We’re excited to introduce you to the always interesting and insightful Nicholas Manente. We hope you’ll enjoy our conversation with Nicholas below.

Nicholas, appreciate you joining us today. We’re complete cheeseballs and so we love asking folks to share the most heartwarming moment from their career – do you have a touching moment you can share with us?

I’d like to preface this story by stating that the world of spinal cord injury (SCI) is very special, and no two injuries are the same. You can have a lot of similarities of course, but every injury is very unique.

One of the first patients I ever worked with on the spinal cord injury unit was woman in her late 40s/early 50s who was injured in a car accident, leaving her paralyzed from the neck down. She was left with minimal use of her arms. In this case, she was left with no motor function but some sensation, so she could “feel” but not actually move. This woman was one of the most motivated people I had ever met. Every day, despite minimal progress in therapy, she continued to verbalize how much she was ready to work as hard as she could and be focused in each session.

She was beginning to get discouraged, until about one month into intense rehabilitation, working 3 hours per day, she was able to voluntarily control some of the muscles in her legs. We began aggressive standing programs, using various types of equipment and multiple people to assist in allowing her to maintain standing positions, to encourage weight-bearing in her legs hoping to encourage more return in motor function. Standing lead to taking a first step, and that first step lead to walking independently with a walker. After 6 months, she was climbing stairs again with minimal assistance and went home with her family.

Despite being amazing, that’s not the best part of the story.

At the time, I was involved with the adaptive ski trip program at Mount Sinai’s Department of Rehabilitation and Human Performance. We would take patients with various neurological injuries (mostly SCI) adaptive skiing in Vermont with expert ski instructors. The woman I described above always kept in touch a few times per year. She was an avid skier prior to her injury and she decided that she wanted to try skiing in this new capacity, now 2 years post-injury.

The ski instructors will always adapt the equipment needs to a person’s physical limitations. Some people are in a sitting position and assisting with weight-shifting, some are just “going for a ride” while harnessed to a skilled ski instructor.

The woman I’ve been describing started the day skiing with her own boots skis on her feet, as well as using a walker with skis on the bottom, while being harnessed to one of the professionals who was controlling her speed. As one of the volunteers, I was assisting patients with getting set up and skiing along side the instructors getting some photos and videos.

She remained focused on every turn, trying to feel exactly how her body was adjusting to skiing again, despite some residual limitations in her sensation that remained in her legs.

Eventually, she wanted to try without the walker and just ski as she did before.
By the end of the day, her and I were skiing side by side down a mountain in Vermont together.

Fortunately there are many stories of people with similar injuries that make significant recoveries. There are also stories where people are not as fortunate due to their type of injury. This was truly unique because I watched this woman go from not being able to move from her neck down, to being able to return to skiing with me 2 years later. Not many clinicians can say they had the opportunity to experience that with a patient over the course of such a time period, and I am forever grateful for it.

I will never forget that day. It was just one example of many that the human body, when combined with the power of resilience and constant faith, can get you to accomplish things that you may never would have thought possible.

Nicholas, before we move on to more of these sorts of questions, can you take some time to bring our readers up to speed on you and what you do?

I grew up in the Bronx, NY and was always a pretty active kid. I’d say I was an average player at best for most team sports but I have always been interested with human movement in some way. I began training in a Japanese system of Fuji Ryu Jujitsu when I was 14 or 15 years old. I was curious as to why certain joint locks and positions were more sensitive than others, and how my instructors can generate so much power while moving so gracefully at the same time.

My family wasn’t poor and they worked extremely hard to give my sister and I everything we could possibly want as kids, but we were far from rich. I did hear the phrases “Money doesn’t grow on trees” and “Do you think I own Con Edison?” often growing up. I think subconsciously it made me worry about having enough money and contributed to a scarcity mindset at a younger age than most. That being said, I wanted a job pretty early. I was working at a beach club where my mother managed the local “Snack Bar” just helping her prep things when I was 12 years old, (For $5/hour) well before child labor laws were actually enforced. I told my parents one day I think I wanted to try to be a bus boy. So when I was 13, I got a job bussing tables by my Dad asking around a bit to local bars and restaurants.

As the years went on, I became interested in business via working in various restaurants and maintained martial arts training on and off through college. I decided to study “business” in college as an undergraduate at Manhattan College. I was always a decent B+ student, but I was sleeping in these classes, completely bored. One day, I injured my shoulder after a fall from training, and I had to go to physical therapy. After speaking with my PT in many sessions and asking if he enjoyed what he did and made a decent living, I changed my major to Exercise Science.

I was much more interested in the anatomy and kinesiology courses, plus I wanted to help people and spend time with them. So after getting my Bachelor’s Degree in Exercise Science, physical therapy school became the perfect fit.

After graduating from New York Medical College with my Doctorate in 2012, I began my physical therapy career at Mount Sinai Hospital on the Upper East Side in New York. I was very much the “ortho/sports guy” in school. I thought I was going to specialize in treating orthopedic injuries but quickly got very bored with that. It was only by chance that I ended up working on the Spinal Cord Injury Unit at Mount Sinai’s Department of Rehabilitation and Human Performance.

This changed my career trajectory. I was working with people who suffered the most traumatic types of injuries, mostly with various types of paralysis. I found helping this population of patients to be much more rewarding.

At some point in their careers, many physical therapists who are highly skilled often get asked by doctors if they work with patients privately. Also, some patients pose the question once they have spent so much time with someone and enjoy working with them. So over the course of 11 years at the hospital, I built up a consistent side-practice of treating patients after work. I went from one session per day to 2-3 sessions per day after work.

