The History of Kaiser Foundation Rehabilitation Center | Kaiser Permanente


Stroke recovery’s not like
getting over the flu. You don’t sit around and wait to
get better. You have to work and challenge
yourself all the time. That’s my goal; I want to go
back to normal life. I remember this one physical
therapist telling me, “You know, Mark, you need to
train like you’re training for the Olympics.” Henry Kaiser’s son Henry Jr.
was diagnosed with multiple sclerosis in 1945. At that time, MS was considered
a fatal and hopeless disease and Henry Sr. looked for the
best hope he could find. Kaiser was a man of action
building highways, dams, ships – always viewing, in his words, “problems as opportunities in
work clothes.” When he read that an
extraordinary team in Washington DC, Dr. Herman Kabat
and physical therapist Maggie Knott, were using
innovative approaches for individuals with multiple
sclerosis and other disabling diseases, he immediately
wanted to know more. He asked Sidney Garfield,
the physician with whom he co-founded Kaiser Permanente,
to investigate. Dr. Kabat was using a
new medication — it wasn’t a new medication. The medication that had been
used for a long time called “prostigmine.” It had been used for other
purposes, but he was using it on multiple
sclerosis patients. It relaxed their spasm so
they were able to move. Kabat and Knott also developed a
new philosophy of practice and technique in physical therapy. Early after the diagnosis,
they would use the techniques to facilitate movement and
improve function. He had people walking who hadn’t
walked for years. Garfield put Henry Kaiser Jr. in
the care of Herman Kabat and Maggie Knott, and Henry Jr.
began steadily improving. Garfield was so impressed, he
sent several of his physicians to learn more about the work
Kabat was doing. They spent six months with
Kabat and then reported to me that the work was really
worthwhile, that he was doing a lot of good
for these people. I decided to sponsor Kabat,
bring him into our operations. And that’s how the Kaiser
Foundation Rehabilitation Center, first known as the
Kabat-Kaiser Institute in Vallejo, California was born. I feel a very strong connection
to Dr. Kabat and Maggie Knott because their priorities and
their focus are very similar to mine and to the center’s
at this point in time, 60 years later. Dr. Kabat had a different
approach to patients who had been diagnosed with disabling
conditions, children and adults. Before the advent of
rehabilitation medicine, the view was that these people
should be confined to bed or confined to a wheelchair and
that there was really no hope for their recovery. So Dr. Kabat’s approach,
Maggie Knott’s approach, looking at patients’ strengths
and helping them to compensate for the impairments
as well as promoting the recovery of function through a
scientifically-based principled practice was really,
really a revolutionary idea. Our whole theory is one of
maximum resistance, manual maximum resistance. We must get the patient to do as
much as he possibly can through whatever range of motion he
can participate. Well, certainly Maggie’s
functional approach was based, very strongly based in
Dr. Kabat’s philosophical and scientific approach, which was
building rudimentary function and then developing even more
sophisticated function. Dr. Kabat’s and Maggie Knott’s
outcomes really proved what we now today would say is the
science of neuroplasticity. That is understanding that the
brain has a great capacity to reorganize; I suppose we
could say rewire itself. An early group of patients
treated at the Rehabilitation Center were
severely injured coal miners from Appalachia brought to
California by rail under special arrangement with the
United Mine Workers Union. In Oakland, caravans of
ambulances awaited and Dr. Kabat welcomed some
of the first. Prior to rehab, these
individuals had no hope for participating in life’s many
activities. Eventually, many of them were
able to get back home to fulfilling activities in
every sector of life. Soon, patients with multiple
sclerosis and mining injuries were joined by patients with a
history of polio and other disabling illnesses
and injuries. The program spread worldwide
through clinical practice, training and research. It was known as
The Kabat Method and Proprioceptive Neuromuscular
Facilitation or PNF. Since 1947, KFRC has treated
thousands of patients with acquired neurological disorders,
trauma, neuromuscular and orthopedic conditions. One of the United Mine Workers,
Harold Willson, had injured his spinal cord at
age 21 in a mine cave in that resulted in paraplegia. He became one of the first in a
long line of spirited Vallejo patients to demonstrate
what could be done once their rehabilitation
was complete. After his time at the KFRC,
Harold earned a degree in accounting and went to work for
Kaiser Permanente as a financial analyst. When the Bay Area Rapid Transit
system was being planned, he waged an almost single-handed
campaign and used his financial expertise to help make BART the
first handicapped-accessible train system in the world. Shelley Bickoff, seen receiving
therapy in 1950, was an avid tennis player when
she contracted polio and was at the Kabat-Kaiser Institute at
the same time as the miners. Now I think it’s remarkable that
I reached a stage where I was stable and that I
could actually stand on a court and turn around and do
a backhand. This is the way I did a serve,
although I have no arm. I would throw it up with this
hand and come down like that. Kevin Ngo had a stroke when
exercising on a treadmill. When this interview took place,
he had been at the KFRC for only a week but was
regaining function. You’re going to walk… They push me on a high level and
try to make me get better, better. I see I can improve a lot. Mark Wellman started
mountaineering as a teenager. In 1982, he was 22 years old and
climbing a mountain in a remote part of the
California’s Sierra Nevada. He fell one hundred feet and
sustained an injury to his spinal cord that resulted in
paraplegia. I wouldn’t be doing what I’ve
done in the last 25 years if I didn’t go through physical
rehabilitation. I really attribute that to my
success today from what I’ve accomplished in the last
20 – 25 years: climbing El Capitan twice,
spending 13 days on Half Dome. What happened to me was a really
negative thing at the time, a fate worse than death. Turning that around into
something positive – I mean, now I make my living
as a speaker, an outdoor adventurer,
equipment designer, do some film production work. You know, I took this tragedy
and turned it into something very positive. After working in the business
world while raising her family, artist Allison Shapiro had
landed a dream-come-true job illustrating a children’s book. Just as she started the project,
she experienced two brainstem strokes in a 24-hour period,
resulting in loss of motor control, slurred speech
and blurred vision. But while at the KFRC, she
attempted to draw. And this was the best that I
could draw. When I did this, I cried. I had no idea if I’d ever be
able to paint again or finish that book. After months of hard work,
Allison regained her fine motor control, created
some sample drawings and convinced the publisher and
author to allow her to finish illustrating the book. In my personal experience of
regaining function, the most important thing for me
to remember is that the brain is very plastic and it’s able to
rewire itself in ways that we really don’t understand. Every day, every week, I’m
seeing patients who come in with catastrophic events that really
change their lives forever. And instead of that being a
hopeless situation, there is reason for hopefulness
and people can improve, and they improve because of the
scientific basis of what we do and of the persistence of
continuing to provide therapy. The approaches of Dr. Kabat and
Maggie Knott are the same approaches we’re using today,
and we are having the same excellent outcomes, and that’s
what’s really gratifying about working here. I expected that rehab
would fix me. What I learned was that rehab
would teach me how to fix myself. And that’s what’s worth
celebrating. ♪♪

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