What’s That On The Path, A Head? Adventures In Crossing the Chasm

posted in: News 9

The Chasm Opens

You’ve been doing your thing for a while now, helping people correct their posture, or strengthen their perpetually weak glutes. Maybe you’ve been releasing their fascia and shifting their fluid and organs, or lengthening muscle and putting pesky joints back into place. It’s a good life, one of certainty where helping someone feel better can easily be conflated with helping someone be better. It’s a place where the client fails the treatment and not the other way around.

Turns out it’s a temporary place, no matter how long you’ve been in it.

The ground is shifting. Has been for 50+ years and, like the eruption of one or more fault lines in BC, is long overdue. Information about pain and touch and movement and the nervous system start growing through the cracks in what you thought was a pretty fucking solid anatomical and biomechanical foundation. You start to question yourself and your knowledge, and if you admit just for a moment that you aren’t sure anymore, the cracks in the foundation start getting bigger.

When you hit dissonance, the chasm opens.

You peer over the side and into the chasm and notice it’s a rough ride down. Rocky, with boulders and the vague suggestion of paths covered with loose stones, sticks, and dirt. A tuft or two of some plant struggling to survive.

More than once you think fuck it, this side of the chasm is just fine, but when you look again somehow the chasm is bigger than you remember it from five seconds ago. You steel yourself. Hike boots, walking stick, power bars, and some water. After all, if it sucks too hard you’ll just come back up again, right?

Down One Side

At first, the descent is not so bad. The sun breaks through the clouds every now and then, and there are some wildflowers amidst the rocks and dirt. The ground is soft, but not too steep yet and if this keeps up you’ll be on the other side in no time. Crossing the chasm doesn’t seem so hard.

But what’s that on the path, a head?

It’s round and white and hard looking and as you come close to it you realize it’s not a head, but the back of a skull, dried and bleached from exposure. You pick it up, examine the sutures and then turn it around in your hands

“What the fuck are you looking at, ya daft cow?” Says the skull, in an English accent. Not the Queen’s English, but the kind of English that sounds best strung together with insults. You barely stop yourself from dropping it.

“N, n, n nothing.” You say, but that’s a lie. How the hell does anyone not stare at a talking skull unless they are already running away?

“Bullshit, ya barmy pillock. You were looking at my sutures.” It’s true. You were.

“Well take a good ‘ard look ya gormless wanker. Gordon Bennet! To think you thought you could move these bones. You’re a complete wazzock, now put me down and piss orf.”

As you stumble away in slight shock you can still hear the skull mumbling … “Must be taking the piss. Daft as a bush that one.”

Eventually, when you can no longer hear the skull’s insults inside your head there is quiet, except for the sound your boots make. A sort of crunching noise and a feeling of walking over rocks and twigs. Every now and then one of the rocks or twigs disintegrates underfoot and after one particularly loud “pffing” sound you squat down to examine it more closely. What you discover is that you haven’t been disintegrating rocks and twigs at all, but bones. The large “pffing” sound was a vertebra, though now you can’t be sure exactly which one. As you look down the path it’s littered with skeletal remnants; a femoral head, several ribs, a sternum, and what might be a calcaneus.

“I say, excuse me.” The voice is right up in your ear and you fall onto your back, startled and look up at what appears to be an x-ray human. You can see the white bones quite clearly, held together by the opaque suggestion of a human body.

“I wonder would you mind terribly adjusting my L5? It’s out again, I just know it is. I can feel it.” The x-ray human turns around and points to its low back. “Right there.”

You look closely, but don’t really see anything out of place. “Everything looks pretty normal to me.” You say, mostly because reading radiology images is a variably reliable skill that you don’t possess.

The x-ray human almost puts bony hands on jutting hips and bends over you until the suggestion of nose is up against yours.

“Well it isn’t normal. It’s out. My last therapist would fix it because I can’t do it myself. I can’t even bend to tie my shoelaces when it’s like this.”

