15 August 2010

Gardening

After a century-old apple tree came down in my backyard, there was enough sun to plant a garden. 

The tree was good and its apples won medals in pies. It endured a variety of pruning theories that left it with a combination mullet, crew cut and perm. Eventually the bugs ate enough so that when I could put my arm through it, we knew it was over. 

Sunlight was a new dimension in that back yard, which abutted a ravine off the Willamette River. Years ago, salmon ran in the stream....

I write this for casual gardeners, students with little time, and those who never gardened before. There is nothing like gardening. 

In our valley, in just a few weeks is an ideal time to plant a winter garden. The beauty of the Willamette Valley is that we can garden nearly year-round. In the past, I grew all my vegetables 11 months out of the year on a small plot, and half the fruits for a family of four. 

Recently my wife urged me to plant a raised bed, which I'm now hooked on. A neighbor generously donated his yard to a community garden after his tree big came down (from ill-advised 'professional' pruning). I've not bought any vegetables since spring, even though it's just a 4x8' bed:

I was first influenced by the 'French Intensive' method, which advocates close planting in deeply dug beds. The density makes for a jungle-like canopy that conserves water and gives great yields. The first year is difficult making double-dug planting beds, but well-worth it after that. This year we made double-high raised beds, using untreated thick cedar. We trucked in garden soil for all the beds, also adding compost from my yard. Trucking in dirt may be cheating, but it helps kick start the process --just once. 

I was then taken with 'square foot gardening', which undoes the linear traditional American garden. This link sees it as a way to eradicate hunger. 

Whichever style you use, you can't do it wrong. It's like the vaunted Schools of Acupuncture that way.... From now to mid-September in our region, a winter garden awaits your hands. I like to wait until it is a little cooler, around Labor Day. You can pick up 'six-packs' of organic veggies at food and garden stores. A few go a long way. I've done the raise from seeds with timed lights in the basement on a hot mat with a fan thing, enough to know those six-packs at the store are a real gift. Brassicas family--known for their anti-cancer effects--are perfect: broccoli, kale, possibly brussels sprouts. Choose a variety of lettuces, and in a few weeks, you've got salad.

From seed, beets always work. Their greens are perfect. Garlic can be planted any time of year. I like Elephant Garlic. Take any garlic from the grocery store and plant the cloves tip up, maybe an inch deep. A six inch sprout will overwinter. You can plant more in the spring. The greens and flower are great to eat. 

Kale will go down to 20 degrees. Brussels sprouts taste better after a hard frost or two. I've done cloches and mini-greenhouses, but didn't like them. They gave maybe an extra week or two, but removed me from the plants. 

I'll do the same thing over during Spring break, and then put in a summer garden in May: tomatoes, beans, and squash. I've done corn, but it depletes soil after a year. 

The Hopis grow corn on 2-3 inches or rain a year. They say to talk to the plants like they are people. I'm not there yet. But I do love to come out and see what's come up overnight. 

In our community garden, it's interesting to see the different approaches. My jungle is looking a little ragged now. A young woman named Zoe made large crescents with carrots and beets that are now coming into their own. Her sunflower grows, but mine does not. 
Another neighbor planted brussels sprouts that I just didn't think would be so great in the hot weather, but they are glorious now. 

Slugs and aphids are a sign of the wrong plant for the soil. The problem is not on the leaves: it's the roots. Chinese medicine takes the same view, using more roots in herb formulas than anything. The ancient Chinese saw the human energy system as a plant, with the legs as roots. Aging starts in the roots, it is said. This is why walking, foot reflexology and the like are so helpful. 
If there are bugs, take it out or cut it back. A healthy broccoli or lettuce can give multiple harvests in one season. 

My chickens love the garden greens better than anything. I'll throw a broccoli leaf into a smoothie. The 8 year-old girl I live with will eat broccoli and kale flowers out of a garden like candy, but not many other veggies.   

A garden gets me out, even in the rain. I know my neighbors better because of it. 

A century ago, much of Portland just west of downtown (around what is now I-405) were Chinese veggie gardens. I liked the book Better Gardens the Chinese Way by Peter Chan, but never went for his non-organic options. He made a beautiful garden in Gresham. It turned out my qigong teacher bought his house and garden--which looked so familiar to me. 

Gardens unite us.  

13 August 2010

Group Qi

I was a loner when I started took up acupuncture, still in my 20s.
I chose to live in lonely, out-of-the-way places with just a few close intimates.

