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“Change never happens at the pace we think it should. It happens over years of people joining together, strategizing, sharing, and pulling all the levers they possibly can. Gradually, excruciatingly slowly, things start to happen, and then suddenly, seemingly out of the blue, something will tip.” –– Judith Heumann1
Now more than ever, the illusory societal lines differentiating spaces for the sociopolitical, philosophical, ethical, professional, educational, and humanistic are dissolving. This change is affording us opportunities for reimagining cultural identity and value systems within society.
The permeability between and among these spheres of thought and influence can also introduce threats to those same cherished values and identities. In these times, it is the simultaneous recognition of opportunities for growth as well as the need to protect our core values of benevolence, equity, inclusion, and justice that will serve us best—as fellow humans, community members, and global citizens.
Nuanced Critical Thinking
Healthcare practitioners and educators have a particularly consequential fiduciary responsibility to the public to serve, commit to excellence, and advance our skills and knowledge. As the profession evolves to keep pace with dynamic societal landscapes, practitioners would do well to engage in more nuanced critical thinking.
It is time to adopt a philosophical approach to healthcare in addition to the critical reasoning already emphasized in health professions. This type of critical reflection, explained by physical therapist and bioethicist Barbara Gibson, encourages individuals to “commit to questioning the taken-for-granted.”2
This approach is particularly relevant to this special issue of the Journal of Humanities in Rehabilitation, which centers the voices and lived experiences of student, educator, and clinician advocates for Disability inclusion within Physical Therapy.
Hard Truths Revealed
At first glance, this may seem like a non-essential or possibly redundant topic to highlight within a caring profession. Don’t rehabilitation professionals demonstrate inherent inclusion of people with disabilities given the nature of their work? Healthcare practitioners, often altruistic by nature, would unlikely be complicit in perpetuating inequity and lack of access for the disabled community. Correct?
Through the powerful experience of speaking at and attending the American Council of Academic Physical Therapy (ACAPT) Inclusive Horizons Summit, it became clear to me that these oft taken-for-granted notions do not reflect the current realities faced by patients with disabilities—as well as practitioners, educators, and healthcare students living with a disability. The summit revealed hard truths—and suggested paths forward for rehabilitation professionals to better promote disability inclusion and equitable access.
Leaders Forging Change
Choosing a path forward requires moral courage. Thankfully, we have many voices within the Disability community—as highlighted in the compelling student narratives and the Disability resource section within this issue—to guide us. There are scholars such as Dr. Gibson—and Dr. Lisa Meeks, and Dr. Amanda Sharp, showcased herein—who continue to lead in these spaces, and invite others to join them in this important work.
Because of the perseverance and diligent work of advocates, positive change is happening. Despite unanticipated turns and disorienting switchbacks along the journey, (which has been the case throughout history) the path toward access, inclusion, and justice continues in a benevolent direction. The foundational elements of critical inquiry will serve as guideposts for practitioners endeavoring to become anti-ableist in their practice and individual lives.
A Three-Step Plan
Actualizing Dr. Gibson’s framework in the context of Disability inclusion may involve three key steps:
- Questioning the taken-for-granted. Approaching with curiosity the notion that being in a healthcare field inherently leads to Disability inclusivity and justice.
- Attending to power dynamics. Recognizing the power inequities often present in practitioner-patient and/or non-disabled-disabled relational dynamics, and actively seeking strategies to empower and collaborate vs. instruct and dictate.
- Critiquing the dominance of positivism. Challenging the notion that all scientific realities and lived experiences (including those of Disabled individuals) can or ought to be measured in objective and neutral ways, decontextualized from time and place, and detached from the realm of emotions, subjectivity, and sociopolitical influence. Upending this narrow notion invites one into a space of humble reflection and encourages a broader way of viewing the world.
There are many entry points to this path toward greater Disability inclusion within healthcare professions. We hope that this special issue of JHR invites our readers into such contemplative spaces—encouraging a sense of curiosity, of vulnerability with oneself and others—and inspires the moral courage needed to continue the vital and necessary work of caring for each other.
About the Author(s)
Sarah Caston, PT, DPT
Sarah Caston, PT, DPT is an assistant professor in Emory University’s Division of Physical Therapy, and a member of ACAPT’s Consortium for Humanities, Ethics, and Professionalism. She is a board certified neurologic clinical specialist in physical therapy. Dr. Caston incorporates humanities and narrative reflections into her areas of teaching. Dr. Caston demonstrates her passion for DPT student growth and well-being through co-directing Emory DPT’s Learning Community Program, and directing research on methods to improve student well-being. Dr. Caston’s additional scholarly interests include the intersection of the lived experience of individuals with disability with rehabilitation education and practice, ethics in rehabilitation, and DPT student well- being. She is passionate about promoting humanities practices and student self- reflection around the lived experiences of individuals in marginalized populations, social justice, and rehabilitation ethics.
This work is licensed under a Creative Commons Attribution 4.0 International License.
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Twenty-five years ago, the Supreme Court’s ruling in Olmstead v. L.C.1 was seen as a victory for disability rights. Led by Georgia disabled advocates Lois Curtis and Elaine Wilson, the decision affirmed that disabled people belong in their communities, not in institutions. It was a powerful declaration: institutionalizing disabled people is discrimination. Olmstead was supposed to guarantee that no one would be forced into an institution simply because they needed care. The decision was meant to offer real autonomy, giving disabled people the chance to live at home, build relationships, and participate fully in society. But outrageously, both Lois and Elaine died without that promise being realized, and today, a quarter-century after the ruling, that promise still remains unfulfilled.
Today, nearly 700,000 people are waiting for Medicaid home- and community-based services (HCBS) waivers across the United States. These waivers allow disabled people to receive care in their own homes or communities rather than being forced into institutions or nursing homes. Some have been waiting for 10, 15, even 20 years. And without a waiver? Many are left with no choice but to enter a nursing home or survive without care.
In the American South alone, where my organization, New Disabled South, focuses its work, nearly 75% of those 700,000 people are on waitlists. States with billion-dollar surpluses like Georgia, South Carolina, and Texas have the funds to clear these lists. However, year after year, lawmakers fail to act, leaving disabled people trapped in a system of institutional bias—the assumption that people have a right to receive care only in an institution, not in their own homes.
I know what it’s like to need these services. I’m one of a set of triplets with cerebral palsy, and my parents relied on HCBS to get us the care we needed to stay at home rather than in an institution. Without that support, we could have been separated from our community and each other. But even with the waiver, my parents, like so many caregivers, faced enormous challenges—juggling work, caregiving, and simply trying to make ends meet.
Families waiting for HCBS waivers today are often forced into impossible situations. Many parents have no choice but to leave their jobs to care for their children, pushing them deeper into poverty. Caregiving shouldn’t mean sacrificing everything else.
The situation is worsened by a care worker shortage fueled by poverty wages, as low as minimum wage. Many care workers, including those who are themselves disabled, can’t afford to stay in these jobs, leaving families without the services they’ve waited years to receive. We can’t rely on the small, incremental changes that have been the standard operating procedure in our states for years. State governments must commit to fully funding HCBS and paying care workers a livable wage to meet the growing demand.
As we reflect on 25 years since Olmstead, we need to confront the truth: the promise of this ruling remains unfulfilled. Disabled people deserve better than institutional bias and endless waitlists. We need lawmakers to prioritize funding HCBS and to ensure care workers earn the wages they deserve. No more excuses. No more inaction. The time for radical change is now. Every disabled person deserves the chance to live and thrive in their own home and community, with the support they need and the freedom to make their own choices. We owe it to the legacies of Lois and Elaine, and to the millions of disabled people waiting for care today, to fight for that future.
As readers of the Journal of Humanities in Rehabilitation, your voices are powerful. Together, we can advocate for the fulfillment of Olmstead’s promise. Join us in demanding change—engage with local policymakers, spread awareness, and support initiatives that prioritize community-based care for all disabled individuals. The time for action is now; let’s work together to make autonomy and freedom a reality.
To learn more about the work of the New Disabled South and for more resources for disability advocacy, please visit their website, including their project Plain Language Policy Dashboard, which breaks down complex legislation into plain language to improve accessibility.
References
- U.S. Department of Justice. (n.d.). Olmstead v. L.C. Available at: https://archive.ada.gov/olmstead/olmstead_about.htm. Accessed October 29, 2024.
About the Author(s)
Dom Kelly
Dom Kelly is the Co-Founder, President & CEO of New Disabled South, a 501(c)(3) nonprofit organization, and New Disabled South Rising, its 501(c)(4) arm. He has been organizing in the South since 2009, committed to building a progressive future for disabled people in his region. His previous roles as a senior advisor and founding staff of Stacey Abrams’ gubernatorial campaign, and as a lead fundraiser and advisor for her voting rights organization Fair Fight Action, both led him to make his vision for New Disabled South a reality.
Dom is one of a set of triplets born with Cerebral Palsy and has been a disability advocate since he was four years old. Starting when he was a young teenager, Dom and his brothers played around the world with their rock band A Fragile Tomorrow, touring and collaborating with artists like Indigo Girls, Joan Baez, Toad the Wet Sprocket, The Bangles and more and releasing 6 records over 15+ years.
