bogeyandruby

Random stuff, reflections on the meaning of life and death, humour, self-deprecation, a bit of bad poetry.

Compassion: “…to put ourselves in somebody else’s shoes, to feel her pain as though it were our own, and to enter generously into his point of view. Compassion can be defined, therefore, as an attitude of principled, consistent altruism.”~ Karen Armstrong from Twelve Steps to a Compassionate Life.

I went on a home visit today and found the client, who was discharged from hospital five days ago, in a state of complete and utter despair. Because of bureaucracy and budget cuts, her case worker has to wait a week before presenting this client’s basic quality of care needs to a manager. And even then, there is no guarantee she will get services.

I find it appalling that qualified healthcare professionals have to justify why a handicapped client sitting in her own bodily functions needs help. Unfortunately, it’s the higher-ups sitting in their offices that wield the power. I’m not saying they’re all without empathy. But there is a necessary detachment that is only possible as one moves up the management ladder, further away from the human story.

I truly wish it were the other way around. A process whereby deciding to veto services makes THEM accountable to the client. And while they’re explaining things to the client, to my client, might as well hand her that box of Kleenex as she weeps in humiliation.

I did not do a physiotherapy evaluation today. Instead, I held out a box of Kleenex and rummaged for facecloths and towels and garbage bags. I cleaned up a mess that started out as a rumour and is now a big fat lie.

I’ll probably get in trouble for this post. I don’t care. The Hippocratic oath I took years ago trumps any loyalty I may have to my employer.

Our lives begin to end the day we become silent about things that matter.
-Dr. Martin Luther King Jr.


I will not be silent about things that matter.

Remember that cross-country race my son ran a week ago? Well, the results are in and he made it into the top 75%! More specifically, he placed 348th out of 458 runners in his age category. Woo hoo!

He was so afraid he might be dead last that I decided to explain what a claim to fame was. I have quite the collection of famous claims myself, not to mention my “hair on fire” photo in a museum in LA.  Perhaps it will be on a greeting card one day. 

I digress …

My boy was thrilled with his virtual 348th place ribbon. So thrilled, he is sleeping with the print-out, probably dreaming of strategies to improve his pace of 5.39 minutes per kilometre.

As for me, I am relieved and happy. I am also very grateful he goes to a school that promotes physical activities in a positive and non-threatening way so that children with motor challenges like my son feel comfortable participating.

You don’t have to come in first to win the race.

So run Sean, run. Run like the wind.

The slow one now
Will later be fast
As the present now
Will later be past
The order is
Rapidly fadin’
And the first one now
Will later be last
For the times they are a-changin’.

— Bob Dylan

I am so proud of you. xo

Where I work, everyone wants to walk. But those who want to walk the most are the ones who, for reasons of illness, progressive degenerative disease or injury, can no longer walk.
I remember asking a young paraplegic client of mine if he ever dreamed about walking. “All the time.”, he said. He also kept up to date on the latest research in spinal cord injuries and knew exactly how much it would cost to get the latest walking devices such as Rewalk. What’s a mere $70 000 if it means you can walk again?

There are huge physiological and psychological benefits to walking, to any weight bearing activity really. Sometimes though, the damage to the neurological system is too severe, and the connections between motor cortex and muscles are no longer viable. In spite of this, there is often a discrepancy between what the clinician knows (prognosis) and what the patient believes (hope). The physiotherapy evaluation then becomes confrontational as we ask the client to perform certain functional movements, only to have them realize they are no longer able to.

After thirty years in the field, I can usually predict what the outcome is going to be. Then there are those times I am proven wrong. In this context, I love being wrong, being put in my place by a universe that knows better than me. Miracles, albeit small ones, can and do occur and clients who were slated to spend the rest of their days wheelchair-bound rise up to pat me on the head. Yep, once in a while the complacency of experience is humbled by a little upheaval.

Last week, one of those very miracles stood up for the first time since her stroke three years ago, from the geriatric chair she is mechanically lifted into everyday. She then walked with a walker at least three meters down the hallway of the private residence where she lives. The first thing she said when she looked over at me was,”Gee, I feel so tall!”. On the other side, her devoted husband couldn’t stop beaming and kissing her. Her private caregiver filmed the whole thing from behind (thankfully cutting off the back of my bad hair day). And the staff of the residence cheered her on.

It was the kind of moment you live for as a physiotherapist, the convergence of an entire career into that one incredible feat. There was joy, there was gratitude, and there was reverence for the powers that be, the ones that allowed the damaged neurones to find their way again.
Accepting the prognosis may make it easier for some to cope. It certainly relieves the discomfort of healthcare workers faced with the sometimes unrealistic and cost-inefficient demands of clients. I mean, facts are science, right? Facts and truth. Yet there is also hope, and hope is something I refuse to take away from my clients, especially when it’s the only thing getting them through the day. Because of that hope (I give credit where it’s due), the universe occasionally offers up a big fat juicy miracle. And when it does, I bow in awe to its magnificence.

Happy Thanksgiving, all.

Namasté.

