Inside the Rehab Unit

It may not be the stuff of Hollywood medical dramas, but Dr. Amelia Barry of Horizon's Saint John Regional Hospital knows that the physical medicine and rehabilitation department she oversees has more than its share of inspirational stories and happy endings.

Dr. Barry, Medical Director of the Regional’s Rehabilitation Unit, is a physiatrist – a physician who treats a wide variety of medical conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons.

The patients who end up in the rehab unit have often gone through acute care treatment in surgical, cancer or even the COVID wards. They can be on the unit for weeks, even months, as the staff dedicate themselves to helping patients recover.

“We are like the quarterbacks,” Dr. Barry says of her team, including fellow physiatrist Dr. Patricia Forgeron and the unit’s physio and occupational therapists and nurses.

“We bring all the different specialties together to get the patient ready to go home. Our goal is to get them back to their best level of function possible.”

“It’s a very collaborative process. We work a lot with other physicians, particularly orthopedic surgeons, neurosurgeons and neurologists. But we also work a lot with the families of our patients.

At the centre of the process, Dr. Barry says, is the patient. Some of the patients can be at the unit for several months, especially if they are recovering from a stroke, spinal cord injury or amputation.

“Patients do have a lot of downtime on the weekends but during the week, their schedule is pretty much filled up,” Dr. Barry says. “It’s almost like it’s their job to get better and do rehab therapy. So from 8 a.m. to 4 p.m., that’s their job.”

Saint John resident Greg Hayes, a retired Canada Post worker, is one of those rehab patients who took his job of recovery very seriously. In February of last year, Hayes, now 81, woke up one morning and discovered he had no feeling below the waist and could not move his legs. It was a frightening development that had come out of the blue because earlier that day he had been shopping and moving around normally.

I said to her, ‘We’ve got a problem,’”Hayes recalls. “So that was Feb. 6 and I was taken by ambulance to the hospital. Turns out a disc in my back had disintegrated and it damaged my spinal cord.”

Mr. Hayes underwent surgery on Feb 12. Following the surgery, he started to get feeling back in his right foot. He says it was Dr. Barry who decided to move him to the rehab unit, where he arrived near the end of February.

“The hard work was just beginning,” he says. No one was sure whether he would walk again. The road to recovery was both uncertain and difficult. There were weeks of exercises.

If it was a struggle, he never seemed to let on. He was upbeat – a bright light on the unit for a lot of patients, chatting and bringing everybody up.

Over time, his legs became stronger. By April, he knew he was making good progress, but still wasn’t ready to walk on his own. He kept at it and by May 21, he was able to go home. He had spent, in total, 105 days in hospital.

“Today I take 2,500 to 3,500 steps a day, most of it without any assistance. So I’m doing very well,” Mr. Hayes says.

Seeing the transformation in patients like Mr. Hayes – often moving from traumatic injuries or illness to walking out of hospital – is what brings a deep sense of reward for Drs. Barry and Forgeron.

The rehab team helps patients achieve a full recovery, the result of customized physical and wellness therapies to regain strength, balance and flexibility. Each recovery is significant to the team, but it’s the memories of patients who get teary eyed after being able to pick up grandchildren or who can once again drive their cars that stick with them.

“There’s a lot of focus on acute care and very little on what happens to that person after the high-tech stuff is used to save lives or decrease disability and disease,” Dr. Forgeron says.

“There’s a whole process that comes after that – the rehab. That’s what we get to see, that continuum. If someone is in hospital for three months, the first four weeks or less might be in acute care and then they could be in our unit for two or three months or longer.” Dr. Forgeron says that in recent months, the unit has seen former COVID patients arrive for rehab care. She says patients who have recovered from multi-system failures may have been in bed for months.

“The big journey, after they are medically stabilized, is learning how to walk, dress and slowly build up their endurance.” Thanks to generous donors, the Saint John Regional Hospital Foundation has been able to dedicate thousands of dollars to fund special equipment used on the rehab unit – most recently, a cross-trainer that has been a big hit with patients.

“We all feel really fortunate that we can rely on the Foundation for some of those little things that might make a huge difference in the patient experience,” Dr. Barry says. “To our community, that is a big thing.”

For both physicians, the big attraction of physical medicine and rehabilitation is the variety of conditions that require their healing attention – everything from broken bones to complex diseases like ALS.

About 15 years ago, Dr. Barry was still a medical student in Ontario when she was paired with Dr. Forgeron to spend a summer at the Regional. She fell in love with rehab medicine, and has never looked back.

“I think the variety of what we do have was a big contributor to my interest in the field,” Dr. Barry says. “But I also grew up playing a lot of sports. So it also lets me do some sports medicine and engage in that side of it as well, which I would have been exposed to a lot when I was young. I think those are the main reasons why I ended up in this area.”

Her decision to embrace the specialty for her career and to work in her hometown suddenly doubled the number of physiatrists in the region.

For the first time, Dr. Forgeron was no longer on her own to cover a territory from Sussex to St. Stephen, to staff a day hospital that she established, to see patients in her office and to cover rounds at the hospital.

And, recently, Dr. Barry stepped up to take over from her mentor as medical director of the unit.

A member of the well-known Barry clan, she is delighted to be working in Saint John – where she has more than a few relatives in the health-care professions, including her physician father, Dr. Mike Barry.

“To be honest, a big part of why I love what I do is because of the city and the people and the ability to collaborate so well with all the physicians in the hospital and the therapists,” she says.

“I trained in a place that was an independent rehab facility, and that’s the case across most of the country. So, typically, there is the acute care hospital, but then you’d have your freestanding building somewhere else for rehab,” she says. “Since I’ve been in Saint John, I think one of the beauties here is that our rehab team has been so collaborative with all of the other team members, like the surgeons and the neurologists, and it definitely helps with patient care.

I think Saint John is a really special place to work. No matter what specialty you’re in, I think it’s a great medical community.”

For Greg Hayes, the team on the unit is near and dear to his heart. To him, they were integral to his recovery. “The rehab unit is kind of hidden away and it doesn’t have the profile of the surgery or cardiac units, but that’s where I got better. I could see it and I could feel it. All of the people there are fantastic.”