Story time

[Barrett Dorko]

It’s been a quiet week in Cuyahoga Falls…

Some of you may recognize that my salutation for this blog is a mild corruption of Garrison Keillor’s opening for his Lake Wobegone ( http://en.wikipedia.org/wiki/Lake_Wobegon) stories. Keillor has been spinning tales about his fictional boyhood town for over twenty years and, as it happens, he’s appearing this evening at Blossom Music Center ( http://en.wikipedia.org/wiki/Blossom_Music_Center). Guess where that is?

Garrison Keillor is, to many, a national treasure. He didn’t become one by virtue of his musical talent, acting ability, good looks or even as a writer of special note. He got there because he could tell stories. And I mean verbally. When he speaks, people listen. They remember. They forget as well, at least, about their own lives for awhile.

As I get closer to that time when I hit the road to teach again I’m considering adding a little more story to my presentation. Those of you who’ve heard me speak know that I don’t do a lot of that because I recognize the problems inherent to any story telling: things get placed out of order, negative aspects of the teller’s behavior often get downplayed, the context is changed or invented to fit the point the speaker’s trying to make and whole speeches are fabricated for the same reason. It isn’t that I don’t like stories; I do. I just don’t trust them – even when I’m the teller.

But a story’s power to inspire, make a point, entertain and teach all at once is undeniable and I need to soften my stance here. I’ve a few to tell: there’s my sitting in the audience before Bobath and Feldenkrais, my first contact and years with Stan Paris, my isolation and revelation for 28 years in a solo practice (the revelation was of the slow motion variety, I should add), my return to staff work in a nursing home. I’ll have to work on some of them in order to make each what it might be. I’ll have to lie a little. I’ll have to forget that I’m lying. As in war, in story telling, the first casualty is the truth.

I have noticed that Keillor’s stories never turn in the directions one might expect though there’s no single dramatic turn to be found. You start here and you end up in a totally foreign place, not quite knowing how he got you there.

Maybe that’s the secret of his success. Maybe I’ll try that.

I suppose this is as good a place as any to try it out.

More soon.

[nari]

The first casualty in storytelling is indeed the truth; and the story gets further away from the truth exponentially as years go by. I'm aware of this at present as I am trying to make sense of my father's 'memoirs' of his rather dramatic life in two hemispheres starting in 1910, and am convinced I will never know the truth - only his truth.

But he made a good story out of his life.

Nari

[Barrett Dorko]

I once began a few workshops in this way:

Soon after moving from Atlanta to our new home in Ohio we had carpeting laid in my daughter Jennie’s bedroom. I noticed that the door dragged along the pile and, after some thought, decided to alter the door. So I took it off its frame, carried it down to the basement held it clamped between my knees and worked on the end with a wood plane.

The wood grain ran in several directions and the tool was by no means ideal but I was young and big and strong and determined. I didn’t let the effort, sweat or painful positioning deter me and I shaved off what I felt would be sufficient length of the door to clear the carpet.

I hauled it back up the stairs and set it in place only to find that I had been working at the top of the door.

Though young, I already understood that expressing any sort of rage would be useless, and I soon came to understand that this event was a metaphor for my career as a manual therapist to that point. I often simply went after the thing in my hands in much the same manner; no real thoughtfulness, no respect for what it might be telling me and always with overwhelming force (or, at least I imagined it so) at my command.

I began to change my approach and then my actual method. I began to think first.

Jennie’s door is still a little short at the top.

[Diane]

This is a great story Barrett. I look forward to more.
Sounds like you had no problem with 'knowledge translation.'

[EricM]

Story Telling and Science (http://scienceblogs.com/cortex/2008/06/storytelling_and_science.php)

[Diane]

Link to the webcast discussed in Eric's last link. (http://pr.caltech.edu:16080/commencement/08/bb/bb.html)

[Barrett Dorko]

On the evening before President Kennedy was shot in Dallas Dick Maxwell lined up at wide receiver for his fraternity team on the intramural football field at The Ohio State University. “Back then those games were little more than organized fights,” he once told me. He caught a touchdown pass, the ball cradled beneath his chin – and then an opponent pounced.

