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Description
Rich woke up super excited that morning. He was going to start his physical therapy internship at the hospital in the city where he lived. Rich had just finished his first year of study working towards his DPT (Doctorate in Physical Therapy). Due to his excellent grades was awarded the internship that would start in the summer and last through his next fall semester. He was selected to work with one of the best known physical therapists in the area: Dr. Jason Gordon.

Rich had decided to pursue physical therapy when he was still in high school. His older brother Sam was in a motorcycle accident, and sustained a spinal cord injury that left him partially paralyzed from the chest down. Watching Sam attending physical therapy and struggle to regain his independence, and seeing the satisfaction when he made progress with his physical therapists made Rich want to make that kind of a difference in peoples' lives as well. To this end he threw himself into his studies. He graduated towards the top of his high school class, and majored in pre-physical therapy as an undergraduate, with a minor in psychology since he had seen first-hand how traumatizing an event like this could be. Rich wanted to be there in whatever capacity his patients would need. Finally it had come to this point. Getting this internship was a big milestone for Rich as far as becomnig a successful physical therapist in his own right once he finished school, and the real-world experience would definitely pay off in the future.

Rich arrived at the hospital and went up to the receptionist. "I'm here to see Dr. Gordon." he said after giving her his name. "Of course, he's expecting you. Follow me." she said as she led him down several hallways. Rich tried to remember the layout so he could find his way back to the entrance. "Right through here." the receptionist said, stopping at a door labeled Dr. Gordon. She knocked and a voice from inside said "Come in."

Rich walked in and introduced himself. "Nice to meet you Rich, I'm Dr. Gordon, though my colleagues call me Jason, so if you want to as well, that is okay by me." Dr. Gordon said with a smile as he stood up and shook Rich's hand. He was a few inches taller than Rich, with salt and pepper hair that was more gray than black at the temples and round glasses framing brown eyes. "Please have a seat and tell me a little about yourself." he prompted as Rich sat down. "Thank you Dr. Gordon, er, Jason." Rich said a little nervously. Dr. Gordon chuckled and this put Rich at ease. Rich told Dr. Gordon his story, and Dr. Gordon listened attentively. Once Rich was done, Dr. Gordon said "That's quite impressive, and admirable. Minoring in psychology while working towards physical therapy? That's no small feat. Well, since it's your first day I may as well give you the lay of the land." Dr. Gordon said, getting up and grabbing several charts from a file. Then he motioned for Rich to follow him.

"My current caseload is six patients, including a new patient I will just be starting with today. I do both inpatient and outpatient work, usually three of each. I see three patients a day for about two hours each. It works out so that one day I do the patients in the hospital, the next day I do my patients that come to see me. I was just about to make my rounds to my inpatients, so why don't you come along and I can introduce you?" Rich agreed. He was ready for this. As they were walking Dr. Gordon told Rich about the patients he would meet tomorrow, the ones that came in for appointments. There was Terrence, a 64-year old man who had had a stroke a few years ago that left him paralyzed on his right side, though he was starting to get some function and movement back. The second was Lauren, a twelve-year-old girl with muscular dystrophy who had been seeing Dr. Gordon since she was diagnosed. Finally there was Tim, a 30-year-old army veteran who had lost both his legs just below the knees during his tour. Dr. Gordon had been helping him learn to walk on prosthesis for the past few months, and he was getting quite proficient. Then they arrived at the first room of the patients in the hospital. "Now, I know you have a good disposition, and empathy with your patients is important, but you also want to maintain a professional level of detachment. There are going to be some sad stories with our patients, and if you let every single one affect you significantly you won't last long in this profession." Dr. Gordon warned Rich. Then he opened the door.

"Hello Jessica, how are you doing today?" Dr. Gordon said as he walked over to the bed. Rich saw it was a blonde woman laying there, her head to the side facing them, a blank look in her eyes. Her tongue was slightly out of her open mouth with a line of drool running down to her pillow and her arms were curled up at her chest. Her feet were pointed inward. "And this is my new intern Rich." Rich wasn't sure what to do, so he just said "Uh, nice to meet you ma'am." "Jessica is a thirty-six year old who sustained a traumatic brain injury two months ago from domestic violence. Her live-in boyfriend fractured her skull with a golf club." Dr. Gordon explained. "She is going to be here indefinitely while her family fights it out in the court for compensation and until they can make arrangements for her care." Dr. Gordon placed a hand on her arm and said "I'll be back shortly for our session." When he touched her arm her eyes rolled back in her head and she let out a gurgling sound. The arm he touched shook a little bit. Then they turned and left. "Some patients we meet in the physical therapy exercise room, but others like her I simply work with in their own rooms. For Jessica it's just a matter of trying to keep her muscles from getting too tight and talking to her, to help stimulate her brain." Dr. Gordon said as they walked to the next room.

