I sit cleverly positioned between the driver, an experienced field guide seated at the wheel on the right and an invisible cameraman operating from the left back corner of the safari vehicle. The guide turns frequently, looking over his or her left shoulder to talk to the cameraman (and me) and to engage enthusiastically with thousands of viewers of all ages around the globe.
Soon after sunrise we’re entranced by a herd of elephants meandering through dense bush from one waterhole to the next. Calves tumble over each other as they play, suckle frequently and suddenly lie down to sleep. Using their magnificent tusks, two cows ease the calf lying in the middle of the sandy road up onto its feet, and we follow the parade of elephants again.
The elephants appear to skip down towards a dip in the apparently dry Timbavati riverbed to find water as close as possible to the surface. A mother hunkers down to draw water up from under the sand using her trunk and her calf plops down on the ground beside her, focused on learning to insert its relatively short trunk into the sand.
After the drive, I trundle slowly towards the bathroom feeling energised and ‘uplifted’. I marvel at how this invigoration of soul and spirit through connection with nature translates into strong feelings of physical well-being and joy.
Staying in has become a way of life since I broke my neck three years ago, so I was well prepared for our initial South African lockdown which came at the end of March 2020. My daily challenge has been to create ways to reach out beyond my immediate environment and embrace opportunities to connect adventurously with the world.
Thanks to WildEarth Bringing the Outside In with daily three hour sunrise and sunset safaris in wildlife preserves across Southern Africa from the red dunes of the Kalahari Desert to the green plains of the Masai Mara in Kenya, I’d been able to enjoy my first virtual live game drive seated in my flat in Cape Town. By engaging and connecting with life in the natural world through daily immersive real time experience and interactive Q&A, children and adults broaden our horizons together and enjoy social interaction whilst practising physical distancing during lockdown.
Founder Graham Wallington calls WildEarth an ‘Engine for Empathy.’ Taking people into the wild to find the same animals every day gives them a chance to gain insight into each animal’s challenges and opportunities. Empathy develops when people begin to see each animal as an individual being, not merely as representative of a species. Virtual tourism provides a way to scale up so people around the world can experience a growing connection with nature without overwhelming it.
Pamela Kipps Hansford
After 25 years of home, school and hospital based general practice on 3 continents Pam opened her neuro practice in Cape Town and worked with people of all ages. Nearby Kirstenbosch Gardens became the ‘outdoor arm’ of her practice. Here she has enjoyed exploring the benefit of connecting with others adventurously in nature, first as a therapist for 30 years and now for the past 3 years as a quadriplegic with family, friends and therapists. These visits bring excitement, relaxation and joy, as does adaptive surfing. This reflects her belief in the interconnectedness of people and nature and highlights the significance of the part the environment plays in each therapeutic engagement.
Since the ‘70s we’ve celebrated our birthday weekends in the West Coast National Park on the western side of the Langebaan Lagoon. We spend much of the day on the water and cook and eat outdoors looking across the marshland and water towards the ridge of purple hills running south along the far shoreline. At high tide the salt water covers the marshland and sea-birds congregate in large numbers at the water’s edge.
I was still ‘locked down’ in the rehab centre on my 75th birthday in March 2018 ten weeks after my accident, a physiotherapist with quadriplegia in the early stages of recovery. To my surprise and delight, I was able to climb slowly down the stairs (which have no rails) to the house with much assistance in 2019 to celebrate my first birthday there as a wheelchair user.
Sitting on the ‘stoep’ with our coffee early one morning we watched a flamboyance of pink and white flamingos (unlike the greyish urban visitors glimpsed from Cape Town’s Black River Parkway) standing in one place on the sand flats and turning full circle as they stamp-feed methodically to disturb the sediment and squeeze out crustaceans. And remembered finding the patterns created by this manner of feeding, discrete round mounds surrounded by moats and raised ‘berms’ superimposed on the ripples in the sand formed by the outgoing tide.
Early last year I ‘fell off my perch’ as I stood up from my bar stool at the counter to reach for my rollator. Instead of focusing on where and how I placed my feet I was talking animatedly over my right shoulder to a carer just back from leave.
My left leg buckled and I crashed down, landing on my left hip and knocking the healthy head off my femur. In the process I won 5.5 weeks of twice daily physiotherapy, together with 10 hours in the pool. All of these therapists have extraordinary collaborative skills and I was able to improve my walking and swimming dramatically with their help but I was still recovering from the hip replacement by mid-March and not yet able to climb down the stairs.
