Braille Monitor August-September 1986
by Kenneth Jernigan
What does it mean to say that an individual is "fighting a straw man?" It means that the person states a proposition (usually exaggerated and ridiculous), claims that somebody he or she doesn't particularly like believes it, and then sets about demolishing it. Even though the proposition may have incidental shreds of truth, it is usually a caricature--and, therefore, totally false. Of course, when you "fight a straw man," you have no trouble winning; but the victory adds no luster to your credibility, reputation, or integrity. There are enough real issues in the world to exercise all of the intellect one possesses and to make the "fighting of straw men" unnecessary.
In the Spring, 1986, issue of the American Foundation for the Blind "News," there is an editorial by William Gallagher, AFB Executive Director, entitled: "Trained Specialists in Blindness/A Growing Need." Since I intend to comment on Mr. Gallagher's editorial at some length, it seems only fair to give you the full text of it. Here it is in its entirety:
"Blindness is on the increase."
I hear this constantly from AFB staff who travel throughout the country to meet with people in the field of blindness. Other comments heard over and over again are, "Our caseloads are increasing, and we have clients and students on waiting lists."
One would think with modern medicine and the remarkable surgical work being done by ophthalmologists that blindness would be decreasing. The cold fact is that this just is not happening. Some ophthalmologists claim that blindness is reaching alarming proportions. With retinopathy of prematurity (ROP) and juvenile diabetes on the increase, many teenagers and young adults are experiencing visual impairments. And, with individuals living longer, more people experience vision loss caused by macular degeration, glaucoma and cataracts.
Statistics will show there are more people within the legal definition of blindness than ever before. Do we have a system to meet their needs? Do we have the personnel? Do we have the finances? And, most of all, do we have the commitment?
Let's examine two philosophies in the field of blindness. One group, and I must say a small one, feels that blindness is just a small inconvenience in a busy world. This group feels blindness is largely incidental, just as some people are left-handed and others are right-handed. Some people happen to be blind, while others happen to be sighted.
The second philosophy maintains that blindness is a severe blow to the individual, whenever the onset. It is a shocking experience for parents of a baby born blind; the newly blinded school teacher is devastated, and a grandmother whose sight is failing feels life is no longer worth living. This group sees blindness as a tragedy--and it can be, without the professional assistance of people committed and trained in the dynamics of blindness. The increase in blindness, the varying psychosocial aspects of blindness, indeed, the very nature of blindness itself dictate the need for professional assistance by qualified, university trained specialists. We need unversity trained and committed people such as teachers, orientation and mobility specialists and rehabilitation teachers as well as social workers who understand the psychosocial aspects of blindness.
The demand for specialists is so great today that generalists, though they may have the educational background, are not the answer for work in the blindness field. They may be committed to human service but we need people specifically committed to blindness. With that, we need more university programs to train specialists in the field of blindness. This is not the time for cutbacks in federal funds to university programs offering courses to train professionals in the blindness field. We need not only more programs but also constant and continuing education courses. We need committed, dedicated staff who continue to study about blindness and its effects on individuals, family and the community. And this commitment to blindness must be total on the part of the agency or school, including its trustees and administrative, professional and support staff.
We see some state agencies for the blind merging with general vocational rehabilitation programs. However, studies show that these mergers do not save money but they do impair the quality of service provided. Clients who are blind do not receive the same quality service they would get from a specialized state program for the blind. Private agencies for the blind that open their doors to all disabilities lose their identity and also lose newly blinded persons who say, "This agency is not for me." Staff also feel they cannot be expected to have expertise in all disabilities. And, most of all, the boards of trustees lose direction and the purpose of their agencies.
Put Differences Aside
This is a time for all people in the blindness field to unite to strengthen services for blind and visually impaired people. Let's put our differences aside and push for categorical services.
If we feel that blindness is simply an inconvenience or a nuisance, and all we have to do is educate the sighted public to have a better attitude toward blindness, then we don't need residential schools for blind students or rehabilitation centers for blind adults. And we don't need to train teachers of the visually handicapped or train rehabilitation and mobility specialists. We can just close our doors and hire "Madison Avenue" advertising and public relations agencies. Let them educate the general public about blindness and change the image of blind people. We know this is not the answer.
Rehabilitation of blind people requires the committed efforts of professional specialists combined with effective programs to help the general public better understand blindness. This must be our goal, for it will mean independence for blind and visually impaired people who will be able to enjoy self-sufficiency with dignity and recognition as contributing members of their communities.
