Bicycling to my very first clinical assistantship almost 10 years ago, I felt pretty jazzed, a little scared, and hugely hopeful. I was looking forward to connecting with patients as a caring student of Chinese Medicine with lots of attention to spare.
Within the first twenty minutes of my time at this hundred-bucks-a-pop clinic with multiple waterfall dioramas, I had all the contact I would ever have with the owner and principle acupuncturist. He asked me to take needles out of a patient in room #6, and then he told me to put on deodorant and to never ride my bicycle in if I was going to smell like sweat. I was asked to do some filing for the rest of the shift.
OK, I thought. Yeah, that must be right. I’m a big fan of paying a lot of attention to what makes patients comfortable and uncomfortable, and of generally being a conscientious community member, where sometimes it makes as much sense for me to get out of the way as it does to be very powerfully who I am.
But, the interaction left me really angry, even spiteful. I couldn’t quite tell why.
The feelings I had that day cascaded out in a manner much out of proportion to the present situation. So, they must have been in me, like a fear smell, waiting to come out. It went something like this: Oh no! I’m dirty and don’t smell right… My clothes are all wrong….I don’t know what I’m doing…. I wonder if I’ll ever be able to afford a car (even if I don’t want one)…. Can I be an acupuncturist if my hands won’t warm up in the winter?… I hope the smell of my breath is OK… I hate this guy.
I wanted to never come back and to generally just forget about my first assistantship experience. At least until I could get some perspective on it, which I finally did this week, during the very first day we were open at Philadelphia Community Acupuncture.
Usually a good crier, I think my lung energy has been a little rigid as I’ve hatcheted away at various critical-seeming tasks these last few weeks before we opened. I figured that at some point during treating people on our first day, I’d probably have another kind of opening, that I’d realize what Ellen and I have created, and be able to cry. True, it was. But, it didn’t happen when I was looking at our beautiful room full of people in recliners, nor from any glance or hug with Ellen. It happened in one of those moments that moved in slow-motion dream speed, and it happened through smell.
I was treating a beautiful middle aged man, an ex professional dancer who’s current (traditionally male) job puts him in a lot of physical danger, makes him witness to a lot of violence, and discourages any self-care. He wasn’t aware I’d be asking him to take his shoes off, and was very reluctant to do so, saying his feet weren’t too pretty, and they didn’t smell too pretty. After some ear points and yin tang and a root treatment, he called me over and said if I really needed him to take his shoes off he was willing. It felt to me fairly unessential for a good acupuncture treatment but like a good opportunity for him to take a step towards healing a very specific self-image injury.
When I needled his feet, I think I did a good job of making him feel he was totally perfect and his presence was welcome and treasured in this space. Without thinking, I also really opened up my smelling, and my breathing in general, with simple curiosity about what part of this man’s physical humanness and qi got attached to the oppression which told him something was wrong with him. He still had his recliner un-reclined, his body curled in, and his feet on the floor.
I could kind of identify a subtle but particular odor from his feet. Slightly fishy. The smell of ……well…..feet! It made me laugh inside. Sitting in the same circle of chairs was a young woman I’d needled earlier. She was on the 1st day of her period and had been sweating a lot before coming in. I could smell a metallic odor from her. I was finally dropping into really being here, and out of all the preparing-to-be-here. Now, I could also smell Chinese food from across the street. It was only then that I noticed my own smell, the fear one, which apparently follows me into every circumstance that feels like I’m doing something for the first time, just like my first assistantship.
But, this is was different in just about every way. An incredible relief. I looked back at the male patient sleeping like a baby with his recliner extended and his perfect smelly feet pointing in to the middle of the circle. I felt really connected to all the people in the room. It felt like there was space enough for everybody’s humanness, and not any space for shame.
This was when my lungs really let go and I got nice and cry-y. I could see the contrast between what was happening here and that first day of “assisting”.
I know that all the not-good-enough and not-normal feelings I had that day were rooted in false conclusions I made as a direct result of the classism I experienced as a very young person. The whole set-up of this clinic, it’s location, décor, services offered , and prices-per-treatment, all made me feel like I definitely did not belong I’ve worked a lot on the feelings and would probably be in better shape now to not be as personally hurt by what was said to me.
But, I would still be mad. Not for being called smelly, but because of the whole dominant clinical dynamic, borrowed directly from the technologically based bio-medical model, in which great emphasis is placed on shielding each patient from the real world, and, consequently, incarcerating him or her in an artificial environment, disconnected from real human experience in ways that have a significant impact on a that patient’s ability to heal.
Because the one-and-one, private-room treatment scenario refers so directly to kinds of intimacy which create a lot of unspoken confusion, and also to other medical procedures, a practitioner may find it important to erase a lot of aspects of the self to make room for a clinical relationship. In my private practice over the last 6 years, I’ve wondered to what extent can I heal, repair wholeness, and help liberate a patient into his own body and senses and intelligences while simultaneously expecting both he and myself to disappear enough to be safe.
I recognize that there is a natural link between our rational expectation that our healers practice good hygiene and an innate understanding that body odors can clue us in to someone’s cleanliness. I also am aware that culture and religion have a lot to do with various personal understandings about smells and the body and cleanliness, and that we’re responsible to keep learning about these norms and thinking flexibly about our relationship to them. (There are a lot of Muslims in my neighborhood. Will it make sense for us to have footbaths in our restrooms?)
I want to make choices about relating to my patients, about how I carry myself, based on my good thinking about them and the community, not on rigid, unexamined and oppressive rules.