After learning, acupuncture, I looked realized I needed to go where people were.
Moving to the city was a shock. I endured and adapted. Now I love cities, groups, people.
The more the merrier!

This is how it happened: It began with my first day at Hooper Center, the public detox I worked in.

I was extremely nervous or 'edgy,' as the Process Work practitioners say when people enter a new field of experience. I didn't want to be there, but the new school I was at said I was the "low man on the totem pole."

Portland's Terwilliger Bike Trail, 2009

Which I later learned is not a bad place to be.

Nobody wanted to go to the detox. I didn't, since I'd worked in front-line social service jobs. They were the kind staffed by young people with good hearts, who feel after six months they are old-timers--with few who last more than a year. Psych wards, nursing homes, special ed facilities.... They each gave me a chance to re-integrate with the 'populations' who were weeded out during my childhood education, taken away somewhere else. Through the work, I found the psychotic to be gentle, the developmentally disabled as joyous, and the elderly to know the cycle of existence as grand seasons and rhythms of life (even while bound to a wheelchair, living in pajamas).

I thought I was done with all that. But no, the State of Oregon said I needed a few more clinic hours. So I went, barely unable to contain myself with the strange burst of energy (that I interpreted as anxiety). I went upstairs, where Patients were cooly playing pool in their pajamas. When it was time to start, they assembled quickly in plastic chairs in a circle on the shiny blue floor. The acupuncturists went like bees to flowers, quickly putting pins in their ears. At a certain point, the energy in the room formed a circle like the Rings of Saturn.
Saturn, associated with Earth (Stomach-Spleen channels)

The group qi field seemed to coalesce, spin, tilt, and then go somewhere. There was peace and some joy. I was hooked. I fell in love, and returned twice a day--once on Saturdays, leaving after ten years.

I'd pull into the parking lot in my little white truck, sometimes exhausted from the drive in, or the family life of raising young children, or starting a practice. But after work, I always felt better, strangely better.

I commuted alone, along with every single other driver on the road. Nose to tail, we formed a serpent entering the city at rush hour. The drive got longer, eventually creeping up to 45 minutes. Just me and NPR, maybe Nina Tottenburg chirping along.

My little practice near my little suburban home focused on individual patients. Sometimes I wanted to pull up the sheet-rock walls so they could all meet each other: I could see the similar patterns among the patients, who thought they were all separate.

Hooper was changing me, though.

Eventually, I brought a bike in the back of my truck. I rode it to the different clinics in town, sometimes three stops a day. It was like bursting a bubble. It felt so alive to ride, even in winter.

After a while, I offered group treatments to my suburban patients. I called it 'Happy Hour:' between 5 and 6 on a weeknight, drop in for a reduced rate treatment in my waiting room with a small group.

Half my patients went for the idea. Many that did said the slight reduction in price was the sole reason they could continue their treatments. I expanded it to three evenings a week.

Everyone seemed to have a great time. Patients instinctively knew who needed the most help, even though they could not read their charts. They would turn with needles in place and give their philosophy of life or some advice to the person who needed it the most.
I even wound up treating 5 generations within one family--one in utero--all in the same room.

I found that I needed to do only about a third of the number of needles on a patient during a group session than a private one. For example, if a patient needed about 12 needles per treatment in a solo treatment, when they switched to a group treatment, then they only needed 4. 

After about 3 months, it became my favorite way to practice. It seemed to take that long for the qi field to gel on some level. It's strange, but other acupuncturists I've talked to notice the same thing with clinic spaces. They seem to need a little time to coalesce, for the qi to saturate the walls and amplify a healing space. It is palpable.

Despite my enthusiasm, some patients just wanted the one-on-one. I could never predict who would: there was not economic or psychological profile I could discern. So I tell my students to offer both types of treatment.

And to let patients talk! If they want quiet, they'll shut their eyes.

We live in a culture where never before have so many people lived, travelled and worked alone.
Not a bad thing perhaps...we'll find out what it does eventually. Some of my suburban patients led monastic existences with great depth. But even monastics had company.

There was one Frenchman who chose to live by himself in a cave for an entire year as an experiment. He got terribly lonely --it wasn't fun. I've treated patients who were punished with solitary confinement in prison: they were never the same. This raises the point: Why do we lock so many people up in jail in this country? And why do we use 'timeouts' of enforced isolation on children as a preferred mode of punishment?

What I learned was: People need people. We are social animals, like birds. We need to talk -- and be heard, and go through rhythms of life together.

