Defining Moment Amputation and Ambulation A youth's fear becomes a PT's passion. By Toran MacLeod, PT, PhD | July 2017 Listen to 'Defining Moment' Let me start by saying there's no single moment, incident, or case that set my career course or perfectly explains why I became a physical therapist (PT). I did have, however, an irrational fear when I was a teenager that ties into my work now. As far back as I can remember, the workings of the human body fascinated me. When I was just a toddler, I'd make my way around the dinner table, giving my family shoulder massages. Even then, I liked that my hands could bring people pleasure and ease their stress. I started playing soccer when I was 3 years old and quickly became engrossed in the “great game.” The more I played—on 3 teams concurrently at some points during my junior high and high school years—the deeper my desire to master the sport. I watched videos of the great players and teams. I learned all I could about how to perform my best and avoid injury. But my joy for playing soccer was accompanied by a strange fear: that of losing a leg. I have no idea where it came from. By the time I was 16—playing at the semiprofessional level and envisioning a future in the sport—I thought a lot about losing a leg. It was terrifying. Were that ever to happen to me, I felt in my heart, I wouldn't be able to survive, let alone achieve my dream of playing soccer professionally. Fast-forward a couple of years, though, and my soccer dream was no more. I'd seen my older teammates struggle to make ends meet, and my mom helped convince me that going to college was a smarter long-term plan for my life. As I pondered career choices, I kept going back to my fascination with the human body. It seemed that all my interests and preoccupations were pointing me toward physical therapy. In high school, my love of anatomy prompted me to memorize all the muscles and bones. And I enjoyed watching people move more than just about anything else. Seeing folks walk, run, or stroll brought me pleasure. When I'd hang out at the mall with my friends, simply being around all that movement put me in my happy place. So, I ended up in PT school and loved it so much that I continued with a PhD to study the biomechanics of movement. When I was doing my postdoctoral work, a prosthetist asked me to help with a residency project centered on gait analysis of an individual with a leg amputation. I was quickly hooked. People with lower extremity amputation often have great difficulty with gait. Figuring out how best to optimize the movement of individuals who walk with prostheses became a passion. I'd once feared limb amputation. Now I embraced its reality, and the challenges and opportunities it presented. In 2014, I assumed my current faculty position at California State University Sacramento. That first year, I started what has become an annual, multi-day, interprofessional clinic that brings together student clinicians from physical therapy and other health disciplines, as well as certified prosthetists, to serve people in the community with limb amputations. Most of these individuals have lost limbs due to complications from diabetes. Physical therapy and increases in physical activity can positively affect their balance, mobility, and overall health. (I've conducted research in this area, as well.) I'll give you an example. A woman came into the clinic with knee pain so great that she barely could sleep, and she couldn't use her prosthesis at all. She was housebound. By simply changing the way she positioned her legs when she stood up, though, and with physical therapy to decrease her pain and build her strength, she's now not only sleeping much better, but she also can go fishing with her husband and take their dog for long walks. Everyone benefits from this clinic—the caregivers as well as the people served. Team members work together in a best-practice environment toward the common goal of improving participants' quality of life. It's had a big effect on me personally, as well. I feel that I'm part of a family of community members, students, and faculty that has embraced me and constantly tells me, through the clinic's many successes, that I'm in the right place and doing the right thing in this phase of my life and physical therapy career. I save all the thank-you emails, notes, and voice messages I get from people we've helped and reread or replay them when I feel exhausted or am having a bad day. They never fail to reenergize me. Three years ago, I started an Amputee Rehabilitation Focus Group site through APTA's Academy of Acute Care Physical Therapy. It's a place on the web where PTs can network and collaborate on best practices and developments in the field. Focus group members have offered programming during APTA's Combined Sections Meeting, as well. It's been a lot of work, but thanks to the dedication of many people, it serves as a valuable resource. Check it out at www.acutept.org/?page=ARFG. (You needn't be a section member to access it.) All of this is a far cry from where I was in my life when I envisioned soccer stardom and couldn't imagine a worse fate than losing a leg. Now, my favorite work as a PT is in long-term rehab. I once regarded limb amputation as the beginning of the end of life. I now know that it can be—and often is—merely the beginning of a different but bright new reality. I'm grateful for the opportunities my career has given me to help people who are broken, in a sense, get back on track. Through the force of their own will and the power of physical therapy, they can walk away with a full life ahead of them.