There Ought to Be a Protocol for This

Since last fall, I've been seeing a massage therapist who specializes in myofascial release and realignment, particularly a type called structural integration (which always sounded to me like he was in the business of building bridges). The fascia is the bag of membranes that holds our muscles, ligaments and tendons together, and through accidents, poor posture and other trauma can become twisted and knotted, resulting in chronic pain and limited range of motion. Our aim was to go past what I was doing in physical therapy and make me more flexible, and integrate the use of my muscles against gravity (the technical explanation), or, basically, get me to the point where I could bend down and pick things up and get back to where I was before my back injury.

He is a soft-spoken man, very professional, very focused, and very good. I've seen so many body care workers that I can almost tell immediately, just from the touch of their hands on my body, if I can trust them or not. Marilyn, my late former massage therapist, was like this. As was my physical therapist. And so was this guy. His office space is clean, and open, and sparse. The treatment room consists of a sheet-covered rigid massage table, a bench, and a hook on the wall. A fan spirals overhead, into a white skylight. His personal self is just as minimalist - a white oxford shirt left untucked over jeans, clean-shaven, slender, hair cut close to his scalp.

He didn't like to say much during our sessions -- said he didn't like extraneous conversation -- so I kept my usual chatter to myself, and reserved any speech for technical questions and anatomy lessons (which he was very eager to give, like he'd been waiting for someone to ask.). When he gave me explanations about anatomy -- many of them involving how intricate the human body is and how everything is connected to everything else -- he tended to keep it in medical terms, speaking quickly in that soft voice of his, and often I had to ask him to repeat himself. I would nod along as he spoke, understanding bits and pieces and then more bits and pieces and then almost all of it. I tried to be in the moment during all of our sessions, absorbing what he was doing, and at times, just watching him work, with complete focus. At one point he apologized for talking in such a technical manner, but then I told him that I actually did understand everything he was saying. And this got me one of the few smiles that I ever saw on his face. And I'm all about trying to make people smile. I have to deal with enough serious crap in my life, so it's important to me that my medical team have a sense of humor. It's kind of been my test for everybody that I ever met. If I could make them laugh, then I'd know if they were human, and if any kind of relationship we had would go any further. Getting my physical therapist to laugh is easy. Getting this guy to laugh felt like one of my greatest achievements. I mean, during the course of our professional encounters, as part of the way he had to do the massage on me, we must've looked like some kind of combination of limbs or a clothed Kama Sutra position or like we were playing some bizarre game of Twister. Yes, it was all above board and professional and clinical, but come on. It's so ridiculous you just have to laugh, somewhere, sometime.

I went to him for a good few months, once a week, for hour and a half sessions. And during this time, while he had his hands, knuckles and elbows all over me (some releases need greater leverage), we knew virtually nothing about each other as people. I mean, guys who've gotten not nearly as far have had to buy me dinner first. It just seems so bizarre.

Anyhow, the sort of therapy that he did with me was never designed to be something that you do forever. An offshoot of Rolfing, it was designed to be done in a series of 10-15 weekly sessions, then stopped, and followed up on six months later.

That's for the average person, and because my body is a virtual cash cow for any kind of physical therapist, I had to go to him a little longer. But the time did come for us to have "the discussion." I expected this, and we both kind of came to it at the same time. We worked out a plan where we'd stretch the visits out to two weeks, then three weeks, then once a month, then whenever I needed him.

But a few weeks ago, we reached a wall. I was doing all of the movement exercises that he asked of me, working on my flexibility, working on integrating my muscles together, but even with all that, fibromyalgia at times speaks with its own voice, its own demands. It can grab onto a group of muscles and not let go. I would go to him one week with the same pain in my butt -- for lack of a more descriptive word -- and he would work on loosening all the fascia all around it and it would feel better for a little while, but then the next visit, it was still there.

We were going in circles. At that point -- I always seem to recognize that point, when what I'm doing isn't working, when I keep doing the same thing and expecting different results -- I decided to give chiropractic a try. After all, if one muscle is always annoyed, there could be some kind of nerve impingement involved, or a trigger point, or something that might benefit from having one bone moved away from another.

I told him about all this at our next visit. And he nodded, and said in that quiet voice that he didn't want to muddy the waters, that I was already spending enough money , and perhaps he should just back away for a while so I can see if this protocol would work. And I got this twisting feeling in the pit of my stomach, like I was back in high school and he was breaking up with me. I was already having an emotional kind of day -- with my raging hormones this happens fairly frequently -- and now I had to fight the urge to cry. He wrote a name down on the back of his business card and pushed it across his minimalist glass desk. It was the name of a guy in Manhattan he rarely referred anyone to except for special cases (meaning, I gathered, people he couldn't help any longer). He did the same thing that this guy did, except this one was more of an osteopath, and he said that he might be able to fix what I had with only one visit (which I sincerely doubted). Not only was he breaking up with me, but he was pimping me over to someone else. At least that's what it felt like to me.

I left his office, walked down the long flight of stairs to the street, and exited into blaring sunshine which made me feel a little queasy, and off-center. I felt rootless, homeless, cast adrift. Dammit, I thought, why do I let myself get so attached to these people?

Later on, when I shook some sense back into my head and put this back into perspective, I puzzled over why I have such abandonment issues. Seeing a body worker means putting yourself into a professional relationship. Unless it's something ongoing, like your doctor, your dentist, or your hair stylist, the relationship is going to end at some point. And that's a good thing, because either it means that you're better, or you realize that this person can't help you and you're moving on to someone who might be able to.

About a week passed, and it didn't bother me as much. I was getting chiropractic treatments, and the two of us were starting to feel each other out, so to speak.

Then I ran into my minimalist structural integrationist in the health food store. He was in the vitamin aisle, balancing a baby on his hip. She was dressed in a yellow checkered sunsuit with a matching bonnet.

I didn't even know that he had a baby. In fact, I sort of had the feeling that he was gay. Nothing specific that I could point to, just a sort of feeling. (Not that there's anything wrong with that). And hey, just because you're holding onto a baby doesn't mean you're heterosexual.

I said hello, and he said hello, and I said some other innocuous greeting-type-thing that people say, then the professional veil went over his face and he moved on. I would never know if this was his baby. He could've said, "Oh, hi, this is April, and we're just out getting a few things. Boy, it's hard to find anything in this aisle." Or something like that. And I continued on my way, and he continued on his, and we passed each other again in the produce aisle, and he said, "well, have a nice day," and left. End of conversation.

And I just stood there, staring after him. It didn't seem right. This man had had his hands all over my body. We'd been twisted up together like pretzels, so close that I could, during several sessions, smell the tobacco on a shirt (the only clue I had that he was a smoker) Yes, it was all professional and clinical. I know that we'd only entered into a professional relationship and outside of the office, he only owed me so much, actually, technically, nothing at all. But still. I felt like he owned me a few more words.

Even if it was only introduced me to his child. I would've liked to know her name.