This is the Gallagher editorial, and as with most oversimplifications, it begins with distortion and ends with total estrangement from the truth. In the middle ages the practice of medicine (though a profession) was still trying to find its way. The doctors of that time insisted that they were highly skilled and absolutely essential to man's well-being. Incidentally (considering the conditions of the day) some of them were skilled--at least, to some degree; but even the best of them prescribed treatments that we now know were injurious to their patients--one might almost say their victims. They gave doses of ground toad, human fingernail clippings, and similar potions. They prescribed the drinking of water from an old shoe and the dunking of feverish patients in ice water. Some of them carried new-born babies to upper parts of the house to induce the child to become "high-minded." Even as late as George Washington's day the patient had as much to fear from the doctor as the disease. It will be recalled that in his final illness Washington's physicians repeatedly bled him and applied such heat to his tortured body that he was blistered. It is now the general consensus that Washington died not from his illness but from the ministrations of the "professionals" who attended him.
If you think that by this recitation I am seeking to discredit the medical profession, you are wrong. Many of the doctors of the middle ages (perhaps most) were sincere. They were doing the best they could with the knowledge they had, and they were groping toward eventual enlightenment. In fact, the false starts, the destructive remedies, and the mumbo-jumbo of mystery and downright foolishness were probably inevitable (and perhaps even necessary) steps on the road to ultimate progress. But all of this did nothing to help the unfortunate patient upon whom they practiced and learned. It did nothing to change the fact that the man or woman who trusted everything to the judgment of those "professionals" and nothing to the lessons of daily experience and common sense was more likely to end up maimed or dead than restored to bouyant health. The plain truth is that in many instances the best thing a sick person in the middle ages could do to get well was avoid the ministrations of a doctor--this despite the fact that by the time of the middle ages the medical profession could point to hundreds of years of systematic study. Even today we are advised (especially, when we are dealing with a serious condition) to seek a second or even a third opinion before following the advice of the doctor.
But where is the encouragement (or, for that matter, even the opportunity) to seek a second or third opinion to verify the counsel of the so-called "professional" who reins supreme in the agency doing work with the blind? Today's ethical doctor (secure in the maturity of professional status) advises a second opinion. When have you ever heard an agency official do it? Work with the blind (if it has developed far enough even to be called a profession) is still very young. It must be viewed in the perspective of medicine. The National Accreditation Council for Agencies Serving the Blind and Visually Handicapped (NAC) is the guild--the organization which attempts to keep others out, to protect the insiders, to give respectability to the complicated ritual and dogma, and to compensate for lack of knowledge by mysterious incantations. I shall shortly show you what I mean by quoting from the testimony of Bill Gallagher in a deposition he gave last fall in an effort to deny certification to Fred Schroeder as a mobility instructor for the blind--or as Gallagher would put it, an "O and M Specialist."
The Schroeder case is especially significant. Schroeder, who is blind and who is not a member of the American foundation for the Blind-NAC in-crowd, enrolled in courses to train him to teach the blind how to travel independently. He took all of the prescribed classes and was recommended by the university for certification. Moreover, he had a background of successful teaching as a mobility instructor for the blind. This would presumably meet all of the Gallagher criteria. But no! There must still be certification.
And what is this certification? Where cbes it come from, and what does it mean? A number of years ago a private organization calling itself the American Association of Workers for the Blind (now merged into a larger group) appointed itself to certify mobility instructors for the blind--or, as they call them, "orientation and mobility specialists"--or, to be "trendy" and to give the appearance of sophistication, "O and M specialists." Before the Schroeder incident, the procedure was that the candidate for certification must take the courses and meet the requirements of the university and be recommended by his or her professor. Then, on paying a fee to the appropriate AAWB committee, he or she got certified. But Schroeder is blind. Never mind that he had passed the courses and that the university had put its stamp of approval on him. Never mind that he had already successfully done mobility teaching. Never mind that many people feel that the AAWB certification is a pretention and a joke and that many agencies doing work with the blind deliberately do not give weight to the AAWB so-called "certification." Never mind that there are hundreds of blind mobility instructors working throughout the country competently teaching blind persons to travel independently.
As I have said, work with the blind is comparatively young, and it is far too early to rigidify it into inflexible dogma. Go back again to medicine. There was a time when very divergent philosophies competed for ascendancy--animal magnetism, diagnosis by the shape of the head (phrenology), low voltage electric current passing through the body, mesmerism, and a passel of other now discredited regimens. What if one of these "professional" approaches had gained dominance and been protected from change and competition by a NAC--National Accreditation Council for Agencies Serving the...whatever? Or perhaps there would have been a "certification" which said to all and sundry: "This is the way and the light and the truth. Conform. Have no new ideas."
