I have been a physical therapist for 32 years.  Everything I need to know to do this job is in my little black bag.  Exercise, massage techniques, pain modalities, compassion, empathy, creative ways to make a functional activity easier in the face of limited mobility, scar control, you name it.  Last but not least, I have the wise words of my clinical instructor at Rehab Institute of Chicago: “It’s not always about what you know in this business, it’s whether you know how to find the answer.”  The diagnoses might change, the variations on a theme of what intervention to use might be many, but essentially I know how to be a physical therapist.

I start a new job next week, in a setting I have wanted to be in for a very long time.  The teaching gig ended up not being practical – too big of a learning curve for me, too much time preparing outside of class to do it the way I wanted to do it (thus making about a buck an hour) not to mention the realization that some students were going to make judgments about me and hate my guts for no reason.  I can live without that at age 60.  I may go back into the classroom occasionally, but the idea that it would blossom into full time has been proven impractical at best.

As is so often the case, when one door closes another opens, I will be working at a small outpatient clinic, owned by a woman my age who has also just completed her DPT, meaning she, too, is a lifelong learner.  Besides the usual orthopedic outpatient caseload, the clinic also serves women with pelvic pain and dysfunction and women post-mastectomy, with or without lymphedema.

Both of these areas of physical therapy are areas in which I have wanted to practice, but was never at the right place at the right time, until now.  I now have a mentor, a place to practice and the desire.  Right place.  Right time.  Right mentor. Most of my patients when I begin next week are typical ortho outpatients – low backs, knees, shoulders, necks.  One patient will be post-mastectomy.

So of course I got digging to review and relearn everything I might need to know about breast cancer – about the anatomy of the breast and axillary area lymph nodes, about the types of surgeries.  The lymphedema was covered well and I have a long distance mentor in that regard from the Advanced Clinical Practice Course in the DPT program.

I have often said I am tired of working in geriatrics not only because it is physically exhausting, but it was also becoming mentally exhausting, a little too close to home for an old lady to be treating her peers. Today, researching breast cancer and mastectomies, I realized that is nothing compared to what I am about experience in my career.  Looking at photos of post-surgical breasts, breast reconstruction, thinking about what that must be like, I realize I have much more than anatomy to study up on.  I need to read about what those women experience.  I need to examine my own feelings about it.

I have often discussed with others how disturbing it is every year to get the mammogram.  To have your breast squashed as flat as possible (one time Al came in out of curiosity to see what I was talking about and was astonished – I can still see how big his eyes got – to see the procedure and how flat the breast is compressed) always leaves me feeling somehow violated.  I always feel something akin to mild grief – as if I want to cry and don’t know why.   I am feeling that way right now after delving into the subject.  I am about to face my own fears, my own feelings about my breasts, my own self-image.

It’s about to get up close and personal.

addendum: If there are any friends out there who have experienced breast cancer or mastectomy who would like to contact me separately to share your experience with me, I would welcome that.  You can message me privately on FB.