I also met my wife, Nehal Manente (also a physical therapist) while working at the hospital. We were friends for about 10 years before the thought of even dating was an idea. Like many experienced PTs, we both were feeling the burn out from working at a hospital.

You can work in various different settings as a PT. In short – there are Acute Care, Outpatient, and Acute Rehabilitation settings. Of these choices, Acute Rehabilitation is the most intense setting where patients receive 3 hours of combined therapy between multiple disciplines. It’s the most intense setting for patients, but also for therapists when you’re working with people trying to learn to walk again after suffering severe and traumatic injuries. It takes quite a toll on the body physically, mentally, and emotionally, leading many therapists to feel a sense of “burn out”. However, it gives you the ability to spend the most amount of time with patients and gain the most skills, knowledge, and techniques.

Nehal and I kept hearing feedback from patients about how poor the physical therapy was that they received at home after leaving the hospital.

Between the feedback we received from patients and doctors, and recognizing the need to have skilled PTs specifically with Acute Rehab experience in the home setting, we gradually transitioned from the hospital to creating our own company – Caliber Concierge Wellness and Rehabilitation.

Our goal at Caliber Concierge is to provide the highest quality of wellness and rehabilitation to clients in the comfort of their own homes. Nehal and I have a combined 25+ years of experience working in the most complex settings with the most severe injuries. We only provide patients with highly skilled therapists that will suit their needs and help them meet their goals.

We also provide consulting and recommendations for home modifications if needed, training for caregivers and family members, or can be a valuable resource if you need to see a specific Medical Doctor or need to hire a home health attendant to assist a loved one. We take pride in the fact that there are very few problems we won’t know how to solve personally, or have a valuable and reliable resource who can assist in the event that we can’t.

Can you share a story from your journey that illustrates your resilience?

In March 2017, I woke up at 2:00 AM to the sound of my neighbor pounding on my apartment door. I thought someone was breaking in my apartment. I jumped up and ran towards the door only to hear “Fire! Fire!” to compliment the loud pounding on the door. I opened up the door and smoke began rushing into the apartment from the hallway. I shut the door, quickly got dressed and managed to grab my car keys and some cash, forgetting my phone as I was rushing. I lived in the 5th floor of a 6 story building. The stairwell was directly across the hallway from my apartment. I ran down the stairs only to meet my neighbors in my lobby who were waiting for the fire department to arrive. As I walked out on to the communal parking the building, I saw flames coming out of the apartment window of my neighbor’s apartment that was 50 feet from my unit.

Unfortunately the resident in that unit was known to have a long history of alcohol abuse and mental health issues. The fire department arrived only to report that the local fire hydrants around the building were frozen due to the cold weather that time of year, and they needed to access water from much further away, running fire hoses over a quarter mile in length if not further.
Meanwhile, the fire spread upwards to the 6th floor and across the entire building. Ceilings collapsed, and the entire 6th floor was incinerated. The 5th floor was badly damaged as well, but fortunately my unit remained structurally intact. However, no belongings were salvageable due to damage from smoke and soot.

I borrowed a phone to call my family which thankfully I got to them before News 12 ran the headline “one dead in 5th floor in Yonkers fire”. Unfortunately the resident of the unit where the fire originated did not survive.

I was overwhelmed by the amount of people who reached out for support. The next day after the fire, someone said to me “you’re so calm, it hasn’t hit you yet has it? You lost everything in that apartment. It’s all gone”. I remember responding with “No, that’s just it. I do realize it, but I’m fine. I didn’t die, and I have so many places to sleep tonight between family and friends. Many of my neighbors don’t”.

I am far from the Good Samaritan here. But I remember so clearly in that moment that I just felt grateful and completely okay. One of my colleagues at the time was kind enough to start a GoFundMe page for me. After people started contributing, I remember posting on Facebook, expressing gratitude of course, but also asked that instead of making additional contributions, to please donate to my neighbors who lost much more than I did”. I had insurance. I had the most supportive friends and family. I had nothing to worry about in my mind. I lost some material possessions but nothing of real value, while someone unfortunately lost their life. I was so fortunate and realized I was truly blessed.

I was displaced for 2 years while the building was reconstructed. At the end of it, I had a brand new apartment. Sure, it was a very large inconvenience for the short term, but in the long run, it worked out for the better as I had faith that it would.

I did not think of this as “resilience” at the time, but after reflecting upon it and speaking with people that I trusted, I realize many people would have responded in a very different way. I am grateful for my ability to stay calm in that situation, and realize that I was more resilient than I thought.

Putting training and knowledge aside, what else do you think really matters in terms of succeeding in your field?

I believe that the field of physical therapy is the most unique discipline in all aspects of medicine. While we are knowledgeable clinicians, and highly educated, anyone can study and pass difficult exams if they put enough effort into it. In my opinion, the true benefit of being a physical therapist is the amount of time that we are allowed to spend with our patients. There is no other discipline in medicine where clinicians or providers spend 1-3 hours with their patients, often multiple times per week.

I have seen people in their most absolutely vulnerable states. Some meet me after only a few weeks of losing limbs at the scene of an accident, suffering a spinal cord injury or a traumatic brain injury, or a mix of all of those things combined. After such injuries, the last thing some of them want to do is move, but they need to in order to make any progress.

The first step in succeeding is connecting with the patient and establishing that rapport which will set the foundation for the lifetime of your relationship with them.

I think I have learned more from my patients/clients than they have learned from me. When you can connect with people and show them that you genuinely care about them, they will teach you things about yourself that will help you succeed in many aspects of life.

Contact Info:

• Website: https://Www.caliber-concierge.com
• Instagram: Nickdpt, caliber_concierge
• Linkedin: Nick Manente