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.

Inner World, On Writing

Which Draft Is This

We went to a show, my friend and I.  It was full of flashes of brilliance — beautiful gems that could be pulled out, polished and made into an even better show.  But it was a one-time-only experience.

It was unique, rare, and temporal.  It was deeply unsatisfying.

As we pondered these truths, imagining the new and gorgeous work of art that could happen if this section came out and that one expanded and it all had a more coherent frame structure —  we also pondered what it was that was so deeply unsatisfying.

“You know what it is?” my friend said, “They stopped at the first draft.”

And of course that was it.  We watched a first draft, knowing there was no possibility of a next draft, and still seeing the potential that a next draft could be.  Frustrating.

So, of course, I will quote that Anne Lamott line about “sh*tty first drafts.”  Here is whole quote:

“Perfectionism is the voice of the oppressor, the enemy of the people. It will keep you cramped and insane your whole life, and it is the main obstacle between you and a shitty first draft.”

It’s a great line, and a great sentiment.  Just get the words out.  Just work.  What happens too often, what happened in that show we saw, is that people get out the first draft and stop there.  The effort of putting forth that much feels like enough.

As Anne Lamott, or any other writer, would tell you — it isn’t enough.  There are revisions and reworkings and next drafts to go, long before something is all the way done.  Some things are never all the way done.  Construction on Sagrada Familia, Gaudi’s adjective-defying cathedral in Barcelona, began in 1882.  It is projected to be completed in 2030.  Maybe.

On a more local scale, I’ve been contemplating my professional life, and how it has shifted and changed over the years I have been a massage therapist.  I’m on, I think, my third draft at the moment.  And several people I know are still on their first draft.

I’m becoming aware that it is part of my mission as a massage educator to get people (and maybe the profession?) to move through whatever draft they are in right now.  It’s so easy to get comfortable with a limited repertoire.  Are we doing things because they are intuitively and scientifically effective, or are we doing things because we always do them?

Every new draft grows under the skin of the old draft, and when it pushes through it is often familiar enough to be recognizable.  So why are we sitting with the old drafts, afraid to move through it into the next best version?

Let’s get to the next draft.  Let’s start by making space for each other’s mistakes, blind spots, and outright incompetence.  These things are temporary, and necessary if we are to move into something new.  Just work.

Hey — Speaking of work — Did you know I host a monthly webinar series called The Interdisciplinary Clan of Mystery?  It’s where my friends at Healwell and I interview someone who is doing excellent work in health care, and we try to learn how to break out of our silos and step up our service game.  If you’re a human who has ever interacted with health care, this might be for you.  Check out the episodes here.  (And while you’re there, take a minute to look at the wonderful goodness Healwell is putting out into the world.  These people are the best, the brightest, the funniest.)
Inner World, Oncology Massage

Into the Rabbit Hole

I have a writing task.  A big one.  I am choosing to take the advice of The Little Book of Talent and keep the biggest plans secret.  It’s not important to know exactly what the task is, just that it is.

 

I have been a writer since second grade.  Our teacher told us to write a Halloween story, and I went to town.  I had elaborate costumes, a haunted house, multiple plots coming together, and a hero facing certain ruin by ghosts.  I also had what I later learned was a deus ex machina — an ending dropped from the sky where the hero of the story got to survive and get away all in one piece.

 

Okay, it was a ghost extinguisher.  I gave my hero a ghost extinguisher.

 

So, maybe plot-wise, it wasn’t my best effort.  But for sheer love of the process of writing, it was enough to keep me hooked for years.  I can still feel what it was like to sit at the dining room table and write that story.  How I could hardly move my pencil fast enough.

 

As many things do, writing became both easier and harder as I grew up.  I learned about plot and foreshadowing.  About the nuances of character and exposition.  I also started writing essays, nonfiction.  I practiced translating facts into a readable story.  I found that this worked best for me if I had piles of facts and supporting facts that I could pick and choose from in the process of writing.

 

I felt most comfortable drawing from a deep well.

 

close up of rabbit on field
Photo by Pixabay on Pexels.com

Which brings me to today —  my writing task, based in fact and research and looming large over my life for the next several months.  I am breaking it into smaller pieces, and finding that each piece comes with its own rabbit hole attached.  These pieces sit before me like tiny cyclones, and if I’m not careful I could get sucked into the vortex of each one, disappear for a while, and come back with not even a pair of ruby slippers to show for it.

