Defining Moment Getting a Rise Out of Him A long but successful walk to recovery. By Aaron Keil, PT, DPT, OCS | April 2015 Listen to 'Defining Moment' I still remember what his room looked like. The curtains always were shut. He never would let anyone open the drapes. The mood was cold. Dark. Depressing. His wife always sat in the same chair in the corner, quietly supporting her husband. Eric was in his late 30s and had had a massive stroke. According to the chart, it was related to recreational drug abuse. That was all I knew about the cause. It didn't matter. What did matter was that he was my patient, and that I was going to help him. I was a brand-new physical therapist, and I was eager to get Eric on the road to recovery. After the chart review, I conducted a mental walk-through of the evaluation. How would I assess his tone? Would I test his reflexes? What was the definition of "1-out-of-4 strength," again? Okay. Now I was ready to meet my patient—and for him to meet his energetic, freshly minted physical therapist. I knocked on the door. Eric's wife gently said, "Come in." As I entered the room I started my spiel. "Good morning. My name's Aaron. I'm your physical therapist. I'm here to help you get better. I… ." That was as far as I got. It was clear that Eric did not want me there. At all. In fact, my mere presence deeply disturbed him. At that early point in his recovery, he couldn't articulate a single intelligible word. But he didn't have to in order to get his point across. He flailed about in the bed, communicating in no uncertain terms that I was to get out—and that he would not be participating in physical therapy, that day or any day. I tucked my tail between my legs and exited the room after meekly acknowledging, "It looks as if this isn't a good time for you." When I entered the hallway I saw empathetic expressions on the nurses' faces. I quickly went on my way. "Why wouldn't he want my help?" I wondered. "Does he have any idea what I can do for him?" The next several visits were the same as the first. I'd go into Eric's room and try my best to convince him to let me work with him. He would yell and scream. I'd go away, defeated again. "I just don't get it—he won't even try!" I thought to myself. "Doesn't he know that his situation can improve?" Actually, I then got to thinking, he probably doesn't know that. So, I decided to give convincing him a final try, but to alter my approach. The next time I went to Eric's room, I asked his wife if I could speak with him privately. She agreed, leaving me alone with her husband. I knelt by his bedside, took a deep breath and said, "Look, I know you don't want me here. I get it. But please just hear me out now. If, afterward, you don't want me to come back, I won't. All right?" He nodded. "Eric, you can get better," I began. "I don't know how much better, exactly, or just how long it will take, but, if you and I work together, you can experience improvement. You can start to get your life back. And that process can begin today." Did I know for sure that he ever would walk again—or even be able to stand up on his own, for that matter? No. Could I tell him with certainty that he was going to "beat this thing"? I couldn't. But I could see that, at that moment in his life, what Eric needed most was a ray of hope that his quality of life could improve. Eric was silent for what felt to me like an eternity. But finally, he looked directly into my eyes and nodded affirmatively. It was on. We sat together on the side of the bed that day, and Eric promptly passed out. He required maximal assistance for most everything we did together during the ensuing few weeks. But slowly, through a lot of sweat and tears, his abilities began to improve. His main goal was to walk unassisted. I wasn't sure that ever would happen, but I wasn't about to deflate his hope. What I told him was that, if it was ever going to happen, he would have to give me 100% effort during each and every physical therapy session. That's exactly what he did. In fact, to this day—20 years later—Eric remains 1 of the most dedicated patients I've ever had. We worked together each day for several weeks, until he was discharged from the unit, to continue his therapy at another facility. At the close of our final session, Eric made me a promise. He told me that when he could walk again on his own, he would come see me. Several months later, a familiar-looking woman approached me while I was walking down the hall at my job. It was Eric's wife. She said she and Eric had come by to say hello, and that Eric would join us soon. A few moments later Eric came around the corner… in a wheelchair. I'll admit that I was a little disappointed. I'd hoped that, in keeping with his pledge to me, he'd be walking on his own the next time I saw him. Eric still was quite a way down the hall from me when our eyes met. I started walking toward him. He held up his hand, motioning for me to stop. He was grinning. His eyes then narrowed, as if to focus on the task at hand. It was a look I'd seen from him countless times in our therapy sessions. He locked the brakes, stood up, grabbed a cane from behind the wheelchair, and started to walk toward me—slowly and deliberately, on his own, just as he had promised. When he reached me, we hugged like old friends who hadn't seen each other in decades. We both shed some tears. Then, Eric handed something to me. It was a small piece of pure silver—the literal color of the figurative lining I'd offered him at 1 of his darkest moments. On it, a single word was inscribed: "Thanks." In the 2 decades since that amazing moment, my career has seen its share of highs and lows. The excitement of opening a private practice and the disappointment of ultimately having to close its doors. The thrill of being part of a successful drive to achieve direct access to physical therapy services in my state, followed by the realization that overcoming local administrative barriers would be a greater challenge still. And so on. Through all the peaks and valleys, however, 1 thing has remained constant: I still have the privilege of helping people. People like Eric. People who have taught me more than I ever could hope to teach them. For that, I am very, very grateful. No, Eric—thank you. Aaron Keil, PT, DPT, OCS, is a clinical associate professor, director of orthopedic residency, and director of faculty practice in the Department of Physical Therapy at the University of Illinois at Chicago.