Occupational justice, as taught by Mrs. J.

I got an interesting email asking me what my current views of occupational justice were - this blog gets a lot of hits on that term thanks to Google page rankings and the fact that I wrote an article on the topic several years ago. I have been long disappointed that no one ever wanted to dialogue (in public) on what I wrote several years ago but that blog post sure does get a lot of hits and tends to generate 1-2 private email responses a month.

For the most part I have tried to lose the concept of occupational justice from my thinking and practice. The primary reason for my purposeful disconnect is that the term has been somewhat politically co-opted in the last two years and now holds a lot of political connotation along with 'social justice.' I also have been re-thinking the difference between occupational need and occupational right. At this time I am a little more interested in occupational needs. Rights need to be considered alongside responsibilities, but the existing political climate is less interested in responsibilities as it is interested in justice in general. That makes me tune out.

The driver for tuning out came from my kid's babysitter (strange place to obtain wisdom - but let me explain).

I remember vividly when my daughter would scream at her sister, “Casey, quit whining!” Older sisters like it when they can boss their younger siblings – at least that is what I noticed in my house. The problem that caused the whining was that my daughter Casey clearly was not impressed with what was being offered for dinner.

“You get what you get, Casey,” her sister continued. “You know what Mrs. J. always tells you.”

The relationships that the kids formed with people outside the family were always something that I have enjoyed studying. Mrs. J. knew both younger girls for several years as their after school daycare provider. Mrs. J. was a third grandmother to the girls and I always felt fortunate to have her care for the kids.

It is a simple philosophy, actually – meant to initially apply to after-school snacks. Neither of the kids were ever raw vegetable crunchers but this is what Mrs. J would regularly offer them. Although they would initially rebel against what was offered, Mrs. J. would always answer them consistently when they asked for some other kind of snack, “You get what you get.” It has become something of a rallying cry for learning how to graciously receive what is offered.

The kids learned how to generalize this lesson without my intercession. Sometimes simple messages are the ones that are most easily received. And applied

The larger application might sound somewhat fatalistic, but I try not to think of it that way. We all want things. Sometimes there are things that I want so badly that my heart feels like it is falling out of my chest. I talked before about how we are a society of people who are largely controlled by feelings of entitled immediate gratification. But sometimes we get what we get, and it is not anyone’s fault. It just is. What we make of the things we get is what matters, in the end.

I pray, regularly, so I can understand where I am, who I am, what I am supposed to do. In my own times of questioning I try to pause myself and invoke a quiet acceptance. “You get what you get.” When I hear the echo of this message through the voices of my children I realize how much that actually is.

So anyway I guess that in my thinking it is more about need, and then how we respond to the need and whether or not the need is met and how this generates meaning for our patients. Talking about rights and justice takes it all into a political spectrum that really takes us beyond the initial issue. OTs can certainly engage questions of rights and justice - but I would rather see that we first engage in better understanding and meeting needs and meaning-making.