To cope with the disappointment of missing my 2020 birthday weekend treat and remain in contact with my family, I asked them to send photographs. I was thrilled to receive birthday wishes with pictures of bontebok welcoming them in the glow of the late evening light, a brilliant sunset and a lone eland visiting in the early morning mist. These pictures of changing light in the natural world and familiar scenes evoked delightful memories, lifted my spirits and created happiness, thus strengthening our bonds with and in nature.
Next day my older grandson surprised me with his gentle smile, a bunch of pink proteas and my favourite crunchy dark chocolate on his way to join his family.
I started using #BringingtheOutsideIn on social media to celebrate any contact which created ‘a window on the world’. These gifts brought me colour, light, life and surprising opportunities for learning, music and fun, enabling me to reach out way beyond the boundaries of the shoebox flat I now call home.
The next day Filip responded to my Tweets by inviting me to write a blog for the Environmental Physiotherapy Association on what nature means to me, how this deep connection developed and its relevance to my health and wellbeing throughout my life.
Challenges of COVID confronting us during the global lockdown include isolation from each other, massive nature deprivation and restriction of movement in the wider environment. At the same time, the benefit of switching humankind’s assault on the natural world off was confirmed, clarifying the need for designing a new and brighter future for all life and igniting an outpouring of generosity and creativity.
Who wants to go back to an ‘old normal’ that wasn’t working anyway? Why would anyone want to ‘aspire’ to mere ‘normality’ when there’s an opportunity to build a better future together by redressing social inequities and our destructive impact on nature? Thinking about the normal bell curve brings an image of a fly trapped in isolation under the dome of one of the heavy glass bell jars of my school science lab in the 50s to mind. Doesn’t escaping entrapment seem like a more exciting option?
In their 2019 Editorial, Filip Maric and Dave Nicholls envision environmentally responsible physiotherapy as an ‘open landscape’ and call for regenerative change by inviting us to build an image of our collective vision on this virtual canvas. Shifting focus from the problem of ‘what’s happening’ to the goal of ‘what we want to see happening’ (2) is enabling us to create and develop this new organic landscape together through the flourishing global responses on Moving Earth: The EPA Blog.
Exploring what ‘physiotherapy can offer a ‘burgeoning environmental consciousness’ (3) is the starting point for working together to restore art, nature and humanity to the practice of medicine in general and physiotherapy in particular. When we respect all life and ‘pay attention to how we do what we do,’ we can learn to tread more lightly on this earth and to deal constructively with the environmental, health and humanitarian challenges facing us. I am honoured to engage in this discussion in celebration of our common humanity, our reciprocal relationship with the natural world and the power of collaborative engagement.
Growing up in nature
My brother and I played in the garden with our neighbourhood friends in all weathers after school. We camped under an old red and white striped veranda awning sheltered by a tall plane tree, cooked apples over the fire, pushed cars around in the dirt and created mud wallows in the rich black soil of the vegetable bed after the root vegetables had been harvested. Venturing out of our immediate environment we crossed the road onto Rondebosch Common with a rusty old wheelbarrow loaded with branches to fight fires in summertime and buckets of water in winter to catch tadpoles before the puddles on the sandy paths dried up.
Richard Louv, American non-fiction author of The Last Child in Woods introduced the term ‘Nature Deficit Disorder’ in 2005 as a metaphor to describe the impact on human development and the societal implications of ‘the growing alienation from nature’.
Louv celebrates the cornfield and woods at the bottom of his garden that he explored as a child as “the place in my heart that I go to”. Mine is that garden, particularly that plane tree at the centre of our world. From its branches panoramic views of the ocean to the north and the south and mountains to the east and the west magnetised our attention and drew us from our home base to distant happy places of play and adventure.
Table Bay to the north holds Cape Town’s harbour, some 10km away. In the late 40s my dad would take us for rides on the penny-ferry, munching crayfish legs from small brown paper bags. The standing oarsman rowed us past bright coloured fishing boats and the Union Castle Line mail boats, which took 14 days to reach the UK and always celebrated ‘crossing the line’ in grand style.
