Just a simple pair of shoes.

They were just a pair of shoes. Like most females I have an overabundant supply of shoes at home. Even here, in Jamaica, I have more than seven pairs of sandals and, yes, still, only one pair of feet to wear them on. Unlike most females I’ve always had an overabundant supply of athletic shoes, as well. This particular pair I’m thinking of today, didn’t even make it to my Philadelphia life, but rather had been collecting dust at home in Oregon for three years. That was until they made it to Jamaica this past June.

Joyce and I have the same birthday, February 4th. That’s beside the point but one other random fact that makes me want to hug up this 37yo woman all the more. Last November, less than eight weeks after giving birth to a healthy son, Joyce had a severe left cerebrovascular accident (CVA), or in other words, a stroke. The entire right side of her body was severely affected, leaving her unable to actively control or move her arm or leg on that side of her body. On top of all of this Joyce had post partum depression.

The first months of her therapy were difficult on more than one level. Joyce showed slow progress but also a lot of low level plateaus. In June, she attended the third ever Stroke Camp, entailing five days of intensive therapy, lots of repetitions and two on one, one on one help. Like the rest of the patients attending, Joyce made huge gains by the end of the camp in many areas. Those carried over into the next weeks of therapy, even in her new found compliance and persistence with her home exercises. Although still without a lot of use of her right arm, by the time we met in July, Joyce was walking on her own and was beginning to gain strength and independence with activities such as dressing, bathing, and rising from a chair.

Joyce is tall like me as well. Another random fact, but also surprisingly not the first thing I noticed when she and I met on a Wednesday in July. No, the first thing I noticed about her was her shoes. As she walked towards me, my PT eyes were glued to her shoes, missing the hesitant asymmetric gait, that relied heavily on a cane. The shoes were the ones I’d actually hesitated to give just two months before.

I was humbled. No longer just a simple pair of shoes, they’d become rather a part of a much bigger picture.

One of the major stumbling points we run into here in the PT world is good foot wear. As you can imagine, most Jamaicans (us PTs included) don’t like to have their feet encased in hot, sweaty closed toed shoes, much more wear any type of sock. Slippers (flip-flops) and sandals reign --which happen to be right up there under high-heels on the “Worst Shoes for Your Feet to Wear All Day” list. Not only do Jamaicans not typically want to wear athletic shoes but they often can’t or won’t afford them.

In a case such as Joyce’s, with a neurological problem, individuals often need some type of brace or orthotic to help them get up and moving, walking again before they have enough of the muscle activation and strength to control the motions themselves. An ankle foot orthosis (AFO), like the one Joyce now wears, would not be possible without a good fitting shoe. Athletic shoes are ideal as she learns to walk again as they provide more support to the foot, won’t fall off while she’s walking, and have some shock absorption as well as fit her foot well with the AFO.

Sheepishly enough, I do have to admit how selfish I was in actually thinking twice, three times even, about giving those shoes away. It seems silly now. They were bought some time in my undergrad life, a pair of cross training shoes that would give some added ankle support for IM basketball, bought and paid for by Daddy no less. They were used maybe a handful of times indoors and then stored away in closet after closet. Yet I hesitated to give them away just in case I would have need of them again sometime in the future. I went back and forth and back and forth, over and over again about giving away a simple pair of shoes that I hadn’t worn in three years.

The shoes lost their pristine white and Adidas logo many a Jamaican day ago, but they are getting more use, better use now than they ever would have gathering dust in my closet or on my possible basketball court years from now. Seeing Joyce in that same simple pair of shoes is a weekly lesson of the beauty of giving and the abundance that can come from it. There are no conditions to what or to whom we give, just that we give joyfully, abundantly, and in faith knowing that God will provide.

So what are you hesitating to give? What has God richly blessed you with so that you may in turn give unto others? This simple pair of shoes could have come from anyone or anywhere to affect Joyce’s life. Don’t let whatever you’re called to give grow dust in the closet instead. It’s not always as simple as a pair of shoes, but I guarantee that no matter what the sacrifice, it will be more than worth it in the end.

This past week Joyce walked across the room without a cane, a smile on her face, one foot after another. Her son will be turning one next month and as she told me this past Wednesday, “Des feet gwan ta be a runnin afta him.”

And then there was one . . .

There's humor to be found in much of the last week. In gaining my student-free, visitor-free, Brooke-free independence there have been an equal number if not more lessons learned. One thing is for sure, the time without other visitors --my first in Jamaica-- or Brooke is all part of the grand adventure in becoming more Jamerican . . .


