David A Nicholls, PT, PhD, Professor of Critical Physiotherapy, AUT University Auckland, New Zealand
In many ways, this remarkable collection of eco-fiction essays, produced by students at UiT Norges arktiske universitet, commissioned and curated by Filip Maric, Liv Johanne Nikolaisen, and Åse Bårdsen, and beautifully illustrated by Heike Jane Zimmermann, reflect a lot of our present thoughts about the social and environmental crises that can already be ‘glimpsed in the distance along existing thought pathways’ (Morton 2016, p.1). ‘This is the future’, Tim Morton tells us, ‘that is simply the present, stretched out further’.
The sense that some things will remain and some things will change pervades this whole collection. The authors already have a feeling for what the near future holds for them. Physiotherapy, like the earth itself, will bend but not break. And many of the essays give an optimistic prognosis for human adaptation, if not flourishing. Technological innovation plays a big part in remediating the worst effect of climate change, and the Enlightenment fantasy of the scientists-saviour still lives strong: “You could almost say that the scientists were the Noah’s ark of that time” (Becker). But, as Becker suggests, the lessons of science are no longer used to build a “huge ship” – a wonderful metaphor for industrial-age hubris and colonisation – but to building “an enormous plantation”.
The terrible fantasy that many of a planet so altered that we need to build new artificial Arcadian worlds to rise above, or shield from, the world ‘out there’ is present in many of the essays. Sigmund Freud believed that ‘The creation of the mental realm of phantasy finds a perfect parallel in the establishment of ‘reservations’ or ‘nature-reserves’ in places where the requirements of agriculture, communications and industry threaten to bring about changes in the original face of the earth’ that have made nature ‘unrecognisable’ (Freud, Strachey & Freud 1963, p.372). How we fit into this world is one of the fascinating challenges Filip Maric and colleagues set the students.
The authors can all see that mutual coexistence need to replace the kinds of unlimited growth, exploitation, competition, and white privilege that have blighted our efforts towards planetary justice thus far. But, interestingly, all of the authors in this collection imagine the role of physiotherapists as a partner and collaborator in the New World Order, rather than agitator and strong advocate.
This is perhaps not surprising. One of the hardest things physiotherapists have to do today is imagine how the profession can become more expansive and holistic, whilst remaining coherent and recongisably physiotherapeutic. Will we be trampling on others’ territory by becoming an ally to the environment, or expanding on to virgin soil? Will it still be simply physiotherapy if we become algae farmers (Karlsen), reindeer manure collectors (Anmarkrud), or dome builders (Molden)? How the students grapple with these questions is a telling insight into how the physiotherapy profession might evolve in the near future.
Asking physiotherapy students to think in speculative and creative ways can be hard. Most education programmes put their emphasis on the retention of facts, evidence-based objectivity, rules, and proper conduct. Rarely do they encourage the skills of imagination, creative speculation and innovation. So it is not surprising perhaps then that the stories all assume physiotherapy will adapt and adjust. As Nygård suggests, ’Physiotherapy is a flexible profession that is constantly adapting to human needs, and humanity is constantly facing new challenges, which, in turn, create societal changes’.
Work too remains a constant motif in the essays. The work of the therapist, but also everyday work. And the division between what humans do, and what robots and AI do is interesting. In most cases, technology is mobilised for human enhancement. Servant-bots to put out our clothes, hyperloop trains and ‘Cesla’ cars (Anmarkrud, Kristiansen) are commodity fantasies designed to make our movements smoother.
And it is still humans that decide what work they do and what the machines control. And paradoxically, perhaps, in many of the stories it is the mundane and quotidian tasks, like therapeutic digging, that people retain, and world (re)building becomes one of the main drivers of future physiotherapy. This may be how young physiotherapists are already reminiscing about a past when we could all could touch the soil, ice was made from water, and the air did not need filtering. Whatever prompted it, it is a stark reminder that it doesn’t matter if the students are enrolled in geology, architecture, commerce or physiotherapy, climate change is an existential threat like no other, and one they are all having to grapple with.
Fiction has always spoken the truth in ways that our logical, reasoned minds do not allow, and this collection is no exception. And it is in the speculative nature of these essays that the real hope and vitality lies. One might dispute the science, the confidence in the enduring importance of professions like physiotherapy, or the challenges of imagining post-human ecosystems, but the message of caution that these stories convey cannot be ignored.
More than any generation before, physiotherapy students born in this millennium are acutely aware that the next 50 years of their professional lives could see greater disruption than at any time in the profession’s history. More evidence-based studies of the efficacy of physiotherapy for supraspinatus tendinopathy will not help them here. In fact, these essays suggest very little of what is currently taught in physiotherapy curricula will endure.
Nygård suggests that the “mental part, social factors and the human external environment have also become important to physiotherapists”, but these essays also show that the sheer scale of possible thinking in the profession needs to expand (Eikrem). Exponentially.
Creativity creates hope; “hope that we can find a way out of pollution and littering that creates new ideas and new jobs”(Becker). Whether this means rebuilding a kind of Arcadian world or reviving indigenous wisdom, writing like this shows not only that our students sense the danger ahead of them, but that with the right kind of help, can play an important role in shaping the future.
Maric, Nikolaisen and Bårdsen call this project Physiopunk. This is a great way to frame this collection. It reminded me of a poem by the great punk poet Roger McGough:
I think about dying. About disease, starvation,
violence, terrorism, war.
the end of the world.
keep my mind off things
What we absolutely need in the profession today are some more people prepared to spit in the face of authority and snub their nose at the voices of reason. A little more anarchism, incredulity, and creative dreaming would not go amiss either. These essays do all of that, and more.
¡Viva la Revolución!
Freud, S., Strachey, J., Freud, A. (1905/1963). Introductory lectures on psychoanalysis (part iii). In: The Standard Edition of the Complete Psychological Works of Sigmund Freud. Vol VIII. London: Hogarth Press.
Morton, T. (2016). Dark ecology. New York: Columbia University Press.