THE PIANO LESSON

Barrett L. Dorko, P.T.


          In the mid-morning my mother sits in her chair, hot tea at hand, her collection of books about Harry Truman on the shelf behind her. Earlier in the kitchen, before breakfast, she had asked where she should sit.

          "Right here, as usual," I said. She looked at me, "Nothing is usual around here."

          Indeed, she is more often confused than not and speaks little except to agree with my father or comment tersely in a variety of ways that she doesn't remember recent events and is not sure about the present. As I watch her sitting silently, she appears to be listening to something and the fingers of her right hand move in a precise and intricate pattern across her knee.

          At the 1993 APTA convention in Cincinnati, I noticed an increasing gap in our profession. It is not simply a split between the research and clinical communities. These are not mutually exclusive. It is a split between therapists who refuse to ignore subtle, but persistent, clinical phenomena, perhaps impossible to measure, and those who insist nothing can be said to exist without exhaustive study. The latter group tends to make fun of the former.

          At the Catherine Worthingham Fellow Forum I heard Helen Hislop, PhD, P.T., define science as "moral imagination." That phrase was just one of many she used, but it was the one I felt I should write down.

          The highly respected psychoanalyst James Hillman states, "The primary function of the human being is to imagine. (Psychology works) not by suppressing our madness, but rather by forming it. And form means art. Art as formed madness."

          Hillman says nothing about imagination having a "moral" quality. Is "immoral" imagination unscientific?

          As a physical, rather than a psycho, therapist, I am accustomed to watching bodily expression. I am trained to note postural habits, dysfunctional movement, weakness, and facilitation.

          It is when I start to note unconsciously motivated movement seemingly unrelated to disability and wonder aloud what it may signify that I invite the derision of some of my colleagues. The unique, artful expressions of the body that make us human cannot be measured or easily interpreted. No graph can contain them, no normative values can be assigned to them. And my failing as a serious researcher probably lies in the fact that I cannot ignore them.

          I asked my mother if she was playing the piano. She smiled, laughed a little, and said yes, stopping for a few moments before returning to complete the piece, some tune learned decades ago and uniquely expressed through her hands. Hands that never forget.

          The therapist in me wonders what this movement provides her that no amount of exercise, positioning, or manual care could. Perhaps she is in some fashion growing younger through her body though her faculties age.

          I doubt that such speculation is scientifically defensible in the strictest sense, but I can't help but wonder what my mother is trying to teach me.

Selected Reading
Hillman J, Ventura M. We've Had One Hundred Years of Psychotherapy and the World Is Getting Worse. San Francisco, CA: Harper; 1992.