He received a Master of Science in Nonprofit Leadership degree from the University of Pennsylvania’s School of Social Policy and Practice where he also received the Excellence in Social Impact award. Additionally, he holds a bachelor’s degree in music production, a master’s degree in journalism, an executive certificate in social impact strategy, and a graduate certificate in interdisciplinary disability studies. Dom is a part of the 2025 global cohort of Atlantic Fellows for Health Equity, was chosen as a 2024 Rockwood National Leading From the Inside Out Yearlong Fellow, and was one of ten winners of The J.M. Kaplan Fund’s 2023 Innovation Prize. He was a 2021 New Leaders Council fellow and currently serves as Chair for the board of The Kelsey. Dom lives in Atlanta, Georgia with his wife Catie, their daughter Mahalia, and their dog Vivi.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Milestones and Momentum: JHR’s Decade of Humanistic Progress and the Crossroads Ahead
Dear Reader,
A decade ago, I contributed this editorial to an early edition of the Journal of Humanities in Rehabilitation (JHR), the first peer-reviewed, online interdisciplinary publication focused on defining the intersection of humanities and rehabilitation in healthcare. While I leapt at the chance, since the journal spoke to issues close to my heart, I never imagined the high degree of success this publication would realize through the leadership of founding editor Dr. Sarah Blanton.
Dr. Blanton’s vision to include leadership voices from the disability community in its published articles immediately enriched the journal’s depth and scope. It generated high-quality contributions from scholars in healthcare and the humanities alongside those in the disability community, social sciences, and applied arts.
Success on all these fronts has been every bit welcome, but it has created an ongoing challenge: to continue JHR’s mission and expand its impact worldwide, its growth requires a corresponding adjustment in resource allocation. The quality and quantity of submissions continue to grow, which in turn makes it necessary to increase staff numbers. And to continue to expand JHR’s burgeoning readership in the humanities, healthcare sector, disability scholarship, and social sciences also requires additional dedicated staff.
Today, still the sole journal of its kind, JHR is an increasingly cited publication valued by readers, educators, practitioners, and researchers throughout the United States and in more than 140 countries worldwide.
JHR in Academia
As part of its mission to expand the integration of health humanities into rehabilitation science education, the journal provides unique digital humanities training opportunities for interdisciplinary students. In addition to gaining skills in academic publishing, these students deliver national conference presentations, serve as graduate student ambassadors, and compete for awards honoring humanism in rehabilitation. Now in its seventh year, JHR collaborated with the American Council of Academic Physical Therapy (ACAPT) to sponsor the first national student essay contest addressing humanities in rehabilitation and healthcare.
JHR in the Disability Community
Fundamental to this work is the elevation of diverse voices. Guided by the lived experience of the disability community to inform and co-create content, the journal seeks to be a public humanities initiative. This approach has the potential to influence federal funding opportunities, support community-engaged research, and enhance more humanistic and equitable clinical care. Because JHR is a diamond-access publication that does not charge for submissions or subscriptions, this model eliminates traditional academic publication paywalls and supports inclusivity and engagement. With more than 230 articles in 19 issues, averaging 3.9k monthly readership internationally, JHR has demonstrated a lasting impact during its first decade.
A New Development Phase
The journal seeks to build on this success and transition to a development phase focused on sustainability and growth. Transitioning through this phase requires building the necessary and robust infrastructure that can sustain the initiative over time, increase confidence among stakeholders, and maximize impact.
Why Is This Phase Important Now?
Given the increased reliance on technology and business models in healthcare that prioritize efficiency and profitability over patient-centered care, a health humanities lens is increasingly essential to preserve humanistic care. This depersonalization not only negatively impacts patient outcomes but is also a primary driver of clinician burnout and moral injury. Maintaining a publication that leverages health humanities scholarship to promote principles of humanistic care, critical interrogation of the healthcare environment, and disability justice advocacy is more important than ever.
With a focus on development and growth, the journal can support the expansion of the editorial board to include members of the disability community as paid staff to help shape the vision of JHR; support a co-editor model that brings together the needed expertise of a health humanities scholar with a rehabilitation science editor; and broaden and formalize collaborations with other health science professionals, including medicine and nursing, as well as occupational and speech therapy.
What Are Our Next Steps?
To date, Emory University has generously provided initial seed-funding to develop, launch, and continuously publish JHR. Building broader community engagement and support for this work is crucial to expanding the journal’s reach and impact. Developing a sustainable business model that is committed to accessibility and inclusivity requires collaboration across the rehabilitation community to support this shared mission.
What Can JHR’s Next Steps Look Like?
- Philanthropic support from donors dedicated to humanism in rehabilitation could enable an endowed editor-in-chief position, providing protected time for both rehabilitation and humanities scholars with co-editorial roles, and enlarging student scholarship funds or the student essay contest.
- Interprofessional engagement by sharing JHR with colleagues will encourage new and expanded collaborative scholarship in the health humanities.
- ACAPT Academies publications can work with JHR as a “supplementary archive” for humanistic content that extends and enriches their existing articles with the lived experiences of the disability community, research participants, and clinicians. Investment in this publication partnership will allow JHR to be a benefit of ACAPT Academies membership, broadening their exposure and reaching new readers.
- Health science educational program partnerships with JHR can support the continued creation of content to integrate health humanities into their curricula and cultivate student development through editorial roles. Aligning with JHR creates avenues to strengthen their clinical partnerships by using the journal to foster clinical educator professional growth and scholarship skills.
- “Humanism in Business” corporate sponsorships provided by companies dedicated to a more humanistic lens can underscore the value for investing in more holistic, patient-centered care approaches.
Helping to Bring Humanities to Healthcare
I urgently invite you to join a number of donors committed to building on JHR‘s signal strengths. Your contribution today will help prevent our losing, at this critical juncture, the gains we have made in the launching and nurturing of JHR’s mission. Together, we can help build bridges to a more enlightened, humanities-based healthcare environment.
Please review my editorial attached to this note and add your own insights to the reasons for our combined commitment to realizing the value of the humanities to our collective and individual well-being. Then, if you are moved to do so, please make a donation to help ensure that the bounty of JHR benefits realized so far will continue to mount.
Ruth Purtilo, PhD
About the Author(s)
Ruth B. Purtilo, PT, PhD, FAPTA
Ruth Purtilo began her professional career as a physical therapy clinician employed in long-term rehabilitation environments. Her subsequent experience in diverse societal and cultural settings awakened a desire to help prepare health professions students for the larger clinical, social and cultural challenges they would face. One path to such a goal opened through the emerging field of medical ethics. She enrolled in Harvard University Divinity School to complete a master’s degree, then transferred to its Graduate School of Arts and Sciences to obtain a PhD. She graduated having gained a solid foundation in religious and philosophic traditions of ethics along with ample exposure to key legal, humanistic and social-sciences studies relevant to healthcare practices and policies.
Her career as a healthcare ethicist—educator, consultant, author and member of several national and international health policy initiatives—now spans over 40 years, many with a focus on rehabilitation. She is professor emerita in Interprofessional Studies at the MGH Institute of Health Professions, Boston, where she has served in several capacities and as director of its Ethics Initiative. She is also a professor emerita at Creighton University, Omaha, where she directed the multidisciplinary Center for Health Policy and Ethics.
Dr. Purtilo holds five honorary degrees for her contributions to healthcare ethics. In 1991, she received the Distinguished Alumni Award from Harvard Divinity School; in 1983, she was awarded the Nellie Westerman Prize by the American Federation for Clinical Research for her article predicting major ethical and social issues that the (then) new disease called AIDS would create. She is a Catherine Worthingham Fellow and McMillan Scholar of the American Physical Therapy Association. She has been an awardee of two National Endowment for the Humanities Senior Scholars summer institute awards. She also has received two Greenwall Foundation grants: one to study moral courage among South African health and other professionals during the apartheid years; the other for an international initiative on ethical and philosophic foundations for palliative care in Alzheimer disease.
Dr. Purtilo is the author of six books and more than 100 articles. She is the founding author of two textbooks (which reflect how over time she took on co-authors to help keep important material up-to-date, and to enrich content): Health Professional and Patient Interaction (10th ed in prep, Amy Haddad, primary author); and Ethical Dimensions in the Health Professions (8th ed in prep, Regina Doherty, primary author).
She is co-editor (with Gail Jensen and Charlotte Royeen) of Educating for Moral Action: a Sourcebook in Health and Rehabilitation Ethics, and co-editor (with Henk AMJ ten Have) of Ethical Foundations of Palliative Care for Alzheimer Disease. She served as an area editor for the Encyclopedia of Bioethics, revised ed. She is a Fellow of the Hastings Center, an internationally-recognized ethics think-tank in Garrison, New York.
This work is licensed under a Creative Commons Attribution 4.0 International License.
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In 2014, a group of educational leaders passionate about teaching health science students to move beyond the “how” and “what” of being a clinician—and explore more expansive questions regarding the nature of human suffering and healing—created the Journal of Humanities in Rehabilitation (JHR).
Embracing these complex concepts demands tools beyond those of the traditional scientific method. The field of health humanities offers alternative ways of knowing that help us grapple with what it means to be human.
JHR strives to define the intersection of humanities and rehabilitation science. Embracing a novel publishing model, it is a scholarly, peer-reviewed journal dedicated to cultivating a dialogue between rehabilitation professionals and the disability community to explore the impact of illness or disability on each unique individual.
Welcoming contributions from academic scholars as well as from patients and families, JHR investigates the deeper meanings of humanism in rehabilitation. The journal is proud to host an international group of award-winning health humanities and rehabilitation scholars serving as editorial board members, editorial associates, and editorial consultants.
