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

by Richard C. Cabot

But when we give pleasure we must try to provide that the stock shall go on. We want to try to build in and with the person some capacity to get that pleasure for himself after we have gone out of his life. This is just as true of course of Beauty which we surely want to try to bring into our patients' lives, and which is one of the things that redeems our failures on the other side of social work. Even people who are dying sometimes can get great enjoyment of beauty.

2. Money is, I suppose, on the whole, the thing we are asked for directly or indirectly most often in social work. If we are not doing direct medical work, if we are not giving a direct medical relief or trying to, we are more than likely to be asked for help in the way of money, clothes, food, or rent. Surely no one works long in social work who does not find the right place to give money. But I have to go back to the figure already used, the parallelism of money and morphine. A person comes to us with pain and begs for money or its equivalent—direct, immediate relief. What makes us hesitate in the one case is the same that makes us hesitate in the other. We may relieve, yes; but have we constructed? In the long run we must both construct and give, else our giving may be useless or harmful.

When can we give money without doing harm?

In a general way, when it is not going to lead to the repetition of the same demand. When are we perfectly sure that we may safely give morphine? In gall-stone colic. For it may be weeks, months, years, perhaps, before there will be another such attack of colic. We give morphine once only. The person gets over the attack, and does not want morphine again for months or years. But if the patient's pain is chronic or likely to recur soon and frequently, it is cruel to give morphine, because soon the patient will have all that pain again, and more—the pain which is produced by morphine after it has been taken a little while. We never can tell that the pain suffered is not wholly due to morphine. So the person's trouble after we have given money may be due to the money itself, ill used. We should be able to say, after a careful, though not care-worn study of the case, that we know the patient's pecuniary need is not going to recur, because we are not dealing with a chronic difficulty like extravagance or alcoholism, which will recur and cannot be checked by money.

3. On the whole, the safest form of giving that I know, that which is surest to perpetuate itself, to be planted like a seed and go on without our having to stand by it, is giving information—a cold-sounding thing, but sometimes very useful. One difference between the social worker and the person for whom she works ought to be that the social worker has had more education, more freedom, more friends, more opportunity to look around the world and see resources. Hence, when, for instance, she comes to find a job for a man, the social worker, because of the perfectly undeserved blessings that she happens to have, ought to be in a position to give information that is of value.

One of the most precious kinds of information is information how to secure more information. The difference between uneducated people and those whom we call educated, is not that the latter know very much, but that if they do not know something they know how to go to one who does. The uneducated person is helpless to improve his education. He does not know and cannot find out how to look up a subject.

I have distinguished information from education. Information as such never changes character in my opinion. This subject has been discussed in recent years in connection with what some call quite falsely sex hygiene. Information biological, pathological, physiological, talks about health and disease, never kept any man or woman straight morally. It never changes character. So our public school education sometimes represents only information, only the facts, not the meaning, the interpretation, the use of those facts. Hence the public school is justly open to the criticism brought upon it by those who say that it does a child no lasting good to know facts. It may make him clever and so able (like German science in war) to do more harm than if he knew less.

But when we give education—for example, hygienic or economic education—we give something else than information. Education is that which, by reason of practice, by doing something again and again, and doing it if possible in the presence of a good model (living or dead, book or person), changes our character and our habits, as the use of a muscle changes the muscle. A person learns to write. That is not merely information—he has learned to do something. Learning to swim is not information. We learn it by practice, by doing it, and by the imitation of good models. How does one learn to think? By doing the thing, and if there is any model in sight, by trying to imitate that model.

4. Education is what social workers try to give most often, most consciously, over the longest time, and sometimes with the greatest results. We try to give people hygienic education. We try to give, not merely hygienic information, but motives fit to bring about a change in habits, a wholly different thing, and one which may be of signal value. We try to teach self-control, the control of sleep, the control of emotion, the control of appetite. It is hard, but it can be done by prolonged effort, under such influences as give us courage to work at it. We try to give economic education, the power of foreseeing what is going to happen by reason of what has happened before. People are extraordinarily prone to forget things which they do not want to remember. We may help people by economic education, to economic foresight, to economic organization of their resources by practice, and by going over with them the cases of other people who have won out in similar difficulties.

5. Anybody who does much talking is asked a good many times, "Won't you please come round this evening and just give us a little inspiration?" There is no request that I look on more sadly, more wistfully, than I do on that. I know how little good such "inspiration" usually is because it can be given the same way as money or morphine can be given. Inspiration or courage means emotion of some kind. Nobody believes in emotion more than I do. I believe the greatest life is the life that feels the most, enjoys the most, suffers the most. But emotion is one of the most transient and unreliable of states. One may be in a most exalted and courageous state of mind at the end of a lecture, and a few hours later be as weak as an invalid, because, though courage has come, it is courage which does not provide for its reënforcement, for a new supply. We never give people help that has any permanence except when we give them reality. We try at first to help people in their woes through our own personalities. But we are not strong enough to keep anybody else afloat. We have to transmit something greater than ourselves, if possible to bring people in touch with a life-preserver that will be there after we are gone.