The Gallagher editorial has holes in it. In the first place the philosophy of the National Federation of the Blind (for he is referring to us) is not what he says it is. He is fighting a "straw man." In the second place the system he is advocating is not working, and more of the same will not make it better. As we have repeatedly demonstrated with the figures from the Congressional appropriations, the federal-state rehabilitation program has not been cut at all. It has been extremely well funded, and it continues to be well funded. Yet, an increasing number of blind persons are saying that if their choice is to have rehabilitation--well funded, unreformed, and as it is--or to have the funds cut off and to have no rehabilitation at all, they prefer the latter. They hasten to add that they hope these are not their choices but that they do not feel that more money and unqualified support for the rehabilitation establishment necessarily means more service, improved programs, or better lives for blind people.
Gallagher says that we believe that "blindness is just a small inconvenience in a busy world." That is not our belief, and Gallagher knows it; for I have repeatedly told him so. We believe that, with proper training and opportunity, blindness can be reduced to the level of a mere nuisance. Surely it does not require the mental powers of a sage to understand the difference between what I have just said and what Gallagher says we believe. Gallagher goes on to say that blindness "is a severe blow to the individual." He further says that the group for whom he presumably speaks "sees blindness as a tragedy--and," he continues, "it can be, without the professional assistance of people committed and trained in the dynamics of blindness.
The difficulty with all of this is that it is a mish-mash, with truth and falsity intermixed. Blindness can be a tragedy, a veritable hell. We have not only repeatedly said this but have underlined it and insisted on it. But here is where we part company with Gallagher. He seems to say that the only way to mitigate the tragedy is through the help of "professionals." He minimizes the role other blind people play in helping the individual who is blind. The experience of Alcoholics Anonymous underscores the fact that we are not alone in believing in the value of peer group assistance. Unlike Gallagher, we do not believe that blindness itself is the principal problem. We think that attitudes (both those of society and those of the blind), outmoded laws, and lack of opportunity are far more critical. We believe that self-organization and collective action by the blind are the most important factors in bringing the blind from second-class status to full citizenship; and we do not see the role of the professional as one of centrality.
Gallagher's philosophy is shot through with inconsistencies. He often advocates (I have heard him do it) that all groups of the disabled should get together for common action, but he vehemently rejects the inevitable consequences--namely, the merging of programs for the blind with other programs for the disabled. He says that certain state agencies for the blind have merged with general vocational rehabilitation programs and that these mergers do not save money but that they do impair the quality of service provided. The National Federation of the Blind does not favor the merging of programs for the blind with other programs, but this does not mean that a program for the blind (just because it is separate and identifiable) is good--or, for that matter, even worth keeping. There are times when a given agency for the blind is so bad and has concentrated within itself such power over the lives of the blind that the most constructive thing to do is merge it or eliminate it. But this should not be expanded into a broad generalization. In fact, as I have already said, that is one of the principal problems with the Gallagher editorial. It oversimplifies and, therefore, distorts--to such a degree that much of it is at variance with the truth.
Gallagher says that if we feel that blindness is simply an inconvenience, and all we have to do is educate the sighted public to have a better attitude toward blindness, we don't need residential schools for blind students or rehabilitation centers for blind adults. "And," he says, "we don't need to train teachers of the visually handicapped or train rehabilitation and mobility specialists. We can just close our doors and hire 'Madison Avenue' advertising and public relations agencies. Let them educate the general public about blindness and change the image of blind people."
The fallacy in that argument, Mr. Gallagher, is your failure to understand the central problem of blindness. As we have so often said, the principal problem has to do with attitudes. The "Madison Avenue" people have, by and large, the same misconceptions about blindness as the rest of the general public--and, for that matter, most of the "professionals." They cannot teach what they do not know or believe. Earlier I referred to a deposition which Mr. Gallagher gave last year in the Fred Schroeder case. Here (without comment) are portions of that deposition. Peggy Pinder is the lawyer asking the questions:
Pinder: Can a person get a proper cane length from anyone other than a certified O and M specialist?
Gallagher: Oh, I think as a blind person, I can hand the cane to another blind person and say, here why don't you use this cane. It is 51 inches or it's 53 or it's 45 inches. I think this might be the best for you. But a sighted person going to that same blind person saying, let me assist you with the appropriate cane that you may need. Why don't you try this length, why don 't you try that. I will observe you as you go down the street, as you cross the street, as you get onto the escalator, as you go down the escalator, as you turn the corner. Maybe a 51 inch cane is better than a 54. I don't think that there is any such thing as a long cane. It is a prescription cane. It should be fitted to the individual. Sure, anyone can go into a five and ten and pick of magnifying glasses so you may be able to see a little bit better. But the person's going to get more use from their sight if they have the appropriate magnifying glasses from an optometrist or ophthalmologist....
