I met Wendy back at PT school in the Philippines, where we became very good friends. Along with a number of other classmates, we used to spend countless hours studying and memorizing physical therapy terminologies, muscle origins and insertions, goniometric measurements, lab values, etc. I recall Wendy having a great deal of difficulty remembering and retaining details of the information. I eventually took on the role of information simplifier for our group, explaining the most convoluted theories and physiologic processes in ways that she easily understood. I also coded most of the sequential steps that we needed to memorize or perform in the lab using mnemonic devices, which helped alleviate Wendy’s anxiety during lectures and practical exams. I believe the strategies I had developed to help my friend learn may have been precursors to some of the teaching techniques I use as a PT instructor.

I also remember Wendy and three of our other friends came late to one of the classes. Having saved seats for them, I was worried when the roster was called and they were not present. Just as the quiz was being distributed by our instructor, Wendy came in, followed by our other friends. All of them were sporting a new hairdo: They had spent extra time in the locker room, fixing their hair to get their late ’80s style just right. I lectured all of them about their tardiness and the importance of setting priorities as a springboard toward completion of our degrees and becoming professional therapists.

We eventually graduated from PT school and parted ways but vowed to keep in touch. Wendy came to the U.S. six months after graduation and became instrumental in introducing me to her employer and visa sponsor. A year later, I came to the U.S., and we reconnected. Both of us worked for the same employer for several years. I observed Wendy enjoying her work as a PT. On several occasions, she consulted me about appropriate treatment strategies for her patients. She found meaning with her role as a PT, especially for her patients with dementia. She knew how to structure their treatments and the appropriate way to provide guidance with their treatments, using meaningful functional activities.

Black outs begin

 Although she lives three hours away, Wendy and her family and I have stayed connected during the years. However, two years ago, she called me for consultation. This time, it wasn’t about one of her patients: It was about herself. She confided that for several months, she had blacked out in front of her patients. Fortunately, she wasn’t gait training them when she had the episodes. She also mentioned she tended to forget details of what she was supposed to document in her PT notes. She wanted to know my thoughts about what was happening to her.

Aside from strongly advising her to consult with her physician, I did a neuro-cognitive interview and assessments with her. We suspected a half-dozen diagnoses, based on her symptoms. I even joked with her during my assessment, reminiscing how much she forgot details of what we were studying back in PT school.

Wendy went through a regimen of neurological and psychological tests, none of which revealed any of our suspected diagnoses. However, her symptoms got progressively worse, eventually affecting her depth perception. This resulted in a minor car accident that precluded her from driving to and from work. Eventually, she had to stop working.

With a supportive family structure and a group of friends, she was able to get by despite the progression of her symptoms. She experienced sleepiness, emotional lability and mild tremors of her lower extremity muscles. However, she had the most difficulty with some very basic skills: Dressing and grooming. She cannot recall how to put on a jacket or brush her hair — this from someone who came in late to class after spending extra time fixing her hair.

The last time we spoke, Wendy said she is getting by, considering her limitations. She recounted her difficulties with dressing and grooming. However, she laughed when I asked her if she remembered the reason why I castigated her for being late to one of our classes. She said that there may be a lot of things that she cannot figure out anymore, but there are still some things in life she has not forgotten. Then, she became serious and asked me a question. She was wondering whether the patients with dementia whom she had enjoyed working with had the same experience.

Gold kryptonite

A few months ago, Wendy’s husband informed me of her diagnosis. After extensive testing and consultations with neuro-specialists, she was diagnosed with cortiocobasal degeneration and hyperthyroidism. As I listened to his description of Wendy’s diagnosis and treatment plan, I couldn’t help but conclude that being in a caring profession, we tend to forget our own vulnerability … that we also can become patients and that each of us has a kryptonite.

In Wendy’s case, it was the gold kryptonite: the one that can remove super powers. However, there is a silver lining. According to the history of the DC Comics’ Superman, a temporary antidote once was developed that negated the effects of gold kryptonite for a short period of time. We just have to find it.