Eight years later I walked into Dick’s room and began doing a job that would become central to my life. I remember it more clearly than any girlfriend, any good time I had with friends, and any class I took.

A former Marine and very sure of what he needed and wanted, Dick wasn’t always patient at 5AM and, in fact, he wasn’t my patient; he was my boss. At 5 I wasn’t always fully awake either, but we found our way. With virtually no hand function and just some weak biceps action available, Dick could write a bit and turn on his speaker phone but his arms were used primarily to gesture. I learned to read his face, the tilt of his head, the subtle changes in the movement of his diaphragm.

Each morning, and I mean seven days a week, I did what attendants do. In ’92 I wrote: “Each day for 3 years I handled limbs that could not be consciously moved…(and) if not moved with a certain care and respect they would object violently. I came to understand that the body that is not consciously moved is yet not perfectly still. In a way unique to itself it always remains reactive to the intent of our touch.”

Today I handle patients in a fashion that reminds me of those mornings with Dick, and I think about how the skills we acquire in life aren’t always the ones we might choose.

Sometimes we're just looking for some way to pay the rent or the tuition, never imagining that the lesson comes in something we're paid to do.

[gerry]

Barrett,

I wondered about this thread for a while, but never got around to posting what I was wondering. After reading your writings for years, it seems to me you are a wonderful story teller. I agree that stories can have the advantage of inspiring as well as teaching. I think it is possible they could encourage your students to use and put into practice more of the information they get from your course.

You said you have not used stories in your classes, but do you consider stories to be part of your writing?

[Barrett Dorko]

Gerry,

Yes, I write them better than I tell them.

I've a few more welling up. More soon.

[Barrett Dorko]

Seated in a fine hotel in downtown Montreal I watched as Stan Paris charmed us, scared us, inspired us and held himself in very high regard. It wasn’t that he had no legitimate claim to this, but the concept of self-deprecation seemed completely foreign to him. It was 1974, and I find today he’s pretty much the same.

I found myself wanting to be noticed, and though this wasn’t new to me, the fact that I was a good deal younger and less experienced than just about everyone else in the room wasn’t lost on me. The World Congress of Physical Therapy was to begin the following week and therapists from several countries surrounded me, including a friendly but slightly enigmatic Chilean named Rocabado ( http://www.unab.cl/fcr/curric/rocabado.htm). We became friends, and our futures were forever intertwined with the self-confident New Zealander.

I remember thinking within the first hour of this nine day workshop, “I want to teach this one day, and I want to work in the clinic this guy imagines he will build.”

It all came true, and in December of this year, 34 years later, I’m to stand before the faculty of Stan’s university and explain what it is I understand and demonstrate what I do.

I’ll begin with this story, but then I’ll have to show them how wrong they’ve been - including Stan.

[Bas]

Oh my. Barrett, you have an unerring talent to put yourself in the crosshairs, don't you? You have brass ones, for sure. A very adventurous opportunity, and I wish I could be there to look around me and see what happens to the audience when you speak.

Will Mariano be there too?

[gerry]

Wow! I can't wait to read the story written about that class!

[Barrett Dorko]

Mariano won't be there to my knowledge. This six hour workshop for about a dozen faculty is being orchestrated by Stan Paris and Katherine Patla. I prepare a little bit each day and though it would be nice if they read something beforehand I've made several attempts to engage them on Soma Simple to no avail.

If anyone out there has any advice I'd be interested. This will not be my usual class or audience.

[EricM]

This will not be my usual class or audience.
If their indifference to appearing publicly here is any indication, in many ways I don't think they'll be all that different from usual. How do you think they'll be different?
Speak to them as peers, your equals, and I would expect them to respond to you the same. They are just people after all. Other than that, I wouldn't go into any great effort to explain how they have things wrong, just stick to your facts and your story.

