Presumably by now you’ve heard of The King’s Speech, a movie playing to rave reivews in theaters. Based upon a true story of the relationship between King George VI of England (father of Queen Elizabeth) and his speech therapist, Lionel Logue, the story resonates for us in the field of vision therapy on many levels.
Though you will undoubetdly find your own favorite parts of the film, I smiled at this exchange between two brilliant actors, Colin Firth as King George and Geoffrey Rush as Lionel, preparing to engage in their first speech therapy session in his office (paraphrased):
Lionel: Don’t smoke that cigarette here.
The King: My physicians tell me that smoking relaxes my throat.
Lionel: They’re idiots.
The King: They are all knighted physicans of the Royal Kingdom.
Lionoel: Well, then …. it’s official.
More so than the movie, the book upon which it is based elaborates the challenges facing a therapist who is labeled as unconventional or unorthodox by physicians with a vested interest in painting others as “controversial” in order to preserve their authority. A comment we received from Charles Boulet, O.D., on an earlier blog post reminded me of this. Dr. Boulet wrote: ”I had a mother come in yesterday with her son who is rapidliy falling behind in reading in Gr2. She heard about the services we provide and drove a long way to get here. Her ‘specialist’ (a general ophthalmologist) told her there was nothing wrong with her son’s eyes. After my exam, I agreed – there was nothing wrong with his EYES. I then demonstrated for her her son’s severe oculomotor dysfunction, plus I explained various other functional and perceptual issues he might be having. She started to appreciate that there is more to VISION than EYES.”
Many of the patients who come to us have significant oculomotor dysfunction. When the child is old enough to participate in the case conference, I give them the analogy that abnormal eye movements can have as devestating effect on reading or other aspects of visual performance as stuttering does for speaking publically. These children and their parents are typically advised that their eyes are fine based on good visual acuity and normal ocular health findings.
All this is rapidly changing. Pam Happ, Executive Director of the College of Optometrists in Vision Development, wrote on her Facebook page today: ”This week we’ve experienced a surge in calls to our office for help in locating doctors who provide optometric vision therapy. Thanks to all who’ve been instrumental in spreading the word. Your efforts are making a difference!”
There is a Gladwellian Tipping Point that has occurred rapidly. The idiocy parading in the guise of patient advocacy by physicians who are well intentioned but misinformed was parodied in The King’s Speech. We are finally shedding analogous misinformation in the vision care field. There’s a marvelous book entitled When Chicken Soup Isn’t Enough: Stories of Nurses Standing Up for Themselves, Their Patients, and Their Profession, edited by Suzanne Gordon. One of the vignettes in the section Excuse Me Doctor, You’re Wrong, relates the experiences of a clinical nurse specialist in neuro-rehabilitation. When the nurse sat down with the neurosurgical resident to discuss palliative care that a patient and her family needed, he denied the need for his further consultation. He remarked: “I take care of her neck. Her neck is fixed, and that’s where my job ends.”
Lionel Logue was a brilliant therapist who knew that his job wasn’t limited to structural mechanics. He knew that most of the people coming to him had been seen elsehwere without resolution. He knew that his gift resided in his ability to get into the heads of his patients, disrupt their previous patterns, overcome their fears and combine all this with repetitive exercises that re-patterned the speech-brain connection. It was a head-to-toe job, and it came with a price in order to do it well. Most of all, it required a significant investment and commitment on the part of the patient and the therapist. Lionel was so confident in his skills that he was able to challenge the King of England to rise to his full potential, even after his physicians had gotten it wrong.
Leonard J. Press, O.D., FCOVD, FAAO