JHR strives to:
Be interdisciplinary. JHR is the first publication dedicated to integrating health humanities into rehabilitation sciences and the first rehabilitation journal to collaborate with international disability scholars.
Give students rich digital humanities training. Students are integral to JHR’s publication process. Their dedicated work provides them national conference opportunities, the chance to serve as graduate student ambassadors, and the ability to compete for awards that honor contributions to humanism in rehabilitation and a nationwide student essay contest.
Elevate diverse voices. Unique in health sciences publishing, JHR invites patients and families to share their lived experiences of disability and healing. This collaborative scholarship model invites a deeper discussion about our shared questions of meaning, uncertainty, and hope, to open new levels of understanding and insight among readers.
Bridge the clinic and the academy. Contributors to JHR strongly believe that only by building these bridges can we effectively address the critical questions that face healthcare delivery today.
Provide accessibility. JHR is a diamond-access publication and does not charge for submissions or subscriptions. By removing paywalls, we support inclusivity and expand our readership community.
JHR is here for the long haul.
If you are inspired by our vision, please join us. There are many ways you can become involved in our mission to expand the humanities in rehabilitation.
Ways to Support JHR
- Create a Business Sponsorship
- Donate as an Individual
- Submit an article
- Subscribe
- Follow JHR on Facebook, X (Twitter), and Instagram
Thank you for joining us on this journey of integrating humanities into rehabilitation. Always feel free to reach out to me directly with your feedback, suggestions, or concerns. We are humbled by the opportunity to join you in this collective work of meaning-making in our shared path toward healing.
Warm regards,
Sarah Blanton, PT, DPT
Editor-in-Chief, Journal of Humanities in Rehabilitation
About the Author(s)
Sarah R. Blanton, PT, DPT, Editor-In-Chief
Dr. Sarah Blanton is a Professor of Rehabilitation Medicine at Emory University School of Medicine, Division of Physical Therapy. She graduated from the University of Virginia in 1987 with a BA degree in biology, from Emory University in 1992 with her masters in physical therapy and received her clinical doctorate in physical therapy in 2003. Dr. Blanton has had several research grants exploring the integration of caregivers into the rehabilitation process and her current research focus examines the impact of using a telehealth platform for the delivery of a theory-based, family-focused intervention program for stroke survivors and their carepartners in the home setting. Dr. Blanton’s Lab, DISCOVER (Digital Scholarship Enhancing Rehabilitation), explores various ways digital scholarship can enhance rehabilitation research, education and clinical practice and promote interdisciplinary collaboration. Dr. Blanton is a Fellow of the National Academy of Practice in Physical Therapy. In 2018, she was awarded the American Physical Therapy Association Societal Impact Award and the Emory University Creativity and Arts award for healthcare faculty.
Dr. Blanton’s interest in the Journal of Humanities in Rehabilitation stems from her ongoing exploration of the intersections of creativity and spirituality to gain insight into the human experience of suffering, joy and mystery. In her teaching, she has found the use of narrative to be an exceptionally powerful tool to foster reflection and personal insight for both students and patients. In her research, she is incorporating multi-media formats to develop family education interventions in the home environment. A photographer since childhood, she has enjoyed sharing her artwork through exhibits at Emory University, speaking with chaplaincy students on “Reflections of Art and Spirituality in Appalachia” and as a guest contributor to the Public Radio show, On Being.
See Dr. Blanton’s recent feature in the Emory Report: https://bit.ly/46mqXVp
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Photo of Mark Johnson (1995) by Billy Howard from the book Portrait of Spirit: One Story at a Time by Maggie Holtzberg and Billy Howard
Mark Johnson is a well-known advocate and leader in the movement for disability rights. As a devoted community organizer, he is committed to participating in and leading actions that demand and inspire justice for marginalized voices within the disability community. In the early 1980s, he helped found ADAPT, an activist organization group committed to organizing around issues of accessibility and justice. He was involved with the Paralympic Games in Atlanta in 1996 and was a major organizer for the Spirit of ADA Torch Relay in 2000, an event that commemorated the signing of the Americans With Disabilities Act (ADA) in 1990. He has served as the Director of Advocacy at the Shepherd Center in Atlanta and as Chair of The ADA Legacy Project, a group committed to recording, preserving, and promoting the history of the ADA.
In this interview-based article, Mark Johnson helps to commemorate, reinforce, and reflect on the groundbreaking policy decision of the Rehabilitation Act of 1973.
History of the Rehabilitation Act of 1973
The Rehabilitation Act of 1973 was the first federal civil rights law for people with disabilities in the United States. It framed the concept of civil rights for people with disabilities in terms of equal access to services, activities, and places. President Richard Nixon signed it into law on September 26, 1973. This year, September 26 will mark the law’s 50th anniversary. The law states:
“No otherwise qualified individual with a disability in the United States … shall, solely by reason of her or his disability, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program, service, or activity receiving federal financial assistance or under any program or activity conducted by any Executive agency or by the United States Postal Service.”1
The law intended to provide equal access to people with disabilities by removing barriers created by non-inclusive architecture, transportation, and employment practices in all settings that receive federal funds.
The law was only a first step, however. Without signed regulations to enforce the law, businesses and organizations ignored Section 504 of it and did not make the practical changes necessary that would provide equal access.
For four years, the disability community grew frustrated by the lack of progress. In 1977, hundreds of disabled activists across the country organized sit-ins, rallies, and protests at the regional offices of the federal Department of Health, Education, and Welfare (HEW) to draw attention to the lack of progress. Activists picketed in Atlanta, Boston, Chicago, Dallas, Denver, Philadelphia, Seattle, New York, and Washington, DC. More than 100 protestors occupied the San Francisco HEW federal building for 28 days—an event known today as the 504 Sit-In. In response to the pressure, the then US Secretary of Health, Education, and Welfare, Joseph Califano, finally enacted a list of regulations for Section 504 on April 28, 1977.2
Prior to the Rehabilitation Act of 1973: How Did Federally-Funded Programs Treat Those With Disabilities?
Before 1973, people with disabilities were not provided with the same opportunities as their counterparts. Mark Johnson recalls life before the Rehabilitation Act of 1973 as a “segregated, out of sight–out of mind, approach,” which included special schools and state institutions where people with disabilities would often get placed. These schools and state institutions were later recognized as having demoralizing standards of care that had long-term negative effects on the individuals who were placed in them and the communities where they were located.2 Johnson remembers Central State Hospital in Milledgeville, GA—cited as the nation’s largest psychiatric hospital, with almost 13,000 patients at the height of its notoriety. The conditions and treatment protocols at Central State Hospital and others were difficult to imagine, and represent the way people with disabilities were viewed and treated prior to the passing of the Rehabilitation Act of 1973.
Fueling the Disability Rights Movement: “Nothing About Us Without Us”
In the years leading up to the passage of the Rehabilitation Act of 1973, Johnson says he noticed a change within the medical community as disabled people increasingly stated, “I am part of the solution.”
“Nothing About Us Without Us” is an empowering mantra that has fueled the disability rights movement and represents the “conviction of people with disabilities that they know what is best for them,” as quoted by James Charlton in his book, Nothing About Us Without Us.3
Johnson graduated with his master’s degree in Guidance and Counseling in 1977, the same year the regulations for Section 504 of the Rehabilitation Act were signed. During this time, he began working with a group who were teaching people with disabilities what their official rights were.
Despite the many years it took for the regulations to be implemented, people within the disability community sought to empower each other by organizing around common issues and making their demands known to the public through public protest and civil disobedience. These issues were discussed in media such as The Disability Rag, which Johnson remembers as “THE magazine in our community. It was like drug, sex, and rock and roll…it was just honest…it was raw.”
Fifteen years later, in 1988, the regulations were still not fully implemented. According to Johnson, “I got some calls from some students at UGA and they said, ‘we just can’t seem to get the university to listen’… So, long story short, we ended up organizing a protest, and a student got out of his chair and crawled up the steps of the building.” The building he crawled to was the disability student service office and was located on the second floor with no elevator access. “It was front page [of] The Atlanta Constitution4 and [the office] got temporarily moved until the students with disabilities decided where it ought to go,” Johnson says.
Looking in the Mirror for Change in the Future
As the 50th Anniversary of the Rehabilitation Act of 1973 approaches, Johnson advises that anniversaries present an important opportunity to bring attention to the shifting of history, but they also help call people to action. “There was this great moment, 50 years ago, there’s this opportunity to look in the mirror, and there’s an opportunity if you haven’t [yet], to implement, after looking in the mirror, what you still need to do,” Johnson says.
According to Johnson, we’ve seen a lot of progress within the context of how long social change takes. He says, “Sliced bread has been around a long time, and it takes a while for different silos to catch up with it—the movement, the paradigm, the language, the policy—and what I see happening around the world and in the country now is a lot more focused on justice and intersectionality, and that’s incredibly exciting.”
Advocacy groups and individuals that Johnson currently finds hope in for the future of disability rights include:
References
- “Rehabilitation Act of 1973,” Pl 93-112 (hr 8070), September 26, 1973. Available at: https://www.eeoc.gov/rehabilitation-act-1973-original-text. Accessed August 18, 2023.
- Atlanta Journal-Constitution: Asylum’s dark past relived as cycle ends
- Charlton, James. Nothing About Us Without Us. University of California Press; 2000.
