It’s been more than a year since I decided not to renew my acupuncture license after earning California’s AC1390 in 1982. Although it was not my vision to leave the profession at age 75, progressively debilitating physical conditions limited my ability to practice in 2014. Within 10 years, I was finished.
I am grateful for having had such a rewarding career, which included over 100,000 unique patient visits. But even as I like to think I have years of accumulated experience to share, I am still learning, especially in my journey as a patient.
Last week, I found myself in a crowded ED. Again. How many times had I landed here? Ten? Twenty? I'd lost count. An ambulance dropped me off at 3 a.m., as I was unable to sit up for the drive. Uncontrollable spinal spasms were wrenching my neck and squeezing my torso. My speech became robotic and tortured as my neck muscles contracted painfully.
After surviving a successful series of spinal fusions requiring 54 screws and supportive hardware, I was all too familiar with agonizing pain. I knew that if I did not gain control over these symptoms soon, I would quickly decline, followed by additional health risks requiring hospitalization.
The emergency doc, a weary man with kind eyes whom I'll call Doctor Doug, walked slowly into the stuffy exam room, as many had done before. I was ready to hear, “So, what brings you in today?” followed by an order for a battery of tests. Instead, he carefully sized me up, and said, “I reviewed your chart and your films. Of course, you know I can’t fix you. What do you want me to do for you today? How can I help?”
I locked into his steady gaze and replied, “Seriously?”
I don’t remember any physician ever greeting me so honestly and directly. After his affirmation, I replied, “I would like some dexamethasone, Dilaudid, and baclofen.” He simply replied, “Will do.”
An accompanying nurse soon sent the steroid, pain medication and anti-inflammatory drugs into my body. I waited, feeling the spasms slowly loosen their horrible grip over the next two to three hours. Dr. Doug went one step further in his care when he checked on me before he left the hospital at 6 a.m.
He suggested I was misleading myself by identifying as a survivor of surgical fusions that were now stable, along with various drugs that only managed my symptoms. He added that previous labs and films had confirmed a diagnosis of ankylosing spondylitis, a chronic rheumatic condition.
He offered that he had AS himself, and that I could learn to influence it with conservative strategies in which I was well-trained. Of course, treating AS with Oriental medicine is not news to TCM doctors.
My family is afflicted with rheumatoid arthritis and other autoimmune disorders, especially AS. I was introduced to autoimmune dangers with a sudden heart infection in 2016, which was followed by a brutal skin condition called pyoderma gangrenosum - not unlike flesh-eating bacteria. Both have been in remission for several years.
Ankylosing spondylosis had been ruled out by a rather uninspired, by-the-book rheumatologist, but a few other docs had alluded to the possibility. At the time, I wasn't ready to hear them.
This time, I welcomed Dr. Doug’s diagnosis of AS, as it is consistent with a descriptive TCM picture of liver internal wind heat with kidney jing deficiency. This diagnosis also offers a healthy shift in the predominant sense of myself as a survivor of rugged surgeries.
I had been feeling like a victim of my spinal fusions, with very little to work with in terms of regaining my health. But now, after years of struggle, I was ready to let go of my victimhood and be the proactive doctor I've always strived to be.
After all, I encouraged my cancer patients to avoid framing themselves as survivors, which has a certain limiting grimness. We are naturally survivors after having prevailed over cancer or other life-threatening conditions, but we are also so much more. I wanted my patients to focus on what they could do, instead of what they couldn't do and to feel their qi, the essential life force. In my own struggle and pain, I had forgotten my own advice to not let illness define me.
At the same time, my heart was touched by this earnest doctor who met me as another vulnerable human. “How can I help you? What would you like me to do for you today?” Such a simple and direct way to build patient trust while receiving valuable information. Instead of trying to prove our merit, we wise practitioners, let's consider trusting our patients. Would you want anything less if you one day find yourself sitting in the patient’s chair?
We are trained to be mindful of our patient’s voice, tongue, pulse, etc. But we must also learn not to overthink as we shuffle through the contents of our mind seeking answers, taking us away from being fully present. From being thoughtful listeners.
I flashed on my studies in China and a particular memory - one that informed my practice for 40 years. My mentor was the elegant and elderly Professor Wu of Guanzhou’s First Hospital, who had come out of retirement to teach. She was observing me as I made a case for a rather complicated five-element diagnosis, based on deducing the patient's constitutional factor, or CF.
At the time, this theory was promoted as a way to obtain a kind of "magical" clinical insight of the patient’s root cause through a sequence of strict observations of the patient with an ongoing effort to analyze that information - instead of letting the patient's response to treatment lead the way. Admittedly, there was a certain arrogance to this somewhat dazzling approach.
Professor Wu smiled as she pulled me aside. "You will make a fine doctor," she said. "But only if you do not forget the most important principle of healing. Be humble. Do not try to be too important. Since you do not fully understand yourself, how can you expect yourself to fully understand another?”
Even separated by time, distance and cultural differences, Dr. Doug and Professor Wu had much in common. Each discovered the magical pearl available to a patient - with fewer than 10 words needed to make it glow. “What do you want? How can I help you?” Essentially, these are words of invitation - and participation.
"Speak to me of your body's wisdom, that together we may embark on a healing journey." - Namaste
