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Editor's Notes |
Those of us in the Midwest know the scene well. The sky glistens with bright sunlight. The blueness is interrupted only by clouds that look like cotton balls floating in the breeze. Then it all changes. It is as though black ink pours from the murky depths of an ancient ink bottle. Darkness spreads across the canopy above us.
The scene heralds not just a storm but tornadoes that will spin out of the sky, claiming lives and destroying property. So it was recently when all of our lives were changed. Madmen whipped up the winds of war, destroying lives and property in monumental proportions.
America now has two days that will live in infamy. On December 7, 1941, our military was attacked at Pearl Harbor, and we lost more than 2,000 people. Thus began our active involvement in World War II. Who would have thought that there could be an even greater day of infamy?
On September 11, 2001, death again came from the sky. The attackers took three times the number who died at Pearl Harbor, and most were civilians. Many died because of the kindness that they were showing others. My mother, who used to live only a few blocks from the World Trade Center and who now lives in Virginia, looked on from a distance and wondered about the fate of those emergency medical technicians who had so often helped her during various illnesses. For my daughter, the playground of her youth—the plaza outside the World Trade Center—disappeared.
Each of us will mark the days of our lives as those that came before the attacks on the World Trade Center and the Pentagon, and those that came after. There will be other days, good and bad, but all days will be marked by their proximity to or distance from what we now call "9/11."
As our military is engaged in combat abroad and as we fight new battles against new weapons at home, we struggle to make sense of the senseless. In the weeks before the hijackings, we were a cynical nation engaged in, among other things, idle gossip about a congressman and his affairs. Media coverage often lost track of the sad fact that a young woman was probably dead. Even more importantly, we lost track of our place in the world, our need for security, our need to understand others, and, above all, our need to unite to do good. Doing good should be our responsibility as a people who are truly blessed—blessed because we live in a country that we now often salute in a show of renewed national solidarity: America the Beautiful. Our nation (like our profession) has taken for granted our bountiful harvests. If anything can be learned from the madness of 9/11, it is that we should never take anything for granted.
There is another clear lesson in the wreckage. Understanding the depth of another human being's hatred does not mean that we think his cause is right, but it does make us wary and better prepared. Ignorance is the enemy of us all—and the ally of the tyrant. Hitler's power grew because people turned away and either refused to see or refused to believe what they saw. Evil flourishes in darkness and is nourished by ambivalence.
Ignorance is the friend of hate and the mortal enemy of understanding. Those who assaulted us illustrate that truth. Let our weapon be understanding. How much does the average American know about Islam? Will we allow our ignorance to overwhelm and separate us? Islam is a great religion, yet in the past we have taken little time to understand it and to understand those who follow in the footsteps of a great prophet. We can reject ignorance and isolationism and embrace the simple concept that we who have been blessed can be our brothers' and sisters' keepers. Goodness spreads faster than any bioterrorist's weapon.
As health care professionals, we reach out (or at least we should) to one another, but unless we take that burden beyond the single encounters with our patients, we won't be very effective. Health care workers throughout the world have united to ban land mines and other weapons that are left behind when the battle is over and that take the limbs of peaceful men, women, and children. In lands sowed with mines, the harvest of bloodshed can continue for decades. Our Association has been relatively silent on this issue, and I run the risk of alienating readers by raising the issue in the middle of war. I believe, however, that it is just such a time as this when we must look forward to a better day, to turning swords into plowshares.
I do not ask you to accept my pacifist views. I know that in wartime they become decidedly unpopular. But I will not shun my beliefs or hide them from others. Mohandas Gandhi said, "Truth never damages a cause that is just," and although you and I may not agree on a single version of the truth, if we choose to respect one another, perhaps we can find common ground.
Hopefully, nations can move toward a common vision, one seen by millions of different eyes in faces with a thousand different shapes and colorations. We can move toward a common vision by accepting that neither the pacifist nor the warrior is morally superior and by accepting that the pacifist and the warrior coexist and are both driven by deeply held personal beliefs. We can move toward a common vision by rejecting the notion that any people or religion has superiority.
This year I was deeply honored in many ways. As the plaques begin to cover your walls, you run the risk of taking yourself too seriously and believing that you have more wisdom than Solomon. There are issues that threaten the survival of our profession, just as there are issues threatening the survival of our nation and the world as we know it. In this Editor's Note, I have given into the temptation of trying to talk about all of them. But there are other people in our profession who need to be heard and who need to act. Our profession, like our world, needs to learn and to banish ignorance.
Issues within and related to our profession must be addressed—but not without discussion. We again hear talk of autonomous practice but seem to have forgotten why we abandoned the term in the first place. (We once used "autonomy" to mean "direct access"; today we seem to use it to mean "independence," but to the wider community, the term seems to dismiss the importance of collaboration and implies a kind of arrogance.) We also hear talk of a "doctoring profession," variants on the DPT, and the need for continuing education—and the need to define the roles of evidence in practice and issues related to reimbursement. Professional roles, educational reform, and research productivity are other topics of importance. Our association is ready for some new thinking, particularly about its structure and the roles of specialization. We also need to revisit the criteria used by the Commission on Accreditation in Physical Therapy Education (CAPTE). Just as this is no time for ignorance about our nation's place in the world, this is no time for ignorance about our profession. Whether it's world events or the physical therapy profession's future, the only way to avoid ignorance is to have a dialogue.
In 1858, America seemed in disarray, and Abraham Lincoln and Stephen Douglas faced off in their famous debates. The little man lost the debates, won the senatorial election, lost the presidential election—and then saw the start of the bloody war that he and his opponent had sought to avoid. On the face of it the outcome seems less than ideal, but we did become a nation more committed to the elimination of slavery. Finally, as a result of Mr Lincoln's brilliance, we survived not just a physical war but also a war for the spirit of the nation. Without the refinement of his thinking born in part from those debates, we might never have known a vision that offered charity for all and malice toward none.
For many physical therapists and physical therapist assistants, there is too much passion and too little knowledge. Most importantly, the debate has been abandoned to big mouths like me. We need the so-called "rank and file" to be engaged in the discussion and to be committed to the idea that respectful disagreement is good, and we need mutually acceptable visions that we all can pursue. Just as we need a new national dialogue regarding America's place in the world, our profession can begin our own new national dialogue—with our own Lincoln-Douglas debates.
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