My mom would head South with a carload of cousins, travelling 20km to the False Bay beaches to swim, to surf using the small wooden boards with curved noses that preceded body boards and to investigate the rock pool treasures. Stopping at Kleyweg’s Windmill on the way home for delicious homemade Dutch ice cream was just as important as the swim. We looked west across the wide open Rondebosch Common directly towards Devil’s Peak and Table Mountain.
My dad’s brother, Uncle Billy, led our weekend hikes through the forests and mountain fynbos from Kirstenbosch National Botanical Gardens with me plodding along at the back of the pack. He taught us how to get up when we fell down, and to stop frequently to enjoy the views and examine the flowers and the insects and birds they attract in the world’s smallest but richest floral kingdom, the Cape Floristic Region, a UNESCO World Heritage Site.
Greater Cape Town sits on the Cape Peninsula and the sandy isthmus of the Cape Flats which connects it to the south western corner of the African continent. Looking over the isthmus towards the east we saw the mountains on the mainland, our gateway to the north for winter holidays with my mom’s family on the arid plains of the Great Karoo. Here we explored the scrubland and ‘koppies’ in search of Boer war relics, such as small medicine bottles, Marmite jars, brass buckles and cartridge ‘doppies’, all well preserved in that hot dry climate.
Having the time and place to grow up grounded and to learn through play and exploration outdoors with other children, together with adults offering support and widening our environmental experience, helped mould and shape my nature, the choices I made and the paths I followed. I became a passionate goal directed physiotherapist working collaboratively with people of all ages to enable them to deal competently and confidently with their daily lives. Our starting point was sharing strengths and ideas and seeking to understand the unique internal environment of every person, the context of each one’s lives in their immediate external environment (of people, space and place) and the path that had brought them to us.
They learnt to:
- Take the lead, starting with the narrative of their diverse strengths
- Set meaningful goals and engage purposefully in collaborative problem solving
- Enhance performance skills through experiential learning and reflection
- Express themselves at the level of their potential in action and interaction
- Build confidence through experience of success and realise dreams with help
- See challenges as opportunities, derive strength from adversity, inspire others
We worked together in meaningful functional activities to effect physical change in ‘form-function’ in ‘time-space’ (5) in order to produce physiological changes beneficial to health and to contribute to psychological development of well-being and resilience. As people built on their strengths and dealt creatively with their challenges at home, school and work and in their leisure, play and sporting environments they also found ways to make the necessary environmental adaptations to support their efforts.
At this stage I enjoy ‘basking in reflected glory’ as I continue to follow the stories of those who I’ve worked with since I established my private practice 35 years ago. For example, my artist friend Tyler, now in his twenties, was a year old when a mutual friend introduced us to each other after his family returned from Australia. Tyler and his family all love the outdoors (especially the ocean), enjoy outdoor sports and share a sense of humour and a ‘can do’ approach to life. As journalists and artists they have all developed strong creative, expressive and interactive skills which are evident within their extended family, the wider community, their work commitments and in support of conservation.
Tyler struggled tremendously at school because a cerebrovascular accident before birth caused a right hemiplegia which naturally interfered with his performance skills in action, speech and particularly on paper so he was not able to express himself at the level of his potential in any way.
By the time we met Tyler had already practiced meeting challenges head on with his family guiding and mentoring him. The first time he wanted to draw a picture he knelt in front of a wooden toy box so I could help him optimise his alignment, balance and control to steady his hips and body and free up his drawing arm. He was delighted to discover that a large piece of paper can be stabilized with small blobs of Prestik in each corner to steady it and that fat crayons don’t break and immediately produced a sheet of round circles each with two legs unmistakably moving across the page from left to right and named his picture ‘Dancing Men’.
Soon after this he started to draw cartoons (adults don’t interfere and tell you how to draw cartoons ‘right’) and decided he wanted to be an animation artist. This dream was realised at Triggerfish Animation Studios three years after he finished school and he passed with flying colours. Last year he was delighted to be offered a full time job as an artist during the Covid-19 pandemic at the firm where he was serving his internship online.
The primary focus of his school-leaving art project was his painting of a mythical seabird. With courage he slashed the canvas and displayed the bird’s stomach contents using plastic waste collected from Muizenberg beach to explore the concept of ‘Fragility’.
He also produced the story of his life as a cartoon book called ‘Better than Fine.’ This was the stock answer he used (delivered with eye contact and a glowing smile) to the question ‘how are you?’ With this reply he charmed the questioner and discouraged further questions because he had a complex word finding problem and processed speech slowly as a young child. He copied a photograph of himself running full tilt towards a photographer accurately for the front cover illustration and inverted it mentally to imagine himself running for joy for the back cover.
