Sunday, August 20, 2006

Re-membering the Forgetting

PTs go to university to learn what there is to know about the human organism that can be applied to helping it improve its function. We all learn anatomy, physiology, pathology, neuroanatomy..

When we graduate, only those of us who end up having a talent and proclivity for "Neuro", a contracted concept that for us means treating patients who have profound functional deficit, profoundly damaged nervous systems from birth or through trauma ... only these graduates ever stay caught up in neurosciences. Metaphorically we all land on the same beach, then a stalwart few head inland to climb steep mountains.

The rest gratefully exhale post-graduation, allow their info base on neurosciences to drop away, erode, disappear, and turn their cognitive hard drive to learning more about biomechanics. They turn their attention to the stuff of the body, the mesoderm, under a large conceptual umbrella called "Orthopaedics", splitting off from the true functional organizer of the body, the nervous system. Metaphorically, these are all the ones who stay by the water and build piers out into it, preferring beach life, the equivalent of treating a host of issues in tissues that (mercifully) they can classify and reclassify to their hearts' content; the nervous systems of the people they treat are usually intact.

But what is gradually and steadily coming in like a tide is pain science. The pain science advance is forcing the beach boys and girls to pack up all our previous cognitive and conceptual gear and move further inland, closer to where our Neuro colleagues make their livings.

I say "our." I was a beach bum too, for a long time, although I like to imagine I'm already a bit further inland than some. It has only been in the last 10 years or so (out of a 35 year long adulthood as a PT) that I have learned to see pain sciences as a link that will (potentially) one day unite the profession, maybe all manual therapies, into a deeper level of real understanding. There are lots of other PTs on the same path, who have been on it much longer, and are much further along. Some are even working to widen the path.

Of great additional benefit to this whole scientific deepening of the profession would be a much deeper appreciation for EvoDevo, something our hands-on social grooming professions currently lack. If understanding human pain means having to grasp understanding of the human nervous system in all its complex multi-faceted glory, it will also mean understanding the place humans occupy in life itself, not just in multi-varied human culture.

No comments: