TO PATIENT ZERO FROM THE INFERNO

(This was written on February 25, 2013)

Last week I started my posting at the CMC Rehabilitation Institute. I am working on the first floor with mostly patients with spinal cord injuries. I was told that I would enjoy my posting at rehab, and so far this has proven to be the case. With the OT confidence and energy I gained while working in OPD the previous week, I was ready with plenty of vim and vigor to meet patients and get to work. I was briefly oriented to the facility and then left with one of the OTs on the first floor. She had been told that I was interested in working with patients with spinal cord injuries, and suggested that I spend the day observing and then begin the next day. Little did she know that “spend the day observing” is a phrase that I have come to loath here in India, and I intended to do some “hands-on observing.”

My first patient was one that I had met already. Charlie is his physio, and having picked her up from rehab a few times I was able to meet him prior to becoming his OT. As soon as he entered the gym, I made my way over to him and set to work. After he found out that he was my first patient with a spinal cord injury at rehab, he dubbed himself Patient Zero. Patient Zero is an early twenty-something young man who has ambition to study robotics at the University of Pennsylvania. He was admitted to UPenn prior to his injury. One of my first interactions with him involved me interrogating him about his plans for the future and whether or not he planned to take Anbu (his trusty caretaker) with him to the good ol' US of A. As a good natured young chap, he honestly answered all my questions and indicated that, helpful as he was, he’d rather not take Anbu with him. With that I told him we had some work to do and goals to meet. I wrote down a list of goals for him to meet by the end of the week.

Patient Zero is a fun and entertaining person to be around. He is highly motivated and loves to come up with creative ways to do things. We have built strong rapport in a short amount of time. The second day I worked with him (or was it the first afternoon?) he admitted that the nickname he had given me was the Towering Inferno. I wasn't sure what to make of such a name. Then he told me that the “towering” part was because I found the highest spots at the mela to shoot photos and video from thus I towered above the crowd. The “inferno” part was because he thought I was an angry person. The first few times he met me happened to be directly after my disappointing days at CHAD when my attitude was less than jovial. I would argue that I wasn't exactly angry, just very disappointed. Regardless of the reason, the Towering Inferno is my new nickname.

At the end of the first day, I had set a goal for Patient Zero to put his own socks and shoes on before the end of the week. We trialed the process in long sitting on a plinth, but twenty minutes later I realized that his determined struggle only resulted in a frustrated and slightly fatigued Patient Zero. I needed a sock aid. I asked around to see if I could get my hands on one, but my request was met with a few blank stares. It became pretty obvious that if my patient was going to use adaptive equipment to donn his socks, I was going to have to fabricate the equipment.

That evening I scavenged some materials and stayed up until the wee hours of the morning making my first low cost sock aid prototype. After many trials, adjustments, reconfigurations and a change in materials, it looked pretty shoddy. I was almost embarrassed to show it in public the next day, but I needed to see how it worked and whether or not my C6 SCI Patient Zero could manage the device. As I pulled it out of my bag, I covered it in apologies and excuses. Patient Zero stopped me short by saying, “I don’t care what it looks like. That is the coolest thing ever! Show me how it works.” His wish was my command. As I demonstrated his new equipment he told me that he would still be calling me the Inferno, but for a different reason now. He would call me the Inferno because I was "the OT on fire." And then I melted. He pretty much made my day… nay… my month! (Dare I say year?)

Over the next few days his new piece of adaptive equipment went through some alterations. My aim was to keep the cost low and the materials easily accessible. I wanted to be able to leave behind a pattern and plan for future use by the OT staff at rehab. 

Cardboard: scavenged from the College Store. 

Rope: less than 15 rupees. 

Rubber tubing: repurposed from physio’s scrap bin. 

Washers for reinforcement: 4 rupees. 

Watching the smile spread across Patient Zero’s face as he put on his sock entirely by himself since his injury: Priceless.

A personalized touch on the adaptive equipment for my Patient Zero.

Patient Zero with some of the other adaptive equipment I had him try out. Gaining independence one device at a time! 

Patient Zero and his sock aid. (Note: this is not the final version. See following post for final version. Also, I was informed today that in my absence, Patient Zero has practiced his sock/shoe donning/doffing and was able to do both his socks and shoes (one side) in under three minutes. I'm one proud Inferno!