Defining Moment It Takes a Moose, Sometimes A reminder of the power of community. By Paula Allen, PT, GCS | March 2016 Listen to 'Defining Moment' "Moose" and "Porky" stepped into the gym, where I was treating Tom, a 78-year-old gentleman who was in danger of losing his right leg due to a nonhealing ulcer. They had come to encourage their friend—to tell him that losing a limb was not the worst thing that could happen. "Look at us," Moose said. "I lost my leg above the knee, and Porky lost his leg below the knee. We've both got prostheses. We're walking around without assistive devices and doing just fine. Heck, we walked all around Summerfest yesterday and did great." I appreciated their positivity but sensed Tom's apprehension. Here he was in rehab, where he was trying to save his limb with vacuum-assisted closure and hyperbaric oxygen therapy. His chin quivered as he blinked back tears. "I'm not ready to lose my leg yet, guys," he said. We continued the physical therapy session. Tom practiced standing in the parallel bars, his arms shaking as he tried to maintain touch-down weight bearing on his right leg. "Come on, man!" Moose exclaimed. "You'll do much better with a prosthesis. You'll have 2 legs to stand on!" "You could be walking in a few months with a prosthesis," Porky echoed. "We know you're scared. We were, too. But the sooner you get the process started, the quicker you'll get your life back. Why mess around?" It wasn't working, and Tom's friends could see it. The apprehension in his face showed that Tom wasn't ready for this conversation. His friends knew him well. And they knew what he was going through, because they'd gone through it themselves. So, they changed gears, calculating that laughter was the best medicine right now. Before long they were kidding Tom about being the only one in their group with a "normal" name. "You remember 'Bozo,' don't you?" Porky asked, referencing another member of their circle. "That's nothing!" Moose blurted, picking up the thread. "What about old 'Bucket Head'?" The 3 men shared a hearty laugh while I tried to imagine what a photo of Tom, Bozo, and Bucket Head—taken by Superman, maybe?—might look like. As Tom's session neared its close I thought of something. In a strange confluence of scheduling, my next patient was a young man named Craig who'd recently lost a leg and soon would be fitted for a prosthesis. He was the guy who really needed Moose's and Porky's pep talk about the wonders of prosthetic legs. So, I asked them if they'd be willing to stay a little longer to talk with him after Tom's session was complete. They enthusiastically agreed. Craig was sitting in his wheelchair in the waiting room. I asked him if he'd like to come into the gym and meet a couple of guys who'd lost limbs and now literally were "walking the walk." "Sure," he replied. Porky and Moose greeted Craig with vigorous handshakes, as if they were reencountering a long-lost buddy. "Hey, man!" Porky said, smiling and pointing to the place where the younger man's leg used to be. "Welcome to the club!" "You're one of us now," Moose said in a proud tone that suggested membership has its privileges. Craig's eyes lit up as he watched these 2 men navigate the room easily, walking with barely a discernible limp. "Seriously?" he asked, looking Porky's and Moose's clothed legs up and down. "You guys are amputees?" "No foolin'!" Moose replied, tapping his prosthetic right leg. Craig's treatment session progressed differently from the usual that day, with spirited anecdotes supplementing the physical therapy. Porky regaled Craig with stories about his prosthesis's varied "bonus" uses—such as the fact that it could be removed and turned upside-down, with the sole of the attached shoe serving as a table for a cold beer. Moose, for his part, shared his secret for soothing irritated skin at the point where the residual limb and the prosthesis meet: a special ointment that makes up in effectiveness what it lacks in bouquet. "To be honest with you, the stuff stinks," Moose said, holding his nose for comic effect. "But I'll tell you what. It'll become your best friend." Throughout Craig's visit, Porky and Moose talked about various obstacles they'd faced and overcome. The point wasn't everything they'd lost but, rather, everything that now was much the same as it had been before the amputation. "I found out, too, that there were things I could do to help myself," Moose noted. "I was a big guy. When I lost 70 pounds, it sure made walking with the prosthesis a lot easier." Witnessing the camaraderie that developed so quickly and easily in the otherwise quiet gym reaffirmed in my heart why PTs do what we do. We use many tools to help people reclaim their lives. These include not only our skills as trained health care professionals, but also the opportunities physical therapy provides for interaction with other people—compatriots who offer hope and healing in their own way. The most skilled PT or prosthetist could not have offered Craig the kind of education he received from Moose and Porky that day. It reminded me that patients in a busy gym are watching and learning not only from their therapists, but also from the people around them. Craig had no idea that, just as he was buoyed by Porky and Moose that day, he, in turn, inspired several individuals in the room who were struggling with their own painful rehab after knee replacement surgery. One of them later told me that he'd felt motivated by Craig's vigor during the session. "If he can work that hard with only one leg, I certainly can do this," the patient said. I went home that day feeling energized by the complexity of human interactions I'd witnessed, the serendipitous crossing of paths, and the blessing and privilege of being present for patients during some of their most vulnerable and life-changing moments. Craig approached physical therapy with new determination after his discussion with Porky and Moose. Tom could see hints of what they had told him as he watched Craig propel his wheelchair with a single foot. I could see recognition starting to dawn on Tom's face that, whatever the outcome might be of attempts to save his limb, he was going to be okay. Being present at moments like these, which PTs experience more often than we may realize, is part of what keeps the profession fulfilling even after many years. I'm forever grateful for such moments. I'm also a clinical educator, and I remind interns to savor these powerful glimpses into the nitty-gritty of human relationships—to embrace this education in experiences that differ from their own. These moments are reminders that learning and teaching can come at unexpected times, from unexpected sources. Sometimes even from people with funny names. Paula Allen, PT, GCS, practices physical therapy on the extended care unit at Northwestern Medicine Lake Forest Hospital in Lake Forest, Illinois.