• This Is Why

    Expect Everything

    The power of conceding nothing.

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    On a sunny March day a few years ago I received a call from Sarah, a colleague and friend who was working in Seattle as a traveling physical therapist (PT). A friend of hers back in West Virginia had just had a baby and had been stunned by the unexpected diagnosis of spina bifida.

    "You must take him," Sarah pleaded. At the time, I was caring not only for my own infant and toddler, but for a full caseload through West Virginia's early intervention agency. I was not accepting new clients.

    "These people are scared, and they need you," Sarah insisted. How could I say no to that?

    A few weeks later, I walked into the home for the first time and met Brenden. He was a sweet, chunky baby with a mop of dark brown hair. His muscle tone was so low he barely could lift his eyelids. His parents asked me many questions. Would he ever be able to walk? Talk? Feed himself? I answered as honestly as I could. I educated them about spina bifida and what to expect from the early intervention program and physical therapy. I said I never make predictions about children, because their achievements often exceed adults' expectations.

    My treatment journey with Brenden lasted 3 years. He went through surgeries, standers, orthotics, new orthotics, and taping. His mother, Michelle, quit her job to care for him full time. His father went back to school and changed jobs to meet their family's needs.

    I met Brenden's grandparents and taught him to climb steps at their house. He and I visited the park and the pool, and had sessions on horseback. Brenden grew stronger and more mobile, and I grew incredibly close to this dear family. I was proud of how well they worked as a team for the determined little boy.

    I told Michelle to expect everything of him. "If you expect him to move and to do things, he will," I said. I didn't care if he had to slide on his belly to put laundry in the basket or to reach the kitchen for his favorite treat—cookies. I wanted Brenden to feel the power of his family's expectations.

    Brenden delivered. He's 3 now, and he walks and runs with a walker, and soon will learn to use forearm crutches. He feeds himself, does household chores, and is becoming potty trained. If you saw him on the street he'd shout, "Hi, what's your name?" and you'd understand his words. I tell his family he's already running for mayor.

    It's all about expectations. My friend Sarah expected me to add Brenden to my busy caseload. I expected Brenden to do things on his own. I expected his family to expect much from him, and they did.

    The sweet, scared young family I first met weathered a storm that turned their lives upside down, and they have excelled. They now expect more of themselves. Michelle writes a blog about Brenden's journey and has spoken with families across the country whose unborn babies are expected to have spina bifida. She informally supports local families of children who have the diagnosis, and she chairs fundraisers as well. In 2011 she ran her first marathon, in New York City, as part of the Spina Bifida Association's team. Brenden cheered her on from the stroller in which she'd pushed him while training for the event.

    This is why I know I'm meant to do what I do. For every time I've been bitten or thrown up on, for every tantrum with which I've dealt, for every time a family has declined my help, I've also met people like Brenden and Michelle. People who illustrate that my impact, through families, can extend to an entire community. I expect that result with each new house I enter.


    Nicole M. Sergent, PT, MPOT, is an early intervention PT in West Virginia and is coowner of Milestones Miracles, LLC (www.milestonesandmiracles.com), which offers development products and education for parents.  

    Share Your Story

    This Is Why spotlights a particular moment or incident that either led the writer to a career in physical therapy or confirmed why he or she became a PT or PTA in the first place. APTA members are encouraged to submit brief essays (approximately 650 words) to Eric Ries, associate editor, manuscripts, at ericries@apta.org. Please include a high-resolution "mug"-style photograph (.jpg file). Submissions are subject to editing. Authors of pieces selected for publication will be notified.

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