Friday, 14 September 2012

Occupational Therapists: The Unsung Heroes (CUT VERSION)



Introduction
            Here in the Philippines, the people have a great deal of respect for professionals. Most especially, medical professionals.  However, a strong stigma in the society exists - that individuals wearing white coats are doctors and that all other folks wearing white uniforms are nurses.  In fact, I’ve had my fair share of prejudice in the last 5 years of my life in medical school. From strangers who greet me on my way home, to friends and acquaintances I meet in social gatherings and yes, even from my own family. 

The conversation almost always start with the simplest question, “What is your course?”  As I would like to answer the question myself, almost always, the interviewer races me for the answer.  “Nursing? It’s a great course.”  You’ll be lucky enough if they actually had good impulse to respectfully wait for you to open your mouth and answer for yourself.  Of course, this rarely happens.  Instantaneously, I correct them, “It’s occupational therapy, OT for short.”  Now, here is where the jokes come in.  I have five (5) for you:

1.      “OT?  Overtime?”
The most common witticism you’ll ever hear if you announce the abbreviation. Yes, it’s funny...but the gag gets old.  

2.      “Physical Therapist? Reflexologist or Masahista?”
Yet another common mistake in identifying the role of an occupational therapist and a misperception on being physical therapists as well.  They did not go to medical school for five years like us to simply give a massage.  Physical therapists help people with disability achieve their maximum potential for functioning with more focus on their bodily aspects.  Likewise, we did not go to medical school for five years to be simply overshadowed by physical therapists or the misconceptions of the latter.

3.      “Psychologist?”
Yes, we do work in psychiatric facilities; however, we transcend beyond gathering data of the mind and couch counselling.  Moreover, both courses DO NOT; I repeat, do not involve reading people’s minds.  That is simply beyond human capabilities.

4.      “SPED?”
It is a widespread misconception that occupational therapists are equivalent to SPED teachers.  You see, children with special needs - kids with autism, ADHD, Down’s syndrome and the like - are also referred to us.  Well, we are not them.  And sadly, despite the longer availability of our course in the Philippines, even SPED teachers do not even know our course to properly explain the difference.

5.      “Huh? Nursing?”
Still, people must insist on the notion that “all white” is equivalent to being nursing students.  At times like this, I just repeat what I have already said and emphasize it more.  The most ludicrous thing is, their response would almost always land on the preceding four items and the cycle goes on.

            You might ask why am I telling you all this.  What’s so important about knowing what occupational therapists are anyway?   Why do I even need to know what they do?  If I’m not ill and if they’re not even going to cater me medical treatment if in the event that I do, why in the world should I care?  Well, to answer all that, let me take you to a muster of words exploring the wonderful profession I’ve been talking about – occupational therapy.

   What is occupation?
For most people, when asked the question, it is one’s job, career, vocation, profession, work or employment they continuously engage in to make a living.   It is that affair that keeps us busy eight (8) hours a day, five (5) days a week, four (4) weeks in a month for almost eleven (11) months in a year.  Needless to say, our occupation is a dire part of our lives.  Yet, there are still remaining sixteen (16) hours in a day with our twenty-four (24) hours.  What do we do then?   Don’t we eat, bathe and sleep to physically charge ourselves?  Don’t we also engage ourselves in recreational hobbies and interests to invigorate our spirits?  The fact of the matter is those activities that occupy your time are considered to be your occupations.  It is not solely defined to be a job or employment that provide you livelihood.  It is every act or deed that you deem to be meaningful, enough to invest important time in. 
And whenever there is a disruption in your daily routine of occupation – whether it is due to physical dysfunction, psychosocial issues, congenital problems, genetic abnormalities, or chronic neurologic illnesses – we, occupational therapists intervene.

 Liminality
Let me ask you, have you ever tried to squeeze down an alley and then find yourself stuck?  Your hands and feet are pinned down by the cold concrete – immovable and useless.  You try to call someone out in the streets but they pay no heed.  A few will look, but since it’s too far and dark in the narrow alley, they walk past you.  Sooner or later, you’ll feel anxious of your current situation.  You try to break yourself free but now it seems that you can’t turn back and you can’t push forward either.  You’re in between, with no escape; and as the clock ticks hastily, you’re scared out of your wits. Ain’t that some luck!  Well, ladies and gentlemen, welcome to the world of those living in-between.  Those people who are not dead yet not fully alive, those who are neither sick nor fully well, those who are in our society but are not welcomed completely either. Welcome to the world of the people who have their occupations permanently disrupted.  Welcome to the world of the people with disabilities (PWDs).

