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The following just appeared in the December '07 issue of PT Magazine, an organ of the American Physical Therapy Association. This Is Why is a back page essay they've been running for a few months, each written by a therapist explaining something about the origins of their career. I wrote this a few months ago and was asked to copy it here by a few who don't have access to it otherwise.
This Is Why
by Barrett L. Dorko, PT
Berta’s Passion
The contagious joy of “dancing.”
I read recently of a man who became a physicist so his work might “provide cover” for his actual goal—to build a time machine. As I read this, I was struck by how easily I might say the same. I am a physical therapist, and I introduce myself as such to anyone who asks. But I always feel a strong desire to explain more fully what that term means—to me, anyway.
In 1973, while a student at Ohio State University, I drove a rickety car from Columbus to New York City to see a lecture by Berta Bobath and her husband Karel—the physical therapist and psychiatrist, respectively, who founded neurodevelopmental treatment (NDT) for cerebral palsy and other developmental disorders. I remember Berta standing tall in front of about 300 of her peers, perfectly confident and almost glowing with a zeal for her work that I’d never seen in anyone.
Even then, I knew that the provisional knowledge offered by truly scientific investigation really shouldn’t result in such abundant confidence, and that I probably should have been suspicious. But on that day, Berta’s passion overwhelmed all that. I haven’t been the same since.
I watched quietly as she handled the patients brought to her, most of them complaining of pain. Years later, the physical therapy historian Jay Schleichkorn, PT, PhD, allowed me to contribute to his book The Bobaths: A Biography of Berta and Karel Bobath,1 and I wrote this: “I watched [Berta] Bobath handle others. Years later I would read Oliver Sacks’ description of a highly regarded medical colleague: He understands patients as nobody else does. When he works, you see a binding-together of patient and practitioner in learning, teaching, communicating, and understanding. There is really no technique—just an amazing display of perception and attendance to the present moment, and a perfect willingness to change contact and instruction as dictated by the patient.2 This is precisely what I saw as Bobath ‘danced’ with the patients.”
I soon was to find that few of my colleagues shared my enthusiasm for this sort of care. Eventually I concluded that Berta’s method lacked two essential elements most manual practitioners insist upon—coercion and judgment. She didn’t take her patients where she wanted them to go; she followed them. Her touch was a catalyst for processes within the nervous system that she barely understood. Her method had run ahead of the neuroscience necessary to explain it, so she let her husband Karel worry about that, and she never presented without referring to his understanding.
Soon after joining a private practice in northeast Ohio, I attended a basic course in joint manipulation taught by the legendary Stan Paris, PT, PhD, FAPTA. His method of handling could hardly have been more different from Berta Bobath’s, but again I saw a fearless and open display of certainty and passion for an idea and method, and again was irresistibly drawn. I became the first physical therapist employed by Stan at the Atlanta Back Clinic in 1975 and spent the next 4 years immersed in the world of manual care as it flowered in North America. I was fortunate to have been present and a participant in huge shifts and battles that took place within our profession. I’m convinced there never will be another time like that.
In 1979 I returned to Ohio and watched my mother move unconsciously yet therapeutically as she succumbed to Alzheimer’s. Eventually, I sat beside my father’s deathbed as he composed a poem about the care he’d received from his physical therapist—distinguishing this from the therapist’s training—and these two insights became major themes in my practice and my writing.
I see patients no longer, but I often travel and teach, relating what 35 years of seeing patients taught me. I often talk about Stan, and when I’m feeling especially courageous I relate the lessons I learned from my parents. But it is Berta Bobath’s passion and courage that truly compels me, and I always speak of that.
She is where my career began. I feel her presence still.
Barrett L Dorko, PT, a longtime private practitioner, now teaches workshops for Cross Country Education. He lives in Cuyahoga Falls, Ohio.
References
1. Schleichkorn J. The Bobaths: A Biography of Berta and Karel Bobath. Tucson, Arizona: Therapy Skill Builders; 1992.
2. Sacks A. Awakenings
SIDEBAR BOX
This Is Why spotlights a particular moment or incident that either propelled the writer toward a career in physical therapy or reconfirmed the reasons why he or she became a PT or PTA in the first place. APTA members are encouraged to submit brief essays (600-800 words) to Eric Ries, associate editor, manuscripts, at ericries@apta.org. If possible, please include a “mug”-style photograph (.jpg file). Submissions are subject to editing. Authors of pieces selected for publication will be notified.
