5. The case-worker's pyramid in social treatment
It might well be objected by any thoughtful reader that if a person carried out the physical, economic, mental, moral, spiritual investigations that I have suggested in this book, he could take care of no more than one patient at a time, and would need years to finish up the tasks suggested by the history of that one person. That is an objection that certainly deserves an answer. I will begin my answer by a comparison with medical work. A trained physician is supposed to know something of all the organs in the body. Even a dentist or an oculist has had some training on all the bodily organs and not merely on the special ones he treats. Among the organs of the body, the medical profession is supposed to include the brain and all the functions of the brain. This implies that he is supposed to have at his finger-ends the ability to make an examination so complete that a whole day would be needed to finish it. Obviously if he attempted anything like that he would soon be overwhelmed. But on the other hand if he limits himself to the professional examination of a single organ, the one perhaps which the patient complains of, he does so at his peril. He is in danger of making a wholly wrong diagnosis. But that can be diminished only in proportion to his knowledge of all the other organs that he does not examine. A well-trained physician must and can safely do some superficial work. So a very well-trained social worker can and must do some superficial social work. In the practice of any doctor who counts up a month's patients we will say to one hundred, there will be about fifty that he has examined and treated very slightly. Then there may be twenty-five whom he knows a little more about, fifteen perhaps that he could give a full account of, and possibly ten whom he has had to study from all the points of view that his medical education has made possible for him. His professional life then is not wholly superficial yet does not attempt to deal exhaustively with every case.
As I see it, therefore, our work in the social or medical field ought to be something like a pyramid.
We should study and treat many cases superficially, a smaller number more intensively, and at the top of the pyramid which represents our case-work will come a few to which days or weeks of time are devoted. Such a distribution of time is not unsatisfactory or slipshod because not all the needs that come to our attention call for thorough study.
Such a pyramidal distribution of our energies is familiar and satisfactory in other fields of life, for instance in the field of friendship. Nobody wants only intimate personal relations. Everybody needs as a basis a host of acquaintances. Out of them all he makes a few friends whom he hopes to know as well as he can know any human being. Almost no one is satisfied to possess only acquaintances or only intimate friends. The properly balanced life has both.
Both among those for whom we attempt only slight study or slight service, and among those to whom we devote ourselves intensively, doctor and social assistant alike must count failures as well as successes. We do not try to balance failures and successes if we are wise. The Lord only knows which of our seeming failures are really successes and which of our successes are failures. Some of the people with whom we seem to have made total failures, a more complete knowledge might show to have been actually helped. All this we must face from the start. Then we shall not be disappointed because we have to touch a great many people superficially and to fail a great many times. That is all right so long as we are not always superficial and do not always fail.
Such a philosophy is my defence for so elaborate and extensive a scheme of social investigation and social treatment as I have tried to explain in this book. The experienced physician and the well-trained social assistant can judge with some accuracy which cases to select for thorough study and continued devotion. But such a judgment is impossible unless one keeps always ready in the background of one's mind the whole apparatus of social diagnosis and treatment as it might be applied in toto, if time and strength were unlimited.
FOOTNOTES:
[4] Polonius (showing out the wandering actors):—My Lord, I will use them according to their desert.