Dr. Yurasek and I scrubbed into the isolation unit, donned our
masks, and needled an in-patient right in her hospital bed. I knew
that shift would be different. It was only my third day, but it
just felt different when I punched in that morning...and I was
Between our usual out-patient pain
clinic cases at Cook County Hospital, Dr. Yurasek, the other
morning interns, and I were discussing some of the more remarkable
results achieved with auricular acupuncture. That's putting needles
on ears, for the laypeople reading today. He told us about a
patient in a wheelchair who rolled in with several bullet wounds
and walked out the same day after the acupuncture
treatment. We told him about patients whose pain level went from
10/10 to 0/10 after their acupuncture treatment. It was basically
"one time at band camp" day at Stroger.
Dr. Yurasek was explaining that these types of staggeringly
effective results are the reason that acupuncture has been making
its way into the world of western medicine. Specifically, he said
it was the "portal to acupuncture ecstasy." That's actually the
start of an entirely different "one time at Stroger" story from
last week... but we aren't talking about that one here.
The point was that with the obvious decrease in patient pain
after a 10-minute needling and tui na treatment, it's hard
to shut the door in the face of the acupuncturist who wants to
treat the people. Let us into your hospitals! Share your space with
us, MDs! We were all on board... but how would we get the
administration to give us the time of day?
Then, the call came. The sixth floor
had an in-patient in acute abdominal pain, and her doctor wanted
the acupuncturist to come up and lend a hand -- a hand with a
needle at the end of it. And, since they called Dr. Yurasek, it
would be a big hand with a really, really big needle on the end of
it. We all know he likes those 6-inch needles. I don't even
near-faint anymore when he whips them out and drives them into a
patient's leg. I still look at the other side, though, expecting to
see the needle sticking out back there... I do still do that.
I had just hooked up my patient to the E-Stim machine and dimmed
the lights in her treatment room, when Dr. Yurasek peeked his head
in my room and said, "Let's go." Where were we going? I didn't know
yet. He calmly said, "There's an inpatient on the 6thfloor in acute
abdominal pain, and we're going up to needle her." Alrighty. If you
say so, sir. I walk next to him, fumbling through the pockets in my
white coat, knowing I probably needed to be bringing supplies or
Halfway upstairs he, very casually, mentions that the patient is
actually in an isolation unit, and we'll need to take extra
precautions. OK, ummm, is it too late to go back downstairs? What?
Thoughts of bringing home some exotic virus (other than the ones
I've already had) to my kids were flying through my mind.
Well, now I'm so nervous that I don't even know
where I am. Where are we heading? East wing? West wing? Where's the
lake? Finally, we make it to her unit. The nurses glance up at us
like, hey, no big deal, go on in. She's through that set of doors,
and then through that next set of doors... the ones with those red
signs taped to the window. OMG. "Droplet isolation"! I don't even
know what that means, but I'm nervous. Very nervous. We scrub in,
the nurse finally steps in and helps us with our facemasks before
we tied them on backwards, and basically pushed us through the next
set of doors.
Well, too late to back out now. Here we go. Luckily I had
needles in my pocket. Or he did, I can't even remember. The next 30
minutes were a blur, mostly because I was nearly passing out from
the recirculating carbon dioxide in my facemask. How do people wear
those for extended amounts of time? Clearly I was doing it wrong.
First timers, right here.
"Where's your worst pain right now," Dr. Yurasek asks the
patient, who I definitely thought was unconscious when we first
walked in, splayed out in her bed with the usual useless hospital
gown covering her nothing. "My back, and my leg, all the way down
to my foot," she says. Well, she's conscious. Great news for my
burgeoning anxiety. Abdominal pain, back pain, she's got it all,
but her back hurts the most right now. So, we treat her back pain.
Cue the 6-inch needles into the ancient secret lock-and-key points
now called "Gall Bladder 30" and Gall Bladder 34." Sciatic pain
relief on the way!
The patient is in less pain and is visibly more relaxed in her
body tension. She was in the middle of telling us a story, but then
she suddenly passed out asleep. OK. As long as she's not dead, I'm
going to make it. I run around like a crazy person in a crazy mask
looking for a gauze pad so we could take the needles out, and
finally, our job is done here. We walk back downstairs to the
outpatient pain clinic and resume our day.
"How's your internship at Stroger going," people keep asking me.
Awesome. It's freaking awesome. If you have the opportunity to
intern at Stroger, and you're not doing it, you're missing out.
I get this question all of the time: "Do you acupuncture
Yes, kind of, not really, I don't know what I'm supposed to say
exactly. Do I put needles in people? Yes, of course. Should I?
Well, that's where you've got me. Technically, I'm not a licensed
acupuncturist yet, so I take that to mean that I can't
charge people for acupuncture yet. Is it safe for me to
needle people? Well, I do have my Clean Needle Technique
certificate filed away somewhere....
