Working from the Heartland

Lori Risner
Occupational Therapist
Chicago, Illinois

This will take just a second. Take your finger off the mouse. And just take a look at your hands. Splay out your fingers. Count them. Ten? Just like yesterday? Do they work okay? How about your wrists? Doing okay? No carpal tunnel syndrome? You can reach for that cup of coffee? You can adjust the volume control on the CD player? Grab the ringing telephone? Necktie on straight? Pantyhose not all twisted and irritating? You have your hands to thank for helping you get through the day. I would bet you also need your hands to get your work done.

The handbone is connected to the paycheck bone.

But say you get careless with a heavy box, a sharp knife or the wood chipper, suddenly you may not have full use of your hands anymore. You're one tendon away from workers comp and a little disability leave. Which is okay for a while. After all, the summer months are a good time to kick back and work in your garden. Oh wait a minute, no hands.

A moment's distraction, and suddenly you're Lori Risner's patient. An occupational therapist who specializes in hand rehabilitation, Lori's work is twofold: to return to you the use of your hands. And return to you the usefulness of your entire life.

"We deal with the whole person," she says. "A lot of these injuries can disrupt a person's entire life and depression sets in when they can't function the way they used to. There's a huge psycho-social aspect to being able to work, and when you can't do what you used to be able to, your self-esteem can suffer as much damage as your original injury."

"I've never taken my own health for granted since I started working as a therapist," she says. "If you have your health, you have everything."

Occupational therapy draws a direct link between healing and doing. Unlike other modes of therapy that provide treatment to bring the patient ever closer to being whole again, occupational therapy uses the actual tasks of everyday living as the key component of the treatment plan itself. Its motto, "Curing by doing," sums it up nicely. The carpenter, for example, who must learn to use his tools again is tasked with actually hammering that nail or screwing that screw. Slowly his motor skills, range of motion and strength might be returned to him as he concentrates on the job, not the exercise of the job.

"So much of our sense of who we are and our place in the world depends on our ability to perform daily activities in both work and leisure," she says. "So what we try to do is set our patients up with tasks that come close to that activity level. This way they're not thinking of the exercise itself per se, but the end goal.

"We see people come in here who can't move their hands at all. Eventually I can tell them that they have increased their range of motion by this much, or their grip strength has increased by that much," she says. "But it's when they come in and tell you 'I opened the car door today,' or 'I turned a key today,' that's when this work really feels good.

"To have someone come in and say to me, 'I held a golf club today,' says so much. It's why I work," she says.

An occupational therapist for 11 years, she discovered the profession by chance: Her father spotted a feature article about the field in the Chicago Tribune. In those days entry level salaries were maybe $18,000 to $20,000. Now, she says, new graduates can start at salaries between $30,000 and $40,000, the demand is that high for skilled occupational therapists. But this isn't good for the profession, she says.

"When I applied to the program, it was difficult to get in, but certainly not like it is now," she says. "Then pay was minimal and you went into the profession because you liked working with people and you loved the health care field.

"But now schools are keeping demand high by severely limiting the number of students they accept every year," she says. "Hospitals are now advertising $10,000 sign-on bonuses. They'll also offer to pay the last year's tuition in return for the therapists' commitment to work at the hospital for a year or two after they graduate.

"This is bringing the wrong kind of person into the field," she says. "The students I'm getting now aren't people people. They don't think about what they say to patients, they're just focused on the money.

"We need occupational therapists who are in the field because they love working with people," she says. "We see some of these patients three times a week for anywhere between an hour or an hour and a half each session. We see them more often than their doctors do. So we need to know how to relate to them. That takes a talent and commitment that money can't buy."

But the field changes everyone, even Lori. It's, in a way, her own occupational therapy.

"I used to be a much quieter, shyer person," she says. "Go back and read all my old report cards and that's what the teachers wrote, again and again.

"But when you're working with people all day long, it builds your own self-esteem and self-confidence. This work has helped me a lot."

Copyright 2005 by Martha Finney. All rights reserved.