The Palliative Connection

Someday, somehow those of you reading this are going to die. In fact everyone not reading this is going to die as well. Everyone you know or have ever met will also be dying. Indeed what a great and final equalizer death is for there is not one person on this planet, rich or poor, privileged or downtrodden who will not be dying once their ‘living’ is done. And if it is the ONLY thing beside birth we know we will ALL be doing why it is so hard to talk about, read about, think about and deal with, particularly in this westernized world that most of you readers are living in? Perhaps it could be suggested that because of this westernized world we live in death has become hidden, never talked about and rarely celebrated. Both as human beings and massage therapists this fact is certainly food for thought.

Every day when we open our clinic doors we are greeted with a day of clients who are moving through life just as we are, all of us at the ‘awkward’ stage between birth and death, otherwise known as life.  Often we are put into situations that require us to use all of our skill, expertise and training to develop a treatment protocol that will assist our clients to lead happier and more healthy, pain free lives. But what happens when we encounter those clients who by their own admission are not much longer for this mortal coil? Those clients who have been diagnosed with a terminal illness meaning their days of living are almost over. As professional therapists how do we deal not only with our clients but also our own feelings? How do we understand and accept not only treating them through this time, but also saying goodbye in the not too distant future? A client we know we cannot ‘save’ but who we may be able to offer assistance to through our touch. How do we offer comfort, connection and warmth as their lives are ending?

To be completely honest this topic puts me outside my comfort zone as well. What got me thinking about the need to understand this and be able to explore and discuss this area of client connection was an experience I had many years ago with a client who was dying. Even though during the course of my life I had experienced the concept and reality of death several times, I was still caught off guard when this client showed up in my treatment room. She was referred to me by another client whom I had been treating for quite a while, using MLD as a post mastectomy treatment for first one and then a second breast removal a few years later. She told me that this lady had been fighting cancer for many years having tried many treatments from both the eastern and western traditions. One of the first things that struck me was her bubbly, vivacious, active and spirited personality. From her very first treatment with me she put her situation quite simply, “I don’t want to die”

Over the course of the next six months her cancer worsened despite her positive and upbeat approach. Towards the end of her life I was seeing her weekly and then visiting her in palliative care.  By this stage her cancer had spread to her lungs, throughout her organs and eventually into her lymphatic system. It became not a question of if she would die, but when? During the course of my interaction with her I was personally challenged to face my feelings about death, I was so hurt for her because I knew she didn’t want to die.  I had to dig deep and really question what it was I could do for her or help her with in her final weeks. She insisted that MLD made her life and pain more bearable. Although the cancer had spread to her lymph nodes and MLD was technically contraindicated, she absolved me from any misconduct and asked that I remain her therapist until the end. How could I say no? Until her last breath she was still living and so I felt that the least I could do for her was bring the bright spark of life and humanity to her through my touch and treatment. I learned to really hold space and be present during this intense, heartbreaking and yet somehow beautiful transition. Although she fought the notion of her existence being over towards the final days there was an acceptance and a kind of peace found within her. The funny things was I never felt like I was in the presence of someone dying, I was in the presence of someone still living, until they weren’t anymore. Even our last session together didn’t feel like the end. She was still conversational yet with a quiet stillness that really moved me. I suppose the most difficult part of the whole experience was the day she died because it felt to me like one minute she was there, living and fighting her illness, and then in an instant she was gone.

I grieved her death for both of us. I grieved for the loss of my ‘innocence’. The truth hit me hard. That experience showed me the way it will be for all of us and everyone we know, in a nutshell – here one minute, gone the next.

The way I see it there are two ways we can choose to deal with death. The first is to stick our heads in the proverbial sand and pretend that death won’t come for us. That death won’t appear in our clients’ lives, on our tables and in our treatment rooms. Pretend that we are immune to the passage of time and the scourge of illness. In our western world we have managed to package death up into neat boxes where families usually make a call to a group of professional strangers so that the body and final details of those they loved most in the world can be handled by someone else. Very rarely does the family involve themselves in direct preparations for the cleansing of the body or the actual mechanics of the funeral.

The other direction that we can choose as human beings and massage therapists is to step forward and accept death as a natural part of life. In order to prepare ourselves for the most probable eventuality that during the course of our professional lives we will come into contact with a client who has a terminal diagnosis, or a client who is in palliative care, we need  address our own feelings about death and dying and come to a kind of peace with it. The reality is that when clients are in palliative care they are waiting and while they wait we can help them with our touch. This opportunity could be seen as a privilege afforded to those of us brave enough to stand up and be of service to a fellow human being, possibly when they need it most. Holding space during that time means we are willing to walk alongside another person in whatever journey they are on without judgement or trying to fix them or impact the outcome. As a body-worker we can hold space for our palliative care clients by opening our hearts, offering unconditional support and letting go of judgement and control.

Death is the truth of life and there is little to say about it because dying and living are two sides of the same coin. How difficult it is in our culture and time to die well. As Stephen Jenkinson said in his remarkable documentary “Griefwalker”, “The cradle of your love of life is death, the fact that it all ends” It took me hearing that many times to fully understand his sentiment but it all comes down to knowing that someday we will die. Shouldn’t that be the inspiration to take this thing we call ‘life’ and do a good job of it while we still can? Again in Griefwalker Jenkinson asks the question, “If you cannot befriend your own death then how strongly in your life are you?”

Finally for those of you working in palliative care or working with terminally ill clients open your hearts and accept this moment your life has presented to you with gratitude and humility. By offering massage therapy as a physical comfort for palliative care we can honor the experience of the client and find solidarity and connection in our common human condition. What a gift clients give by allowing you to share their journey towards death.  As a massage therapist make the palliative connection, learn from it and be inspired to a fuller life while you are still gifted the opportunity to do so.

The Palliative Connection” a 3 part webinar series by Rhythm Massage Development will commence in 2018. Keep an eye out on the website or FB page for details.) Michelle Vassallo