He enjoyed drama, soccer and cross country running at school and applied himself with great determination to his family’s sport surfing as a knee-boarder, integrating his interests by using surfing as a metaphor for animated storytelling in ‘Better than Fine’. He became a competitive adaptive Surfer and represented South Africa as part of the national team, eventually assuming the role of cheerleader on the beach and becoming the spirit of the team that won the Team Spirit award.
Tyler’s unique story, (like those of many others who have also exceeded expectations), presents a spectacular illustration of the way that nature connectedness serves to support the development and enhancement of characteristics such as compassion, care for others and for nature and creativity which enhance health and well-being and can drive the conservation ethic in future generations.
A new day dawns
The body of research developed over the past 60 years on the importance of fostering a reciprocal relationship between nature and humanity (to enhance health and well-being on personal, professional and interspecies levels now and in the future) carries the same message as the wisdom of our common ancestors being delivered around the world today.
In contrast to Western ethics, the cultures of indigenous people (6) around the world point the way to ‘Restoring Harmony’ through relational ethics and nature as expressed so well by Oka Sanerivi in his EPA blog post. “Pacific identity, as described below from the Samoan perspective, is innately bound to the natural environment ….. The Samoan self is a relational self that exists within connections to others, family, village and nation. Foundational to this sense of self is the awareness of our kinship relationship with the natural world and that the land not only sustains us but is part of us.”(7)
Similarly EPA student representatives, Thies Bundtzen and Issie Long, suggest that Ubuntu, a system of relational ethics influencing sub Saharan Africa which promotes unity of all life, offers a useful alternative to the Western ethical system for evaluating global bioethical issues.(8)
“People are not individuals, living in a state of independence, but part of a community, living in a relational moral system of relationships and interdependence” (9). Each individual is a link in the chain between our ancestors of the past and our descendants in the future.
I would like to suggest that this integrated intergenerational approach promoting community interests through building quality relationships could form the basis for transformational change in healthcare. I look forward to exploring this concept further from the dual perspective of both therapist and ‘patient’ with my story of rethinking rehabilitation adventurously in a collaborative context.
(1) Capaldi, C. A., R. L. Dopko and J. M. Zelenski (2014). “The relationship between nature connectedness and happiness: a meta-analysis.” Frontiers in Psychology 5. doi:10.3389/fpsyg.2014.00976
(2) Jules M Rothstein, John L Echternach, Daniel L Riddle, The Hypothesis-Oriented Algorithm for Clinicians II (HOAC II): A Guide for Patient Management, Physical Therapy, Volume 83, Issue 5, 1 May 2003, Pages 455–470, https://doi.org/10.1093/ptj/83.5.455
(3) (2019) A call for a new environmental physiotherapy – An editorial,Physiotherapy Theory and Practice, 35:10, 905-907, DOI: 10.1080/09593985.2019.1632006
(4) Nooshin Razani, Kelley Meade, Christine Schudel, Carol Johnson, & Dayna Long. (2015). Healing through Nature: A Park-Based Health Intervention for Young People in Oakland, California. Children, Youth and Environments, 25(1), 147-159. doi:10.7721/chilyoutenvi.25.1.0147
(5) JC Smuts Holism and Evolution 1926 Retrieved from https://ia800202.us.archive.org/31/items/holismevolution00smut/holismevolution00smut.pdf)
(6) Ratima, M., Martin, D., Castleden, H., & Delormier, T. (2019). Indigenous voices and knowledge systems – promoting planetary health, health equity, and sustainable development now and for future generations. Global Health Promotion, 26(3_suppl), 3–5. https://doi.org/10.1177/1757975919838487
(7) Oka Sanerivi 2020 Restoring harmony – How pacific indigenous knowledge can help physiotherapists navigate environmental responsibility
(8) Thies Bundtzen & Issie Long 2020 A voice for our education – Student’s perspectives on the EPT Agenda 2023
(9) Ewuoso, C., & Hall, S. (2019). Core aspects of ubuntu: A systematic review. South African Journal Of Bioethics And Law, 12(2), 93-103. doi:10.7196/SAJBL.2019.v12i2.00679
Header: Charles Mercer – Leaves
1 Tyler Pike – Elephant calf learning to drink from below the surface
2 Charles Mercer – Reframing the baboon, respecting the individual
3 Rosalind Molteno – Langebaan Lagoon
4 Jenni Bessesen – Table Mountain and Devil’s Peak
5 Jenni Bessesen – A new day dawns: nature is part of us and we belong in nature
This is a fabulous, fantastic, beautiful, wonderful work!