 

Today I am perched on the edge of a rabbit hole, trying not to dive in.  If it weren’t so fascinating, if every piece of information didn’t lead to twelve others, if I could just write one crappy sentence —

 

There it is.  The thing I keep banging up against is the first sentence.  More precisely, allowing the first sentence to be crappy and moving forward anyway.  Because, as I used to tell my writing students, revision is more than half of the writing process.

 

It may help me to look at this craft the same way I look at the craft of a massage.  Prepare.  Deeply and thoroughly prepare.  Then, when the person is in front of me, empty my mind and trust that the training is there.  Right where I left it.  Just make contact and go.

 

Just write that crappy first sentence and go.  Forward.

Thoughts on the profession

The Imperfection of Sight

“It wigs people out when someone actually sees them.  And it wigs us out to fully see ourselves.”

I am fortunate to be able to teach in a number of different venues, and I love them all.  My favorite, though, is the almost overwhelming intensity of a short workshop. With a room of people who have chosen to spend their time and money in a very particular way.  I teach continuing education, and in the workshops we often take time to consider ourselves, and what version of ourselves we bring to our clients. 

A few days ago, we were talking about working with people who are seriously ill.  We were considering medical decisions, and what we might do if we are working with someone who makes a decision that is different from one we might make.  The question on the table was about a specific case; about our thoughts, resistances, and feelings.  It was about what we would do.

Everyone in the room took the time to think about the question.  They sat in their groups and talked animatedly with each other and when we came back together, they gave their thoughts in echoes. 

Of course we would work with this person. 

We are massage therapists.

It’s not our concern what decision someone makes.

And that was the end of it.  Or was it?

I agreed with and believed everything they said. We are compassionate professionals and we practice unconditional positive regard.  Everyone’s health care decisions are their own to make.

And yet.  After the work is done and the client feels better and we get home alone at night with our feelings and our truth, what is there? Is there only a practiced neutrality that never allows for any conflict or feeling of distress?  Are we that good?

We are not.  I know deep in my own being we are not.  Because we are human.  The thing we are good at is hiding the uncomfortable bits of ourselves.  Our fears.  Our prejudices.  Our anger and our hurt. 

There were only a few minutes of class left.  So, I took a deep breath and offered some homework.  Dig a little deeper, I said.  I told them the truth.  I had conflicted feeling about working with the person in our scenario.  I saw wasted resources in the decisions being made.  I have prejudices that are causing me tension around the whole situation. 

If we don’t take out our darkest feelings and consider them, how do we trust our light? 

Remember when you were a child and were scared of the monsters under the bed or in the closet? Remember that a swift antidote to those fears was to go and look.  Put on a light and see the places where your fears reside. 

ancient art artist artistic
Photo by icon0.com on Pexels.com

It wigs us out when we see ourselves.  Because when we do, we must acknowledge the parts of ourselves that are not kind, not loving, not full of unconditional positive regard.  In our oversimplified way, we might think this makes our kindness and love somehow invalid.  What is does, really, is give us the tools we need to make our kindness and love richer and more true.  It saves us from collapsing under the weight of our unacknowledged shadows.  It returns us to our wholeness. 

The students left with the homework.  I hope they went home and looked into their own hearts and saw everything, or a little closer to everything.  I know some of them did not.  But I believe some of them did, and that is enough.  It is imperfect and it is enough. 

massage education, Massage Tales, Modalities, Oncology Massage, Thoughts on the profession

Interdisciplinary

How about a quick peek into the emerging future of healthcare?

Interdisciplinary:  integrating knowledge and approaches from a variety of different approaches

Interdisciplinary Team: a group of professionals from multiple disciplines working together toward a common goal

I have been thinking and reading a lot about interdisciplinary teams in healthcare.  As the abstract “aging American population” becomes more concrete, both in my practice and my personal life, I am seeing humans who interact with multiple professionals, all for their individual care and keeping.  I am seeing this done very very well, and very very not-so-well.

What is clear to me is this:   the future of healthcare is interdisciplinary.  It is both necessary and desirable that humans have access to multiple professionals to address the multiple and complex needs of their healthcare.  Also:  the future requires us to communicate with one another.  While I know and massage and sometimes take care of people who are receiving interdisciplinary care, that does not always include great communication.

Take, for example, the cancer patient who also has hypertension*.  The oncologist and the nephrologist ask the patient for reports from other physician visits, but they are not asking to communicate directly with each other.  And neither of them wonders about the massage therapist who has been working with the patient since the cancer diagnosis.

In an ideal interdisciplinary world, patients could have access to a wide range of professionals and those professionals would speak to each other on a regular basis.  They might even, I don’t know, learn from each other and gain creative insights into sticky healthcare questions.

Unicorns!  Fairies! Rainbows!, you say?

