Tuesday, August 23, 2011

A Biting Response

The act and art of physical therapy for a stroke patient should be part of any ongoing recovery strategy, it’s not, but it should be.  We have had the great good fortune to have a physical therapist visit our home twice a week for the last month.  Great and Wise thought it a good idea for Marty to work with a therapist to help with her overall strength, her flexibility and improve the use of her right arm, broken over a year ago.  
The therapist who is working with Marty is reasonably gentle, knowledgeable, relaxed and a good conversationalist, all important traits to do therapy with Marty.  The ability to hold a reasonable conversation is a must for me as I am always full of questions and pretty much always present, I have the need to supervise.
Last week the therapist was dutifully stretching and taxing Marty’s right arm, the one she broke in March of 2010.  The therapist was supporting Marty’s right arm with her right hand while reaching across Marty with her left arm to pull Marty’s arm up and across the front of her body; thus stretching and taxing.  The break in Marty’s arm has healed but because of her general lack of strength and mobility its very stiff so the amount and the direction the therapist was moving it hurts, I could see it in Marty’s face.  

I sat across the breakfast table watching the process unfold; the therapist slowly moving Marty’s arm to the point where Marty would sort of grimace and the say “Quit it,” then back again.  Generally I accept and reasonably tolerate this sort of benign abuse of Marty; it really is causing pain for her a good cause.  I don’t like it but truly the means justify the end and I Marty knows that, most of the time.  

As I sat watching the process and making mental notes for when I would do what the therapist was doing I caught Marty’s eye just briefly and saw the flash in her eye, I saw that part of her that hates the lack of control in her new life start to surface.  I could see it before it happened as Marty said stop and grimaced each time the therapist moved Marty’s arm to the point of pain and each time she moved her own arm slowly in front of Marty’s face.  Marty’s eyes lit up, Marty’s brain engaged, old Marty started to resurface as she grimaced, as she felt helpless at stopping the pain, as she thought about her only way to get release from the pain and assert her control.

I started to say something but I was a bit slow on the uptick and before I could warn the therapist Marty reached over with her head and tried to clamp her teeth into the fleshy part of the therapist’ bicep.  I swear I could see it in Marty’s eyes before she did it, I could see in her face she going to put a stop to this nonsense in the only way she could.

The therapist stopped quickly, and pulled her arm out of harm’s way.  I said, “Marty, don’t you dare,” and the therapist retreated and the pain in Marty’s arm stopped, immediately, exactly what my diminished wife wanted to accomplish, stop hurting me.

Her response, biting the arm that was hurting her arm, was almost childlike; it was a way for her to gain control, a way for the person who had the least control to assert her will.  It was clearly a premeditated action; Marty knew exactly what she was doing, she planned it, she exerted control in the only way a person with limited physical capabilities can, she consciously used the tools, she had at hand, so to speak.  Marty has always, always used her mouth to control the outcome of events, she just never bit anyone before, she simply outtalked everyone.

There are times, moments, when Marty exerts control over her life, over her circumstances and says in her actions, “I’m done, quit damn it.”  Sometimes she just shuts down and won’t talk or won’t participate, she becomes passive aggressive.  There are other times when she’s simply had enough of being handled, of being poked, prodded, moved and hurt and she drops the whole passive part of that act.  The lesson learned is if you are going to push her that far, it’s best not present her with an option; she might just take a bite.

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