Defining Moment Taking a Stand The power of stubbornness, physical therapy, and prosthetics. By Mariya J. Spencer, PTA | October 2017 I never intended to go to college, let alone pursue a degree that would challenge me in every way and shatter perceptions of my physical limitations. I was born in Russia with a congenital condition that affected both of my lower extremities. The fibulas never developed, the tibias were deformed, and a mass of disorganized tissues constituted my "feet." From birth, it was determined that, were I ever able to walk, I would require amputation and prostheses—services that the medical system at that time and place could not provide. Thus, my parents made the unimaginable sacrifice of allowing me to be adopted into an American family that could help me get the services I needed to live the best possible life. I was 18 months old when I arrived in the United States. The necessary procedures were swiftly scheduled. I received physical therapy to learn to navigate my environment using prostheses. Given the obstacles I faced as someone with bilateral, trans-tibial amputation, I frequently was told, when I was growing up, what I likely wouldn't ever be able to do. All that did was make me very stubborn. Eventually—after undergoing various childhood surgeries, using and discarding multiple prostheses, and benefiting from many years of physical therapy—I was a high school graduate who aspired to follow in the footsteps of the individuals who had helped me. With only a narrow knowledge of the variety of available medical professions, I set my sights on becoming a nurse and dove headfirst into my collegiate studies. Before long, however, something inside me shifted. I was all set to apply to the nursing program, but I couldn't bring myself to commit to it because I knew that I wasn't "all in." Somehow, it didn't feel like the right fit. I needed to take a long look at myself and ask what I really wanted to do with my life. During my semester off from college, I heard rumors of a physical therapist assistant (PTA) program that was in development at my school. I was overcome with a sense of urgency. "That is for me." I simply knew it. At this time, I was working 3 jobs—2 at restaurants and another at the front desk of a gym where I also exercised. It's important to note here that, at that point, very few people who knew me had any idea that my "legs" actually were prostheses. I always wore long pants, and physical therapy had done wonders for my mobility and gait. One morning at the gym, a woman approached my desk and bluntly inquired about my legs. I was annoyed that she'd even noticed anything was different about me, because I was used to fooling people and I didn't want the attention. But she introduced herself as a physical therapist who owned a local outpatient pediatric facility. She told me that she'd noticed a few subtle compensations—typical of people with amputation—that I'd made one day while I was working out. She added that she wasn't sure if my amputation was bilateral or unilateral—a testament to the excellent physical therapy I'd received. The PT invited me to spend time at her facility and meet families with children who were just beginning physical therapy, in hopes that their seeing how much I'd achieved with the help of physical therapy might encourage them. Little did I realize at the time that this facility would be the site of my first full-time job as a new PTA. After months of preparing my application, I had the honor of being part of the first group of students accepted into the Tyler (Texas) Junior College PTA education program. This was where the real work began. Not only were the academics challenging, but I quickly learned that I sometimes needed to creatively modify traditional classroom methods in order to complete tasks. This occasionally could be daunting, but remember: I am stubborn. Sometimes I had to surrender to the idea that asking for help was not only okay but also necessary to best ensure a patient's safety and my own. There were situations in which I needed to request a little extra time to determine how best to complete a task. For example, I can't demonstrate heel raises because my ankles are immovable, yet I wanted to show a patient how to do them. I learned to laugh and simply ask someone else to demonstrate. In school, I also had to overcome what I call my "physical bubble." Because I'd long hid my prostheses for fear of being seen as "different," I'd grown to shun close contact with other people, as they might accidentally bump into my lower leg and discover it was a prosthesis. This was my biggest obstacle to successfully completing the PTA program. I'll always remember the first day we were required to wear shorts to lab in order to identify physical structures. I was terrified and even tempted to excuse myself from the activity. I stepped into the lab room feeling terribly bare—I hadn't worn shorts in public since childhood. I anticipated lots of stares and whispering, as I so often had experienced when I was younger. My classmates, however, were great. They acted as if they didn't even notice. I became more at ease being "out there." It helped, too, that midway through the PTA program I acquired a fabulous new set of prostheses that further enhanced my comfort level with being "exposed." I cannot say precisely why I knew I needed to be a PTA when I first learned about the Tyler program, although physical therapy obviously always had been a big part of my life. But I thank God for guiding my steps toward and through the program, outside of my own bubble, through the PTA board exam—I cried tears of joy as I discovered this summer that I'd passed—and into my career as a pediatric PTA. My full patient load is challenging, but in these early months of my career in physical therapy I savor the reassurance I can offer parents that I know, to some degree, what their children are experiencing. I'm enjoying my ability to encourage those kids to reach higher ground. I'll never forget that I once was a child learning to take her first awkward steps.