ANCORA IMPARO BY RICK RADER, MD ■ EDITOR-IN-CHIEF
Poop and pee are hardly strangers to Direct Support Professionals. The DSPs have to return the situation to its pre-event status and do it with dignity, respect, grace and reverence to the individual.
It’s been a hot summer in the South, and virtually every part of the country has seen extraordinary higher than average temperatures. At my community agency, The Orange Grove Center, we are particularly mindful of the needed precautions that must be implemented to protect individuals with intellectual and developmental disabilities from the consequences of heat related fluid loss.
The reality is we all must be vigilant about excessive sweating, sunburn, maintaining hydration and insuring we have an adequate and balanced replenishment of electrolytes.
Simply put, our body fluids keep us alive. Let them get out of whack and we begin a potentially nasty roller coaster ride with a cascade of organs failing as they try to play catch up with fruitless compensating efforts. We are a system of fluids in motion; if those fluids are diverted to a new path they might become catastrophic.
Physicians have a need to understand fluid dynamics like race car drivers need to understand steering geometry. Fluid dynamics is the natural science of fluids in motion. Like most sub-disciplines in physics, fluid dynamics has a wide range of applications. Writing in The Dawn of Fluid Dynamics, Michael Eckert describes those diverse applications to include “calculating forces and moments on aircraft, determining the mass flow rate of petroleum through pipelines, predicting weather patterns, understanding nebulae in interstellar space and modeling fission weapon detonation.” Fluid dynamics are even used in calculating traffic patterns and crowd dynamics.
On another level, to another group, fluid dynamics refer to a task, a chore, a necessary assignment that is among the most unappealing, distasteful and disgusting practices…the cleaning up of human fluids.
While you can poetically describe the orchestration and choreography of the human body, how it strives for balance, efficiency and preservation, it’s no more than an ongoing exercise in waste management. While the human body does a Herculean job of ecology, open loop recycling and “just in time” manufacturing, like all systems, there is waste. Sometimes we control the waste and, more often in compromised systems, we are simply bystanders and observers.
But for the thousands of direct support professionals who provide front line supervision, support and guidance to individuals with intellectual and developmental disabilities, they do more than simply observe the “fallout.” They move to action. Their goal replicates the “tag line” of one of the country’s best known commercial post-disaster recovery companies: “Like it never even happened.” Removing the debris, damage, soot, dirt and filth from a living room, office or store is relatively easy; it can be done with indifference, industrial equipment and a group of uniformed team members who can stop for a break, lunch or a smoke. The Direct Support Professionals (DSPs) have to return the situation to its pre-event status and do it with dignity, respect, grace and reverence to the individual.
Poop and pee are hardly strangers to Direct Support Professionals. And while Oprah Winfrey has shared that, “Everybody looks at their poop,” it somehow (and for some reason) becomes a challenge to look at poop belonging to someone else.
Make no mistake that DSPs are full time “poop and pee” recovery specialists. While it comes (all too often perhaps) with the territory, DSPs are also coaches, counselors, instructors, protectors, mentors, role models, decision making assistants, translators, teachers, friends, memory joggers and navigators.
At the Orange Grove Center, we appreciate the role of fluid dynamics in the lives of all professionals dedicated to caring for and about individuals with special needs. In the “hands on” course, we provide to the Special Education majors at the University of Tennessee at Chattanooga (Teaching Students with Complex and Special Health Care Needs ), we teach “peri-anal care” on the first day of class. We don’t do it to get it “over with,” but to announce how important it is to the teaching and learning environment. We have had to provide special counseling and instruction to several linebackers (Special Ed majors) who found it to be particularly difficult to get it right.
In the reception area of the Morton J. Kent Habilitation Center at Orange Grove (the Center of Innovation, Research and Collaboration) the visitor cannot miss a unique and novel display case.
To indicate that we know all about “fluid dynamics,” appreciate the need for adding some humor to the “P and P equation” and, above all, want everyone to get over it and move onto the other challenges facing DSP’s (like health promotion, community inclusion, self determination, employment and opportunities for meaningful relationships), we have dedicated a display named “Grossology 101.”
In the showcase we have a display of fake vomit, rubber poop, toy snot, Whoopee Cusions, books with the enticing titles of “The Truth About Poop,” “Prince of the Potty,” Everybody Poops 410 Pounds A Year,” “The Gas We Pass,” and a “Fart Gun” (featuring eight different and distinct sounds of flatulence). They are all intended to demonstrate the common human element of human waste and how it serves to connect us–it seems, when the time is ripe, we all have special needs.
Perhaps the sign explains it all, “GROSSOLOGY 101: We find them gross, yucky and disgusting. But they’re as natural as a wet puppy’s nose. The Orange Grove Center caregivers take it in stride. They do what needs to be done and they do it with speed, dignity and pride. It’s just part of what we do.”•
“It seems, when the time is ripe, we all have special needs.”
In his 87th year, the artist Michelangelo (1475 -1564) is believed to have said “Ancora imparo” (I am still learning). Hence, the name for my monthly observations and comments.