How does it feel to be cared for?
In Quebec, your 18th birthday is a big one, you are officially and adult, you are allowed in bars, you can drink and you are finished with High School and have moved on to CEGEP.  It is a big deal, friends and family make a big fuss of you, lavish you with love and attention, humour, gifts and drinks, lots of drinks in some cases!
But what happens if your family is disjointed, ill and absent?  That was my lot, on my 18th birthday, my mother was yet again in a hospital somewhere, my father was missing, he had not given signs of life for weeks, one sister was studying in a far away town and the other was doing her best to make up for all this mayhem, but was overwhelmed with her own life, my two brothers had been absent from our lives for a few years by then, and probably didn't even know it was my birthday.  I had learned by then not to need to much from others, so on that day, a Friday, I was going along my business not to fussed about the fact that it was my birthday, friends had called  and there was some vague plans to try and get together later that evening and celebrate in a bar somewhere.  No dinner, no cake, as far as I was concerned, that was a certainty.
Alone in our apartment around 5pm, I was contemplating going off to the store to start gathering the necessary items for my dinner.  The doorbell rings, I buzz whoever it is in and wait to see who the mystery visitor coming up the stairs is.
My uncle and aunt, there with a cake, some flowers and bags of groceries.  Now these two had opted very early on in their relationship not to have kids, focus on career and be jet setters travelling the world over with no restraints.  For them to show up unannounced bearing gifts was unusual, and therefore even more of a heart warming moment.
Within minutes, my aunt was in the kitchen, preparing an extravagant meal for way more people than I could imagine at the moment, there was laughter in our home, it was magnificent.  My uncle was on and off the phone, contacting all my friends inviting them to an impromptu dinner party.  By the time he was done, 8 people were on their way and we were madly preparing a feast and decorating as if this was a 3 year old's party, streamers, banners and balloons everywhere!
During diner, my friends, uncle, aunt and I had fits of laughter, great political debates and I am pretty sure that we tried really hard to make plans to end world hunger.
It was wonderful, my hodge podge family had come together in the most wonderful kind of ways.
Sitting at that table, I felt love, the kind of love that has no boundaries, no strings attached.  No one was there out of pity for me, they were there out of pure joy just to be part of this evening.
26 years later, whenever I recall that birthday, I feel warmth and light and a smile immediately comes to me. In that moment, I was important, worthy of attention, love, humour and compassion.  I quite often go back to that memory, as one of the best moments in my life. Of course,since then, I have had many wonderful moments, but this one is special, it was unexpected and it came from the most unlikeliest of sources, my aunt and uncle.
My uncle passed away very suddenly 2 years ago, and I still miss him, he will forever be in my heart as the man who brought the party to me!

Mister Van Manen and Phenomenology.
Reading Max Van Manen's article on Modalities of Body Experience in Illness and Health has been an eye opening experience.  I was quite vague on what phenomenology was and how it could help with my field of work, massage therapy.
As a read along, I started to see how this form of research is really needed in my profession.
" The phenomenological approach asks of us that we constantly measure our understandings and insights against the lived reality of our concrete experience, which, of course, are always more complex than any particular interpretation can portray" (Van Manen, 1998)
What I understand from this is that, as RMTs, we need to constantly use critical thinking to adapt our book/science knowledge to the lived/felt experiences from our patients.   A prime example of this would be how to consolidate the evidence from research to real life clinic, for example, research says that we cannot feel or correct sacral torsions, nor can we prove they actually exists, yet in practice, many of us have found that treating as if a patient has a sacral torsion results in reduction of patient pain and dysfunction.  The research purist will say I am fooling my patients and nothing but placebo effect is shown is such cases, but is that realistic?  What about the Human factor?  That invisible variable that no scientific method has been able to measure and has a tendency to discard.
This is where I see phenomenology helping bridging the gap between our knowledge and our lived experience which is so prevalent in Massage Therapy.
Recently I was conversing with 2 orthopedic surgeons and one anesthesiologist, the conversation migrated toward efficacy of physiotherapy post surgery.  All three physicians have been observing that lately, physiotherapy seems to have lost efficacy.  To them, it seems that, in their push towards evidence based practice in the recent years, the physiotherapy profession has lost it's instinct and ability to treat the human being behind the dysfunction.  Of course, all  three admitted that this is just a vague observation, and not backed with actual data or research, but it did bring up questions on how we still have a long way to go with our approach to research and how we use it to improve our professions' efficacy.

