Haere rā Hilda ... and thanks!

As she stepped down from the Capetown train in February 1971 young Hilda Mulligan grasped the meaning of the term 'in the deep end'.

After two days and one night in a smoky steam train from the Eastern Cape to university, a weary Hilda found that her luggage was missing.

It helped that kindly older relatives were at the station to greet her and she was soon exploring the spectacular local outdoors on brisk hikes to Table Mountain and beyond.
She soon learned that cold beer could be refreshing after exercise.

Fast forward 30 years, and we say 'so long' to physiotherapist, educator and colleague Dr. Hilda Mulligan who has recently retired from the School of Physiotherapy in Christchurch.

Why not medicine?

Her father's work as an engineer meant that Hilda's family traveled widely.

Education proved to be a natural drawcard - she found sciences and Arts studies engrossing, and her early successes pointed to a career in medicine. Hilda was accepted for medical school but intuited that medicine's 'diagnose and treat' model might not allow the close and holistic personal connections she wished for. Her father also emphasised that six years of training for a degree in medicine would be out of order 'for a girl'.

After graduating Hilda worked as a clinical physiotherapist in hospitals, private practice and community settings before emigrating to New Zealand in 1989 with her medical doctor husband and making a new home in the Hawkes Bay.  The pediatrics unit where she worked hosted undergraduate physiotherapy students from Otago on placement and Hilda loved learning about the individual students and their career aspirations. She soon found herself stepping into a relief teaching role.

Hilda advocates strongly for collaborative learning styles and believes that educators can become learners in a circle of mutual exchange. Students who take more responsibility for their learning often derive more meaning from it, and educators can learn much by listening.

Such close attention brings particular rewards to students from other countries. If a student 'fails' within an alien education structure educators must reflect on possible factors at work behind such 'failure'. Unfamiliar systems can be more difficult for individual students to navigate than teachers sometimes take on board. It becomes critical that educators need to find out as much as possible about each student and their culture.

“I always tried to encourage my students’ independence of thought and action”.

In the Hawkes Bay Hilda met teaching staff from the School of Physiotherapy, and after moving south in 1995 she was shoulder tapped by the co-ordinator of the Christchurch branch, Gay Wood to help with teaching. She was escorted to a tiny desk in an equipment storage space at Christchurch Hospital, handed a stack of texts and told to 'get on with it'.

Made for movement

The human body has evolved to be in motion and with such facts in mind Hilda has learned how effective dance can be in therapy as it engages body, mind and spirit.

She recalls working in a daycare centre where she met 'David’, a Parkinsons patient in rehab. While his shuffling gait and instability caused some concern for staff, in conversation with Hilda he said 'If you bring some music, I will dance you around the gym'. It was the kind of invaluable lesson patients at times can offer their therapists

Hilda dances the Argentine tango, but as soon as the music started she and David were enjoying a series of quickstep moves 'in the moment'.

“I learned very early on in my career that physiotherapists must always listen. Our patients are the real experts of their own bodies, they understand their own contexts and what help they might need to achieve the very best in their rehabilitation”

Today Hilda still questions some accepted notions such as asking patients in therapy about their goals. Such questions can be too broad for those who want the best quality of life possible at that moment.

Within the bounds of effective treatment a therapist can step back and accept that they are not always the experts. They don't have to fix and treat each patient every time. She would like to see more physiotherapists enabling more of us to enjoy all forms of movement through exercise, and notes that while there is a growing understanding of such principles within the profession there is some way to go to expand physiotherapy’s capacity by better informing and educating peer groups and decision-makers.

Physiotherapists need to tell better stories about themselves and their role and by doing so extend the profession's cultural reach into wellbeing in its widest sense rather than confining itself to 'aches and sprains'.

“As physiotherapists we can be advocates for health services that lay the foundations for meaningful change in patients’ lives”.

For some time Hilda has been helping older and disabled Kiwis call for better access to planned environments. Architects and engineers may apply effort to considering better access at the initial design stage, but often appear to consider the form of buildings more important than its functionality for all users. The late addition of a concrete access ramp around the back and out of sight does little to help perceptions.

• What does equity mean in terms of access and ease of use?
• How fit for purpose are current rules in this area?
• How might physiotherapists work with architects and engineers to improve access to buildings and public facilities?

Meaningful connections

Most recently Hilda has been part of the WellConnectedNZ project, a collaboration between researchers from Otago University, Canterbury District Health Board, and Canterbury University GeoHealth, funded by the Health Research Council of New Zealand.

“The more choice, control and support our people have in being active the more likely they are to make and keep meaningful and healthy connections with friends and whanau in their communities”

These projects have drawn together years of Hilda’s clinical and research expertise aimed at improving health service delivery in New Zealand.

In her rare spare time Hilda can be found out and about on her new e-bike, or walking, swimming, gardening, dancing Argentine tango - and helping children expand their imaginations.

“My retirement will I hope allow me to have fun working with children. I often wondered why my own children struggled to answer some of my questions. How can they grasp the whole story when all their energy goes into trying to read words as single entities? My 7-year-old grandson isn’t a great reader (he is into maths and science), but I would like him to enjoy language and expand his imagination. During the recent lockdown, we have been Skyping and reading about how to make a plaster cast for a rhino that broke its toe, and how x-rays work so that vets can see if the toe is healing!
When the (Covid19) lockdown finishes, I will contact schools in my area to offer myself as a reading partner”

In many ways, Hilda's life and work as a physiotherapist and educator embody the extraordinary reach and scope of the physiotherapy profession and its critical importance. The profession of physiotherapy and physiotherapy education in New Zealand are richer as a result of her tireless work.

Our thanks and gratitude Hilda, and farewell for now!

Associate Professor Hilda Mulligan holds a BSc (Physio) (Cape Town) MHealSc (Otago) Ph.D. (Otago)