Issue link: https://www.massageandbodyworkdigital.com/i/1174218
58 m a s s a g e & b o d y w o r k n o v e m b e r / d e c e m b e r 2 0 1 9 When you first meet a young person, it might feel like calling them "kiddo" or "pal" or "champ" is a comforting, friendly way to greet them. It isn't. It's a way of showing them that their name is not that important to you. Using a patient's name when you speak to—or about—them is a way of telling the patient and their family you see them. Using a person's name is a way of acknowledging they are an individual. It reminds them (and it reminds you too) there is a whole life outside of—and around—this moment in the hospital. When you use a person's name you are saying, "I know you are a whole person. You are not just another diagnosis or room number on my list." The choice to use an invented nickname or to slip into diagnosis-as-name is essentially about discomfort with an unknown person or situation. There are many ways we use language to distance ourselves from difficult situations, things that frighten us, and things that make us feel unprepared. In reality, these euphemisms, nicknames, and aphorisms have the opposite effect. They don't distance us from the reality of what's happening. They distance us from the people who are living that reality, like the patients and families we serve. (See "Recommendations for End- of-Life Communications," page 59.) Use More Than Words Marley was born two weeks ago with congenital issues that have still not been fully diagnosed. He has a head of thick, curly hair and striking blue eyes. His skin is very hot, and his breathing is very rapid. Marley's life will be measured in weeks, not months or years, and he will not leave this hospital during his short life. He cannot hear, and it is unclear what he can see. If you place your finger in his tiny palm, he does not grip it. It would be easy to spend the 20 minutes described above wrestling with your own head trash. "Is it working?" "Does she like it?" But that takes you out of the present moment. This patient is a person who has an intimate relationship with pain. She also demonstrated, from the beginning of this interaction, that she did not feel up to proactive or engaged verbal communication. The therapist has to believe in the value of her presence there and also be quiet enough inside to see and feel the patient's nonverbal feedback. "Don't Call Me Buddy!" In the children's hospital where I work, it is not uncommon for the nurses to put signs on the doors with special instructions for other visitors and providers. They usually say things like "Please cluster care to avoid overstimulating me," or "Male providers, please knock, introduce yourself, and wait until mom opens the door." My favorite sign ever said, "Don't call me Buddy. My name is Stephen." Justine was born with a rare birth defect called agenesis of the corpus callosum (ACC). Justine's mother was sitting in her daughter's hospital room one day when a group of health-care providers doing rounds stopped at the open door of Justine's room. The physician leading the rounds said, "This is 721, ACC, female …" Justine's mother sat in disbelief. She said that she wanted to ask, "This is 721 ACC female? Did someone change my daughter's name? Because this is Justine." I knock on the door and slowly open it. Simone's room is dark and silent. This "pediatric" patient is 22. She was diagnosed with sickle cell anemia when she was 5 months old. She experiences severe and frequent pain crises and has been admitted to this hospital many times. Simone is lying in the bed. Her makeup is perfect. Her hair is wrapped in a colorful scarf, tied with a flawless, complicated knot. Her eyes are closed, but, after watching her for a moment, I'm pretty sure she's awake. There is a chair near her bed. I sit down and I say, quietly, but clearly, "My name is Kerry. I'm a massage therapist. Your care team asked me to visit and see if you'd like a massage." She nods a barely perceptible nod. When I ask where she's experiencing the worst pain, she points to her legs. I place my hands on her right thigh and wait. She nods again. We spend the next 20 minutes in silence. Simone never speaks. She never opens her eyes. When what I am doing is helpful, she gives me that tiny nod. When what I am doing is unhelpful, her leg tenses ever so slightly under my hand and her pencil-thin eyebrows twitch. At the end of the session, I whisper, "Thank you for letting me work with you today, Simone." She nods. I close the door behind me as slowly and as quietly as I can.