I’m preparing for a keynote lecture at the APA Conference in Sydney in a couple of weeks time, looking at aged care as a ‘bellwether’ of the physiotherapy profession at large. (Spoiler alert if you’re going) I’m going to argue that if we can work out how to provide meaningful physiotherapy to older adults, we’ll fix a lot of the problems now besetting the rest of the profession (abstract here).
Part of the joy of this kind of work is the opportunity it gives you to think ‘otherwise’ about seemingly obvious, taken-for-granted things, like ageing as a natural biological process, or our inalienable role as the leaders of rehabilitation for the elderly and disabled. Testing why we think these things, and what these ideas make possible and deny is, for me, the cornerstone of critical thinking.
A big part of the work is in the background reading, and sometimes searching for ways to think differently takes you in some unexpected directions.
I came across this quote from one of my favourite philosophers – Paul Virilio. It’s a bit obscure on first reading, but read more deeply, and you may start to see that this can apply to the history of physiotherapy, and some of the reasons why we are what we are:
‘Every technology produces, provokes, programmes a specific accident … The invention of the boat was the invention of shipwrecks. The invention of the steam engine and the locomotive was the invention of derailments. The invention of the highway was the invention of three hundred cars colliding in five minutes. The invention of the airplane was the invention of the plane crash. I believe that from now on, if we wish to continue with technology (and I don’t think there will be a Neolithic regression), we must think about both the substance and the accident’ (Virilio 1983, 32).
What I see in this is that every positive act of creation – like forming a physiotherapy profession – automatically also scripts the ‘accidents’ or downstream effects that follow. These are often unseen or unthought, but are no less real. You might say the invention of total war (WWI) produced the need for rehabilitation, and rehabilitation programmed a kind of therapy that physiotherapy responded to. Would physiotherapy have developed that way if there had been no war?
The creation of disability as a problem to be overcome; the public health crises that ‘programmed’ the welfare state into existence; the present-day ‘crisis’ of an impending ‘grey tsunami’, are themselves accidents which necessitate responses that sometimes result in things like physiotherapy.
We fantasise, sometimes, that physiotherapy is an autonomous profession, ‘born’ from the actions of a far-sighted pioneers, and that the profession established its direction as if it had been written fresh onto blank sheet of paper. The truth, however, is probably far from that, and we must always look to the conditions that have made physiotherapy historically possible if we are to really understand where physiotherapy has come from, where it is, and where it might be going.
Virilio, P. (1983). Pure war. New York, Semiotext.
There is an historical focus to today’s post, partly because today marked the launch of the first ever International Physiotherapy History Association (IPHA). Born from a meeting at WCPT in Cape Town, the first group currently has 42 members and met online today to start thinking about the future. If you’d like to know more about the Association, or have your name added to the contact list, email me here.