The Arc of Resilience: Postoperative Cranioplasty

Story

She was 56.

January 26th, a right fronto‑temporo‑parietal craniotomy after intracerebral haemorrhage.

February 26th, cranioplasty.

March 26th, tracheostomy closure.

From March to August, five long months of home physiotherapy.

Every day, effort. Every day, patience.

But still, no sitting balance.

Struggle

• The family watched her try and fail.
• She grew discouraged.
• Then came another blow: drug‑induced encephalopathy.
• The family worried. The patient’s confidence reduced.
• Hope seemed distant.

Small Win

• And yet, on August 10^th, 11^th, and 12^th, something shifted.
• She sat. Independently. For more than two minutes.
• Her family clapped. She smiled.
• Hope returned to the room.

Family Reactions

• They didn’t ask for miracles.
• They asked for a home visit.
• Because they trusted the process.
• Because they trusted us.

Lesson for Clinicians:

• Persistence: Five months of steady physiotherapy.
• Right dose: Neither overdoing nor underdoing.
• Shared reasoning: Family part of every step.
• Empathy + autonomy: “You are the boss.”

The Lesson

Recovery is not linear.

It is an arc of resilience:

1. Rock bottom (encephalopathy, no sitting)
2. Small win (sitting independently for 2 minutes)
3. Hope restored (family joy, renewed patient confidence)

And in that arc, physiotherapy is not just exercise.

It is the guardianship of dignity, trust, and progress.

S Hemakumar
Physiotherapist,
Kauvery Hospital