As I drive the winding roads of what is known as "the Lakes Region" of Maine in order to treat patients/clients in their own homes, I often find that my mind wanders to some interesting places until interrupted by the somewhat annoying voice coming from the GPS unit that ensures that I do not drive to Vermont, or beyond, to find the home of the person who is next on my list. Recently, I was thinking about the jobs that I have had throughout my life and what I learned from each job. When I was 13 years old, I went to a nursing home after school and my job was to make toast and cream of wheat and serve it to the people who lived there. Now, while I learned that I actually did like cream of wheat, I also learned that it seemed wrong to ask the residents to eat the same thing every single night. Although I have tried the "hot fudge sundae for dinner" diet, I found that I could not sustain that for very long and actually craved variety. I actually looked forward to the variety of different meats, fishes, and vegetables, with the exception of lima beans. My next job was making Italian sandwiches and pizzas at a "take-out" establishment. At that job I questioned why only the boys were allowed to make pizzas. When the owner realized that there was no good rationale, I actually became the first girl who was allowed to be in the pizza making line. When I worked at a florist, I was taught that in order to get a successful bloom at the top of the plant, one had to sometimes remove smaller buds from other areas of the plant. When I was working on my Master of Science degree, I had several jobs. When I was teaching a beginning swimming class, I observed one young woman who could do the land drills well enough but had problems in the water with performing alternate motions of her arms. So, I asked her to stand in front of a mirror at night and actually say, "right arm, left arm." With that practice, she became a good swimmer. That brought to light to me that "practice makes perfect" is not an accurate statement. The correct statement is that "perfect practice makes perfect" (my cooking skills confirm that the simple act of practice is not enough and that paying attention to the specific details of a recipe results in a more palatable and rewarding experience). I also worked at a car wash during that time, and the only thing I learned then was that would not purchase a red car. I made that conclusion from the observation that when I wiped down a red car after it came through the washing process, the white rag I used would become red. It made color choice for a car a smaller list. During my 2 summers as a land sports counselor at a summer camp for girls, I learned that whether a person is financially wealthy or poor, what individuals really respond to is respect, kindness, genuine caring, honesty, and being listened to. The only thing I learned during my summer as a lifeguard was that I did not want to do that again. As assistant director of a YWCA, I learned that while some youngsters can be entertaining and say some hysterical things, it was nice to send them home so my evenings could be quiet. During my years as a student to receive a Master of Science degree and then a Doctorate, I learned that sometimes one just has to sit still and read in order to learn. I admit that the "sitting still" part was, and continues to be, challenging to me (and, I suspect, to those around me). During my many years as an academician, I learned that some students just wanted me to tell them what they would need to know so that they could rote memorize it in order to pass the test. There were some students who did not want the challenge of thinking. I remember with fondness those students who accepted the challenge to critically think about what they were being asked to study. Both the student and I were rewarded when the lightbulb above their head clicked on when they understood a concept and could expand it into something meaningful so that it translated to "real world" knowledge. (Hey... if some people can see blue lights next to a person when they perform a technique, I can say that I see lightbulbs.) I vividly remember one student stating "I don't want to be a cookbook PT," but then when we were discussing the problem of a rotator cuff tear the student then asked what the specific protocol was.
During my years as a physical therapist (PT), I have worked in a level 1 trauma hospital, I taught Physical Therapy in a University setting, I worked as a clinician in an outpatient clinic, in a rural hospital in both inpatient and outpatient settings, and finally in my current position as a homecare PT. As I thought about how my lifelong experiences affect my current work, I generated the following guiding principles.
1. Variety is stimulating and motivating.
2. Questioning established practice is a good thing. Having a logical rationale for what one does results in confidence and trust.
3. Sometimes one must remove insignificant practices to get to the most significant and most productive result.
4. If you want a patient/client to achieve the best and most efficient result, tell them that "perfect practice makes perfect." We must be lifelong students of movement in order to guide "perfect practice."
5. The painters of automobiles should have done more research on the durability of colors before red was listed as an option. They should have proved that the color would not rub off so easily.
6. Financial status should not enter into attitudes about individuals.
7. I must be productive so that I can hold onto my day job so that I do not have to be a lifeguard at a swimming area.
8. Pediatric PTs have patients and patience that I do not.
9. The ability to take pieces of knowledge from various cognate areas and generate an idea or solution is a very pleasant experience. Of course, when some ideas are not supported by careful, unbiased testing, they must be modified and tested again, or abandoned.
10. To get better at a specific skill, one must practice that skill. If a person wants to get better at golf, they must play golf and not soccer (though I appear to be an exception to that in that my golf practice continues to place me in the "save our fairways" club. However, I do get more swings for my money). The lesson to learn from this is that it is important to know the goal(s) of a person and then that skill is the one that should be specifically practiced. If the goal is to reach into a cupboard then activities that mimic that specific motion should be performed.
11. Physical Therapy can be fun and rewarding for both the patient/client and the PT. I know I have more fun and enjoy my work more when I continue to educate myself by reading the research generated by my PT colleagues.
Reading the articles that are peer-reviewed, for inclusion in the Journal of Women's Health Physical Therapy, is one way of accomplishing rule number 11. This month readers will learn about the effectiveness of exercise for the treatment of pregnancy-related lumbar and pelvic girdle pain from the meta-analysis and evidence-based review written by Dr Inna Belogolovsky and colleagues. Dr Gerard Gorniak and Dr Will Conrad provide us with education with their review of anatomical and functional perspective of the pelvic floor and urogenital organ support system. Dr Betsy Donahoe-Fillmore, Dr Mary I Fisher, and Dr C. Jayne Brahler report on the effectiveness of home-based Pilates in college females.
It is my hope that you continue to be a lifelong learner from the articles published in this journal. I want to make one more comment about something I have learned along my path. Although work is a necessary component of life for most people, I believe it is equally important to laugh and play and participate in activities that, very simply, are fun (and legal).
Nancy C. Donovan, PT, PhD
Editor-in-Chief