Showing posts from November, 2005

prayer as occupation

I saw my first patient 20 years ago, and at that time the debate was raging over whether we should call the people who we work with 'patients' or 'clients.' I don't know that there was ever any 'official' decision made, but now we see patients, clients, students, workers, etc. I usually use the term patient, which is mostly out of habit. When you work in a single field for 20 years you can be accused of being 'old school' and old habits die hard.

But I didn't choose to write tonight about semantics.

I was thinking back to my first patient contact 20 years ago because that is when I learned about people who have cancer. When I am struck squarely between the eyes with a proverbial baseball bat I automatically start working from the beginning of my experience to remember what I have done before, seen before, experienced before. My experience is my crutch, like an old man's walking stick.

A former patient's mom emailed me today and told me tha…


All I do is write, but not here. This evening I cranked out about 18 pages worth of evaluations. That is single spaced technical reporting. My hands are numb.

I've been spending a little time thinking about what I am choosing to write lately and what I am not choosing to write. There is a story I needed to record - and I will only put the snippet here for memory-jogging purposes, but there was so much behind it.

I have been considering the nature of disability, particularly as it relates to children. It is hard to be disabled as a child because so many people do so many things for you ANYWAY. The standards are just not the same as with adults.

Example: if an adult has a stroke and can't dress themselves, they are considered disabled. If a child has a stroke and can't dress themselves, the parent provides care. Because children are children, and because parents do what they do, the concept of disability is different with kids.


Well a parent asked me an interesting question…

96 hours

I saw a posting on my discussion forums from a previous student; she was talking about her experiences working in pediatric critical care. I am sure that she does an excellent job; she was a very competent student.

I am still recovering from my pediatric critical care experience. Here's a story that is stuck in my mind, despite it happening nearly ten years ago.


Transference is an old Freudian term that refers to the unconscious redirection of feelings. I didn't know Mandy for very long, but I felt that I loved her the moment that I walked into her room. This little girl was just six years old, beautiful and blonde - she could have been my daughter. So when I saw her I felt love for her.

When I walked into Mandy's room I also felt an immediate sense of deep and profound sadness. She was lying still in the bed, eyes defocused toward the ceiling, and not responding to anything. In a corner of the room I saw a man who I imagined was her father. His eyes were just as distant …

On string theory and muddy paws

I mentioned a couple months ago that I would be an astrophysicist if I wasn't currently practicing as an OT. Actually, I lack the mathematical ability to do this kind of work seriously. Despite this, in my ongoing attempts to enlighten myself on the nature of the universe I went and listened to a Brian Greene lecture this evening.

This actually does have something to do with OT. This has to do with our choice of occupations and the impact that it has on our world-view.

I have a General Systems Theory Knowledge Map hanging on the wall of my office. I keep it there to remind me to think expansively, but the bottom end of the Knowledge Map is a little outdated - I think it lists atoms or perhaps just quarks. Tonight the lecture was about strings, of course. It was interesting, but perhaps not as technical as I was hoping to hear.

Actually the most important part of the evening to me was listening to the questions that people asked him. There were some very hostile questions, although th…


I watched the young boy approach the table at the farmer's market. He was only 8 I figured. Maybe 9. His hands reached immediately for a ball on the table. It was oddly shaped so that as it 'rolled' it would go in unpredictable directions.

The young boy looked at the 75 cent price tag and dug deep into his pocket. He smiled, excitedly: he had enough money. Still, he seemed to pause. I imagined that he was trying to decide. Is this what he would spend his money on?

"My son and I spent hours and hours playing with that ball," announced an adult voice from across the table. "We would play with that ball for hours. It was the most fun we ever had."

I don't know how to convey the true intent of this man's statements. I am sure that I heard something very different than the little boy. I heard a professional farmer's market pitch-man, trying to eke out another sale. The little boy's eyes lit up. This statement made his decision easy. He quickly h…

Reflections on the occupation of collecting

In an ongoing attempt to develop a (hopefully expanding) understanding of childhood occupations, I offer this self-reflective entry. In it I can find the dynamics of interpersonal interaction, the rule-making and gamesmanship that hopefully leads to participatory democratic thought and action, and of course meaning that transcends time. All interesting, when you consider it was just a childhood collection.


Young children enjoy collecting things. Bugs. Baseball cards. Comic books. Rocks. Lincoln pennies. My brother and I collected bottle caps.

I am thinking that Gary, one of my earliest school friends, was the first one to have a bottle cap collection. His Dad worked for the government (we weren't allowed to know what he did - and to this day I still don't know) and he went to odd and exotic places around the world. Their living room was decorated in a Japanese motif - and Gary's Dad brought back bottle caps from Japanese beer bottles. That got us all intrigued.

As ten year…

The Slow March of Change

I provided expert testimony last week in a state Supreme Court case. A municipality is suing a family because they keep three goats and a llama on their property for purposes of 'animal-assisted therapy' for their child who has autism. The family purchased the property (previously used as a horse farm) thinking that they could keep these animals on the premises. It turns out that the land was re-zoned and the previous owner's animals were 'grandfathered' but that the land use restriction came into effect when the property was sold (unbeknownst to the family who has the autistic child). They had these animals for over ten years and the child does derive some benefit from interacting with them.

My testimony centered around the child's condition and the use of animals in a therapeutic context. The child interacts appropriately with the animals, enjoys 'pushing' fights with the goats, and it is one of the few purposeful activities that sustains his attentio…

New York's Disgrace, 30+ years later

Willowbrook State School was the pride of Governor Rockefeller's Mental Hygiene program. In the early 1960s it was the largest residential facility in the nation for people with mental retardation. Willowbrook Director Dr. Berman wrote in the Staten Island Advance that Willowbrook had "approximately 6000 patients, more than 1800 employees, and 24 patient buildings..." Governor Rockefeller developed the 'New York State Institute for Research in Mental Deficiency' on the Willowbrook grounds.

The 'gem' of Willowbrook quickly lost its luster. In 1965 US Senator Robert Kennedy toured the facility and stated that "Particularly at Willowbrook we have a situation that borders on a snake pit and the children live in filth. Many of our fellow citizens are suffering because of the lack of attention, lack of imagination, and lack of adequate manpower. There's very little future for the children or those in this institution..."

People who had developmental…