FEATURE
Upon returning to South Korea , they ran an inpatient rehab center , which continued to bloom . It came time to pass it on to the capable hands of Dr . Kim , who grew it into a 300-bed facility ( she later went on to become the first female president of a university hospital in Korea ). Forty years later , both Shaws still light up when talking about Dr . Kim and her accomplishments .
When learning about Dr . Shaw ’ s life , I began noticing a pattern ; he moves on to the next thing while the inspiration he ’ s put out into the world continues to ripple out behind him . It is why he is known as the father of rehabilitation medicine in South Korea . His work still continues there years after he ’ s left : a day rehabilitation facility opens in Masan named for him , “ John ’ s House .” Awards of appreciation kept trickling in , the grand opening of the 250-bed J C Shaw Rehabilitation Center in Chonju , and so on . In hindsight it all looks seamless , but in real time such progress often felt slow and uncertain to the Shaws . The idea of rehab as a multidisciplinary team of equals didn ’ t translate freely into Asian culture . Yet the Shaws saw the team approach as the only way forward , so they kept at it .
Mrs . Shaw describes their early efforts as dripping water on the rock . We saw “ No perceptible changes from day to day ; but then you looked back , and something brilliant had formed .”
Evolving in parallel was Dr . Shaw ’ s interest in specialized surgeries to restore function for tetraplegic patients . He began to meet with surgeons from all over the world to discuss how to address these functional challenges surgically . During a 1979 meeting in Edinburgh , the group developed the International Classification for Surgery in the Tetraplegic Hand . This tool became useful in assessing for transferable muscles in surgical planning in spinal cord patients and is still used today . It remained a large part of his practice when he returned to the states in the mid-1980s , and he established the Tetraplegic Hand Program in Louisville and Southern Indiana . For his earliest patients , Sharon stepped in and directed the OTs post-op on how to approach these patients .
Relying on her psychology background , she guided patients through the process and coached the rehab personnel to work together as a unit . Over the decades that followed , Dr . Shaw developed his approach and surgical techniques through this program . In 2014 , he took this knowledge with him back to South Korea to teach the surgeons there , traveling from city to city operating . For him , it was the passing down of the knowledge that was the pinnacle of the work he had developed in his unique approach to tetraplegic patients .
An aspect of rehab medicine that seems to resonate most with Dr . Shaw is the space it provides for lasting , meaningful relationships with patients . In clinic he would emphasize the long game , reminding us , “ These people have a lifetime with their stroke or spinal cord injury .” Before considering any surgery , he would get to know patients to understand their skills , habits and support systems . He would watch carefully how they transferred or managed their belongings at the wheelchair level . He would wait things out to let more recovery , more therapy take hold . Above all , he would scrupulously seek to understand what patients hoped to gain functionally . This process often took months , even years . The patients became family . When the time came to distribute his patients to other physicians as his retirement closed in , it felt as if he were putting his children up for adoption . He received many parting letters in that period , his favorite being from his most stoic patient , who slipped it to him discreetly at the close of his last appointment . This patient was a police officer who lost his career due to a stroke and left hemiparesis . Dr . Shaw saw him regularly for Botox treatments , and he had made a ritual of shaking hands with the doctor , the patient showing that he could still out-grip him . Dr . Shaw would readily comply , explaining , “ I can ’ t make his left side come back . But I can see him as a whole person . I can give him confidence and encouragement .” This was the truer therapy . I carefully unfold the police officer ’ s hand written letter ; it reads more like a sympathy card than a thank you note . The patient offers comfort to the doctor , acknowledging the great loss felt as a treasured career ends .
Driving the Shaws in all their work was and is an unflinching belief in wholeness . And with that , an understanding that - for now - we may only catch a glimpse of it . This quest for wholeness was behind the efforts to blend orthopedics and rehab medicine . Dr . Shaw explains , “ I am operating with a faith and conviction that wholeness will come to my patients . We are facilitators to bring the best quality to their life that we can , to maximize their ability to excel .” Above all , it was important to Dr . Shaw to make patients feel empowered in the face of disability . He sought for them to feel that they were not discarded , not tethered down . After all , he often points out , “ We are all disabled in different ways .”
Though retired from clinical care , Dr . Shaw continues as a gratis professor at the University of Louisville , where every spring and fall he teaches a cadaver lab for the physiatry residents . I remain somewhat baffled at the idea that such an accomplished physician would happily return to this undignified ( for civilians ) place in the bellows of the medical school ( not so unlike returning to residency after starting a hospital , I suppose ). In the cadaver lab , we all lean in as he softly describes surgical techniques , say , transferring the posterior deltoid tendon to the triceps . We are not surgeons and will never perform these surgeries , but he sees this as necessary knowledge when it comes to caring for the whole patient . The details are everything , as the outcome of one of these surgeries may simply be to allow a patient to extend his arm for a handshake . A simple and possibly non-essential gesture except in that it can restore a sense of self-esteem and wholeness . Many of us are not quite sure how to apply this wisdom yet , but sense its importance . We put it in our back pockets for a later time and file out of the basement . On the way out , we often pass therapists or surgeons whom Dr . Shaw has invited heading into the lab to glean wisdom from him : more ripples going out into the world .
Dr . Penman is a Physical Medicine and Rehabilitation resident at the University of Louisville .
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