Written by Dan Harren
“What counts is not the best living, but the most living.” Camus
The problem with rehab is it leads to more rehab. Rehab should not be thought of as an ongoing process, but as a necessary step to the rest of the patient’s life. There must be clear goals and there must be an end point – a point at which either rehab is no longer necessary or no longer sensible.
Rehab can be self-perpetuating in that there is always something to work on, some area that needs improvement, or some technique that could be taught. But the problem is; life is put on hold. The patient thinks “once rehab is over, then I can (insert life goal here)”. Rehab goals are often in the context of getting physically healed, cognitively healed, and psychologically healed. All very crucial, but what about what’s next? What about a life goal?
Being a survivor makes our patients extraordinary. They are exceptional people because they have struggled through pain, loss, despair and fatigue. Why can’t these exceptional people look forward to exceptional lives? Why does damaged mean reduced; injured mean less than? You know, in Japan, broken tea cups are treasured for their beauty. A broken cup is glued back together and the cracked porcelain reveals itself in a new way, with lines spidering across its surface. By sustaining wear and tear, by getting damaged, the cup gains history and character, becomes more beautiful; by revealing the reality of its existence – its story can be known.
Is the catastrophically injured person looking at a very different life than what he or she might have envisioned pre-accident? Yes. Does it need to be less full, less fulfilling? No way. Who said a good life is an endless string of happy events and sunny days, anyway? I happen to think that a good life should be defined by its fullness, its stories, its challenges, its defeats, with a few wins thrown in there for good measure.
Let’s encourage our patients to be forward-thinking, to plan for a life well-lived. Is rehab a goal unto itself or is it a means to an end? Your patient has defied the odds and survived. The qualities that have served them so well in struggle will again come to bear in times of growth. What’s out there for your patient? What’s next?