“Doctor Joe, you have another patient to see you.” I never get tired of hearing this phrase from Prajawl, the front desk attendant. Wearing my white lab coat and a smile on my face, I walk out of my treatment room to the front desk with my interpreter, Ritesh, Maneesha, or Satyamohan. “Namaste,” with my hands clasped together I give a short bow to my new patient who returns with the same bow and “Namaste”. We escort her to a back room - before we enter she takes off her shoes as a sign of respect for my space – I prefer to think of it as our space.
The three of us sit at a small table where I first read the patient’s chart and try to get an idea of what type of physical issues my client has been troubled with and the treatments she has received.
“How is your back feeling today?”
Although I’m speaking through a translator, it’s important that I talk to my patient and maintain eye contact with her. Neither a person’s nationality nor culture change the fact that being heard and understood are prime signs of respect.
“Doctor, my back hurts.”
“Could you please show me where it hurts?” I ask.
She moves her hands to the lower right part of her back but slightly over the crest of her hip.
“I’ve had massage and acupuncture before but I’ve been working in the fields and the pain has come back. Doctor, can you please help me?”
The trust, faith, hope, and uncertainty in her eyes meet mine and I immediately feel a sense of humility. Here I am a rich foreigner from a wealthy country who has at his fingertips some of the best healthcare in the world, who has running water and 24/7 electricity, who’s notions of farming all arrive from television, books, and riding rural roads on my bike and her eyes are begging me for compassion and relief from her pain. It’s with a complete humble heart that I nod my head and tell her that I will do my best to help.
Treat the patient not the issue.
It’s so easy to get lost in the daily grind back home: massage after massage treating clients who have succumb to the stress of daily life. Here I can’t do that. Every treatment session, usually 45-60 minutes long and up to 8 per day, I have to give all my attention and dig deep to remember all that I have been taught and learned.
With a deep breath, I place my hands on her back and remember the advice of Paul Fowler, one of my Thai instructors, Love, not technique. There is no other way and no massage technique as healing and as powerful as love. I’m learning that with love, compassion, and a conscious breath comes healing. Listening with my hands I start to palpate her back through her clothes (although my patients are on a massage table-except for their feet, are completely clothed) and find a hypertonic QL.
“Dukksha?” I ask using the Nepali word for pain.
In a groan she replies, “Dukksha.”
Throughout the session of compressions, friction, and stretches I mumble “ramro, ramro” – good good, as she breathes and I feel the tissue release its stubborn tension.
Helping her to sit-up on the table, “How does your back feel?”
“It feels much more relaxed, dhanyabaad – thank you.”
“When should I come back?”
We go over some simple stretches and the preferred way of rising from a chair and using one’s legs rather than back when reaching for the ground.
“Give it a week and if the pain comes back, please come back to see me – dhanyabaad.”
We exchange Namaste’s and Maneesha, my interpreter for the day, escorts her to the front desk as I sit down to write my notes on her chart.
“Doctor Joe, do you have time to see a monk from the gompa?”
With a humble heart, “Of course, please send him back to see me.”
With love...
Namaste.
Note: I apologize for the slow response to emails. We only have internet access when the power is on and often the power is on while I’m working in the clinic.
