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. 

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