[nari]

I tend to agree with Eric. Presenting your stories without reference to what's wrong with theirs could have the following effects:

1) Wow, who is this guy?
2) I hadn't known/realised that before...hmmm
3) He's in lala land - hasn't he read about EBP?
4) When's lunch?

This is a real challenge, Barrett. In short, though, I would not mention their errant ways. Just yours, (without the errantcy). Then see, with the post-mortems, what happens.

Nari

[Barrett Dorko]

I probably should have mentioned that it is my intention to simply present what we now know and what they has led me to do, not to point out that they aren't current with their theory and practice. I imagine that a few there might arrive at this conclusion but how they handle that is up to them. Of course, I'll do a brief bit on cognitive dissonance and my personal struggle with it. I have a couple of stories about that, and in them I am not the hero.

Though I expect this group to have read some neuroscience I won't be surprised if they haven't. The course will challenge some because they are teaching something I contend is neither necessary or wise, however effective they might claim it to be clinically. This is common to every workshop.

Perhaps this will be Soma's foot in the door of an institution (The University of Saint Augustine) that has some history and influence in the world of therapy. Ultimately, this is my goal.

It's tough though. I spoke face-to-face to the faculty member there in charge of their online courses and Internet resources after Paris himself introduced me two years ago. This Icelander was verbally quite enthusiastic and assured me he'd join us. I can't remember his name because he never did. An email from me went unanswered.

What do these people want?

[Diane]

They want what they imagine their stripped down, essentialist version of therapy to prevail. Nothing more, mothing less.

[Jon Newman]

Sway: the irresistable pull of irrational behavior (http://brainethics.wordpress.com/2008/07/25/sway-irrational-desires-and-errors/) sounds like a book worth reading.

The first video is commercially but features cleaner sound and is shorter.

Hat tip: Brain ethics blog

[Barrett Dorko]

Jon,

I brought that book home from the library today. Looks pretty good.

Now we have another gift to this thread in the form of the final Radio Lab (http://www.wnyc.org/shows/radiolab/?gclid=CODWioGM5pQCFRYLIgod4jIKRg) this season. Go to the link and listen to Tell Me a Story.

It fits here perfectly.

[Jon Newman]

As usual, Krulwich weaves a good story. This time a story about story. A meta-story. Now in a thread about stories. A matryoshka story.

Cool.

[John W]

Stanley Paris is one of eight founding members of the Academy to which I belong and am a Fellow. While I have tremendous respect for these visionary and charismatic leaders who helped make physical therapy in the U.S. part of the larger world order of orthopedic rehabilitation, I have grown somewhat jaded by the organization's inability to to stay up to date with current neuroscience and pain theory.

I think the inertia has been enabled in large part by the powerful personalities that laid the foundation for what constitutes current advanced practice in OMPT. A tremendous amount of man-hours have been devoted to researching, teaching and legally advocating the right to perform manipulation. Men and women have staked their careers on advancing the right of PT to perform manipulation. Manipulation has become sacrosanct to the AAOMPT. It is the rallying cry around which we gather at conferences. It is the "pop" heard round the world.

Stanley, himself, has traveled the country to assist various groups and individuals to defend, advocate and testify for the right of PTs to perform spinal manipulation. He and Catherine, his wife, have been instrumental in getting manipulation taught to PT students in entry level education, which is now the norm.

Stanley's University of St. Augustine Program in Physical Therapy is a bastion for connective tissue-directed interventions. It is a temple to the "mesodermal" gods. It is Manipulation U.

I have a story about Stanley Paris. It was at a Combined Sections Meeting in Dallas some 10 years ago or so. One of his residency students had prepared a poster presentation that he didn't like. He literally ripped the thing down from the board while people were standing their reading it (I was one of them).

I hope you fare better, Barrett.

[Barrett Dorko]

That's a pretty good story John, and I'm certain it's true. I can't say that much about some other Stanley stories I've heard over the years, or even stories I've heard about myself.

