Confessions of a Physical Therapist

Dear “Lucy,”

I must apologize for something that happened many years ago…  I still remember your story vividly.  I remember how you described your pain – in such simple terms: “I feel like I’ve been run over by a truck – from the moment I wake up until I go to bed.”

I remember your diagnosis – one that was completely unknown to me at the time (back in the day when there was no internet) – fibromyalgia.  Of course, not having the internet isn’t a valid excuse for my lack of expertise… but times were different then.  It wasn’t easy to search for research or information and it most certainly wasn’t easy to connect with colleagues for help.

I couldn’t imagine what it must have felt like to hurt like you described… and I believed my role was to eliminate your pain permanently.

Lucy, you got the worst treatment interventions from me.  At the time, I actually was kind of scared to talk about pain… I mean, what was I supposed to say to you?  You felt like you’d been run over by a truck!  The only thing I knew about pain, at that time, were the supposed modalities that supposedly reduced pain.  Ultrasound, hot packs, electrical stimulation and myofascial release/massage made up the bulk of treatment sessions with you.  If I bombarded your body with all sorts of things that felt good, your pain would just have to go away, right?

Your Experiences Transform You

The webs that we weave.  Yes... we weave webs.  So often I read Facebook relationship statuses that simply state, "it's complicated."  Guess what?  Your life experience sort of complicates matters when you decide to begin physical therapy services.


 Got your cup of java?  Settle down and learn about "Joe."  Joe's web was very complicated... and was very much dependent on how well he'd be able to unweave some of his web to eliminate his back pain.  Joe was a young man in the Army reserve.  The quandary I was in... I knew physical therapy would help him, but in getting him back to life, that meant he was most definitely headed to Iraq.  What if he died?  How would I handle such news?  He had a wife and two young kids... and how responsible would I feel if he died?  I mean, I could stall my normal philosophy of care and make the benefits of physical therapy longer to achieve - which would mean he wouldn't be able to head to Iraq.  He began services with a deadline of 3 weeks to be back to normal and ready to serve our country.   Those of you who know me know I ask whatever is on my mind.  Well, Joe was determined to head to Iraq and he was willing to do anything so he could serve.  Because of his attitude and his strong desire to serve, I had to forget about me and truly focus on getting him as close to 100% as he could be.

Uniqueness

Memories of two patients continue to be etched in my brain.... memories from many moons ago.  It was their experience and the timing of their experience that has helped me evolve as a clinician.

My "No Fear" patient was a 20 something year old male.  The whole world was ahead of him and his life took a huge change after an automobile accident.  In all seriousness, he was lucky to have survived the accident.  He brought in pictures and told me the full story of just what happened during that accident.  Now, what sticks out in my mind are the substantial losses this guy experienced - a spiral effect of sorts.  His car was his "baby."  It was totaled and trashed.  His girlfriend broke up with him.  He had been a bouncer at a local bar and he lost his job.  On top of that he had no health insurance... and sadly, no auto insurance.  He was in a wheelchair unable to walk due to the multiple bone injuries and was beginning services to learn to walk again.  At the time, I couldn't come to grips with his situation... it seemed so bleak to me.  I didn't know at the time if he was just plain stupid or an inspiration.  His tattoo of  "No Fear" said it all... he will forever be engrained in my mind as the "No Fear" boy.  His attitude - oh, my goodness, I am still blown away to this day by his attitude.  The car would be replaced and he'd alter the new car way better than the trashed car.  Girlfriends come and go... he'd have a new girlfriend in no time.  Okay, so he couldn't be a bouncer now, but he stated he'd be back at the bar doing what he enjoyed to do, but for now, he'd find a more sedentary job (and he did).  And the cost of the hospital and surgeries and physical therapy... he would pay that off in time.  And, yep, you guessed it, he walked again.  He hardly ever complained about pain to me... he focused and worked hard... and yeah, he walked.

Contrast this with another gentleman.  He too was in an automobile accident.  He was probably even more lucky than the "No Fear" boy.  Besides the same injuries "No Fear" boy had, this gentleman had also ruptured a major artery in his leg.  His story is different.  He had health insurance.... he had automobile insurance... his wife stayed by his side... Although it was so long ago, I remember thinking how great it was he had so much going for him (you see, I had "No Fear" boy as a comparison).  My role was exactly the same for this gentleman as it was for "No Fear" boy.

Something was different though.  I need to call the second gentleman "Pain Man."  With "Pain Man" I was so excited... I had fresh memories of  "No Fear" boy.  Working with people to get them back to life is very invigorating for me.  This time things were different.  "Pain Man" had a lot more pain.  Sure, he walked again, with pain and with a cane.  "Pain Man" became like family - he was in physical therapy month after month.  He worked hard too... it just took way longer for results.  His pain fluctuated.  He never felt anything like he did prior to the automobile accident.

Over the course of time, I learned something that was different than "No Fear" boy.  The reason for "Pain Man's" accident was because of a drunk driver.  The drunk driver came out of the accident unscathed.  To my knowledge, the drunk driver never contacted "Pain Man," never acknowledged how a choice affected another person and never reached out and apologized.  "Pain Man's" whole life was turned upside down and completely changed all because of a drunk driver.  In hindsight, I kind of think "Pain Man" had a lot more mental turmoil.  I've never been in his shoes, so I can't say, but I know forgiving is never easy... trying to move forward without focusing on losses can't be easy either.

Your stories matter.  I know sometimes I ask what seem to be dumb questions... and I know sometimes it may seem as though I am probing.  Your stories though... your stories help me to help you.  "Pain Man" still haunts me - I was young.  I was too fearful to probe... too fearful to get too close (if that makes sense).  I will always ponder whether I could have changed anything I did or said to have helped him to have moved forward with better results.

photo via Flickr by StreetFly JZ

Post Thanksgiving Excitement

Very infrequently do I share my cell number.  It's not that I don't want phone calls from anyone, it's just that you could say my cell is used more often for outgoing calls than it is for incoming calls.  My lack of communication habits via my cell phone does create anguish for my family.  Seriously, there is a time and place for conversing ... when I'm at work, driving or doing something in the community that just isn't the time to be yapping on the phone. 

Well... my heart went out to a particular patient prior to the Thanksgiving holiday.  There is nothing worse than having pain, being afraid and having no one to walk you through what you can do to alleviate your symptoms.  I know this... and decided to share my number.  (I didn't tell her, "good luck in actually truly reaching me," because it really wasn't the time or place to let her know that I prefer to make calls and not take calls.)