Supreme well done.
I’ll get this printed (twice), one copy for me and one to your other fans at O,Ways
Thanks for your enthusiastic response Jenni and for your glorious sunset and sunrise photographs.
The ‘red sky at night’ (behind Table Mountain and Devil’s Peak) symbolises hope for the future as we reconnect with nature (when surveying the world from the top of the tree across the Rondebosch Common or hiking with family on the mountains).
And the golden dawn with the sun rising behind the trees in Keurboom Park brings back memories of daily walks with my succession of dogs there. And of watching the grove of indigenous trees growing in number from the 13 Keurboom trees planted by City Parks and Peter King on Arbour Day in 2003 (after he read ‘Bringing Nature back to your Garden’) to 261 in 2010 (with 53 varieties) many contributed by the association of friends of the park led by Peter and Justine Thornton.
During the drought years that followed I remember chatting to Peter as he leapt down into the canal and clambered out with bucket after bucket and watered each tree by hand. Years later once taps had been installed he would bring his own hosepipe with him on each visit …..
As cultural anthropologist Margaret believed ‘Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has’.
Thank you Pam. Your blog illustrated the, in so many ways forgotten, necessity of our sustenance from nature and the need to protect it. Hopefully, lockdown/Covid 19 has redirected us.
The Tyler story is inspiring and memorable, specially his ‘Better than fine’ personality.
Thank you for highlighting the need for reciprocity in our relationship with nature and all forms of life Jenny.
The value of embracing nature with all one’s senses is apparent in the Londolozi Game Reserve’s blog, ‘Learning to See’ as game ranger Sean D’Araujo tells the story of how Shawn Cheshire, a blind visitor, taught him how to be quiet, listen and see using his ears.
Such important skills for us as health practitioners to learn if we hope to transform medicine by restoring art and humanity
Glad to continue my ongoing collaborative journey with Tyler by inviting him to illustrate the elephants from the word picture I ‘painted’. As always way ‘Better than Fine’
Ah Pam thank you taking the time to write this wonderful and inspiring article. I could picture your brother and you with your buckets of water back in the day. Thank you for the reminder of how important it is to spend time in nature. Hope to see you soon … Lou
Filip’s invitation to contribute to this blog came serendipitously 5 days before SA COVID-19 lockdown began so I had plenty of time. Glad you found this article inspiring Lou and identified the importance of spending time in nature as the focal point. This is in turn is the starting point for establishing/ restoring nature connectedness which in turn enhances health and wellbeing and promotes pro-environmental behaviour.
Nature connectedness is regarded as the extent to which individuals include nature as part of their identity, I discovered today that an interdisciplinary group of researchers at University of Stellenbosch (Zylstra et al 2014) define connection with nature (CWN) as “a stable state of consciousness comprising symbiotic cognitive, affective and experiential traits that reflect, through consistent attitudes and behaviours, a sustained awareness of the (reciprocal) interrelatedness between one’s self and the rest of nature.”
Zylstra, M.J., Knight, A.T., Esler, K.J. et al. Connectedness as a Core Conservation Concern: An Interdisciplinary Review of Theory and a Call for Practice. Springer Science Reviews 2, 119–143 (2014). https://doi.org/10.1007/s40362-014-0021-3
What an inspiring read. Taking so many concepts and weaving them together into such an uplifting message. Thank you for sharing Pam and truly bringing the outside in and the inside out!
Thank you for your kind words Donne, your enthusiastic engagement, fun loving spirit and ability to see potential have always been a source of inspiration and upliftment to even the most severely challenged children you worked with as well as to their families, students, friends and colleagues in all disciplines. Do you remember structuring obstacle courses with children by connecting the ‘stations’ with Airex mats so that even blind children could crawl along safely at top speed as they worked to improve their personal best times by enhancing alignment, balance and control each step of the way? And going further connecting outside and inside as they track went out one door (or even through a window) and in through another.
