Barrett L. Dorko, P.T.
"Do you think you might lose some sales?." I say.
"Yeah, I suppose. In fact, I was thinking that I might actually gain some out of sympathy, but I guess we'll see."
Carl has been selling cars for years, and has always been able to use his easy, athletic movement to his advantage. He knows how to move around a customer smoothly while demonstrating the accessories and he could stride across the showroom confidently, gliding effortlessly between his small office and a buyer's shoulder, ready to serve them, and thus, feed his family.
He could hide the pain in his knee by simply not favoring it, although his gait then represented something he wasn't. When this pretense became intolerable, he'd have another arthroscopic procedure and begin the cycle again.
But when the total knee replacement became his only option, Carl found that he'd have to return to work while still limping, and limping badly. All the past procedures contributed their scarring and fear. Now full extension is not possible, and Carl doesn't just limp, he's tipped to one side.
Do you know why they bring you to attention in the service? They do it to make you weak, to make you vulnerable. With your feet together your balance is precarious and diaphragmatic excursion is limited. Your neural tissue is pulled tautly. The command to face forward reduces your visual and auditory access. In short, this would be the last posture you would choose if under attack. When you are called to attention the officer immediately becomes more powerful, and that is its true purpose.
Of course, our culture looks at this posture with admiration. It thinks it implies discipline and readiness. These notions have been expanded to include the attributes of strength not only in the muscles but of the character. Our own profession says that it's healthier though there is absolutely no evidence that this is so. It's cosmetic and nothing more.
"You know," says Carl, "I've been playing golf with a bunch of friends for years, and I usually win. But on the back nine I'd start to limp. I've never finished a round without one of them commenting on this. I don't mean sympathetically. And these are my friends."
Now Carl has to return to a world where limping and a lack of erectness is deeply suspect, especially when the limper is in his 40s.
His previous caregivers have constantly exhorted him to straighten up. Prior to coming to see me, Carl saw physical therapy as a magnification of our culture's bigotry toward disability, and I believe that this is commonly the case.
In my office Carl is allowed to be fully himself in a physical sense, and this permission has provided him relief and natural progress toward his goals. His gait is moving toward normal, and he is not further burdened with a therapist's judgement.
Tomorrow in the show room he'll face a public less forgiving of his limping, and he knows that it will be harder to sell himself now that coming to attention is not an option.