On compassion and reward

 

I know that sometimes I start stories and they don't always get finished.  Sometimes that happens because there is no ending - or at least there is not an ending to be found with the framing I was using.

That was always the nature of my private practice - and my hesitancy in discharging children and their families. Who is to say that any person's needs are completely addressed? Or that as a therapist I was able to generate a perfect and complete answer that would persist over time?

Sometimes the stories I think about finished themselves and were easy to write even if it hurt.  Sometimes the stories needed some kind of ending punctuation - a final act from the therapist.

I keep thinking about one story that did not seem to have an ending, so I thought I would visit with it again. I might have found an ending.

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I wrote, "I guess now we will see what happens next."

Xinren never came back. I never heard from the family again.  I don't actually know what happened next.

I have been thinking about this a lot lately, mostly in wondering if I did my job correctly. I spent quite a bit of time praying about that and in the last week an answer just keeps coming at me from so many different sources. I have always believed that sometimes G_d hands out answers that way.

When one is considering if they have done their job correctly, I think it is helpful to assess whether or not the correct questions were asked. In this situation, I think I may have accidentally stumbled upon the correct phrasing. With this family I was obsessing about asking things the correct way - I wanted to be sure that Xinren's parents understood my thinking and my intention. I asked them, "Please tell me - what is your biggest worry? What can I do to help?"

I have asked this question before and it generally yields good results. But not always. I remember one time I was meeting with a mom and the child had so many needs and the family was so overwhelmed. I asked the mom, "What can I do to help?"

The mom just looked at me blankly and said, "What's your angle?" That question hit hard; I spend my life trying to live in predictable straight lines. I just wanted to help. Imagine being a parent who has been so abused by a system that the first response to an offer of help is to ask, "What's your angle?" At that moment I don't know that I came back with the best response.

Anyway, over the last week I keep hearing the message about Bartimaeus from Mark 10. Bartimaeus asked for help, and Jesus replied with a question perfectly, "What do you want me to do for you?" Jeff Cavins talked about asking the right questions in a mini-podcast last week, and then I saw the similar message in an Imprint Hope email. 

This is leading me to believe that I may have asked the question the correct way after all.

As occupational therapists we have so many different ways that we can ask questions. Unfortunately, we have been philosophically lost about our methodology ever since I entered the profession. Mary Reilly tried to frame a solution to our lack of a unifying approach to questions in her Slagle lecture - talking about Fromm's perspective that needs were an indispensable part of human nature and imperatively demand satisfaction. She believed that work and human productivity were physiologically conditioned needs - something that reflects her American context. She suggested that we intervene at the point of that human need - and that a proper assessment starts by asking about these things.

Forty years later, with globalization a very real impacting factor, Wilcock put a different spin on need with her discussion of doing, being, and becoming. She framed need in occupational terms, and expanded the concepts to whole population and ecologic/global contexts. I get it on a philosophic level, but I always find myself face to face with people like Xinren and his parents. They just wanted him to be like everyone else - to fit into the school context - to become a productive and happy individual. I am not certain they were concerned about global health equity. There has to be something more immediate that gets to the heart of human need.

So I asked Xinren's parents, "What can I do to help." Then I gave them the orthotics for free, and did not bill their account. As I reflect, I think that was the most morally correct action at that moment.

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But they did not come back.
What does that mean?

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Jesus asked a question to Bartimaeus perfectly. And then there was a perfect outcome. Bartimaeus was healed, and began a life of discipleship. But there is more than just that - because this story has echoed across two thousand years, which is amazing when you think about it.

Bartimaeus had a need.

He asked for help repeatedly, even when encouraged not to. He demonstrated persistence and trust, even if others discouraged his methodology.

Maybe the persistence and trust and faith are what mattered. As fallible human beings we will probably always wonder if we asked the right question or if we asked it the right way. For Bartimaeus was begging the correct methodology?  Calling out, "Son of David, have pity on me?"

I suppose we can debate that, but the bottom line is that if we have faith, and if we have persistence and trust, we can hope that we might be met with another person who demonstrates understanding and compassion.

In occupational therapy, and health care, and I guess in life we often look for more pragmatic and measurable outcomes. We get stuck on the way the questions were asked, looking for error or affront when our expected outcomes are not achieved. Somehow on all sides the larger issues get forgotten, or misplaced.

But - when we have the opportunity, we should always try to model our questions back to people very carefully, and not get confused by any methodology that we encounter.

Maybe in that act of compassion and service we are rewarding others. And if we find a way to those correct questions, we will also find our own reward.

In any given moment in any person's life trajectory, that love might be all that anyone needs to hear, and it might be precisely what is most desperately needed.

So in that sense I don't need to know about what happened next, because what mattered most is what happened then.

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