"...everything figured out..."

[Barrett Dorko]

It’s been a quiet week in Cuyahoga Falls…

A few days ago someone who remains anonymous over on the Evidence In Motion (http://myphysicaltherapyspace.leveragesoftware.com/mypage.aspx) discussion list complained that “Barrett has a way of sounding like he has figured everything out…”

This haunts me, and though in all honesty I do not care what the person who said this thinks of me, I have been ruminating since about the nature of our work with patients in pain and how it mirrors the nature of our own lives. Attending to this is something I can’t help but do, and I know that the best way to order my thoughts is to sit and write. No, I don’t have “everything figured out;” but that much I know.

I spoke to my son Alex this morning. Now a senior Lieutenant with both Ranger (http://specialoperations.military.com/army-rangers/training.html) and Sapper (http://www.wood.army.mil/sapper/) tabs on his left shoulder, he waits near Ft. Lewis in Washington for further orders. He’s done a year in Iraq but anybody paying attention these days knows that another deployment is imminent. Like me, he watches the news, reads the papers and tries to divine the minds of those who make such decisions. Of course, there are events no one controls that may make these decisions for them – and for him. And me.

This morning I said to him, “It’s like waiting for the weather to change. Our ability to predict that is very small, but it’s infinitely larger than the events in this world (and I mean the whole world) that will affect your life in the next couple of years.”

Whatever else I might be occupied with these days the future location of my son in the service intrudes quite often. I’m going a lot of places myself according to my schedule but don't think about that much. I won’t be taking a weapon with me.

Though my time seeing patients is over, I remember quite clearly what it was like to wonder quite regularly about what I had just seen, what might happen next and how I might learn enough to shrink that uncertainty a bit. I never “figured everything out” and never wrote as if I thought that was the case. But science does occasionally offer us enough evidence to make certain things obvious. I focus on those because I know about them.

Perhaps the one who complained about the way he/she thought I sounded hasn’t read enough yet, especially my stuff.

I think that they should stop listening to me and start listening to others. I have a few to recommend.

[christophb]

There might be something relating to this over in the "aging gracefully" thread. In the NY times article about wisdom from Bownd's mindblog:

Boiled down to its essence, the “Berlin Paradigm” defined wisdom as “an expert knowledge system concerning the fundamental pragmatics of life.” Heavily influenced by life-span psychology, the Berlin version of wisdom
emphasized several complementary qualities: expert knowledge of both the “facts” of human nature and the “how” of dealing with decisions and dilemmas; an appreciation of one’s historical, cultural and biological
circumstances during the arc of a life span; an understanding of the “relativism” of values and priorities; and an acknowledgment, at the level of both thought and action, of uncertainty.

Perhaps the thing you have figured out is that it can't all be "certain", and that perspective and context are important in any interaction with humans. Gaining more knowledge about pain and the complexities of the human organism doesn't necessarily make us more certain, but rather it gives us a greater perspective.

At EIM people seem to want all facts and certainties without any of the understanding to respect the uncertainty.

Does that make any sense?

Chris

[nari]

I thought I'd chime in as the thread seemed to be fading.

Chris, it makes sense. Nothing is certain. In fact the greatest respect, earned after an initial round of boos and rhubarbs, should be for the scientific mind who is perfectly happy with being uncertain, and keen for announced certainties to be proved erroneous, in order to keep on learning.

That's my feeling, anyway.

Nari

[Line M]

Nothing is certain. The only thing you know learning things is that the more you know the more you realise you do not know. All our knowledge is based on certain assumptions and models, very complex matters and we haven't figured out all influencing factors yet. In decision making in my opinion decisions are often being made depending on last minute emotions and a coin can at the last minute flip over into another direction. Based on critical mass. The only way to approach things is with an open mind and without tunnel view.

[Randy Dixon]

Well Barrett,

I know you don't know everything, even everything about PT, and I know you know that you don't know everything, but I think you do sometimes SOUND (or read) like you think you know everything.

This forum often gives the impression of "We are so much smarter and cleverer than you..". My personal advice is there should be a lot, and I mean a whole lot, less concern about how wrong everyone else is. We've been down this road before though and nothing ever came of it so I won't belabor it. Okay, I have to belabor it a little bit. This site, and your contribution to it, should engender so much good will and understanding of the positions held here. You have been as unselfish and as open as any educator, particularly one who makes a living because they can charge for what they teach, as I have seen. Yet too often what I see as a result is anger, resentment and a closing of minds. Like Jason, I think the EIM members and you should be natural allies, even though you hold some opposing ideas. Instead you attempt to marginalize and discredit each other. It is a waste.

About your son, I'm not sure what words are appropriate. Congratulations? Great Job? Thank you? Well, you get the drift.

[Barrett Dorko]

Randy,

You miss the mark. There are things done in therapy today that are worthless and often counterproductive and this is demonstrated in a number of ways. What people do and think and then charge for should be challenged and called "wrong" when appropriate. This isn't anger or resentment - it's the way science progresses.

People aren't marginalized here but their ideas are. I am concerned when I see something proposed that I know not to be the case and I will continue to express that concern. It is then the responsibility of the one proposing the idea to defend it. Without that we will remain as we are - a profession that often has no clue. This cluelessness comes from ignorance and nothing less. When that ignorance becomes willfull I always wonder about its origins. Today I can only surmise that they are fear and inertia. (My mother would have called that second one laziness)

It is precisely because these are revealed on this site that so many visit only once or twice. They know the information they crave is here, but what they haven't done begins to haunt them as they read.

Ironic, huh?