Oncology Massage

The Woman on the Plane: a short, “true” story

She and her husband were in the last boarding group for the early morning flight on Southwest. They rushed onto the plane just before the doors closed. The husband came down the aisle first, squinting towards the back of the plane, his unzipped jacket lightly brushing the elbows of everyone in the aisle seats. He strode past my row, near the back of the plane and found a seat.

She stomped behind him, lips pressed together and breathing in sharp little exhales. She wore a black scarf wound artfully around her head, eyelashes too long to be real, and perfectly arranged black leggings under a voluminous, colorful sweater.

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Only middle seats were left on the plane. In my row, a quiet older woman had the window seat and I had the aisle. The woman in the black scarf carried a half-unzipped backpack in front of her. She stumbled over the emergency light strip just before my row and a tumble of makeup, brushes and lotions spilled from her bag. She blew a forceful gust of air through her lips and crouched down in the aisle to pick everything up.

She mumbled to herself as she filled her hands with the debris from her backpack. When a man on the aisle leaned in to help, she waved a hand at him and shook her head. Finally, she scooped everything from the floor back into her pack, pulled the zipper mostly closed and shoved it into the bin right above my head.

She stood in the aisle then, right next to my elbow, scanning the back rows. “Stan!” she whispered, “How could you do me like — ” and she sighed deeply. She looked down at the empty seat in the middle of my row and started to climb over me to reach it.

“Please let me stand,” I said. I got up to stand in the aisle, brushing heavily against her as I did. She did not move from her position right against my seat. Her gaze hovered somewhere behind me and her brows knit together ever more tightly.

She took her seat, crossed her legs and arms and started bouncing her foot. “. . . so stressed out . . ” she said, then pushed her scarf-covered head into the headrest and closed her eyes.

Up close, I could see that the eyelashes were, indeed, fake. Also, her perfect brows were drawn on. Underneath the expertly applied foundation, her skin hovered at a shade between pale and gray. Her nails were acrylic and the fingertips underneath were chapped and red.

You never know what someone is going through, but in this case, I had an inkling. I put aside my book (The Cancer Chronicles) and spent the flight focused on loving kindness meditation for her, and for everyone on the plane.

May you be well.

May you be free from suffering.

May you live with ease.

Near the end of the flight, as she and the other woman in the row started talking, I learned she was on her way to a treatment center for a recurrence of her cancer. She named the type and the diagnosis. It was familiar to me, as was the typical prognosis. (May you be free from suffering.)

She mentioned neuropathy and I asked if I could show her something that helped my clients sometimes. She agreed and as the plane landed, all three of us in the row held our left hands with our right hands and gently, mindfully, lovingly paid attention to every part of our fingers and hands.

In the moments before boarding, we learned that I had worked at the center where she would be getting treatment, and the woman in the window seat was also suffering from neuropathy — hers related to an auto-immune condition.

“See –” the woman in the scarf said, “We’re all family and we didn’t even know it until now.”

Except that if we are paying attention, we know it all the time.

MLD, Modalities, Oncology Massage, Thoughts on the profession

Absolutely Maybe

I have spent the weekend at a conference doing one of my favorite things — talking to other nerds about nerd things. The weekend started with discussion of the adaptations of lymphatic drainage protocols for specific types of plastic surgery, and ended with speculation on the titles of our future TED talks.

Mine is: “The Metaphor is Everything.”

But that’s not what I wanted to talk about today. Today I want to talk about certainty. Or, more accurately, capital-C Certainty.

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The end of the first day of the conference featured a panel of super smart guests, ready to talk about their particular view of oncology massage. It was a house tour of the neighborhood where you’ve always wanted to live — a chance to peek into the day-to-day lives, the medicine cabinets, and the private closets. (Metaphor. See what I mean?)

The first speaker made an entrance. She strode out from the wings of the stage and solemnly said her name and her specialty, then went on to spend her allotted time sharing images and stories of her work. I found the images and stories fascinating. I found her approach challenging.

After she introduced herself, she talked about the specific training she received, similar to mine, as it turns out, and talked about the danger of deviating in any way from the tenets and protocols of that training.

