In the clinic and around the hospital I carry with me a cane. The cane serves several purposes. Its main purpose is a way to nonverbally tell patients of my difficulties. I initially was resistant to the idea of using a cane, as I feared it would portray vulnerability to patients. I was also afraid that those who see me periodically might view it as a regression. Functionally, it serves to help me traverse the long walk especially in the hospital. And lastly, it helps my body sense its position in space (proprioception).

As I mentioned, I was initially hesitant about the idea of using a cane, but when my program director, as well as PM&R physician and Neurologist suggested it, I finally put aside my stubbornness and reconsidered my stance. Upon getting the cane, one of the first people I told was my residency family in an email titled ‘Cane’. You may sense from this excerpt of that email, my reluctance to use it: I hope you guys aren’t too thrown off by it- don’t be mistaken I don’t need the cane for mobility – I can get around without it. I wrote this in late March and have come to the realization since then that the cane does in fact serve all those purposes. Even though I was reluctant at first, I now realize that I need the cane and often use it as a crutch.

My walking stick
My walking stick


Yes, it works as a symbol for patients that ‘something is off’[1], but it also works to help me in physically maneuver around the clinic and hospital. What I didn’t realize were the countless other purposes it served. Firstly, I have a cane with an LED light on the end of it and pediatric patients are amazed when I turn it on. The light also serves as an “ice breaker” with many adult patients I see. These added perks of the cane are superficial though. I mentioned in earlier posts the issue of neck tremors or ‘titubation’ that still afflicts me to this day. For some reason, sitting and using the cane as a pseudo armrest prevents these episodes. Thus, when I am in a meeting where I anticipate I might suffer from an episode, I’ll often have the cane by my side to thwart any episodes. Other people in the room must wonder why doesn’t he just put the cane on the floor? Also, at first I thought it would only serve as a symbol to patients of my disability, but I now know that it not only serves as a marker for patients, but to anyone who happens to come across me, or see me trudging along. It has gotten to the point that if I anticipate meeting anyone new, I’ll take out the cane for that activity.

The idea of it as a ‘marker’ stemmed from the notion that if one second of my encounters with patients is taken up by questions about my condition, then that is time lost; my hope with the cane was to possibly bypass some of those questions. I’ve come to realize that the cane, even though an inanimate object, tells a story to anyone who sees it. While it may not paint the whole picture, it at the very least gives people a starting point for a story.

That made me think, even though my crutch is a visible one; we all have our own canes that we rely on for everything from nervousness to boredom. In thinking of myself prior to my surgery, I would often use my son in any social situation I deemed awkward; I would also use music to alleviate emotions like anger, sadness, or boredom. But in thinking about this piece, I’ve realized that these are all forms of a ‘crutch’ and that we all have metaphorical canes that we rely on. Many of us would deny these crutches in our lives. Now, I am not telling you that use of these ‘crutches’ is negative or advocate that you should stop using them. (You use it for a reason, and there are, without a doubt, many unintended benefits to using them). What I am asking is that you recognize that everyone has these crutches. Simply acknowledging that they exist will increase your empathy and encourage tolerance of others.

[1] I’ll often notice when I meet a patient for the first time that their eyes immediately focus on the cane.

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