Rehabilitation Today
George B. Clark, Jr. *
Editor's Note: This article is condensed from an address given at the meeting of AOPA Region VIII in San Antonio, Texas. Mr. Clark is Assistant Director of Field Operations for Vocational Rehabilitation in the state of Texas.
It is an honor and privilege for me to have this opportunity to talk with you tonight about the rehabilitation of handicapped individuals with whom we both have a common interest.
Rehabilitation is the American way and we must expand if we are to retain the philosophy of our society, "that each individual has his right to life with dignity." Theodore Roosevelt once said "Americanism means we must give to our fellow citizen the same wide latitude that we demand for ourselves." But, for the handicapped, this is not enough—we must give him more than we demand for ourselves.
To expand and to bring rehabilitation to a maximum level of operation, we must take into consideration a new measurement—the measurement of time. And we must consider time more as a dimension than a measurement.
I would like to illustrate this dimension by quoting from a talk made by Mr. Bob Mallas of the Texas Research League on April 16, 1962.
"Most of us think in terms of obsolete concepts. For example, I can tell you the exact cost of a B-58 bomber in dollars and the exact weight in tons, but you only become interested when I tell you that a B-58 costs more than its weight in silver." Our interest increases because tons of silver have meaning in value, but hundreds of millions in dollars does not.
Today—especially today—time is most important to every concept. Let me give you another example.
There have been 50,000 years of mankind's history. None of us can visualize 50,000 years so let's compress history into 50 years—a span of time that all of us can understand. If all human history had happened in the last 50 years, then:
10 years ago you would have stopped being a caveman.
5 years ago the most intelligent man here would have invented pictorial writing.
2 years ago Chrisianity would have appeared on the scene.
15 months ago you would have invented the printing press.
20 days ago you would have invented electricity.
18 days ago you would have invented the airplane.
10 days ago you would have invented the radio.
4 days ago you would have invented the TV.
Yesterday you would have seen the first hydrogen bomb exploded. Before I started this example, Lyndon B. Johnson would have become President.
Let's consider more tangible examples of this new tempo. For example —speed:
In 1910 the first military aircraft was launched with a top speed of 42 miles an hour.
In 1960. Sputniks. Explorers, and Vanguards were launched with speeds
up to 18,000 miles per hour. Another example is that of warfare:
For 47.000 years clubs were used as the basic weapon for warfare.
About 3,000 years ago the bow and arrow replaced the club.
The short bow lasted 2,000 years and then was replaced In the long bow. which lasted 500 wars.
The long bow was replaced by the rifle and cannon, which were good weapons and a lot more complicated but they didn't last nearly so long.
Presently, I pose this question to you: How long was the battleship, aircraft carrier, artillery piece, piston-driven airplane, or even the atomic bomb a good weapon?
The newer and more complicated anything is, the sooner it becomes obsolete. It took man 250 years of painful technological advances to progress from a short bow and arrow to a long bow and arrow. Yet it didn't take man ten years to move from the A-bomb to the H-bomb or from piston-driven airplanes to space exploration.
These examples should serve to show us that today if we are 20 to 30 months behind the times, we are further behind than our fathers were when they were 20 to 30 years behind, and our grandfathers were if they were 200 to 300 years behind.
These are just some items that I thought you should know and should apply to yourselves as you think what you would like to do. Time must apply to endeavors that we will undertake in the next few years and we must realize how limited we are in the amount of time we have in our lifetime to accomplish even some of the things that we wish to accomplish.
Technological growth in prosthetics and orthotics began shortly after World War II when research and development programs were launched by the National Academy of Sciences. Even as late as 1958 arms and legs bought by the Vocational Rehabilitation Division were bought simply because the client needed one or the other. Function wasn't considered to any extent other than to give the client something to stand on or to wear for cosmetic purposes. By and Large, the limbs were made and lilted to the client for comfort only.
Vocational Rehabilitation bought few or no orthotic devices because at that time they were considered experimental and as far as Vocational Rehabilitation was concerned, they didn't add anything to the client's rehabilitation potential.
The first hydra-cadence leg was purchased by the Texas Vocational Rehabilitation Division in 1958. At that time there was much said throughout the Division about paying so much for an artificial leg. Yet today the purchase of a hydra-cadence leg is not an oddity. Many other devices that only a few years ago were not even considered by Vocational Rehabilitation, are now being purchased routinely.
Again, the dimension of time has entered into the picture of changing concepts. I am sure that technological progress and gains in the development of better Orthotics and prosthetics will be forthcoming in the near future. However, the expansion and improvement of Vocational Rehabilitation has fallen behind and has become a victim of the time lag.
Just for a moment let's pretend that Vocational Rehabilitation in the State of Texas is a private business. Let's compare it to your shop that you operate. Suppose that Monday morning you opened the doors at your shop, and lined up in front of your place of business there are 12.000 people asking for some type of service.
Your first thought, of course, would be that business is getting belter and then, suddenly, you would realize that even though business is good, you are not equipped to provide these people with the services that they are requesting. You would then immediately begin to make arrangements for adequate financing so as to increase the size and personnel of your shop to meet the need- of the 12.000 people waiting for services.
Certainly you would have no trouble in getting money to finance you because any banker could look at the line and see that a loan to you would be an excellent risk. Certainly you would increase your business and provide the services: not necessarily because of the profit that you would make from it. but because you would feel obligated to pass on to these individuals, through management and manufacturing, the things that they desperately need. In fact, this type of change would he relatively easy to do as far as financing is concerned.
Let's change the picture now and not pretend. Every day. when I go to work. I know that in front of our place of business, over the State, there are 12.000 people waiting anxiously for some type of rehabilitation services. I know that during the day 50 more new people will join the ranks of the 12.000 asking for services. I know that during that day we will be able to provide services to only 25 of those people, which means that every day in Rehabilitation we are getting 25 customers behind.
Each time we serve a person asking for Vocational Rehabilitation, we make a profit if We are successful in our endeavor. Over and over again we have proven and pointed out to our banker (the Legislature) that Rehabilitation is a profitable business, not only in dollars and cents, but in human worth and dignity. Although the Legislature individually sees this to be a true fact, it has been difficult in the past to convince them collectively of the desperate need for adequate financing for services designed to benefit the handicapped of this State. Even though Rehabilitation in the past 5 years has doubled its budget and its professional stall we are still getting further and further behind simply because we have not kept up with the times.
In closing. 1 would like to point out that we in Rehabilitation appreciate those people who work with us in our efforts to provide rehabilitation to the many, many, handicapped people of our State, and of our Region. Especially. 1 would like to say that we know of no group of people wilb greater interest, with greater professionalism, and with greater integrity, than the orthotists and prosthetisls who work with us in this Slate.
As time goes along. I am sure that each of us will improve our methods of operation and provide better services than we have provided in the past, but time will overtake us unless we begin thinking in terms of the rapid pace in which we live. This, ladies and gentlemen, is the dynamics of change. In times past we have had years to think and solve problems. Now, at the most, we have months and, in most instances, only days.
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