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Poetry - Spring 2018 - temp secondary articles
See Me
Poetry - Spring 2018 - temp secondary articles

See Me

Contents
Disengagement
Restoring Humanity
Let’s Challenge Ourselves
About the Author

See Me

By Amanda LaLonde, PT, DPT, GCS

Download the article (pdf)

I’m here. I have a name.
I still dance, I cook, and laugh.
I’m known and I’m loved.
I’m here, your patient, looking at the space we share.
The waiting room, an ICU, a therapy gym.

I need trust, respect, and a healing touch.
Do you know me? Do you see me?

I’m here. I’m more than what your paper says.
I’m not cancer.
I’m not diabetes, not hypertension.
I’ve lost a leg, but I’m not some amputee.
I’m not a stroke, not Parkinson’s; I’m not an ACL, not a total hip.

I’m here. I have a name.
I’m open, honest, seeking your care.
I’m here and present on this journey we share.
Through training and instruction, from cues to independence.
See me, know me, look beyond.

I’m here and I’m more than what your paper says.
I’m no diagnosis.
My wheels carry me; I’m not confined.
I’m not cerebral palsy.
I’m not depressed, not a fracture.
I’ve struggled with pain, but I’m not defined by suffering.
I’m not Alzheimer’s, not spina bifida, or tendonitis, or anxiety.

How do you define me? What do you see?
See me, see all of me.

I’m your patient, complex, sum parts to a whole.
See me, see all of me.
Don’t call me a condition.
I’m here and I’m more.
I have a name.

Healthcare is desensitizing. Suffering becomes commonplace in our workplace, and rarities—truly new cases—are few and far between. Humanity is easily lost in the day-to-day healthcare routine, and perhaps understandably so. Best intentions are stretched thin after long daily hours and years of study.

As professionals, our own sacrifices abound. We are informed, dedicated, and ambitious. An early end-point may have been connection; but after years on the job, silos are formed. Time spent with a patient, the one who needs you, the ultimate goal, becomes swallowed by tasks and necessities. Our focus on productivity, although important and necessary, only serves to perpetuate our tendency to disconnect. Challenged are many to balance demand with limited emotional supply. Is this trade-off worth the price?

I often wonder: How did we get here? When did we stop thinking about the human being in front of us and start categorizing individuals by their diagnoses? Bad enough to categorize, we rarely use names and are unfit to emote. This trend of desensitization and disconnection doesn’t discriminate among providers. Physicians, therapists, nurses, and aides all tend to label patients. Educators often set bad examples as well.

Disengagement

So healthcare remains, understandably, disengaged. Media even joins in on the name-calling as reporters refer to people by their diagnoses and impairments rather than noting the individual strength of characters. An easy oversight, you could say, when the language of providers referencing clients solely by room number, or some self-deprecating patients so-naming themselves crippled or worthless is not called into question.

That stroke in room 202 has therapy today; the total hip needs a walker; the amputee is waiting for a prosthesis. He’s confined to a wheelchair and my 4:00 is cancer-stricken. She is too anxious, and the traumatic brain injury keeps acting inappropriately. The ACL repair is too eager to return to sport. Dementia patients always need more time. MS patients are all the same.

Restoring Humanity

Who will shift this conversation and its vast generalizations? We all have a responsibility to restore and value humanity in healthcare. Small, attainable changes are waiting at our fingertips. Simple shifts in language and awareness, being fully present with the other. Humanity is not a lofty goal; rather, a requisite along a journey to healing. If you seek to have an impact on others, then respect must be a part of your conversation.

Let’s Challenge Ourselves

Humility, humanity, and empathy: essential elements lost in the hustle of each day. How do we reset and infuse these necessary components into healthcare? What will you ask of yourself, how will you rise to the call? To be the one, to take the time, to invest in those in front of you requires dedication and a necessary awareness. Tomorrow, will Adam know you speak to him and not his diagnosis? Will Sarah be reassured by your warm smile, your gentle touch? Challenge yourself and others. Be the one to see.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

About the Author

See Me

Contents
Disengagement
Restoring Humanity
Let’s Challenge Ourselves
About the Author

See Me

By Amanda LaLonde, PT, DPT, GCS

Download the article (pdf)

I’m here. I have a name.
I still dance, I cook, and laugh.
I’m known and I’m loved.
I’m here, your patient, looking at the space we share.
The waiting room, an ICU, a therapy gym.

I need trust, respect, and a healing touch.
Do you know me? Do you see me?

I’m here. I’m more than what your paper says.
I’m not cancer.
I’m not diabetes, not hypertension.
I’ve lost a leg, but I’m not some amputee.
I’m not a stroke, not Parkinson’s; I’m not an ACL, not a total hip.

