No One Gets Left Behind

A hand reaches up out of a large body of water, the person submerged. Photo by Stormseeker.

Several months ago I was working with a new patient. We will call them Pat. Pat was born with a sort of mysterious genetic disability that altered how their joints worked. The disorder didn't have a name, it was presumed to be a genetic problem and that was that. Pat did struggle with different abilities though truthfully it was hard for me to call them disabled. I know they were considered disabled but wow this person was a juggernaut in the arena of life. Multiple degrees, working on a PhD, and while use of a wheelchair was sometimes necessitated they preferred, often, to use crutches to navigate the world as that enabled them to deal with stairs.

Due to the issues with their joints and reliance on crutches for daily movements around home, school, and elsewhere, there was a lot of muscular tension throughout their back, neck, and shoulders. Our goals were related to relieving this tension and restoring neck mobility as their muscles would get so tight moving their head became a challenge. Historically massage had proven to be very helpful for them.

When I asked why they were seeking a new RMT Pat informed me that their last RMT discharged them from practice because they weren't getting better. ...huh?

I was a little surprised and said "but... you can't get better. This is how your body is." They looked at me with a smirk and said "no shit." Well. I responded "well, as long as you get some kind of benefit from my work that you can define, I don't see a need to discharge you. If the massage is not helpful at all in any way, or you decide I'm not the right fit for you then we will part ways but unless that comes to pass I'm willing to journey with you as long as it makes sense."

I suppose I get it, from the other RMTs perspective. We are often driven to "fix" as if that is possible for all people and all problems. Sometimes the solutions look a lot more like how to manage long term with a crappy situation. Relief really can go a long way for some people. For the RMT, though, it can feel like you're failing and not helping people and that may leave you wondering if maybe you should be sending them elsewhere.

At the same time, when working with people who have persistent illnesses or disorders that just will never go away our work becomes less about "fixing" and more about "relieving and supporting." It sucks but sometimes symptom management is the best a person is gonna get. They got a raw deal in life and they gotta do what they can to make the best of it. Being in this role for someone can be challenging but also just as rewarding as seeing someone "get better." People need support, care, and skilled help when making the best of a lousy hand and we can absolutely play that role. This can enable a person to be more active, present, and comfortable in their life even with on-going challenges to their health.

Complex case management can take more effort and the goals are different but they are still achievable. A slight reframing of treatment trajectory is all it takes.