jedi mind tricks

There comes a point when you have to pick an area in which to base your OT practice. Generally speaking, these are mental health, physical dysfunction, or pediatrics. But really the decision is more about setting than population as crossover is inevitable. Until the people in psychiatric hospitals cease becoming physically ill and the people in for "physical rehab" stop having underlying psychiatric diagnoses, the divide will never be clear. Damn that mind body connection.

Here's a case to illustrate the point above... last Friday, I took Mr. L to the giftshop to pick up a newspaper and to see how he manages his rolling walker in a store, how he interacts with the people in the store, and if his neuromuscular endurance is enough to support his weight for standing and walking 50ft. (See a simple trip to the giftshop to the average mind is actually a world of analytical opportunity to the OT mind.) Mr. L is recovering from sepsis, an infection which nearly killed him and created a change in his mental status, which has allegedly returned to baseline. After picking up the paper, we headed back to the unit or at least attempted to head back to the unit, when he insisted that I leave him in the lobby unattended. After explaining the policy and need to return the unit, I got this response, "I'm sick of this micky mouse bullsh%t! I'm a retired trial lawyer of 25 years and I won't be pushed around by you! YOU have ruined my day!" This harrassment continued for about 2 minutes as I wheeled him back to the unit, all the while I practiced my best de-esculating tone and unconditional regard, "I understand you are feeling upset about this Mr. L, but we need to get back for your meds and to check in with your nurse. Perhaps they can bring you back out to the lobby." His verbal abuse included irrationality and delusions such as, "I spoke with someone in administration and they said it was okay for me to do this. I had this all set up. I'm a well man and can sit out there if I want to."

My head began to spin as Dr. Yoda entered the scene, "What seems to be the problem Mr. L?" As he explained his anger peaked, "I'm leaving" and he attempted to stand without checking the wheelchair brakes. I saw it coming and caught him just in time. He sat and shrugged it off, "You know I used to represent hospitals and doctors like you." Dr. Yoda replied, "Than you must clearly understand our position and realize the potential liability. You must then understand that if you fell in the lobby unattended I could loose my license. You must realize that these policies are established to protect you." Mr. L went on for a bit more about this place being very Mickey Mouse, but his tone was defeated. An hour later he apologized to Dr. Yoda and asked that he pass that onto the rest of the staff.

Afterwards I spoke with Dr. Yoda. He explained that his ability to think clearly in this tense situation came from working in inpatient psych and from studying Aikido. Aikido techniques are normally performed by "blending" with the motion of the attacker, rather than directly opposing the attack. The aikidoka (aikido practitioner) redirects the attacker's momentum, using minimum effort, with various types of throws or joint locks. He recommended I read, "Giving In to Getting Your Way" by Terry Dobbs. Midge suggested this was all a bit like "Jedi Mind Tricks."