But I have a new patient occupying much of my afternoon. A woman about my age with a very sweet smile. H. came to our hospital with multiple bed sores. She recently suffered a T11 level spinal cord injury, and the hospital she originally went to sent her home after two days. No wheelchair. No patient education. NOTHING.
She has asked me many times if she will be able to walk again. Each time I tell her no, she asks 'Well, maybe with crutches? Or a walker?' It breaks my heart each time I have to say that she will never walk again . . . mainly because, even though she shows no emotion on her face, her eyes give her own heart away, and it too, is broken.
So after several days of sitting balance and strength training (because she's done nothing but lay still for at least a month since her accident) today was the day for the commencement of transfer training.
Now, there's something you need to know about Nigerien culture. The women are incredibly modest. They are always covered . . . well, almost always covered. Here, a woman's breasts seem to only be private starting at the age of 10 and ending with her first baby (which, I'll leave to your imagination in a world where the legal marrying age is 14). There are boobs everywhere . . . even in church! If baby cries or fusses or is simply just bored, out comes a bazooka. And it is impossible to make it through ward-rounds without seeing at least a dozen sets of ta-tas.
So, keeping in line with tradition, H. has been choosing to do her therapy everyday topless. It's one of those awkward cultural things that I just don't really know how to handle. And until today, they weren't getting in the way. But transfer training . . . yeah, there's just no way to avoid the jugs. By nature, it requires being up-close-and-personal . . . in a slow-dance-hugging kind of way.
I'm pretty sure I apologized to her five or six times for accidental bumpings of the sisters. There was just no way around it! All attempts at avoiding second-base seemed to fail.
Now, you have to understand . . . in OT we spend a lot of time with our patients when they must be 'scantily clad'. We do dressing and bathing and toileting training, for goodness sakes! Impossible to do those for-real when the patient's clothes are already on. But transfers?!?! Nope! Time to reinstate Rule Number One: NO FREE SHOWS IN THERAPY! (So much for keeping things in the right 'cultural context'!)