where the rubber meets the road…
Posted by Robert Nurisio COVT
It’s always interesting to me when those who have graduated from Vision Therapy return for a 6 or 12 month follow-up and share their favorite memories from their time in our program. Some are poignant, some silly, and some are quite personal. Often times patient’s will remind me of a funny or embarrassing personal experience that I shared with them during one of their visits, some recall their favorite activity, some remind me of the day they realized that they could do it, and still, there are the few patients whose stories are raw and full of impact; stories which remain protected within the confines of our office and will not be shared, even under the cloak of anonymity. In good turn, I share my funny mishaps with them. Like the time a sweet little 5-year-old girl weighing all of 25 pounds, who with a closed fist to the left cheek, inadvertently knocked me clean out of my chair while losing her balance on the Billy Board. It was only after hitting the floor that I realized my conversation with her mom was a little less important than she was. There was also a young man who decided to use a Tootie Launcher (for launching and catching bean bags), which was assigned to his brother for VT, to launch their youngest brother’s frogs into the neighbor’s pool “to cool them off”; failing to realize, of course, that frogs cannot survive in chlorine – even for the short time it took these boys to scale the fence and reload. I laugh about that one now, but at the time, not so much.
Vision Therapy really does change lives, and hearing it recalled from those who now have a new perspective is both gratifying and rewarding. I try to never miss the opportunity to visit with a former VT patient when they are in the office, even if it means interrupting their exam for 60 seconds to say hello and share a smile. At first my doctor frowned upon this interruption, but over time has come to understand it is from the heart, and has learned to accept and even welcome it.
One memory from the VT room that will always stick with me is the day I met Chris, an 11-year-old boy who seemed full of anger. During our orientation Chris appeared quite disheveled and yelled at his mother continuously. He ranted about ineffectiveness of any intervention including VT, and seemed more interest in burying his face in his parka that maintaining any meaningful dialogue. As an aside, we met last August when it was over 100 degrees during the day, and Chris was most comfortable in his jacket. Chris was supposed to be someone else’s patient that morning, but because of my co-worker’s illness, he was shuffled to my schedule at the last-minute. Less than an ideal set of circumstances, I peaked through his chart for 10 minutes (mostly his exam and perceptual testing information), walked into the reception area, and led him into VT. The orientation went poorly (I’m being very kind in my description) and when it was over, his mom sheepishly thanked me and said she’d “work on him” for next week. Feeling a bit guilty for not being as prepared as I might have been had he been on my schedule the night before when I was reviewing my charts for this day, I reported the unfortunate situation to the doctor. I was sure Chris would not be back. I spent my lunch hour that day reading deeper into Chris’ chart, trying to unravel the mess in my head and hoping to better understand this 11 year-old enigma that had chewed me up and spit me out a few hours before. As if it happened yesterday, I remember turning to page three of his new patient questionnaire to read the words his mom had written about her 11-year-old son:
Has suicidal ideation, all medication ineffective to this point, convinced he’s going to die by his 16th birthday.
I almost choked on my lunch.
I spent the next 45 minutes reading about this young man and his struggles. How his mom had locked up all sharp objects including butter knives and number 2 pencils, and his dad had asked a family friend to hold on to an heirloom – a pistol from the 1800’s – out of fear that Chris would try who knows what. I read on and on, trying to figure out an answer to the obvious question – why?
The following morning I emailed Chris’ mom to thank her for her patience during the orientation and to ask a few simple questions. Basically, I needed to know what his triggers are and how to proceed effectively without sending him down a destructive path. Chris’ mom was extremely gracious in her explanations, sharing that Chris had been bullied in school after talk of possibly repeating 5th grade and essentially had “given up”, resigning himself to the fact that he was “one of the stupid kids”. The bullying had been dealt with, but his outlook on life began to spiral downward even though he did not repeat 5th grade. She wrote:
It all started there. He came home from school one day last April crying, saying he wanted to kill himself. We took him to Dr. XXXX (a psychiatrist) the next day and have been trying many different medications since. I’m scared for his life. He told me recently that it would ‘be better to be dead than to be stupid’. I burst into tears. I try not to cry in front of him, but I couldn’t help myself.
To my surprise, Chris returned the next week. He was as combative and cantankerous with me as he was his mother the week before, but we got through it. Week by week we would grit our teeth in each other’s space for 55 minutes. Sometimes he’d engage, sometimes he would shut down, sometimes he would cooperate minimally, and sometimes the only rebuttal I had for his arsenal of resistance was to simply say “OK”, and to move on. One time, he even challenged me to a fight. At times, I admittedly tried to take the big brother role, just reassuring him that he could do these things and many people believed in him – including me. It didn’t seem to help. His perception was that his life was horrible, and perception is everything. To his credit though, Chris stayed in VT. His estimated 6 month program was extended by our doctor, and although his attitude often was the most challenging piece, I always looked forward to seeing him. Along with his negativity came an interesting adult-like sarcasm that I quietly enjoyed, even when aimed my direction. It’s been a long road; for both of us.
This week marks the beginning of the 11th month Chris has been in VT. He appeared in our office this morning in quite a different state than I have ever seen him. He was wearing new clothes, his hair was combed, his glasses were clean and straight, and he was smiling ear to ear. He told me:
“We went school shopping over the weekend. My mom said I could pick one outfit to wear today so you could see it. I chose this one for the first day of school”
Even as I wrote that, I’m still beside myself thinking about it. In 11 months, this kid went from doom and gloom to looking forward to the upcoming school year. Along with external emotional support, Vision Therapy made an impact on this person’s life, as he now believes he can accomplish anything and welcomes all challenges. And even more important, it seems I’ve made a friend for life.
In preparing to write this entry tonight, I Google’d the words “where the rubber meets the road” – www.usingenglish.com offered this description of the idiom:
Where the rubber meets the road is the most important point for something, the moment of truth.
Chris is a kid I will always remember. The experience has truly been humbling…
Posted on July 28, 2014, in From My Perspective... and tagged Angry Patients, Changing Lives, First Day of School, Flying Frogs, Vision Therapy, Vision Therapy Success. Bookmark the permalink. 2 Comments.