Now I live in the city. I try to see how many days I can go without being in a car. I rode a bike to work everyday last year, and love the connection with other cyclists. We nod and smile and murmur to each other, "on your left, thanks." The car drivers meanwhile look either bored or furious --I remember that. I love living in a family, and wait for the children to come back to roost. Although originally shy, I eagerly await the return of my students in the fall. There is so much to talk about, so many rhythms to go through together.

Credibility

Is credibility our best option?

Today I spoke with students about the psychic surgery I witnessed during while in acupuncture school. I was in the front row of a public lecture. It was incredible in many ways:
  • He gave an accurate diagnosis after brushing the body with his hands
  • He proceeded to give the best chiropractic adjustment I've witnessed
  • He mentioned herbs for cancer that are increasingly endangered
  • The theories of organ function he learned from his Aztec grandfather closely paralleled the Chinese teachings in my first year of acupuncture college
  • The patient (apparently a stranger to the practitioner) gave a profound look of appreciation after the session
OK, did I mention the psychic surgery?

The practitioner, Mike Valenzuela, worked in bare shirt sleeves. The patient pulled her shirt up to the chest. He pressed a bare hand through her skin -- up to his knuckles into the liver area, and retrieved what looked like a baseball-sized clotted blood, rather like seaweed. I could see about two-three cups of blood, heard gurgling sounds, and watched him throw the items into a bucket with a splat.

He never advertised himself as a psychic surgeon. It was a fringe benefit. The whole event took place on an Indian Reservation in Northern New Mexico at one of the 12 Pueblos. Had it occurred in Portland, he would have been quickly arrested for practicing medicine without a license.

He supported himself as a car mechanic, and did healings gratis.

Regarding auto mechanics, his grandfather said that if his teachings were true, then they were applicable to any domain. The grandson found that the same theories handed down to him worked on cars as well.

I write this because 'alternative and complementary' health practitioners like myself seek to gain credibility in this amorphous 'system.'

If we can provide 5% improvement --like Prozac did in some of the trials that made it a blockbuster drug-- then we are fitting in.

If we do something incredible though, what then? Would total cures threaten our position?

Patients want the incredible. They don't mind a miracle. Miracles are supposed to happen. Children get that rap every Christmas....

Practitioners, like everyone, don't mind being loved and accepted.

Do we have to be auto mechanics to find that?

...My son just entered motorcycle mechanic school....
in the home state of that Aztec healer, who is now dead (or "transitioned," as his friends say).

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~

While travelling in China on a low-budget cruise ship, I saw another incredible healing act with nothing more than human hands and imagination.  There were so many, but this one comes up tonight....

It was by a travelling Buddhist monk, who'd been given up as dead with an incurable disease by his impoverished parents in inner Mongolia. They dropped him off at a monastery as a last-ditch effort. He learned Buddhist qigong and recovered his health.

Every ten years, they send the monks for a year-long sabbatical into the world, to see what they are missing.

(The Amish who lived a bicycle ride from my boyhood home did the same thing for all young men, briefly, to see where their hearts lay. Most returned.)

So here was this monk, getting a close look at the world, making his way by doing healings and readings on the cruise ships.

Our trip was on a budget. The ship was comfortable, but more like a Tri-Met bus. We were delayed for mechanical failure, so we had time. Time is one thing China seems to have a lot more of.

We were nestled into the Yangtze River, prior to its damming. It was much like the Columbia Gorge in the Pacific Northwest, with rugged mountains sculpted by ancient floods, petroglyphs, and local bigfoot/yeti legends.

The monk did his thing. One treatment he gave was to stand about 20 feet away from a patient. He would vigorously crouch and wave his arms, eventually pointing at the patient.
Coins the size of a quarter were placed on acupoints. The monk directed his intention at them, which warmed the coins. When the patient said, "hot!" then the coins were removed. He tapped them on a table, and ash would fall off the coin.

Were he in America, it would be no doubt be televised. Then he'd be decried as either a charlatan or locked up in a lab for study, as a kind of treasure to be watched over. The reaction would be extreme either way.

In China, however, it was a Middle Way. There we were, stuck in a Gorge, getting palm readings and Buddhist external qigong heat treatments by this young monk. The shipworkers were totally unfazed: vaguely interested but not excited by the monk. They did not seem jaded, but what they saw seemed more part of life and nature.

In my experience, more things like this happen in China. It's in the air.

Could it happen here?



One of the patients, Claudia, was from Texas --she could take heat! Just out of acupuncture school, she was curious. "I wanted to see how hot the coins could get," so she didn't tell him when the coins got hot. As a result, blisters welled up at each acupoint, as thick as a little finger. I've got pictures of them.