I've had a few graduates from the St. Augustine program in my classes and while nothing negative has come from this, it doesn't appear that anything positive has either. They seem about as computer literate as John McCain and I have yet to see a single one contribute to a conversation here.

Maybe my little bit about cognitive dissonance and its effect will be especially important when done in the presence of so many bright meso-minded people. The fact is, I think about what I'm going to say and do there every day.

[Jon Newman]

A thread, inspired by this one here at SomaSimple (http://www.somasimple.com/forums/showthread.php?t=5828), was started over at Rehabedge (http://physicaltherapy.rehabedge.com/Does_reading_my_posts_make_you_stupid%3f/m_58707/tm.htm). Interestingly, that thread morphed into the topic of stories so I figured I'd provide reciprocal links with this thread for those interested.

[Diane]

Way to "bridge," Jon.
;)

We can all communicate without any individual having to put up with any overwhelming amount of snark.

[Barrett Dorko]

I should look up the word "snark." I was thinking more along the lines of senseless and often completely made up babbling. What I find interesting is the fact that a few find something in Bird's posts to which they can relate - even applaud. Perhaps there's a story in there somewhere these people find compelling. Whatever it is, I can't seem to tell it myself. In fact, I'd prefer not to stray from factual narration to such a degree in order to appear as if I actually knew something or had thought it through.

My stance toward story telling has softened considerably, especially after listening to the Radio Lab podcast referenced a few posts ago. It is a fact that the educational system in Turkey has been swayed from rational thought by a well told and illustrated story and that Galileo's ideas were conveyed effectively through story while Newton's were not. This accounts for the fact that no one attended Newton's lectures. I certainly don't need that.

Perhaps mesodermally dominant thinking and the readily accepted orthodigm got there and remain simply because their stories trump ours. Does McKenzie ever begin explaning what he's done without telling his story? Does Paris? Has the story evolved? You bet.

Working among others these days I've noticed that I carefully avoid listening to their stories and I rarely tell much of my own. I'm convinced that in this way all the lies we tell each other and ourselves will diminish in size. This includes my own lies, of course.

Here's a quote from Longfellow I've always liked and I think it fits here:

If we could read the secret history of our enemies, we would find in each person's life sorrow and suffering enough to disarm all hostility.

[Mary C]

Longfellow was right on. That's a truth that has saved me a lot of grief.

[Diane]

Here is snark (http://www.google.ca/search?hl=en&q=define%3A+snark&btnG=Google+Search&meta=lr%3Dlang_en%7Clang_es) defined. The first one in the list was the snark I had in mind.

[Barrett Dorko]

Sam Keen (http://en.wikipedia.org/wiki/Sam_Keen) writes that the way in which a story is told reveals what the teller wants from the listener. A tragedy requests sympathy, an adventure with the teller as hero or heroin begs us to admire them and a tale with an ironic twist is told in an effort to paint the speaker as just a little smarter than the others – in the last case they want respect.

It seems to me that just about every story can pass through each of these versions or, perhaps, contain bits of each. In any case, I feel that people who always employ the same form no matter the story are kind of pathetic.

Keen suggests that many stories that begin in a manner already described here might eventually morph into something containing humor. Though not all stories are capable of this evolution, humor, when used properly, leads to what Keen calls “embrace” – “a condition of communion and a common feeling between the storyteller and the audience." I know of a few people who do this in a way that can only be described as genius, and they are my models for storytelling.

It occurs to me that my friend Stanley Paris has recently created another story (http://www.somasimple.com/forums/showthread.php?t=5908) he might tell one day.

I wonder what form it will eventually take.

[Mary C]

I like this quote from Wikipedia
"There are two questions you ask in life; where am I going and who's going with me. Don't get them in the wrong order."

He's a person with ideas to explore.

