Ruminations on sports, training, health, and wellness

Posts tagged “Atul Gawande

A Massage Therapist’s Notes on an Imperfect Art

Nearly 2 years ago, when I was just starting to post on this blog, I was thrilled to attend a talk given by one of my childhood heroes, Robert Ballard, who answered my questions about how to get kids excited about science. He told me to meet their passions with matched enthusiasm, and to keep asking questions of my own.

Two years later, and I’m happily in the position of doing just that — getting young people excited about science as I continue to delve into the beginnings of what I hope will be a career as a science educator. Yesterday I took my students on a tour of active biomechanics labs at a high research activity institution, and this morning we talked about physics in the context of football pads and baseball bats. It’s been a pretty awesome week already, and it’s only Tuesday night.

temp-complications-cover-203x300The highlight of my week was outside the classroom, however — I had the great good fortune to attend another Bryan Series talk given by Dr. Atul Gawande: surgeon, MacArthur fellow, and author of four highly acclaimed books. I read Dr. Gawande’s Complications: A Surgeon’s Notes on an Imperfect Science in 2010 while I was recovering from a cholecystectomy (which made me really glad I waited until after the surgery to read it when I got to the chapter about how often cholecystectomies go terribly wrong). The book made me examine my own approach to science and knowledge; one of my great frustrations with massage school was hearing teachers parrot outdated assertions because that was the way it’s always been done, even though advances in science give us new perspective on our practices. Dr. Gawande’s approach to medicine by asking why we do what we do, whether it’s working, and how we can do it better was the first in a series of “eureka” moments that ultimately led to my decision to go to graduate school and pursue a better rounded education in STEM topics.

I’m batting 1.000 at questions I submit to Bryan Series speakers actually getting asked in the Q&A portion of the lecture; I posed to Dr. Gawande how allied complimentary healthcare practitioners, such as massage therapists and acupuncturists, can communicate better with physicians to become a more effective part of the healthcare team. Dr. Gawande described his sister in law, a massage therapist and “holistic healer” in Asheville, NC as an “artisan” whose vocabulary and rhetoric regarding medicine failed to mesh with his own and resulted in communication breakdown even when probably talking about very similar things. But, he said he recognized that his patients seek out practitioners like her for their services, so it’s important for physicians to be aware that these people are meeting some kind of particular need. And he added that his wife much more frequently seeks advice from her sister than she does from him.

Albinius-217x300Atul Gawande’s tacit acknowledgement of complimentary alternative practitioners as a bit of a fringe entity to the medical mainstream speaks to a lot of my frustrations with massage education and science education as a whole. I had a huge epiphany when I took a continuing education class on structural myofascial therapy last winter and I caught myself tuning out as soon as the instructor mentioned “energetic connection.” My woowoo-ometer is on a pretty fine hair-trigger these days. But as I willed myself to appreciate the spirit of the instructor’s message, I realized that when he talked about the implicit energetic connection between the feet (energetic grounding) and the hip (energetic centering), he was using different words to describe the principles of biomechanics that I know and embrace — kinetic energy manifested in the form of mechanical work is dispersed from the feet (ground reaction force) to the hip (joint reaction force) by the same network of musculoskeletal and connective tissues he was describing as a “myofascial meridian.” Holy crap. Mind blown. We’re talking, gray matter spattered on the walls, here.

We massage therapists devote a lot of hand-wringing to being taken seriously as medical professionals. Indeed, we have come leaps and bounds thanks to leaders in the field who are producing some very fine scholarship and advocacy for better education and standards for licensure. We’re enjoying a very exciting time for our profession as cutting-edge evidence-based practice collides with millennia of tradition to snowball into a paradigm shift. I’ve only recently come to recognize that great groups of thinkers and doers don’t become great without extremely hard, intentional work. I want to be there — out on the front lines, surging ahead at the prow as we enter a new era in integrative medicine.

I also recognize I can’t do it alone; this has to be a group effort. The old adage goes, “dress for the job you want.” We, as a profession, need to become fluent in the language of progress. We need to make a concerted effort to learn not only the common tongue of medicine, but of professional scientific practice. Let us abandon the days of “we do it because that’s the way we always have” and open wide the floodgates of the relentless, “why.” We need to be critical consumers of information and implacable questioners of the provisional. When our best understanding of our practice evolves, we have to evolve with it.

I take my fair share of barbs for voicing my criticisms, but I assure you I hold no one to a higher standard than to which I hold myself. I make no asservations of touchy-feeliness. I am utterly fascinated at the phenomenon of how different people, presented with the exact same availability of information, can arrive at diametrically opposite conclusions on any matter (science or otherwise), and I am recognizing that my convictions I hold to be self-evident are just as true to me as their mirror images are to my peers who fall on the opposite side of the fence. What I mean is that I am becoming more aware, as a practitioner and an educator, that all truths should be subjected to equal scrutiny to separate the staunch edifices from the crumbling sand foundations. When we ask the tough questions, we have to be prepared to accept tough answers.

Keep digging, friends.

Digging