Barrett L. Dorko, P.T.

          Imagine that one day you are handed a vase and told that it is now your job to hold it with your hands alone. You cannot put it down or give it to somebody else. You don't own it, but it is your responsibility to keep it with you, and this is what you are paid to do.

          I am often given credit for having remarkably sensitive hands. Therapists watching me work speak wistfully of how wonderful it must be to have such a gift. If they don't think it's genetically acquired, they assume my sensitivity is the result of years of concentrated effort.

          I don't buy any of this. If either were true, I think I would know it.

          Imagine now that you've been holding on to the vase for a few minutes and that you are told from a perfectly reliable source that the vase is worth millions of dollars.

          How might you change? I've asked many therapists this very question and they almost always insist that they be allowed to put the vase down despite my specific admonition to the contrary. But, in time, they may describe their hands in relation to the vase now that they have this new knowledge.

          Assuming that its worth might mean it is fragile, their hands now grasp it more fully, but gripping is out. In their imagination they become increasingly aware of the vase's shape and tendency to respond to gravity as they shift its weight.

          If I prod them a bit, they tell me that something worth this much might be interesting to see. They look at it carefully. Its texture, glaze, and shape might reveal why it is so expensive, and the therapists usually wish they knew more about vases.

          In short, there is no distinct increase in the sensitivity of the therapist. All the sensitivity they use in the end was with them when first handed the vase. It is much more accurate to say that they now appreciate what it is they are holding. Their gentle handling and interest in the subtleties of the vase follow their knowledge of what it is worth. Before that, care and attention to the holding was haphazard, at best.

          Although we don't ordinarily assign monetary worth to the human body, something akin to that is evident in all contact with others. The potential referral source (read: money in the bank) is more likely to elicit more interest and consideration from us than some of the patients he or she might send. This is the nature of business, like it or not.

          I feel that the role of the physical therapist should include an appreciation of the body that is reflected in the way we hold it. But what is our reputation? Most patients come to me fearful of being poked, prodded, and painfully bent. It's what their friends got elsewhere, for similar conditions and I can understand their fear.

          It is absolutely impossible to handle another with care and wonder, without feeling you deserve the same. When I was handed this "vase" years ago, I wanted to put it down too. I felt not up to the task and my methods reflected that. I was known to relinquish this responsibility to an aide or assistant, a protocol or machine. This doesn't always work very well, and it added nothing to my appreciation for the patient or myself.

          My hands are not unusually sensitive, nor are my skills especially difficult to acquire. But when I'm with others on the job, I can sense their worth, and I hold them with care.