In class, Saturday, we had a visit from Randy Persad, self care advocate and silence specialist!
He came to get our cohort to start thinking about self care and it's importance in our lives.  Now, as an RMT who actually had Randy as a teacher, self care has been a subject impossible to avoid.  Mainly because without it, I cannot do my job properly, I also cannot be a good mom, spouse or friend.  I learnt that the hard way, a few years ago.  After a few years of difficult emotional times for our families, I fell deep into my introverted personality and retreated from everyone and everything, except my kids.  I had lost touch with my spouse, my friends and family, I was unable to connect. That is when I was reminded about self care and it's importance, I left for 10 days of absolute silent meditation at Dhamma Surahbi in Merritt, BC.
That was by far the hardest and best thing I ever did for myself.  The first 4 days were terrifying, I cried, had insomnia, I was in actual physical pain.  Close to 12 hours of meditation and absolute silence at all times leaves you very vulnerable to all that your brain has been hoarding.  Years and years of stored memories and experiences come back to flood your consciousness, and there is very little you can do to stop it.  By day 5, your brain starts to calm down and accept the meditation focus, your body follows suit and the pain subsides, sitting for all those hours is starting to feel good. From day 6 on, it is pure peace and calm, there is no more war being fought in your heart and brain, your mind is settled and you are happy with the silence.
Day 9 and a half, you are allowed to start talking, but I didn't feel like it, just listening to all the chatter in the centre was overwhelming to me, I sat in the courtyard listening to the noise from afar.
It took a full week before I started playing music in my massage room again.  Clients would comment how quiet and peaceful I seemed.  I was again able to reconnect with my friends and family, it was no longer painful and difficult to be part of society.  The 10 days of silence had allowed me to regenerate, find myself again, and mostly, give up holding on to all that pain.  I have since been back to Dhamma Surahbi 3 more times, each time I experienced an new set of emotions and pain, each time, I came home renewed and reconnected.  Since my first silent retreat, I have tried to incorporate meditation and silence into my life, I quite often ride the bus with my earbuds in but no music playing, eyes closed, meditating, not sure if I am fooling anyone, but that's ok with me!
My self care practice involves making sure I find time alone to reboot daily.  I also allow for me to get one treatment a week either Massage Therapy, Acupuncture or Energy Healing.
Of course, when I can find a spare 12 days, I fly off to Merritt for some silence and meditation.

I just finished reading a section of our class book, Social Determinants of Health, a Canadian Perspective from Dennis Raphael. A few thoughts came to mind as I was reading the chapter on Precarious work and the Labour Market and how it affects our sense of employment security in Canada.
The thing that came to mind and kept nagging at me the whole time I read and took notes is that we are evaluating insecurity of employment based on our opinions of what a good employment actually is.  Meaning that my generation, and the one before me, we have been raised to believe that full time employment with one company, one pay check, a pension plan and some upward mobility is important to our sense of security and therefore the preferred employment styles.  But the landscape of employment and career types have greatly changed, for example, I have 3 jobs, one as a self employed RMT, one as an faculty for Langara College and one as a contractor for the College of Massage Therapist of BC as a consultant.  All three jobs add up to full time work.  My brother and sister-in-law both have a very similar situation.
I now see this as not only normal, but as giving me a sense of security because if one job falls through, I have the other two to keep my family afloat.  It does have moments of feeling very overwhelming, especially when deadlines in both jobs for which I have bosses end up being to close to each other and it is difficult to meet the demands.
So for me, this is both a good thing and a difficulty that I have adapted to, but when I talk to my children, this is the only employment landscape they know of.  For them, multiple part-time jobs with different industries is not only normal, but acceptable and actually desirable.  For example, I was having a chat with my teenage son, I casually asked him what he thought he might want to do later in life, his reply:  "Well I think I would like to start with..."  Yes, those were his words, I would like to start with.  He already is planning on multiple career paths/changes for his life long working experience.  To him, it's a no brainer that you are not expected to spend your entire career with one company doing one job, that thought is probably stressful to him.  It's not entirely surprising being that he is raised by a woman who started as a nurse, changed to an RMT, added teaching and consulting on the side and is now going back to school toward another new career path.  His father has had 5 completely different jobs since he was born 16 years ago.  He only knows this new form of employment landscape.  So as we evaluate this "precarious" work as a source of insecurity for Canadians at the moment, I suspect that in a few years, this might be completely different.

