One of my patients which I had been providing consensual physiotherapy management to was a newly diagnosed T2 motor and sensory complete spinal cord injury patient. According to the patient he had left church early and went out drinking with his friends. On his way home he was ambushed by a group of guys and was stabbed in the neck, the abdomen and the arm. before the incident the patient was not the most behaved person. he reported to me that was involved with gangsterism but that was a while ago and he had changed his ways and now had a job as a taxi driver. however, he made a lot of enemies while in the life of gangsterism. He reported to me that when he got stabbed, he could not feel anything from the waist down and that he crawled to go find help. While i was conducting my subjective interview he kept on saying that if he could only just take a couple of steps then he would be good for discharge and that his family would be able to take care of him. I began to be very confused. I asked him if the doctor had explained to him his condition. He said no, so I had to explain it to him so that he didn’t have any expectations during treatment. Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion(Kemal Nas, 2015). Being a T2 spinal cord injury he presented as a paraplegic patient. This term refers to impairment or loss of motor and/or sensory function in the thoracic, lumbar or sacral (but not cervical) segments of the spinal cord, secondary to damage of neural elements within the spinal canal(Kemal Nas, 2015). With paraplegia, arm functioning is spared but the trunk, legs and pelvic organs may be involved depending on the level of injury(Kemal Nas, 2015). Complete means there is no sensory or motor function preserved below the level of lesion.
He took it as any person would if they had just found out that they would never walk again. I came back the next day and he seemed okay, he seemed quite motivated for treatment and he seemed quite excited to see me. I thought I had broken a shell but that was not it. He had revenge on his mind and that was his motivator to get better.
On this day during treatment all he said was “I need to get better soon so I can get the guys who did this to me in here too”. I tried to put a different picture in his head as a motivator. Things like the fact that he had a daughter and that he should want to get better so that he can go home to his daughter. I figure that something important about acts we label as revenge when the motivation is unclear. I kept stressing that he can’t let revenge take over his life and he shouldn’t rely on it all the time. For days I stressed the same message, and nothing changed his mind. I then asked myself if I should use his revenge as a motivator. This would allow him to stay compliant with his exercises and results would then follow. My concern with this was that, using a patients personal motive to get them to do what i want was ethically incorrect and the patient had a violent background to start with so if he was to go out and seek revenge he might end up right back in hospital or worse, dead. Though ethically incorrect, my patient would benefit greatly from his compliance and motivation. I felt like this was the only way to get him to start working on his functionality. In some regard, i felt like using his revenge for myself. I say this because my treatment would be effective, sometimes not for the benefit of the patient but im there to be marked.
Historically, there are two schools of thought on revenge. The Bible, in Exodus 21:23, instructs us to “give life for life, eye for eye, tooth for tooth, hand for hand, foot for foot” to punish an offender. But more than 2,000 years later, Martin Luther King Jr., responded, “The old law of ‘an eye for an eye’ leaves everybody blind.” Revenge comes at a price. Instead of helping you move on with your life, it can leave you lodging on the situation and remaining unhappy.
Revenge is a label that is ascribed based on perceivers’ attributions for the act. Revenge is an inference, regardless of whether the individuals making the inference are the harmdoers themselves, the injured parties, or outsiders. Because revenge is an inference, various individuals can disagree on whether the same action is revenge or not. (Ross, 2010). For example, Osama Bin Laden portrayed the 9 ⁄ 11 attacks on the World Trade Center as revenge for
humiliations dating back to the crusades (‘‘Letter to America’’, 2002).
Considering revenge is a very human response to feeling slighted, humans are atrocious at predicting its effects. Considering the fact that revenge alone is not the greatest way to go about anything, is it still wrong when used in a setting where a person is to become more cooperative and effective? Revenge fosters cooperation(Ross, 2010).
References
Ross, K. S. (2010). The Benefits, Costs, and Paradox of Revenge. Social and Personality Psychology Compass, 1193–1205.
Kemal Nas, L. Y. (2015). Rehabilitation of spinal cord injuries. World journal of orthopaedics, 8-16.
Ross, K. S. (2010). The Benefits, Costs, and Paradox of Revenge. Social and Personality Psychology Compass, 1193-1205.
Laden, B. (2002). Letter to America.
2 thoughts on “Revenge as a motivator”
Hi Cheryl
Thank you for sharing your piece. Your description of what happened is good. I feel that you can be confused as to whether or not you should give your best when treating a patient out for revenge as you know they will hurt someone when they are discharged. I can only imagine how you felt when you had to inform the patient that he will not be able to walk again. Maybe you can write about how you felt when you had to tell him about his prognosis and what your thoughts were regarding the doctors not informing him. You should try and highlight your ethical dilemma more as I feel that it does not come across strong enough, You should also try and introduce it earlier and start your piece stronger. Also try and link your content to literature as you only have one reference present and literature will make your piece stronger.
Just a few spelling mistakes I picked up:
Paragraph one, line one “ad” should be “had”
Paragraph one, line three “e” should be “me”
Paragraph two, line five “is” should be “he”
I hope these suggestions help.
All the best
Robert Bantham
Hi Cheryl!
I thoroughly enjoyed reading your writing.
Herewith find my comments which I aim to create a respectful, friendly, open-ended climate, I will also think about my own thoughts and feelings before providing you with feedback and I will try to be non-judgemental. Should you disagree with any of my comments, feel free to respond to this comment and we could discuss the disagreement and possibly come to a mutual agreement.
