Friday, July 20, 2012

Forced Perspectives In Rehabilitation

Considering the two previous posts were relatively "heavy" in nature and content, I thought it would be appropriate to put a slightly "lighter spin"into this post.  Forced perspective is something that I have always been aware of, but it is only recently clicked on how it actually applies in everyday life...and of course, rehabilitation. 

The image to the left is one of many examples of Forced Perspective Photos.  What is forced perspective?  It's quite simply examples of how reality can sometimes easily be distorted depending on "how you are looking at it".  In photography, this distortion results in some fabulously creative images...however, in the field of rehabilitation, the results are not as pleasant.  Distorted perspective leads to inefficient strategies and therefore unproductive results.  

With forced perspective photography, we KNOW that it is all a trick...whereas in the rehabilitation community it seems like most are convinced that their perspective is the actual reality.  Using the clever image to the left, if this was your only perspective, you would be lead to believe that while two men are enjoying a pleasant day in the city, another man is dangling precariously in the air.  Which is the reality and which is the distortion?  I suppose it depends on who you ask.  In the healthcare industry, the idea of "it depends on who you ask" is an unfortunate reality...however, if there is focused effort to step back and gain some additional perspective, the inevitable product would be an improvement in the desired goal and result. 

In the spirit of keeping this a "zero-calorie" post, I will use a very simple (yet organic) example of how perspective plays a fundamental role in the implementation of successful rehabilitation protocols. 

 Nothing could be simpler than a good old's round, has a skin, and is filled with delicious pulp.  Although this is in fact true, the paradox is that the information it provides is quite complex and comprehensive.  For the sake of efficiency, I will formulate this idea in a conceptual manner...thus it will simply be a question of importing this concept to your existing reality.  Consider the skin of the orange (the bright orange outer layer) as analogous to human skin, the dull orange underlayer as the subcutaneous tissue, the watery orange pulp as the muscle, and the "stringy" portions that seperate the orange segments as the connective tissue. 

Fundamental Perspective Question #1  What provides the structural stability within this organic system?  It seems strange to ask such a complex question about a simple fruit...but the conceptual message is quite important.  Is it the pulp itself that supplies the compressional integrity of the fruit or is it the "connective tissue" within?  Further, is it a combination of both...with the pulp delivering the compressional stability and the rest supplying the tensional support?  If you ask this question in relation to the human organism, the flood of new questions would be quite powerful.

   Fundamental Perspective Question #2:  How is the internal architecture organized? In the case of our friendly orange,  your perspective would be dependant on whether you sliced it axially or transversely.  When most of us think of oranges, we perceive them in the classic "transverse" way...nice triangular pieces housed nicely within the soft skin of the orange.  But the "axial" slice is obviously part of the same orange, but it presents a very different understanding of how the orange os actually organized.  It is a hslf-circle of pulp secured to the center via a thickened extension of the outer layer.                                                                      
These questions and analysis may seem trivial, however the conceptual message should once again be understood:  If a simple orange can demonstrate such vast architectural differences depending on perspective, imagine how important perspective becomes when analyzing the human organism. This is precisely why even professionals gets confused when presented with cross-sectional images...the anatomical perspective changes completely and leaves them confused as to "what is what". 


 Fundamental Perspective Question #3:  Where does the skin end and the pulp begin?  This is perhaps the most important concept to integrate.  Is the orange the sum of an outer skin, an inner skin, and pulp...or is it one complete entity.  My perspective should be obvious...the orange (and therefore the human organism) is a singular entity that is characterized by the differentiation of tissue types.  Each differentiated tissue is intimately connected to the other and function in complete inison.  In addition, integrity of the whole organism is dependant on the balance and stability of the combined tensional and compressional forces within. 

In summary, I am sure you have never devoted as much analysis to a fruit...however, examples of the complexity of life are everywhere...even on the kitchen table.  It is important to realize and understand that it is impossible to import simplistic strategies into complex systems...which is the unfortunate reality in many cases with respect to current healthcare.  Ido not pretend to hold the answers to the complexity of the human body...but gaining proper perspective is most certainly one of the first steps towards responsible and effective strategies.

I will end this post with some more cool forced perspective photos...they are not only fun, they remind us to always think about what we ware looking at!  Cheers!


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