‘I’ve been real lucky in my career. Everything has just come to me’

Margaret Cullen, a 26-year-old occupational therapist at Mercy Hospital, has worked with young accident victims, people disabled by strokes, and psychiatric patients, helping them adapt to the world around them in spite of their disabilities. Now she is faced with one of her biggest challenges, applying her skills to help Kim, a small 6 1/2-year-old monkey with cerebral palsy at the San Diego Zoo. Cullen volunteers two to three times a week with the rare, lion-tailed macaque. She was interviewed by Times staff writer G. Jeanette Avent and photographed by Vince Compagnone.

The first time I went into Kim’s cage, his keepers had me put on these black rubber boots, a gown, gloves and a mask. They don’t want any germs brought into Kim, and they don’t want Kim to give anything to me. I wasn’t sure what to expect really. I felt like I was on the spot, and Kim was on the spot.

But the very first thing I did was rock him.The second week, I put him in a hammock-like net and rocked him back and forth. He loved it. He looked just like a little baby. He was so content. But I didn’t want to do a lot of rocking because I didn’t want to set off any seizures.

Usually he doesn’t have spasms or seizures, but the first time it happened it really scared me. He clamped down with his teeth and he was biting his own paws real hard. I know he doesn’t want to bite me, but I have to be real careful with my hands. And I have to be sure he doesn’t hurt himself because it’s involuntary.

I first learned of Kim from one of my patients who also volunteers at the San Diego Zoo. She told me Kim’s previous therapist had moved to another state and he had been without a therapist for almost a year. Kim was born at the zoo, and zoo keepers noticed right after his birth things weren’t going smoothly. He was clinging to his mother a lot and he wasn’t very social. He would not explore his environment and interact with the other monkey babies. They also noticed it was very hard for him to walk around and to use his limbs.

So zoo keepers had someone do a CAT scan to just take a look at his brain. There was atrophy in the affected areas. Cerebral palsy is a nonprogressive disorder and it usually occurs before birth or right after. It can be due to not getting oxygen to the brain, trauma to the brain or hemorrhaging in the brain. Once the brain is impaired, it affects a person’s ability to control their movements.

Cerebral palsy affects a lot of areas. With a human it affects their social interaction, how they feel about themselves. They get frustrated real easily, because it’s hard for them to move around in their environment.

Kim’s not a human, but it’s similar. He gets frustrated when he’s trying to walk up a ramp or if he’s trying to get from one part of the cage to another. He falls down, and it’s hard for him to get back up again because of his stiffness. For a normal monkey, it would be very easy to get back up and swing off a branch or the cage. But for Kim’s it’s not, and he gets very frustrated.

To work with Kim, I had to observe the other monkeys to find out what was normal behavior for macaques. Knowing about cerebral palsy and just watching how Kim uses his body I try to correct any abnormal posture, using the other monkeys as a basis. So what I do is try to reduce his stiffness through sensory stimulation such as rocking. Once his stiffness is decreased, I’ll try to position him to stretch out the muscles.

I also look at his environment. What can I do to make it easier for him to move around and act as normally as possible in this environment, given the deficits he’s given? Before he wasn’t even able to feed himself. The previous therapist worked on that. Now he’s able to eat by himself. He doesn’t bring the food to his mouth, but he is able to eat out of a bowl.

I’ve been trying to get him to go over a ball and rock back and forth so he can work on his balance. Right now, he’s not really keen on that idea. I’d also like to think of a way to get him swinging again, but we’ll have to wait and see what happens. With a monkey, you’ve just got to go real slow.

I’ve been real lucky in my career. Everything has just come to me. So I wanted to give something back. Working with Kim makes me feel good too because I can help him out a little bit. My hopes, my long-term goal would be for him to start feeding himself and bringing food up to his mouth.

Last week, his keeper said he went for a biscuit with his hand and it looked like he was bringing it to his mouth. He’s never done that before in his life. I’d love to be able to make his life a little bit easier.

It sounds weird saying that about a monkey, but I’d like to see him get around in his environment a little bit easier and not have him go through so much pain and frustration. It would be great if I could get him to swing on a branch or climb the fence. That would be wonderful.