Archive for tag: classes

Jabbing Nerves with Needles

"I hope the points aren't just nerves being shocked by needles," I said to AOM classmate Irene. As one of the few AOM students who originally came into the program to focus on herbal preparations and dietetics, I felt particularly uninformed about this whole acupuncture thing. So, there in one of the first courses on the theory of point energetics -- what the acupoints do and how they do it -- I finally vocalized, albeit in a whisper-like fashion, my growing fear: Maybe there's no meridian or point energetics beyond just sticking a needle into a nerve and hoping it stimulates something productive in the patient's body. Sure, that might still help, but it certainly doesn't have the mystique that interested me in the first place.

2014-03-14_ancient"Moving blood and qi," "balancing energy," and "harmonizing yin and yang"...these concepts are intriguing, promising, and yes, darn near magical in my opinion. If we're just jabbing people with needles and shocking them wildly, then I'm not sure I have the buy-in that a 3-year master of science in oriental medicine degree requires. So there I sat, giving power to my secret fear by speaking it aloud, not knowing what Dr. Yihyun Kwon was going to say to pull me back over to his side of the fence, and hoping that there was something more -- more ancient, more Daoist, more qi-related in any way. (Spoiler Alert. Dr. Kwon wins!) 

Irene surprised me with her response, which I recall as being something along the lines of, "So what if acupuncture is just stimulating nerves with needles?" How could she be so callous to this deep fear that I'd been subconsciously fostering for the first three months of our program? Didn't she understand that I was sitting there, suffering in silence, desperate for some oriental medicine justification?

What Dr. Kwon went on to explain in that first Energetics class, and even more so the following year in Neurophysiology of Acupuncture class, was a concept that bridged the gap between the mysticism and the mundane. He simultaneously satisfied my cravings for evidence-based medicine as well as ancient tradition. Dr. Kwon = 2. Juli's irrational fears = 0.

Photo of Dr. Kwon with studentsYes, he explained, some points are located right beside or above a nerve -- grazing it ever so slightly and eliciting that loved or hated sensation we call "de qi," when energy arrives along that meridian. Further research and dissections have confirmed that many of those points not located at a nerve are actually located exceptionally close to an artery or vein. Here's where he blows my mind in 3...2...1....

Next, he tells us that these vessels and other structures harboring acupoints are essentially wrapped up in nerve fibers themselves. Yes, readers, we've come full circle in Juli's understanding of neurophysiology (which doesn't take long). Many acupoints are on a nerve; those that aren't, still kind of are.

And now to process this information.... Do I hate this answer? Does it ruin the grandeur of ancient energy meridian theory? Nah. I took the news fairly well, all ignorance and expectations considered. In today's health care climate, I like that modern science keeps proving acupuncture theory to be true. Time and time again, I see modern western research pointing to the validity of traditional medicine. At the end of the day, or the century, who doesn't like being told, "You're right"?

Doctors and Patients

What's the appropriate relationship for doctors to have with patients? How do you know when it's OK to accept a gift, meet for a coffee, or call a patient at home? What's the difference between being empathetic towards a patient's horrific home life and being taken advantage of by a patient who thinks you are her new best friend? 

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In a recent "Doctor and Patient Relationship" class with the talented Dr. Dennis Delfosse, we explored the all-too-common gap between what patients might be experiencing in life compared to what we assume their lives are like. The point of the discussion was that everyone is dealing with something. Maybe you've heard the saying "Everyone is fighting a battle that you know nothing about," and its usual ending, "...so be kind." But are you?

Do you, interns of acupuncture and oriental medicine, treat your patients as important individuals, worthy of your time and energy? Have you ever groaned when you discovered that you suddenly have an "add-on" patient halfway through your shift? Do you dread treating that "difficult" patient who keeps scheduling with you, stealing your qi? Are you counting the minutes until your shift in clinic is over for the day?

Much like the general population of American doctors (of whom only 54% would choose medicine as their career if they could do it all over), practitioners of acupuncture and oriental medicine might find themselves unfulfilled, unchallenged, or unhappy at work from time to time. How can we refocus, reframe, and recharge ourselves and our passion for helping patients find balance and wellness? We must revisit our goals from time to time, remembering why we chose our respective field in the first place, realizing that our next step might be in a slightly different direction than we originally planned. It's OK to change treatment strategies, to move towards a different specialization, or to study under a different clinician this trimester.

2014-01-23_wheelOne way to change your personal energy dial-back to "Positive" is to remember that the patients, their oftentimes unfortunate circumstances and their health needs, are the reasons that we're here. They aren't in the way, they aren't the reason we can't finish our paperwork, and they aren't the problem. Helping them is the whole picture. The key is figuring out how to strike the perfect--or at least, a workable--balance with each individual patient to optimize their satisfaction and yours.

Do you want to make your patients happy? Start by being happy yourself!

  

References:

Physician Frustration Grows, Income Falls - But a Ray of Hope. Medscape. Apr 24, 2012. Retrieved 1/18/14 at http://www.medscape.com/viewarticle/761870