Eric’s trademark approach as a physical therapist is to emphasize the importance of establishing rapport. Routinely, he’d sprinkle humor and laughter throughout each session, along with a small dose of tough love. He believed it was paramount to break down barriers, draw the patient’s attention away from their woes even briefly, and focus their energy on giving their best. "Once there's a personal connection," Eric stated, "I can sell patients on my ability to help."

Thirty- to forty-minute sessions were often not enough time.

As I noted in a previous chapter, Eric often teased Matt, subtly goading him and holding him accountable with a simple, direct challenge: "Matt, I can't help you if you don't try." He encouraged all of his patients to be vulnerable enough to risk a blunder or gaffe, telling them, "Throw out an answer to what's my name," or “Be willing to skip or gallop if I ask you to, even if you think you’ll look foolish.” He'd assure Matt that others would understand, or more likely, no one else would even notice.

Eric quickly observed that Matt was pokey. He was unable to form opinions and didn't seem to process success or failure like you or I—or even a toddler, who responds to affirmation with smiles, giggles, or applause. To get through to "Deadpan Matt," Eric set out to crack his shell and find what made him tick.

He applied strategies similar to those of Lee Silverman's Voice Treatment, known as the LSVT BIG protocol, which is typically used for Parkinson's symptoms. This approach explicitly challenges patients to use large, exaggerated motions, in direct contrast to the small, slow movements associated with their condition and Matt's. Eric's intent was to jolt Matt out of his post-TBI lethargy.

Physical therapy sessions with Eric focused on power, quick responses, and changes in speed or direction—aspects that directly correlate with daily life. This meant practicing tasks that mimicked crossing a street safely before a light could turn red, the ability to alter course to answer a doorbell or ringing telephone, walking while carrying a cup of water, or performing a task while distracted. Other therapists rely heavily on an initial regimen of exercises before moving to functional tasks. In Eric's assessment, this approach did not have as timely an impact on purposeful learning, nor was it readily transferable to the real world.

Core strength, stability, and controlled motion are vital to almost everything we do. On any given day, Eric might have Matt half-kneel on a mat table, switch knee positions, get up onto both knees, and then figure out how to untangle his limbs and lie flat again. Often, Eric applied counterpressure to resist Matt’s momentum while he practiced rolling over, getting up, sitting, standing, or walking. And if that wasn't enough, Eric pushed some more, not yet satisfied. Matt was challenged to raise his arms or rotate his trunk in diagonal patterns as Eric sought to topple him. Yet even this didn't ripple Matt’s demeanor.

Let's take a moment to travel ahead in time. Seven years have drifted by since those early therapy sessions with Eric. Just yesterday, a familiar dialogue unfolded between Matt and me, one that perfectly encapsulated a long-standing challenge. When asked who his physical therapist had been, he demurred and offered his usual justification: "I don't know... I've never been good at names. Did you know that as a professor, it took me a month to learn students’ names?" I encouraged him to think, to really try. He hesitantly threw out the name, "Bob." It wasn't right, but it was a try. With no further ideas, I provided Eric’s name. Then, for his speech therapist's name, he changed tactics, trying to sound out the beginning of different female names to conjure it up, as if it was on the tip of his tongue. His efforts to remember Jessica were unsuccessful, but they were genuine. Kudos, Matt.

This particular exchange between us, while routine in its questions and initial struggles, marked a profound shift. The fact that Matt had tried--reminded me of Eric’s words from so long ago, urging Matt to be vulnerable and risk making a mistake. This newfound willingness to actually try, to take ownership of a challenge that once seemed insurmountable, felt like a missing linchpin.

Finally, imagine a Domino Masters competition, where teams have meticulously built elaborate structures with strategic stop-gaps to prevent accidental cascades. Our years of hard work have been building sections of neural pathways, but they have lacked a unifying connection. This small, conscious step—this new dawn of internal commitment—might be the requisite synapse—forming vital neural connections.  Each in turn, we hope will trigger and spread, unlocking new potential and possibilities across different areas of brain function.

Sadly, our look into the future has ended. This realization is only a whisper of the future, in a galaxy far, far away from the here and now, waiting to be discovered.

© 2025, Sarah Watkins