and I should remember not to depend upon that, of course) I’ll maintain my sanity in this way.

Nick
27-05-2007, 04:05 AM
Hi Barrett,

While I know the pace of change is incredibly sssslllllllooooooooooooooowwwwww, I thought it was great to see how much your 'act' had changed in the last 4 or 5 years. I found it especially encouraging to see how many of the contributors to SomaSimple have made their way into your pitch. It may not seem like much in proportion to your efforts, but I think this is a brilliant community that will eventually help transform physical therapy. I know I, for one, am grateful to you for waking me up to the facts of neuroscience and encouraging (okay insisting) me to continue learning and developing on my own. It is a great gift to help someone see that he can teach himself. It is amazing to have those more wise help guide one toward that which is most important. I bet your act gets better every day and I look forward to when I see it again.

Jon Newman
27-05-2007, 04:37 AM
I'm waiting for Barrett to write about an experience while traveling that has him standing on a moving sidewalk in the airport with the song "Remind Me" going through his head as he passes a poster exclaiming "Your physical therapist says 'standing up straight is so easy even you can do it'". (Don't get it? see this (http://www.geico.com/video/airport_h.htm)(broadband)). Polite laughter appreciated.

Although not all change is slow and therein lies the rub. Check this out (http://www.youtube.com/watch?v=1Kh5PoyLS2A)

nari
27-05-2007, 09:28 AM
Barrett,

I wonder if you are planting more nonconscious perceptions than you think. Imagine that in 1-5 years, a percentage of therapists will be thinking at some course or seminar: Ah, that's what Barrett was saying in that class I went to; he was right.

They might not remember your name but will remember what you said.

Nari

Barrett Dorko
27-05-2007, 06:16 PM
I appreciate the kind words, of course.

In the Delta Hotel in Victoria British Columbia the carpet on the floor of the elevator is changed daily to reflect the day of the week. I noticed this as I descended toward the fitness center early this morning, grateful in fact to be reminded that it’s Sunday since my schedule is completely out of whack.

My wife and I are here with my son Alex and his wife Melissa. It is I suppose the kind of weekend he would dream about during his year in Iraq and all it had to offer someone who hunts for bombs and constantly shields his men from danger. Having accomplished that he seems fine to me but I doubt that his calmness isn’t punctuated by an increased watchfulness that is unlikely to leave him entirely. Some stories have leaked out. He manages to make me laugh at them, but within the context of another setting I know they’d be horrific.

In the fitness center the treadmill ran beautifully with one exception; the speed indicator. I’m quite certain I wasn’t running nearly that fast (9.3mph) but that’s where I had to set it in order to keep up with the music on my iPod. “What an odd thing,” I thought. “They’ve actually got a fancy cooler for the towels in this beautiful place but can’t fix the treadmill settings.”

I walked along the harbor after a while and felt this correlation: As therapists are offered ever more beautiful and fancy facilities to work in they become impressed with the wrong things. The numbers indicating the training effect of today’s treatment for painful problems are skewed and don’t reflect what is actually needed but rather only what many imagine our patients need, and, frankly, what we can bill for. Maybe what I’m trying to teach is the shift in this perspective, and I do this with what I sense is very little success.

Alex came by the room a few minutes ago and we planned breakfast. He’d been on the treadmill a little after I was. “That kilometer indicator threw me a little,” he said.

I said, “Oh.”

Diane
27-05-2007, 06:28 PM
Barrett, that is hilarious.

Line M
28-05-2007, 12:58 PM
In the NL therapy centres turn more and more to treadmills, hometrainers and rowing machines for the movement programs set up for chronical diseases like COPD and DM and fibromyalgia. This is a part health and wellness centres easily can take over. The essential difference in PT care is eventually the hands-on and neuro approach.
It's also the difference of depending on parameters and indicators to know what your limits are and to feel and be aware and trusting on your own body to know what your limits are.
When you're on to something good and valuable you want the world to know about it. People eventually WILL know. It just takes some time to get a critical mass. Butler and Shacklock are well received here in certain crowds, but the coin just didn't drop yet.