Shoulder Therapy

     Rushing into Manhattan, I started to feel a little dizzy and it occurred to me that I hadn’t stopped to eat breakfast.  I needed to get my blood sugar up fast, but the options are kind of limited on 57^th St,  where there are multiple expensive, formal restaurants.  I spotted a Duane Reade, hurried in, grabbed a Twix and paid the cashier.  “Enjoy  it, young lady,” she said to me.  I was surprised because, at almost 51, I was pretty sure I’m older than she is.   I figured maybe she addresses everyone this way, regardless of age, but then she said “enjoy it while you still can, unlike me,” gesturing at herself. I was too behind schedule to ask what she meant, so I dashed out the door.

At shoulder therapy, I sat on the table with my feet not touching the floor because I’m so short.  I had to keep myself from swinging my legs like a little kid.  The young Cuban doctor of physical therapy was trying to move my shoulder, but it has been so painful for so long that the surrounding muscles have contracted around it like a fortress.  “We have to get your nervous system to relax and stop this guarding,” he said and I was startled by the language, which I have not encountered in all of my other rounds of PT.  “That sounds like something we would say in psychology about trauma,” I told him.  He nodded in agreement.  “Physical therapy is half body and half psychology,” he says, also a concept I have not encountered before.  “That makes sense,” I tell him, “because so many mental health conditions have physical effects.”

I arrived at work just in time for the staff meeting, where we discussed D., who is cognitively impaired from fetal alcohol syndrome.  She keeps leaving placement after placement – Safe Haven, women’s shelter, medical respite, supportive housing and she is running out of options.  When asked why she left someplace, she always says that it was giving her flashbacks and we can’t get her to understand that because the flashbacks are in her mind, they are going to go wherever she goes.  

As a staff, we agree on a single message, to encourage her to stay where she is while she is waiting for permanent housing.  It’s a hard line to hold sometimes because she seems convinced that there are more options that just haven’t been offered to her.  “I’ll  sleep in Port Authority,” she’ll say, hoping that our concern for her safety in that situation will make us magically come up with an option that doesn’t exist.  Although we ended the meeting with a plan, there isn’t one of us who doesn’t expect to hear that she has left her latest placement again.