Do I know what I'm doing?
Can I help someone feel better? I don't want to be a pretentious
jerk and assume the answers are "yes" here, but over the past year
I've certainly had some good feedback. As a sometimes full-time and
sometimes part-time student in the acupuncture program, I'm
somewhere around Tri 5. I've completed a large chunk of the
coursework, the whole observation phase in the clinic, and now I'm
actively practicing on everyone who schedules an appointment with
me in the AOM clinic on campus.
For the next year, I'll continue along in this internship,
enjoying the opportunity to test out treatment strategies, hone my
diagnosis skills, and figure out if "patient consents to treatment"
actually belongs in the "A" or the "P" portion of the SOAP note.
I'll do intakes; I'll form diagnostic impressions; I'll pow-wow
with Dr. Cai, Dr. Stretch, and any other clinician I can find. I'll
needle patients; I'll moxa their cold feet; and I'll do as much
moving cupping as my forearm strength permits. If you're really
special, I'll do tui na and I'll gua sha you
afterward. Want some herbs? Sure, we have raw, granules, or patent
pills. Right this way!
While the patient visits are the most important and most fun
parts of the clinic internship experience, the clinic lottery is
the part that causes the most anxiety among the interns. "Will I
get my same shifts next tri?" "Which clinician will I work under?"
"Which interns or observers will be on my shift?" All of these
panic-stricken questions and many more can be heard all over campus
right now -- the infamous Week 12 clinic sign-up and resulting
lottery has arrived!
interns get to sign up for their preferred shifts and locations for
clinic internships. We AOM students have the luxury of choosing the
on-campus Lombard Whole Health Center clinic or driving to Stroger
(Cook County Hospital) in Chicago for an off-site experience. My
45-minute commute is plenty, so I try to keep it simple and stick
to the main campus. There we all are, fluttering around the sign-up
sheet in the clinic lounge room, which is busting at the seams on a
regular day, elbowing the interns who are actually trying to sit
nicely and write SOAP notes that day.
If all goes well, there is a nice white empty slot shining and
waiting just for you on the day and time that you've decided would
be perfect for your upcoming trimester. In reality, someone else
probably agreed and already signed up for that one. In the end,
many interns are able to secure an acceptable shift and everyone
survives the sign-up week. Some lucky individuals end up in the
clinic lottery, where randomly drawn numbers allow devastated
interns to play a sort of game-show rendition of "This will be your
life next trimester."
In my two years at NUHS, we haven't lost anyone yet! The sign-up
process can be stressful for some, but by the time the next
trimester rolls around, we're all just excited to start treating
our patients and working with our clinicians to hone our skills. I
have one more year of this endearing learning process, and then
it's out into the real world for me (again). No more clinicians to
ask questions of, no more easily accessible chiropractors down the
hall to consult with on orthopedic issues (thanks, Dr. Anderson!),
and no more half-days of work! Maybe this whole clinic deal is
pretty great after all....
You've made the first move. You've called to schedule an
appointment in the AOM clinic. Just as you think you're almost done
with this first critical step, the receptionist throws a massively
important, yet completely unexpected, wrench in your plan. "Which
intern are you looking to schedule with?"
Oh. My. God. What do you do? Which name do you say off the top
of your head? As you feel the pressure mount in those two seconds
of silence on the phone, your brain quickly scans the names,
personalities, general skill levels, and specific competencies of
every student you know at NUHS.
It might not seem like a big decision to some, but for many
patients, your intern will make or break the entire appointment.
I've heard it all in the halls of the clinic, "He got a D on that
Point Location Exam, so I don't want to schedule with him!" "She's
the only one who follows up needling with tui na every
week--I want her!" "I only (or, I don't) want my best
friends seeing me with my pants down." If you're bringing sensitive
people--the elderly or young children--then even appearance might
matter. If I scheduled my kids with a super-tall bearded man, they
might run outside and hide by the swans!
If you haven't thought about which intern you will choose for
your first or next acupuncture appointment, here is a handy guide
to help weigh your options. No, I'm not going to provide a rating
list of each intern in clinic this trimester, complete with names,
pictures, and assorted blasphemies or accolades. Instead, I'm going
to walk you through the options that may or may not be important to
you in your decision-making process.
Image source: www.visualphotos.com
Now for the great part--there isn't one intern who fits every
criteria! This is wonderful news, because it means that a variety
of options exist for each patient who walks through the door. Each
patient is different, and each intern is different. If you've tried
acupuncture once, but just didn't get that great feeling, then try
again with someone else! If you were lucky and hit it out of the
park with your first intern, then stick with that person, or ask
him or her for a referral for another intern who treats in a
Good luck, and happy hunting!
• So What Is Chinese Medicine?
• Jabbing Nerves with Needles
• Mission in Nicaragua
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