Physical Therapy and Heart Therapy

As I reviewed her chart before I went to see the patient, I noticed a note written by the chaplain a day or two prior. “Patient feels she has failed God.” It went on to explain the patient’s background as a minister and how she was struggling to process her inability to participate in ministry because of her illness. She had been in the hospital for 40 days and this was not her first stay; I recognized her name from multiple admissions in the last year or two. 

Does she know the Gospel? I wondered. I had worked with her the day before, and it was clear she was unhappy. She was quick to roll her eyes, easily frustrated, impatient, but with encouragement, she had been willing to participate in physical therapy and for the first time in the weeks she had been here this admission, she walked more than the two feet from the bed to the chair. It took two people to help her stand and she needed close guarding during gait, with one supporting her and helping her manage the walker and the other following closely with a chair. But she walked! And I was here today to help her continue that progress. Unfortunately, as often happens in the acute care hospital setting, my timing was less than ideal. She was upset about her dietary restrictions and was requesting to speak to multiple people to have that changed. It was late in the afternoon and even if we started her session immediately, I would be staying late to work with her. I was prepared to do that, but at that moment, her priority was sorting out her food, and after a bit of discussion, we agreed that I would come back the next afternoon instead.

That line from the chaplain’s note kept coming to mind. “Patient feels she has failed God.” What did she know and believe about God? Before she lost her health, what did she think earned God’s favor? What was the foundation of her faith? Where was her hope?

When I came back the next day, she was ready and eager to participate. As we got her lines organized and joked a bit to set the tone for the session, we planned what our goal would be. In preparation for walking a longer distance today, we switched her oxygen from the wall supply to a portable tank to connect to her trach collar, hung the tank to the back of the chair, and got started. Her strength with transfers was improved, her gait was more stable with decreased need for assistance managing the walker. Her steps were longer, and she more than doubled the distance she had walked during her last session. 

When she sat to rest and indicated that was all she felt she could do for the day, she looked up at me and reaching up to block her trach so she could speak, asked, “Can you wheel me out to the hallway so I can feel human again?”

“Let’s go.”

Instead of just rolling out to the hallway near the nurses’ desk, there is a large window set away in a corner between the two units on that floor that has a nice view of town and is a good place to soak up a little vitamin D. It’s my go-to place to take patients when I think they could use a change of scenery. I parked her chair right in front of the window and after we admired the view for a couple minutes, perched myself on the window ledge to face her. The little productivity alarm was sounding in my brain because this wasn’t billable treatment time, but I felt certain in this moment, to truly care for her I needed to remember that her need to talk and be heard was as important as her need to walk to build her strength. We talked a bit about what had led to this most recent hospitalization and about some of the challenges and discouragements she had faced recently. She shared how disappointed she was that her health now kept her so isolated and prevented her from doing so many of the things she loved. Then she said that phrase that had been on my mind the past few days. “I feel like I’ve failed God.”

I asked her why she felt that way and she explained she had always been known for her gift of prophecy and how she ministered to others, but now she felt as if that was gone.  I had been working through Ephesians recently and chapter 2 was fresh on my mind. Kneeling down next to her chair I asked her if I could read her a passage. I read verses 1-10, and I shared my hope with her. I shared how God’s love for us was never based on what we did for Him and that the Bible even went further to say that God moved to rescue us when we weren’t just useless to Him but His enemies. I shared how believing and accepting the truth that my standing before God is solely dependent upon the work of Christ and Christ alone freed me to use my gifts and serve him with joy and peace because they were a response, an overflow of my love and gratitude for Him, not a requirement to earn His favor. I read Ephesians 3:14-21 to her hoping that she would “have the strength to comprehend with all the saints what is the breadth and length and height and depth, and to know the love of Christ that surpasses knowledge”. 

When she closed her eyes and rested her forehead in her hand, I was a bit worried. Was she tired of talking? Was she feeling fatigued and needing to go back to her room? When I asked, “Are you alright?” she looked up at me, gave a smile that reached her eyes, and nodded. I’m not sure who is quoted saying, “If it’s on your mind, it’s on God’s heart,” but she had definitely been on my mind, and in that moment, I wanted her to know how deeply the Lord cared for her--that she was on His heart. 

“I was hoping I’d get the chance to talk to you; I’ve been thinking about you the past couple of days,” I said. She didn’t voice it, but her eyes widened and her eyebrows raised in surprise as if to say, “Really?” When I shared why she had been on my mind and what I hoped had been an encouragement to her, she was quiet for a moment before saying, “Thank you for letting God use you.”

As we wheeled back to her room, she made sure to ask where to find the passages we had read and said she was going to read them again for herself. She shared a bit more about her family, and we prayed together once I had her settled again in her room. She was discharged from the hospital before I was able to work with her again, but our encounter was an important reminder. 

As healthcare workers, we are in such a unique position to walk alongside people during difficult seasons. When illness crushes what many people attach to their identity and they are left empty handed and adrift, we can enter in and point to the only truth that offers a real and steadfast hope that can’t be overcome by sickness or death. Sometimes it is those gestures and acts of care that may seem small to us but honor the dignity of the individual in front of us that build trust and can open the door to significant conversations. Now full disclosure, the conversations don’t always go so smoothly as they did with this patient, and in my desire to say just the right thing for others to know Him, my tendency is to fear that I will fumble the opportunity, overthink things, and then talk myself out of saying anything at all. However, the Lord is patient and faithful, and He has been kind to remind me that the work is His and the outcome is in His hands not mine. He is generous to let me participate in what He is doing but not reliant upon my competence or eloquence. So friends, take heart, have courage, act and speak when He leads! As Ephesians 2:10 reminds us, He has already prepared beforehand the good works He intends for us, that we may walk in them.  

Hebrews 13:20-21 “Now may the God of peace who brought again from the dead our Lord Jesus, the great shepherd of the sheep, by the blood of the eternal covenant, equip you with everything good that you may do his will, working in us that which is pleasing in his sight, through Jesus Christ, to whom be glory forever and ever. Amen.”

Written by L. George, PT, DPT.