There is a mysterious cycle in human events. To some generations much is given. Of other generations much is expected. This generation…has a rendezvous with destiny.
— Franklin D. Roosevelt
It is early morning as I stare out my window. In the stillness, I notice the deep rose-colored blooms from the redbud tree draping over my porch, the first burst of growth that heralds spring’s arrival each year. Vibrant shades of green make up the forest canopy, songbirds fill the air with their music. Spring persists. Despite the chaos both within and outside of myself, spring persists. There is comfort in this paradox, this odd juxtaposition of beauty and fear. Whatever happens, the days are always 24 hours long, the seasons always come and go.
Isn’t it fascinating that, in the midst of this awakening spring, it is not a sprawling military force or a charismatic authoritarian leader that is reaching a level of infamy long craved by men and nations, but something too small to be seen with the naked eye? This force that is wreaking such profound havoc, crippling global economies, and penetrating human lives in such a ubiquitous manner is an invisible one.
When our lives are brought to a collective standstill because of an invisible enemy, how do we respond? At the beginning of this tumultuous period, my dear colleague Sarah Caston asked this question of me, which I use to start all my conversations as of late: “What is saving you now?” Simple, yet straightforward and demanding of more authenticity than the customary “How are you doing?”
What is saving you now? The answers I’ve received in these past weeks of isolation reveal a certain level of intimacy and draw me gently into the lives of my friends, family, colleagues, and students in ways perhaps we were too busy to share before. The spectrum of responses is broad and not unexpected: long, contemplative walks, being in nature, gardening, cooking meals from childhood, red wine, my wife’s smile, meditation, unhurried time with family, daily reflective journaling. For me, it is the realization that there is no more important time than right now. In the midst of this historic pandemic, there is no more important time in our profession, in our lives, in our world—to embrace the humanities.
The humanities provide tools to navigate uncertainty, tolerate ambiguity, and broaden moral imagination. The very nature of science and medicine conditions us to seek definitive answers in our fields, yet the art of caring lies in the ability to sit comfortably with not knowing facts—but knowing people. We learn the action that is inherent in stillness and the healing powers of simply being present with one another. When all the statistics of rising infection rates, estimated hospital overload dates, and ominous economic forecasts are set aside, what remains is the resiliency of the human spirit. Art, literature and poetry serve to buoy our sagging moods, connect us across space and time with the deeper questions of meaning and purpose, beauty and truth, grace and forgiveness. As the poet Wendell Berry begins his poem:
When despair for the world grows in me
And I wake in the night at the least sound
In fear of what my life and my children’s lives may be…
He takes us into the presence of still water, wood drakes and herons. And we join him as he comes
…into the peace of wild things…
The image that illustrates this editorial, Pajamas, San Marco, Venice, Italy, 2017, is by New York City-based photographer Gail Albert Halaban, as part of her “Out My Window” project. Created (pre-COVID-19) to explore what we see as we gaze out our window to our neighbors, it is exceptionally timely, during this time of quarantine, to capture our feelings of social isolation. I am drawn to the imagery, echoing similar feelings as I peek into colleagues’ windows through Zoom meetings.
The window is both a boundary and a gateway, connecting viewer and viewed. Significantly, I work not from the street or the air but from the window across the way: when you look at my pictures, you stand in the neighbor’s shoes. Connecting those neighbors, strengthening that local community lies at the heart of all of my work. Deeply seated in the artistic layers, beneath the play of light and form, lies human connectivity.
—Gail Albert Halaban, Artist Statement
Through visual art, we find that connection of shared experiences, and perhaps we see each other a little more clearly, more compassionately.
As with poetry and art, I find respite in striving to understand current events in the context of history. Learning about the 1918 flu pandemic, I confront COVID-19 with more confidence, knowing others endured similar hardships. Learning about the Great Depression through the lens of the photographer Dorothea Lange, I develop insights into the personal toll of confronting radical economic uncertainty, and see that “to be good, photographs have to be full of the world.” When we struggle with illness, grief and suffering, we can find solace in the lessons of history and the wisdom of previous generations who endured world wars, economic depressions, and plagues. We can find inspiration in the eloquent words of visionary leaders like Franklin D. Roosevelt.
It is this current global generation that indeed has a rendezvous with destiny. As David Brooks states in his book, The Road to Character, “We have a chance to take advantage of everyday occasions to build virtue in ourselves and be of service to the world.” On those days when I struggle, it is that notion of being a part of something bigger than myself that gets me out of bed. And I understand more fully what Viktor Frankl meant in his reflections on his time in a Nazi concentration camp:
“Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.
—Frankl, Man’s Search for Meaning
As with history, the fields of philosophy and ethics provide valuable direction when we must overcome our fears and face the danger of providing care in the midst of such a fierce virus. Knowledge of biomedical ethics becomes just as critical as diagnostic skills, as clinicians confront the stark intersections of their Hippocratic oath pledge and their own personal safety. Scarce medical resources plunge us into making profoundly difficult decisions surrounding the rationing of care. Our work is dedicated to the care of those with disabilities, yet debates rage around the ableism rampant in our healthcare system that would restrict critical care or ventilator support for those with complex medical needs.
Yet, despite the uncertainty of this strange time, the undercurrents of fear and anxiety, I am struck by the abundance of compassion and kindness I see everywhere around me.
What is saving me now? Hope that can be mined through the skillful tools of the liberal arts. The immense opportunity that is presented before us to grow individually and collectively. The calls not just for moral courage, but moral action in the delivery of care, health policy and allocation of resources. The opportunity to redefine professionalism beyond simplistic examples of dress code and attendance, to deeper concepts of meaning and values that are called upon during periods of moral distress and injury. The demands of this time require, as stated in Step 4 of the Alcoholics Anonymous recovery system, “a searching and fearless moral inventory of ourselves”—and of our profession.
