Friday, July 07, 2006

The Power of Perception

M. has cancer. They almost all have cancer of some sort. She had just gotten back from a long stay at the hospital and she and her family had decided to stop all treatment and enter hospice. She was weak, she could barely walk. She used a walker to get a around her condo in a house coat, because it took a lot of energy to get dressed, so she saved her energy and only got dressed when she needed to.

I started working with her legs and feet intially because she didn't like that they had gotten swollen with her long stay in the hospital. I told her I would do what I could, knowing full well that the swelling in the legs is a hard thing to reduce at this stage.

Two to three weeks later, the swelling in her legs and feet had noticably gone down and she thanked me. I was frankly surprised, but I knew massage could help, so accepted the thanks gracefully. A few weeks later, M. was walking around with out her walker and only usuing the furniture for support when needed. She was energtic and feeling very well, not to mentioned dressed when I arrived. She attributed this renewed energy and ability to walk to the massage. I smiled and thanked her for her confidence in me, but assured her it was her hard work that brought her to this point, not just the massage.

After a couple months I notice M. is out visiting friends more often and leading an active live. It wouldn't seem that she was part of a hospice program. At the end of the 6 months I arrive for a visit and M. is beaming. "I've got some good news and some bad news!" she says. "I just heard from the doctor, my cancer is in remission!" This is great news. It is rare that I get to see a client get better. "The bad news is, I won't be in hospice anymore, so I won't be able to get your massages! I know that it was your massages that helped turn things around!"

I thought about that. Of course I told her that massage wasn't the only thing that was working in her favor, but later I got to thinking about people perceptions. I thought about all those placebo tests and 'postive thinking'. This woman feels strongly that my work helped to heal her, at least into a remission. I know this is not biologically possible for massage on it's own to stop a cancer growth.. but her perception is different.

It got me to thinking about how other things in life don't really work if you don't believe in them either. I'm starting to wonder how much the medicine, therapy, doctors visits, etc play a role in healing and how much of it is your brain or just luck. Either way, M. is living up the days she has been granted and thanking me for the oppertunity.

The polite thing to do would be say "Your Welcome" so.. "Your welcome, M. I did my best and was happy to help you."

Small Towns and Childhood Mysteries

Two thoughts:

My first private client in this town died yesterday. I am glad. E. was in terrible pain even though we did what we (hospice) could to help her. Curiously, besides the day I was stuck to near tears by working with her, I am handling like I handle the deaths of my other clients. I think that is probably good.

Besides, a new patient was added to my roster. His wife is one of my clients. I guess I've lived here long enough where this is going to start happening more regularly.

*******

I guess growing up I heard the word cancer and never new what it meant. I knew that it meant you were eventually going to die. I knew that it usually started in one area and sometimes went someplace else. It was so mysterious and the implied meaning that it was terrible way to die was only explained by the sigh, nods and silence after someone said the word.

I know a lot more about cancer now. I know about the cellular process involved in mutations and 'mets' and some other biology stuff. Knowing that stuff doesn't really help though... All it tells you is what happened. It doesn't tell you 'about' it.

What I've learned from hospice is that cancer is painful, and the treatment the clients received before entering hospice were as bad as the disease. That people can live with this pain for years or they wake up one day after living in what they thought was a reasonably healthy body with a stomach ache and find that their body is riddled with cancer and subsequently die a week later.

How do you prepare people for that? You could live 5 more years or a week? There's not any way to know, really.

Thursday, July 06, 2006

Some people just never wake up.

Yesterday, my cousin died. This is the first family death after starting work with hospice.

Of course the situation is completely different than a hospice related death. My cousin died suddenly for no appearant cause. My uncle is guessing sleep apniea, but I don't think they know for sure. The way I recieved the news was a bit of shock as well, because I haven't spoken to my uncle in two years, and that was at funeral of my grandmother, so there wasn't really 'talking' going on then, either. I didn't know who it was when he called.

I get calls telling me that someone died all the time. I got one this morning in fact. It's kind of like getting call that says, you can come in late to work today. It sounds odd and cold, and while your sad, you also know that your visit schedule has just changed and you need to make adjustments.

So when I took the call about his death, my first reaction was to make a note of it and say "okay, thanks for letting me know". It took me a second to realized this was more than that and then I completely flustered. I remembered to ask when the services were, but not where. And I didn't even think about getting a phone number encase there was questions.

I'm strangely sad and not sad about the situation. I can't say that I was close to my cousin, but that shouldn't matter. Maybe working with hospice has given me tools to handle personal dealths as well as those related to my profession. Maybe I'm cold and heartless... but I doubt it.

Monday, July 03, 2006

The Audience


When I walked into E's home, it was filled with children. Her eldest daughter was there with E's grandchildren and they were preparing their lunch of brats and potato chips. I smiled and walked around the scooter that was deposited on the floor and headed back to E's room.

E was sleeping through my work with her today, so I didn't get to talk to her very much. I like to talk to the clients while I'm there and learn a little bit about their history. I find that it usually is a good distraction for them, and it sometimes ends in laughter, which we all know is the best medicine.

I was having a little bit of a frustrating day today and was disappointed that she wasn't able to respond, but I tried not to let the time be about me, and stay focused on her care. As I was working I heard the mother say to the children, "why don't you go in with the massage therapist and watch her" My first thought was "are you kidding! I'm trying to work in here!" and then I heard the mother say "she can show you how to give grandma a massage"

Before I let myself feel inconvenienced or grumpy about it, I told myself. "This is why you are here! Do your job!" So I welcomed the five children into the room and showed them what I was doing. I encouraged them to give their grandma a massage and for them just to remember to be gentle and reminded them that it would feel really good. I told them to practice on each other"

I hope that I accomplished two things today. I hope that I gave these children a way to connect to their grandmother in the time that she has left. I hope that I helped them realized that you don't have to be afraid of touching a dying person. They are so young and this is the time when these ideas about life and death start to form. I hope I helped these children as much I am trying to help E.

Second, I hope that I helped the field of massage therapy. I wished I had been more prepared today to teach the children today. I want my community to know about the therapeutic affects of massage and the uses of it outside a spa. I think introducing this to the grandchildren could possibly change or form their views on the craft, which will change the future of massage.

It is a huge struggle for MT to be funded for hospice these days. I'm lucky that I actually get paid. Most hospices rely on volunteers, if they use MT at all.

It doesn't feel like a big day today. It feels like a long tired one. It feels like I didn't accomplish much, but maybe I did. Hopefully writing things like this down will help my realize the affect this work has on me and the world around me.

Frustration

I'm feeling very frustrated today. It having very little to do with the clients themselves, but the whole atmosphere of job. I am fairly sure that everyone runs into bureaucratic nonsense of being employed. Then why write about it? I guess because there is the added part where you are taking care of people, and their impending death is not waiting for you to figure out your vacation schedule.

I'm feeling frustrated because I wanted 1 day off, just 1. Just like everybody else gets. Well I got that day off, but I had to reschedule all my visits for that week on different days of the same week. I couldn't just not see them that week. Sounds reasonable, except I have three jobs, and few of these clients live close together. Well, I figure it out, but I screwed up, and had to redo it... but when I re-did it I forgot to tell the office and clients that I had changed it, so the client was expecting on the original day, the office was expecting me on the first rescheduled day and I showed up on the 2nd rescheduled day. Sigh.

This job is difficult enough as it is, and now I'm having trouble keeping track of what day it is. I'm so tired and it was so much work just to take one day off that I'm not sure that it will be worth it in the future.