I’m here. I have a name.
I’m open, honest, seeking your care.
I’m here and present on this journey we share.
Through training and instruction, from cues to independence.
See me, know me, look beyond.

I’m here and I’m more than what your paper says.
I’m no diagnosis.
My wheels carry me; I’m not confined.
I’m not cerebral palsy.
I’m not depressed, not a fracture.
I’ve struggled with pain, but I’m not defined by suffering.
I’m not Alzheimer’s, not spina bifida, or tendonitis, or anxiety.

How do you define me? What do you see?
See me, see all of me.

I’m your patient, complex, sum parts to a whole.
See me, see all of me.
Don’t call me a condition.
I’m here and I’m more.
I have a name.

Healthcare is desensitizing. Suffering becomes commonplace in our workplace, and rarities—truly new cases—are few and far between. Humanity is easily lost in the day-to-day healthcare routine, and perhaps understandably so. Best intentions are stretched thin after long daily hours and years of study.

As professionals, our own sacrifices abound. We are informed, dedicated, and ambitious. An early end-point may have been connection; but after years on the job, silos are formed. Time spent with a patient, the one who needs you, the ultimate goal, becomes swallowed by tasks and necessities. Our focus on productivity, although important and necessary, only serves to perpetuate our tendency to disconnect. Challenged are many to balance demand with limited emotional supply. Is this trade-off worth the price?

I often wonder: How did we get here? When did we stop thinking about the human being in front of us and start categorizing individuals by their diagnoses? Bad enough to categorize, we rarely use names and are unfit to emote. This trend of desensitization and disconnection doesn’t discriminate among providers. Physicians, therapists, nurses, and aides all tend to label patients. Educators often set bad examples as well.

Disengagement

So healthcare remains, understandably, disengaged. Media even joins in on the name-calling as reporters refer to people by their diagnoses and impairments rather than noting the individual strength of characters. An easy oversight, you could say, when the language of providers referencing clients solely by room number, or some self-deprecating patients so-naming themselves crippled or worthless is not called into question.

That stroke in room 202 has therapy today; the total hip needs a walker; the amputee is waiting for a prosthesis. He’s confined to a wheelchair and my 4:00 is cancer-stricken. She is too anxious, and the traumatic brain injury keeps acting inappropriately. The ACL repair is too eager to return to sport. Dementia patients always need more time. MS patients are all the same.

Restoring Humanity

Who will shift this conversation and its vast generalizations? We all have a responsibility to restore and value humanity in healthcare. Small, attainable changes are waiting at our fingertips. Simple shifts in language and awareness, being fully present with the other. Humanity is not a lofty goal; rather, a requisite along a journey to healing. If you seek to have an impact on others, then respect must be a part of your conversation.

Let’s Challenge Ourselves

Humility, humanity, and empathy: essential elements lost in the hustle of each day. How do we reset and infuse these necessary components into healthcare? What will you ask of yourself, how will you rise to the call? To be the one, to take the time, to invest in those in front of you requires dedication and a necessary awareness. Tomorrow, will Adam know you speak to him and not his diagnosis? Will Sarah be reassured by your warm smile, your gentle touch? Challenge yourself and others. Be the one to see.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

About the Author

Amanda LaLonde, PT, DPT, GCS

Amanda LaLonde, PT, DPT, GCS, received a Bachelor of Arts in Dance from the University of Wisconsin- Stevens Point in 2003, and is a 2008 graduate of the University of Wisconsin-Madison Program in Physical Therapy. In 2014, she earned her Transitional Doctor of Physical Therapy degree through The College of St. Scholastica. She is a Board Certified Geriatric Clinical Specialist through the American Board of Physical Therapy Specialists. Amanda is the Director of Clinical Education and an Assistant Professor in the Program in Physical Therapy at the University of Minnesota. Shaped by her own experiences as a clinician, Amanda strives to ensure students reflect on the complex role of clinical practice; seeing beyond a diagnosis or treatment plan to truly engage with their clients. Amanda notes that value in interaction and appreciation of the human side of healthcare is as important as new technology and treatment approaches.

 

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See Me

Contents
Corinne
Coming Home
OT and PT
Recovery
Compassion and Healing
References
About the Author

Healing from ‘Brokenness’: The Story of Corinne

By Chad Jackson, PT, DPT, OCS

Download the article (pdf)

Children in foster care are often described as “broken” due to the emotional, mental, and physical trauma they’ve experienced from abuse and neglect.1-5 Many states lack adequate resources to help these children heal, which perpetuates the effects of trauma.2,6 However, as a physical therapist (PT) who has fostered and adopted, I have experienced healing when families choose to provide consistent love and support. Karen Purvis, a researcher, and specialist with children who have experienced trauma, described three ingredients for caregivers to provide a healing environment: empowerment, connection, and correction.4 As a rehab provider, I realize using my clinical skills is important for healing; however, it was through my daughter Corinne’s rehabilitative journey that I developed a deep appreciation of the healthcare provider’s empathy, empowerment, and connection in the healing process.

Corinne

Corinne was born six weeks early, weighing 4.2 pounds. Her young, petite, blonde-headed mother welcomed her into the world with words of love but communicated to the nursing staff she had been using drugs during the pregnancy. That day, she tested positive for heroin, cocaine, and marijuana, causing Corinne to enter into foster care at birth with symptoms of drug withdrawal and a diagnosis of neonatal abstinence syndrome. Corinne not only endured trauma from drug abuse but also physical abuse as her biological father beat her mother at 23 weeks of gestation. So severe were her mother’s abdominal injuries that a two-day hospitalization was required.

Following her birth, Corinne would have much to overcome, facing the challenges of the foster-care system. Children in foster care have been shown to have many negative outcomes, including poor health and significant developmental issues as a result of abuse, neglect, and drug exposure.7-10 Fortunately, early childhood intervention (ECI), which provides developmental services, has been shown to have a significant positive impact on children in foster care, and on foster families.11 ECI became involved in Corinne’s care due to her prematurity and drug withdrawal at two weeks of age. Her first foster mom provided care, food, safety and, most importantly, love. She also welcomed the assistance that ECI provided. Pam, the occupational therapist (OT) assigned to Corinne’s case, knew that the length of time before Corinne was moved to another home was unknown, because children in foster care often are moved to another foster home for a multitude of reasons. After two months of providing care, Pam arrived at the foster family’s home and discovered the next visit would be her last. The family was moving; Corinne would be placed in a new foster home. Pam later expressed that she was concerned for Corinne at the time, and wondered what would become of her. She was soon to find out.

Coming Home

November 1, 2013 was what I call “Gotcha Day”—the day Corinne became my foster daughter. She was a bald, normal-sized baby who had a passive personality. She entered a home filled with love and support from everyone who became a part of her life, but especially from her new foster siblings. Eight-year-old Lorelei was excited and wanted to help with bottle feeding and diapers. Seven-year-old Tanner and five-year-old Reuben provided her toys whenever she was awake. Most important of all was my wife Beth—a mother who would love Corinne as her own.

My 10 years as a PRN ECI therapist allowed me to easily examine her history and perform a developmental assessment. The findings revealed moderate developmental delay. I thought, We do not need early intervention, as I am a physical therapist and can provide therapy sessions to progress her development! However, as her dad, will I be able to be objective enough if Child Protective Services asks for an official report? Ultimately, I chose ECI to provide therapy services. Pam, the OT, was excited to see Corinne again and provided empathetic encouragement to Beth and the older children as they worked to implement her suggestions. (They followed through much more than they might have if I were acting as the primary therapist!) As the weeks progressed, Pam thought Corinne would do well to recover from her “broken” past and overcome her deficits.

OT and PT

Corinne continued to progress as each week Pam encouraged, educated, and celebrated the “little wins” with Beth and the kids. However, because she did not meet her gross motor milestones, physical therapy was needed. I thought, It’s great that Pam is involved, even though I’m a PT and can help Corinne. I do see how Beth and the kids respond to Pam; their connection, and the motivation they receive. After much thought, I welcomed Kathy the PT to our team when Corinne was 7 months old; she immediately invested in Corinne’s well-being, and connected with my family.

Occasionally, I attended the therapy sessions and learned new strategies. I was encouraged to see Corinne receiving love, encouragement, and compassion from Kathy and Pam as both joyfully interacted with her every week. They celebrated with us when Beth and I adopted Corinne at 15 months of age, becoming her “forever family”. At 18 months, Corinne started to walk, and clearly, her left leg did not move like her right leg. Every week, Kathy arrived with a smile, and Corinne greeted her at the door with a squeal. Kathy continued to encourage Corinne and my family, offering ideas about how to decrease her left-side neglect. When Kathy clapped for Corinne, she was motivated to perform the next task. Occasionally, Kathy would visit when the other kids were not in school and would teach them activities to do with Corinne. Lorelei, Tanner, and Reuben were hooked! When I came home from the office, they often greeted me with, “Hey Daddy, the PT wants me to help Corinne climb on the playset, and make sure she uses her left leg.” Or, “Daddy, watch me set up the obstacle course and help Corinne use her arms and legs!”

When Corinne was 18 months old, she met all of the established occupational therapy goals. Beth recalls Pam, as she said goodbye, describing the joy of observing Corinne overcome much of her past trauma. Kathy continued to provide PT services for the following 4 months until Corinne met her established early intervention and family goals. When departing, Kathy described the joy she had in Corinne’s healing journey and how much she would miss Corinne’s weekly hugs.

