Balancing the Needs of the Population, Profession, and Self: Aligning with the Environment

Thanks, Susan, for your introduction, kind words, and as always your tremendous spirit and leadership. Following in your footsteps from last year's wonderful lecture is indeed a daunting task. I will leave my thanks to the end, as I have been told by others that one can become very emotional during this lecture and, given this once-in-a-lifetime opportunity, I can't waste time being choked up! I would have been pleased to go anywhere in the country to present the Enid Graham Memorial Lecture, but to be honoured in Vancouver during the World Congress of Physical Therapy (WCPT) 2007 is indeed a tremendous pleasure and adds an extra-special meaning to the day. Thanks to Pamela Fralick, CEO of the Canadian Physiotherapy Association, for the call in December; as I am sure you would say, the first time you found me speechless was when you announced that I had been selected for this award. This week, Canadian physical therapists have the unique opportunity to meet colleagues from around the globe. Anyone having a very narrow concept of physical therapy only needs to look at the diverse scientific program of more than 1,700 presentations. I know that all of us will take in as much as we can this week, but we have our work cut out to translate the research, take the lessons learned back to our own settings, and apply the findings to our patients, students, and communities of practice. Today's lectureship was established in honour of Enid Graham, and I want to spend a few moments, as have the past 24 recipients, remembering this outstanding woman. Thanks to Christine James, CPA Director of Membership Services and Component Relations, for assisting me in my research on Enid Graham, as my usual source—Google.com—was not very helpful in this regard! Enid Graham was a founder of the organization now known as the Canadian Physiotherapy Association (CPA). As noted by Joan Cleather in Heads, Hearts and Hands,1 Enid Graham was one of the first individuals to demonstrate the important role of physical rehabilitation through serving the needs of injury and illness of soldiers involved in World War I; furthermore, her achievements are described as “one of the few positive legacies of the war.”1 Enid was a member of a Voluntary Aid Detachment and provided medical care at the start of World War I. After studying physical therapy in Philadelphia in 1917, she entered the Royal Military Army Corps. In addition to her work to assist with establishing the first physiotherapy schools in Canada, she fought for and received a Dominion Charter for the CPA. She chaired the Canadian Military Affairs Committee and succeeded in securing the granting of officer rank to all CPA physiotherapists who volunteered for overseas duty during World War II. I was amazed when I read that 138 of the 340 qualified physiotherapists in Canada volunteered for overseas duty during World War II and were paid and had privileges equal to male volunteers of similar rank. Cleather suggests that “Enid Graham is to the profession of physiotherapy in Canada what Florence Nightingale was to the profession of nursing worldwide. She was a visionary, a true leader and the ultimate champion for the profession as it has evolved.”1 As I contemplated a focus and inspiration for the twenty-fifth Enid Graham Memorial Lecture, I looked to the work of the 24 previous award recipients (see Table 1). These papers are an amazing collection of work—thought provoking, reflective, and visionary. Brenda Meyers used photos from her past to take us through her world travels in physical therapy; through her eyes she has seen physical therapy at its best and most challenged. Carol Richards walked us through her experiences with research teams, mentors, and students. Last year, Susan Harris reflected not only on her professional experiences but on her personal experiences, challenging us to remember the person we work with—listening and observing and responding. Joan Walker's address in 2002 challenged us to consider our place in the health professions, using the wonderful theme of steering a ship—obviously her maritime roots. Table 1 Enid Graham Lecture Award Recipients: 1981–2006 So what to add to the Enid Graham Lectureship series of great works and wonderful authors (no pressure, I assure you!)? I thought I could have an analogy like Joan Walker's building on her life near the ocean—for me, of course, that would be living on the prairies. I thought I could use farming—evoking thoughts of ploughing fields, planting, growth, resiliency, dealing with adversity, and always looking to large and expanding horizons. These concepts and experiences provide a backdrop to many of the issues facing our profession and our society. The prairie analogy is also fitting for physical therapy at this point in our history, as our opportunities are substantial. I am confident that we are positioned to respond effectively to the many challenges facing our profession, as so eloquently proposed to us by Martha Piper during her address at the opening reception of the 2007 WCPT. As we all know, farmers spend considerable time scanning the horizons, observing, assessing, and determining actions based on the environment. Farmers consider what is in front of them and predict their actions based on experience. We all are aware of the Farmer's Almanac as an important planning tool! So I have approached this lecture by considering the question, How is physical therapy as a profession responding to the environment? In addition to reviewing a variety of publications as a basis for this scan, I have blended my clinical, teaching, and research experiences and my bias, or perhaps we should say “mature reflections.” I have also been tremendously influenced by more than 10 years of experience as chair of Saskatchewan's Health Services Utilization and Research Commission (HSURC) and, most recently, the Saskatchewan Health Research Foundation (SHRF); you will see this background reflected in my presentation.

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