#PTHistory: Enid Graham

Enid GrahamThe Canadian Physiotherapy Association and the Department of Physical Therapy at the University of Toronto recently jointly nominated Enid Gordon Graham (née Finley) to the Historical Sites and Monuments Board of Canada in order to recognize her contribution to the development of rehabilitative care and the education and practice of physiotherapy in Canada.

Over ninety years ago Enid Graham pursued the highest standards of education and practice for physiotherapists. The 100 year history of physiotherapy in Canada is a testament to Enid’s remarkable vision and spirited leadership. 

In 1917, when Enid was invited to teach in Toronto, few in Canada practiced physiotherapy. Having trained in Europe and the United States and provided treatment in military hospitals, Enid had a particular understanding of the need for rehabilitation. Her experience during the First World War underpinned Enid’s vision and commitment to the development of physiotherapy in Canada for the rest of her life. She had a unique vision of how the existing practice of medical gymnastics, massage, electrotherapy and muscle training could be combined more effectively into one medical discipline, now known as ‘physiotherapy’.

She was convinced that the education, practice and ethical standards of physiotherapy should be consistent across ‘the Dominion’ (Canada) and be available for civilians as well as for the military. Enid worked tirelessly to these ends throughout her life, despite competing demands of a busy family and social life. In Canada, The Toronto Society of Trained Masseuses was formed in 1915 and the Montreal Society in December 1918. In 1919 the Montreal Society applied for a Provincial Charter to formally recognize the profession.

However Enid and Lt. Colonel Wilson, Officer in Charge of the Military School of Orthopaedic Surgery and Physiotherapy in Toronto, imagined an organization that was national in scope and longed for a Canada-wide charter. Enid persuaded the Montreal Society that all would benefit from the presence of Canada-wide standards of education and practice. On March 24, 1920, the Canadian Association of Massage and Remedial Gymnastics (CAMRG) was formed with Enid as one of its Charter members.

Enid was a brave woman in the face of personal tragedy: in 1922 her husband died at the age of 38. Left with a young son and a two-month old daughter, Enid went to live in Europe, until her children became of school age. On returning to Toronto she discovered that no progress had been made in educating physiotherapists.

Convinced that physiotherapy education should be within a university in association with the Department of Medicine, she began to work on the development of a physiotherapy school at the University of Toronto.

In 1929, Enid remarried and had another child. However, family commitments did not slow her perseverance: with the support of colleagues, Enid persuaded the medical faculty to support a school of physiotherapy at the University of Toronto. A two-year educational program was opened in the Department of Extension on condition that it be financially self-sufficient.

Initially there were many difficulties in maintaining the program, due in large measure to the Great Depression. Whatever the circumstance, Enid Graham came to the rescue. Initiating a new medical discipline is a major achievement in and of itself. Gaining the appropriate acceptance, recognition and support for its future offered further significant hurdles, but Enid was always up for the challenge.

The experiences of the First World War had been etched in Enid’s memory. At that time the profession of physiotherapy was poorly trained, without rank or recognition, and remuneration was not commensurate with its role on the health care team. Thanks in large part to Enid’s work in the intervening period, when the Second World War broke out, military officials recognized that physiotherapists would be needed in hospitals overseas and at home.

In September 1939 the Association, now known as the Canadian Physiotherapy Association, turned to Enid once again. Along with representatives across the country, Enid formed the CPA Military Affairs Committee. The lion’s share of the work fell on a small committee of three in Toronto, and particularly on Enid, the Chairman.

They voluntarily met weekly to determine policy and standards for the appointment of physiotherapists overseas. They lobbied the army, navy and air force to accept the standards of the CPA and the work of the Military Affairs Committee in making appointments to each service. They established courses in rehabilitation for Nursing Sisters. Hours and hours were spent at the typewriter maintaining complete records for those who volunteered and in keeping close personal contact with everyone serving overseas and in Canada.

The development of national standards in Canada can be challenging, as health care and education are the purview of the provinces. Yet national standards were Enid’s dream and commitment. She believed in and worked towards the development of a strong professional association. She made sure that high standards of practice were imbedded in a Code of Ethics for the profession.

Enid challenged CPA members to continually improve their standards of education and practice.  As a result of her vigilance and efforts the Canadian Physiotherapy Association remains the voice of the profession in Canada and a leading contributor to the development of rehabilitation professions world-wide.

In 1961, in recognition of her outstanding leadership, the Canadian Physiotherapy Association awarded Enid Graham its highest honour: she became the first Honorary President of the Association to be chosen from amongst its members. Later, in 1979, in memory and honour of her distinguished leadership, the CPA instituted the Enid Graham Memorial Lecture. Each year the CPA asks a member who has influenced the growth and development of the profession and enhanced its practice to deliver a lecture that calls upon the ideals first expressed by Enid.

From her return to Canada in 1915 until her death in 1974, Enid Graham remained committed to the development of physiotherapy in Canada. She not only shaped the education of physiotherapists at the University of Toronto but also the practice of physiotherapy in Canada.