Taking Stock

The following is the most recent in a succession of my articles published by CommonDreams.org . While the subject of this essay concerns contemporary life in America, I think you can see that my views have been shaped, at least in part, by my life and adventures here in Vietnam.

Published on Monday, July 14, 2008 by CommonDreams.org
Taking Stock
by Virginia Lockett

In America these days, conventional ideas of wealth and security are being turned upon their heads. Large, luxurious cars that once carried us in air-conditioned splendor over well-maintained roads become less seductive with each refueling at today’s elevated prices. Roads and infrastructure crumble before our eyes, as our “common wealth” is siphoned off to pay for weapons and wars and tax breaks for the uber-class. Savings dwindle as stocks and bonds and even the US dollar lose value every day. Family homes have lost so much value that, strictly from an accounting point of view, many Americans would be better off walking away from them, rather than continuing to pour money into monthly mortgage payments. And how rational does the prospect of incurring tens of thousands of dollars of debt to cover the cost of a university education for our progeny or ourselves appear when tens of thousands of Americans are losing their jobs every month?

The American way of life — once described by Vice President Dick Cheney as “non-negotiable” — isn’t working for us anymore. Nor, for the vast majority of us, is it likely to work within the foreseeable future.

So, what’s to be done? Should we, as a nation, invade other sovereign nations in an attempt to control their petroleum assets? That hasn’t worked out well thus far, has it? Should we turn a blind eye to the hungry of the world and press the world’s corn and sugar and soybean fields into service to produce biofuels so that we can continue to motor about in our SUVs? Shall we continue to uphold zoning regulations that prevent laundry lines, vegetable gardens, and small businesses from invading our suburban landscapes? Should we continue burn vast quantities of fossil fuels in order to heat our out-sized homes so that we can step into a 72F body of air whenever we throw back our bedcovers in the morning or return after hours or days spent away from home? How long will we continue to send the kids to day care and pay for the fuel and upkeep on two cars so that Mom and Dad can go to work at jobs that barely pay enough to cover expenses?

What is the “cost of living” anyway? What do we actually need to stay alive? Well, we certainly need a fairly regular supply of fuel for our own bodies-carbohydrates enough to keep our brain and muscle cells operational and some additional nutrients to take care of growth and maintenance and repairs. As we are relatively hairless warm-blooded creatures, we need a little extra help, in the form of clothing and/or shelter, to maintain our optimal body temperature-the 98.6F at which the chemical reactions of life processes occur most readily. And it goes without saying that we need breathable air and drinkable water.

Everything else is gravy.

It’s quite a challenge for any one individual — anywhere in the world — to survive alone. It’s even more difficult to survive unassisted while caring for young children. And that is the basic purpose of community: to help people to survive — by sharing labor, knowledge, skills and resources.

We are awakening now from our long American Dream. The petroleum-fueled, mass-produced lifestyle that Americans have enjoyed for as long as most of us can remember is unlikely to re-manifest itself in the foreseeable future. We need to open our eyes to what survival really requires — and how necessary community is to that survival. In this new America, the neighbor who raises tomato seedlings and can teach us how to grow them in our particular micro-climate may be more relevant to our lives than the Wal-Mart Super Center twelve miles outside of town. The friend who can help us drain down the water pipes in our unheated upstairs bathroom each winter will be infinitely more valuable than a homeowners insurance policy from State Farm. A local farmer with a functional pickup truck, wagon or a hand-cart who is willing to haul produce to an isolated suburban enclave — and those who know how to turn that raw produce into something tasty and nutritious and are willing to share those skills with others — will be central to communities of the future.

Survival will depend, not only upon careful stewardship of our material resources, but also upon cultivation of local sources of knowledge and skill. Most importantly, it will require the nurturing of communities in which we care for one another, in every sense of the word.

Virginia Lockett spent the first 53 years of her life in America. She lives now in Da Nang, Vietnam, where she is happy to eat, sleep, shop, work, and play within the radius defined by the range of her electric motorbike. More about Virginia’s life and work can be gleaned from her blog at www.steadyfootsteps.org


The Ethics of Compassion

This article appeared in the most recent issue of Dispatches,The Newsletter of the International Health Division, Canadian Physiotherapy Association.

The Ethics of Compassion
By Virginia Lockett, PT
President, Steady Footsteps, Inc.

compassion n. Deep awareness of the suffering of another coupled with the wish to relieve it.