We can say that magic is everywhere. Personally, though, I've seen more of it within the context of ancient cultures.

May we grow old together, then--and quickly.

10 August 2010

The Inner

Inside. Innerness. Innernicity.

'The answers lie within....'

Why did the Chinese aptly call their cornerstone text of acupuncture the Inner Classic?

Wow--that is different for us. 

Ask someone, like a patient, how their eyes are. They'll bring up data from their doctor, opthamalogist, optometrist --anyone but themselves. Then we have to ask again, "No, how do your eyes feel to you: how do you experience your eyes?"
   Puzzlement is the response. 
   "Do they feel tired, blurry, irritated, burning...." 
   "Oh, well, they feel tired, but that's just because I read a lot."
Or, if they burn, "Doesn't everybody have hayfever?"
We want to be normal, it seems. 

Why do we discount the self, our own perspective, and the entire subjective realm?

"If you can't trust yourself," I tell my students when they look to me for answers, "who else can you trust?
 
Ken McLeod studied Tibetan Buddhism and quantum physics--both very extensively. One of his strategies for healing the mind in our place and time is simply returning the 'I' in scientific discourse. All meaningful discussion in our culture led to the erasure of the 'I' as some egoic, unreliable and limited perspective. This led to some useful knowledge, but the effect is now so complete, so saturated into daily awareness, that people look outside themselves completely for validation. This creates a situation ripe for exploitation, powerlessness, and "learned helplessness." The latter is the title of a great article on his website. 

The Other Ken--Ken Wilber, referenced in the first blog--attempted the same project: reclaiming the subjective as something meaningful. He studied Tibetan meditation as well, and wrote my students' favorite book of his with his wife as she was dying of cancer. True Grit is its title. 
Acupuncture, as all modalities, is a metaphor for healing. All the needles point in one direction: inside. 

When there is a change, we realize we were just a few needles away from liberation. 

"What drug is on these needles?" surprised patients used to ask me, when feeling acupuncture's effects for the first time. Especially addicts had no idea their own body could whip up such a heady brew on short notice, with such little prompting.
Some attempts to determine how acupuncture works describe it as a 'wounding.' In my experience, this is utterly not so. Acupuncture is simply a medium of communication. A lot of acupuncture, chiropractic and physical therapy these days is like somebody shouting at the body. The target then goes into duck-and-cover mode. There is no 'qi flow' in that! The 'wounding' approach is about the Outer, about overpowering. 
Alternatively, when any practitioner really listens and then engages in a soulful dialogue at an appropriate 'volume,' the inner emerges to meet the outer. We say that yin and yang then unite. This creates life, and life is healing.

09 August 2010

Mental Health

By the time I left Hooper, the in-patient facility, it was ten years after I'd started. I was so nervous getting there the first time, I was exploding in the little Toyota truck on the way in. I didn't know at the time, I was meeting myself in the work there.

By the time I left, my boss (Ed Blackburn) estimated I'd interacted with over 50,000 patients. Acupuncture is based on experience. Those interactions left me a changed man.

The type of patients I'd feared the most I wrote about in the last blog.

The patients who taught me the most were the ones with 'mental health issues,' as we say in our culture.

In our field, we sometimes half-joked about taking a 'mental health day' -- a day off to recoup. We all needed them.

What was stressful about our job?
There was no heavy lifting....
It was a matter of the heart.
Most days, something would break it.

When I started doing acupuncture at Hooper, my heart was weary to see some patients hiding under their beds when it was time for acupuncture. Or in the shower --fully clothed.

"Come out and let's talk about it," I'd say.

All of the patients who hid themselves away during acupuncture had a severe mental health issue.
If you've met someone like that, you know how gentle they are. Our treatments were doing just one thing: blowing them away. They couldn't handle it.

I listened and negotiated with them. I told them to take a break, and then when they were ready, we could try just a few needles.

I went home and looked up more treatment ideas for what they had. The Chinese sources had what we needed. There were protocols for hallucinations, anxiety, 'yang psychosis' (throwing chairs), anger issues --there was plenty to try.

One man who had a particularly hard time with needles was amenable to trying moxa, a heat treatment. We use a compressed herb, mugwort, a relative of sage, formed into something like a huge incense stick that is held over acupoints. A Chinese text recommended moxa on a Small Intestine channel point on the neck (SI 17) for auditory hallucinations. When we did that, he could feel a circle going from his neck to his brain. The voices stopped. It all tickled him.

