Social Work; Essays on the Meeting Ground of Doctor and Social Worker

Eighty per cent of any human being's body is made up of water. Where did it come from? It came from what he has taken in in the form of drink. Where did that come from? From the earth and the streams. Where did they get it? From the clouds. Where did the clouds get it? From the seas. Where did the seas get it? From the interplanetary spaces and God knows where. Eighty per cent of our bodies, of our available energy, comes out of something as far off as that, out of sources that have ultimately as little to do with us as that.

The other twenty per cent, the solids of every organ in our body, the brain included, are alike widely distributed in source. We do not always stop to think how widely distributed are the foods out of which the body's solids are built. Grains, fruits, vegetables, meats, we get them out of every part of the globe. The minerals that are deposited in us as what we call bone, the lime and other salts, are something which a plant once sucked up out of the earth, or another animal took out of his food to pass on to us. The bones of a human being come out of the bones of the earth through his food, animal and vegetable. The breath of the trees, the oxygen which the trees give out every day and every night, we breathe in. They take up in turn the carbon that we give out, so that there is constantly an exchange between the animal and vegetable kingdom and ours. We are warmed by inheritance from thousands of years in the coal that plants have laid down their lives in layers and strata to form; we are warmed also by the constant literal burning up of food energy in ourselves. We are clothed with borrowings from sheep and cows and other animals; birds' feathers go to make our pillows, beds, and hats.

Sometimes I wonder whether we are worth all this destruction and all the other forms of destruction whose living incarnation we are. I described, in speaking of fatigue and rest, how our physical life is a constant process of burning up and breaking down tissue, hence of destruction. And of course the money and labor of our parents that kept us alive up to the time that we call ourselves self-supporting, represents other stores of energy passed on through various way-stations, by the same sort of borrowing, from every part of the universe.

All that death, that suffering, that destruction, are we worth all that? One certainly could see a tragic aspect to this question if one were so minded. Many philosophers have so seen it. But the answer depends, I think, on what we do with that energy. It may easily be wasted. It may just run through us, as much of our information runs through us, uncaught, unused, sacrificed for us, and nothing come of it. But it may be used right.

When we come to think of our mental energies, are we any less incurably borrowers, incurably indebted to the universe, incurably wasters except in so far as we make use of what we borrow? Anybody who has not studied how the child learns to talk, does not realize what a borrowing the simplest acts of language are, what imitators we are from the earliest moments of our lives. And if we try to think back to the pieces out of which we have been actually made, our intellectual, moral, spiritual life, we could take ourselves apart like a piece of machinery and say where each piece came from. If we look into the generation of our own minds I think we shall be overcome with wonder as I often have been, by the consideration of how little there is left that is us if we take out what has been given us. I can say from whom every idea I have had came, from whom I had it as a free gift. I believe the greatest of all our borrowings are from people we never saw, from books, from music, from art, from personalities to whom we feel inexpressibly near although we never saw them in the flesh.

Our spiritual borrowings are not only from sources such as I have mentioned, but from impersonal sources also, from beauty, from nature, that does not speak to us through any man. I have seen a hepatica on a rocky hillside under brown oak leaves, the sight of which made me conscious that I could never pay off my debts for life. I have heard a thrush singing in the early morning in wet dark woods, and known then and there that after the gift of that song I could never get even with the universe.

Most of us have had that sort of experience many times; it goes on and on piling up our debt. But our obligation grows and grows when we think of our country, of the traditions of our race, and of what has been given us by the church or university or family in which we have found ourselves without our doing anything about it. What should we be without those? What shred of personality would remain? I do not think the figure of the body, as I have tried to describe its borrowings, is any more striking than that of the mind, the spirit, and the inexhaustible debts that it has laid up.

All this energy poured into us from the material and from the spiritual universe around us accumulates in us. It accumulates bodily in vital force, zest, animal spirits, or "pep"; the desire to shout and sing or jump or slap somebody on the back. That is the vital side of our unexpended borrowings, the bodily expression of the fact that we have received more than we can easily take care of. But mental energy accumulates too; and the sense of its pressure is expressed in what seems to me the greatest word in our language —gratitude. Gratitude is "happiness doubled by wonder," happiness such as anybody may contain almost unconsciously or may let out of him, if he is thoughtful, in action sprung from conscious gratitude. Gratitude seems to me ultimately the motive of social work. We find in ourselves this painful head of energy – to me often painful. The sense of an animal caged, of a dog in leash, is the figure that most often comes to me as I am aware of what has been given to me and of how little I have paid it back. The extra flood of physical energy which any healthy human being or animal has, is paralleled in this tension of gratitude for all the gifts which we have not properly handed back, have not passed on, and never shall.

