Just going through my notes for a presentation I’ll be giving tomorrow at the european Shiatsu Congress in Vienna, Austria, I came across this article I wrote in 2004 for the Shiatsu Society News in the UK.

They Do It In Hospitals, Don’t They?

Shiatsu Society News, UK, 2004

Just knowing that something you dream of actually exists can be a great catalyst towards making your own dreams come true. When I was younger my interest in health drove me to medical school, but I quit, disillusioned, shortly after. While studying shiatsu in England, a few years ago, I took a workshop by a visiting teacher who was having his shiatsu students practice at a Vienna hospital. Here I was, thinking I was worlds apart from the traditional medicine I had initially approached, when it dawns on me that actually doing shiatsu in a hospital would make a lot of sense. That “Shiatsu in Hospitals” workshop I attended helped materialize my vision of marrying the two worlds.

This vision helped me through a long time of proposing, lobbying and finally convincing MDs and the powers-that-be that shiatsu practitioners had something of value for their patients and that ABT (Asian Bodywork Therapy, as all the bodywork techniques that use Traditional Asian Medicine theory are known in the U.S. ) should be taken seriously.

I now work for the Columbia University Hospital’s Integrative Medicine Program, in New York City, one of the most renowned hospitals in the world, and famous for their excellence in heart surgery. I was lucky to get to meet Dr Mehmet Oz of Discovery Channel and Oprah fame and author of “Healing from the Heart”. Dr Oz is a heart surgeon, co-inventor of the LVAD pump (Left Ventricular Assistance Device) that helps transplant candidates keep their hearts working until a suitable heart is found for them. Dr Oz is a pioneer of CAM (Complementary and Alternative Medicine) integration and he is the medical director of the program at Columbia. In his book, he says that he realized that a heart surgery procedure could be a success but that alone didn’t determine the outcome of recovery. Patients that had more support from their immediate circle and the ones that kept a positive outlook, had better rates of survival than those that didn’t. Thus he started experimenting with giving extra support to the ones that needed it. The way was through touch therapies, guided imagery (visualization techniques of positive images) and spiritual healing.

It took a couple of years until I got what was needed (more credentials, amongst oher things) to see the first of his patients, then I worked solely on referrals on a fee-per-service basis at the hospital, and recently the program hired me and another ABT practitioner to see as many heart surgery patients as we can every week. When offered a session (pre or post open-heart surgery and transplant candidates) 93% of the patients were interested. Of those, we get to treat about 96% of the patients between us, just working part time.

The program regards our work as a great success and the feedback they get from patients is excellent. It’s interesting to note the high percentage of people interested in getting a session, considering that many have never had any bodywork whatsoever before. Some patients actively seek us since they heard about our services even before being admitted for their surgery.

Amongst the anecdotal results we consistently see is a reduction in pain and anxiety and an improvement in the mood of the patients. We haven’t yet come up with a system to collect data that would be scientifically acceptable with the budget we have, but we want to do it in the future.

Doing shiatsu in the hospital is challenging on many aspects. Misconceptions about shiatsu being painful, deep tissue, too vigorous for ailing patients, etc., and other perceived contraindications still abound. This is what took me the most time to change people’s minds about before I even laid hands on anyone at the hospital. The way to verbally present what we do has to be done carefully, both with patients and health professionals that are not familiar with our work. Now, with the experience of approaching hundreds of total strangers with my “spiel” I feel a lot more at ease, but it used to take a lot of my energy. Sometimes it still feels odd to approach a patient in the intensive care unit (ICU) when they are plugged into so many machines and maybe still confused from the after-effects of anaesthesia. “Appropriate” becomes a big word to live by when deciding the time and manner to approach a patient that is coming from such a life-altering experience.

