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Barrett Dorko
27-08-2008, 02:15 PM
It’s been a quiet week in Cuyahoga Falls…

I’ve just a few weeks to go before I leave the job that has filled the summer months here in Ohio. The rehab staff is aware of my impending departure and more than once I’ve heard the supervisor ask, “What are we going to do when you’re gone?” I want to answer, “You’ll just go on seeing actual patients and doing real therapy,” but I don’t usually say anything. That’s just a phrase that came to me one day in June as I sat next to an elderly woman, lifting my knees repeatedly as I wished her to do.

Now, I’m not certain that this movement of the leg is actually worth much or that it translates to real improvement on the patient’s part, but it’s what I’ve seen my colleagues do and it fulfills the patient’s expectations of therapy. We all know the drill, and I try to do my part.

When I leave, a physical therapist assistant will be added to the staff and things will return to normal. I have the sense that there will be a lot more knee lifting.

But yesterday I saw a vital and active man in his eighties for the first time. He has a primary complaint of shoulder pain and markedly restricted mobility that came on insidiously a few weeks ago and he was hopeful that therapy would provide some relief. He left with a new understanding of his problem and its solution, an exercise that made sense and helped immediately and a loud “thank you” for what I had done, though I hadn’t really “done” much of anything.

There wasn’t any “real” therapy there when seen from a traditional perspective and I see no reason to believe that any of the therapists working here beyond my leaving will employ any of this thinking or method. What will they do when I’m gone? The answer is obvious.

I composed this addition to “The News…” as I drove home last night and this morning my son Alex sent me a poem from his tiny quarters deep in Kirkuk. It’s titled A Dozen Finches and written by Kay Ryan.

A dozen Finches
in unison
dip down,
tilt their wings,
swing up
sink to their
chosen inch
of branch, and
settle, neat
and silent in
their arrival,
intent upon
that courtesy
that marks the
nearly weightless,
careful with
the imposition
of their half ounces

This is what the clinic I currently work in will miss – my courtesy, the nearly weightless nature of my method, and the perfectly natural response of the patient in pain.

It’s available, but, in the end, most don’t consider it “real” therapy.

I’ll fly away, and land somewhere else.

nari
27-08-2008, 10:54 PM
Wherever you go, Barrett, think of that poem and the impact of its weightlessness. Kay Ryan understood 'real' therapy.


Nari

ian s
29-08-2008, 11:02 AM
http://www.sanfranmag.com/story/let-there-be-lightness

last paragraph --first page seems to fit the bill?

ian

nari
29-08-2008, 01:31 PM
Certainly does, in my books.
I also recall someone (Carl Sagan??) saying that looking up at the sky gave him a sense of lightness, which had nothing to do with his scientific mind or any supernatural belief. But it was therapy (my words).

Nari

Barrett Dorko
29-08-2008, 01:48 PM
Ian,

You’ve done it again. This is a wonderful exposition of the poem’s author and I hadn’t yet looked that far into it. I hope it generates some more comment in this thread.

Meanwhile, the phrase “bearing witness” has been going through my head lately as I work with patients who display their own way of recovering (or not) despite all the “therapy” offered them, physical or otherwise. Commonly I spend most of my most productive time simply watching things play out. I might have my hands on them for a few moments there, but mostly I just watch – I keep them company. Please don’t tell the insurance companies.

I googled “bearing witness” and got 942,000 hits, the fourth of which was this essay (http://www.selfhelpmagazine.com/articles/wf/bearingwitness.html) by Tom Heuerman. I thought the following lines could have easily been written for our profession specifically:

The actions we take when we bear witness don’t have to be large. We change our world by bearing witness to what is in front of us daily. Because everything is interconnected, nothing is trivial or inconsequential. Our small moments of authenticity have large impacts that we are often unaware of.

Indifference is the alternative. What is the virtue of our shared indifference? Why do we want to pretend that what is real is unreal? Our mindlessness is the most fundamental harm we do to ourselves.

It’s all right there, and the key therapeutic ingredient is the nearly weightless nature of our touch.

Diane
29-08-2008, 05:39 PM
She is definitely into the 'space' and not the 'stuff' of being made of matter.
I like this. I think my eighty-five year old mom would too.