One of POEM's main raisons d'être (reasons for being/existing) is to provide solid and validated support for learning and exploration in massage.
Because all of us are curious and engaged, and because we care about the world around us, we naturally try to explore further, and sometimes we take a leap into the unknown to try to figure it out.
There's absolutely nothing wrong with that--it's one of the core things that makes us human. I want to continue to encourage that exploration, because out of it will come new knowledge that will eventually benefit our clients/patients, and make us better MTs through improving our understanding.
It's easier to give updated information to someone who's already exploring than it is to try to spark curiosity in someone who, for whatever reason, doesn't demonstrate it spontaneously.
So when I see someone making a leap into the unknown, but--through no fault of their own--going down the wrong path because they're missing a crucial piece of information, that tells me that there's a need for that information, and that it therefore falls within POEM's mission to provide that information on a universal level.
If you've been shamed and shut down before by others for not knowing something, then having misinformation corrected by someone else, even by a caring teacher, may feel similar to that previous situation.
That's understandable, but that's not the intent here. A better analogy is that you're exploring a trail through an unfamiliar forest, and you come to a fork in the trail. Not knowing which branch will lead to your goal, you guess which one to take. Then, on your journey, you meet someone who has traveled that path before, and--while not knowing your exact destination--at least knows the area you are traveling toward.
For that person to tell you "that trail over there goes where you want to go; this one doesn't" isn't a criticism--it's encouragement to keep going to where you want to be, in a way that makes it more likely for you to get there.
Source: http://matadornetwork.com/wp-content/uploads/2011/05/20090923-wanderlust.jpg accessed 5 April 2012
In keeping with that mission, when the emphasis is on correcting what appears to be a genuine misunderstanding on someone's part, I don't plan to single them out by name. Doing that can make it feel more personal and more critical than it is intended to be.
Instead, I'll quote them anonymously here, in order to focus on the ideas, and to involve us all in the search for the right path.
As a teacher of, and a research scientist in, anatomy, it absolutely warms my heart when I see people using anatomical reasoning to try to figure out how the body works, why something might not be working as we would expect or want it to, and what we might be able to do to help support it returning to optimal function.
When I see someone applying anatomical reasoning to assess a client's situation and make a recommendation to improve care, as Kim LeMoon does here:
In reviewing Louisa's case, the possibility of lumbar radiculopathy was reconsidered. A previously overlooked sign was that the injury had occurred during a twisting motion. The lumbar intervertebral discs are thought to be more vulnerable to herniation in rotation. Between the clinical pattern recognition and Louisa's report of hearing a "loud pop" during a twisting motion, the new hypothesis was that Louisa may have herniated a lumbar disc and that lumbar radiculopathy could be the source of her referred pain symptoms. I described the hypothesis to Louisa and advised her to seek the advice of an orthopedic surgeon.
During this time, for reasons unknown, Louisa had started working with a different chiropractor. She was asked to describe the hypothesis to the new chiropractor to solicit his opinion.
Results
The chiropractor considered the new hypothesis plausible and referred Louisa to an orthopedic surgeon who specializes in treating low back pain. As a result of a magnetic resonance imaging investigation ordered by the surgeon, an L5-S1 herniation was found.
I do a little happydance, often literally or sometimes, if I'm in a public place, figuratively.
I'm also very pleased to see the openness to evolutionary biological explanations among members of the MT community. Based on my experience (and, of course, as we know, the plural of "anecdote" is NOT "data"), I'm under the impression that there is very little actual evolution denial in the MT community, when compared to the larger American public.
The following graph shows where the US rates in knowledge of evolution, as measured by their acceptance of the statement of a non-controversial statement based on foundational biological knowledge.
http://upload.wikimedia.org/wikipedia/commons/5/5c/Views_on_Evolution.svg accessed 5 April 2012
Only 40% of Americans got the correct answer, "true", compared with about 75-80% in countries such as the Scandinavian nations, and France, Japan, and Germany.