Regarding ‘bringing the outside in and the inside out’ I was pleased to discover that Richard Louv’s work sparked the No Child Left Inside movement in the United States which seeks funding for environmental education and promotes environmental literacy for schoolchildren of all ages.
Fantastic, Pam! A well written, thought provoking and inspiring article which I will pass on to my daughter-in-law, Diony Lalieu. She is very involved in keeping the oceans free of pollution through her NPC, Ocean Pledge.
Thanks Adrian, so glad that you, a writer, found this article to be well written, thought provoking and inspiring and that you will share it with to your daughter-in-law, Diony Lalieu.
Thank you for introducing me to her and the amazing Ocean Pledge Organization she founded and developed along with her husband and an extraordinary group of like minded people all acting in a voluntary capacity.
“The ocean is the blue heart of our planet – a living system that connects all beings and is a vital mechanism which supports the health and livelihoods of us all. With research, science and our current age of information technology most of us have been made aware of the rapidly declining states our eco-systems. We now have to RESPOND and ACT.
Like individual drops, we so often feel powerless when it comes to our own ability to impact meaningful change. We may think ‘What difference is a single straw going to make?’. On the contrary, at Ocean Pledge we believe in the power of the individual. We believe in COLLABORATION and our ocean inspired projects aim to empower and nurture change from deep within.
Through the ‘collective actions of individuals’ we will co-create the groundswell of positive change, shift paradigms and turn the tide on single-use plastic throw-away culture for good”.
In this way Ocean Pledge focuses on changing perceptions and behaviour around single-use plastic. In the Pledge Options and in Diony’s blogposts on the website the organization provides a comprehensive range of ideas we can all apply as individuals on a daily basis (and share with others) to help turning the tide as part of a worldwide collaborative effort to turn awareness into action.
Cape Town’s beauty and creativity ‘go hand in hand.’ This is not surprising as a high level of nature connectedness has been shown to develop characteristics like care, compassion and creativity. These all associated with the development of collaborative problem solving ability and the promotion of health, wellbeing and pro-environmental behaviour.
Having known you since our student days, I needed time to go through your blog and see your life in perspective. It is a wonderful reflection of your life and how your accident has added a new dimension to connecting you to the outside world and nature at its best.
Bringing the Outside In has enabled you to interact at such a multidirectional level with every aspect of life and living – the very essence of the word and its meaning, rehabilitation.
Thanks for sharing Pam.
My love ,
Thank you for taking the time to go through my blog and see my my “life in perspective” Marge.
Its hard to believe that we met as students 60 years ago and that 8 of the group living in greater Cape Town were able to reconnect and celebrate at the lively lunch you hosted!
As children our generation learnt about action learning and reflection as a way of life through outdoor play, exploration and experimentation and we naturally passed this on to our children too.
When I established my practice in 1987 I was able to ‘make play my work’ and Kirstenbosch Botanical Gardens (one of the ‘Magnificent 7’ world’s most beautiful gardens) naturally became the outdoor extension of ‘Pam’s Play Place’. In our therapeutic encounters we focused on health and well-being and on ‘putting FUN into FUNction’ as we learnt thinking skills in action and practiced collaborative problem solving creatively with both children and adults throughout the sessions.
Fortunately my accident combined with the digital explosion during Covid-19 has indeed added a new dimension to my connections with the outside world and nature at its best!
Good Afternoon Pam,
What an inspiring article. This takes me back to the time I consulted you. As a multiple stroke victim, interdependence wasn’t in my vocabulary, let me say when I was healthy. Now I understand the model of dependence and interdependence, really a positive. As I look at the beautiful mountains from my living room window, I am comforted and motivated. Positive self talk is my third language. Very importantly I am independent in my thoughts. The power of a positive mind can conquer so much, even if from a wheelchair.
Greetings to you and your family Priscilla,
Thank you. Our journey began in 1986 at a careers counselling meeting at your school. To my delight you were accepted into the Physiotherapy Dept. at the University of Stellenbosch the following year.
Worcester is 112km from Cape Town. We both worked enthusiastically with children with neurological challenges and met frequently as colleagues at courses. I was shattered to hear of your right CVA in 1996. Two weeks later you walked carefully into my practice using a crutch in your right hand. Experimentation confirmed the crutch was aggravating your problems of asymmetry and imbalance and you were delighted to ditch it when your walking improved after that session.