The content of your piece is satisfactory. I would advise that you link it more clearly towards one of the topics in ethics which had been discussed in the lectures by Prof Michael Rowe as I am struggling to link your piece to one of them. It is aligned with class discussion as I remember one of our classmates (Dylan. Excuse me for mentioning names) asked the question in class and we had an open discussion on how to approach a situation where a patient feels a certain way, and we sort of make use what we know about their private lives as a means to sort of change their mindset and thinking about a situation. I would like to suggest that you maybe consider providing the background story of this patients incident as your introduction, thereafter in the second paragraph you could maybe define what a spinal cord is, define that patients level of injury in terms of what they should generally be expected to be able to perform and define what a complete spinal cord lesion is and how doctors go about determining the sensory and motor level of the lesion. I’d like to advise that when you are making the edits to your wonderful piece, that you pretend that your readers have absolutely no idea about what you are talking about. with that being said, try to explain everything to your readers, include literature based on others experiences on this matter and maybe how they may have dealt with it. then somehow try to incorporate your existing paragraphs into the literature.
Regarding your argument, you have made a claims about the following:
– claiming what happened to the patient which resulted in the injury. I would suggest that you start it off by typing where you obtained your information on the incident by stating, “according to the patient”, or “according to the file” or “according to my clinician” and then you continue describing the incident.
– you mentioned that your patient wished to be able to walk, however taking his diagnosis into consideration, literature states that he may not be able to walk again. if you include what a level T2 patient should be able to perform above, then you neednt have to repeat it here. however, I would love to have you further a discussion on why doctors dont discuss an/or council the patients and their families on their diagnosis. This is something which I have also had to deal with in clinical practice and it created certain ill feelings towards the doctors regarding their lack of communication towards the patients. Also, I would advise that you present literature based on others experiences on being the first to explain a patients medical diagnosis.
– you made a claim about the patient suddenly being motivated the following day and that it was more due to wanting to seek revenge. is this part of the nature of your patient? is he a violent individual? what do you think would happen should he attempt to seek revenge? how do you think we could intervene?
– the claim on revenge which you included in the end is very good! I would advise that you discuss more about this matter.
You do have references present and you have made use of the APA style of referencing and you made use of the correct method of referencing which is excellent. I would advise that you do the same for the other references, should you add more when you edit your piece.
your writing has a few grammatical errors. the few which i have picked up on are as follows, kindly revisit other errors.:
* “I had a patient in ICU. He was a T2 motor and sensory complete.”
– rather: One of my patients which I had been providing consensual physiotherapy management to was a newly diagnosed T2 motor and sensory complete spinal cord injury patient.
* “When he explained he said that he ad left church early and went out drinking with his friends. On his way home he was ambushed by a group of guys and was stabbed in the neck, the abdomen and the arm. He reported to e that when he got stabbed, he could not feel anything from the waist down and that he crawled to go find help. He got admitted to the hospital and I was asked to see him”
– Rather: According to … the patient had left his church service early (what day does he attend church?) and opted to go out with his friends to consume ?alcoholic/?non-alcoholic drinks. En route to his household, he was ambushed by a group (how big was the group?) of (?armed) men and sadly he suffered stab wounds to the neck, abdomen and arm (?which arm). According to the patient, after being stabbed, he had ?decreased/?absent sensation from the waist down into his ?legs/?toes. He then crawled with difficulty, using his arms to be able to seek help, and thereafter he was transported and then admitted to hospital for medical attention.
* “During my subjective interview he kept on saying that if he could only just take a couple of steps then he would be good for discharge and that his family would be able to take care of him”
– Rather: While I was conducting my subjective interview with this patient, he was persistant on the need to be able to walk by taking a few steps so that he would be able to be discharged ?Home so that his family could care for him.
* “I began to be very confused. I asked him if the doctor had explained to him his condition. He said no, so I had to explain it to him so that he doesn’t have any expectations during treatment. ”
– Rather: “I suddenly experienced feelings of confusion which then urged me to consult his medical doctor by asking whether he had explained the patients newly diagnosis to him as this patients functional means has been affected for life. I then learnt that the doctor had not explained to the patient his diagnosis. Thereafter, I took the initiative to explain the diagnosis to the patient to aid in the prevention of unrealistic expectations during physiotherapy treatment.
* “He took it as any person would if they had just found out that they would never walk again.”
– Rather: ? I struggled with rephrasing this, because personally, I would not advise therapists to generalize in how patients handle being made aware of this diagnosis. Unless you state that he appeared to have dealt with the information about not being able to walk in again in a rather accepting manner.
* ” I came back the next day and he seemed okay, he seemed quite motivated for treatment and he seemed quite excited to see me. I thought I had broken a shell but that was not it. He had revenge on his mind and that was his motivator to get better.”
– Rather: When I followed up on this patient the next day, he appeared to be okay (?was it his attitude that came across as okay? Or are you referring to his vitals and general medical condition?) as he appeared motivated for physiotherapy treatment and excited towards my presence. (I’m uncertain what you are referring to at the breaking a shell part, so I would rather advise that you kindly rephrase this). I identified that his motivation towards successful rehab was to be able to seek revenge (?on who).
Furthermore, regarding your writing, it does flow well.
Also the image which you’ve included to your piece goes well with your writing.
A good first attempt at your third term ethics assignment.
I look forward to seeing your final piece
Kind Regards,
Carla Everton