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Editor's Notes |
jules-rothstein@attbi.com
Journals such as this one are special because they are "owned" by an entire profession, through individual memberships in an association. Each member of the American Physical Therapy Association owns Physical Therapy. As a result, I believe that the Journal is obligated to accomplish many things: to publish original research and other types of content, such as case reports, updates, and perspectives; to disseminate important Association documents; and to help our profession and our patients by raising questions and stimulating dialogue about critical issues.
This month we serve the Journal's mission with articles on fall prediction, the efficacy of a videotape-based exercise program for patients with fibromyalgia, quadriceps femoris muscle weakness after total knee arthroplasty, whether similar electrical stimulation protocols can be used on lower-extremity muscles of differing fiber composition, whether a recently proposed form of mobilization causes a physiological effect similar to that of more commonly used forms, and the use of constraint-induced therapy on a 53-year-old woman who had a stroke 15 years earlier. These articles offer a wide view of the physical therapy profession and provide practitioners with information that they can use to be more effective.
The benefits and use of new knowledge are discussed often in these Editor's Notes. This month, however, I am reminded of the need to place new knowledge in context. Yes, we need science. We need data. We will survive and flourish because we deal forthrightly with controversy and put the benefits of others before our own concerns. But just as we need to show the world what we do, we also need to show the world the heart and soul of this profession.
We are at our best not when we function as calculators or moveable databases, but when we are human beings who use the literature effortlessly in our patient management. This is no idle observation. It's something I learned from wise and courageous teachers. My father, who died more than 30 years ago after becoming paraplegic, taught me about the intersection between caring and competence. In the years following his death, my mother reaffirmed that lesson.
There are many reasons why people join APTA. We may join so that we can achieve some political goal, such as direct access, or so that we can alter reimbursement policies, such as the $1,500 Medicare cap. Supporting our profession's research efforts and having access to publications and data such as those found in the Hooked on Evidence database are other good reasons to become members. But perhaps the best reason to join is to belong to a vast community, a community that shares one heart and soul and nourishes its members.
A few weeks ago, the strongest human being I have ever known passed away. My Mom was a little lady. Never in her life was she taller than 5 feet, but even as she became frail in her later days, she had a towering will, powerful and positive. Even after she had an above-the-knee amputation, she looked not to what she had lost but to a new living arrangement with her granddaughter's family, including her beloved great-grandson. A variety of physical therapists and physical therapist assistants at multiple facilities assisted Mom during her illnesses, and almost without fail they were her favorite health care professionals, with the exception being her geriatrician, whose competence was equaled by his caring and willingness to listen.
The feeling of kinship that Mom shared with her physical therapists had nothing to do with her son being a physical therapist. The kinship developed because the profession and Mom shared a commitment to a positive outcome and a focus always on what could be done—no dwelling on the negative. Mom was not a quitter, and she found comfort among those who supported her attempts to better herself. She drew strength from her memories of my father struggling to walk with Lofstrand crutches. My father's illness drew me into this profession, and my mother's presence sustained me in it. My parents, like the therapists who worked with them, faced life on their own terms, refusing to let anyone constrict them with barriers or artificial boundaries.
In my life I have been fortunate to travel all over the world on behalf of the physical therapy profession. Whenever possible, my family, including Mom, would accompany me. These "adventures," as we would call them, began in Australia. We visited five universities across that continent. Mom would talk about the kindness of the physical therapists we met and their extraordinary friendliness. I was jaded and took all of this for granted until she made sure that I heard her. She wanted me to know that these were very special people and that barriers, boundaries, and borders had disappeared in the oneness of physical therapists who have a vision for themselves, their patients, and their practices. As we crossed the globe, she wanted me to understand that although physical therapists spoke with different accents, we had a common language born of one heart and soul. It took my Mom to constantly remind me about how miraculous all this was.
In Africa, we saw again the special bond of physical therapists, and, in a post-apartheid South Africa, we moved effortlessly between people who had been subjugated and those who had oppressed them and now were seeking to move beyond their sins. Mom couldn't stop talking about the land and the animals, and she also couldn't stop talking about the African family that had made room in their house for us and treated us like royalty. In Africa, Mom was once again in awe of the physical therapists she met, and by now I had learned from her to truly appreciate the miracle of this shared heart and soul.
The night that Mom lay down in her bed for the last time, my family lost its matriarch, the world lost a valuable citizen—and our profession lost a great friend who perhaps understood us better than we understand ourselves. She was small and almost bird-like when, in her sleep, her heart stopped. I can think only of her spirit taking flight and being among us forever. Her most recent physical therapist feels as though a member of her own family passed away, and Mom's other physical therapists remember her will and her willingness.
I want all of you to know that there was a very special lady who believed in our profession and in you; a woman who would want us all to move forward with pride, joy, and dedication. She loved learning and science. She had an insatiable appetite for knowledge. Above all, however, my mother would want us never to lose sight of the profession's heart and soul.
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