I learned and tried a lot on these patients. I found I was able to get very good results with psychiatric conditions. This was an area we never studied in school. I often had to wing it. Just finding good protocols was not enough. I found I had a resonance with the psych patients, an understanding. I was puzzled by it.

We were then asked to do acupuncture at a community mental health clinic in on Northeast Alberta street in Portland. To be in a room filled with people with mental health diagnoses, on medications for severe mental health issues --and do acupuncture on them was new. I worked in psychiatric settings: It was my first job after college, a burnout path. But to be their acupuncturist led to a different level of interaction. I was scared, but had no choice but to plunge in.

In feeling into them, I realized that I held a love for these patients that I had for my grandmother. My mother's mother suffered from bouts of psychosis. It was brought out when her husband left for both world wars. Running a farm with five children was a stressor. She was beautiful, a poet, dignified and very quiet.

From that connection, I felt I knew what to do with these patients.  That proved essential, since conventional protocols didn't always work. One point listed in contemporary texts for auditory hallucinations (San Jiao 17) seemed like it ought to work--but never did.
Instead, one day while treating a patient with voices, I got an idea to use a set of three points on the back of the neck. After they worked, I looked them up. One was called Ya Men in Chinese, which may translate to Muteness Door. Acupuncture is bi-directional: this is a well-known point for treating deaf-mutism, but it was the first I'd known of it for silencing an irritating inner voice. The points below it, to my surprise, were called Fu YaMen, or Below Mute Door. From their names, they were meant to go with together, and formed a triangle about an inch apart, with YaMen at the apex.

More commonly, I used a Scalp Acupuncture point for disturbing voices on the auditory center of the brain, just above the tip of the ears (GB 8 & 9). This worked in about 5 minutes, and on every patient. There was not a single time it did not work; I used it hundreds of times. Just this year, I found that ancient Chinese understanding of the brain understood the use of this point to affect the ear in this way.

At the time I was making these discoveries, or re-discoveries, an Aleut medicine woman taught me something. Her name was Share Bear, and she came to Hooper to teach. She came in her traditional apparel from the Aleutian Islands, head held high and carrying a huge walking stick. As we were crossing Martin Luther King Drive, she said, "The real problem, Roger, isn't when people hear voices: It's when they don't hear them at all." Good point!

Whatever happened to that inner voice we once knew and loved?
In contemporary culture, the inner voice was relegated to irrelevance, insanity and untruth in the quest for objectivity. That gave us a certain knowledge, but physicists now tell us there is no such thing as objectivity.  

The Chinese classics never saw a problem with subjectivity. They excelled in building an organized, inter-subjective field. As Wilber points out (see previous blog), this is not 'merely subjective,' but the basis of culture and language.

The acupuncture classics provided an architecture of the soul, poetic writing that was not taken up by later herb classics.

My training in acupuncture emphasized treating the Liver channel, as is common in contemporary Chinese texts and clinics. I was puzzled that so much was going on in the Heart instead --until I read the Chinese classics years later.

Mental-emotional issues are disparaged in our culture. Just the terms are enough to make us run away. For example, when someone is 'mental,' that is a demeaning term. "You're so emotional" is another pejorative remark. Psych and psycho translate as 'whack job.' Not good.

If we are to heal the psyche in our culture and times, we will need to upgrade the language. Chinese is a better place to start. The term for the mental-emotional aspect is called the Jing-Shen, or Essence-Spirit.

It's not just a spiritual thing: that has connotations that can be airy-fairy or highly debatable in our culture. When we first call it Essential, of the Essence as half of it, then we have something real, something substantial and important. Essence-Spirit is a perfect term for what is considered the most refined part of the life of our organs.

To call someone depressed or psychotic isn't real in a scientific sense: there is not objective validation of that reality, unlike diabetes, for example. There are intriguing patterns, but no definitive diagnosis. Psychiatry a matter of convention, of collective subjective definitions and agreements. This does not make mental health issues less real or significant. It can make them our collective responsibility. The Chinese experience in crafting a collective-subjective medicine can teach us how to go about it.

Every day, I am proud to ride my bike to work. More importantly, I love the exhilaration it provides. For a year now, I ride past people laying on the sidewalk, sleeping into the morning by the river or on the bridge. In my car, I could remove myself from them and turn up the radio. On a bike, rain or shine, I'm just feet away from their feet. Jungians  say the homeless are manifestations of my psyche, as is everything. They got that idea from the Buddhists. So, there is part of me: laying on concrete at ten in the morning, face pressed under the metal railing to get as close to the river as possible. Even downtown, there is peace and solace in that river.