You do your best “I’ve got nothing” shrug and stop yourself from pointing out the bending currently being done. The x-ray human stands up straight, huffs angrily and stomps off, voice fading the further away it gets. “Why are there no bloody therapists around here willing to put my bloody bone back in place?”

As you continue on the “pffts” start coming thick and fast, and every now and again the ground is so soft you feel your footing slip. You can see the stream at the bottom of the chasm, giving you hope that the journey is almost over, but there’s some sort of obstacle blocking the path. As you get nearer you see a woman in severe distress, propped against a large rock, trying desperately to push back in the coils of intestines spilling from her abdomen.

“Oh my God!” You say, forgetting your first aid training and just recoiling at the horror. “I’ll call an ambulance.”

“Oh no, no.” The woman says, gasping between words. “No doctors. They don’t understand this. They can’t see it.”  She reaches into the bag beside her and pulls out a phone. I’ll call my osteopath, my organs have ptosed again. They just don’t seem to want to stay in place.”

“I’m so, so sorry,” you tell her, stepping away cautiously. “That’s not really what we mean when we say the organs have -” but you don’t get to finish. The ground is now just bone dust, and as you slide toward the bottom of the chasm it crumbles away. Just for a moment, you’re free-falling.

Hitting Bottom

There’s a pillow of soft grass an inch beneath your face, but you’ve stopped. You’ve been caught in a net or a web. Before you can start making your way to the edge of the web you hit ground and the web wraps itself around you. It’s a bit frightening because the spider that spun it must be huge, but it isn’t sticky like a spider’s web. And it’s strong. Really fucking strong. You struggle, trying to pull it apart but it won’t break, it barely even gives. You gnaw at it with your teeth for what seems like an age before you fall back, exhausted and still bound in the web.

“Aha, yes. I see what the problem is.” Suddenly, standing above you is a person in a surgical mask, gown and gloves, wielding a very sharp scalpel. “It’s fascia. You can’t do anything with just your hands. But it’s ok. I’ll get you out. Hold still.” The surgeon pulls a part of the web away from your body and starts cutting.  You expect the scalpel to cut through like a hot knife through butter, but it’s more difficult than that. Though it only takes a few minutes to create a hole big enough for you to get out, the surgeon is sweating with effort.

You look around at the bottom of the chasm. It’s beautiful, peaceful, but big. There’s considerable distance still between you and the other side, and as you turn to thank the surgeon for rescuing you the ground starts to heave and rock like it doesn’t like the feel of your feet on it. You’re on the move at a pace faster than you thought you ever could, leaping from tussock to tussock avoiding the shifting, dough-like ground beneath you.

Swamp of Despair

As the ground settles you find yourself at the edge of a swamp that goes forever in both directions. There’s no way around.

Entering the swamp is when it hits you. You’ve come too far to turn back, you’ve seen the folly of your prior ways, a skull insulted you FFS, you literally pulverized a skeleton and everything you had faith in was not just a lie, but a joke. All that money wasted, all that certainty lost and you realize that far from being the great and powerful therapist your ego had you believe, you are in reality, nothing. The dark, dank swamp is heavy around you, and leaches cling to your ankles. It seems hopeless and useless, and you think of just sliding under and maybe finding a different profession altogether. The only thing that keeps you going is that you think you owe self-pity as much of a chance as you gave self-pride.

Raging Torrent

Finally, you get to the edge of the swamp and though you feel better about yourself, you’re faced with a raging torrent of a river. It’s shallow but running fast over hundreds of small rocks and pebbles; roaring. There’s no way you can cross, you’d be swept off your feet and pulled violently downstream over the rocks.

By this time you’ve had it. Your shoes are wet and giving you blisters, your backpack was not able to be retrieved from the web of fascia and you’ve lost everything you thought you could count on.

You start screaming at the river, roaring with it. Every swear word you’ve ever known comes hurtling from your mouth. Stomping up and down, throwing rocks and sticks, crying and bawling, and having a hissy fit like when you were two and couldn’t use your words.