The attempt to pay out, to pass on, this energy naturally divides itself up according to the ways in which we have received it. We have received the physical bounty of life. We know how good it is to get water when we are thirsty and food when we are hungry, and along with the full-flavored awareness of this good we feel the pain of not being able to share it as swiftly as we would like to share it, as fully as we would like to share it, with people who have not got what we have. We call that pity, the sense of kind. I think of it as the sense of a common need. Other people are such as we. We are painfully aware of what has been given to us, and how much we and everybody else need it, and how little we deserve it. We are eager therefore to pass that on in any such form as it can be received. We are grateful for any good chance to pass it on. A homely but true image is that of the nursing mother. The baby needs milk and the mother needs to get rid of that milk. It is a painful pressure in her breast and a pressing need in her child. The two needs meet and satisfy each other.

We are just as eager, I think, to give back in kind all the different sorts of delight and of beauty for which we are grateful. But we have not well expressed this eagerness. I have dwelt already on the great lack of beauty and of art in social work, on its ugliness and drabness, and on the care-worn look in the social worker's face. But no one who is vividly conscious of the gifts of beauty which have come into his own life can continue to make his attempts at social work as unbeautiful as they have been hitherto.

If we have any sense of gratitude to the people that have cared for us, we want to pass on affection. We know the affection that was our physical creation in the beginning and our upbringing through childhood and youth, yet most of us have never tried through most of our lives to pay back these debts to our parents. Indeed we usually do not become aware of those debts until it is too late. To know that would bring us to almost insupportable remorse after our parents have left us, if we were not aware that we could pay over to somebody else the affection and care which they once lavished on us.

As we know that the physical energies of water and oxygen and carbon, of the food, the lime salts, and whatever else goes to make up our physical being, all come out of one source, so we are aware that all spiritual gifts come out of one and the same source. To be vividly aware of that, to stop and face the facts, to stop and take a view of where we are, tells us what next to do. It makes us eager to pay back some of that gratitude directly in prayer, and also indirectly through all the way stations by which this help has come to us. If you want to please a mother you do something for her children. A human being lives in his children, in the people or the undertakings that are his children literally or figuratively. If you love him, you feed his lambs. So we get the impulse to pass on the best fruits of life, first to the one source of all that makes us grateful, and then to the children of this central Energy, the different way stations from which it has come to us.

We eat our heads off like stabled horses with too much oats, if we do not get a chance to give away some of what has come to us. A man who tells funny stories is always grateful to the man who will listen to him. The same principle holds true all the way from story-telling to social work. It can be taken as humiliating, but properly viewed it is a sanifying and humbling fact.

I wrote a moment ago of the sense of what we owe to our parents, a debt that seems almost insupportable sometimes. It would be insupportable if we could not pay it on to somebody else. Were it not for this central fact our gratitude would be a curse not a blessing. But in fact those who gave to us, our parents and all the rest, are best pleased if we pay over their gifts to somebody else. That is how we can best repay them.

If this is a right conception of the source out of which comes the energy that has set us going and will keep us going, I think we can trace out a justification for the principles of social work which I have tried to present in this book and will now summarize:

1. We want to do social work because we have got something that we must share, something that is too hot to hold. There is a false emphasis, approaching sentimentality, in saying that our social work is done because of our love for the individual people to whom we give. We have a hope that some day we may know a few of these people well enough to say that we love them. But that is hope, not fact or present impulse. Hence it is not right (although it is not a fearful error) to say that we do social work for love of the particular individuals whom we try to help. We are looking for an opportunity and are grateful for the opportunity that social work gives us, to pass on the gifts which we are grateful for, not as has sometimes been said, to people whom we love but to every one who needs them.

That may seem a very slight difference of emphasis. I think it is a very important difference of emphasis. We are in a much more self-respecting position if we do not have to think of ourselves as having already conquered at the beginning that which we aspire to win in the end, a personal affection for all our patients. If we remember that our patients are (unconsciously) doing us a favor in allowing us to pass on something to them, and that although we may have found a genuine need, still we are grateful to them because they want what we have to give, then our work is humble and free from taint of Pharisaism.

2. The second principle is: give as one passing on that which is not our own. That is familiar enough in relation to money. Any one who has any money and any capacity for thoughtfulness, knows that his money is not his own. Whether it happens to be literally in trust or not, the only right he has is the right of rightly choosing what he will do with it. He holds it rightfully just so long as he needs to find the chance, the best opportunity for passing it on.