From a clinic standpoint I've been exhausted as much as I've been exhilarated. And that's with cutting down a lot of our caseload---so thankful Brooke was firm in insisting on doing so. Finding my feet as an independent clinician, without anyone to look to for help has been fun and informative as I'm discovering I can do this and trust things I've learned for years. And if something crosses my path that I'm clueless on I do actually know where and how to look for the answer, given time. Add in the scheduling, phone, and little things like power outages and you've got more of the not-so-fun part. A full day of manual therapy, transfers, and lifting makes quitting time all the more beautiful as well. Decisions like where patients should sit in the van to be transported back home on Tuesday seem so much bigger, time absorbing ordeals when you're running the show. Explaining to an aphasic, so-so patois speaking caller that they cannot have an appointment tomorrow but will unfortunately have to wait is a whole separate learning experience. My patients, thankfully, are more than generous and gracious and patient with me, coaxing smiles and giving reassurances when my look is anything but normal. It's certainly been a juggle and I've never been more grateful for the weekend. Brooke did this on her own for so long. .. I've definitely come into an even greater appreciation for her this past week!

Until this week I definitely didn't fully appreciate the sense of security I had in Brooke's knowledge of Jamaican ways, presence in town, and ability to share the load. Like I mentioned in the beginning, in looking back it's been a humorous learning week.

Screaming at cockroaches does nothing to phase them. Swinging a broom and screaming puts them on the defensive (i.e. running and hiding only to reappear again later), especially since screaming while swinging leads to missing again and again. The swinging the broom part did give the broom a unique but still functional look as well. After that experience I didn't bother swinging at the anancy spider later that night. I do know they can jump up to 1.5 ft in the air. If only a scream was a weapon, and not something that simply kicked your heart rate and parasympathetic system into high gear, I might try it on the rats (at least which I hope and pray are rats) in the ceiling as well.

That was last Sunday. Monday I was rear-ended on my way home. No damage to me, Toots, or our car, praise the Lord. But what do you do with an accident in Jamaica? On that day, apparently nothing. Tuesday I was greeted at my gate by a loose, collar-less dog that had definitely rolled in something dead. Found the collar, caught the dog and ended up only slightly red in the process. Wednesday I left my phone at Logic's shop and didn't realize until after 9pm. Thursday morning my addicting machet and I gave the huge plum tree a new look all before work--I can only imagine what my neighbor thinks of the pink rainboots whitey gurl hacking away at 5:45am. I also managed to "sunburn" my newly picked bananas that day. Who knew that once picked, green bananas are only supposed to sit in the sun for one day not two!?! Friday involved more yard redecorating although I haven't dared enter the garden with it's waist high weeds as yet. I proceeded to scrub the house down therapeutically the rest of the day earning the unexpected surprise of a rotting 6" lizard in the window sill--God has a sense of humor that's for sure!

While I've certainly needed the filling up of alone time, it has been nice to know there are people watching out for me. Anna prays with and for me as much as she still makes sure I'm eating by feeding me dinner and giving me advice on the yard and such. Katy still washes the clinic sheets when they're dropped off at the end of the week. Ryan, my neighbor, still helps me with identifying duck ants (i.e. tree termites) and what to do with them. Dr. Carol checks in with me throughout the day at the clinic. Logic will drop my phone by the house in the am if I leave it by his shop and watches out for me every night. Toots checks in on me and my plants, including sunburned bananas--earned a lecture on that one. Peter will (hopefully soon) be cleaning out my rat-infested roof and securing our generator for possible hurricanes. He and his family also check in with me most days to make sure I'm doing alright.

And then there's the entire Nice family who are so much more than just nice. I'm loving getting to know all five and a half (Linds' preggo), especially to spend time with the kids --another filling up therapy for me!. They've certainly taken me under their wing this past week. Jamaica from a family vs. single point of view is a whole different world, but one in which I'm learning a whole heap.  I've discovered I can still have princess parties, I've been introduced to coconut cookie mini marshmallow s'mores (if you ever send me a care package and I don't ask for jumbo marshmallows, no matter how stale, here's a reminder to please put them in!), and now know where to find some of Junction's (our town) hidden gems, like the Devon House ice cream store that also sells movies for $150J ($1.60USD) . . . just to name a few. In many ways they remind me so much of my own family growing up that I can't help but praise God for the way He provides and makes this feel more and more like home.


Amongst all of this I've actually updated facebook, uploaded pics, caught up on a few emails (if I still owe you one, sorry), organized patient lists, and worked diligently on learning how to bake in Jamaica -- including turning trail mix into cookies, amish white bread, guacomole (not baked, no), crock pot-esque, and the like.

Doubtless there's still much adventure to be had as Brooke remains in the States for at least another week. I look forward to catching up with uno (ya'll) so feel free to drop me a line, call, text, etc. I'll be holden on pon mi jesus, everting gwan be alright!

"Watch, stand fast in the faith, be brave, be strong.  Let all that you do be done with love"  

1 Corinth 16:13-14

May this be as much of an encouragement to you as it has been for me this past week . . .