Here is where I admit that I have been deviating from the tenets and protocols of that training pretty regularly. I have a whole new kind of clientele — young, healthy people recovering from plastic surgery. For them, the exact protocol is often not as effective as some critically reasoned deviations.

I found myself becoming more and more uncomfortable as she spoke. She has been doing this a long time. She has gotten great results with some really challenging cases. She knows what she is doing. She is certain of it.

That is what made me uncomfortable. The certainty of it.

There are so many things in this profession that we were “certain” of — that massage increases systemic circulation, that mechanical pressure can change certain body tissues from solid to a more pliable gel, that we should never touch people who have cancer. Thank goodness enough open-minded, curious, smart people have challenged these and other certainties and proven them mistaken. Because of these people, who were uncertain, we can reach more people and provide much better care and education about these bodies we live in.

Certainty is a hard stop. It is the period at the end of a sentence and “The End” written at the bottom of the page. Certainty freezes us in time. I don’t want massage therapy to become dusty and desiccated like those life-size dioramas that used to terrify me at the Natural History Museum.

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We are, like the bodies we work with, living and growing. We may be educated, we may be experienced, we may be confident — but I hope, for own future growth and the benefit of our clients, we never become certain.

Massage Tales, MLD

The Right Thing. The Sick Feeling.

I had a new client today. This person saw my card on the crowded Community Board at a local coffee shop and actually called me. He had a serious and extended conversation with me about the type of massage I do and where I got my training.

Once I got over my initial shock that someone actually (a) saw my card and (b) called me, I sank in to the process of interviewing and being interviewed by a potential new client. He asked appropriate questions, offered information about his own experience with massage, and generally did all the things that dispel any creepy vibes. We scheduled an appointment for later in the week.

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I asked him, as I always do, to tell me more about the specific reasons he was seeking massage. He deferred, said the problem was “embarrassing” and that he would rather talk about it in person. I decided not to press him and to wait until his appointment to get more information. And then I made sure two or three friends knew exactly when this new client was coming to my office, and that other people would be in the building while I was there.

I will say now that everyone leaves this story safe, and with their essential trust in human nature intact.

He arrived on time, filled out the paperwork and sat down with me to talk about his health history. He described his current discomforts with candid detail. He answered my questions and listened to my answers to his questions.

He started talking about everything that his condition altered in his life. I felt the frustration in his voice, and my compassion reflexes kicked in. This person is in pain. Witness this. Listen. Honor this experience. Be in service to this human.

And so he asked me the question, “Will this help me? Will this fix the problem?”

And I had to answer him honestly. “I don’t know.”

We talked a bit more and settled on what we both felt would be true — that if nothing else, this could be a time for his body to relax. That felt like enough. I let him get settled on the table and I started the session.

I should mention here that the work we agreed on — manual lymphatic drainage — is gentle work. There is no smashing of muscles or kneading of tissue. It involves rhythmic stretching of the skin that is so gentle it can be done after surgery. It is the kind of massage that one of my clients calls “petting butterflies.”

We discussed this, or I thought we did. I even demonstrated for him (on my arm) how manual lymphatic drainage looks much different than massage. I reminded him that this was his session, and we could switch to massage during the session if he felt like it would be better for him.

About 20 minutes into the session I noticed he had a confused look on his face. “What’s on your mind?” I said.

“I’m just not sure, I mean, I’m not sure this is working.”

I stopped what I was doing. “Okay,” I said, “What would you like to do?”

“I guess, I don’t know, I mean, you’re the professional, right?”

This is where I paused to take a deep breath and save my rants for later. Just because I went to school for a thing and have practiced it for many years does not mean I get any kind of agency or ownership over anyone else’s body. I would like the idea of the expert who also takes a client/patient’s agency to be extracted from every health care interaction everywhere, all the time.

I am the professional, I agreed, and I reminded him that he is the expert on his own body.

Then I got a sense that what he might need was permission. So I said, “Would you like to end the session?”

He sighed and looked at me, relieved. “Yes, I think that would be best.”

He wanted me to be confident and bold in my predictions for what I could do to help. All I could be was honest. He wanted something that he could not articulate, and that thing was definitely was not the type of work I was doing.

It was the right thing to say I didn’t know, to give no assurances where I had none, and to stop working when his mind and body were clearly agitated. We parted on good terms (yes, he paid for the session) and I have no regrets.

