By John Amaro, LAc, DC, Dipl. Ac.(NCCAOM), Dipl.Med.Ac.(IAMA)
In the early days of my career, I treated a young lady who suffered extensive neurological injuries to her face after slipping while cleaning the side of the bathtub. Her nose and facial pain were agonizing and had been going on 24 hours a day, seven days a week, for over four years.
She complained of multiple paraesthesias, and her teeth felt like "mush" when her tongue touched them. Virtually every medical doctor in every specialty she consulted ultimately suggested psychiatric care. This was simply out of total frustration in their failure to eliminate or even reduce her horrific pain.
The doctors of chiropractic she saw were some of the best experts in a variety of techniques, including cerebral manipulation, endonasal technique, kinesiology, and various adjustive procedures from the atlas to the coccyx. She consulted me for the possibility of acupuncture, even though it was very new to the country in 1973. In those early days of acupuncture, it was the most desperate patients who sought it.
Even though I was young in my practice, I had this incredible confidence, backed by minimal clinical experience. After numerous treatments of acupuncture; chiropractic adjustments to the spine; manipulations of the hard and soft palates; and "pulling" her uvula, I came to the hard realization that I had failed her, too. I suggested a psychiatrist. Why is it so often that when a patient fails to respond, we are so eager to put the blame on their mentality?
One evening, I felt a sudden urge to find a newspaper article I had saved in a large box in the back of my closet. Upon dragging out the box, I sat down and started to extract stacks of papers, old photos, a slide rule, a thousand paper clips, etc. As I was slinging items over my shoulder onto the floor around me, a small steno notebook appeared. I attempted to throw it over my shoulder to join the rest of the heap, but instead it struck me right between the eyes, scratching my forehead with the sharp edge of the projecting spiral binding.
The notebook landed in my lap, with a page staring up at me that said, "For nasal pain - point #17." There was also a small, barely legible sketch of a hand I had personally drawn with the acupoint illustrated. This was the notebook I had used on my first visit to China in 1973 when I visited the Tai Chung Medical School in Taipei. It was here I was first presented with the concept of Chinese hand acupuncture.
Talk about something hitting you between the eyes! I immediately thought of my patient and wondered if this point could do something for her. I had used every method I knew and had accepted the fact that I was going to have to relieve her from care, as it was apparent that was the only relief she was going to experience.
On her next visit, I stimulated the point on her hand I had discovered by accident the night before. I remember she was irritated with me, because the only procedure I performed that visit was simply to tap with a noninvasive needle (teishein) on a point on her wrist. She felt the simplicity of this treatment was inadequate to help her raging pain and wanted me to do more. Frankly, at this point there was nothing else I knew to do.
As she walked through the reception room on her way to the door following her treatment, she slumped into a dead faint in the middle of the floor. Upon reviving, she stated that she was overwhelmed because as she moved across the room, her pain and paraesthesia, which were of the highest magnitude, were suddenly and instantly relieved.
I cannot explain it, nor does it make any sense to my physiological (or just plain logical) mind, but it happened. I shall never forget that acupuncture point, two fingerbreadths distal to the dorsal wrist crease, in line with an imaginary line drawn down the middle of the index finger.
The patient was released from over four years of devastating unexplained pain and paraesthesia in a matter of seconds. While this is an incredible testimony for acupuncture, it is imperative the reader come away with the whole message, not just the specific point used.
The real message is to always act upon those glimmers of innate, intuitive insight, and to truly listen to that small voice that whispers in your ear throughout the day. Anyone who has been in the health care field long enough to be called a "veteran" certainly knows exactly what I am talking about. Sometimes the answer to a troubling patient may come to you in a most unusual way. Always be receptive to those innate, intuitive thoughts regarding patient care.
I recall what may have been one of the first graduate school programs in acupuncture in the United States when the principle speaker from Kowloon, China stated, "When you don't know what to do any more with a patient, or didn't know what to do in the first place - always consider the tsing (jing -well) points because they're magic." My initial thought was that this was an extremely exaggerated, simplistic statement. It seemed barely worth noting; however, I scribbled the thought down, which, as we know, unfortunately often ends up buried in a myriad of words and paper, never to be seen again.
Months passed, and my practice was becoming increasingly filled, as acupuncture was at a fever pitch and the general public was being inundated with positive reports of acupuncture's effectiveness from the media. As I was closing the office one late spring evening, the front door opened. Standing before me were a mother and father carrying their daughter, who was in obvious severe neurologic insult. Gazing upon this twisted child, I wondered how, due to her advanced state, the parents could care for her. I then noticed the hospital band on her wrist. The parents explained to me that they were in the process of returning the child to Children's Mercy Hospital, as they had been out on a very rare day pass. Apparently, that day was the child's seventh birthday, and she had been taken home to celebrate the day with friends and family. This would be her last birthday. The prognosis was grave.
The diagnosis from the Mayo Clinic was idiopathic neurogenic syndrome. Since she suffered from an unusual unexplained neurologic condition, there was no treatment to save her life, only prolong it - and that was failing. She presented in rigid neurologic opisthotonis. Death was imminent.