- Clippings from The Atlanta Constitution:
About the Author(s)
Madison Beasley, PT, DPT
Madison Beasley, PT, DPT is currently a physical therapist at Baylor Scott & White Health. She earned her Doctorate in Physical Therapy at Emory University School of Medicine and graduated from The University of Texas at Austin with her Bachelor of Science in Kinesiology and a certification in Medical Fitness and Rehabilitation. The humanities help her to understand the biopsychosocial and emotional aspects of patient care and to find meaning and connection with others, especially her patients. She hopes to continually challenge her understanding of the world and those living in it to create a dialogue with patients and a relationship of togetherness in the healing process.
Mark Johnson
Mark Johnson is a well-known advocate and leader in the movement for disability rights. As a devoted community organizer, he is committed to participating in and leading actions that demand and inspire justice for marginalized voices within the disability community. In the early 1980s, he helped found ADAPT, an activist organization group committed to organizing around issues of accessibility and justice. He was involved with the Paralympic Games in Atlanta in 1996 and was a major organizer for the Spirit of ADA Torch Relay in 2000, an event that commemorated the signing of the Americans With Disabilities Act (ADA) in 1990. He has served as the Director of Advocacy at the Shepherd Center in Atlanta and as Chair of The ADA Legacy Project, a group committed to recording, preserving, and promoting the history of the ADA.
Wayne Brewer, PT, PhD, MPH, OCS, CSCS
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The “thicket of life.” This metaphor resonates deeply with me as I struggle under the weight of unanswered emails, overdue tasks, and demands for my attention from every angle. Searching for a salve to calm the self-judgment around missed deadlines and unmet expectations, I always return to the humanities as a compass to a more grounded, centered place. While the image of a thicket captures how a dense over-growth can limit movement forward, it also illustrates how such a stand of trees or shrubs is frequently a domination of one or a few species—at the exclusion of others. I pause and wonder: What do all my “yeses” exclude? Who am I overlooking? What am I missing when I feel overwhelmed by an onslaught of information? The humanities offer us a creative space to re-evaluate our current processes, reflect deeply on our values and assumptions, adopt a critical lens to explore other perspectives, and re-imagine new avenues to tackle old problems.
In that vein of re-imagining, the JHR editorial staff have been closely examining our publication model. Working collaboratively with the Emory Center for Digital Scholarship, we have decided to shift our bi-annual (Spring and Fall) issue format to a rolling publication model. This change in our timeline creates several opportunities:
- We can bring to press new articles in a timelier manner, reducing the lag time for both author and reader.
- With a revised homepage layout, we can pull articles from our archives—“Encore articles”—in response to current events.
- We also can bring to the forefront previous JHR articles that may offer context to a newer piece.
In this inaugural issue, for example, we present our first set of paired articles—the previously published The Intouchables–A Reflection on Disability and Caregiving: Who Helps Whom? and a new piece, The Intouchables Revisited: Shifting Perspectives With our Dynamic Society, both by Dr. Sarah Caston. The author re-visits her previous article with a fresh perspective.
The Intouchables movie is a true story about a wealthy white man living with a cervical spinal cord injury, and his relationship with his unorthodox caregiver—a Black man from a disadvantaged background. As Dr. Caston notes while viewing the original article through a different lens:
“I now have a deeper recognition and awareness of the complex dynamics portrayed in this movie, which go beyond a traditionally conceptualized ‘opposite side of the tracks’ tale. I have been able to reflect on other aspects of this story, thinking about what people who are often marginalized—or viewed as ‘untouchable’ as the title of the French film denotes, such as Black and disabled individuals—have experienced, and continue to experience. I can never know that reality firsthand; however, by centering the voices of those who have been harmed by unjust systems, we can learn how to widen our view, to combat the ignorance that privilege affords, and become better advocates in our respective spaces.”
On her own journey to revisit this piece, Caston invites us into this “space of curiosity,” to question our long-held presumptions, and rethink words like independence, autonomy, and flourishing. She asks us to ponder what it means to “relinquish…our power in order to empower.” We present both her original review and her current commentary together, to observe the process of critical thinking–and re-thinking–and to perhaps prompt us to do so in our own work.
With our new model, we are crafting strategies to periodically land more gently in your inbox with a less dense thicket of articles, and instead present a smaller selection of new ideas and Encore articles.
We hope this first in a series of thoughtfully-curated selections will serve as a gentle nudge to invite you back to JHR on a more regular basis throughout 2023—to find novel ideas and revisit past issues in a timely manner.
As Dr. Caston so eloquently offers up to us:
I hope the JHR Newsletter will prompt readers to revisit, remember, and rethink. In our world of overcrowded inboxes, overcluttered minds, and overwhelming news, what a welcome reminder this is to cultivate humble perspectives, challenge preconceived notions and ill-wrought structures, and consider first not the ability, but the humanity of others.
Finally, a heartfelt thank you for joining us on this unique and exciting journey to integrate the humanities into rehabilitation, and for continuing to support JHR as it updates for today and into tomorrow. We are incredibly grateful for our community of readers and contributors who help make this work possible. If you have any questions, concerns, or suggestions for us, please feel free to reach out to me directly. We are eager to have your feedback. It is our deep and true intention to be a model of humanism in publishing and to embrace our collective work of meaning-making in our shared path toward healing.
Warm regards,
Sarah Blanton, PT, DPT
Editor-in-Chief, Journal of Humanities in Rehabilitation
About the Author(s)
Sarah R. Blanton, PT, DPT, Editor-In-Chief
Dr. Sarah Blanton is a Professor of Rehabilitation Medicine at Emory University School of Medicine, Division of Physical Therapy. She graduated from the University of Virginia in 1987 with a BA degree in biology, from Emory University in 1992 with her masters in physical therapy and received her clinical doctorate in physical therapy in 2003. Dr. Blanton has had several research grants exploring the integration of caregivers into the rehabilitation process and her current research focus examines the impact of using a telehealth platform for the delivery of a theory-based, family-focused intervention program for stroke survivors and their carepartners in the home setting. Dr. Blanton’s Lab, DISCOVER (Digital Scholarship Enhancing Rehabilitation), explores various ways digital scholarship can enhance rehabilitation research, education and clinical practice and promote interdisciplinary collaboration. Dr. Blanton is a Fellow of the National Academy of Practice in Physical Therapy. In 2018, she was awarded the American Physical Therapy Association Societal Impact Award and the Emory University Creativity and Arts award for healthcare faculty.
Dr. Blanton’s interest in the Journal of Humanities in Rehabilitation stems from her ongoing exploration of the intersections of creativity and spirituality to gain insight into the human experience of suffering, joy and mystery. In her teaching, she has found the use of narrative to be an exceptionally powerful tool to foster reflection and personal insight for both students and patients. In her research, she is incorporating multi-media formats to develop family education interventions in the home environment. A photographer since childhood, she has enjoyed sharing her artwork through exhibits at Emory University, speaking with chaplaincy students on “Reflections of Art and Spirituality in Appalachia” and as a guest contributor to the Public Radio show, On Being.
See Dr. Blanton’s recent feature in the Emory Report: https://bit.ly/46mqXVp
This work is licensed under a Creative Commons Attribution 4.0 International License.
Table of Contents
Sabbaths 1999-IV
We travelers, walking to the sun, can’t see
Ahead, but looking back the very light
That blinded us shows us the way we came,
Along which blessings now appear, risen
As if from sightlessness to sight, and we,
By blessing brightly lit, keep going toward
That blessed light that yet to us is dark.
Wendell Berry, Given
I am contemplative this morning as I think back on a memorial service I recently attended for my friend and neighbor Ralph. Our paths crossed when he first volunteered for one of my stroke research trials. He struck me as a wise and thoughtful man in those early days, as he graciously donated his time to the study. We were evaluating the impact of a family-focused intervention to support carepartners at home during the rehabilitation process. As the years passed and I had the privilege to get to know Ralph better, I saw how his presence shaped so many individuals in a multitude of ways. His life truly was one of service. He modeled kindness and compassion as he treated everyone he met with joy and respect.
As I was working to revise my study intervention this spring, Ralph and his wife graciously agreed to help me craft this new approach to rehabilitation. Welcoming us into their home, together we created educational videos of ways carepartners can work collaboratively with stroke survivors to make functionally-based activities therapeutic and motivating.
On that rainy afternoon, knowing he loved the poet Wendell Berry, I asked Ralph to recite his favorite poem. He chose “Sabbaths 1999.” While I filmed this joyful moment, my intent was to simply capture the unique exchange we had. It was so special. What I did not realize at the time was how those words would resurface to resonate so profoundly. When I heard of Ralph’s passing, I shared this video with his wife.
It was not until I viewed the footage collectively with the rest of his community at his memorial service that I understood how important that simple gesture had proved to be.
It has been said that poetry always arises in public discourse when language fails us. Indeed, during our time of mourning, Ralph spoke to each of us through these powerful words—words captured during a simple encounter when a physical therapist and a patient chose a poem to learn more about each other. Until I heard his eulogy, I also did not know how much he had regarded his participation with the research and teaching in our physical therapy program as an expression of service following his stroke.
Ralph taught me so much. I asked his family’s permission to share his story in this editorial because I know it is his nature to keep teaching and sharing wisdom even after his passing. I learned from my dear friend that taking a moment in a clinical encounter to read a poem can be transformative—for all parties involved.
