The Old Guard

Barrett L. Dorko, P.T.

          Paul, age 9, has had a terrible weekend. On Friday, he turned his head left in response to his mother's call and it stayed there. Acute pain, worsened with any attempt to move his head back to the center, has remained until now, Monday afternoon. He stands before me, eyes full of recent tears, nearly sleepless for 3 days, shoulders hunched, hands and arms curled up to his throat.

          In Arlington, Virginia, "The Old Guard" marches before the Tomb of the Unknowns. Its members are remarkably the same in every respect. The precision of their movement is matched by the perfect stillness of their erect postures. Their presence lends dignity and a sense of ritual to any gathering. They seem to embody composure and stability. The public watches their performance silently, almost reverently.

          Paul's mother is a nurse working for a local physician, so Paul was quickly and thoroughly examined before the doctor called asking for help. "He's stuck. Maybe you could do some manipulation?"

          I, too, am drawn to any display of human precision and discipline, the kind The Old Guard offers. I like drum and bugle corps, drill teams, marching bands. There is something about a collection of humans moving and appearing as one that fascinates us so that we support them monetarily and emotionally. Most governments in this world have institutionalized such groups and use them as an exemplar of their tradition and power.

          Pauls's doctor is clearly concerned and I appreciate his confidence in my care. It has been suggested that Paul be corrected, that something be done to reduce this obvious deformity. In other words, the deformity is the problem and a return to the center is our first and foremost concern.

          Paul doesn't care much about straightening out his neck. He just wants the pain to stop. He's been cold for 3 days and has asked repeatedly to lie in a warm tub. He is making absolutely no effort to return his neck to a neutral position.

          As a fan of human precision and erectness, I feel an urge to coerce Paul back to a straightened position. I want very much to see him facing forward, composed and ready for movement, to make him look like a member of The Old Guard. I am in fact licensed to push him in that direction.

          But many failures with coercive technique have taught me that Paul knows a lot more about what to do than I. If I accept his resistance to movement toward the center as appropriate, he will show me the path out of trouble. And if I listen carefully, he might just tell me how he got into such a fix. When I finally grow silent I hear of his roughhousing, go-carting, sinus surgery, a terrific fall from his bike. Paul has all the answers.

          I have a friend formerly of The Old Guard. He tells me it's not unusual for members to wear girdles, use strapping tape to maintain their posture, or alter their boot heels to achieve a uniform height. Some of what the public perceives is an illusion. The uniform hides it well, and it is the only thing we can actually see.

          Paul's posture wasn't much changed after the first visit; his shape was the same. But he was smiling, he was warm, and he felt real sleepy. If we suppress the urge to make him look better on the surface, his recovery will proceed in its ideal time.

          When understood, the underlying, invisible processes beneath the surface are every bit as impressive as The Old Guard.