Except. There is always the voice from old stuff of the past that snickers in my ear and points at me, laughing, whenever I am not the smartest and most brilliant of them all. She is a persistent little gremlin and I can hear her laughing even as my stronger adult self knows this was the right thing.

I am a human who has chosen work that involves intimate interaction with other humans. There is no way to keep this from reaching in and stirring up all of my stuff. I am reminded, again, today that part of my job is to learn how to balance being an emotional being within the space of my professional work.

On Writing, Oncology Massage, Thoughts on the profession

Beyond Stillness

I am currently re-reading The Emperor of All Maladies by Siddhartha Mukherjee. It is a fascinating, novelistic, nerdtastic telling of the history of cancer. There are so many facts and nuggets in it that are buried in the larger story, and are breathtaking in their own right. Today, I am thinking of one of those nuggets.

In my edition of the book, Mukherjee states (somewhat erroneously) that the root of the word “metastasis” means “beyond stillness.”

Let’s put aside, for the moment, the actual root of the word, and consider the breathtaking poetry that is “Beyond Stillness.”

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Metastasis, as we currently understand it, is the movement of a disease from one part of the body to another. In cancer land, this can exponentially increase the dangers of a particular disease process. Every cancer patient hopes to be free of metastasis, leaving the rest of their body intact and functional. (As much as it can be after systemic treatments like chemotherapy, anyway.)

We shorten metastasis to “mets” in talking about progression of cancer. Breast cancer with bone mets. Lung cancer with brain mets. This short, sharp, easier to say word that contains within it layers of fear, anxiety, and potential physical pain.

Which brings me back, to beyond stillness. With cancer metastasis, the disease has moved beyond the stillness of a body at rest in wellness. It has moved beyond the stillness of an in situ tumor which yields obediently to removal or treatment. The disease moves beyond stillness into a kind of strobe light-illuminated motion, where the confirmation of movement comes through the flashes of a PET/CT scan.

And what exists beyond stillness?

Is it the growth of the opposite, a kind of frantic and endless motion that never quite rests, never quite allows the body to rest?

Or can we find, beyond stillness, another level of stillness — something even more quiet? Is the movement beyond stillness like the movement from the parking lot at the top of a hiking trail to the spot a mile or so down the trail, where all the city noises are erased and the senses can expand into this new space?

The simple etymology of metastasis, mistaken though it may be, leads to a particular kind of poetry. This is the poetry of words that lead into a compassionate and loving meditation on life, disease, and death. This is the poetry of breathing and being in a vulnerable, human body.

Inner World, Massage Tales, On Writing, Thoughts on the profession

Until They Know

The other night, I sat with my partner, talking about life’s work, life’s purpose, and other meaningful things. We have that conversation a lot, both as a way to check in with each other for support and as a way to clarify for ourselves what is truly important. Sitting there, in our middle ages, we stretch forward and reach into what we both hope will be our renaissance.

I was telling my partner about the moment. The moment when I was sitting with a client, presumably massaging them but really being a loving, peaceful presence for them. In that moment, I felt all the struggles and blocks to my creative energy dissolve away. I felt open to receive and translate what ever might come forward. I knew beyond the shadow of a doubt that I was in the exact right place doing the exact right work.

My client that day was frail, small, elderly. My client was also an open fount of love and kindness who never let me leave without telling me how beautiful and sweet she thought me to be. She was exhausted from a restless night and bouts of nausea. She was in extremis. From the outside, it looked like all I did was sit next to her and gently hold her hands.

As I finished telling the story, I tried to find a way to explain the rightness of that moment, to translate it into words that could describe what I want my work to be. Finally, I said:

I’m just here to love on people until they realize how much they’re worth.

And that was it. The exact right phrase. I have found my mission statement for the remainder of my career, and, truly, of my life as a human being.

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In my past, I spent several years in corporate America, and in those years I learned to deeply mistrust the idea of a “mission statement.” To me, it had the association of wasted hours in meeting rooms and whiteboards full of meaningless phrases. It meant a lot of back-patting while everyone settled back into the exact same soul-numbing atmosphere as before. Mission statements, I thought, look nice on annual reports or company-branded merchandise, but in practice they meant nothing.

