iSAW 03.01 Auto Versus Ped

Case turned down. Nearly three years ago a Workman’s Compensation insurer sent us a case for evaluation, and then puzzlingly denied our request for treatment. The patient, a doctor herself, decided that she would come anyway, pay out of pocket, and know that she would be reimbursed eventually. We’ll call her Charlotte, because that’s her real name. In December 2011, she had been hit in the left buttock by a car, as she crossed a road in DC. Six months later we evaluated the massive soft tissue and sciatic nerve damage to the left buttock, and ligament damage to her right knee. She could only walk with the aid of a walker, or more recently a cane.“Nothing is broken, you can go”

At the 360 NMT intake she described her ER experience. After CT scans of the pelvis and abdomen and a chest x-ray revealed no broken bones they said to her “nothing is broken; you can go home now”. “I can’t walk” she replied. After a day in the ER they reluctantly admitted her, but to a maternity ward, where she remained for another three days. As a former Emergency Room physician herself, Charlotte decided to write up her less than impressive ER patient experience for Health Affairs. Her story describing providers relying on testing and metrics versus meeting her actual needs has become one of Health Affairs most-read health articles. The article was picked up by the Washington Post in June 2014.

New encounters and adventures

The 360 NMT team have been working with Charlotte for over two years now. We concentrate on her hip, pelvis and thigh muscles. Although she’s off the cane and can heel-and-toe forward and backward, she still leans a bit to the left, and still feels vulnerable, especially in crowds. Just over a year ago Charlotte asked me if she could try skiing. I laughed and said why not, not for a minute thinking she would. A short time later I got a photo of her on skis. Last summer she picked up cycling, and now she scuba dives. She has even tried combining the two (not photoshopped). All these activities are new.

She has gained an inch

Recently, during a routine physical the nurse said ‘Charlotte, you’re five foot three”. She responded, “I’ve always been five two. Please check again.” Sure enough, she’s now 5′ 3″. Not sure how to explain this. She is about to write a sequel to the first article. I can’t wait to read how getting hit by a car makes you try things you wouldn’t have done otherwise, and gains you an inch in height along the way.