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Preaching from the Pulpit of our Lives

The sisters share stories about how they preach in the ordinariness of their lives by their presence, attitude and values.

April 2011
Sister Darylynn Costa, OP

When one day flows into the next, and days become weeks, weeks become months, and months become years, I have the feeling of effortlessly gliding on a conveyor belt through time and space.  When I push the pause button on the conveyor belt, and come to a complete stop, I am temporarily shaken out of my reverie and realize that, I have been doing physical therapy for 17 years.  I quietly, humbly, stand in awe.  Lord knows, I have been richly blessed on this spiritual journey.

“But how do you, as a San Rafael Dominican, preach?” you inquire.  Without the slightest hesitation, I respond, “With my hands, of course.  And I’m not even Italian!”  From the moment I stand at the doorway of a patient’s room, say a quick prayer that God will bless our encounter: like the holy embrace of Mary and Elizabeth; do a cursory assessment of the patient: checking facial expression, movement of limbs, presence of IV’s, PCA’s, catheters; to the point where I offer my hands in the service of the gospel, there is a heightened sensitivity within me as to how I can best meet the unique needs of the patient lying in the bed.  If I stay connected to the Spirit, I will allow my hands to be a conduit of God’s healing graces.  If I stay open to God’s will, divine energy will flow through me like ‘living water’.

The most critical portion of the treatment session is at the outset.  When I amble into a patient’s room with a smile on my face, I am cognizant that I have a window of 3-5 minutes to establish a rapport with the patient, one who may reek of alcohol, or be depressed after a failed suicide attempt, or angry and frustrated that he/she is now hemiplegic from a CVA (stroke), or is in excruciating pain after a laborious 10 hour surgery to debulk a nonmalignant meningioma.  Whatever the situation or tragedy, I have to secure the person’s trust to allow me to assist them out of the bed, stand, and possibly ambulate.  Be mindful, that in the best of situations, most people don’t like to have their personal, private space invaded, much less from a stranger.  Moreover, when a person is most vulnerable, his or her fears escalate.  There can be a fear of anticipatory pain, a fear of falling, a fear of failing, a fear of incontinence, a fear of being put in a nursing home, a fear of dying.  It can be overwhelming!  I daily experience a palpable heaviness in patients’ rooms.  Is it any wonder that there are days when it takes untold finesse for a patient to agree to participate in therapy?

In an effort to keep the door of trust wide open, I make it clear to the patient that we will work together as a team, like an awesome duo harmonizing in sync.  I promise to move slowly, and if, for any reason, he or she asks me to ‘stop’ or ‘wait,’ I will honor the request pronto.  Giving patients a measure of control facilitates their building a genuine trust.  Letting them know exactly where I will place my hands prepares them psychologically, as well.  Most people don’t like surprises.  Once I approach a patient and stand within his or her personal boundary, it is incumbent upon me to establish spatial empathy with my hands.  The quality of that initial touch on a person seals or breaks their confidence in me.  Gently lifting their knees and placing their feet on the bed is tantamount to delicately setting fine China on a satin tablecloth.  No one, absolutely no one, wants to be jerked, prodded, or pulled.  Softly resting one hand on a shoulder, and the other hand on the ipsilateral hip to roll a patient into a sidelying can honestly take 10 minutes with a patient in agonizing pain; that’s no hyperbole.  All the while I’m coaching the patient, often to take deep breaths into the pain.  (It’s common to want to flee from pain; I coax them to enter into it, even converse with it.  Describe it to me … I know there is sacred pain.)  As I cradle one arm along a patient’s back to raise them from supine to sit, I am humbled to hold the suffering Christ in my arms.  If the person has good sitting balance, I can take a deep breath, check the back and buttocks for pressure sores.  It also affords me an opportunity to do a short back massage.  Invariably, I feel, through my hands, tension melting away.  Occasionally, someone will prefer I ‘scratch’ his or her back with my nails.  Sometimes they purr like a kitten.  (Let me tell you, sisters, when you lovingly massage a person, you make a friend for life.)  Now, if a person has poor sitting balance, I have to buttress the trunk with my hand so they don’t fall anteriorly, posteriorly, or laterally like Humpty Dumpty.  With these patients, I’m connected to them like an umbilical cord.  At no time can my hands leave their corpus, which resembles a ragdoll.  In situations like these, humor can help to dissipate tension or fear.  It’s not beyond me to tell a patient that I’m taking away his Jim Crow until he can sit upright without falling over.  After all, laughter stimulates abdominal tone, a dear friend of physical therapists.

And last, but not least, the Napolean stand.  Patients are most anxious about standing, usually fearing that their sea legs won’t support them.  Or, worse yet, insufficient quad strength to bring them to standing at all.  Or, looking at my diminutive size, I hear, “You’re too small to catch me if I fall.”  And, having a Ph.D in comebacks, I retort, “All the angels in heaven will assist me in lifting and sustaining you, lest you dash your foot against a stone.”  Fortunately, on a pragmatic note, I know that the center of gravity on a person in sitting is located on the sacrum at S2.  Placing my hands there to give a bear hug gives the most success for an upward lift.  With this technique, standing becomes more like the Ascension.  From there, weight shifting of the hips appears like a dance, as I move them to a commode or chair and gracefully sit them.

Working with patients keeps me humble.  It propels me out of the head to dwell in the heart.  I am summoned to extend Christ’s compassion through my hands, to embrace patients in their suffering, to mend broken spirits.  All around me I see conveyor belts that have come to a screeching halt, some even have signs posted near them that read, “Temporarily out of order.”  But there is no need to worry.  When I extend a hand, I invite a patient to join me on MY conveyor belt.  We work together through the ‘fits and spurts’ until they are effortlessly gliding like the Michael Jackson Moonwalk.