Defining Moment Harnessed Yet Unleashed A resolute patient moves forward-on a treadmill. By Karen Gage Bensley, PT, DPT, MS, PCS | October 2015 Listen to 'Defining Moment' Determination. Persistence. Ability. These are the words that stream through my mind as I watch Alec walk on the treadmill in his partial-weight-bearing harness: face determined, each step a huge effort. His dad coaching him while I fine-tune the controls, the pace, and his alignment. Alec, 18, has neuromuscular issues throughout his body; the origins are not completely clear. He spends much of each day in a manual wheelchair. But he comes to our clinic twice a week to work out with me, assisted by our LiteGait® apparatus. He is motivated, even happy. He moves me, sometimes to tears of joy, as I learn from him. Today, Alec arrived sweaty from the June humidity and tired from a full day of school. He may also have visited the local Walmart, where he buys groceries for the school's business selling student-made dog bones. Perhaps he's already ridden his adaptive bike. Maybe he's done some homework, too, painstakingly pecking away on his communication device with his imprecise pointer finger. I don't always know everything Alec's been up to. Nor does his dad, necessarily. Alec can't directly tell us. We can, however, take a "21 questions" approach. He answers each query with a subtle head shake that means "No," or with his right hand closed and his fist pumping up and down to signal "Yes." I love it when he jokes with me—responding "Yes" when the answer's really "No," but doing so with a playful twinkle in his eye and the hint of a smile on his lips. His dad and I ask Alec if he's up for the challenge of the 6-minute walk test—a potentially nonstop performance on the treadmill in the LG harness. His answer is a vigorous "Yes," even though he looks a bit pale, is sweating, and seems tired. We're not surprised. That's his determination and persistence talking. They are the qualities that, in turn, have produced his ability. After all this time supporting Alec together, his dad and I work with almost mechanical precision, as teammates, through the many steps required to get Alec safely and securely into the apparatus. It lifts and safely supports Alec, allowing him to stand upright on his feet and move without fear of falling. This is a dance we've performed for the past 2 years, as Alec slowly but surely has transformed from a teenager who relied on his wheelchair into a walking, biking, skiing, and swimming athlete. Alec has blossomed into someone who loves life—every last drop of it. He motivates and inspires me, my workmates, and the clinic's other patients. We relish these opportunities to, in a very real sense, activate his aspirations. So, we harness Alec in. We stand him up. We walk onto the treadmill with him. He's aligned well, stepping forward before the treadmill belt even has begun moving. I ask him, "Are you sure you're ready for this challenge today?" Now I'm the one doing the teasing, because I know that he is. Alec snorts, squeals in the deeper voice he's been developing of late, and flashes his strikingly blue eyes at me—as if to say, "Let's go, already!" He stomps his feet, emphasizing the point. Love. Joy. Encouragement. More words stream through my mind. His dad and I step off the device. The treadmill and the timers start. Alec begins stepping, acknowledging his own intent image in the full-view mirror. I feel certain that he'll beat his own distance record, because that's what he does, continually. His dad, Alec's amazing coach, shouts words of support and encouragement. "You're doing great!" "Those are perfect steps!" "Pick up the pace. Don't let the treadmill get ahead of you!" I step back and watch in awe as Team Alec—father and son—power ahead, relentlessly toward the finish line. The timer quickly counts down. Although Alec's effort always is 100%, sometimes a single minute seems much longer to me, as he laboriously steps and strains. But not today. The minutes fly by, with Alec immersed in the challenge. Still, I frankly expect him to take a break at any moment. He always works hard, but typically his feet begin to drag behind him after a minute or so on the treadmill, signaling his need to rest and regroup. Today, however, the minutes tick by with no drop-off, no letdown. Alec's face is set in determination. His dad excitedly spurs him on. "You're two-thirds of the way there!" "Great steps!" "Make your last minute the best! You can do it!" I've been adding my own words of encouragement, but my voice falters as I tear up, deeply moved by what I'm witnessing. By now, other people—staff and patients—have stopped what they're doing to cheer Alec on. There's a palpable feeling in the air that something big is happening before their very eyes. Watching Alec and his burgeoning fan club, I reflect on how quickly this all has happened. When Alec first arrived at the clinic, he could not walk at all. I was the manual facilitator of his every step. He was a frustrated teenager who felt misunderstood—seen as someone who perhaps was incapable of ambulation. I sensed that he had his own doubts, as well. But now Alec is a happy, confident young adult who accomplishes big things every session, teaching himself and all of us the value of persistence. The visual timer changes color and beeps, indicating the 6 minutes are up. Well, the timer changes color. I assume that it beeps. The truth is, any sound from the machine is buried in the cheers that have erupted. Alec has walked at 1.1 miles per hour for 6 minutes without any break in his stride or focus. This is farther and longer than he has walked in his entire life. Alec is beaming. The room is a sea of wide smiles. I wipe the tears from my eyes as I see the pride and joy on the face of Alec's dad. Caring for Alec is challenging, but the ultimate payoff for his father are moments like this, when Alec's abilities, passions, and accomplishments are on full and powerful display. I feel amazed and blessed to be a part of this team. For me, this is what being a pediatric physical therapist is all about: helping to transform lives, being inspired by the resilience of patients and their families. It never gets old. In fact, it's constantly renewing. Karen Gage Bensley, PT, DPT, MS, PCS, is a pediatric physical therapist in Maine, with several clinical affiliations and teaching positions. She also is her state's representative to APTA's Section on Pediatrics.