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Marissa Lingen

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PT/OT, TV [Mar. 24th, 2014|10:20 pm]
Marissa Lingen
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Last week I was watching yet another murder mystery on television with my workout–really, on any given day, it’s a good bet that I will be watching at least one murder mystery on television with my workout, sometimes two depending on how long they are–and this time it featured a character who had been seriously injured and could not walk. And whenever I see that, I wince, because I know that they’re more than 50% likely to do dodgy PT/OT on screen, and in fact they did.


See, on TV, PT and OT are the same thing. Here is what they both consist of: there are the two parallel bars at armpit height, and the person who cannot walk is supposed to walk between them, and the PT/OT/random relative of the person who cannot walk yells at them to walk. And mostly they eventually do. Isn’t that easy? Isn’t that great? Why can’t everybody walk unassisted by now! How straightforward it all is! And why do people bother to go to school to learn to do PT or OT when anyone–the janitor, the hospital administrator, in fact the random relative of the person who cannot walk–could quite easily do this task?


SIGH.


And I know that the actors who play these characters who cannot walk are usually themselves able-bodied. But the PT/OT characters never do anything like, for example, making sure the characters they are supposed to be helping are stepping down on the correct part of their foot, by which I mean the bottom. I know that gait problems are one of the things the able-bodied can see when they watch someone with assistive devices walking, but they’re also one of the things that therapy will be working to correct, and they don’t show up out of nowhere. “I was in a car accident, and now I walk on the sides of my feet for no reason!” No, and also no. There’s a reason you don’t see people with visible gait problems walking around without assistive devices very often: incurable gait problems make it very hard to walk without them. So if you’re aiming for unassisted walking, you’re going to try to correct the gait if at all possible. A therapist worth their salt will notice that you are setting your feet down sideways and will stop you and work to correct it. They may remove you from the Parallel Bars of Doom and set you to doing different exercises somewhere else.


But that can’t be right, because being shouted at to walk is the only therapy anyone who cannot walk needs, right?


Another thing that never happens: nobody on TV ever needs to be told to slow down and take a rest, because we always need to be yelled at to do more and try harder. So no physical therapist ever says, “You’re not doing yourself any more good here, you’re just wearing yourself out.” Even though in people close to me alone, I can think of four physical therapy examples where the therapist said, “Now for heaven’s sake don’t do more than X amount, because it won’t help and might hurt you.” But on TV, no. Never.


(Yes, I know that sometimes you do PT and are told to just do it for as much as you can stand, until you drop, etc. It’s just that this is the only mode I see represented on TV.)


This is just sloppy, and I’m very tired of it. Physical therapy and occupational therapy are not the same thing, and between them they cover all kinds of activities to rehabilitate all kinds of body systems. If you’re someone who writes fiction, please think about portraying something different for your PT or OT. If you don’t know what that might include, do some research. There are physical therapists and occupational therapists and lots and lots of people who have been through one or both, and I bet you can easily find boatloads of us who are willing to talk about our experiences and the details that do not involve walking on the sides of your feet between two bars and being yelled at.


Oh, wait. I’m being unfair. Sometimes people who can’t walk also get to go swimming for their PT/OT. Nothing much happens there except they go swimming. Well. I take it all back, then. I was very, very wrong.


Seriously, if you have some examples of PT/OT on TV done better than this, please recommend them to me in the comments.




Originally published at Novel Gazing Redux

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Comments:
[User Picture]From: markgritter
2014-03-25 04:08 am (UTC)
As I think I mentioned in person, I think Elementary (season 2) handled Detective Bell's injury reasonably, but they didn't show much of his actual therapy sessions. He did have some hand exercises that were on-screen. Mostly I appreciated that it was not a one-episode-and-done thing, and they treated the possibility of permanently reduced function seriously. But he never had a mobility issue, only an occupational disability.

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From: diatryma
2014-03-25 04:19 am (UTC)
Maybe Friday Night Lights? I don't remember the first season well enough, and that's all I've seen.