When I hit on that sentence, though, I also hit on a new understanding of mission statements in general. After the political and religious definitions of the word “mission” in the dictionary comes this definition:

a strongly felt aim, ambition, or calling

dictionary.com

I am not a traditionally religious person, but the idea of a “calling” still resonates with me. The truth is, we humans really are intertwined and connected in ways we don’t quite understand. There is a need in the community that each of us is suited to fill. That need has a voice, which calls out and, I think, it is our job to listen, and, on hearing, respond.


A few weeks ago I started out trying to write a few different posts about relaxing massage, gentle massage, and the underappreciated benefits of both. As with much of my writing, I thought I was doing one thing, but the writing eventually led me to a new (better) place.

I thought I was providing some education about physiology and the mechanisms of massage therapy as I understand them. In fact, I was writing my way into my personal mission statement, the guiding force that all my endeavors must support.


I have a postcard on my refrigerator which I got form an artist at the St. James Court Art Show a couple of years ago. It says: “Don’t become famous for doing something you don’t love.” I get that now, in a way I didn’t get it before.

It’s the love. It has always been the love.

Inner World, Massage Tales, Modalities, Thoughts on the profession

Chicken Skin and Butterflies

“Rebecca, your touch is so gentle I bet you could pet butterflies.” She said this to me as she dropped into the table and let her arms fall away from her body. She breathed deeply and evenly and within a few minutes I could see that she was asleep, or nearly so. At the end of her session, she smiled at me warmly and said she appreciated being able to fall asleep comfortably.

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She reminded me of my time in Thailand a couple of years ago. I studied Thai massage for a couple of weeks — just enough time to confirm that I really know nothing about Thai massage. The teacher used to joke about “elephant skin people” and “chicken skin people.”

Elephant skin people, to him, were those who wanted more aggressive bodywork. They seemed to thrive on the deepest compressions, the most rigorous stretches, and the rough handling of their bodies. He gave a demonstration on one of these people while I was there. The client, a muscled American motorcycle rider complete with leather vest and chaps, groaned and whimpered his way through the session with my teacher. After the session, he got up from the mat, smiling and testing his newly mobile joints.

Chicken skin people, on the other hand, required gentler handling. Their bodies could not take deep work and they often could not move into some of the postures typical of Thai massage. My teacher teased me that I was a chicken skin person. In that, he was (is) completely correct. I do not respond well to aggressive bodywork.

And, as I am starting to fully embrace, I am a massage therapist for the chicken skinned. I feel most connected and at my best with those whose bodies, minds, and/or spirits require gentle handling and a careful, loving approach.

My client, who found such a vivid and lovely metaphor for the way I work, also gave me the perfect ending to this three week exploration of “just a relaxing massage.” I am here to whisper, gently, to your nervous system and let your body sink into its own healing capability.

Modalities, Thoughts on the profession

Just a Relaxing Massage, Part 2

Let’s talk about your nervous system. How about a quick check in? How’s it doing? If you are alive and reading this, it’s pretty safe to say that your nervous system is functioning.

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Your nervous system, the control system of the body, the keeper of the keys to so many other functions, is, for me, the primary target of massage. If I can facilitate a switch in your nervous system from sympathetic (“fight or flight”) mode to parasympathetic (“rest and digest”) mode, then a whole cascade of benefits happen in your body and mind. These include:

  • drop in heart rate and blood pressure
  • decrease in muscle tension
  • increase in energy required to focus
  • warmer body temperature overall

And these powerful effects come from that thing that is undervalued so much — “just” relaxation. Those effects seem pretty powerful to me, and definitely worth an hour of time.

Today I saw a new client. She chatted during part of the massage, talking about how she was always busy, always running, found it hard to stop and sit for a minute. She booked the massage as part of an ongoing plan to take care of herself. She talked about how it was necessary to take care of herself, but she said it in a way that seemed like she was trying to convince herself. For the last ten minutes of the massage, she grew quiet and her breathing deepened and slowed. Her arms, previously held close and tight by her sides, fell gently out to the sides. Her face softened. At the end of the massage, I said “Thank you,” and she said, “That felt good.”

That felt good.

It is enough, more than enough, to facilitate a space where someone can step out of their busy life and feel good in their own body, their original home.