Ep 1 – Conversations in Quarantine – Interview with Cal Cates – Part 1

00:00 Darren Buford: Our gift to you, weekly free CE from ABMP. As a way to give back to the profession during this challenging time of COVID-19, ABMP is offering free access and CE for five courses in the ABMP Education Center each week for four weeks through May 6. Simply register online at abmp.com/CE for access to watch these video-based courses which are among the 200-plus available to all ABMP members in the ABMP Education Center. Please enjoy these courses and free CE while we look forward to resuming practice.

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00:45 DB: Welcome to Conversations in Quarantine. My name is Darren Buford and I'm the Editor-in-Chief of Massage & Bodywork magazine and Senior Director of Communications for ABMP. Our goal here is to speak with luminaries and experts in and around the massage profession, to talk about the effects of COVID-19 on bodywork practitioners, and more importantly, to discuss next steps towards safely reopening our doors when the time is right, how to pivot now, how to prepare for the future and discussing what the new normal might be. My guest today is Cal Cates. Cal Cates is an educator, writer, and speaker on topics ranging from massage therapy in the hospital setting to end-of-life care and massage therapy policy and regulation. Cal is a Founding Director of the Society for Oncology Massage and current Executive Director and Founder of Healwell, a non-profit organization that works with children at numerous hospitals and clinical facilities. Healwell also trains massage therapists in sustainable caregiving, as well as partners with hospitals to conduct research about the effects of massage on people living with illness. Cal is also an author and columnist for Massage & Bodywork magazine, whose feature article, Death Dying, and the Breakability of Us All, won best feature article at the 2019 Maggie Awards in Los Angeles. Cal is also the Co-founder of the excellent new podcast, Massage Therapy Without Borders. Hello, friend.

02:07 Cal Cates: Hello, good to see you.

02:09 DB: Good to see you, too. I wanted to speak with you because I think you have a unique perspective on the massage therapy and bodywork profession because of the work you do with Healwell, and also because of the good work that you've been doing with your podcast. I've really enjoyed the episodes I've listened to thus far, and they've sparked a lot of ideas for us at ABMP and with the magazine just about a lot of definitions in the field that are floating around, reactions in the field to not being able to practice, and what everybody is wanting to know which is how do we get out of this and what are those next steps forward. The first question I really wanted to ask and start with you was, when was the last time you were able to work hands-on with a client?

02:58 CC: That was a lot easier question when you emailed it to me yesterday. Yeah, Friday the 13th, actually, was the last time that I saw a client. I saw a client two days before that who was maybe the hardest one to stop seeing because I've been seeing her for the last few months and she has had a cancer for six years, and when I met her, it had come back again and it was really clear that it was gonna be an end-of-life relationship, and she died three days ago. And the last time I saw her, I didn't know that was gonna be the last time I would see her. So yeah, that was really hard. And then I can't now go see her husband and give him a message, which I would typically do. So yeah, that was the last time and I've been doing massage since 2005.

03:48 DB: I am sorry to hear that. And I think it leads naturally into the next question that I really wanted to ask you, what is... And you've mentioned a little bit, what is it like to not touch right now? This is the essential nature of what massage therapists and body workers do.

04:02 CC: Yeah, well, I thought a lot about this because I feel like massage therapists are... We're sort of taking this as a unique suffering that we're experiencing because as you said, we sort of do this for our work, but I think it undersells the reality that humans touch each other. And I think even though I have a very close relationship with a few clients that I still see, most of my work now is at a desk or is behind a podium, but everything I do is really... Hands-on work drives everything I do and sort of creating opportunities for people to do that work. And I love to touch people. I just... [chuckle] We made some bread and took it to our neighbor and I... It was so weird to just put it on her doorstep with a CaviWipe and be like, "Hey, we made you some bread. You can wipe the outside before you take it in your house." And I just said, "I put a hug in there." [chuckle] Yeah, so it's hard to not... It's certainly hard to not touch in a sort of therapeutic work-based way, but the not touching at all, I find very, very difficult.

05:10 DB: I am not a massage therapist, but I have worked at ABMP and I have worked on Massage & Bodywork magazine for 20 years now. And I enjoy, as a client, receiving massage, obviously, but the only way I can relate to it right now and it's nowhere, it's not even comparable, is we're not necessarily going to the grocery store right now, but we're having our groceries delivered. And when the kind person who is taking that on is leaving them in our doorstep, it's just this weird void of being in a bubble waving to them and then thanking them. And then the other thing... They're not related, but the other thing that probably should be the most recently, was when Dr. Fauci had suggested potentially not shaking hands for the future. That one was particularly tough to hear that. There was just such a reality to that. And immediately, again, I thought about our practitioners that we represent and our members that are out there. I'm sure that you heard that comment as well.

