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Caring for clients with Cancer

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The Health History of a Human Being

March 27, 2013 by Tracy Walton 39 Comments

 

I begin this first-ever blog with a deep breath…

…and the reason I am a massage therapist, from a piece I wrote long ago. We’re all a little older now, but my reason hasn’t changed. My clients’ stories continue to get me up in the morning, and I’m grateful.

DSC_0148-300x249My two-page health history form takes clients a few minutes to complete. It lists a handful of medical conditions. The client indicates yesย or noย and fills in comments for each “yes” answer. Some clients object: “Do you have to know all this? “Can we get to the massage please?” Some simply draw a fierce long line through the “no”ย  column.

The human condition, it seems, involves paperwork at every turn. By the time my client gets to me, “form fatigue” may already have set in. But this short health inventory is required, so they fill it out. Some scribble hurriedly and mechanically, others work slowly and thoughtfully. But everyone fills it out.

Once complete, we go over the client’s “yes” answers out loud. I probe a bit if there are only “no’s.” The conversation informs our massage goals and any precautions. We plan out the session and move to the table.

A Collection of Stories

My questions may feel tiresome or repetitive to the client, but they’ve unearthed many stories. Some stories are life-changing, some not so much. I’m honored to hear them and marvel at the variety: Through this process, clients have told me stories about poison ivy, the 6-week cold, and countless minor aches and pains.

Sometimes a story of deep consequence leaps out from the litany of checked-off answers. Eczema, hidden away under long sleeves. A complicated pregnancy. The two new hips. The old Back Injury of 1974.

Clients have told me about asthma episodes and insulin injections. Whirlwind hospital stays and endless fertility treatments. About the dreaded family history, always threatening to leap into the present day.

From thousands of conversations, I have learned about survival, healing, and unfathomable loss. The steady drip of chemotherapy. The multiple surgical scars. The long wait for the transplant donor.ย  The cherished child who died.

I try to breathe when I listen, it helps me to hear.

Why all the questions?

Some stories hold critical information for safe, effective massage practice. They point to certain massage guidelines, such as taking care with pressure or joint movement at a certain area. Other stories signal a need for more research, or some input from the client’s physician.

Most of the time, these rich and colorful stories hold as much weight in the relationship as in the treatment design. Our willingness to listen may be a welcome chance for a client to tell the whole story, without interruption. The hour we have set aside for a client is a luxury. It is an invitation.

It is essential.

Why is this essential? Because history-taking invites history-telling. Because the human body is one of the loneliest places to be, and sometimes that loneliness is unbearable. Because in its understated way, my short client health form asks, How is it to be you? And your answer to that question sends your story into shared space.

DSC_0076-300x199When we tell the stories of our bodies to each other, whether we tell them in writing, out-loud, or through the wordless way we receive someone’s touch, we may be healed in some small way from the isolation of living them alone. Shared space can mean a warm room, a quiet listener, or a pair of skilled hands.

By touching a body, we touch everything that has ever happened to it. For a few brief moments, we hold all of the client’s stories in our hands. We witness someone’s experience of their own flesh, through some of the most powerful means possible: the contact of our hands, the acceptance of the body without judgment, and the occasional listening ear. With these gestures, we reach across the isolation of the human experience and hold another person’s legend.

In massage therapy, we show up and ask, in so many ways, what it is like to be another human being. In doing so, we build a bridge that may heal us both.

 

(Adapted from “The Health History of a Human Being,” Massage Therapy Journal, Winter 1999;37(4):70-92.)

Filed Under: Art and Soul of Massage Therapy, Massage Tagged With: client health form, client interview, health history, massage goals

Comments

  1. Megan says

    March 28, 2013 at 1:44 pm

    Beautiful thoughts, Tracy! Makes me re-think the health hiSTORY form and how in an intake interview, I know that I can sometimes get caught up in the yes’s and no’s and black-and-whites instead of remembering all of the details, emotions, and things weaved into the background that can’t always be put down on paper. Thank you for this poignant reminder.

    Reply
    • Tracy says

      April 5, 2013 at 9:09 am

      Megan, yes. The hiSTORY form! Stealing that, thanks.

      Reply
  2. Joan says

    March 28, 2013 at 9:36 pm

    Reading this was a bit like coming home again. Tracy, you have an amazing gift for bringing your students, readers, clients and friends back to our own humanity. What a great reminder that those tasks which may seem so mundane at times can actually offer us a multitude of experiences if we just slow down and allow for them to appear.

    Reply
    • Tracy says

      April 5, 2013 at 9:10 am

      Joan, thanks. I keep coming home again.

      Reply
  3. Donna Thomas says

    April 1, 2013 at 2:18 pm

    “By touching a body, we touch everything that has ever happened to it. For a few brief moments…” LOVE THIS! It really captures the essence of what our work is all about!