They cleared out the mental health hospitals while I worked at Hooper. A yellow schoolbus, rented by the state, would pull up across the street from the homeless shelter on our block called Baloney Joe's. The doors opened up to freedom, cascading patients who'd not been out of an institution for 20 or so years. "Here's your new home," they were told.

Homeless activists made them stop that madness. A more subtle route was found for discharging patients during those rounds of cutbacks. Our neighborhood became a psych ward.

My grandmother's spirit is probably still out there somewhere.

I found my maternal grandmother's Essence-Spirit in those acupuncture clinics. She taught me that there is a lot that we can do for more sane, loving and humane care of the lost among us. The methods in Chinese medicine are simple, effective, safe and teachable. They are needed.

08 August 2010

On Teaching

After my father died, I started teaching.

Nothing made me wait -- or so I thought.

Within months of his funeral, I taught my first class on ear acupuncture. I was as excited to teach acupuncture when I began in 1994 as now.

I started teaching observers soon after I began my public health acupuncture work. I was excited about what I was learning and experiencing while practicing in that setting.

I'd originally thought that most of my learning would occur in my private practice, tucked away in a woodlot on the main road near my house. There I had the chance to palpate points, pulses, and watch for changes. Instead, the situations I encountered in the in-patient facility called Hooper informed my practice and challenged me to grow. I took the lessons learned there to my private practice, rather than the other way around as expected.

Hooper was named after the last man to die in Multnomah County jail of alcohol-related causes. Cops and public inebriates are a bad combination. Alcohol can blow open the solar plexus center, creating a veritable superman. Such a knight-errant could walk right up and assault on officer of the peace, who would not take to it kindly. While under the influence, their aim was dead-on --whether choosing a physical or emotional blow.

I worked in the Drunk Tank while working on getting my license in Oregon. It was an eye-opener. Alcoholics enjoy their 'eye-openers' in the morning. Our work began in late afternoon, when our wagon went out on calls with paramedics to harvest the fallen drunks.

This was after the Viet Nam war, and already by then the self-inflicted death rate among Nam Vets surpassed the war casualty rate. More of our veterans from that war committed suicide by various means than were felled by the enemy.

Volunteer activists saw their plight, and started the Central City Concern. They eventually were given various public roles by the government. It seemed that the marginalized and homeless population were a little more receptive to a non-governmental organization. CCC became the largest provider of 'Single-Room' housing in Portland, for those one step up from homelessness. This put them by default into the role of healthcare, job training, and a host of other projects.

CCC discovered early on that group acupuncture helped fill many gaps in their system --and in a cost-effective way. Ear acupuncture improved completion rates for the 5-day residency program at Hooper from 34 to 85%, while the 6-month return rate dropped from 25 to 6%. That was from 3 months of volunteer acupuncturists using a simple ear acupuncture protocol. We could see 10-15 patients an hour easily.

Acupuncture helped addicts to wait--the hardest thing for some of them to do. How do you tell a 17 year-old to wait all day in a lobby to see the nurse, while their withdrawal is just starting? It's odd, but putting needles in their ear helps just that.
It reduced fussing and fighting among patients. It empowered nurses and staff to feel that they were in a place that was using new methods like acupuncture to treat an old problem. When they asked a patient to get some acupuncture and it worked, they felt doubly proud. For example, a nurse would tell me that several patients' blood pressures indicated a potential seizure: I'd go treat them and change the numbers.

Using drugs to treat drug addiction is problematic. I have yet to see one that really works. The message it sends is not what anyone is really comfortable with. Psychiatric meds certainly work, but it was amazing to see how quickly patients changed once off their street drugs. Somebody might act crazy, until you dried them out for a few days. The social system had a hard time determining who needed what --detox or psychiatric hospitalization.

So there was a lot to talk about with students. Just walking in the door was entering another world. If a student had an alcoholic mother, for example, she'd be shell-shocked on the first shift. The brother or sister in trouble back home was there to be seen --in the full glory of their pajamas. I felt bad for those students. Some could never come back: it was too much.

We were all drawn there for a reason. For me, maybe there were some people there a little like my father, who drank heavily at times and was also a jaded veteran.

What were we really treating? Maybe an aspect of ourselves, a primary relationship. Someone we wanted to know better, or had a charge around.

For me, I was treating my father, or a lot of people like him in some ways. I was understanding, coming to terms with, and changing that aspect.

