In last week’s blog, I wrote about the claims strategy of empathy as a recap from the WCI conference.
Just a few days later, I was sitting in a room at the Georgia State Board of Workers’ Compensation conference listening to two experts make that idea tangible.
The session was titled “When Life Is Not a Beach.” It featured Josh Schuette of Brooks Rehabilitation and Scott Hoskins of Shamrock Prosthetics. Josh is a physical therapist. Scott is a prosthetist. Both have spent their careers helping people rebuild lives after catastrophic injuries.
Scott said something early that I wrote down and stayed with me during the entire session: “Life is unfair to everyone, so it actually is fair.”
At first, it sounds almost flippant. It isn’t. It was said in the context of helping amputees adjust to a new normal.
One day the prosthesis fits perfectly, then the next day it hurts. One day, forward progress is tangible. The next day, everything falls backward. Bodies change. Limbs change. Strength changes. Confidence changes. Recovery is not linear, an important reminder for catastrophic injuries.
Josh framed the entire session around two concepts: resilience and empathy.
He gave the audience example after example of people who suffered injuries that most of us would find almost unimaginable, and yet they somehow found a path forward by being resilient. One example involved a woman who had lost all four limbs, became independent again, resumed caring for her family, drove herself, and later became a mentor to another quadruple amputee. She certainly had assistive devices to make that happen, but getting there was primarily due to her mental strength.
What separates the people who make extraordinary recoveries from those who struggle? There is no easy formula. As Josh put it, there is no gene for the human spirit. You can study injury severity, age, comorbidities, functional measures and every other variable we routinely put into our predictive models. But none of those fully measure the person. Until presented with a seemingly insurmountable challenge, nobody ever really knows how they’ll respond. With resilience by them and empathy from us, the path is easier (relatively speaking) to recovery.
One of Scott’s slides addressed something we don’t talk about nearly enough in workers’ compensation: identity. After an amputation, the challenge is not simply learning to use a prosthetic device. It may be grieving the person you were, anger that it happened to you, or a completely altered body image that stares at you in the mirror. The slide said it plainly … “I’m not the same person anymore.”
Scott estimated the journey as “20% physical, 80% mental.” His point was not that physical rehabilitation is easy. His point was that the body can often adapt faster than the mind accepts what has happened. We cannot separate physical rehabilitation from that psychological adjustment.
Think about the implications of that for workers’ compensation. One morning someone wakes up, goes to work and assumes the day will be ordinary. Hours later, they may wake up in a hospital without a limb. They are still a spouse, parent, an employee. They are the same person who fixed things around the house, coached Little League, went fishing, worked construction, picked up their grandchildren or lived independently. Except they’re not. In the blink of an eye, almost everything about how they performed those roles has changed.
The hardware matters, but the human matters more.
Scott talked about the sophistication of prosthetic technology, but he repeatedly returned to the idea that the device itself does not create success. He could put a crude device under a highly motivated, capable amputee and that person would find a way to use it. “The componentry doesn’t make you a good walker,” he explained. “The human makes a good walker.” Read that again, just to let it soak in.
That statement does not minimize the importance of excellent prosthetic care. It instead underscores that no amount of technology will empower an unmotivated patient to regain their life.
The question should never be: What is the most advanced device available?
It should be: What will help this person rebuild their life?
The goal is, in the work comp context, returning to work. But it also includes playing with their children, walking on the beach, fly fishing in Montana or simply moving through the house independently. In other words, whole-person recovery. Sorry (not sorry) to constantly bring that up in everything I write …
Josh did something clever during the session. Sometimes, we need to experience frustration to make progress. He asked several able-bodied audience members to temporarily experience what injured workers face.
One used a lower-extremity simulation device that forced the person to relearn balance. Another tried a body-powered upper-extremity device that required coordination, practice and concentration. Another used a wheelchair on carpet.
That theme continued with traumatic brain injury. I happened to be one of the people given glasses that simulated visual impairment. My assignment sounded ridiculous in its simplicity: Text someone. Except suddenly I was trying to decide which of the multiple phones I appeared to be seeing was the real one. It was disorienting, frustrating, and humbling.
None of those temporary experiences compared to someone living without a limb or with repercussions from a TBI. But it changed the question.
Instead of asking, “Why is this person having so much trouble doing something simple?”
You begin asking: “What does simple feel like from their side?”
In other words, empathy.
Recovering from these kinds of injuries is a marathon, not a sprint. Both Scott and Josh repeatedly emphasized patience.
For example, pushing harder is not always better for an amputation. Wearing a new prosthesis an extra hour may seem like determination, but if it creates a wound or infection, that “extra effort” can set recovery back weeks or months.
Scott also warned against comparison. An injured worker sees someone online running a marathon with a prosthetic leg and wonders why they can’t do that (yet or ever). It could be that person was born without a leg and has had a lifetime to adjust, while the injured worker is only two months past the traumatic event. Comparison, for anybody at any time, can be the thief of joy.
The biggest takeaway from this session is simple but profound. In the case of catastrophic injuries, sometimes the old life cannot be restored exactly as it was. The goal then becomes something more difficult.
Reinvention.
That is a good lesson for us all. When bad things happen, our response is the only thing we can control. If that response is pity, fear, and anger then the outcome is not likely to be positive. However, if the response is hope, resilience, and reinvention then the new you might even be better than the old you.
Shamrock’s three pillars are hope, inspiration, and reinvention. For those of us fortunate enough to work alongside someone whose life changed on the job, our responsibility is not simply to manage the impairment. It is to help create the conditions for their hope, resilience and reinvention.