06:08 CC: Yeah, yeah. I'm that guy who if you try to shake my hand, I will be like, "Get in here."

[chuckle]

06:16 CC: So clearly, if we're not supposed to shake hands, we're definitely... I mean, I have a T-shirt that says, "Thug life," and the T is crossed out and it says, "Drop the T & get over here."

[chuckle]

06:25 CC: So, I mean, yeah, the idea that... I feel like it's gonna create another division because you're gonna have people who, "Damn it to hell! I'm gonna hug you," and then you're gonna have people like, "What are you doing?" Yeah, I don't wanna live in that world.

06:40 DB: Let's transition here to probably the biggest conversation that's the focus of what we're talking about here, it's what you're hearing everywhere in the news, and it's the reopening of the economy, reopening of the profession for us, and there's a couple of trains of thought that are out there. One is, there could be some grand reopening of the economy, and another one is that there'd be reopening in stages and one of the quotes that I really liked that was out there, I'm not sure who said it a few days ago but, "There was a slow shutdown and there will be a slow reopen." If it is the latter and we reopen in stages and that's local, regional states, federal, does it come down to the essentialness of massage therapy and bodywork when we come back? And what I mean by that is the safety, the who's next up in that list of essentials and what does that mean. And I know this is a super-loaded word, and a super-loaded question, and I've watched all the massage therapists on social media and the various groups and forums take this on. So tell me a little bit about that word 'essential'.

07:39 CC: Yeah, well... The whole... Everything that's happening right now, I mean, certainly in our profession because that is where I focus, but it's just making me so deeply sad because I work in massage and the things I do are about massage, but what I really... I get up in the morning because I want people to get out of their own way, and because I want everything that I do and that our organization does to help people see how asleep they are, and sort of how disconnected from reality they are, and how tired they are from trying to create a reality that's different than what's in front of them, long before this pandemic. That what's true is that what's in front of you isn't what you want almost all the time. And so we're just working so hard to be the boss of everything, and to just cling to our identities and to cling to our importance, and just making ourselves so small and the story of like, "If I can't do massage, there's no point to me. And I'm just gonna try to create some version of myself that's worthy." And I think the essential, nonessential conversation really, really highlights that.

08:57 CC: And I don't think it's unique to our profession, I think it's a very human thing. I do certainly think that in the helping professions as nursing, and being a physician, and a massage therapist, and all these things sort of get categorized, that there is a healthy dose of not-enoughness. And I feel when you're told that what you do is nonessential, and when you hear it in that simplistic way, 'cause I think a lot of massage therapists have heard "What you do doesn't matter," and that's not what we're talking about here. We're really talking about how do you square the truth that the way you serve right now is by not doing what you feel is the most important thing in your life. You are possibly having a life-and-death impact on a person right now if you're massaging them. And that it's not about how valuable your particular brand of massage is, or the way that your work affects your clients. There is no one doing massage right now whose massage is worth a human life. That is really what we have to keep coming back to. And I think we will reopen in stages. And I'm sad to say that that means a lot of things. I think it'll mean that they are therapists who just can't wait anymore and just decide, "Screw it. I'm tired of being sequestered. I'm just gonna see people." And clients are gonna become impatient, too, and be like, "Come on," or can't weigh in.

10:18 CC: So I think we're gonna see some of that sort of leakage, if you will. I think it'll mean that we're gonna get into this ugly war about whose work matters most. And I've already seen some massage therapists saying, "The capital C, capital E, COVID Economy is not gonna have room for relaxation massage." And that when people come out of this, they're gonna be looking for what I do. Whoever wrote this is they're gonna be looking for my work, and so if you wanna be viable in the new economy, learn this thing that I do that's better than everything else. And I think that we're just bad at being uncomfortable. And I think that the people are gonna hit the wall of discomfort at not doing at different times. And I think that's gonna guide the speed of the reopen as much as actual vaccine or containment practices or any of the things that logistically allow us. I think that people's sort of spiritual ability to sit in the not-knowing is really what's gonna break the dam.

11:20 DB: At Healwell, you worked in a really unique environment. You worked in hospitals, and because you had that relationship with doctors and in that environment, does that affect your definition of essentialness? You work even closer to those people who are on the frontlines.

