Physical therapy as a medical service is still a very foreign concept here at Galmi Hospital. So many of our patients come from remote villages and barely have access to primary health care, let alone functional rehabilitative services. There are so many tasks and commands I give to my patients that must seem incredibly bazaar and so out-of-this-world to them.
Today, B. and I were working with a little old lady (her chart said she was 50 years old . . . pretty sure she was actually on the upper end of her sixties . . . which around here is about 107 in western-years) who had one of her legs amputated yesterday. We were teaching her how to do some important exercises to keep her residual limb flexible and strong.
The first of which required that she lay on her stomach.
Normally, when laying to do exercises, people relax. Muscle tension lowers . . . posturing takes a break.
But not for this LOL (that's Little Old Lady in Hausa)! She was just as rigid and stiff as she was when she was learning to use a walker.
B. tried to position her legs, but she kept resisting all movement. He looked to me for help.
'Tell her to relax,' I said.
He told her.
He turned to me for Plan B.
'Tell her to take three deep breaths. In through her nose and out through her mouth. Like this.' And I exaggeratedly inhaled and exhaled.
B. moved from where he was standing next to her waist, and bent down close to her ear and gently whispered that she should breathe in and then breathe out.
I would attempt to reproduce with letters the sound that reverberated from this tiny lady, but I wouldn't do it justice. Lets just say it was a cross between a snoring pig and passing elevated train.
But that wasn't the end!
As she nosed her not-so-relaxing breaths in, she began to collect in the back of her throat all the mucus that had just evacuated her sinuses and shot to her lungs.
She snorted and hacked as if she was suffering from a very bad cold.
The old lady who had accompanied her to the hospital began laughing.
Feeling the freedom of the broken ice, B. and I joined in.
'OVJIWJ LL JGLJOWI RJVLK LKJBOISJRGLKSD VKJOIRW HJ:LKJLKDJGLSIBJLJ!' her friend chortled at her in Hausa.
She tried again.
In that split second of silence before her inhale, I thought for sure it would be impossible for her to reproduce the sound. She was, after all, quite a dainty lady.
But, once again, I was proved very wrong!