A disease of the spirit.

Production deadlines require that I write this Editor's Note before America has elected its next president, a president who will through legislation and appointment affect much of our daily lives and who, by necessity if not by choice, will have to deal with the growing chaos in American health care. As I consider this election, my heart aches--not because of who might or who might not be president, but because as a society we seem to justify apathy by applying a sugar coating to cover its awful taste. I am not talking about voter turnout, but about American attitudes. Just as professionals have in the past found a euphemism for failure to perform in the term "burnout," society as a whole has created a euphemism for failure of citizen involvement. It's called "alienation."

Burnout and political alienation have a common thread. In both cases we view ourselves as disenfranchised visitors unable to influence the house rules. We act as though it is not our house! The problem always seems to be caused by "someone else," by "the system," by "them," by forces we seem incapable of changing. We see too many people trying too hard to explain how their involvement is a function of the whims and wishes of others. In arguments that seem more petulant than logical, people appear to be saying that as long as things are not their way, they want no part of the system.

Perhaps this is the legacy of the '60s generation, which saw itself capable of changing everything, but committed itself to changing little when there was a personal price to pay. Perhaps things have come so easily to so many of us that we do not understand that involvement and commitment require time and effort. Or it could be that we simply find it easier to cry over lost opportunities than to share with our leaders responsibility for what occurs in our world.

An illustration might help make my case. In an outcry heard loud and clear, especially this past year, many Americans damned the presidents and the congresses who they say created the national deficit. Our elected officials created the deficit. Yet we who are complaining now stood by while the deficit was being created and then elected and re-elected those who made the deficit grow. For me the point is not where you or I stand on this issue or any other, but the need for us to recognize that once we have stood by in silence, we have lost the right to be outraged and to claim that our will was not done.

My argument is not new. Thomas Paine reflected on a tendency toward apathy and a preference for words over activity when he observed: "These are the times that try men's souls. The summer soldier and the sunshine patriot will, in this crisis, shrink from the service of their country; but he that stands it now, deserves the love and thanks of man and woman." Paine may have been thinking about service in grand terms; after all, there was a revolution going on when he made the statement. Mine are less grandiose expectations. I simply want to know what gives us the right to criticize when we refuse to become involved? More of us need to become involved earlier in the political process to determine who runs in primaries, who wins in primaries, and as a result what choices we eventually have. If we value our opinions, then we need to remain active in political organizations in between elections. Such involvement may reveal that, at least in our country, them is us, something that people living outside of democracy cannot say.

For those who believe that these Editor's Notes should not be a place for political issues, I can assure you that today I am not writing about national or even global politics. The point is more far ranging than that. The apathy I bemoan seems to be rampant in American society, permeating almost all of our civic, professional, and personal activities. We as physical therapists understand the issue of learned helplessness. We also know that too often when patients say they cannot do something, it becomes a self-fulfilling prophecy.

Even within our professional activities the malaise of apathy hurts us all. Members of our profession, for example, often find it easy to criticize the American Physical Therapy Association's elected leadership, but show little commitment to encouraging change among that leadership, Our professional leaders, like our political leaders, can be blamed for everything and anything. in each case, such blame is an injustice. Too few of our members pay attention to the issues, attend meetings, or participate. We hear from some members only when they perceive that some great misdeed has been committed, but where are they in between such episodes? And what happens to their indignation when the feelings of the moment have passed? The issue is not rhetoric or reaction, but commitment and interaction.

When Eleanor Roosevelt died, it was said that she would rather have lit a candle than cursed the darkness. I am haunted by the possibility that by giving social acceptability to apathy in the name of alienation we invert that noble thought and encourage anger in the darkness. If this past year of political confusion leaves us with the notion that systems do not work and that this in turn justifies withdrawal from the process, then we will have given ourselves up to a disease of the spirit that will run unchecked through all aspects of our society--with activism and involvement as its casualties. If, on the other hand, regardless of election results, we look to the opportunities that occur when we empower ourselves, then we will in effect inoculate ourselves against apathy and the fatality of surrendering our fate to others. To me the answer is clear--do we in our governments, our work settings, our professional associations, and our personal lives consider ourselves controlled solely by external forces, or do we accept the responsibility of interacting with those forces?