Colleagues from different countries often ask me to help shape / expand case studies they want to publish in British or American journals on Asian medicine. Technically the articles they show me are perfect. But as a typical bodyworker, I need to visualize the client! I don’t just want to read a stiff diagnostic and treatment profile.
Age? Profession? Work habits? Body type? Background? Chronic or acute problem? I need to flesh out the client central to the study before it makes sense to me and possibly to other readers.
One case involved a tall, thin cook nicknamed “Q” in a small cafe. Q experienced chronic back pain from tossing food in a hefty wok several times a day. My advice to his practitioner? Go watch Q at work.
Spend time in his cramped kitchen. Don’t just treat him one time, but suggest some specific stretching or slow qigong moves Q could do before and after work. Examine his posture when he tosses the wok. Make sure his shoulders are relaxed and not hunched if he’s working against the clock.
Another colleague asked me for a second opinion as he was working with a modern dancer, “Jaylin,” who was experiencing severe joint pain. We went to watch her perform. We winced when we saw how the dance involved repetitive, jerky movements and impact with the wooden stage. Ouch! No wonder Jaylin’s joints suffered!
When we spent time with her the next day we suggested she practice some fluid slow-motion qigong moves before and after she performed. My colleague also taught her some specific exercises to enhance supple joints. Jaylin was young and ambitious but took this advice to heart, especially when she was given a chance to weave in some qigong moves as she choreographed dance items for her group.
Add Vibrant Details!
Adding an ABT touch for a colorful image of the client certainly enhances diagnosis and treatment protocols. I always advise my students to observe clients in-action in any work or the performance arts or sport, to be able to relate directly to repetitive-stress injuries. This also makes the subsequent case study a lot more interesting – not only for the students, but also for us teachers reading through endless assignments or theses.
In short, I encourage students to go beyond brisk theoretical case study summaries such as I read recently: “40-year-old female. Depressive symptoms. Severe abdominal pain. Strong resistance from left hypochondrium; etc., etc.”
Ahh. If one of my students had presented such blunt facts in a project or thesis, I would have suggested, “Tell us more about your client. Work? Family background? Exercise routine? Eating habits? Recent illness or trauma?” Interestingly, when I mentioned this to my shiatsu students in Berlin during one specific class, there was silence. One of the students raised her hand. “But Pamela, some of us are shy about asking too many personal details.”
I responded: “Then weave the questions diplomatically into your intake forms. Offer them a choice of forms in five-element colors and note which color they choose. Add fun body outlines and a box of crayons so your clients can shade in areas of pain or discomfort in a color of choice.”
I told students this would teach them more than a formal verbal exchange with new clients.
Open Your Clinic to the World
During my teaching days at AOMA in Austin, our corner dojo plate-glass windows faced a bustling courtyard with a koi pond, surrounded by cafes and various businesses. Not only was our work and daily qigong in full view of a busy area, but if I saw anyone limping or on crutches or having some difficulty navigating the bridge, I’d invite them into the dojo to talk to us. The immediacy was a win-win.
One guy, “Bob,” was just stiff jointed and hazy after a period of insomnia caused by computer overload, and he welcomed our invitation after I noticed him walk by, coffee in hand.
I worked my typical 10-minute “computer shoulder” package of BL 10 / GB 20 and slow arm rotations. adding points like B 1, B 2 and SJ 23 to ease his eye strain. I shared fun eye exercises I crafted for managing computer stress. We talked about the ergonomics of his work station in terms of chair height, mouse and screen position.
We suggested Bob ask someone to photograph him at work and show us the pic so we could offer yet more advice. This brief 30-minute exchange not only boosted Bob’s day, but also prompted him to sign up for all our student clinics!
The exercise also encouraged my students to observe future – and especially senior – clients walking, moving, and/or grappling with stairs, and then to figure out specific techniques to ease blocked qi.
Miriam’s Stiff Hands & Wrists
For example, I observed “Miriam” having problems rotating a circular door handle to the restroom when she came in for a session. Not only was it invaluable to work wrist, hand and elbow points for her arthritis, and to do subtle hand stretches and movements; I also encouraged her to rotate her hands around a soft ball, a large grapefruit or a bunch of wool.
She graduated to a ball with bumps, so the rotation would automatically activate points in her hands. So simple! It literally converted a disability into a fun task. It also added consciousness to the way Miriam used her hands whenever she worked on the computer, rolled pastry or walked her dog.
Author’s Note: For further information on adventurous diagnostic and treatment techniques, see my past columns in Acupuncture Today: “Moving With Imagery: Help More Patients” (July 2017); “Be Flamboyant With the Five Elements – Study in 3D” (October 2018); and “It’s Time to Help Patients With Their No. 1 Health Issue – Screen Overload” (November 2019).
Mast cell activation syndrome (MCAS) affects more than 15% of the U.S. population but evades most practitioners’ radar. Just five years ago, it wasn’t even on my radar, despite already having 20 years of experience as a clinician at that time. The more I dug (similar to leaky gut and post-COVID syndrome), the more I found my patients were suffering from this disorder.
Research supports the effectiveness of selecting the distal acupuncture points for the treatment of microtrauma and for relieving pain, particularly in cases of chronic shoulder pain. But to make the treatment results long-lasting, clinical experience and research suggest that instead of treating the most painful structure first, we identify the inhibited driver, restore reliable recruitment, confirm it with immediate re-testing, and only then address the painful area as a branch of a deeper pattern.
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The motivation behind our practice of medicine is important, impacting not just our experience but also the experiences of those we treat. It is perhaps for this reason that the aspiration to help not just some, but all beings heal, has historically been an important part of the medical tradition. To explain this, we need to consider how medicine is interwoven with other social domains.