This Review appeared in the July 1996 edition of "Physiotherapy: The Journal of The Chartered Society of Physiotherapy", London England.

Shallow Dive
Essays on the craft of manual care
by Barrett Dorko

Barrett Dorko graduated in 1973, became the senior clinician at the Atlanta Back Clinic, and has been in private practice since 1979.

It becomes clear from reading this book that during his professional life he has kept his role as a physical therapist constantly under review. He has studied so very many manual approaches to treatment from Grieve, Maitland, Kaltenborn, McKenzie, Feldenkrais, Rolfing and others, to craniosacral therapy. It has been a journey for him, a quest "not about what to do, but about what anyone touching others in the hope of being therapeutic might consider before they begin".

He realises that "care is inseparable from understanding" and that real care comes not from externally imposed mechanical forces but from a gentle touch which "respects a patient's ability to change."

He says much about the individuality of a patient, even with a given recognisable set of symptoms, and how limiting is the application of treatment techniques or protocols.

This delightful book is written as a series of essays, many of which appeared as "From Dorko's Desk", a column run in the magazine PT Forum, or given as lectures. These essays are often apocryphal stories which make their point gently and leave the readers introspective about the real value of their work as physiotherapists.

The author is extremely well read and the book is unexpectedly peppered with appropriate and lively quotations taken from a wide range of literature and poetry. At the end of each essay he lists selected and suggested reading.

The book is in sections leading contemplative thoughts through the value of therapy and assessment to considerations about treatments and inevitable interactions between therapist and patient, and the effect on the therapist.

At no time does the author recommend techniques but continually suggests that readers question their present approach and offers the alternative of another deeper but gentle approach.

I found this a most thought provoking and enjoyable book to read and certainly applaud the sentiments and attitudes of the author.

Susan Hollenbery
GradDipPhys MCSP