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Public Outcry
Gathered in an inconsequential room around a small table with the physiatrist, social worker, and my sister-in-law, Debbie, I eagerly awaited further words affirming Matt’s progress after six weeks of intensive therapy. When asked for his opinion, the doctor lazily leaned back, arms across his chest, and nonchalantly reported, “Perhaps he is a little better.”
“Perhaps he is a little better?” How cavalier and disrespectful of, and in stark contradiction to, the weekly reports therapists and staff enthusiastically recounted in his presence and later to our family. Based on some underlying intuition, he seemed to have a predetermined outcome in mind and wouldn’t yield regardless of what Matt did or what others said. In defense of his personal beliefs, the doctor willingly discounted the staff’s input and the family’s observations. He didn’t factor in or understand the above-and-beyond contribution Matt’s parents offered—two physical therapists who were fully invested in facilitating his recovery.
How can it be that, yet again, this physician, whom I had met when Matt first arrived, did not care about us as fellow human beings? Offering no sympathy or display of compassion to soften his convictions. I wondered what had become of the golden rule, “Do unto others as you would have them do to you?” I was struck mute, believing I had no comeback that could possibly shake off his negativity and reclaim a semblance of mutual regard, support, and purpose.
Thankfully, Debbie, a nurse, took the offense on my behalf and peppered him with questions that led to dead ends. “No, he did not think Matt would ever be able to live alone, and most likely, he would require extensive home services.” Mustering my composure, I interjected the presupposition that surely, he must have seen similar cases where individuals beat the odds and reclaimed a modicum of a normal life. After some thought, he replied, “Yes, in his extensive experience—one person—just one.”
The final battleground: Matt would need lengthy outpatient therapy at Sunnyview. Forthrightly and firmly, I shared that Matt would receive therapy through Saratoga Hospital, close to home. The doctor was shocked and insulted, and when I couldn’t be swayed, he dismissed the quality of Saratoga’s rehab services and anything other than Sunnyview’s program. The final jab, this choice would hinder Matt’s potential achievements.
Unbelievable, yes, but true. It was difficult to cast off the disparaging words, flood of emotions, and gloom imposed upon us in that short meeting. We sought validation from the different therapists, who, walking a tightrope, told us to trust the tangible, observable changes we have witnessed all along. They weren’t done, and neither was Matt. Don’t get distracted. Stay focused on the plan of care and give it time.
Making a concerted choice, we reviewed the evidence and regrouped. First, the ICU, which had used the Glasgow Score to identify the level of injury and coma severity, had documented its progression from a three to an eight out of fifteen. Here, Sunnyview utilized the Coma Recovery Score to direct and monitor their interventions in rehab. This tool, which assessed six subscales: auditory, visual, motor, oral motor/verbal, communication, and arousal on a 23-point scale, likewise showed improvements. Earlier in the week, Matt’s score had risen from a baseline score of 10 to 19.
Secondly, based on Wednesday’s Rounds, as documented in my Journal, all the therapists had given Matt glowing reports and said he was “emerging:” (1) Speech: Increased arousal, emerging yes/no responses, pointing to objects correctly 4/5 and words 2/3. He is mouthing words and sipping water, and it is anticipated that soon he can eat regular food. (2) OT: emerging cognition and physical function, beginning to use the right arm, and demonstrating better movement quality. (3) PT: Matt walked 400ft. x 3 with the Rifton Tram and, another time, walked buddy-style 60ft x2 with moderate-maximal assistance of two. He is initiating advancing his right leg more often.
Thirdly, we relied on experiential observations and truths. As his parents and family, we knew Matt best, and our rabbit ears were sensitive to a spectrum of changes. He was better. His current presentation and ability did not compare to the day he arrived, let alone when the police first found him. We knew that the hemorrhage had bled into the ventricles and not cortical tissue, and we remembered the encouraging words of the physician in the ICU who declared, “Matt’s chance of recovery was good because he had been so smart.”