Recovery

Corinne’s substantial recovery was beyond what any of us expected. Today she is a humorous, healthy, and fun-loving 4-year-old. Even though the effects of the in-utero trauma are still evident—occasional tremors and behavioral reactions—her joyful spirit has forever changed our family and friends. One evening, Beth told me, “I believe Corinne overcame her issues largely because of the support and encouragement Pam and Kathy provided. They were excited to see Corinne, and she, in turn, wanted to play and perform the activities they thought would help with her recovery.” Pam and Kathy communicated that Corinne’s efforts, her environment, and the love she experienced allowed her to overcome her delays.

Compassion and Healing

Throughout Corinne’s journey, I often reflected on the many people who contributed to her progress, and I filed various thoughts and feelings away. One of my recurring questions was, Does love, care, and compassion positively contribute to the healing process? Studies have demonstrated the positive effects of healing when healthcare providers provide compassion, especially when combined with touch.12 Although Pam and Kathy utilized sensorimotor and developmental activities that have been shown to contribute to a child’s developmental progress,13 it was the authentic display of compassion and caring that seemed to have a major impact on her healing process.14 Through this reflection, and my exploration of the value of caring in healing, I became a more understanding and effective physical therapist, educator, and father. Additionally, I have a greater understanding and compassion for children and adults who have experienced trauma.

As healthcare providers, we can positively impact the healing process by demonstrating engaged communication and clinical empathy, which I am now convinced is as valuable as the clinical skills unique to our professions.15 Pam and Kathy were instrumental in Corinne’s recovery as they exemplified empathy, compassion, and empowerment, which led to a deep connection with our whole family.

I invite all healthcare providers to reflect on how you are connecting at the human level with those you serve. I believe each of us can fully embrace our chosen vocation by empathetically connecting with our patients to optimize healing. The impact can change your life and the lives of those you serve.

References

  1. National Council for Adoption. Adoption advocate no. 61. Available at: https://www.adoptioncouncil.org/publications/2013/07/adoption-advocate-no-61. Accessed November 30, 2017.
  2. Floyd J. Broken foster care system is breaking lives. Dallas News Website. Available at: https://www.dallasnews.com/news/news/2016/01/22/broken-foster-care-system-is-breaking-lives. Accessed November 30, 2017.
  3. Carlson D. Foster care as the way of Christ. Desiring God Website. Available at: https://www.desiringgod.org/articles/foster-care-for-the-least-of-these. Accessed November 30, 2017.
  4. Purvis KB, Cross DR, Dansereau DF, Parris SR. Trust-based relational intervention (TBRI): a systemic approach to complex developmental trauma. Child Youth Serv. 2013;34(4):360-386. doi:10.1080/0145935X.2013.859906.
  5. Becker-Weidman A. Effects of early maltreatment on development: a descriptive study using the Vineland Adaptive Behavior Scales-II. Child Welfare. 2009;88(2):137-161.
  6. Child Welfare Information Gateway. Child welfare/foster care statistics. Available at: https://www.childwelfare.gov/topics/systemwide/statistics/childwelfare-foster/. Accessed November 30, 2017.
  7. Healey CV, Fisher PA. Young children in foster care and the development of favorable outcomes. Child Youth Serv Rev. 2011;33(10):1822-1830. doi:10.1016/j.childyouth.2011.05.007.
  8. Simms MD, Dubowitz H, Szilagyi MA. Health care needs of children in the foster care system. Pediatrics. 2000;106(4):909.
  9. Gorski P, Borchers D, Glassy D, High P. Health care of young children in foster care. Pediatrics. 2002;109(3):536-541. doi:10.1542/peds.109.3.536.
  10. Sullivan DJ, van Zyl MA. The well-being of children in foster care: exploring physical and mental health needs. Child Youth Serv Rev. 2008;30(7):774-786. doi:10.1016/j.childyouth.2007.12.005.
  11. Meloy ME, Phillips DA. Rethinking the role of early care and education in foster care. Child Youth Serv Rev. 2012;34(5):882-890. doi:10.1016/j.childyouth.2012.01.012.
  12. Shaltout HA, Tooze JA, Rosenberger E, Kemper KJ. Time, touch, and compassion: effects on autonomic nervous system and well-being. Explore N Y N. 2012;8(3):177-184.
  13. Elbrecht C, Antcliff L. Being in touch: healing developmental and attachment trauma at the clay field. Child Australia. 2015;40(3):209-220. doi:10.1017/cha.2015.30.
  14. McGee MD. Authenticity and healing. J Relig Health. 2014;53(3):725-730. doi:10.1007/s10943-014-9835-1.
  15. Halpern J. What is clinical empathy? J Gen Intern Med. 2003;18(8):670-674. doi:10.1046/j.1525-1497.2003.21017.x.

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