Case II: Chapter 3: Physical Therapy with Arnold Jr.

Case II: Chapter 3: Physical Therapy with Arnold, Jr.

As he left Isabella’s office, he felt only partially relieved by the conversation. He was glad that she was aware of the situation but somewhat concerned with her apparent laissez-faire attitude. He decided that as he worked around the facility he would have to remain alert and recognize the signs of potentially inappropriate behavior and not get trapped by any particular situation.

Dudley was still somewhat shaken by Mrs. Torres’ behavior when he walked into the physical therapy room that afternoon for his scheduled appointment. He had reluctantly convinced himself that the physical therapy was doing him some good, particularly to strengthen his cardiovascular system which may have been the source of his mild heart attack.

As he entered the room, he noticed a number of people engaged in various forms of physical therapy. Some were doing cardio work and others were on machines that focused on stretching or strengthening specific muscles. For the older residents, there were numerous programs to help them maintain mobility and keep them ambulatory for as long as possible. He was aware that a number of these people were not residents, but were paying to come to this facility to recuperate from hip or knee replacement surgeries, some sports injuries and other specific types of physical therapy. La Vida Aureo maintained a state-of-the-art facility with highly trained physical therapists. Although the original intent was to serve only residents, more and more doctors in the Albuquerque area were sending patients here. Some were covered by so-called “Cadillac insurance programs” and some were private or self-pay. Isabella Duncan quickly realized the opportunity and had expanded the facility with additional equipment and staff.

As an integral part of this expansion of La Vida Aureo’s physical therapy capabilities, she had worked closely with the exercise equipment companies to incorporate sophisticated computer monitoring. Each potential new patient was given a battery of tests on several exercise machines to characterize their mobility and range of motion. The machine’s computer would create a “trace” of the motion on a display screen to be observed by the therapist. With a specific type of injury, there would be a “break” in the trace at a point characteristic of the particular injury. Failure to repeat this trace, including the break, was an indication of potential fraud. As the reputation for La Vida Aureo’s physical therapy program grew, there were more cases of people trying to “scam” the system. But, the sophisticated monitoring system had been able to quickly detect these various attempts so that the current participants in La Vida Aureo’s physical therapy and rehabilitation programs were “legitimate”.

Matthew Dudley was soon to learn that there was another reason for the growing popularity of the facility among certain Albuquerque physicians and orthopedists.

As he continued to look around the room, Dudley noticed a young female therapist that he hadn’t seen before. Dudley didn’t think he was staring, but her highly affected mannerisms caught his eye.

Someone walked up behind Dudley and said quietly to him, “That is not part of your regular cardio exercises and it is probably not good for your heart.”

Dudley turned around and looked up into the smiling face of Hans Werner, his physical therapist. He was somewhat embarrassed and knew that he had “been caught”. He felt that it was useless to try to convince Hans that he wasn’t staring, but he sensed that there was more going on that was apparent. “I just couldn’t help but notice that she seems to be awfully close to the patients while she’s talking to them and seems to touch a lot.”

“That young woman has been here a few months and perhaps you just hadn’t noticed; you’re probably only man who comes in here that hasn’t! Her name is Ekaterina Bubolsky but many of the male patients simply refer to her as Betty Boop! Maybe it’s her short skirt or her out-going manner; I don’t know. She was recommended by a prominent orthopedic surgeons group in Albuquerque and seems to be quite popular with many of the patients.”

“I’m certain her popularity has to do with her physical therapy skills rather than her physical appearance”, remarked Dudley cynically.

“Nevertheless, Mr. Dudley, are you ready to begin your session with me?”

“I guess so, Hans, but you have to be patient with me today it as I’ve had a rather unsettling experience this morning which may affect my heart rate; and, NOT this one!”

“It is no problem. We can start slow and build up. If you’ll just let me know how you’re feeling and I’ll keep checking the heart rate monitors, I’m sure you’ll do fine.”

As Dudley began his first exercise on a recumbent bicycle, he realized how much better he felt with even a small amount of exercise. It was further evidence to him that, if he were to live alone, he would probably deteriorate. As the exercise proceeded, he seemed to feel stronger and his mind was less unsettled by the events of the morning.

“Well, Hans, I certainly appreciate your encouraging me to get started and I feel much better once I get moving and get some additional oxygen to my brain.” Dudley completed his entire therapy session, thanked Hans and decided to return to his room for a nap.

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