A Day in the Life of a Physical Therapy Student at On With Life 

Vincent Ann, a physical therapy student at Washington University in St. Louis, spent a clinical rotation at On With Life, working with physical therapists in our inpatient and outpatient neuro rehabilitation programs. Read his experience, his highlights and his lessons learned.

Today, I wake up in Des Moines, Iowa, where I am spending ten weeks on clinical rotation at On With Life, a Brain Injury Rehabilitation Clinic. On With Life was founded with a focus on Traumatic Brain Injury (TBI), but quickly grew a reputation for inspired care, and has rapidly grown into a flourishing neuro facility. I see the whole gamut of neuro diagnoses as part of my caseload—TBI, stroke, Parkinson’s, post-concussive, and vestibular.

This morning, I’m on an outing to the Des Moines Sculpture Gardens with one of my patients. These outings are all about community reintegration. One of the worst things a patient can do after a devastating injury is cage themselves at home all day for fear of falling, judgment, disablement, whatever it may be. As a physical therapist, my role is helping patients get back to… well, life. Getting out into the community. Doing the things that make life worth living.

So I’m walking down the sidewalk alongside my patient, James, who’s absolutely engrossed in the sculptures to his right. So engrossed, that he’s not paying all that much attention to propelling his wheelchair straight. James sustained a TBI from falling off a roof, and has neglect of (fancy word for ‘doesn’t pay attention to’) his left side. I see that he’s heading straight for a tree basin. I don’t say a thing. This is about learning, after all. His left wheel drops into the tree basin, and startled, James looks over at me sheepishly and says, “I wasn’t scanning.”
After the outing, I head back to the clinic to work with another one of my patients, Sally. We’re having dance rehearsal. Yes, you heard me right. For the past four weeks, every therapist and patient here has been revving up for the annual On With Life Talent Show. We use this talent show to give patients something to look forward to, but also as a vehicle for providing our therapy. For example, the dance that Sally is currently working on was carefully choreographed to work on her weaknesses: standing from a low chair, dynamic standing balance, reaching out of base of support, engaging her right visual field.  
The song that Sally chose for this dance was “This is Me” from The Greatest Showman. If you haven’t heard it yet, stop everything right now. You need to listen to it. The chorus of the song goes:

“This is brave. This is bruised.
This is who I’m meant to be—this is me.”

Sally stays seated for most of the dance, but it is at this moment in the song that she gathers all her strength for a glorious stand. And then she stands there, arms out, chest proud, chin high. Staring unapologetically at the audience. This is me. My clinical instructor chokes back tears every time we get to this moment in the song. I’m not ashamed to say that I’ve shed a few as well.
It’s hard to grasp the power of this moment unless you saw Sally when she was first admitted to this clinic. She suffered a devastating stroke, couldn’t walk, couldn’t stand. She went from being a successful florist, leader in her church, a fiercely independent woman to needing a mechanical lift to get out of bed.
A week later, when she performs this in front of the entire clinic, friends, and family, she’s met with raucous applause, whistles, more tears.
I wanted to highlight these two parts of my day, because I think they are unique aspects of my clinic. They are how we embody the principle of salience: choosing meaningful interventions for the patient. I haven’t mentioned the other stuff. The countless repetitions of weight shifting, weight acceptance, stepping. Home evaluations. Aquatic therapy sessions. There’s just not enough room to discuss it all.

But if you want to learn more about what it’s like to be a PT student, talk to one! Our work is exciting, challenging, and humanizing. We help people get better so they can do the things they love. It doesn’t get much better than that.

Vincent Ann
Washington University in St. Louis
Program in Physical Therapy ‘19

On With Life offers observation and internship opportunities for students interested in learning more about brain injury rehabilitation. We look forward to any opportunity where we can share our expertise in the training of future professionals.