Such a sense of trusteeship we ought to feel about everything that we have and want to give: beauty, information, education, affection, and courage. One should give them (if he can!) not as one who has any special merits, not as one having property which is one's own, but as one who has received without any possible deserts an incredible wealth and would like above all things to share it because it is not his own.

3. We ought to give and build, because the effects of any giving that is not also building will not last. Our bodies and our souls are what they are because of what has been given and built into them by nature and by man. The same energy which burns in our bodies and knows in our consciousness should make us desire always to give and build by giving, because we have ourselves been built up of such gifts.

4. We ought to give and take. That is another aspect of giving as one who passes on. We can give only what we have taken. Hence if we allow our lives to get cooped up, narrow and stifled, so that we are not taking in steadily, or not getting fresh energy out of what we have already taken in during the years that are past, we soon have nothing to give. I have written of the ugliness and the depression that I have seen too much in social workers' lives. That is partly because they are often led into giving without providing for any adequate source of renewal. They are not taking in enough to have anything to give out. They give until they are drained dry, squeezed out.

5. We give not as people who find the world so pitiable, so miserable that we want to diminish its misery. We give as people who find the world so glorious, so overflowing, in what it has done for us, that we want to even up, to pay out. We want to share our enthusiasms. Pity led Schopenhauer to pessimism. He pitied the world so much that he thought everybody ought to get out of it by suicide. Pity therefore does not necessarily lead us to social work.

But if we admire anybody, that fact gives us a duty to get our admiration over to somebody, to share our enthusiasm. The whole of a Christian's duty might be phrased as the duty to share his sense of the beauty and the wonder that is in Jesus Christ. Almost the only act that we can be sure will be of use in the world is the act of sharing what enthusiasm we have.

6. But this cannot be done without some care to shape it, without some labor to put it in a form in which somebody else will understand this sense of our admiration or gratitude. Without form and study to give it form, our enthusiasm is mere noise and good spirits. As I have described the fund of energy which comes into us, is felt as gratitude and then pours out of us in social work, one may have wondered, where does man's individual will and choice come in? Where does he begin and these tumultuous energies stop? What is he?

He is that which focusses, that which forms, which makes comprehensible, which expresses the energies that have been given him as a free gift. And because miraculously he is made new – for everything that is new is a miracle – because miraculously he is different from every human being that ever was, so different from all others is the gift that he has to give. I think it is sometimes comforting to look at a finger-print. One gets doubtful whether there is any special reason that the individual called by one's name should persist on top of the earth. Then it is well to go back to simple, elemental facts like finger-prints, with the pretty nearly irresistible conclusion that the rest of our body and soul must be as unique as that, and so possesses something as original to contribute to the world. I have no doubt that there is waiting for each of us to-day a job much more individual than we have ever yet done.

Although, then, we can rightly give in social work merely as people who pass on to others in gratitude and wonder the energies which create our bodies and our souls, yet we can be perfectly sure that if we do what it is up to us to do, we shall in time be giving as people never gave before and never will again. We have missed rare chances in social work unless through presence of mind we find our chance to express differently from what we have ever heard it expressed before that which we feel pushing in us to get out.

7. Since it is our business to give as people who pass on, we want if we can to make it clear sooner or later to the people to whom we pass it on, that we know this. Then they will feel no shame in taking since they know that they do not take from us. There will be no sense that a higher being is distributing what a lower being has to take, if we make it clear that we are sharing that which it is uncomfortable not to share. We are sharing that which we share because in view of all the bounty which we have received, in view of the beauty which has struck us dumb, in view of the flood of affection that we never have answered, we know what to do next. We know that we are branches of a vine, and that the sap of that vine can flow out in us and through us to other tendrils.

THE END

notes

1

Conférence Interalliée des Mutilés. Paris, May, 1917.

2

Bosanquet, Helen. The Standard of Life and Other Studies. (London, Macmillan & Co., 1898.) The Family. (London, Macmillan & Co., 1906.)

3

See Health of Munition Workers Committee. Final Report, Industrial Health and Efficiency. (London, 1918.)

4

Polonius (showing out the wandering actors): – My Lord, I will use them according to their desert.

Hamlet: Odd's bodikin, man, much better! Use every man after his desert and who shall 'scape whipping.

5

In the volume called The Musical Amateur. (Houghton Mifflin Co., Boston.)