More often than not, the populace have a limited view of people with disability.   Admit it, even as you read this now you’re imagining a person confined in a wheelchair or people with amputated feet who walk with crutches.  Well, let me tell you that they are only a tiny part of the disability spectrum we occupational therapists work with.  Disability encompasses physical impairment.  It also covers for psychological, emotional, social and developmental impediments in daily occupations.  It is anything that restricts you from engaging in activities that are meaningful in your life.  Therefore, PWDs include not only those who have a problem with walking; they are also those who have depression, schizophrenia, autism, Down’s syndrome, mental retardation and the like.   

Truly understanding it requires a lot more and perhaps, yes, one can’t fully understand the horrors of living with disability unless you experience it as well.  I attest to this.  Even though I work with them a lot, I can only imagine the weight of the difficulty so much to what I have already experienced. I remember watching Jay Taruc’s documentary, “Gulong ng Buhay” where he had his leg cast for a day to experience the prejudice of the Filipino community to its PWDs.  We do it as well in school during National Disability Prevention and Rehabilitation Week in July.  We dress ourselves with braces, act like schizophrenics and approach people to experience their situations just for a day.  Can you imagine the disgust people give you or the much hurtful ignorance they feign?  

  A Helping Hand
We occupational therapists help a lot of people live their lives independently after impairment strike. Can you envision now how magnificent this profession is? Studying mountains of textbook to comprehend the human body and mind, knowing the client and family to a level of comfort yet maintains an air of authority as a professional and respecting the culture and values of the people involved.  We are holistic.  And in order to be a helping hand to them, you need to be as well.  Well, what is the first step in that?
First, let me tell you the most important golden rule.  Ah yes, Confucius at work here.  Do unto others what you want others to do to you.  This means you treat them as you would like yourself to be treated.  Not at the first sight of his incapacitated body part, you render him/her useless.  Not when you see him having difficulty walking, you’ll just discourage him all the more to move.  Not some useless junk stored away in the closet after it’s broken! How would you feel about that if it was you in their place? Treat them as an equal, as people. What we can do, they can do.  It’s just a difference of the manner of doing so as they adapt to their new bodies and mind.  

Second, don’t treat them with sympathy.  They don’t need that.  They have experienced enough of those from ignorant people they don’t even know.  You always think “in their shoes”.  Empathize.

With the growing awareness and interest of the people in the last couple of years with people with disabilities, it is only natural that we pay heed to the proper way of treating them.  Subsequently, it is also greatly important to know which professions you seek help to and their differentiation with others. You have the right to know what services are given to you and the reason behind it.  It’s your body after all. I heard of a client once who went to a “therapist” and received only massages for treatment after his stroke. He just went with it. He didn’t know the difference between and massage therapist with the others. After a year, realizing that there was no improvement, he sought after an occupational therapist as his hand was already much worse than it should be. If only he knew that he was supposed to see an occupational therapist.  Heck, if only he had heard there was an occupational therapist! 

  The Promise of Tomorrow
Imagine the world formed by the people joining their hands, slowly setting the world into motion.  All of them have a place inside the circle as it progresses.  Each individual unique and irreplaceable, all of them have their own roles to fill.  As disability strike, they lose themselves – their roles.  They are led astray outside the circle, forming yet another one but with their hands not united.  They are neither alive nor dead, neither sick nor well.  No past to go back to and it seems no future as well.  They are close enough to seek help but are too far away to be pulled back by stares alone.  We, as occupational therapists, bridge this gap.  We are trained well to reach for them and help them connect with the ones in the inner circle - you.  Though few, we are strong.  Strong enough to bear the responsibility of pulling them back and wise to know that we alone do not suffice.  They need to be given back to society in order to be independent.  That is our ultimate goal – our promise.  Hear us out and make us known.  For we are heroes who are not willing to be unsung for long.


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