I Broke My Patient’s Skull. Tales of a Homecare Physical Therapist.

I know the title sounds ominous but this is truly a great story if you can just stay with me.  This falls into the category of “you just can’t make this stuff up.”

I love it when patients get personal with me.  I love asking about their lives and having them share pieces of themselves.  It helps me to really tailor their treatments.  Whether it be through types of exercise or how I deliver the whole P.T. thing.

Being in homecare, I think the setting lends it to be more personal.  Engaging with my patient over a painting in their hall as we practice sidestepping is just something you won’t get to do in a rehab gym or outpatient clinic.  You can get to know their support system, what drives them, and in what ways to lift them up.

At times I view myself as an actor.  I’m sure other PTs may feel this too.  With one patient you can be dryly sarcastic, with another you are the sweet grandchild type, and with another, you are all business, no fluff.  To connect with your patient this way can add to the PT-patient relationship and build trust.  Who knows, it may even get them to buy in and actually complete their HEP.

This situation was no different.  After a few visits with, we’ll call her Claire, we had bonded over dancing.  She had been a dancer and performer most of her life and often showed me pictures of her on stage.  I shared that I had taken ballet lessons as a little girl but didn’t continue with it past college years as I did with tap dancing.  It was a great aspect of her life to incorporate into treatments and make therapeutic exercise feel more meaningful.

I also love to ask what patients did for work.  It’s so interesting to find out about odd jobs and Claire had a wild one.  She was an intake clerk for police evidence.  She saw it all.  Most of it was items of clothing that had blood or other evidence material on it.  She had to log it, bag it, and shelve it.  She loved her job and was quite proud of it.  She even assisted the examiner at times.  Knowing this I should have been more prepared for what happened.

It was close to our last visit and while we were on a rest break (read here: I was documenting) that Claire left the room to retrieve something.  As I was attempting to come up with new ways to describe gait training I could hear her speaking from the other room about wanting to show me this item.  I think I mumbled an ok as she was walking back into the room.

Claire walked up to me over my right shoulder and started to hand me the item that she wanted to share.  Eyes still down on my computer screen I barely turned to her to see what she had.  Then the unexpected happened.  I was assuming she was going to show me more pictures of her dancing days.  But what happened is she handed me a skull.  Well, handed would imply that it was a delicate and planned passage of an item from her hands to mine.  No, she dumped the skull into my outstretched hands when my attention was still on that darn screen.

What played out was something that you could only imagine in some comedy troupe routine.  It was like slow motion when my eyes finally were turning towards my hands.  My brain saw the item and said, oh a skull.  In the next moment, that fraction of a second, my brain realized, oh my god this is an actual human skull!!!! from her days in the crime lab!!!!

I panicked, jumped out of my seat, and started to bobble the skull.  It bounced back and forth between my hands like it was a hot potato.  Every thought was racing through my head while that thing was hurtling through the air.  Oh my god, this was somebody!  This is where his eyes were, and where his scalp was and OH MY GOD!!!  All the while I’m repeating out loud in a shrieky voice:

Oh my god, it’s a skull, it’s a real SKULL!

Before I knew what was happening I bobbled that skull up into the air and out of my reach.  It fell to the floor and shattered.

If you could see me doing the dramatic re-enactment of this insane scene you would be rolling.

Trust me.


It took a minute but then the reality of what just happened set in.  I could finally process that Claire was trying to share with me pieces from her job life.  After the pieces of skull were picked up and cleaned from the floor, and I sufficiently purelled my hands, I could finally regain my breath and slow down my heart rate.

Apparently, there was more than just blood-soaked clothing that she had to handle at her intake desk.  At times the office had no further need for items and they would usually dispose of them.  When the time for disposal of the skull came along Claire had asked to take it home and her supervisor said ok.  First of all, that is so crazy I can’t even imagine it.  Second of all, why on earth would anyone want to take it home?

Claire was a bit kooky and I totally loved that.  She said she wanted to take the skull home as a decoration for Halloween and to tell guests that it was her ex-husband’s.  She was too good to me to accept my apology for destroying her skull in a completely frantic moment.  This I concluded was the epitome of Claire.  I can usually find something about a patient that I hope to be when I grow up.  This kookiness and kindness I hoped to adopt from Claire.

What better job is there than this?  As physical therapists, we have the rare opportunity to really connect and make a difference in our patients’ lives.  We get more time with them than they have with their doctors in their care visits.  We have more opportunities to shape outcomes and have an impact on their quality of life than other professions.

And sometimes we come away with a “you gotta hear this,” tale of super-awesome-ness.

What a gift.



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