Pinder: Can a blind person learn to be a safe cane user without learning from the certified O and M specialist? Gallagher: He is going to be a better one, he will make the major leagues in mobility if he's trained by a mobility specialist....
Pinder: Are there any other ingredients that you want to identify as going towards the making up of a good cane user?
Gallagher: I think the person's got to have a great deal of experience in different climates, weather. I think for a totally blind person, there is a difference in traveling in the daytime and at night. I think also in the environment, if a person is trained, let's say in New York City to use the subways, the buses, what we would classify as an independent traveler, that this person has been trained in orientation and mobility. If he or she goes to Albany or to Buffalo, they may need some orientation to the environment, but they do not have to be trained to be a traveler in Buffalo or Albany....
Pinder: ...Can a blind person learn to use assistance and how to use assistance without the assistance of a certified O and M specialist?
Gallagher: I think you could talk it over with the orientation and mobility specialist as the orientation and mobility specialist has observed this person in traffic or in crowded situations. They observed them from certain distances, and indicate to them that he should have accepted assistance or he didn't need to. The person who is giving the assistance and observing the individual be able to have more confidence in giving assistance if he is able to see the person in the situations....
Pinder: Where did you learn to use your cane?
Gallagher: I went for 11 years as a blind person who would not accept a cane. A cane to me meant black glasses, a tin cup, begging. I didn 't have the confidence. People talked with me and other blind persons talked with me and said, why don't you use the cane? You got it from your family, I got it from my family. I got it from many different people. It was my own attitude and feelings about being independent, what the cane stood for. It wasn't until we started to see trained mobility specialists that gave dignity to the cane and gave independence to the person. I had some counselling and I was then ready to accept the cane and I did take some lessons...
Pinder: Now, have you yourself ever taught any other blind person how to use a long white cane?
Gallagher: I would be scared to. Pinder: Have you ever done it? Gallagher: It would not be fair to the person if I did teach them. Pinder: Have you ever learned any use of the long white cane from another blind person?
Gallagher: No. I am sure I have talked over my techniques on how I do it. I'm sure other blind persons have shared with me some of their techniques on doing it. I have never been taught by another blind person. I have come in contact, as you well know, with blind people day in and day out over many, many years. If I came up with a new cane that I would like, I might share it with somebody. It's the same way a golfer may share his clubs that he is using with another golfer. But for me to go and to work with a blind person to teach this person mobility, I don't think it's fair to the person and I don't think that I should put that person in the position of being able to take my advice and my teaching...
There is a great deal more to the Gallagher deposition, but these quotations are sufficient to give the flavor of it. It will be observed that Mr. Gallagher makes a great deal about the fact that determining the length of a cane which a blind person should use is something that requires very special "professional" expertise--not to mention sight, certainly something that a blind person should not dabble into. Yet, one (so to speak) of the granddaddies of the training of mobility instructors--or, should we say, "O and M specialists?"--says otherwise. I refer to Professor Stan Suterko, who has always stood tall at Western Michigan University. In the October, 1985, New Beacon (a journal published by the Royal National Institute for the Blind) Suterko is touted as one of the original instructors trained by Dr. Richard Hoover after the end of the Second World War at Hines Hospital. He is said to have played a key role in establishing the mobility program at Western Michigan University. Suterko is quoted in the New Beacon as saying that the National Federation of the Blind supports the use of the "extra long cane" but that all of the rehabilitation centers in the United States not associated with the Federation (and this is a direct quote) "issue canes to the bottom of the breast bone." Apparently it is just that simple--no mystery, no mysterious professional analysis--just "to the bottom of the breast bone." Ah, if we could only get past the use of ground toad and the drinking of water from old shoes!
Surely nothing else need be said about the Gallagher deposition. Let me return instead to the Gallagher editorial. Since Mr. Gallagher refuses (at least by implication) to a speech of mine called "Blindness: A Left-Handed Dissertation," we are reprinting it immediately following this article so that Monitor readers may determine for themselves whether it says what is alleged. I, for one, believe there are many knowledgeable and dedicated workers in the blindness field, but I also believe there are a great many phonies, and even more sincere but misguided practitioners of inconsistent nonsense. Some of these latter are more concerned about keeping their jobs and advancing their careers than helping the blind. The greatest hope for the blind is not the "professional" or the agency but self-help and collective action. I think that work with the blind has a good chance of advancing beyond the stage of drinking from old shoes and eating ground toad, but in the meantime the blind must be prepared to do for themselves and look with long teeth at some of the advice they get.