  

07 August 2010

Why Not?

Or-- The Best Treatment I Ever Gave

The last post looked at external resources, how their simplicity and beauty can be overlooked in acupuncture. This one looks at internal inspiration, its ideal conditions for ripening, and how Mind, Ego, and collective experience combine into the amazing experience of doing acupuncture.

After a few years of practice, I had the 54-bed facility to myself. I'd spent a year being encouraged and coached by a dedicated team of acupuncturists: David Eisen, Arlette Siekmann, Sheila Moran. They were patient and kind co-workers and teachers. My boss, David, went on to develop an out-patient clinic that I'll write about later.

I'd arrive by 8:15 in the morning after a killer commute to disappear into a our blocky, brick building. Then it was time to take blood pressures, orient new patients, serve up some herb tea... then head upstairs for the main event: treating 54 people, ostensibly there to detox for 5 days or more.

One man I'll never forget. He had a wiry intensity, a kind of integrity despite his compromised circumstances. We had the best and the worst come through our doors, and he was on the brighter side of that continuum. People in Recovery can emit a kind of light. It might turn on after several days or several visits, but once it's on, you can't miss it.

His light did not have the fierce shine of newness. It was there, but dimmed by a struggle with something else, a physical malady.

He was sitting in one of the big green vinyl chairs in front of the TV (the arena for my finest treatments, it now appears). He told me he was scheduled for surgery the next day to remove his prostate. And that he had every urinary symptom known: painful, dribbling, burning, frequent, urgent, and bloody.

I was making my rounds. I was a young man around 30 with limited training and a few clinical references. The best part of my training was hiking for about an hour, then doing acupuncture on peers in some remote canyon or mesa in Northern New Mexico.

When this patient told me his plight, I was moved by both the novelty and intensity of his symptoms, and the earnestness of his approach. When people 'hit bottom,' it can be a fertile ground for healing.

I'd treated most of the other patients, already put in their ear points --I was warmed up, like after those 3 mile hikes.

Instantly, an idea to treat him arose in my mind. It was a single point near the nail bed of his left ring finger. But it's not a conventional nail bed point, also called Well points in the Chinese nomenclature, which sees the channels as a waterways. Instead, it's a few millimeters above the known point.

How did I know to use this point?

I don't know--it came out of nowhere.

What else to do the day before surgery, on a patient with every possible symptom on a body part?

The beauty was this: nobody was there to ask me, "Why? How come? What is this point?"
I'd not started teaching yet. I was absolutely alone, just myself and the patient, lost in a sea of non-onlookers, waiting for the next smoking break prior to group.

He had his standard detox ear points in already, a set of 5 needles popularized by the National Acu-Detox Association. They were both wise and coyote-like enough to choose the acronym NADA, which means "Nothing" in Spanish.

I put the needle in, and went on my way, putting more needles in other patients, taking others out when someone was restless and needed to go back to bed or stand by the smoking room door to be the first one in, or what-have-you.

After about a half hour, he flagged me down with an urgent look in his eyes, like a deer in the headlights. "Gotta go!" he said. Out the needles came, and he went to the restroom.

He returned some minutes later, to announce that every urinary symptom was gone. The look on his face was glowing with some amazement but mostly certainty.

His surgery was cancelled.

We did some follow-up treatments the next several days. Everything improved, and symptoms were clear after 2-3 treatments. It seemed odd that I'd treated him for at least several days prior to the breakthrough, with no effect.

Some might interpret this as placebo, but he had needles before this, twice daily for several days.

What was different was the one needle on his ring finger in the special location.

Afterwards, I considered the point a lucky gift, and used it on other men with urinary issues. I pushed my luck, and used it as a first option on every single one. Naturally, as other acupuncturists know, I had a run of men with urinary/prostate issues. We acupuncturists often find 'runs' or synchronous patterns of patients with similar conditions in our practice. Years later, my own father died of cancer, and the prostate was a major area for it in him. But these treatments never worked as well. The effects were, well, we could say dribbling at best. They were enough to keep me going.

I gave the point a Chinese name. I told my students to find new acupoints like this one, since if we each found a new point, wouldn't that be wonderful?

Some ego!!

Almost 15 years later, I was learning in a program that bothered to teach the acupuncture classics. OCOM realized when they set up their clinical doctorate program that very few times in acupuncture education were students regularly exposed to the seminal classics of acupuncture.