While the American public at large's knowledge and acceptance of evolutionary biology comes in almost last among developed countries (ahead only of Turkey), I don't see that in the MTs I come into contact with. They seem open to anatomical explanations and reasoning grounded in rigorous biological science.
The only wrinkle is, if you're going to use evolutionary explanations, you need to be sure you're getting the science right. Otherwise, rather than actually explaining or understanding, you're only passing along yet another "just-so story".
When this anatomy teacher sees MTs making statements such as:
If, besides sensing temperature, skin was truly as vital as scientists claim it is, wouldn't the body protect it better?
then I would say to the MT, "It is very good that you are grappling with your questions in this way. There are a couple of pieces of information you need, in order to make sure you stay on track with what you want to figure out.".
First, of course, a review of the skin's barrier function is in order.
But, significantly, this MT is clearly open to evolutionary explanations, in the linkage between the survival value of the skin's function and the body's "investment" in it.
The problem is that, as we humans often do, this practitioner has fallen into a pattern of teleological, or goal-directed (from Ancient Greek τέλος/telos, “purpose”) + λόγος/logos, “word, speech, discourse”), thought, and then applies that teleological thinking in an arena where it doesn't apply--that is, evolution.
Evolution is a blind, unguided process--the body doesn't "decide" to "protect" the skin. It's the other way around--those organisms that happened to develop protective barriers happened to survive longer, because of the survival value those barriers provided, than those that didn't have them.
So in that longer time, they had more offspring, who then were able to out-reproduce the offspring of organisms without those barriers, and this cycle continued for thousands of generations.
There's no "why" for the body to make a decision about. There's just what anatomy came about blindly back in the deep past, and what physiological and pathological consequences resulted from that chance development.
With that bit of foundational knowledge from evolutionary biology, this MT is much more likely to find the answer they are seeking than by continuing down the path of teleological thinking about anatomy.
Another example of a question from an MT wanting to know about the brain puts them right on the verge of an important discovery:
Earlier you said the brain had an old bossy part and some younger naive parts that don't get along with each other. I'd consider that mismatch to be a systemic flaw. With all those faults why would MTs even want to work with the brain?
Yes! You're almost there! You're so close!
Yes, there are old bossy parts of the brain that don't get along with the younger naive parts (h/t Diane Jacobs for the terminology!).
Yes, that is a systemic flaw.
And that's one of the threads in the multiple lines of evidence for evolutionary biology, and that reinforces it as a basis for anatomical reasoning--if the body were specially created by a designer, you'd expect it to work better than having parts of the brain that don't play well together, or Kim LeMoon's client having the inherent weakness in the lumbar discs that come from starting to walk on 2 legs at some point in our history as modern humans, or hundreds of other examples that a brief glance at any A&P/pathology book will provide.
So it's not that the neuroscientist is mistaken, as the MT thought by finding that flaw--scientists know that already.
If you understand that parts of our anatomy are systemically flawed--and that that's ok by evolution, because evolution doesn't teleologically "seek" a perfect solution; it blindly makes do with a "good-enough" workaround--then you are that much further to being able to apply real and solid anatomical reasoning and gain understanding that puts you in a position to help clients better.
We work with the systemically flawed human brain (and some of us with the brains of other animals as well), because that's what we have before us. We meet the clients where they really and truly are right now, not where we might want them to be in a different universe that operated by different rules, and provided them with perfectly-optimized brains.
That's the demonstrated need for evolutionary biological information to support clinical reasoning that I'm planning to meet with POEM's introductory evolutionary biology for MTs e-Book. At the moment, I project it will be available in 2.5-3 years (roughly, between November 2014 and May 2015), after the research literacy book and several others that are more directly connected to the material tested on MT certification exams.
http://upload.wikimedia.org/wikipedia/commons/d/dd/Horseevolution.png accessed 5 April 2012