Skills cultivated through disciplines of critical theory provide guides to formulate these probing questions. Perhaps it is uniquely through a pandemic that we can be pressed to look past the individualization of healthcare delivery to our societal responsibilities as rehabilitationists. There is always a very real concern for meeting the educational requirements of clinical experience and lab-based skills essential in rehabilitation science for our students. Yet, I truly believe this cohort of clinicians, experiencing this pandemic, will emerge with exceptional levels of resiliency, compassion, cognitive flexibility, and critical thinking skills as well. Our world will be remarkable in ways we have yet to imagine.
The humanities offer us insight into what that new world may be, and provide a compass to lead us through this dark night, confident that dawn will come and spring persist.
So, what is saving you now?
Our Spring 2020 issue of JHR offers us opportunities to sit in that space of humanities for critical reflection and exploration. The articles and essays include:
Profiles in Professionalism With Carol M. Davis
By Melissa McCune, SPT
Dr. Davis, PT, DPT, EdD, MS, FAPTA, is Professor Emerita in the Department of Physical Therapy at the University of Miami Miller School of Medicine, and the author/editor of numerous manuscripts and books. Dr. Davis relates her process of becoming a physical therapist, noting that the road to professionalism involves a willingness to “mature into oneself.” Describing her experiences working with students entering the field of physical therapy, she illustrates why studying the humanities helps students move beyond viewing their work merely as an occupation. Her reflections steer us toward a deeper understanding of what it means to be part of an extraordinary profession.
Dynamic Autonomy in Chronic-Pain Management: Frida Kahlo Illustrates
By Debra Gorman-Badar, PT, MA
As today’s healthcare professionals struggle to address the challenges of chronic-pain management, Debra Gorman-Badar argues that current multidisciplinary programs are missing a crucial component: an updated conception of patient autonomy. She details how expressive therapies help patients integrate their chronic-pain experiences into their lives and promote healing self-knowledge—as Frida Kahlo did through her remarkable paintings.
My Journey Using Art as Physical Therapy
By Babs McDonald, PhD
Babs McDonald describes her journey toward recovery from an ischemic stroke through painting and sketching. Presenting numerous examples of her artwork, she details her experiences pushing through impairment to create images chronicling her life. Based on her success, she advocates for the use of fine-art techniques to foster upper-limb movement in stroke survivors. Creating her art, she says, has taught her that “there are no failures in my recovery, only new challenges.”
How Art Embodies Story: An Exploration of Basquiat Through a Physically Integrated Dance Performance
By Melissa McCune, SPT
Melissa McCune reports on a recent dance project of Full Radius Dance—a company that integrates disabled and non-disabled dancers—which interpreted the works of artist Jean-Michel Basquiat. As a child, Basquiat experienced a debilitating injury that greatly influenced his art. Encountering groundbreaking works such as these, McCune explains, can help clinicians look beyond basic anatomy to see the “layered nature” of pain and disability.
What’s at Stake With Biomusic? Ethical Reflections on an Emerging Technology
By M. Ariel Cascio, PhD, and colleagues
Biomusic, an emerging technology that translates physiological signals into sound/musical output, may offer utility as an assistive technology for people with autism. The authors explore a variety of perspectives in the humanities and social sciences to reflect on the ethical issues at stake with the use of biomusic in rehabilitation.
Perspectives On ‘Person-Centeredness’ From Neurological Rehabilitation and Critical Theory: Toward a Critical Constellation
By Jenni Aittokallio, PT, MH, and Anna Ilona Rajala, PT, MA
Jenni Aittokallio, PT, MH, and Anna Ilona Rajala, PT, MA explore in-depth the concept of person-centeredness in healthcare and rehabilitation. As a part of their research, the authors interviewed recipients of neurological rehabilitation to determine what in their treatment had been truly meaningful for them. The authors suggest that person-centeredness is best viewed as encompassing a complex constellation of factors and issues surrounding each unique patient.
The Americans with Disabilities Act (ADA): Honoring 30 Years of Civil Rights Protections
By Jamie Fleshman, SPT
In a timely and important editorial, Jamie Fleshman, SPT, calls for new amendments to the Americans with Disabilities Act. She identifies a critical contributor to American disability: the continued inaccessibility of public spaces. Attention must be drawn, she argues, to an American infrastructure that has been constructed for “a certain set of abilities,” and is profoundly outdated.
Winner of the CHEP-JHR Essay Contest
Congratulations to Northwestern University Doctor of Physical Therapy Program graduate student Bethany Shieh, SPT, the winner of the annual physical therapy student essay contest co-sponsored by the ACAPT Consortium for the Humanities, Ethics, and Professionalism (CHEP) and JHR! In her essay, “Have ‘No’ Fear,” Ms. Shieh illustrates how we can create space to understand the pain, suffering, and frustration that accompany and influence patient care if we are willing to enter and dwell for a moment in our patient’s life experience. Essays from the two additional finalists, Grace White and Amanda Kaufman, will be published in the Fall 2020 issue of JHR.
Finally, I am honored to announce a new addition to the JHR Editorial Staff, Sarah Caston, Assistant Professor, Emory University Division of Physical Therapy. Dr. Caston will serve as Associate Editor, helping us with our Narrative Section. With an extensive interest in bioethics and deep passion for the intersectionality of humanities and rehabilitation science, she brings a valuable wisdom to our mission.
Thank you for joining us. We hope you find hope and inspiration in the Spring 2020 issue of JHR.
If you are interested in submitting your work to JHR, please review our Submission Guidelines. If you are considering being a reviewer, please contact Dr. Sarah Blanton: follow the Contact link, indicate the content area you are interested in reviewing, and attach your CV.