Stories are wonderful teachers. They have been used throughout the life of Oriental medicine to pass on information, history, values, traditions and skills. Our medical practices are filled with rich, humorous and poignant stories.
They blend together to form the rich history of our careers, our lessons and our lives. I hope you enjoy this one; perhaps you can be spared some of my hard-won lessons by reading it.
I had been licensed about a year when Philip became one of my patients. He was 43 years old, had anxiety attacks and was generally a nervous, overly stressed person. He wanted to see if acupuncture could calm him and help him lead a more normal life. At the time, psychotropic drugs were not as sophisticated as they are now, and Philip experienced severe drowsiness from his medications. It was hard for him to fully enjoy life through the fatigue. "Maybe," he told me, "acupuncture will help me use less medicine and feel less sleepy." Even at that tender age in my practice, I knew this was viable thinking.
With Philip's permission, I notified his psychiatrist as to his patient's request and my intentions. The psychiatrist felt strongly that I was wasting my time and Philip's money, but he agreed to my involvement nonetheless, citing that "it couldn't hurt." With that ringing endorsement, I eagerly set to work.
Philip came in once a week, and I learned how to give him strong enough treatments to affect his state of mind even with the substantial amount of medication in his system. It felt risky at first, because he was sedated substantially enough so as to require very intense acupuncture. I gave him the strongest treatments I had ever given anyone. But the work appeared to be helpful and after a few months we had a rhythm going. As long as he came in every six days, Philip could maintain his dosage levels but feel more energetic. It was a rewarding and moving experience for me to expand my range and see a patient improve. My goal was to keep things going as they were until both Philip and I had spoken with the psychiatrist about lowering his medication dosages.
On this particular day that Philip came in for his appointment, I looked at his tongue and took his pulses. I asked if anything of note was happening that might be considered before I gave him a treatment. He said no and I proceeded as usual. Once the needles were in I put on some gentle music, made sure Philip was comfortable and left the room, as I always did.
The clinic I was working in at the time was large, having about 10 treatment rooms off of a single hallway with the reception area and waiting room in the middle. My next patient was in a room at the far end of the clinic. Nonetheless, about 15 minutes after I left Philip and about five minutes after having checked on him, I heard his booming voice coming through the door. My receptionist was immediately knocking, telling me in an urgent whisper that we had a problem. I excused myself and ran back to the other end of the office. There was Philip, standing in the hallway with his gown flapping away (without the benefit of underwear). He was flushed bright red, yelling at the top of his lungs and walking toward me.
Considering the four other patients (no longer) resting peacefully in the rooms on either side of us, I raised both my hands like a game of red light/green light. "Philip, STOP" I yelled, as softly as one might while getting the attention of an enraged, near-naked man. My first thought was that I had to stop him from moving. There were 37 needles embedded in his muscles and only one of them needed to break off as a result of his movement to require a hospital visit and surgical removal. I stared straight into his eyes, internally demanding that he look back at me as I darted forward toward his feet faster than he could fight me off. Instantly, I was on my knees. I held my breath as I worked my way up his body pulling out warped and contorted needles. Finally, with all the needles unidentifiably bent but removed from his body, I gasped for air, unceremoniously turned Philip around and pushed him into the treatment room.
"What was that about?" I asked with minimally suppressed exasperation while trying to fit 37 unrecognizable needles into a sharps box one at a time. "I guess I forgot to tell you that I cut my medication in half last night and hadn't taken any this morning. I was so excited about how much better I was doing that I thought I could start lowering my dosage on my own. I didn't tell you because I wanted to surprise you. Maybe that wasn't such a good idea," Philip growled through his teeth.
I decided it would be best to count to some very high number, like 764, before I responded. I took several deep breaths while listening to my receptionist addressing the concerned calls from patients in surrounding treatment rooms. "No, Philip. It is very important that we work together as a team. Though I appreciate your desire to lower your dosages, surprises don't work well," I said quietly as smoke shot out the top of my head.
Philip was still filled with anger because the treatment had been far too strong for someone who wasn't as heavily sedated as he generally was. Rather than calm him, it had increased his emotionality. Simultaneously, he felt shame at having tried something that backfired. My time was short, as a patient with half a treatment inserted was waiting for me in a quiet little room far away. I suggested he walk home to calm his nerves. He agreed. It was an 18-mile walk. When we spoke later, he told me that it took him four and a half hours and that he calmed down in the last mile or so. I laughed to myself that it was a good thing my office hadn't been conveniently located near his home or else he might have destroyed something.
What I Learned from This
This story was rich with lessons for me. First, I learned that one must ask each patient if they have made any medication or dosage changes prior to every treatment. Patients cannot be the ones to judge how their medication changes will affect my work. Even something as benign as Tylenol or over-the-counter cold medications can have an effect. I must have all the information, even details patients consider superfluous. Next, I realized that needles are amazingly flexible. They seem to understand when the practitioner working with them is in a jam and they try not to break. In 38+ years of needling, I have never had one break in a patient. Lastly, from that day forward I kept a pair of underwear in every treatment room just in case a patient wasn't wearing any when they came in. And I don't care where the point is located, the underwear stays on!
A New Project
Practitioners all over the world work diligently to heal patients using the same skills you do. We encounter similar challenges and surmount parallel hurdles. We can relate to a common body of professional knowledge and experience. While honoring a patient's legal right to privacy, wouldn't it be fascinating to know about the stories going on every day in acupuncture practices around the world? I thought it would be helpful to students, new practitioners and seasoned veterans alike were there to be a published compilation of stories from acupuncture practices. I thought it would be not only interesting but helpful for the development of skill and wisdom. To that end, Andreas Null, a German colleague, and I are going to compile an anthology of stories titled The Best and Worst Things That Have Ever Happened in My Practice: How I Handled Them and What I Learned.
This book will contain stories written by practitioners from all over the world and will initially be published in Germany and the U.S. Several other countries and languages already are being considered for publication. We want practitioners like yourself to send us meaningful business- and practice-related stories that you think will be heartwarming and educational for our colleagues. We are requesting stories from all continents and hope to publish compilations that represent acupuncturists as a world community. If you are interested in participating with stories to share, please go to www.om-practitioner.com to learn more.
The I Ching, a great Chinese philosophical and fortune-telling oracle, discusses an important concept: The Taming Power of the Small. Not only that which is blatant and grandiose determines one's outcomes. The little things of life may, in fact, be the subtle influences that establish its path. The smallest pearls of wisdom in a story may provide for the building of a good life.
Click here for more information about Felice Dunas, PhD.