The next room had a young boy laying in the hospital bed, wearing a neck brace with a ventilator attached. His legs and arms were propped up by pillows. "How's it going Matthew?" Dr. Gordon said as he walked in and leaned over so Matthew could see him. "Hi Dr. Gordon, I'm doing fine today." Matthew responded. "This is my new intern, Rich. Why don't you tell him how old you are Matthew" Dr. Gordon said, motioning Rich over. He walked over so Matthew could see him as well. "I'm eight" Matthew replied. "Nice to meet you Matthew, I look forward to working with you." Rich said. "Matthew had a bad skiing accident about three months ago while on vacation with his parents, and sustained a c-5/c-6 incomplete spinal cord injury. I've been working with him for a little over two weeks now, and he is already starting to be able to hold his head up by himself. He should be coming off the ventilator soon." Dr. Gordon said. "I can't wait for that. I can also move some of my fingers, see?" Matthew replied as he showed Rich his left pointer finger curling slightly. "I know, that's great Matthew! I will see you in a little while." Dr. Gordon said as he and Rich left.

They continued walking, and Dr. Gordon said "The next patient is Megan, and she is the new one I will be meeting for the first time, as she will be just starting physical therapy. She is a 21-year-old female who was in a bad car wreck and was thrown through the windshield about a month ago, while out celebrating her 21st birthday. Another drunk driver hit the car she was in. She was in the passenger seat and was not wearing a seat belt. Her friend who was driving suffered some broken bones, and the drunk driver was killed at the scene. Her two friends in the back sustained minor injuries. She has a long road ahead of her, as according to her chart she sustained a t-4 complete spinal cord injury. She will be getting out of bed and into a wheelchair for the first time today with us." They arrived at Megan's room and opened the door.

They walked in to see a girl with shoulder-length brown hair sitting in a hospital bed at a 45-degree angle, wearing a large brace from her shoulders to her waist over her hospital gown. Her arms had some scars that were starting to fade from glass cuts, and her lower body was covered with blankets, but there was a catheter tube and bag attached to the side of the bed. She was staring out the window, looking away from Rich and Dr. Gordon. "Hello Megan. My name is Doctor Gordon, and this is Rich, my intern." he said with a smile as he and Rich walked over to her. She slowly turned her head, and Rich had to suppress a grimace. Her face was purple and bruised in most places, though there didn't appear to be any permanent damage and most of the swelling seem to have gone down. There were still a few healing glass cuts and scrapes on her face as well. She had a neutral look on her face. "Hi." she said blandly, not even acknowledging Dr. Gordon's outstretched hand. "I just wanted to introduce myself, and get to know you. How are you feeling?" Dr. Gordon immediately flipped from cheerful to empathetic, but did so in such a disarming way that Rich almost didn't notice the transition. He took note of this technique for the future. "If you're referring to the lower two-thirds of my body, I don't feel anything below the middle of my rib cage!" Megan spat. Dr. Gordon gave a sympathetic smile. "I understand that, but I mean how are you doing emotionally? This is a big change, and both myself and Rich are here for you if you want to talk, or vent, or even if you need company whenever our schedule permits." "Mhmm" Megan grumbled. "Anyway, Rich and I will be back later since you are cleared to get out of bed and into a wheelchair today. It's not going to be an easy transition, but you will get through it I know. We will be there for you every step of the way." Megan said nothing.

Dr. Gordon turned to leave. Rich walked over and sat down in the chair next to Megan's bed. He took her hand. "Megan, I know this may not be of much help, but I know what you are going through, at least partially." "Do you really? Last I saw your legs were still working." Megan said sarcastically. "My brother was in a motorcycle accident, and he became paralyzed from his chest down. I watched him struggle through his recovery and adapting to his circumstances. He lives independently now, and is proof that you can come out the other side of this. I can draw on my experiences from him if you need anything. Maybe once you start to feel better I could arrange for him to come visit you, so you can talk to someone who gets it." "We'll see." Megan said as she turned away again. Her voice was a little bit softer than it had been before. "I'll see you later." Rich said as he followed Dr. Gordon out the door. Megan just stared out the window.

