Wednesday, March 27, 2013

Can I talk about this? I mean, it's right there . . .

I am teaching a course now where we explore massage considerations and adaptions for various groups : pregnant women, the elderly, people who have chronic illnesses, etc.  On our first day of class, we were having a discussion about how and why we might need to classify certain groups as "special populations" and what that label might mean.  One student raised her hand and asked me to silently read her written-out question because she "didn't want to be rude."

The question was: "Is obesity a special population?"

This was not an abstract question.  One of the students in that class is clearly obese.  The stress of her weight on her body shows in the way she moves, and in the way she tolerates work from her classmates.  The first time I saw her, I wondered if she would even make it through the first quarter.  Massage is a physical job.  It's not ultra running, true, but you still work standing up (usually,) and rely on your body to do the work.  The first quarter, she could barely make it through a half hour practice without stopping because she was "tired."

She is now in her third quarter, just barely scraping by.  This has more to do with missing classes and failing tests than with her physique.  Her endurance has improved, but she still tires easily.  I wonder if and when it would ever be appropriate to discuss her weight with her.  I have talked to several other teachers, and we all agree that it is outside our scope of practice to discuss this with her directly.  We are not physicians or dietitians.  We don't know her actual health details.  We know the physical demands of massage therapy, but we also know that you don't have to have a healthy BMI to do great massage.

It is still a dilemma to me, though.  I firmly believe it is not my place to initiate a specific conversation about anyone's weight.  I can speak realistically about the physical demands of the job,
though, and hope students make their own choices to support themselves.  Meanwhile, I realize there are more prevalent barriers to her success, which have to do with responsibility and time management.  In that she is hardly unique, unfortunately.

Thursday, March 7, 2013

C Word

Yesterday I behaved in a way that makes me ashamed of myself.  Someone reached out to me for a nonjudgmental, caring touch, and I pulled away.  I don't want to make excuses, but here's the story:

Once a month, my friend and I work in the memory care wing of a nursing home. One of the residents, "Agnes," has. Been there since we started two years ago.  She never wants a massage, but she does want to say hello.  She regularly peppers her language with cursing and insults.  Example:

"Hello Agnes.  How are you today?"
"Shaddup ya c***."

Recently, she has taken to spitting at people to get their attention.  She does this with a noisy warm up, so most of the time we can cut her off with a simple, "Agnes, please don't spit on me right now."

Every time we see her, we ask her if she wants a massage.  She always says no.  We try to sneak in a little bit of caring touch.  She will let us hold her hand for a few seconds, and sometimes even lets us rub her shoulder.  Agnes has surprisingly strong and sharp nails for a woman her age, though, and after a few seconds of hand-holding, she will rake one against our fingers -- hard.  I am ashamed to say that I am always cautious when holding her hand.  She has nearly drawn blood a couple of times.

Yesterday, she was letting me hold her hand, and even put both her hands around mine.  Quite suddenly, she pulled down on my hand, and by instinct I pulled away.  When I looked int her eyes, she looked devastated.

I immediately bent down and gently hugged her and laid my head on top of hers.  She has never
accepted so much touch from me.  Still, I knew that I had rejected her when she was most vulnerable.  She tried to pull me closer, and I pulled away. I tell myself that I am on a mission to bring human touch to those who need it, to show people that age and infirmity should not exclude you from the world of warmth and connection.  In that moment, though, I failed myself.  Every time I see Agnes, I will try to make it up to her.