You fall asleep, exhausted.

When you wake up the river is dry, and you cross over to the start of the other side.

Up The Other

The other side is steep. The dirt and sticks look like dirt and sticks and there are no surreal surprises. Just trees and rocks. But it’s a long way up and it’s going to take days. You have no water, no food, and your clothes are torn and still a little damp. It’s starting to get cold and you can’t see how you’ll be able to make it.

“What’re you waiting for. An invitation?” The voice is distant and coming from above. You look up and through the magic of TV vision where sight and sound can travel enormous distances without fading, see the faces of the people at the top, peering over the side looking down at you. They are smiling or sneering; beckoning.

“I’ve got no food. It’ll take days to get there. I’m not going to make it.” You shout up.

“No need to yell. Here, this should do you.” One of them throws down a backpack and it lands at your feet. It doesn’t have everything you need, but it has enough to get you started.

The climb up is hard. Not because there are obstacles, but because it’s steep, and slow going and takes a lot of effort. You run out of food pretty quickly and have to keep stopping to take the stones out of your boots.

“What is keeping you?” Slightly closer now but still above you; this voice sounds annoyed.

“My boots are broken. I can’t walk without getting rocks in them, it hurts.”

You look up in time to see a pair of boots hurtling toward your head, and another backpack with supplies.

“Do you think that’ll do it? Come on. Hurry up.”

It goes on like this for days. A slow trudge up in quickly disintegrating boots, and limited food and water. When you look up at the people looking down some of them are smiling and give you words of encouragement .. “take your time,” “everyone’s journey is different,” “you’re doing great.” Others are impatient … “what’s the problem?” “how many breaks do you need?” “I threw boots at your head two days ago, put them on already.”

Eventually, you get to the top of the chasm on the other side.

It looks much the same as where you started, only different. Clearer somehow. There are people waiting for you with a drink and food and slippers for your sore feet. They toast your journey and celebrate with you into the wee small hours and then some of them pick up their bags and leave. They’re moving on, beyond the chasm and they’ll see you later.

In the meantime, it’s your turn to look down because it’s your turn to support the people on their journey up. You have choices to make. You can throw boots at heads and tell people to get a wiggle on, or you can send down some supplies and provide encouragement.

It doesn’t much matter because the one thing you can’t actually do is go down to help.


Inspired by all the pain science people and groups. The look of the chasm is inspired by Dr. Silvernail from his 2015 San Diego Pain Summit, Crossing the Chasm presentation.


9 Responses

  1. Penny
    | Reply

    Nice one, Monica, I absolutely loved reading this

  2. Lennart Bentsen
    | Reply

    Relentless and awesome piece.

    I pictured Stewie Griffin’s (Family Guy) voice from the skull, but he is maybe to much upper class 🙂

    • Monica Noy
      | Reply

      Actually, Stewie’s voice would be perfect. He can string insults together with the best of them!

  3. Leah Wesley
    | Reply

    Fantastic! Next time I’m in TO I’ll come and see you. I’d love to meet you. Cheers from Sydney, Oz.

    • Monica Noy
      | Reply

      Please do! I’d love to meet you too. Heading to Aus next year, but Melbourne is my home town otherwise I’d come visit you.

  4. Matvey Kipershtein
    | Reply

    This is a fantastic piece. Thank you. Reading it maked me relieve how I feel. The lost years and money wasted. The fatigue of learning things that made no sense to begin with. Made me wonder where am I in the valley of madness. Did I cross the chasm?

  5. Marshan Ssm
    | Reply

    So relevant to the learning journey .. at some point it does become easier ..
    Thank you..

  6. Robert Rex
    | Reply

    Nice anthropomorphism. read this must after Bronnie’s tribalism blog piece. Interestingly, my presentation at the Advanced DNM seminar this summer was entitled “Bridging the Chasm.” sort of a supplies and encouragement throw down through the lens of Narrative Medicine and Autonomic Responses. Thanks, Monica!

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