"I'm going to predict that your personal experiences with your brother are going to be very helpful in this career. Just remember what I said about professional detachment" Dr. Gordon told Rich as they headed back to his office. Once they arrived, Dr. Gordon said "If you want to set up anything you need at that table over there, I can offer you that work space. I will be starting my sessions in about 15 minutes. Today we will be working with the patients you just met in their rooms. Tomorrow I will show you the gym where we will be meeting our patients for their sessions tomorrow. Matthew and Megan will eventually be working in there with us as well, but chances are Jessica will not."

Rich worked on some paperwork while Dr. Gordon made a few phone calls, then it was time to begin the patient sessions, starting with Jessica. They re-entered her room, and this time Jessica was laying on her side facing away from them. "Looks like the nurses came and turned her while we were gone." Dr. Gordon remarked. "Okay so I am going to start with stretching and working her arms, and then move down to her legs. If there is time I will see if I can work on her head and neck." Dr. Gordon began by rotating Jessica onto her back. She groaned again when he touched her, and it seemed like every time Dr. Gordon touched her, that part of her body would spasm. "Jessica's very sensitive to physical touch. Her brain is trying to comprehend and reconnect with her body." Dr. Gordon explained. He started massaging her curled arms to loosen them up, the whole time talking to her about nothing important, just to have her hear his voice. Her arms were vibrating more often than not, she was groaning and gurgling, and drool had begun to flow freely from her mouth. Rich grabbed a tissue and wiped it away. If Dr. Gordon had not been there, Rich would have been certain Jessica was having a seizure. After a little while Dr. Gordon stopped, and Jessica's arms had relaxed significantly. They were no longer curled at her chest and rested on her legs, though her arms were still slightly bent and her fingers curled.

"Would you like to try, Rich?" Dr. Gordon said, motioning to Jessica's legs. "Um, sure, if it's okay..." Rich said unsuredly. "Of course, you're here to learn, and I will be supervising." Dr. Gordon responded. Rich came over and started massaging Jessica's legs the way he had been shown in school, with a few pointers from Dr. Gordon. Her body started having the same reaction it had when Dr. Gordon worked on her arms. Rich fought the spasms and kept working. It was surprisingly tiring, but once the session was finished her feet were no longer pointed at each other. Dr. Gordon cleaned up the drool that had accumulated on Jessica's face and pillow. "Goodbye Jessica. Great work today and I will see you next time." Dr. Gordon said with a smile. Jessica just stared blankly at them both as they left the room.

Description
Rich woke up super excited that morning. He was going to start his physical therapy internship at the hospital in the city where he lived. Rich had just finished his first year of study working towards his DPT (Doctorate in Physical Therapy). Due to his excellent grades was awarded the internship that would start in the summer and last through his next fall semester. He was selected to work with one of the best known physical therapists in the area: Dr. Jason Gordon.

Rich had decided to pursue physical therapy when he was still in high school. His older brother Sam was in a motorcycle accident, and sustained a spinal cord injury that left him partially paralyzed from the chest down. Watching Sam attending physical therapy and struggle to regain his independence, and seeing the satisfaction when he made progress with his physical therapists made Rich want to make that kind of a difference in peoples' lives as well. To this end he threw himself into his studies. He graduated towards the top of his high school class, and majored in pre-physical therapy as an undergraduate, with a minor in psychology since he had seen first-hand how traumatizing an event like this could be. Rich wanted to be there in whatever capacity his patients would need. Finally it had come to this point. Getting this internship was a big milestone for Rich as far as becomnig a successful physical therapist in his own right once he finished school, and the real-world experience would definitely pay off in the future.

Rich arrived at the hospital and went up to the receptionist. "I'm here to see Dr. Gordon." he said after giving her his name. "Of course, he's expecting you. Follow me." she said as she led him down several hallways. Rich tried to remember the layout so he could find his way back to the entrance. "Right through here." the receptionist said, stopping at a door labeled Dr. Gordon. She knocked and a voice from inside said "Come in."

Rich walked in and introduced himself. "Nice to meet you Rich, I'm Dr. Gordon, though my colleagues call me Jason, so if you want to as well, that is okay by me." Dr. Gordon said with a smile as he stood up and shook Rich's hand. He was a few inches taller than Rich, with salt and pepper hair that was more gray than black at the temples and round glasses framing brown eyes. "Please have a seat and tell me a little about yourself." he prompted as Rich sat down. "Thank you Dr. Gordon, er, Jason." Rich said a little nervously. Dr. Gordon chuckled and this put Rich at ease. Rich told Dr. Gordon his story, and Dr. Gordon listened attentively. Once Rich was done, Dr. Gordon said "That's quite impressive, and admirable. Minoring in psychology while working towards physical therapy? That's no small feat. Well, since it's your first day I may as well give you the lay of the land." Dr. Gordon said, getting up and grabbing several charts from a file. Then he motioned for Rich to follow him.