    Reply
    • Tracy says

      April 5, 2013 at 9:10 am

      Thanks and nice to meet you, Donna!

      Reply
  4. Nanci says

    April 1, 2013 at 2:25 pm

    Thank you ,Tracy! We do hold our client’s stories in our hands. I do not take that responsibility lightly … EVER ! Everyone has a story if only someone would have the courage to listen.

    Reply
    • Tracy says

      April 5, 2013 at 9:12 am

      Nanci, yes. Joy AND responsibility.

      Reply
  5. Judy Stahl says

    April 1, 2013 at 2:41 pm

    Tracy, Congratulations on your first blog! This is EXCELLENT and written on such an important topic. In my practice, the care which is taken with going over my new client’s intake form is often the reason why my client realizes that they want to come back for another treatment— before I have even put my hands on them! It is the creation of our therapeutic relationship. It is the part of the massage experience that allows them to realize that I truly have something significant to offer in their life. In a well done intake interview, my client gets to know themselves in a new way, almost as though for the first time. Thank you for this reminder and I look forward to your future blogs!

    Reply
    • Tracy says

      April 5, 2013 at 9:12 am

      Judy, I’m glad you take such care with it, and that it helps build the relationship.

      Reply
  6. Don Dillon says

    April 2, 2013 at 8:43 am

    An eloquent discription of a very human exchange. Well done Tracy!

    Reply
    • Tracy says

      April 5, 2013 at 9:13 am

      Thank you, Don!

      Reply
  7. Michael Mcaleese says

    April 2, 2013 at 8:50 am

    thank you Tracy..

    Reply
    • Tracy says

      April 5, 2013 at 9:13 am

      Welcome, Michael. See you around the discussion threads!

      Reply
  8. Dawn Williams says

    April 2, 2013 at 9:24 am

    I’m hooked! I love how when I read this, I heard your voice sharing your perspective and reminder of why we love doing this work. Thank you, Tracy!

    Reply
    • Tracy says

      April 5, 2013 at 9:13 am

      Dawn, hook away! Thanks.

      Reply
  9. Kristen Burkholder says

    April 2, 2013 at 7:25 pm

    Oh my God, Tracy….this is so beautiful, and exactly why I love reading your writing and listening to your teaching. It’s like a healing salve to my soul. Thank you so much for starting this blog, I am looking forward to your next post…

    Reply
    • Tracy says

      April 5, 2013 at 9:18 am

      Kristen, your blog is quite the salve itself: http://kristenburkholder.com/. Glorious!

      Reply
  10. gael wood says

    April 3, 2013 at 8:19 am

    Thank you! I love this. One of my fears for our profession is that we are losing this kind of compassion and thinking.

    Reply
    • Tracy says

      April 5, 2013 at 9:14 am

      Gael, you are welcome. I think these are holding our profession together. It seems like it just needs celebrating.

      Reply
  11. Benjamin McDonald says

    April 3, 2013 at 8:28 pm

    I’ve always felt that when a therapist takes time to listen and learn about me as a client, my trust is deepened, even if I am annoyed at forms. The foundation of trust begins with the intake process.

    Reply
    • Tracy says

      April 5, 2013 at 9:15 am

      Benjamin, true about trust. Thanks.

      Reply
  12. Roger Olbrot says

    April 10, 2013 at 7:29 pm

    Tracy, As always I find your words to be gentle, kind, loving and so deep. as some of those above, I believe that some of my clients come back because they feel that they have been heard and I am genuinely concerned. All this, from a simple in-take.

    Reply
    • Tracy Walton says

      April 11, 2013 at 9:32 am

      Roger, here’s to hearing and being heard.

      Reply
  13. Elizabeth says

    April 10, 2013 at 8:45 pm

    Dear Tracy,
    Yes, you taught us during our oncology massage training that, to touch a person is to hold where ever they have been, and what ever they have been through; the health history is the first step in this process. I too, thank you for starting this wonderful communication with us.

    Reply
  14. Wayne Erskine says

    April 10, 2013 at 9:24 pm

    Tracy,
    As usual, your sharing of thoughts a reminder of why I hold such a special place in my heart for you.This blog shines the light on why I am so proud of this profession and of how important it is for all of us to bring reflective understanding to each client client who trusts us to touch them. Thank You

    Reply
  15. Linda Dwyer says

    April 10, 2013 at 10:11 pm

    Tracy…..
    You have so eloquently expressed what i’ve been unable to…at least not like this! I’ve always felt that the most important part of what we do is the intake…. If, as the therapist, you are successful in making a connection….a true relationship with your client/patient..the object of your full focus, heart, mind and soul, the rest will be a success. Your intention, coupled with the connection you’ve been able to make with that person creates a sort of bond, a true energy exchange where both are equally giving and receiving. It is awesome. The career we have chosen..or that has chosen us.. Is beyond compare.

