When members of the public are unable to make a Sophie’s Choice (an extremely difficult decision), or they make a choice that turns out to be illegal, we turn to those at the peak of reasoning to deliberate and provide opinion. Who said it was easy being a judge?
Sophie’s Choice is a novel and film starring Merry Streep, where a mother is sent to a Nazi Concentration Camp, Auschewitz, and told to choose between her daughter and son — one who is to go to the gas chamber. If Sophie does not make a choice both children will be killed.
In our daily lives we all make choices with effects and side effects, pros and cons, advantages and disadvantages. Try as politicians might to broad brush societies behaviour, regulations will never prevent, resolve, or satisfy each individual’s uniqueness. The best that can happen is for government to take a holistic approach and provide for the health of society, then leave the minutiae for others to remedy.
For physiotherapists — the experts in movement — one of the biggest dilemmas is what requires rest and what requires movement? Evolution and improving scientific knowledge means exercise prescriptions are fluid — not only per patient, but generically as well, and times change. When I was a recent graduate, many years ago, The New Zealand Herald had two pages of advertisements saying, “Ill health forces sale of farm.”
The farmers forced to sell were usually aged between 40 years and 50 years old. An onslaught by a ram had blown out a knee that nature did not rehabilitate, or a horse fell, or sitting too much on a tractor had damaged hips beyond reasonable functional use, and back pain (all regarded as psychological because the medical profession did not have pathological answers the modern world has) made useful function on a farm a deterrent for continuing duties. Nowadays, one seldom reads this headline.
What has dramatically changed? Better movement of hips, knees, and backs via rehabilitation, surgery, or both. Oral prescription medicines have mostly stayed uniform.
You may recall a classmate fracturing an arm or leg and being incarcerated in a plaster of Paris from hip to toe, or upper arm to fingernail. One felt an outcast (pun intended) if not asked to sign the white casement. Today, where are the plaster of Paris casts? Gone — and for good reason. The injured tissue was provided with rest, but so was the surrounding sound tissue. Latrogenic injury to previously perfect structures eventuated, not because of medical maliciousness, but we just did not comprehend the value of each cell of the body being able to move if that cell was to maintain health. Only the severely dysfunctional cell needed to be incarcerated.
Recently, someone from the United States of America contacted me about a Subluxed Patella ( kneecap) which had dislocated and self reduced. The person was prescribed three weeks bed rest. There is a cultural difference between suing and no fault systems. Virtually no one in New Zealand is given bed rest for the 90 per cent of the unaffected body because of injury to the 10 per cent. Ten days bedrest and it takes approximately three weeks to recover cardio-respiratory fitness. Muscles lose two to three per cent strength per day, or 50 per cent in three weeks. Tissue “jail time“ should be directed to the perpetrator, not the whole innocent support mechanism.
If you have a major health event, do not take the law into your own hands. Here in New Zealand, primary medical providers are amongst the most progressive in the world when prescribing the right movement for your whole body while still graduated resting the injured part. Fortunately, we also have an insurance system that still financially has value, albeit not as strong as it was when Justice Sir Owen Woodhouse ‘activated‘ the Accident Compensation Corporation scheme. Dull in comprehending the most recent economic research, which demonstrates a dollar invested in movement returns five dollars in immediate financial health returns, let alone the added benefits high-functional performance, feeling of achievement, and remaining in one’s community.
Unlike the past, now The New Zealand Herald carries two pages on how New Zealanders who move superbly win gold medals against the best in the world, but even more of value is how a hip replacement, early rehabilitation of a knee, mobilisation and manipulation of a lumbar spine, a moon boot for a lower leg injury, which can allow some movement to tissue other than the injured area, have profoundly improved our overall health and society’s fortunes.
The laws of human health and the laws of the land have much in common. Keep encouraging normal moving in the right direction, dissuade and restrict abnormal as best as one can prescribe.