I was having a conversation recently with a friend over the tremendous influence of one’s mindset. I gave him examples of how two totally different mindsets can lead to completely unexpected and disparate outcomes. The examples I used astonished my friend, and me. Until that moment, I had not fully realized the power potential of one’s mindset.
Over the years, my work as a family physician as afforded me the opportunity to interact with all types of patients with all sorts of medical problems and all manner of emotional difficulties. Never is my job made more difficult than when dealing with a patient’s fixed, unyielding, rigid mindset.
It seems that once a person locks into a certain paradigm in their way of thinking which then dictates a certain patterned behavior, it becomes extremely difficult to change their mindset. Even if their mindset is harmful to them. Especially, if their behavior has been enabled, supported or provides other secondary gain.
Here are some cases in point. Over my practice career I have cared for two completely unrelated paraplegic patients. Each were paralyzed from the waist down. Each were bound to their wheelchairs when up and about. Each had their cars equipped for driving. Each of them had full time jobs.
Each of them always came to my office unaccompanied for their appointments. They would retrieve, set up, use and then return their wheelchairs from behind the driver’s seat of their automobiles all by themselves.
They had families but rarely asked for their help. They valued their independence and did not wish to be considered handicapped. And they never, never asked me for a handicapped placard for their cars.
In stark contrast, at least once every week or two, I have patients with back pain, knee pain, hip pain, morbid obesity or patients just pitifully out of shape ask me for handicapped placards for their cars. These are individuals who walk into my office under their own power without any assistance from others or without assistance devices such as canes or walkers. In other words, most of them are able-bodied.
Here are the criteria set by the state of North Carolina as qualifications for a handicapped vehicular placard.
- Can walk 200 feet without stopping to rest.
- Can not walk 200 feet without an assistance device.
- Is restricted by severe lung disease.
- Uses portable oxygen.
- Has a Class III or IV cardiac condition.
- Is severely limited in their ability to walk due to arthritic, neurological or orthopedic conditions.
- Is totally blind or eyesight is severely limited (shouldn’t be driving anyway).
Most of the patients asking for handicapped placards do not meet any of these criteria. When I suggest they do not need one, that they should start parking as far away from the front door of the mall as possible, all are disappointed and more than a few have become incensed. In my defense, it is my job to do what is best for them, even if they do not agree.
For those patients with back, hip, knee, or ankle/foot pain, most of the time the primary underlying cause is inactivity or obesity due to unhealthy eating and lack of adequate exercise. This is what is interesting about their request, were I to grant it. Even if they were able to park 30, 50, or 80 feet closer to the door front door of a business, they will walk much further once inside the doors of the stores.
The difference between those patients and the two paraplegic patients is the difference between night and day. The paraplegic patients with obvious physical disability do not want to be considered handicapped while the able-bodied patients want to be considered handicapped.
So, what’s the fundamental difference? The paraplegic patients do not believe they are handicapped while the able-bodied patients believe they are. The difference, in a word, is MINDSET.
Mindset is a powerful potential force. I say potential force because it is just as potent either way, for good or for ill. It can open people up to tremendous possibilities or lock others into a life of considerably less, even one of self-pronounced disability.
Why, you might ask? The answer doesn’t come down to a question of genes, luck, intelligence or resources. It comes down to a simple choice. With few exceptions, mindset can overcome physical, mental and emotional disability.
I had a gentleman in his 70’s who had a dense right sided stroke which left him a flaccid left arm and leg. He came into the office in a wheelchair 6 weeks after his stroke, unable to move any finger of his left hand, flex at the left wrist or elbow, raise his arm, bend any toe of his left foot or stand without assistance, much less walk.
At his family’s request, I filled out and signed a form for a handicapped placard to make it easier for him to be transported. He asked me if he would ever recover any use of his now useless left side. Conventional wisdom is that whatever remains after 6 weeks is what will remain and what ever is lost will remain lost.
I have never been one to take away a patient’s hope and I have witnessed amazing recoveries. So, I looked him in the eye and told him it would be entirely up to him.
Most patients who get rehab will attempt the rehabilitation exercises only as long as they are with the physical therapist and then stop after they are gone. I told him he could rewire around the damaged areas of his brain if he made it his number one priority. It would be very hard and take time but, I thought it was entirely possible. He left my office determined.
When I saw him again a few months later he was still in his wheelchair but he proudly demonstrated for me how he could flex ever so slightly two of the fingers of his left hand. He told me how he would sit all day concentrating and working on moving those two fingers.
Many months later he presented with a very weak grip in his left hand. He was also able to flex slightly at the shoulder and bend his left great toe a bit. Months after that he was able to shake my hand with a stronger grip while flexing some at the left elbow and shoulder. His family would tell me about how he would sit every day squeezing a tennis ball while listening to uplifting music, sun up to sun down.
Always positive, always smiling, I never saw him down or in a bad mood. He showed me something new he could do each time he came back in for a checkup. One day, a few years after his stroke event, he walked into my office pushing a walker wearing a brace on his left lower leg and foot which kept it at a 90 degree angle so he wouldn’t trip.
He was able to raise his left arm to shoulder level and he had dexterous use of his left hand. He reached into his pocket with his left hand to retrieve something he said he wanted to give me. He said, “I don’t need this anymore.” It was his handicapped placard.
He gave me a hug and thanked me for all I had done for him at which point I was reduced to tears. What had I done for this man? I gave him a few simple words. He made a choice. He did all the work. He essentially moved a mountain all by himself. I made sure he knew it too.
Whatever I did for him pales in comparison for what he has done for me. He continues to serve as an inspiration to me, proof of what is possible with the proper mindset. He makes me grateful I went into medicine in the first place.
He continued to improve. It has been eight years since his stroke. He now walks into my office under his own power with no walker and no leg brace. He has full and complete use of his left side. Anyone would be hard pressed to know he was once completely paralyzed on his left side just by watching him move. Now in his 80’s, he drives himself to the Family-Y every day, parks next to the street and walks on in to work out.
All my able-bodied patients requesting handicapped placards have chosen a mindset powered by limitations. Which to them, appear everywhere. My patient who recovered from stroke and the two paraplegic patients share something in common too. In spite of physical disability they each chose a mindset powered by potential, one without limitations…and for them, there were none.
Do you feel you have limitations? How is your mindset? Is it in need of revision?