[Barrett Dorko]

Rising gracefully a quarter mile away from the highway on the way to work is a Marriott hotel. Lit from beneath, it glows in the early morning light like a beacon of civility and comfort. Every day I feel it beckoning, and I want so much to be going there.

I drive past, and I plan.

I thought I was through seeing patients. I thought that the steady work teaching workshops would continue indefinitely. I thought that I would become increasingly popular or, at least, the ideas I carried around with me would.

That didn’t work out.

He says, “Bill I believe this is killing me,” as the smile ran away from his face. “I’m sure I could be a movie star if I could just get out of this place.”

From The Piano Man ( http://en.wikipedia.org/wiki/Piano_Man_(song))

I’ve landed in a large facility; a collection of buildings, really, and it is populated primarily by an upper middle class group of well-educated and friendly patients. The staff reflects the good will most here show each other and I’ve always felt welcome and appreciated. From the first week in February of this year I’ve found it possible to carve out a small, individualized practice that emphasized my esoteric knowledge and skills. Those around me have a sense of these but first hand experience has, for the most part, been carefully avoided. I’m just known as “the pain guy” in a department where pain has always meant “the need for a hot pack” and little else. For the most part, “real” therapy is left for others to do.

Billy Joel sings along with my harmonica as I glide past the Marriott each morning. The Piano Man features a harmonica of its own but I’ve added quite a lot to this. Buy a “C” harmonica, turn on the song a start to blow and draw. You’ll soon find that it’s easy to sound like you know what you’re doing.

Margaret lies in her bed just a week removed from a fall that has fractured both her clavicle and hip. She says her neck is “killing” her as her middle-aged son hovers nearby. She prefers to be called “Marge” and I begin to speak of how my own mother preferred “Peg” instead of Margaret. “If anyone had called her Marge she wouldn’t have been very happy,” I said as I smiled and shook my head. As I spoke I began the handling developed over several decades of study and experience. I spoke of what I was doing and, more importantly, what she was doing. Within a few minutes she was much better in a variety of ways and her son was nearly speechless with gratitude. At least, this is what I perceived.

And the piano sounds like a carnival and the microphone smells like a beer. And they sit at the bar and put bread in my jar and say, “Man, what are you doing here?”

One day soon I’ll return to the Marriott. I’ll enjoy the comfort of room service and an easy walk to work. I’ll study each night but the paper work for the week will take about ten minutes to complete. I’ll talk to therapists truly interested in how they might handle the Marges in their own practice. I’ll speak of my time here and remember what it’s taught me.

I can’t wait.

[Luke Rickards]

Barrett,

I like your story about the future.

BTW, I think "the microphone smells like a beer".

[Barrett Dorko]

Well, I always get it right when I'm singing along.

[Barrett Dorko]

Here's a perfect link (http://www.sciam.com/article.cfm?id=the-secrets-of-storytelling) for this thread from Scientific American Mind.

Perhaps a few of you check it out and add some appropriate quotes for this thread.

[Mary C]

Green co-authored a 2006 study that showed that labeling information as “fact” increased critical analysis, whereas labeling information as “fiction” had the opposite effect. Studies such as these suggest people accept ideas more readily when their minds are in story mode as opposed to when they are in an analytical mind-set.

This could have implications in patient education. When I look at "Explain Pain", I see echos of the books I worked with in the children's library( -- a far cry from the "Dick and Jane" series in use when I was taught to read.)

Would this explain the sales power that testimonials seem to have over solid research? :secret:

[Jon Newman]

Why Geese Don't Winter in Paradise (http://isotope.usu.edu/web/1-2/price.htm) by John Price (hat tip: Isotope (http://isotope.usu.edu/index.htm))

[Mary C]

sorry Jon, but the links do not work :-(

[Jon Newman]

Their server may be inoperative right now but the links worked yesterday. My bookmark link doesn't even work at this time.

Try again later. It's an excellent essay.

[Jon Newman]

It's working again. At least last time I checked.

[Diane]

It's working now. Great essay. Thanks Jon.