The integration of the humanities in our classroom and clinical spaces can take on many forms, with unexpected encounters and surprising impact. As Ralph sought meaning in a poem, I found a renewed sense of meaning in my own work, as both a researcher and health humanities scholar. The skills of mindfulness, reflexivity, and intention—learned from studied time in the humanities—helped create a space where two individuals on a shared rehabilitation journey came to find a deeper meaning in the process. And isn’t that what true healing is all about? This shared meaning-making we do with each other, within ourselves, and through each other.
What does your clinical day look like when you start with an intention of learning what knowledge you can gain from each patient’s life, their lived experience of illness, and, more broadly, their search for meaning? How do those questions shape your own life’s search for meaning? And, most importantly, how do they encourage healing? I’ve now learned first-hand how asking one thoughtful question can have an ongoing, exponential impact for good.
Thank you, Ralph, for so many powerful life lessons given. Perhaps the simplest one I gained, one that I’ll carry with me moving forward, is that life and clinical encounters are too short to not take a moment to pause, reflect—and maybe read a poem.
Our Fall 2022 issue of JHR offers us opportunities to sit in that space of humanities for critical exploration and reflection. The articles, essays, and videos include:
“Ease in Motion: Rehabilitation Inspired by Science, Guided by Art”
By Francesca Tuazon, PhD
Clinicians may well agree that rehabilitative treatment is both a science and an art. Francesca Tuazon makes that concept concrete in this telling piece. She details her own path to healing inspired by her study of a specific chemical reaction and the works of artist Alexander Calder. This combination of seemingly disparate elements has led her to a fascinating new definition of rehabilitation—one she calls Ease in Motion. Just when is rehabilitation really “done”?
By Saminder Dhillon, PhD (candidate); Sandra Moll, PhD; Magda Stroinska, PhD; and Patricia Solomon, PhD
In this institutional ethnography informed study, researchers aim “to determine how the accommodation work of occupational therapy and physiotherapy educators is being organized by institutional expectations and practices and to critically reflect on how this impacts the accommodation process.” The authors identify a “false dichotomy” that places the needs of these students in opposition with some of the professional requirements of a practicing clinician—and suggest some solutions.
“Doing Healthcare Research Differently: SocioHealthLab’s Special Video Series, Part 2”
Edited by Tim Barlott, PhD, MScRS, BScOT
The SocioHealthLab “is a research collective of health and social science researchers, practitioners and students from Australia and around the world, striving for healthcare transformation through applied, justice-oriented, theory-driven, creative and collaborative socio-cultural research.” In this final video installment, authors share their creative works that range from a “poetic meditation navigating” life with aphasia to “healthcare related to sex and intimacy in the disability space.”
By Eric T. Wanner, DPT; Jennifer Lynne Bird, PhD; and C. Jayne Brahler, PhD
This extensively-researched article presents a compelling argument for encouraging physical therapy patients to put their thoughts and feelings into writing. The authors argue that while empathetic verbal exchanges are fundamental to the rehabilitation process, simply encouraging patients to write—by using short answer prompts or other methods suggested here—can produce deeper insights that help improve treatment and outcomes.
“Three Poems: Lost in Translation”
By Marta Tymchenko, BS
In this series of three striking, spare, and emotionally authentic poems, Marta Tymchenko provides thoughtful insights into three different perspectives on a clinical encounter. What is lost in translation when a loved one needs to interpret thoughts between the patient and the doctor?
“Profiles in Professionalism with Bruce Greenfield”
By Bruce Greenfield, PT, MA, PhD, FNAP and Melissa McCune, PT, DPT, MPH
In this installment of the Profiles in Professionalism series, we interview Professor of Ethics at Emory University School of Medicine and one of the founding editors of the Journal of Humanities in Rehabilitation, Bruce Greenfield, PT, PhD, FNAP. In this interview, Dr. Greenfield discusses the intimate connections between professionalism and ethics and how he works with students to better understand their own core values alongside the core values of the profession.
By Noah Watson, SPT
Physical therapy students nationwide are grappling with an unprecedented change in the educational system: forced remote learning of a hands-on profession. In this amusing and thoughtful essay, Noah Watson describes how experiencing one course—and witnessing its caring instructor addressing students’ frustrations—taught him the crucial importance of “empathy, patience, and compassion” in the healing process.
“Finding Balance: The Hidden Gift of Being Thrown Off-Course”
By Bridget Graff, DPT
In this second student essay focused on the Covid learning years, Bridget Graff details how her frustration with forced digital learning led her to discover a whole new perspective on life and work. Moving from being an active, dynamic, overworked student to one focused more on “concepts,” she developed a work-life “balancing act” that improved her academic performance—and will serve her for years to come.
Resources for “Finding Joy, and New Perspective”
By Madison Beasley, SPT and Nela Handac, SPT
In this issue’s Resource section, Madison Beasley and Nela Handac provide a thoughtful list of resources curated to spark joy and lead to new perspectives. Offering options from a variety of multimedia sources, these engaging pieces serve as a reminder of the important role of tending to our well-being and fostering joy and creativity.
About the Author(s)
Sarah R. Blanton, PT, DPT, Editor-In-Chief
Dr. Sarah Blanton is a Professor of Rehabilitation Medicine at Emory University School of Medicine, Division of Physical Therapy. She graduated from the University of Virginia in 1987 with a BA degree in biology, from Emory University in 1992 with her masters in physical therapy and received her clinical doctorate in physical therapy in 2003. Dr. Blanton has had several research grants exploring the integration of caregivers into the rehabilitation process and her current research focus examines the impact of using a telehealth platform for the delivery of a theory-based, family-focused intervention program for stroke survivors and their carepartners in the home setting. Dr. Blanton’s Lab, DISCOVER (Digital Scholarship Enhancing Rehabilitation), explores various ways digital scholarship can enhance rehabilitation research, education and clinical practice and promote interdisciplinary collaboration. Dr. Blanton is a Fellow of the National Academy of Practice in Physical Therapy. In 2018, she was awarded the American Physical Therapy Association Societal Impact Award and the Emory University Creativity and Arts award for healthcare faculty.
Dr. Blanton’s interest in the Journal of Humanities in Rehabilitation stems from her ongoing exploration of the intersections of creativity and spirituality to gain insight into the human experience of suffering, joy and mystery. In her teaching, she has found the use of narrative to be an exceptionally powerful tool to foster reflection and personal insight for both students and patients. In her research, she is incorporating multi-media formats to develop family education interventions in the home environment. A photographer since childhood, she has enjoyed sharing her artwork through exhibits at Emory University, speaking with chaplaincy students on “Reflections of Art and Spirituality in Appalachia” and as a guest contributor to the Public Radio show, On Being.
See Dr. Blanton’s recent feature in the Emory Report: https://bit.ly/46mqXVp
This work is licensed under a Creative Commons Attribution 4.0 International License.
Editorial: Strange Bed-Fellows: Can the Humanities Help the Electronic Health Records Problem?
Table of Contents
“Time, sympathy and understanding must be lavishly dispensed, but the reward is to be found in that personal bond which forms the greatest satisfaction of the practice of medicine. One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient.”
[Excerpt from a speech given by Francis W. Peabody, MD, to medical students at Harvard University, October 21, 1926.]
I was recently intrigued by a New York Times Opinion piece by Theresa Brown and Stephen Bergman entitled: “Doctors, Nurses and the Paperwork Crisis That Could Unite Them.” They aptly describe the required use of the electronic health record (EHR) system as “a pernicious problem that drives so much of our [clinicians’] mutual discontent.” With the passage of the 2009 Health Information Technology for Economic and Clinical Health Act, the use of the EHR was originally intended as an innovative approach to improve healthcare quality and efficiency. Yet today, clinicians are consistently pulled away from interactions with their patients to engage with the demands of these not-fit-for-purpose technologies.
EHR systems, notorious for poor user interfaces with inadequate usability, are now causing the “4,000 clicks” quandary. In a study of emergency-room physicians, researchers found that over the course of a busy 10-hour shift, the mean percentage of clinical time spent on data entry was 43%, as compared with only 28% of time spent in direct patient contact, with nearly 4,000 mouse clicks recorded. Melnick and colleagues found in a cross-sectional survey that American physicians gave EHR technologies a grade category of ‘F’ compared to other current technologies’ usability. What is even more concerning, the researchers found a strong dose-response relationship between EHR usability and risk for physician burnout.
The National Academy of Medicine has published a report, “Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-being,” confirming that clinicians spend fully half of their days interacting with the screen instead of the patient, concurring that this immense documentation burden is a primary contributor to clinician burnout.
Where do the humanities fit into this complex and broad-reaching issue? First of all, a humanities perspective helps us see that the core issue is not simply the frustration caused by the dysfunctional check-boxes or the poor metrics of technical usability. It helps us focus on how these factors negatively impact our relationship with our patients—and ourselves. The true value of our work lies in the shared meaning-making we experience during our clinical encounters; the disconnect arises when de-humanization occurs as a result of our requisite divided attention. Not only are we separated from our patient’s story; we also risk our own story, our reason for choosing healthcare as a profession. As Dr. Ron Epstein notes in his book Attending, the industrialization of medicine erodes our sense of self because we can no longer practice in a manner consistent with our values.
