Therapy 1

Steven H. Cornelius
Music and Stroke

February 7, 2012

When released from intensive care, I was moved Mass General’s neurology ward. Things were coming along nicely. Already I could raise my left shoulder, slowly bend my elbow, and even move my thumb.

That day, a physical therapy intern came in to see me. After few niceties, she put a comb on the bed table, and then asked me to comb my hair. If I could have spoken more than a couple words at a time, I would have tried to explain why hers was a stupid request. (Nearly 30 years of college “professing” makes ideal teaching moments hard to pass up.) But alas, I could manage neither the words nor organize the concepts.

So being a good sport (and appreciating her attention), I gave it a try. After some struggle, I captured the comb between palm and thumb. With much shoulder raising, head lowering, and eventually some elbow bending, I eventually got comb to head, which knocked the comb out of my hand.

So I tried again, and again, and for what seemed like an eternity, as she looked on encouragingly. I could go through the gory details of the repeated attempts, but not much changed.

So, the teaching moments…

Was there a teaching moment for me?

I’m guessing she had a big one in mind: One can lead a normal life after a stroke, but you have to try.

I already knew that. As noted in earlier posts, I had begun my rehab almost as soon as I regained awareness. Indeed, I was anticipating full recovery within a month or two.  Being stubborn and resilient had always worked in the past. I assumed it would work again now.

The teaching moments for her:

1. Solve small tasks before attempting big ones.
2. Strong structures require solid foundations.
3. Break up a complex problem in multiple smaller ones.
4. Focus the mind on the problem (not practicable without having done #3).
5. It may be appropriate to ask the impossible at some point, but probably not at the beginning.

I was constantly surprised that my therapists didn’t break down complex tasks into their basic elements. After all, every successful musician knows to do this.

Perhaps a holistic approach is generally most effective in physical rehabilitation? Or perhaps my therapists simply didn’t have the benefit of being musicians.

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Postscript: A friend of mine had a right-brain stroke last night. He was a longtime program host on public radio and has a golden voice. Let’s hope he recovers quickly.

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