11:34 CC: Yeah, I think it does, but maybe not in the way that you might expect. I think, initially... And it didn't last long, but I think initially, people expected Healwell to really take up the "massage is essential" spear. And we even thought about, "Oh, yeah. Oh, boy, what do we do here?" This is why we exist. This is why people donate to us. This is [chuckle] why people wanted me to go and talk about stuff, because we do wanna live in a world where massage is considered essential. And I really think we're missing the point. This isn't about the importance of massage. It just isn't. The dichotomy created by the language needed for stay-at-home orders has raised this alarm, that somehow culture is saying massage doesn't matter. Is culture also saying haircuts don't matter and dental cleanings don't matter? No. [chuckle] They're saying, "Just chill out a minute until we figure out what's happening."

12:30 CC: People are still gonna want massage. Nobody's gonna decide that somehow massage is now dangerous any more than going to the dentist or getting your hair cut. And I think that for me, in this moment of COVID, and it's gonna continue to change, that it becomes so much more clear that this is a matter of life and death. And I think that the answer to the, "Is this worth a human life?" question, is gonna continue to shift because in this period right now, where... I guess, if I'm thinking in terms of illness, this is the acute phase. We're headed toward adaptive coping and chronic illness as a globe, but I think in this acute phase, we're too unstable.

13:12 CC: When a patient is in an acute illness state, we don't wanna do too much to challenge the body, and I feel right now, we're... Massage therapists are like another micro, or even a temperature change in the room for a person who is just trying to maintain homeostasis. And that we really have to... Our physician and nurse colleagues were the last to be willing to say, "You're right. You guys have to stay home for a while." They were like, "No, no, you're essential. We've got enough whatever," and then it became really clear that there wasn't enough PPE. And for our therapists in particular, some of our therapists are in anywhere between one and five different hospitals or patient homes in a single week. So if you think about... It's not even me just working in this one hospital. It's like I'm going from this hospital in this city, to this hospital in Virginia, to this person's home in Maryland.

14:02 CC: How many... When you pour your little red dot into everybody's cup of water, that's a lot of spread. So I think it definitely... It made it clearer for us that in the COVID environment, we are most definitely nonessential. And certainly in the PPE crisis, which is just running right alongside the COVID crisis, because really, that's a big part of what's made this so bad is that, "Oh, we don't have enough things to protect each other." We've got people selling masks in their homes, and one of the companies, Battelle, made a machine that can sanitize masks because we can clean them faster than we can make them. So I think that if there had been enough PPE and there wasn't a concern that our whole healthcare system was gonna be overwhelmed, the conversation might have been a little different, at least for hospital-based massage, but it doesn't make the reality of the question of essential versus nonessential different. And I think we're looking at the question wrong. And that's... We're wasting a lot of energy fighting about it when we could be doing more useful things. [chuckle]

15:08 DB: There's a psychological aspect to practicing again, and when those doors open, and that's a possibility, how do we attain comfort level? And that's two sided: That's practitioner comfort level and that's client comfort level. I know there's a lot of steps and a lot of nuances to that, but I really... I'm worried a little bit because I've watched... The common phrasing is it takes 21 days to establish a routine, and we're beyond 21 days to establishing a routine and a new normal. And that seems like a big hurdle to cross when we first open up those doors. I can't imagine people running out.

15:48 CC: Right.

15:48 DB: There's gonna be a trickle, and there's the people who couldn't wait to get out, and then there's gonna be that slow comfort level. And that's gonna be a huge thing for the profession and for practitioners to adjust to when we open the doors.

16:00 CC: Yeah, I think it is. I think about... We just had... It's interesting that you say this thing about 21 days because I love to read about neuroscience, and how do we develop habits, and how do we shift our behavior. And we had... We've been having calls twice a week with the Healwell leadership team, mostly just to like, "Are you okay? Are you okay?" [chuckle] But after we do... Really, I'm so grateful for a really heartful check-in. We sort of shift to "What are you hearing, what do you think about what you're hearing?" And I had read the questions to sort of think about what we were gonna talk about and I said, "You know, I hadn't thought about it," but we all hit a wall either Monday or on today's call where we were like, "Kinda don't care, just gonna stay in." And I was like, "Oh, yeah," 'cause we have solidly developed the habit of being apart from our clients, from each other, from... And it's like, "Oh, my brain is rewiring, and boo!" [chuckle] And then it won't just be a matter of being different. It'll be a matter of being able to hold each other up and being different for a long enough time that we don't go back. It doesn't even feel right when I say, "When we go back to... " We're not going back to anything we've known before.

17:12 DB: I'd like to thank Cal for joining us today. We will continue the conversation in our next episode of Conversations in Quarantine, where we'll discuss the use of PPE in the massage community.