This Is Why Lesson in Motivation Her father's determination shaped her own. By Cara Brickley, PT, DPT | February 2010 Podcast: Listen to 'This Is Why' My dad is a retired Marine who survived a mortar attack during the Vietnam conflict. A jock when he left, he returned home scarred, unable to walk, facing the prospect of above-knee amputation of his left leg, and battling osteomyelitis. Over the next 2 years he endured infection, medical treatments, surgeries, and physical rehabilitation that ultimately allowed him to keep his leg and return to active duty. But I knew none of that as a child. All my brothers and I knew was that we loved to play with dad, and he with us, and that we needed to be careful with his hurt leg when we tackled him. When it came time to talk with my parents about college, I asked dad about his injuries. It was then that he shared the story of his rehabilitation: the countless surgeries, hydrotherapy for his wounds, traction, hundreds of hours of physical therapy to regain strength and flexibility in his leg. The recurrent theme was his fierce determination to return to active duty, which motivated him to participate fully in his treatment and sustained him through many painful procedures. After listening to his story, I knew I wanted to be a PT and help injured people return to productive lives. A few years later, as a new clinician, I encountered some difficulty with patients who were not as highly motivated as my father had been. Gradually, I learned how to listen to them and communicate the central importance of compliance and exercise in achieving their goals. One of my first patients was a lady in her 80s who lived with her daughter and the daughter's family. She had sustained a hip fracture in a fall, and her goal was to return home to be with her grandchildren. The situation quickly turned into a battle of wills, however, as she refused to get out of bed. I was frustrated: How could she insist she wanted to go home, yet be unwilling to do what was necessary to reach that goal? I came to realize that I needed to change my own attitude and approach. At the start of each treatment session, we worked together to establish goals for that day. We reviewed the activities required to achieve those goals, until she fully understood what needed to be done and why. The day she took her first steps, the wisdom of my new approach was confirmed. She continued to progress and was able to return home, walking independently, a few weeks later. My work at Spaulding Rehabilitation Hospital allows me to develop relationships with people from all walks of life. Each day I continue to learn. One day I might get a lesson in living history, as recounted by an older patient who'd been a Marine as a young woman, was discharged at the end of World War II, and hitchhiked her way from California to the East Coast. On another day I might work with a patient, his family, and staff to devise strategies to meet mobility challenges facing him post pelvic reconstruction due to carcinoma. Of all my daily tasks and responsibilities, what I find most rewarding is helping my staff on their journey of development as PTs. I tell them from my own experience that basing practice on evidence, listening intently to patients as they articulate their goals, and engaging in creative problem solving all are keys to optimal patient care. I relate the lesson my dad taught me, which my patients have reinforced time and time again: patient motivation lies at the heart of successful rehabilitation. The scars on my father's legs, arms, and face are constant reminders of what can be accomplished when a patient's will is strong and his or her treatment plan is well-communicated and well-designed. I know my dad is proud of me, but I'm even prouder of all he has accomplished-and shared with me.