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Getting an Accurate Picture

Donovan, Nancy C. PT, PhD; Editor-in-Chief

Journal of Women’s Health Physical Therapy: January/April 2014 - Volume 38 - Issue 1 - p 1–2
doi: 10.1097/01.JWH.0000444258.08802.64

The author declares no funding or conflicts of interest.

At the very top of my “bucket list” is my goal to visit as many National Parks as I can in my lifetime. To that end, this past summer I traveled with a friend to Glacier National Park. As my hobby is nature photography, I packed up 2 of my cameras, along with my hiking poles and everything that made me look as though I was a fit and legitimate hiker. I believe it is my duty as a Mainer to help keep L. L. Bean in business. Each day I would pack my backpack, grab my hiking poles, hang 2 camera bags over my shoulders, and set foot on another hiking trail. During one of my hikes, I was at a lookout point when I heard a person say that they thought there was a family of mountain goats just down over the cliff. Well, I instantly left the safety of the lookout and began to climb down the cliff. I was rewarded as I sat and watched as a family of mountain goats walked about 20 yards from me and lay down to rest. I proceeded, of course, to take about a bazillion photographs so that I could show my friends the accurate evidence of my exquisite day in one of the most beautiful spots I have visited. The accuracy I speak of is provided by the fact that my camera documents the date, time, and global positioning system coordinates of each picture taken. My friend later told me that I was the highlight of the lookout point as people were asking who that person in the blue shirt was. My friend said she just shrugged her shoulders.

Later that evening, we sat out on the deck that faced the lake and the mountains and I clicked through my photographs to see how well I had done documenting my experience. I usually select 2 or 3 of the best photographs and place them in a frame on my walls so that when I walk past them I can relive those peaceful and happy moments. Somewhere during the second or third day of my 8-day trip, I noticed that some people were no longer using cameras to collect evidence of what they saw. I saw people who were in hiking boots and hiking clothing and they were carrying their iPads in their hands. I thought that was a bit strange as there is no WiFi on the trails. But then I saw someone lift their iPads up head high to take a picture. Throughout my time in the park, I was very surprised to see how many people carried their iPads with them. First of all, most of them actually carried them in their hands while they hiked, versus my having my cameras in bags strapped around my neck so that I could use my poles to ensure that I remained upright. It just seemed wrong for people to be wearing wilderness clothing, and with a large can of bear spray on their belt just in case they happened upon a not-so-willing-to-share-the-same-trail grizzly bear or black bear, to be hoisting up their iPads to record evidence of their National Park experience.

Since that trip, I have had many opportunities to think about how the documentation of personal experiences has changed in my lifetime. I was watching a news show one night and there was a spot about a concert at a high school. I looked up at the television and saw that upward of 500 students were holding up their phones to document in pictures what they were seeing. My conclusion is that technology has made it easier for each person to provide accurate evidence of what she or he has seen. Then, in the blink of an eye, that person can share the evidence with any number of interested (or not so interested) contacts. Almost every night now I am informed on the news about how technology is being used to provide evidence of good, bad, and some absolutely incredulous things that I really do not want to know. I mean, really ... did we all really need to see the pictures that Congressman Anthony Weiner sent on his phone camera—twice? We have gone from saying, “I can't believe that ...” to, “whoa ... you have got a picture of that!” One result I am beginning to see is that people feel they must show evidence of what they are claiming, and receivers of information want to see actual evidence of what is being claimed. Technology has made almost every piece of information immediately available on any number of mobile devices. Earlier this year, I was at a presentation about the future of how scientific research will be disseminated to the public, and a major theme was that in the future all information will likely be immediately available to every person wherever they are. This will take away the need to guess, or to wait until you can get home, or to the library to seek an answer.

However, with the explosion of availability of all information, it will continue to require a discriminant mind to decide what to believe and what not to believe. Along with information, there is bound to be a lot of misinformation from individuals or organizations who might hope that we will believe whatever they say, or whatever is put in print in some format. There are some who will teach and write about untested theories, and claim the effectiveness of unproven techniques because they hope we are naive and gullible enough to believe without documented evidence.

As physical therapists, we claim to be in a profession that uses proven principles of science and physiology and chemistry and biology as a basis for what we do each day for the patients/clients who put their trust in us, we must not believe in anything for which there is no well-designed research evidence. It is each physical therapist's duty not to be duped into believing when there is no high-quality evidence. Pictures can be manipulated with a cursor. Interventions and techniques can be manipulated and purported to be effective when research evidence is not required. We must not accept that which is not supported by science. We are intelligent professionals. We must demonstrate that intelligence by demanding an accurate and well-documented picture.

In this issue of JWHPT, we are provided with very interesting information from authors who are not just asking individuals to believe in what they say. These authors have completed investigations and have submitted to our process of peer-review so that naivete is not required regarding acceptance of the information. Dr Brisbee and colleagues have documented the resultant vaginal squeeze pressures with variations in forced expirations. Mr Madson described his interventions for a female who it was thought had sustained a femoral nerve injury during the labor and delivery process. Drs Welty and Davia describe how they chose to treat a male with chronic pelvic pain. The abstracts of the peer-reviewed posters and platforms that were presented at CSM are also included for the readers of this journal.

By the way, my final hike in Glacier National Park was to a site called Iceberg Lake. I actually have a picture of me standing near real icebergs. You can believe me because I have documented evidence in my camera. Better yet, each of you should go and get your own evidence.

Nancy C. Donovan, PT, PhD


Copyright © 2014 by the Section on Women's Health, American Physical Therapy Association.