"My current caseload is six patients, including a new patient I will just be starting with today. I do both inpatient and outpatient work, usually three of each. I see three patients a day for about two hours each. It works out so that one day I do the patients in the hospital, the next day I do my patients that come to see me. I was just about to make my rounds to my inpatients, so why don't you come along and I can introduce you?" Rich agreed. He was ready for this. As they were walking Dr. Gordon told Rich about the patients he would meet tomorrow, the ones that came in for appointments. There was Terrence, a 64-year old man who had had a stroke a few years ago that left him paralyzed on his right side, though he was starting to get some function and movement back. The second was Lauren, a twelve-year-old girl with muscular dystrophy who had been seeing Dr. Gordon since she was diagnosed. Finally there was Tim, a 30-year-old army veteran who had lost both his legs just below the knees during his tour. Dr. Gordon had been helping him learn to walk on prosthesis for the past few months, and he was getting quite proficient. Then they arrived at the first room of the patients in the hospital. "Now, I know you have a good disposition, and empathy with your patients is important, but you also want to maintain a professional level of detachment. There are going to be some sad stories with our patients, and if you let every single one affect you significantly you won't last long in this profession." Dr. Gordon warned Rich. Then he opened the door.

"Hello Jessica, how are you doing today?" Dr. Gordon said as he walked over to the bed. Rich saw it was a blonde woman laying there, her head to the side facing them, a blank look in her eyes. Her tongue was slightly out of her open mouth with a line of drool running down to her pillow and her arms were curled up at her chest. Her feet were pointed inward. "And this is my new intern Rich." Rich wasn't sure what to do, so he just said "Uh, nice to meet you ma'am." "Jessica is a thirty-six year old who sustained a traumatic brain injury two months ago from domestic violence. Her live-in boyfriend fractured her skull with a golf club." Dr. Gordon explained. "She is going to be here indefinitely while her family fights it out in the court for compensation and until they can make arrangements for her care." Dr. Gordon placed a hand on her arm and said "I'll be back shortly for our session." When he touched her arm her eyes rolled back in her head and she let out a gurgling sound. The arm he touched shook a little bit. Then they turned and left. "Some patients we meet in the physical therapy exercise room, but others like her I simply work with in their own rooms. For Jessica it's just a matter of trying to keep her muscles from getting too tight and talking to her, to help stimulate her brain." Dr. Gordon said as they walked to the next room.

The next room had a young boy laying in the hospital bed, wearing a neck brace with a ventilator attached. His legs and arms were propped up by pillows. "How's it going Matthew?" Dr. Gordon said as he walked in and leaned over so Matthew could see him. "Hi Dr. Gordon, I'm doing fine today." Matthew responded. "This is my new intern, Rich. Why don't you tell him how old you are Matthew" Dr. Gordon said, motioning Rich over. He walked over so Matthew could see him as well. "I'm eight" Matthew replied. "Nice to meet you Matthew, I look forward to working with you." Rich said. "Matthew had a bad skiing accident about three months ago while on vacation with his parents, and sustained a c-5/c-6 incomplete spinal cord injury. I've been working with him for a little over two weeks now, and he is already starting to be able to hold his head up by himself. He should be coming off the ventilator soon." Dr. Gordon said. "I can't wait for that. I can also move some of my fingers, see?" Matthew replied as he showed Rich his left pointer finger curling slightly. "I know, that's great Matthew! I will see you in a little while." Dr. Gordon said as he and Rich left.

They continued walking, and Dr. Gordon said "The next patient is Megan, and she is the new one I will be meeting for the first time, as she will be just starting physical therapy. She is a 21-year-old female who was in a bad car wreck and was thrown through the windshield about a month ago, while out celebrating her 21st birthday. Another drunk driver hit the car she was in. She was in the passenger seat and was not wearing a seat belt. Her friend who was driving suffered some broken bones, and the drunk driver was killed at the scene. Her two friends in the back sustained minor injuries. She has a long road ahead of her, as according to her chart she sustained a t-4 complete spinal cord injury. She will be getting out of bed and into a wheelchair for the first time today with us." They arrived at Megan's room and opened the door.

