**Written and verbal consent has been grated by this patient to share his story.**
If you’ve been following along on this most recent trip to
India, you’ve met him already, but his name and story were not revealed. He was
the man who fell victim to the imaginary magic wand that I seemed to have
stashed in my back pocket. Although my prior post may have painted an alternate
picture, the reality is that this man is incredibly determined and hard
working.
His whole story isn’t mine to tell, but he has grated me
permission to share the part of his story that intersects mine with a little
background information. Two years and three months ago, Nitin sustained a
cervical level spinal cord injury in a chance accident. Since then he has
endured surgical stabilization followed by various version of physical
rehabilitation. He was at Chandigarh Spinal Rehab to gain further independence
with daily life and higher-level mobility. Being an English speaker, he was an
easy target for me and quickly fell victim to my attention during therapy.
As my rapport with him grew, so did my admiration for who he
is as a person and the lessons he taught me. When I met him, Nitin had a pretty
good handle on many of his activities of daily living. He was reliant on an
attendant for some things, but by and large he was already living deep into the
areas of independence he had gained. However, there were little things that he
wanted to refine, and his goal remains to live life to the fullest and attendant-free.
The first item on the “to conquer” list was lower body
dressing. We started by having him demonstrate what he could do to mange his
pants. His sitting balance was excellent, but managing his legs proved to be a
challenge. So, I attempted to provide some assist… and all efforts were
immediately road-blocked with some of the most intense muscle tone I’ve ever
seen. His legs might as well have been cast in iron; there was no moving
them without their prior consent. They moved on their own in what seemed like their own timing and
direction. I asked a few questions about how his tone was being managed and how
long he had been experiencing this level of tone. The outcome of my brief
interrogation left me scratching my head while trying to wrap it around the
fact that for now this was going to be his reality and we just had to work
around it. After trial and error and a few tips on how to use wrist extension
and elbow flexion to leverage his legs, we began to realize that with specific movements
we could use his tone instead of fight it. For instance, he could get his feet
into the pants, but was unable to straighten his legs to pull them up to his
waist; however, when he leaned back his legs straightened out like sentinel
soldiers and gave him the freedom to get his pants when they needed to be with
relative ease.
Once we figured out some strategic pant donning techniques,
we began to time him to see if we could get more efficient. Slowly but surely,
he would whittle time off the clock with each and every attempt. When we got his
time down to something reasonable, we up the challenged and had him practice in
a smaller bed with less room to maneuver rather than a sprawling mat. When this
was suggested, his initial reaction was to drop his shoulders, let his head
sink, and whisper something along the lines of “Who did I piss off to deserve
this torture?” But he never backed down from a challenge. Never once. He looked
at us like we were crazy, but he trusted the process and he leaned deep into a
new level of determination and carried on. Never did he question what was asked
of him.
We didn’t stop with pant management. We attacked car
transfers, slowly removing his dependence on people and products to achieve greater
independence. Because he intends to drive again someday, we even challenged him
to transfer to the driver’s side of the car. Fatigued, yet resolute, he rose to
the challenge. It didn’t end with car transfers; we had him get himself off the
floor… more than once. Then when exhausted and weary, we had him do it again so
we could video it as a demonstration to others that would come after him. “I
will do it” was his response every time we set before him a challenge.
At the end of my term at Chandigarh Spinal Rehab we started
to plunge into “fine tuning” mode. We wanted to iron out the kinks in all that
we had accomplished over the past two weeks. His physical therapist mentioned
that he wanted to wear jeans and a proper shirt again. It was the uniform of
his prior life and until that point he has been rocking fashionable pullover
shirts and gym pants as they were easier for him to manage. I believe it was
when we told him he was going to put on his own jeans and button-up shirt that
he began to believe he had pissed someone off and this truly was the sentence
of the crime committed. But he offered no excuses, only resolution to try his
best. In short order he was dressed in jeans (skinny jeans at that!) and a
proper shirt that he put on without assistance. (He did use a button hook that
was fashioned for him out of whatever was found lying around the facility.) As
if he has just unlocked a new level of independence, we celebrated his success
with a delicious lunch out on the town.
 |
| Mastering the button-hook we fashioned for him. |
What you’ve probably gathered by now is that whatever
seemingly insurmountable challenges were placed in front of him, he never
backed down. He kept going. When his unpredictable tone kicked in at importune
times throwing his body backwards on the bed or preventing him from getting up
in the first place, he never gave up. He kept going. He found a way to work
with his obstacles and not around them or avoiding them. He is a man with goals
and the determination to achieve them.
Nitin, thank you for allowing me to invade your life for two
weeks. Thank you for never backing down from a challenge. Thank you for
demonstrating to me the sweet reward of hard work. Thank you for teaching me to
get back up when I fall or get thrown down by something outside my locus of
control. And thank you for inviting me along to celebrate your successes; (that
lunch was so much more than just a meal to me.) Keep fighting, my friend (but
not your tone… fighting your tone will just wear you out, use it to your
advantage. 😊)
 |
| All dressed and ready to go out on the town! |
 |
| Now that we have your dressing skills down, Nitin, perhaps we should work on your Connect Four strategies. ;) |
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