On the way back to the hospital following the party, which literally was a living funeral as family and friends gathered to be with her one last time, the parents passed my office and decided to stop. Having heard of the benefits of acupuncture, they wondered if perhaps it could help.
Once the parents explained the gravity of the situation, diagnosis and prognosis, I was frankly overwhelmed. With tears streaming down their faces, they asked if I could treat their "baby." Looking at this pitiful rigid child and the parents, I reluctantly told them "I'm sorry, this is really out of my league, I wouldn't even know where to begin." When they asked if I would just try, as there was literally nowhere else to go, or even if I would work on her as a research project, I again responded with apologies and sorrow that I wouldn't even know where to begin.
At that point, it became as if someone was sitting on my shoulder, whispering in my ear, "When you don't know what to do any more or didn't know what to do in the first place - always use the tsing points because they're magic." Was it a thought, or were these words really being whispered to me?
In any event, the feeling was too strong to ignore. I took a non-penetrating teishein (one of the original nine acupuncture needles first described) and stimulated all 12 meridian tsing points next to the nail bed for approximately 15-20 strokes apiece. I then took a green marking pen and marked each point I had just stimulated, with the instruction to the parents that they repeat this procedure every day in the morning and evening using a ballpoint pen.
Even though they realized they were now on the way back to the hospital to watch their daughter's eventual demise, they left the office with a glimmer of hope from the words of a master (and I am embarrassed to say I never even got the master's name).
That event happened on a spring evening. On a fall morning several months later, this child began school with her regular class. I only officially saw her once, but the parents stimulated the tsing points of that child with love, compassion and expectation twice a day. I was invited to her eighth birthday party! To this day, I still use a green felt tip pen to mark points for followup stimulation.
Where did this point selection come from? It had absolutely nothing to do with my academic excellence or highly evolved intellect; it came directly from innate intuition and listening to what was being said. How many times have we heard, but not listened? Sometimes we are afraid to act because the thought may be contrary to what we felt. Be alert and aware of the clues and fleeting thoughts received throughout the day. Acting upon some of these innate intuitions can be extremely rewarding.
My last celebrated case of innate intuition bordered on the eerie. I recently saw a middle-aged woman complaining of multiple visceral symptomatologies. It appeared as if every system of her body was pathologically involved, from the respiratory system to cardiovascular, digestive, musculoskeletal, lymphatic and endocrine systems. She had seen a variety of specialists and was on 14 different medications. She presented an extremely complicated case history which, when the reports from the primary doctors she was seeing came in, actually had to be filed in two folders due to the sheer mass of the paper.
I began treatment on her using the electro-meridian imaging (EMI) method of diagnosis, which showed 10 of her 12 meridians extremely involved. She had been to a TCM practitioner I know has a stellar reputation, but even with his years of practice and study, he could not commit to a TCM diagnosis. To say this case was complicated would be an understatement.
One afternoon while driving my car, I was stopped in traffic when I found myself wandering mentally. I thought of this patient, what her underlying problem might be, and what I could do for her. As I sat gazing out the passenger window, another vehicle pulled up and rolled just past my window as his rear bumper came into my direct view. I couldn't help but notice his license number from another state: LU6 TW4.
I tried my best to talk myself out of using these two points on this patient; however, having been in similar situations before, I had no choice. Following the first treatment, the patient's condition worsened, which I did not think was possible. However, by the next morning she reported feeling considerably improved. I treated her twice a week for four weeks, at which time she stated she felt like an entirely new person. I also balanced her meridians through electro-meridian imaging.
A recent examination by her primary medical physician revealed major improvements in her blood chemistry. Her symptoms are a fraction of what she previously experienced. Her EMI exam is close to being balanced. She is energetic, sleeps all night and has regained her appetite. She came into the office today and stated she had just signed up for a yoga class. She is excited about the future, as her extreme depression is now just a memory. She has had a total of 12 treatments.
As I try to justify the rationale of the two points used so successfully, namely LU6 and TW4, I realize LU6 is the hsi point and TW4 is the yuan point. They have to have a rational explanation. However, how they worked together in the success of this case is a mystery to me. I guess the biggest mystery is, whose car was that?
Of course, this is just a freaky coincidence ... or a script from a "Twilight Zone" episode ... or a total fabrication ... or a dream after too many shitake mushrooms. Our rational minds won't allow for any other explanation. However, these events are around us daily. Take advantage of them.
We are often presented with the answer to our patients or our own problems in unusual ways. We may see a sentence in a book or a billboard that may trigger a thought, or hear a statement on TV. Act upon it. Don't be afraid to let intuition enter your thoughts. These thoughts, coupled with sound academic principles, are extremely powerful. Keep yourself mentally attuned by constant reading and study, but also allow the sixth sense to become a part of your being.
One of the most significant masters I have had the good fortune to study with said it best: "When the student is ready, the teacher shall appear."
Best wishes for a healthy, happy and productive 2003!
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