This Is Why
by Barrett L. Dorko, PT
Berta’s Passion
The contagious joy of “dancing.”
I read recently of a man who became a physicist so his work might “provide cover” for his actual goal—to build a time machine. As I read this, I was struck by how easily I might say the same. I am a physical therapist, and I introduce myself as such to anyone who asks. But I always feel a strong desire to explain more fully what that term means—to me, anyway.
In 1973, while a student at Ohio State University, I drove a rickety car from Columbus to New York City to see a lecture by Berta Bobath and her husband Karel—the physical therapist and psychiatrist, respectively, who founded neurodevelopmental treatment (NDT) for cerebral palsy and other developmental disorders. I remember Berta standing tall in front of about 300 of her peers, perfectly confident and almost glowing with a zeal for her work that I’d never seen in anyone.
Even then, I knew that the provisional knowledge offered by truly scientific investigation really shouldn’t result in such abundant confidence, and that I probably should have been suspicious. But on that day, Berta’s passion overwhelmed all that. I haven’t been the same since.
I watched quietly as she handled the patients brought to her, most of them complaining of pain. Years later, the physical therapy historian Jay Schleichkorn, PT, PhD, allowed me to contribute to his book The Bobaths: A Biography of Berta and Karel Bobath,1 and I wrote this: “I watched [Berta] Bobath handle others. Years later I would read Oliver Sacks’ description of a highly regarded medical colleague: He understands patients as nobody else does. When he works, you see a binding-together of patient and practitioner in learning, teaching, communicating, and understanding. There is really no technique—just an amazing display of perception and attendance to the present moment, and a perfect willingness to change contact and instruction as dictated by the patient.2 This is precisely what I saw as Bobath ‘danced’ with the patients.”
I soon was to find that few of my colleagues shared my enthusiasm for this sort of care. Eventually I concluded that Berta’s method lacked two essential elements most manual practitioners insist upon—coercion and judgment. She didn’t take her patients where she wanted them to go; she followed them. Her touch was a catalyst for processes within the nervous system that she barely understood. Her method had run ahead of the neuroscience necessary to explain it, so she let her husband Karel worry about that, and she never presented without referring to his understanding.
Soon after joining a private practice in northeast Ohio, I attended a basic course in joint manipulation taught by the legendary Stan Paris, PT, PhD, FAPTA. His method of handling could hardly have been more different from Berta Bobath’s, but again I saw a fearless and open display of certainty and passion for an idea and method, and again was irresistibly drawn. I became the first physical therapist employed by Stan at the Atlanta Back Clinic in 1975 and spent the next 4 years immersed in the world of manual care as it flowered in North America. I was fortunate to have been present and a participant in huge shifts and battles that took place within our profession. I’m convinced there never will be another time like that.
In 1979 I returned to Ohio and watched my mother move unconsciously yet therapeutically as she succumbed to Alzheimer’s. Eventually, I sat beside my father’s deathbed as he composed a poem about the care he’d received from his physical therapist—distinguishing this from the therapist’s training—and these two insights became major themes in my practice and my writing.
I see patients no longer, but I often travel and teach, relating what 35 years of seeing patients taught me. I often talk about Stan, and when I’m feeling especially courageous I relate the lessons I learned from my parents. But it is Berta Bobath’s passion and courage that truly compels me, and I always speak of that.
She is where my career began. I feel her presence still.
Barrett L Dorko, PT, a longtime private practitioner, now teaches workshops for Cross Country Education. He lives in Cuyahoga Falls, Ohio.
References
1. Schleichkorn J. The Bobaths: A Biography of Berta and Karel Bobath. Tucson, Arizona: Therapy Skill Builders; 1992.
2. Sacks A. Awakenings
SIDEBAR BOX
This Is Why spotlights a particular moment or incident that either propelled the writer toward a career in physical therapy or reconfirmed the reasons why he or she became a PT or PTA in the first place. APTA members are encouraged to submit brief essays (600-800 words) to Eric Ries, associate editor, manuscripts, at ericries@apta.org. If possible, please include a “mug”-style photograph (.jpg file). Submissions are subject to editing. Authors of pieces selected for publication will be notified.
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