Monday, July 12, 2010
Continue: A Good Physical Rehabilitation Idea
I thoroughly enjoyed this short film about an myriad of adaptive sports and outdoor activities. The film, much to my chagrin, was made by Jeffrey Rosenbluth, a doctor who specializes in spinal cord injury rehabilitation. My personal bias would have prevented me from ever guessing an MD much less one that specializes rehabilitation made the film. Everyone knows rehabilitation medicine is a dead end medical career. There is not much positive I can say about physical rehabilitation aside from the fact that many physical and occupational therapists are very attractive and dedicated women who do an amazing job. They are the only inspiring figures in rehabilitation, a field I passed through long ago and hope to never return. Rehabilitation has changed radically since I experienced it in the late 1970s. Back then doctors, nurses, therapists, and social workers were struggling to figure out exactly what rehabilitation entailed. Adaptive equipment was primitive at best and choices severely limited. Yet there was a large measure of excitement. People with spinal cord injuries were expected to survive and thrive after injury. Wheelchair technology was about to explode with a dizzy array of options once the monopoly enjoyed by Everest & Jennings was broken. Adaptive sports gear was being created and there was real hope for the future. I was driven to work exceptionally hard in rehabilitation. I worked hard for a simple reason--rehabilitation is deeply depressing. One must work long and hard to relearn how to do the ordinary. This hurts one's ego and can be a shattering experience. Add in the fact rehabilitation settings are grim. Back in the 1970s rehabilitation was often done in an acute care hospital. A few rehabilitation hospitals existed but as far as I recall rehabilitation floors were common. This is where I experienced rehabilitation. I was the only young person surrounded by elderly people may of whom had strokes. Such a setting was not a bad place. I was scared to death and driven to get out.
Much has changed in rehabilitation--a veritable revolution has taken place. Yet I wonder if all the changes are positive. In the 1970s rehabilitation lasted as long as it was deemed necessary. Today, health insurance dictates care and the sort of adaptive equipment a person will use. This sends shivers down my spine. The durable medical goods industry is populated by crooks that sell inferior products to newly paralyzed people who know nothing about wheelchairs they will use. Rehabilitation setting have also changed. Gone are the rehabilitation floors in acute care hospitals. They have been replaced by rehabilitation centers in rural or suburban areas that are quite pretty. Gone by extension is the fear I felt provided by a grim social and physical setting. Thus I think rehabilitation hospitals provide social cocoons where one can, if well insured, hide from the real world. I cannot blame people though--the real world is a hostile place to people with disabilities.
The above memories were triggered by the film Continue. The film also gave me hope that at some rehabilitation centers appear to get the physical and social consequences to paralysis. Rosenbluth works at the University of Utah and directs the acute rehabilitation program. There he has set up TRAILS: Theraputic Recreation and Independent Lifestyles. I am not a fan of cute acronyms but I do like what TRAILS seeks to accomplish: the return to a healthy, rich and full life via recreational activities. For a newly paralyzed person they experience a shock to body and mind but it is the mind that really gets fucked. The mind more than the body must learn to adapt. People need to learn how to reject the stigma associated with using a wheelchair and assert their rights as a human being. This is not easy but I can readily imagine this transition being assisted by recreational activities. The feeling of equality is in part what draws me to adaptive sports such as skiing and kayaking. This feeling is liberating and for a newly paralyzed person I would imagine this experience can have profound and long lasting consequences. It is a return to being "normal", that is being an ordinary person. Society denies we paralyzed people our ability to be ordinary--we are reduced to stereotypes that belittle and demean us. Our choices are limited--at one extreme we are portrayed as angry or bitter and at the other end of the spectrum we are lauded as heroes that overcome paralysis. The truth is we are just like anyone else except we cannot walk, a physical deficit that leads to social denigration. I for one reject this inferior social status and hope through the program created by Rosenbluth newly paralyzed people will come to the same conclusion.