They walked in to see a girl with shoulder-length brown hair sitting in a hospital bed at a 45-degree angle, wearing a large brace from her shoulders to her waist over her hospital gown. Her arms had some scars that were starting to fade from glass cuts, and her lower body was covered with blankets, but there was a catheter tube and bag attached to the side of the bed. She was staring out the window, looking away from Rich and Dr. Gordon. "Hello Megan. My name is Doctor Gordon, and this is Rich, my intern." he said with a smile as he and Rich walked over to her. She slowly turned her head, and Rich had to suppress a grimace. Her face was purple and bruised in most places, though there didn't appear to be any permanent damage and most of the swelling seem to have gone down. There were still a few healing glass cuts and scrapes on her face as well. She had a neutral look on her face. "Hi." she said blandly, not even acknowledging Dr. Gordon's outstretched hand. "I just wanted to introduce myself, and get to know you. How are you feeling?" Dr. Gordon immediately flipped from cheerful to empathetic, but did so in such a disarming way that Rich almost didn't notice the transition. He took note of this technique for the future. "If you're referring to the lower two-thirds of my body, I don't feel anything below the middle of my rib cage!" Megan spat. Dr. Gordon gave a sympathetic smile. "I understand that, but I mean how are you doing emotionally? This is a big change, and both myself and Rich are here for you if you want to talk, or vent, or even if you need company whenever our schedule permits." "Mhmm" Megan grumbled. "Anyway, Rich and I will be back later since you are cleared to get out of bed and into a wheelchair today. It's not going to be an easy transition, but you will get through it I know. We will be there for you every step of the way." Megan said nothing.

Dr. Gordon turned to leave. Rich walked over and sat down in the chair next to Megan's bed. He took her hand. "Megan, I know this may not be of much help, but I know what you are going through, at least partially." "Do you really? Last I saw your legs were still working." Megan said sarcastically. "My brother was in a motorcycle accident, and he became paralyzed from his chest down. I watched him struggle through his recovery and adapting to his circumstances. He lives independently now, and is proof that you can come out the other side of this. I can draw on my experiences from him if you need anything. Maybe once you start to feel better I could arrange for him to come visit you, so you can talk to someone who gets it." "We'll see." Megan said as she turned away again. Her voice was a little bit softer than it had been before. "I'll see you later." Rich said as he followed Dr. Gordon out the door. Megan just stared out the window.

"I'm going to predict that your personal experiences with your brother are going to be very helpful in this career. Just remember what I said about professional detachment" Dr. Gordon told Rich as they headed back to his office. Once they arrived, Dr. Gordon said "If you want to set up anything you need at that table over there, I can offer you that work space. I will be starting my sessions in about 15 minutes. Today we will be working with the patients you just met in their rooms. Tomorrow I will show you the gym where we will be meeting our patients for their sessions tomorrow. Matthew and Megan will eventually be working in there with us as well, but chances are Jessica will not."

Rich worked on some paperwork while Dr. Gordon made a few phone calls, then it was time to begin the patient sessions, starting with Jessica. They re-entered her room, and this time Jessica was laying on her side facing away from them. "Looks like the nurses came and turned her while we were gone." Dr. Gordon remarked. "Okay so I am going to start with stretching and working her arms, and then move down to her legs. If there is time I will see if I can work on her head and neck." Dr. Gordon began by rotating Jessica onto her back. She groaned again when he touched her, and it seemed like every time Dr. Gordon touched her, that part of her body would spasm. "Jessica's very sensitive to physical touch. Her brain is trying to comprehend and reconnect with her body." Dr. Gordon explained. He started massaging her curled arms to loosen them up, the whole time talking to her about nothing important, just to have her hear his voice. Her arms were vibrating more often than not, she was groaning and gurgling, and drool had begun to flow freely from her mouth. Rich grabbed a tissue and wiped it away. If Dr. Gordon had not been there, Rich would have been certain Jessica was having a seizure. After a little while Dr. Gordon stopped, and Jessica's arms had relaxed significantly. They were no longer curled at her chest and rested on her legs, though her arms were still slightly bent and her fingers curled.

"Would you like to try, Rich?" Dr. Gordon said, motioning to Jessica's legs. "Um, sure, if it's okay..." Rich said unsuredly. "Of course, you're here to learn, and I will be supervising." Dr. Gordon responded. Rich came over and started massaging Jessica's legs the way he had been shown in school, with a few pointers from Dr. Gordon. Her body started having the same reaction it had when Dr. Gordon worked on her arms. Rich fought the spasms and kept working. It was surprisingly tiring, but once the session was finished her feet were no longer pointed at each other. Dr. Gordon cleaned up the drool that had accumulated on Jessica's face and pillow. "Goodbye Jessica. Great work today and I will see you next time." Dr. Gordon said with a smile. Jessica just stared blankly at them both as they left the room.