I haven’t taken any sick leave in over a year, the incentive being an extra paycheck for unused days, right before Christmas. As it happens, tomorrow I will take a couple of hours off to watch my son participate in a cross-country race. Because he asked me to.

He hasn’t been training for long. In fact, it’s only been once a week for the past month, at school, before classes start in the morning. I like those days because I get to the office early after dropping him off and feel like we are both getting a productive start to the day.

Truthfully, I could do without the race but it is included with the activity fee, tee shirt and all.

I want my son to run because he can already put one foot in front of the other and running simply means doing so at a faster pace. It’s what the literature recommends for DCD kids. Activities that involve reciprocal movements of the arms and/or legs such as swimming, cycling or running. Of these three activities, running is the only one he can do with relative ease. We have been working on swimming in an adapted program for the past seven years. Cycling, the past four. It’s been exhausting for all of us but particularly for him, because the gains are so slow in coming and he is so behind in everything. Deep breath, mummy. One day at a time.

I decided the best strategy was to prepare him both physically and mentally for not winning the race, even though I know he secretly wishes he would. So we have been training on my treadmill, trying to improve his individual time and speed, without having to compare himself to others. We’ve also been working with the occupational therapist on things like technique and breathing.

The most difficult part however, is the mental preparation. It takes incredible persistence on his part to learn a new motor skill let alone improve upon it. And even with all his hard work, the payoff is at best, mediocrity, all of which take a toll on his self-esteem. “I suck” or “I’m not good at that” is a pretty common refrain these days and while I don’t feed into it, we do discuss how he feels about things. So the challenge is to avoid setting him up for failure and to find a deeper meaning to the race, something that will stay with him longer than any medal would, long after the runner’s high has faded.

I hope the race is a positive experience for him and that running remains an activity he can pursue long term for all its health benefits.

I will be watching the race with my heart in my throat tomorrow, cheering for my boy.

My dog does a jig in the window as I gather leaves into bag number forty and I’m not sure if it’s me he wants to dance with or the swirling leaves that escape my stuffing but I appreciate his cheering me on as my iPod plays its melancholy raking mix and the sun makes me look taller and thinner on the newly swept lawn.
the referral said
teach exercises
and train stairs
we reach the second floor
easy peasy
where her son waits
she’s fine
but the dizziness may cause a fall
it already has
mended bone, broken spirit
does she want to go upstairs?
no
do you need her to go upstairs?
no but —
she needs to move more
to stay strong
he looks towards the room 
where she used to sleep
and at me
tired eyes plead
bring her back 
the mothering mother
who comforts
not the other way around
right then I am useless
so I bring her downstairs 
to the bed in the living room
where I show her exercises
that will keep her strong.

Three years ago
I bought my soul back
And remortgaged the house
I’ll give it a year, I said
Before giving up
And when a year passed, I said
I’ll take it one year at a time.
The other day my father told me,
Your fence needs mending,
Then watched me sag against its twisted trellis
How long will you stay
He asked
At least two years, maybe seven
He sighed.
One should not remain
In a house that can’t be fixed
Or a relationship without tenderness
I left the marriage
But kept the house,
Searching for peace
Within crumbling walls,
And buried brown thumbs 
Deep in its neglected garden,
Hoping to find something to save
And love again.

Post-op update.

I sat for all of five minutes in one of the nicest waiting rooms I’ve ever seen in my life. Gorgeous red leather chairs, tasteful art work on the walls, sculptures of healing hands, free wifi, and would you believe a coffee pod machine! I found it odd that the pen I was given to fill in the medical questionnaire was so crappy. Turns out it was a deterrent to me writing my life’s story.

Much to my dismay, I was called into the “operating room” before I was ready. What’s the point of a nice waiting room if you don’t get to wait in it?

On the other side, things were rather clinical but still tasteful. An assistant set me up in a chair soooo comfy-cosy I could’ve had a nice nap. She bustled about the room giving me post-op instructions when all of a sudden this tall cowboy walked in. He was wearing blue jeans and a kelly green gingham shirt with what looked to be a little pink cowboy on the front pocket. I can’t remember if he wore a hat or not but I can assure you, he looked exactly like this.



“Howdy ma’am. What seems to to be the trouble?”
“I broke a tooth.”
“Don’t you worry about a thing. We’ll get it out for you.”
And get it out they did, the cowboy and his posse. Six hands taking care of my every need, kind of like a French restaurant where the service is so good, you only have to take a sip of water before someone is hovering with a pitcher ready to refill your glass. In this case, all it took was for a little gurgle, a trickle of drool slipping out for not one but TWO suction technicians to make it disappear. I swear, there was no splatter to be found when I got home.
I must say it was odd, this tooth extraction experience. There were so many people in the room at one time, I felt like I was at a cocktail party having to make small talk. Overall though, it was a really good experience considering why I was there. Cowboy Gingham to the rescue!
Think I’ll go early for my follow-up appointment to have extra lounge time in that lovely waiting room. I’ll take lots of pics and maybe even sneak one of the cowboy hat. Yee haw!
MJ Tremblay

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