    Reply
  16. Nancy Keeney Smith says

    April 11, 2013 at 6:42 am

    As always, straight to the point with a velvet hammer! Your class taught me thoroughness is necessary along with an open ear and open heart. Sometimes a sparse intake turns into a 20 minute conversation to “fill in the blanks.” In my experience, for those beautiful souls it is the first time a health care provider has taken the time to ask and to listen.

    Thank you for continuing to do the work and passing your knowledge on to us.

    Reply
  17. Teba says

    April 11, 2013 at 5:41 pm

    Tracy, Congratulations.Inspiring as always and well worth reading. I look forward to many more and will definitely encourage the participants of our courses to link in. ๐Ÿ™‚ Thank you.

    Reply
  18. Joyce says

    April 11, 2013 at 5:43 pm

    Lovely Tracy, thank you.

    Reply
  19. Tracy says

    April 12, 2013 at 12:43 pm

    Elizabeth, Linda, Wayne, Nancy, Teba, Joyce: Thank you–I appreciate your words.

    Reply
  20. Bonnie Pato says

    April 15, 2013 at 7:45 pm

    Hello Tracy,
    Looking forward to taking your course at Educating Hands Miami in July.
    Moreover, I am further inspired, by your thoughts and the enthusiasm of all who responded, to begin my path to do this work. Thanks!
    Best Regards,
    Bonnie

    Reply
    • Tracy says

      May 15, 2013 at 9:50 pm

      Bonnie, happy path! Cindy Gillan and Julie Streeter, instructors for that 4-day course, will be glad to accompany you on it.

      Reply
  21. John Wackman says

    April 18, 2013 at 1:52 pm

    So glad you are doing this Tracy. Beautifully written! And I appreciated all of the comments. One phrase that has always held meaning for me: Meet the client where they are. From that place we walk forward together.

    Reply
    • Tracy says

      May 15, 2013 at 9:50 pm

      Yes. Meet the client where they are.

      Reply
  22. Mel Delger says

    May 10, 2013 at 12:10 pm

    So clearly written and heartfelt, as always, Tracy.
    I was a clinical physician assistant for over 30 years, and I know all to well how patients dislike filling out medical history forms. Too often this necessary task seems to solicit hostility rather than a welcoming between medical practitioner and patient before the actual encounter even begins. Some patients become extremely frustrated when they are told they must complete the medical history form prior to seeing the practitioner. Practitioners become frustrated because the typical too short appointment blocks today do not afford sufficient time for practitioners to record the baseline medical history…one is lucky if there is enough time to evaluate the patient’s presenting complaint.
    If this article was framed and posted on the wall of every medical reception room, posted online prior to the online medical history form, and attached to the front of
    every medical history form given to patients, patients would welcome the opportunity to complete these forms. Education is such Good Medicine.
    My heartfelt gratitude for sharing your wisdom.

    Reply
    • Tracy says

      May 15, 2013 at 9:51 pm

      Mel, spoken from experience! We all need more time, don’t we?

      Reply
  23. Walter Lokey says

    June 20, 2013 at 8:24 am

    The term eczema is broadly applied to a range of persistent skin conditions. These include dryness and recurring skin rashes that are characterized by one or more of these symptoms: redness, skin edema (swelling), itching and dryness, crusting, flaking, blistering, cracking, oozing, or bleeding. Areas of temporary skin discoloration may appear and are sometimes due to healed injuries. Scratching open a healing lesion may result in scarring and may enlarge the rash. ^;^-

    Ciao for now
    http://livinghealthybulletin.comlj

    Reply
  24. Physiotherapy Nedlands says

    August 10, 2013 at 9:28 am

    We always thought that therapy is always good when we exert more force. But the truth is we can really feel the relaxation when our muscles told us to and that is when we are to be massage lightly.

    Reply

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Service. During cancer treatment and beyond, people need support. They need symptom relief. They need sleep. Oncology massage therapy (OMT) can help people cope during cancer treatment, at end of life, post-treatment, and during diagnosis.
Practice building. With the right skills, you can meet growing client demand and build your practice. You can be part of cancer care. It is better for your business to be able to work with people right then, right where they are, than to refer them out or send them home.
Career satisfaction and longevity. OMT is immensely satisfying work. Your steady presence and your hands can make a huge difference in someone's day or week. You might even find our approach to be easier on your hands and alignment. We offer new ways to provide comfort without effort and "deep tissue" work.

To practice OMT, massage therapists need to know what to ask clients before the massage, and how to use the client's answers. They need to know how to think through what to do, and how to communicate with clients in difficult circumstances. They need confidence, sensitivity, strong interview and table-side instruction. They need to learn from actual case studies and real-world exercises, and good chances to practice.

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