More than medicine: What I learned about my patients from an adaptive yoga training

by Sarah M. Smith, MD

“One of the big healing things for me was to recognize that my paralyzed body didn’t stop talking to my mind. It changed its voice.” These were the words of adaptive yoga instructor Matthew Sanford to our group of eager trainees — yoga instructors from all over the country and the world, who had come to learn how to teach adaptive students.

Matthew has a spinal cord injury himself. He sustained his injury when he was a child in a car accident that killed his father and his sister. He has been using yoga as a means to teach people how to reconnect with their bodies for many years now. I was a fourth year medical student at the time, and as a soon to be PGY-2 PM&R resident now, the benefits of my training continue to reveal themselves. I had already been teaching yoga for 6 years at that point, but most of my experience had been with students with little to no functional limitations. During my intensive training, I was able to learn from students with cerebral palsy, spinal cord injuries, brain injuries, prior CVAs, and multiple sclerosis. Adaptive yoga is quite different in practice than the average mainstream class that comes to mind when we usually think of yoga. In an adaptive class, an instructor leads a group of students, who may each have up to four volunteers working with them to assist them into postures. I was surprised to learn how sometimes it was the simplest of movements that had the greatest impact on my students. I will never forget the look on a student’s face when I spent a few moments stretching out and opening her spastic hand.

I enrolled in the training in order to learn how adaptive yoga could benefit my patients, but I did not anticipate how much it would help expand my own toolkit as a future physiatrist. Instead of focusing on what I knew about my students’ medical conditions, I sat back and let the students teach me about their bodies. “This probably won’t make sense to you,” one student started, “but since I’ve been doing yoga, I can feel my feet. I can’t feel them like you can feel them, but there is something there now that wasn’t there for the first few years after the accident.” This student had a complete thoracic spinal cord injury. It’s probably impossible to know exactly what this student was experiencing, but the point is that she was reconnecting to her body in a way that was changing her everyday experience. And as I’ve learned from my students and patients, feeling disconnected from your body can be one of the greatest challenges to overcome as an individual with adaptive needs.

I have to admit that I struggled with some of the concepts Matthew was trying to teach us that week. We weren’t focusing on the anatomy or the movement science. We were learning how to teach an experience to someone. I realized I was having a hard time asking students to be in touch with their bodies when I had spent that last four years being conditioned to suppress all of my own bodily needs. As a medical student, I had learned how to operate on little sleep, hold it when I needed to go to the bathroom, and skip meals to get work done. I actually fractured my wrist at the beginning of interview season and didn’t seek medical attention for several weeks, because I was worried about missing flights for interviews and potentially not matching.

Disconnection with our bodies is not uncommon in the medical profession, and I do wonder how it impacts our ability to understand our patients’ experiences. A physiatrist’s job is to reconnect our patients with the world, but in order to do that effectively, we must reconnect our patients with themselves first. I realize this concept is abstract. It is not something we can quantify, like the number of feet a patient can ambulate. But despite being scientists, I think we can all recognize that the quantifiable aspects of rehabilitation are only one piece of the puzzle. I have not yet figured out how I will integrate all of this into my practice, but physicians can do more than order medications and perform procedures. The goal is not to leave any of the science behind; it is simply about using a different lens to see the patient. The data and diagnostics remain sturdily in the background, but the patient comes back into focus.

Sarah Smith is a rising PGY-2 in the Department of Physical Medicine and Rehabilitation at the University of Washington (UW). Follow her on Twitter: @DrSarahMSmith



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