Sunday, October 25, 2009

The real therapist

Kate had her first appointment with a new physical therapist last week. At 21, she has aged out of the pediatrics department at Lenox Baker Children's Hospital in Durham, where she landed after she was hurt. Laura Case was the therapist who agreed to take Kate on after she was released as an outpatient. I don't know if she knew what she was in for, but I knew why we wanted her. She was, and is, the most dedicated, creative and empathetic therapist Kate has ever had.

At a time when doctors and therapists thought patients made the most recovery from a brain injury in the first six months, Laura gave us hope. She felt strongly that recovery continued indefinitely -- as long as people worked at getting better. At a time when others predicted Kate's balance disorder would confine her to a wheelchair, Laura got Kate to sit up on her own for two seconds, then worked on doubling that time over and over again.

Getting down on her hands and knees, she showed Kate how to crawl. Kate had a stubborn streak, and more than once she showed up for physical therapy complaining about how tired she was. But Laura would nod understandingly and ask Kate if she wanted to go on strike. Then she would make a banner: "On Strike, Gone Fishing" and have Kate wear it as she used a walker to laboriously make her way up and down the hall. Laura can turn even the hardest exercises into a game. When Kate needed to strengthen her stomach muscles, Laura would sit her atop a huge therapy ball, hold onto her legs and then send her down backwards, asking her to come back up with a surprise. Kate would invariable grab a "smelly sock" from the floor and pop back up to present Laura with her "gift," which she would accept with just the right amount of nose wrinkling and laughter.

When she wasn't working at the hospital she worked outside it. She used vacation time to go to Vietnam, where she helped children who had no access to physical therapy. She met us at one of Kate's horseback riding therapies to make sure Kate was getting the most out of the program. She also earned a doctorate in physical therapy. The last few years she has asked Kate to help her teach the students who attend Duke's three-year doctoral physical therapy program. Kate, of course, is thrilled to be the center of attention as Laura shows her students how to stretch muscles and problem solve.

Over the years Laura has taught me more than she will ever know -- giving me the confidence to help Kate carry on her journey to greater independence. Posterior or anterior tibialis? I probably will never pass an anatomy class. But the wealth of information Laura shared -- sometimes repeatedly -- was given with grace and good humor. We will miss her, but Kate's in good hands. Her new therapist was one of Laura's doctoral students a few years ago.

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