Secondly, exploration in the humanities is characterized by interdisciplinary approaches seeking creative innovation. Solving the problem of a dysfunctional EHR system will take more than the development of more advanced computer technologies. Truly solving complex problems such as these necessitates pulling wisdom from a broad range of disciplines. Recognizing that EHR is not just a function of technology and data, but also of policy, politics, law, and business, shows us that a solution must be found beyond pure science and engineering-based approaches. For instance, how can legislative policy alone inform the efficient flow of clinically meaningful information that supports novel ways to approach problems of health disparities? How does economic theory alone help us step out of a narrow focus on health data to a broader understanding of the financial drivers of healthcare that influence implementation practices?
The humanities help us recognize that our focus must begin with developing more human-centered approaches, from the societal level down to the individual, personal level. For example, solutions that pull from the arts that engage visual-design strategies can guide the individual user experience with ERH. Having a fluency in the language of art history—such as understanding how the formal elements of light, color, lines, and space interact to create composition in paintings, or how meaning is communicated through images—can fuel innovative perspectives that view interactions with a computer monitor in similar ways that we see movement in classic works of art. Could these more humanized electronic platforms not pull us away from our patients, but perhaps even facilitate our communication and connection with them? What would it look like if the patient actually co-created that record with us? The founder of the Columbia Narrative Medicine Writing Program, Dr. Rita Charon, does precisely this, using skills of narrative medicine to write collaboratively with her patients to ensure an accurate medical history-taking.
Thirdly, the humanities offer a space for critical inquiry, pushing us to ask: “Why are things the way they are?” Learning lessons from critical theory and disabilities studies, how do we create spaces to challenge normative assumptions that bind and dampen creative solutions? Barbara Gibson, PhD, comments on how the role of critical perspectives in rehabilitation can easily be applied to the use of healthcare Internet technology (IT):
“Critical thinkers utilize theories from the social sciences and humanities to consider the underlying assumptions, understandings, and contexts behind [rehabilitation] practices. There are many different critical perspectives (including for example, post-modernism, feminism, critical disability theories, new materialism, and post-colonialism) that can be utilized to interrogate and inform [rehabilitation] practices. All share a consideration of the socio-political aspects and cultural contexts informing care, and work to illuminate the assumptions that underpin health practices and their hidden or less obvious effects on recipients of care… Research and scholarship employing a critical approach work toward creating unanticipated opportunities to think and do [rehabilitation] differently. They offer ways to consider deeply why practitioners do what we do, and to highlight the intended and unintended effects of practice-as-usual. The aim of critical work is to build more ethical, inclusive, and equitable healthcare practices. As such, they complement the humanities and the arts with their shared aims of challenging reductive, linear, and/or evidence-based modes of thinking that dominate the [rehabilitation] sciences.”
Perhaps policy makers did not anticipate the consequences of clinician burnout from the EHR implementation; however, the continued lack of critical inquiry perpetuates this progressive erosion of the clinician psyche.
Coming back to the NY Times Opinion piece, Brown and Bergman note that:
“Part of the reason for inaction is that not enough clinicians are making it loud and clear that change is necessary. Doing so requires a unified voice across our professions—and unfortunately, right now, doctors and nurses are anything but unified.”
I underscore the critical role of working together across disciplines to drive the societal and policy changes that must occur to fully capitalize on the positive potential of healthcare IT. Yet, while it is perhaps a symptom of the greater problem of healthcare silos, these authors only mention physicians and nurses. Lamenting the lack of a unified voice, I say, what about other healthcare professionals such as rehabilitation therapists? Perhaps if we recognize the problem of EHR in the context of broader issues of social justice and inequities in healthcare we can harness the power of activism to truly unite across professions to solve the “4,000 clicks” problem. Indeed, health systems that are authentically patient-centered have the potential to help us as clinicians re-imagine our sense of purpose in work, fostering humanism (humanitarianism) in that re-connection with our patients.
Our Spring 2022 issue of JHR offers us opportunities to sit in that space of humanities for critical reflection and exploration. The articles and essays include:
Viral Imaginations: Healing Through Pandemic Narratives
By Michele Mekel, JD, MHA, MBA and Lauren Stetz, PhD Candidate, MA
As the COVID-19 pandemic blindsided us in 2020, an interdisciplinary team at The Pennsylvania State University (Penn State) developed the Viral Imaginations: COVID-19 project to encourage all Pennsylvanians to creatively cope by telling their unique stories. The results, sampled here, were profound. The authors note that similar projects could “benefit healthcare, including rehabilitation, by creating understanding among and between patients, providers, and others involved in the circle of care.”
By Cynthia Dodds, PT, PhD; Brooke Mulrenin, OTR/L, MS; Lisa Kerr, PhD, Carrie Cormack, DNP, APRN; Kimberly Kascak, MS; and Rebecca Hiester, Director of Education and Programs, Gibbes Museum of Art
In a second article deeply exploring the insights of the Eye Spy program (see Eye Spy, 2018), Cynthia Dodds et al examine the effects of guided visits to an art museum on affective domain development and interprofessional perspective in health science students. The authors demonstrate, step by step, how using visual-thinking-strategy instruction in a museum setting can support the development of “compassionate and patient- and family-integrated care providers.”
By Sarah E. Luna, PT, DPT; Nathan Brown, PT, DPT; and Cynthia Dodds, PT, PhD
This article strives to encourage the use of humanities within physical therapy education and practice by offering examples of three health humanities-based instructional activities, including two implemented at US universities. “As curricular models in physical therapy education evolve,” the author notes, “the importance of humanities-based instruction to develop empathetic physical therapists should be considered and implemented, as it will not only benefit future patients, but the field of physical therapy as well.”
By Michele Slaton, PhD, and Brick Johnstone, PhD, ABPP
This poignant report maps the direct line between the introduction of humanities into rehabilitation and its powerful impact on healing—and beyond. It begins with a case study of a 47-year-old woman with a right temporal lobectomy at age 22, who has written poetry over the past 30 years “to express her positive mystical experiences.” The content then switches to the first-person, with poet Michele Slaton describing the remarkable insights she has experienced on her rehabilitation journey. Her poems, included here, present a deep and moving argument for the gifts that a physical crisis can unlock when humanities play a part in treatment.
JHR-CHEP Student Narrative Essay Winner
By Joseph Rivera, SPT
Congratulations to Columbia University Doctor of Physical Therapy Program graduate student Joseph Rivera, SPT, the winner of the 5th annual physical therapy student essay contest co-sponsored by the ACAPT Consortium for the Humanities, Ethics, and Professionalism (CHEP) and JHR! The judges described his essay, “Finding Voice and Vulnerability through Virtual Learning,” as “intriguing, thought-provoking, and courageous” as he draws insights from his Puerto Rico background to describe his journey to find his voice through the safety of Zoom enclosed dialogue. He highlights the intersection of power and privilege and the impact that virtual learning had on those discussions. Essays from the two additional finalists, Bridget Graff, SPT (Marquette University) and Noah Watson, SPT (A.T. Still University), will be published in the Fall 2022 issue of JHR.
Doing Healthcare Research Differently: An Introduction to SocioHealthLab’s Special Series, Part 1
By Rebecca E. Olson, PhD; Jenny Setchell, PhD, BScPT, Grad Cert (Clin PT); and Tim Barlott, PhD, MSc, Grad Cert (Community-Based Participatory Research), BScOT
In this first of two installments within SocioHealthLab’s special video series with JHR, the authors “begin doing health research dissemination differently” by telling their “story/stories” through animation, music, sound, and discourse. The videos shared here range from heart-rending personal patient experiences of pain and fear, to a humorous ‘what-if’ look at rehabilitation processes with the use of cartoon animals. Viewers are invited to relax and share these brief accounts in a “quiet space.”
“Afflicted With Wishes for Change”
By Dustin Willis, PT, DPT
In this powerful poem, Dustin Willis reflects on the frustration a parent feels while seeking answers and compassion from doctors who are limited in their ability to offer adequate time, thought, and care to his son’s complex needs. His reflections are a plea for change as he navigates our broken healthcare system- a heartfelt appeal that keeps needing to be made.
By Kirsten Woodend, RN, MSc, PhD
Kirsten Woodend considers the space between being “broken” and being “whole,” when the patient’s road to recovery will never end in full rehabilitation. She writes of the difficult struggle to choose between “acceptance” and constant striving toward “recovery.” In this poignant poem, she finds herself at a fork in this unique road.
By Sophie L. Schott
Inspired by reflections on the current Covid-19 pandemic and recalling American Medical Association debates over the “duty to treat” individuals with HIV and AIDS in the 1980s, Sophie Schott has crafted a poem that challenges us not to repeat history by refusing to treat marginalized patients. “History of Present Illness” questions whether clinicians should be guided by personal preferences or by a higher calling.
By Michele Mekel, JD, MHA, MBA
With observant humor and a brisk rhythm, Michele Mekel’s poem evokes the memory of an awkward encounter in a waiting room, where a doctor initially dismissed her at first sight. “Office Visit” serves as a reminder to healthcare professionals to be aware of tendencies to make snap judgments and underestimate their clients.
Resources to Promote Inclusion and Belonging
By Anjanette Nuñez, PT, DPT; DeAndrea Bullock, PT, DPT; and Sarah Caston, PT, DPT
For Spring 2022, the JHR is publishing for the first time a resource list related to cultivating belonging for students and patients in healthcare education and healthcare settings. This exceptional compilation of articles, books, movies, and artwork could serve as “an academic course in and of itself,” according to one of our editors.
Thank you for joining us. We hope you find inspiration in the Spring 2022 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.