Another challenge is my body posture to work on a hospital bed. I learned to do shiatsu on a mat at floor level so I had to re-invent a lot of the techniques as I adapted them to working on the upright position. I must thank my teacher Pauline Sasaki for helping and supporting me through this. It wasn’t easy to let go of prejudices I had, that if it wasn’t on the floor it was almost surely not “shiatsu”. Working upright liberated a lot of my creativity to work with shiatsu, at the same time that I keep true to the principles of touch I’ve always used. As a matter of fact, all the years of experience working on the floor gave me an invaluable connection to the Earth and grounding that I would need in this job. The kind of grounding I’m talking about also helped to deal with difficult conditions like stuck bed mechanisms that leave me working in impossible positions, tubes gone astray, bleeding patients, mentally confused patients, etc., as well as in helping patients re-build their connection with, and trust in, their own bodies.

I still get queasy sometimes. I observed two surgeries in the operating room during which I worked on the surgeon’s back, since they are standing for hours perched over the patient. (We do get calls often to treat surgeons with back pain). It was very helpful to observe the operations because it gave me an idea of what patients go through. It helped me to see why I was seeing back and shoulder pain, for example. The mechanics of the opening of the chest, displacing the ribcage, results in back pain due to the stress on the rib heads that attach to the spine. The patients are tied to the operating table for long periods and this creates shoulder pain and sometimes numbness in the arm and hand (curiously often along the Heart channel and ending in the ring and little fingers).

Shiatsu provides a lot of relief for these symptoms. Using distal points to relieve chest pain that is created from the huge incisions as they heal is a frequent technique that I use. Just the thought of someone touching their chest could send a patient into a panic. Working on the relevant meridians from the feet or hands is extremely effective. More than once when I do this I’ve been told: “It’s like a weight gets lifted from my chest”. Oedema, cramps, dropped foot, numbness, insomnia, constipation, neck and back pain, anxiety, fatigue and more symptoms are usually relieved during our rounds. We can only see patients for short sessions but it still works pretty well. Some patients hire us privately to keep treating them when they go home.

Shiatsu theory explains quite beautifully a lot of the symptoms we encounter. Although I can’t usually do a Hara palpation because of tubes and/or electrical devices (the LVAD, for example) inserted in the abdomen, I rely on intuition and my own energy perception system to determine which meridians are the relevant ones to work on. It’s very important to listen carefully since a complaint of a specific issue could be a door to understand an important imbalance somewhere else. There’s no way to generalise but I’ve noticed certain trends: Other than Heart and Heart Protector, some symptoms are related to the Blood and circulation imbalances, also affecting the Spleen; some to the disturbance of the Shen, housed in the Heart. Large Intestine, in the “holding on for their dear lives”. A very responsive one is Small Intestine, for its connection to the Heart, its meridian pathway and its role in the “shock response”. Stomach and Bladder are crucial to give someone that “oomph” to get them going. It’s also interesting to note the interplay that the symptoms have with the various medications regularly administered .

The social worker that visits the patients in the ward explained to me that she resists being moved to other areas of the hospital. “Heart patients are special”, she said and couldn’t explain further. There’s a sense of compassion in the air. I believe patients change somehow after their “hearts are touched” (metaphorically and literally) during the surgery. The heart is, after all, a very special organ. It’s difficult to measure compassion (an emotion traditionally associated to the Heart) but there are studies that determined that one third of heart surgery patients get depression after surgery. Depression is a risk factor that also affects levels of morbidity and death months and years after heart surgery.

This is something where caring and compassionate touch can make a difference, and I believe another important reason why it’s important to be there.

Diego Sanchez

Diego Sanchez Dipl. ABT (NCCAOM), C.P. (AOBTA), L.M.T. was a MRSS until he moved to the U.S. in 1998. He has a private practice in New York (www.Sohoshiatsu.com) where he also teaches shiatsu. He’ll be presenting workshops in Boston U.S.A. (www.CharlesRiverShiatsu.com in October 2004) and next year in Italy on the applications of shiatsu for critical illness patients and hospital work.

Diego would like to hear from anyone that may be already working in a hospital providing shiatsu. You can contact him at diego@sohoshiatsu.com

©Diego Sanchez 2004 www.sohoshiatsu.com

We’ve spent centuries trying to control, minimize or deny our shadow.  Now it’s time to integrate it into our Unified Self.