We have a student here whose file includes a paragraph saying, "Yes, we know she walks funny. Her team has decided that correcting her gait is too much trouble for too little gain." But that's a different set of gait problems.
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[User Picture]From: mrissa
2014-03-25 01:38 pm (UTC)
Yes, it's not that nobody has permanent gait problems, it's that they aren't addressed at all in TV PT/OT. They go away magically with repetition. Which: sigh.
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[User Picture]From: sprrwhwk
2014-03-25 04:25 am (UTC)
Another thing that never happens: nobody on TV ever needs to be told to slow down and take a rest, because we always need to be yelled at to do more and try harder.

This seems really true of any problem TV people have. The answer is always more motivational speeches. Which is not to diminish its silliness here. Frustrating all 'round.
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[User Picture]From: sartorias
2014-03-25 01:18 pm (UTC)
Yes, yes, yes. One thing I love about the TV program "Switched at Birth" is that they are using deaf afters to portray the deaf characters. It is so wonderful to see that--and to have Deaf culture be a major thread in the series, without being presented as a problem to be solved.
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[User Picture]From: mrissa
2014-03-25 01:36 pm (UTC)
I think Deaf culture has a lot more cohesion than a lot of other disability issues due to language, so it's a very good place to do a frontrunning treatment like the one you describe. I'm glad that someone is doing it.
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[User Picture]From: klwilliams
2014-03-25 09:42 pm (UTC)
"St. Elsewhere" covered this. A woman had a stroke, and her overachieving husband "helped" her do her physical therapy, and vastly overdid it. There was at least one conversation with the medical staff talking about her fast recovery, plus a little bit of worry that it was going too fast. Finally, the woman got well enough to be able to say "No" to the husband, and take her physical therapy at a more reasonable rate. But "St. Elsewhere" rocked in so many ways.
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[User Picture]From: laurel
2014-03-26 04:39 am (UTC)
If I recall correctly, China Beach got it right. I haven't made my way that far into my nifty complete series DVD set that Kevin got me for Christmas so it's been a while since I saw the final season which is when much of the stuff happens at VA hospitals and so on. I think.

In trying to recall how it went on House, I think I'm remember fanfic that covers the period when House recovers from his surgery post infarction and not the actual show! D'oh! (I recall with the show being rather cranky when suddenly House was walking and jogging and all that jazz and . . . gah. Love bits of the show, other bits not so much.)

Also in thinking about this and trying to recall shows and movies that got more right than wrong, I really am thinking of a lot of fanfic in general and noticing that I apparently have a keen interest in fic relating to disabilities and recovery and all that fun stuff. Well, provided it's done in what seems to me a reasonable manner and not something someone is basing on the aforementioned horrible TV versions.

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[User Picture]From: rmnilsson
2014-03-28 02:06 pm (UTC)
I think it's just generally the case for many long-term, complicated health condition.

For example, I was over 5K (after insurance) and 18 months into fertility treatment, with a clinic that had stopped treating me because they didn't have a protocol for my particular case when I watched the episode of Scrubs where Carla thinks she might be infertile. She undergoes some unnamed fertility test (that only takes a day, and gets back results via phone that she's not infertile. So it's either her husband or they just need to wait a couple episodes.

I was briefly enraged before it settled into lingering disappointment. I mean, I get that it's a 30-minute sitcom and all, but it's also a show about doctors and medicine, and infertility is really common and very isolating for people going through it, so they could have at least been slightly honest about it rather than making stuff up.
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[User Picture]From: swan_tower
2014-04-11 07:51 pm (UTC)
Not TV, but of all things, the (so far terrible) movie Battleship has a better depiction of PT/OT than most I've seen -- I'm guessing because it features actual amputees with prosthetics who are probably actual veterans. There's a brief montage of them doing everything from throwing balls at one another to rock-climbing, and then a brief bit of a double leg amputee walking in some kind of screen setup where they are, in fact, talking about his posture and gait and so on.

I have a bad feeling that said montage will turn out to be the best part of the movie, but for something to have on while I wash dishes, maybe it'll work.
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