At the SASP International Congress in CapeTown a year later, pregnant with your first child, you inspired the audience with your story of your ‘lived experience’ of stroke and life thereafter. Visiting leader in quality research, Prof Kay Shephard and I were bowled over.
Recently I asked you to tell me more of your story of becoming a proud multi-stroke survivor. “In 2000, I became a right hemi, unable to talk after my second stroke. With great effort I managed to say ‘I want Pam’ after a few days.” A klipspringer (rock jumper) poised on a huge boulder ‘directed’ me through the glorious mountain pass as I emerged from the Du Toit’s Kloof Tunnel on my way to see you at Worcester Hospital. Your face lit up when I told you about this nature based experience of light at the end of the tunnel.
2 weeks later you were discharged and you invited your rehabilitation centre colleagues to watch our first session filmed at your house by your principal. You used this film (and more) for reflective practice and teaching others and still do.
Ten years passed. We joined forces occasionally when you needed to relax, realign and restore balance and postural control after well meaning students had focused on strengthening, stretching and encouraging you to ‘try harder to do more.’ By this time you’d learnt that ‘trying softer, not harder or hardly at all’ is the best way to improve your performance and level of participation in all tasks. During this time you were “fully functional, working as a physiotherapist, driving and performing motherly tasks.” Most exciting was that you “tied the knot with Jacob in 2009.”
The third stroke struck you in 2010, “a light stroke … meaning” you “could still do most things”. In March 2012 we made a video of a session in my rooms and a month later you experienced your fourth stroke.
Fortunately your husband noticed a recurrent pattern in the two incidents he witnessed. Apparently a prolonged time spent sitting bent forward with head-on-neck extension (so you could see what you were doing as as you struggled to tie your shoelaces with great determination) caused a kink in either the basilar artery or the Circle of Willis.
Won’t it be wonderful to meet up at #AdaptiveSurfing at Muizenberg once this Covid Lockdown is over?
Priscilla shared your blog with me. An awesome read. You truly have joie de vie and obstacles that would cause others the crash and burn, are viewed by you as opportunities to do things different. Inspirational. Sending lots of love. Lindsay
Thank you Lindsay. I enjoyed meeting you and Priscilla at your school careers counselling meeting in your final year and was delighted when you were accepted into the Physiotherapy Dept. at University of Cape Town in 1987.
I used to feel intimidated when somebody I admired used the word inspirational with reference to work or achievements of mine. When I began to practice catching people, especially children, ‘doing things right’ instead of focusing on pulling them down by constantly pointing out what they were doing wrong, I started to understand that “It takes one to know one!”
You have inspired me in many ways too, for example with your innovative approach to rehabilitation with the creation of a practice focused on work hardening after work related injuries.
You also understand that the best contribution one can make to someone’s experience of rehabilitation is to ensure you ‘meet on the same footing’ and engage in such a way so that ‘the other person’ feels like ‘a real person’, the person they really are, through natural interaction rather than an object defined by their ‘diagnosis’ of disability or disorder.
Much of the time in my first two years as a wheelchair user (ie before Covid) I experienced being ‘looked down upon’ both literally and figuratively. I remember going to a Pain SA meeting in the River Club building which has 2 floors but no lifts and feeling super proud of having climbed the wide staircase moving sideways with both hands on one rail (so I could use my carefully developed gluteal muscles for mobility while my shoulder girdle provided a degree of stability). The only help I required was the kind waiter who carried my chair up.
A friend came out of the lecture room, cheered me on and helped me up the last five steps with no rail. I heaved a sigh of relief and settled down to enjoy the lecture. The young physiotherapist back from the Middle East next to me was good company. After the meeting several colleagues came towards me from all, greeted me enthusiastically, and proceded to have lively conversations over my head. Some even stroked my upper arm and rested a hand on one shoulder. My highly reactive very floppy body experienced this as being being pushed into the ground.
You however went out of your way to collect me, a fellow course junkie and ‘transport’ me to various venues for evening and weekend meetings, our favourite venue being the Western Province Cricket Club. The room was spacious and comfortable with a lively pub right near the door looking West out over Keurboom Park, one of my most special dog walking spots to the mountain view of Table Mountain and Devil’s Peak.
Thanks for your generosiy and friendship, Pam
Dear Pam, I came across this today as I wanted to find your number to refer someone to you. I am deeply moved and not surprised in so many ways that you would respond to you accident in the manner you had. Thank you.
Thanks for your support & ‘uplift’ Olivia