Something quite funny happened today, not funny ha!ha!, but funny as in making me rethink my core values and how I judge a situation or person based on them.
So here is what happened:  I am coming home from work on my beloved scooter, just enjoying the ride.  I get to a red light and come to a stop near a motorcyclist, I look over towards him, and there he is, on his big motorcycle smoking a cigarette.  Somehow, my brain just glitched, I could not comprehend the image and therefore found myself blankly staring in absolute confusion at what was before me.  Of course, it didn't take too long before he stared back at me with this "What do you want?" look of annoyance.  I quickly reconnected and looked away just as the light changed and our world separated again.
As I rode away, I started thinking about this image and how I felt it was an absolutely waste to be riding a bike while smoking.  Then, it came to me to question my reaction, why is it that I find it incomprehensible that someone would make such a choice? Barring the obvious, smoking is bad for you, why was I so perturbed?
I then had to figure out why I love riding motorcycles and scooters so much.  My first thought was, I can breath better when I am on a bike. With age and wisdom, I have been slowly coming to the realization I have air anxieties, I regularly feel like there is not enough air around me and in a car, that is a problem for me.  Obviously, not an issue on a 2 wheeled motorized open vehicle! So this was it, my big confusion with this man and his cigarette was that he was challenging this very big reason I love riding, the amazing amount of air I get when I ride.  As far as I was concerned he was ruining the best part of riding, but who am I to place this value on him?  Maybe his favorite part of riding is the fact he can smoke to his heart's content and not end up getting busted by his wife because the fresh air of the ride prevented his clothes from smelling of cigarette? Who knows?  Certainly not me!
Which then opened the question; how often do I unconsciously judge a patient's or student's choices based on my own likes, dislikes and wonderful little neurosis'? I am going to guess many, many times, if not all the time.
So how do we, as educators, healthcare practitioners, fathers, mothers, sisters, brothers and just plain humans keep that in check?
Right now, I am thinking with regular check-in sessions with ourselves and questioning our reactions, good and bad to different situations and people.   Forcing a reevaluation of our value system as we go along our merry way in this complicated life journey!
Just a thought that occurred to me on my ride home, one of the other reason I love motorcycles and scooters so much, it is a mini meditation and refocus session every time I go for a ride.

Hello,
My name is Anne-Marie, I am a student of SFU in the Masters of Health Education and Active Living (HEAL).
 More importantly, I am a wife, a mother, a teacher and a healthcare practitioner, specifically a Registered Massage Therapist.  This Masters degree is meant as an addition to who I have been for what is coming up to be 44 years now.  The next 2 years are being set aside for growth and reinvention, brain stretching is what I am aiming for.
Already 2 days in and I am learning how to blog, which, for me, is a serious exercise in brain stretching.  I am not computer literate.  My teenage son has been sitting next to me for the past 45 minutes painstakingly trying to teach me how to use and organize this blog, amazingly enough I did not get one eye roll from him, we are having a good day!
A little bit about my background.  After a weak start in Nursing back in Montreal, I moved to Vancouver to study Massage Therapy.  Graduating from West Coast College of Massage Therapy (WCCMT)  in 1997, I first left for what was probably the coolest job in my world at the time, being an RMT for a Helicopter skiing company in the middle of nowhere land British Columbia.  It was brilliant, I got to ski and ski and ski, oh and of course work...
I then came back to the real world and have been working ever since as an RMT in North Vancouver in various clinics.  In 2005, after having my second child, I decided to push my boundaries and stress my comfort zone and started working at WCCMT as a teaching assistant and a clinic supervisor.  I quickly discovered a love for education.  In time I took on a lead instructor position and through some trial and error, I slowly became a teacher.
Now 11 years on, I have learnt an amazing amount from my time in the classroom with my students.  I am ready to push these new boundaries and use these next two years to "explode" right out of my little box.
So, other than blowing up my surroundings with all my new knowledge bombs, what am I planning to do with this Masters degree?  That is a very big question I have yet to fully answer.  Loosely floating in my mind at this present moment is the idea that I would like to help bring Massage Therapy education to a higher level. Presently, RMT programs in Canada are mostly being taught in private for profit schools, only a very few programs are being offered in a public setting.  I am lucky enough to be one of the few teachers working in a public college teaching in an RMT program, Langara College.  That said, we are still offered as a continuing education program, therefore, although in a public college, we are not funded by the government.  Massage Therapy education is very expensive, close to $40 000 for a two year program.  Getting a stronger background in Health Education, I hope to be part of a team that could bring our program fully into the public system, which would increase Massage Therapy education quality overall and making it much more affordable.  On a even greater scheme, maybe even elevate RMT education from a diploma to a full degree.  Big lofty goals, I know!

My first postcard for the HEAL program.

Health Education and Healthcare practices cause a “disjointed” view of the human body.

In school, we teach physiology, anatomy, pathology and kinesiology of each body part/section independently from each other.  I have been noticing that students have a difficult time seeing the full body component of health.   I am finding it hard to get them to reassociate all the individual learning of body functions and kinesiology back into one big entity.

When I look at how our healthcare system is set up, with all the specialists working independently from each other, a patient gets again separated in bits and pieces and very rarely gets viewed/assessed as one entity.  Big health concerns that affect multiple systems are often missed and treated as a multitude of individual concerns

How can I help the students understand that a reduction of extension with the right big toe can be the cause of the left TMJ cracking?

Anne-Marie Cote