Dr. Tran, Viet-Dzung was our first teacher. He'd translated with Dr. Van Nghi as his student for 40 years. I first saw him in our little 'barefoot doctor' acupuncture school in Santa Fe in 1985. These acupuncture scholars came in their sharp French suits. We sat on the floor, and they talked to us as brothers. They were overjoyed with what we were learning. They left us with a Zen-like koan, "The yang channels carry water, and the yin channels carry fire."

Twenty years later, after Van Nghi died, Tran knocked himself out for 3 days solid as our keynote speaker. He poured himself into the teaching, giving his all. Most of my peers didn't get what he said, but I was entranced. He answered the riddle of the 'magic' point that worked so well on the one patient.

It was not a new point, nor 'my' point at all. No. I'd simply re-discovered the classical location--different from what I'd learned--for the Well points. Tran described these Well points as in the depression in the bone next to the nailbeds. What I'd needled was a 'classical' location of the first point on the San Jiao channel.

This year, I had the pleasure of reading Lorraine Wilcox's translation of the Ming Dynasty classic of acupuncture, the Zhen-Jiu Da Cheng/Acu-Moxa Great Classic. In it, she bravely translates the original point locations. Those for the Well points on the nailbeds as something like, 'one green onion's width from the corner of the nail bed.' This moves it several millimeters up from the modern textbook location. (Now, I need to do the cross-cultural anthropology of what green onions were like in China, especially in the Ming Dynasty!)

Why does this matter? Because all of our conventional textbook locations for this category of points, (one of the 5 major Phase categories at that) may be inaccurate. My treatment on that gentlemen may not have worked if I were better trained, had a supervisor correct me, or a student to impress, or doubted my intuition.

This case may illustrate some optimal conditions for healing:
  • a patient who is doing their work, working a spiritual program daily
  • a practitioner who is trained enough to know what their doing, but not so much that their intuition is closed off --and is not self-conscious
  • a resonant response by the universe
How did I know that one point would have a chance of working, on one channel and on one side of the body?

Later, I learned about the San Jiao channel, and more about left-right dynamics.

There is nothing like a burst of inspiration, especially when somebody really needs it and is 'ready' for it (something we can't determine as practitioners). When it takes 14 years to understand it, it is even better. The universe is a generous place.

02 August 2010

Why?

How is it that both I and my students seem to get the best results when we don't know what is going on?

The interns I supervise are getting great results in clinic. It's their first month in action, and they are uncomfortable with the "I don't really know what I'm doing" phase. But patients are saying things like, "This is the best I've felt --ever."

Give them a month. Once they start to think they've figured out what's going on ...or--worse--take credit for it, results diminish.

There is nothing like Beginner's Mind.

When I was learning the most acupuncture, I was seeing up to 70 patients on a good day. These were public health settings. I was the only acupuncturist in a 54-bed facility. Funding cut us way back. I had no time to think while working. I'd go home, look up treatment ideas for what I'd seen that day, and try them the next.

Every clinician runs into their walls. Every modality has its miracles, but there are some patients or some issues for which nothing seems to work.

That's when we dig deeper, into resources both inner and outer. The latter are books, articles, websites, or something a teacher said. The inner aspect is intuition, ideas that seem to come 'out of the blue.' We don't know why.

Acupuncture is the opportunity to develop both.

I'd treat patients for conditions we'd never learned about. Improvise the best I could, read up, and improvise again.

There was a man in terrible pain from pancreatitis. I used every Spleen point I knew, since in TCM this is paired with the pancreas. Ear, back, scalp, legs: No luck. Every day, twice a day for several days.  I was stumped.

I felt some solace that pancreatitis has no treatment: no drug can touch its pain. And its pain level is 'right up there with childbirth,'  a proverbial ten out of ten.

I went home and looked in my best clinical reference (one not used much where I teach) called Acupuncture: A Comprehensive Text. The index had a reference to pancreatitis in it's tiny #6 font. There were a number of points, none of them related to the Spleen channel: PC 6, GB 34, ST 39, 36.

I'd given up. "This will never work," I thought. I commented to a student, a visiting MD, that this case was an example that "acupuncture doesn't always work." What wisdom!

But I was soon wrong. I did the recipe points: The patient went to nirvana in ten minutes -- he smiled blissfully. The doctor went white with shock.

I was puzzled. Who knew?

The next question, one that can take years, is figuring out how a set of points worked. Where did these come from--which classic? We don't always know that, either. 

If a protocols works just once, I never forget it. They are seared into my memory.

Once I figure it all out entirely, something else comes up to keep me in a certain zone, one of not knowing. This field returns us back to the Beginning. It's part of how it works.