New: Greatness

Edgar Cahn was Robert F. Kennedy’s speech writer and senior counsel.  He is now a professor of law at the University of the District of Columbia.  But he is known throughout the world for inventing time banking (see these links 1, 2, 3).

The idea of time banking is that people who are dependent on others but are unable to pay them back with money, offer whatever skills and services they have to offer as repayment.

In many parts of the world, people have long bartered for goods and services with whatever they had to trade, and time banking works along similar lines.

The key thing about time banking is that it values all time equally, so an hour of physical therapy is the same as an hour of gardening, or dog walking, or brain surgery.

It’s egalitarian principles are fundamentally about valuing everyones contribution and, as a result, it’s a great tool for capacity building.  (It’s also a powerful way to empower people whose work has traditionally been less valued).

Many of our patients can’t afford expensive treatments, others are quite dependent on peoples’ help and support to fulfil even some of their most basic needs.  Our current system sees these people as a burden on society and asks practitioners like physiotherapists to motivate and mobilise them back to ‘normal.’  Those who can afford the cost of long term care are encouraged to pay it themselves, creating a two-tier health system between those who have and those who have not.  And no-one, it seems, knows what to do with the coming demographic time-bomb of increasingly dependence and decreasing health care funding.

So time banking offers some radical ways for people like health professionals to continue to work with their communities, after central government funding has dried up.

The thing that I love most about Edgar Cahn’s ideas, though, is his assertion that greatness comes not from the measure of a person’s productivity, but from the quality of their giving.  Gandhi, he says, was a lawyer, but no-one measures his achievements by the number of cases he won.  Mother Teresa was a nurse, but no-one measures her work by the number of patient contact episodes she achieved in the month of March.  Cahn argues that we should not care for the trivialities of objective measures of performance, but focus instead on the greatness of simple human acts of kindness.

Perhaps time banking offers a practical solution to the problem of how to bring high quality physiotherapy to people who cannot otherwise afford it?  It might also offer some insights into ways that future generations of practitioners can rediscover the modest pleasures of giving and receiving without elitism and privilege.