About the Author(s)
Sarah R. Blanton, PT, DPT, Editor-In-Chief
Dr. Sarah Blanton is a Professor of Rehabilitation Medicine at Emory University School of Medicine, Division of Physical Therapy. She graduated from the University of Virginia in 1987 with a BA degree in biology, from Emory University in 1992 with her masters in physical therapy and received her clinical doctorate in physical therapy in 2003. Dr. Blanton has had several research grants exploring the integration of caregivers into the rehabilitation process and her current research focus examines the impact of using a telehealth platform for the delivery of a theory-based, family-focused intervention program for stroke survivors and their carepartners in the home setting. Dr. Blanton’s Lab, DISCOVER (Digital Scholarship Enhancing Rehabilitation), explores various ways digital scholarship can enhance rehabilitation research, education and clinical practice and promote interdisciplinary collaboration. Dr. Blanton is a Fellow of the National Academy of Practice in Physical Therapy. In 2018, she was awarded the American Physical Therapy Association Societal Impact Award and the Emory University Creativity and Arts award for healthcare faculty.
Dr. Blanton’s interest in the Journal of Humanities in Rehabilitation stems from her ongoing exploration of the intersections of creativity and spirituality to gain insight into the human experience of suffering, joy and mystery. In her teaching, she has found the use of narrative to be an exceptionally powerful tool to foster reflection and personal insight for both students and patients. In her research, she is incorporating multi-media formats to develop family education interventions in the home environment. A photographer since childhood, she has enjoyed sharing her artwork through exhibits at Emory University, speaking with chaplaincy students on “Reflections of Art and Spirituality in Appalachia” and as a guest contributor to the Public Radio show, On Being.
See Dr. Blanton’s recent feature in the Emory Report: https://bit.ly/46mqXVp
This work is licensed under a Creative Commons Attribution 4.0 International License.
Table of Contents
JHR Fall 2021 Editorial
‘Hope is a Muscle’
By Sarah R. Blanton, PT, DPT, FNAP, Editor-in-Chief
“Hope is an act of imagination, a leap of imagination that has real world consequences.”
—Bryan Stevenson
“Hope is a muscle, a practice, a choice that actually propels new realities into being. And it’s a muscle we can strengthen.”
—Krista Tippett
Grappling with this next phase of the pandemic, we are called to be fully present in this shifting space while deeply reflecting on the challenging time we have endured. At the moment, we are pressed to look toward a future of healing that, as yet, remains just out of reach. Our CHEP-JHR student essay prompt for this year is a reflection I think we might collectively contemplate:
The pandemic highlighted a critical need to reimagine education in physical therapy, as programs had to quickly pivot to adopt virtual learning environments. Standing on the edges of the crisis, we are emerging forever changed individually, institutionally, and professionally.
As you consider the challenges and benefits of remote learning from a student perspective, how has this unique experience impacted your image of yourself as a physical therapy professional? How has your idea of physical therapy training and practice changed?
How we respond to this transition depends upon our ability to cultivate a sense of agency and find support for our inner strength, individually and collaboratively. How do we rise to meet these lessons from a landscape of loss, transforming to a horizon of hope?
In my own journey, I am finding an invaluable compass in Krista Tippett’s OnBeing Wisdom app course “Practicing Hope.” I agree wholeheartedly with her observation that “hope is a feature of every wise and graceful life I have ever encountered.” She offers this definition:
“Hope is a muscle, a practice, a choice that actually propels new realities into being. And it’s a muscle we can strengthen. It is not the same as idealism or optimism. This kind of hope has nothing to do with wishful thinking. Hope as I’ve seen it lived is at once fierce and persistently joyful. I’ve come to understand this quality of hope as an essential foundation and power for the generative story, the generative landscape, that is emerging out of all of the rupture this moment in the life of the world has laid bare.”
As Bryan Stevenson describes: “Hope is an act of imagination, a leap of imagination that has real world consequences…Hope is the thing that gets you to stand up when others say, ‘Sit down.’ It’s the thing that gets you to speak when others say, ‘Be quiet.’”
In the field of rehabilitation, we begin each relationship, whether clinician with patient or instructor with student, with a mutual commitment to hope. Hope for healing, hope for learning, hope that this therapeutic relationship leaves both of us better for the interaction. We deal in the currency of hope every day—sometimes leaving richer, but sometimes poorer.
Why is that? Why do we often assign a two-dimensional prognosis-of-function to a multi-layered and complex lived experience of disability? “Will I walk again?” the patient pleads. I wonder if we spend so much time on the evidence-based answer, that we overlook the person behind the question. If hope is a muscle, a practice that can help reimagine another person’s life, then it becomes a moral choice. Akin to other character virtues we seek to cultivate in our students and colleagues, what would it look like for dimensions of hope to be explored in our curricula alongside ethics of caring and professional integrity? Such an examination demands deep thinking, critical reflexivity, a moral imagination—and a humanities framework. We struggle to respond to another’s definition of hope until we have grappled with our own meaning. To bear witness to another’s suffering demands a special type of hope—one that is strong enough to endure uncertainty and pain while also patient enough to maintain a curiosity during a stumbling journey toward a new source of optimism, of belief.
When we embrace that rehabilitation is a field of applied hope, we underscore the importance of gaining skills to recognize, explore, cultivate and honor hope in each other. We recognize that building up this muscle of hope takes practice. Take a moment, and ask yourself: How have I embodied hope in my life? Do I understand, really understand, what gives hope to the patients I saw today? What gives hope to the students I taught today? To the people I simply encountered today? How can I stay curious to this concept of hope?
Why is this so important? I lean on insight from Bryan Stevenson: “You should not underestimate the power you have to affirm the humanity and dignity of the people who are around you. And when you do that, they will teach you something about what you need to learn about human dignity, but also what you can do to be a change agent.”
We are continuing with our designated themed series dedicated to topics of social justice as well as the experiences of people caught in the COVID-19 pandemic. We encourage our readers to consider sharing their reflections and perspectives as we forge deeper connections together to envision, with hope, our collective future.
Our Fall 2021 issue of JHR offers us opportunities to explore these deeper meanings through the humanities lens, and find hope in many forms. The articles and essays include:
Is the Assumption of the Autonomous Individual Holding Us Back in Vocational Rehabilitation?
By Joanna K Fadyl, PhD; Lynette Reid, PhD; Christine Cummins, MHSc; and Barbara E Gibson, Ph
Presenting an intriguing exploration of professional mindsets, Joanna K. Fadyl, in a creative collaboration with colleagues, argues that assumptions regarding individual autonomy are indeed holding rehabilitation practices back. The article calls on wide-ranging concepts such as that of whānau in Kaupapa Māori scholarship and assemblage within critical disability studies, to explore different understandings of what an individual actually is—and how assumptions can affect healing. She expresses the hope that exploring these and other concepts might help us perceive individuals as “collective constellations and configurations, rather than autonomous units.”
By Paulina Wegrzyn, MScPT; Celina Evans, MScPT; Gina Janczyn, MScPT; Jasline Judge, MScPT; Remi Lu, MScPT; Rahim Manji, MScPT; Julia Gray, PhD; Meredith Smith, MScPT; and Stephanie A. Nixon, PhD
Guided by the work of cultural theorist Sara Ahmed and critical race scholar Camara Phyllis Jones, these authors explore the perspectives of experts regarding barriers to and opportunities for increasing the recruitment of Black students into physical therapy programs in Canada. Three themes emerge from this qualitative study: the field of physical therapy as a white space; the fact that white orientation of physical therapy limits Black people; and the goal of co-creating an inclusive physical therapy profession. The authors invite readers to focus on fundamental change by unlearning previous assumptions.
Toward a Social Psychoanalysis of Rehabilitation Practice
By Thomas Abrams, PhD
In a thought-provoking piece, Thomas Abrams calls on the works of Sigmund Freud, and of modern critics and interpreters of Freud, to explore the rehabilitation clinic as a “space of desire.” What desires motivate patients and rehabilitation teams alike? How do those desires affect healing? He introduces the reader to a fresh perspective on the rehabilitative process—offering a glimpse of what it might become if a deeper psychoanalytic focus were applied to it. “To treat the clinical space as a libidinal space is, I would argue, a critical and political act,” he states.
Art History as a Resource for Understanding Social Bias in Disability
By Brick Johnstone, PhD, ABPP
In a dramatic presentation of imagery past and present, Brick Johnstone invites readers to consider ongoing attitudes toward persons with disabilities. From painful depictions of cruelty directed at disabled individuals over the centuries, to eye-opening reports of lingering attitudes in present times, the article demonstrates how difficult it can be to change human minds. The author offers suggestions for the use of visual arts “to educate rehabilitation professionals regarding individual and societal biases of disability.”
Community Mobility Method Selection in Individuals With iSCI: A Qualitative Analysis
By Carey L. Holleran, MPT, DHS, NCS; Jennifer Fogo, PhD, OTR; Stephanie A. Miller, PT, PhD, NCS; and T. George Hornby, PT, PhD
A primary rehabilitation goal for individuals with motor incomplete spinal cord injury (iSCI) is to regain their walking abilities. But what factors influence their paths to achieving that goal? Although quantitative information may be readily available in the clinic, these authors note that there is a paucity of qualitative information detailing each individual’s personal choices regarding mobility methods. Through extensive interviews, this groundbreaking study presents a range of deeper factors to consider when working with an individual to achieve community mobility
By Jim Carey, PhD, PT, FAPTA
This eloquent and empathetic poem is accompanied by a photograph of a woman dressed in protective gear. The woman in the photo happens to be the author’s daughter—who works daily in hospice care with coronavirus patients. The author offers the poem and photo to send a simple, compelling message about preserving humanity in these difficult times.