This is not only possible, it is happening.  Wouldn’t you like to hear from a real interdisciplinary team about how they put it together, how they keep it going, and maybe even how the massage therapy profession can contribute?

You are in luck!

Starting this September, I will be hosting a monthly webinar series for Healwell where we explore these very questions.  We have secured some of the most interesting people working in healthcare today — the people who are asking the questions and creating the change.  Come and join us for the Interdisciplinary Clan of Mystery, where we explore how to deepen our service to the humans we care for, and broaden our perspective to invite collaborations, curiosity and plain old increased clinical knowledge.

We are going to have some fun, challenging, thoughtful, and (best of all) interactive conversations. Join me to take a peek at the disruptors, innovators, and smartest people working in healthcare today.

 

*–patients mentioned are composites or theories and do not represent actual humans

massage education, Thoughts on the profession

Job Description

The question that often follows “How long have you been doing this?” is: “How do you like this work?”  The answer is pretty easy.  I love it.

I’ve tried several other careers and even done well in a few, yet none of them held my heart and my interest like massage therapy.  This particular work is, for me, a fantastic blend of several different jobs.  I am a massage therapist, which means I am:

A Scientist

It started in school where I did a deep dive into the anatomy of the muscular system, and started on the path to learn more about Anatomy, Physiology, and Pathology.  It continues now as I try to connect everything I do with some understanding of the working of the human body, and with information from the latest research I have been reading.  It is my job to be curious, to ask questions and to continue learning and discovering.

A Tradesperson

I learned a skill that I perform with my hands.  After my period of learning and apprenticeship (at the student clinic) I started practicing this skill and I work every day to further perfect and advance my skills.  I have apprentices (students) of my own now, and as I am guiding them through how to work with their hands, I am finding better ways to work with my own.

An Educator

Given the chance and the interest, I will talk to every client about what I notice and what that could mean for their particular body.  I will also take the time to talk through what massage might be able to address and what might need a different kind of support.

A Student

As I said to a client this week, I may be the “expert” in the room on muscles and soft tissue, but each client is the expert on their body.  I am here to learn from them.

An Artist

person with body painting
Photo by Sharon McCutcheon on Pexels.com

Every human, every human body, is unique.  Every day and space that body moves in is unique, so every time a person walks into my office it is the time to create something that never existed before.  Massage does not, for me, happen by formula.  It happens by being completely present in the moment so I can make something new that will never happen the same way again.

I have the opportunity to be all of these things, and sometimes more besides.  This week some asked me, “Have you always been a massage therapist?”  I’ve had lots of occupations, and this is the one that lasts because it pulls in all of those jobs.  It asks the most of myself and give the greatest rewards.

Massage Tales, Oncology Massage, Thoughts on the profession

Don’t Rush the Intake

I have unusual leisure in my practice — I can usually take as long as I feel necessary for an initial intake.  Despite the added stress of being in business for myself, this leisure is one of the things that makes it all worth while.  Here’s a story about that.   All client details have been changed.

My new client arrived late.  She had trouble finding the building, then had to circle around a few times to find parking.  She walked in already a bit anxious because of the time, and because it was her first massage.  I left her in the quiet of the waiting area to finish the health history form and assured her there would be time for most of the scheduled session.

She handed back her completed form, and we began our conversation.  I took my time, making sure to ask about everything she had marked on the form.  After I felt sure that I understood her health history, I told her what to expect during the massage:  how to get onto the table, what parts of her body I would touch and in what order, how draping worked, etc.

She smiled and nodded through this whole explanation.  As I finished she said, “That all sounds so good.”  She paused. “I want you to know, though, that when you get to the front part of my legs I might tense up a little,” she raised her shoulders and tensed her arms, then released them, “See, I’ve been sexually assaulted and I just might be a little nervous.”  She had a friendly smile on her face and tears in her eyes.

I settled further down into my seat.  We had more conversation about how she was in charge of the massage, and that she could tell me at any time to change or stop what I was doing.  “You get to direct how and where you are touched,” I told her.

If I had to rush the intake, I might have missed this vital fact about how she experienced her own body.  I certainly would have missed the chance to reinforce for her that she has dominion over her own body.  I might have never been able to build enough trust with this other human that she revealed her own fears to me.

person holding hand
Photo by Pixabay on Pexels.com

She arrived late, and the intake took longer than “normal.”  In that extra time, she was able to trust me a little more and reveal something vitally important.  This helped me approach her with more compassion and awareness.  She emerged from the massage smiling wide.  She thanked me and gave me a hug, and made an appointment to come back again.  This never would have happened if I rushed the intake.