Beating the Odds

I just finished reading Andre Agassi's book, Open: An Autobiography. I followed Agassi's ups and downs throughout his very long career but, even the non-tennis fans among us, would be captivated by this book - a remarkably candid and moving story of one athlete's life. As I read, I realized that training to be a champion and rehabilitating oneself from a neurological deficit or injury share many things in common.

Whenever I read books about star athletes, I am overwhelmed by descriptions of their training. Nothing is taken for granted. Each muscle is conditioned, every movement analyzed and rehearsed over and over again. By the time Agassi was seven years old, he was hitting more than a 1,000 tennis balls per week. Champion athletes may be "naturals" at a sport, but their innate talents would take them nowhere without exhaustive practice. They train with an intensity, concentration, and focus that most of us can't even imagine.

When I first saw my developmental optometrist as a 48-year-old, crossed -eyed woman, she explained to me that she could help me see better, but it would take a great deal of self-awareness and training. Like an athlete preparing for a high-powered contest, I could take nothing for granted - not even the simple act of looking. Through daily practice of vision therapy procedures, I had to discover how I habitually used my eyes (looking with one and turning the other) and then teach myself, in small incremental steps, to move them in a more coordinated way. As I learned this, I began to see in 3D. I did not need to re-arrange my life to do this, but I did need to train every day and pay careful attention to what I was doing and seeing.

Most people recognize that sports are as much a mental as a physical game. In his memoir, Agassi stresses the importance of assembling a good team including a coach, trainer, and manager. He had to have great confidence and trust in his team in order for them to build him up both physically and mentally. The same is true for a patient. I have a friend whose daughter Lisa has cerebral palsy. By the time Lisa turned ten, she had grown quite heavy and was having a hard time getting around on her crutches. She had been going to physical therapy, but the therapy was not very effective. Her parents then hired for her a physical therapist who was also a personal trainer and this changed everything. In Lisa's mind, people with injuries and disabilities see physical therapists, but the rich and famous have personal trainers who come to their home. Lisa loved her trainer, practiced regularly, stuck to her diet, slimmed down, and worked up to walking one mile per day.

A champion has to want to win more than he fears losing, and the same is true for any patient going through rehabilitation. You have to want to change, and this means taking a risk. I know one young man, who like me was cross-eyed and stereoblind. As he went through optometric vision therapy, he got better and better at the tasks in the optometrist's office, but something was holding him back. He couldn't see in 3D outside the doctor's suite. Only after he completed his school exams and began vacation did the world pop out for him in three dimensions. He had to be mentally ready to take on a whole new worldview.

Over and over again in his book, Agassi describes his losses and his comebacks, and these comebacks depended upon enormous support from his team. Many people have told me that my experience is "one in a million" because a person who has been cross-eyed since infancy can never learn to see in stereo. Indeed I was told by several doctors that it would be a "waste of time and money" to pursue vision therapy. This is what the vast majority of adults with crossed eyes are told. When you are given such a pessimistic and fatalistic pronouncement by people in authority, then you are defeated from the start. It's almost impossible to take a risk, to try to improve. I was indeed fortunate to find an optometrist who thought beyond the current dogma, recognized the potential for change in me and many other patients, and had the knowledge and skills to guide me to a new way of seeing. Like champion athletes, patients undergoing rehabilitation need inspiring coaches - clinicians and therapists - who help them aim higher and further and give them not only the therapies but also the confidence and courage to defeat the odds.

(Teaser image from http://www.clevelandleader.com/files/andre_agassi.jpg)