Piloting a Photography Program as Recreational Therapy for Adults With Spinal Cord Injury
By Yaga Szlachcic, MD; Nicole Bayus, MA; and Michael A. Ziegler, BA
This article and the photos that accompany it speak volumes about the lives and perspectives of the photographers presented: SCI patients at the Rancho Los Amigos National Rehabilitation Center in Los Angeles. The authors describe the development of their pilot program of educational courses in photographic arts offered to adults with SCI at ‘Rancho.’ The result is these poignant and moving photographs, demonstrating with images—and a few insightful words from their creators—how art can lift the human spirit above life’s challenges.
By Bruce Greenfield, PT, MA (Bioethics), PhD, FAPTA
Arthur Kleinman’s new book takes a hard look at what ‘care’ means by taking the reader on his own personal journey—one that led to the challenge of caring for his wife. In this insightful summary, Bruce Greenfield highlights Kleinman’s call to “move beyond a narrow definition of caring as technical excellence to caring based on a continuous healing relationship …” This is the true patient-centered care, Greenfield notes, “where patient values, goals, needs, expectations, and fears are invited into the decision-making process.” He encourages readers to explore their own capacities for true caring by reading this courageous book.
JHR-CHEP Student Narrative Essay Finalists
Congratulations to Xavier Gibson, SPT (Springfield College) and Henry Fok, SPT (Columbia University Vagelos College of Physicians and Surgeons), the finalists of the 4th annual physical therapy student essay contest co-sponsored by the ACAPT Consortium for the Humanities, Ethics, and Professionalism (CHEP) and the JHR!
The Therapist Advocate: Transcending Knowledge and Skill to Address Societal Needs
By Xavier Alexander Gibson, SPT
In the beginnings of the Black Lives Matter movement, Xavier Gibson was studying for his DPT. “Important muscles and important social movements; how could I possibly weave a life as a future healthcare provider while being an advocate for change?” he asked himself. In this essay, he details how he was able to coalesce his roles as student and advocate by developing a creative presentation at his university’s ground-breaking event, “S.E.A.T. at the Table.” By expressing his commitment to change, he encourages others entering the profession to strive to become therapist-advocates.
By Henry Fok, SPT
On a day that should have been memorable for its joy, Henry Fok had an encounter that would ultimately inspire him to re-examine his future role as a physical therapist. He and his fiancée were attending the wedding of his best friend from college when, out of the blue, came the question in this essay’s title. “It was to me a joke disguised as an ethnic slur,” he notes. This essay details Fok’s thought process as he ponders the encounter – and steadily strengthens his conviction to fight racism through “thoughtful communication”—as a person and a professional.
Fall 2021 Resources by the Humanities Committee
By Amber Baas, SPT; Nela Handac, SPT; Stefano Campana, SPT; and Madison Beasley, SPT
For the Fall 2021 issue of JHR, we have invited the Emory DPT Humanities Committee to contribute these resources, which aim to not only “broaden our understanding of the human experience, but to help us develop ways to approach new or different experiences.”
We are pleased to announce the 2020 recipient of the Frank S. Blanton, Jr., MD, Humanities in Rehabilitation Scholar award, Eric Holshouser, PT, DPT, MBA, PE. Dr. Holshouser exemplifies a compelling character with a wonderful combination of sincerity, humility, and joy that shines through in his approach to work and relationships. These qualities, in combination with a solid ethical compass, strong intellect, and deep passion for personal and professional growth, made him a natural fit for this scholarship award. After graduation, we are excited that he will continue on as JHR’s first business manager.
The Fifth Annual Student Essay Contest is Now Open for Submissions!
The essay prompt for the 2021-2022 physical therapy student essay contest is:
The pandemic highlighted a critical need to reimagine education in physical therapy, as programs had to quickly pivot to adopt virtual learning environments. Standing on the edges of the crisis, we are emerging forever changed individually, institutionally, and professionally. As you consider the challenges and benefits of remote learning from a student perspective, how has this unique experience impacted your image of yourself as a physical therapy professional? Using details and analysis from a specific experience, explain how your idea of physical therapy education, training, and practice have changed. This narrative essay should describe the experience and your reaction to it. It should explain what you learned from the situation and what that lesson means for you as a physical therapist, along with the field of physical therapy more broadly.
Timeline: Submissions will be accepted until January 7, 2022. The winner and two finalists will be announced in the Spring 2022 issue of JHR. For more details, see our CHEP-JHR contest webpage. For more information about CHEP, please see their CHEP webpage.
Thank you for joining us. We hope you find inspiration—and hope—in the Fall 2021 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.
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
About the Author(s)
Sarah R. Blanton, PT, DPT, Editor-In-Chief
Dr. Sarah Blanton is a Professor of Rehabilitation Medicine at Emory University School of Medicine, Division of Physical Therapy. She graduated from the University of Virginia in 1987 with a BA degree in biology, from Emory University in 1992 with her masters in physical therapy and received her clinical doctorate in physical therapy in 2003. Dr. Blanton has had several research grants exploring the integration of caregivers into the rehabilitation process and her current research focus examines the impact of using a telehealth platform for the delivery of a theory-based, family-focused intervention program for stroke survivors and their carepartners in the home setting. Dr. Blanton’s Lab, DISCOVER (Digital Scholarship Enhancing Rehabilitation), explores various ways digital scholarship can enhance rehabilitation research, education and clinical practice and promote interdisciplinary collaboration. Dr. Blanton is a Fellow of the National Academy of Practice in Physical Therapy. In 2018, she was awarded the American Physical Therapy Association Societal Impact Award and the Emory University Creativity and Arts award for healthcare faculty.
Dr. Blanton’s interest in the Journal of Humanities in Rehabilitation stems from her ongoing exploration of the intersections of creativity and spirituality to gain insight into the human experience of suffering, joy and mystery. In her teaching, she has found the use of narrative to be an exceptionally powerful tool to foster reflection and personal insight for both students and patients. In her research, she is incorporating multi-media formats to develop family education interventions in the home environment. A photographer since childhood, she has enjoyed sharing her artwork through exhibits at Emory University, speaking with chaplaincy students on “Reflections of Art and Spirituality in Appalachia” and as a guest contributor to the Public Radio show, On Being.
See Dr. Blanton’s recent feature in the Emory Report: https://bit.ly/46mqXVp
This work is licensed under a Creative Commons Attribution 4.0 International License.
“This book is not so much about the subject of ‘the disabled’ as it is about the cultural context in which disability occurs. That culture is shaped by the fact that we live in a society which is largely uninvested in the experience of being disabled.”For our upcoming issue, we revisited Kate Gainer, a participant in the “Portrait of Spirit’ project. One of 18 students to attend Atlanta’s first special-education class for black children in the 1950’s, she felt it was an empowering experience for a black child growing up in the segregated South. In a compelling reflection that mirrors the lessons of our current day, she said:
“If I ever write my autobiography, I’m going to title it: ‘I was born colored and crippled but now I’m black and disabled’”We asked Kate about her thoughts (and hopes) now regarding the #Black Lives Matter movement and what it is like being disabled in the time of a pandemic. She shared her feelings that “Being black and living with a disability in the US in 2020 is scary and exhilarating at the same time… Realizing what little value society places on people with disabilities and the elderly and having a history of asthma, in this era of COVID-19, I am an endangered species. This pandemic has identified the US as a country of limited resources. And … the present administration’s unwillingness to address our limitation puts us all in danger.” Concerning the country’s current focus on racial injustice, she spoke from her experience as a civil rights advocate.
“Covid-19 forced the country to sit still and look at our surroundings. George Floyd was not the first man to die the way he did. But the advent of the cellphone and the virus making us sit still, put us in a position where we all heard him call out for his mother. We saw a man realize he was going to die and give up. We were placed in a position where we had to react. In a position where you had to say, ‘Enough is enough, and this is too much’. It was reminiscent of when Dr. King called for marchers after ‘Bloody Sunday’ in Selma, and when Hosea Williams called for marchers in Commerce, GA. The difference was, no one had to call Black Lives Matter. Young people were ready, willing, and knew what to do. It really felt good to watch. What they are asking for probably will take years to implement, but it has been put in motion, and this generation will not let it stall-out.”Where can we go from here? The COVID-19 pandemic has unveiled an uncomfortable truth about our world and how deeply rooted our problems with racial injustice and health inequity are in our society. So, what do we do? We believe, in moments like these, that the next right step begins with seeing each other more clearly and using the humanities as a conduit for exploring the lived experience of others, especially those of our Black patients and colleagues. We are designating a themed series dedicated to topics of social justice as well as the experiences of people caught in the COVID-19 pandemic in each JHR issue moving forward. We encourage our readers to consider sharing their reflections and perspectives as we forge deeper connections together to envision our collective future. Emphasizing the qualities of humanism, the noted Boston College Theologian Roberto S. Goizueta believes that when each of us learn “how to embrace our common vulnerability and suffering, then we are free to live lives committed to justice, committed to freedom.” As witnesses to this part of our collective human experience especially inherent in the disability journey, we are uniquely poised in this world of rehabilitation to participate in the healing not only of our patients but also of each other and society.