I embarked on my career as an American physical therapist over thirty years ago, imbued with a vague sort of idealism and a notion that the field of physical therapy would allow me to use my body, as well as my voice, to teach the most motivated students in the world—people who wanted to regain control over their own bodies.

As a young therapist, youth and inexperience limited my appreciation for the suffering of others. The distress of my patients was, to some degree, an abstraction to me. I could not fully appreciate the distinction between the experience of acute pain, for example, and the dark terror accompanying chronic pain associated with irresolvable physical deterioration and the impending dependence that that might imply. I could not, until I had children of my own, read the anguish in the eyes of the parents of teen-aged accident victims. And I could not fully share in the ambivalent feelings of middle-aged children of frail, aged parents until I had walked a mile in their shoes.

The accrual of life experiences helped me empathize with my patients and their families as I grew older. But something else happened along the way: I became a “professional.” Precise documentation, efficient time management, technical expertise and emotional detachment were considered the hallmarks of a good therapist in the facilities where I worked. Only within the framework of my last American job, where I treated patients in their own homes, and was paid on a per-visit basis, did I feel free to spend extra time and, occasionally, a bit of my own money, to help my patients beyond the role defined by my profession. In essence, it was the first job where I felt I could—on a fairly regular basis—fully exercise my compassion without being viewed as behaving “unprofessionally.”

In 2006, I moved to Da Nang, Vietnam, and established my own NGO, Steady Footsteps, Inc., in order to further exercise that compassion. According to the terms under which my organization is partnered with the Da Nang Rehabilitation-Sanatorium Hospital, if I identify a need—patients lacking walkers or canes or appropriate footwear, for example—it is understood that I, in my capacity as the director of Steady Footsteps, may address that need. I’m not stepping outside my professional mandate—this is part of my role as a humanitarian.

As my schedule is my own, and I do not charge for my services, I can take all the time I wish to address the concerns of a particular patient and family. Because I cannot speak Vietnamese—let alone write it—there is no expectation that I will spend my time producing volumes of documentation, as I did on my American jobs. A side benefit of not sharing a common language with my patients is that every encounter is slowed down by the translation process. And when things slow down, you can see a lot more. It’s much easier to read facial expressions and body language when you’re not constantly engaged in talking, measuring and taking notes. And that’s where compassion has its roots--in our innate ability to read facial expressions and gestures. I read the patients, and they read me. Ironically, because I strive to establish eye contact, use visual demonstrations, and focus on functional activities, I can often elicit better responses from the brain-damaged patients at our rehabilitation facility than can the Vietnamese therapists who tend to rely on verbal instruction and cardinal plane range-of-motion exercises, as the patient lies supine and stares at the ceiling.

Many of the patients at our hospital are the same age as our young therapists. Two months ago, they were riding motorbikes to work and to the market, just as these therapists do. They might have passed each other on the street or sat sipping coffee in the same cafĂ©. A simple motorbike mishap was all it took to set their lives upon a radically different trajectory. It would seem that compassion—if not for the patients, who might now be drooling and inarticulate, then at least for the desperate and ever-present family members who care for their loved ones at the hospital--would be a young therapist’s inevitable response.

But it’s not.

Even in a place where physical therapy skills are rudimentary and where therapists enjoy no particularly elevated status, there’s often a remarkably wide gulf between these white-uniformed professionals and the patients and family members who turn to them for help.

It’s worth considering, I think, as we contemplate the education of young physiotherapists, just what aspects of our profession we want to model and encourage. Did you become a therapist merely in order to demonstrate technical virtuosity and professional detachment? I did not. We may assume that the fact that we are engaged in the “healing arts” is evidence that we are compassionate people. But I invite you to examine once again that definition of compassion at the start of this essay:

compassion n. Deep awareness of the suffering of another coupled with the wish to relieve it.
How can we develop “deep awareness of the suffering of another” without being fully present for that human being? Our years of education and experience should certainly inform our assessment and management of the patient’s condition, but they in no way substitute for that “deep awareness” which comes only from paying attention to the patient and his loved ones. “Pathways” and treatment protocols may have their place, but they are no substitute for the compassionate eye and caring touch of an experienced therapist. Let’s make sure that compassion lies at the heart of the legacy we pass on to the next generation of therapists.