Now that I have been in clinic for a couple weeks, I am able to observe the effectiveness of the community style of acupuncture that I am giving. Treating multiple people in the day turns out not to be as hard as I thought it would be, but rather I have found I have a limit to how many people I can see, at this point in my life, without losing quality of care. Going beyond my magic number creates a fast food assembly line aspect that requires a very similar treatment each time. Some practitioners, such as Miriam Lee, swear by using the same few points over and over again. I, on the other hand, do not find that to be specifically helpful to the various patterns of disease I am seeing. So what to do?
My magic number does tend to fluctuate depending on the day of the week (for example later in the week I have begun to tax my energy reserves), how many new patients I am seeing, which clinic I am working in, how complicated the cases are, do I need to constantly reassess in great detail or is it a repeat treatment case, am I adding in more than needles, and so on. Plus, treating nearly 20 patients a day, six days a week is a new phenomenon for me. So far I have seen more patients in 2 weeks than I had in one quarter at OCOM (Oregon College of Oriental Medicine)! I am humbled and amazed at the skills I seemed to have acquired along the way in order to treat in such a fashion (and make people happy with my care)!
Something else I have noticed is the patients expectations are more realistic here than in the west. Back home people want miraculous results after one treatment and do not want to come back multiple times in a week. Sometimes this is due to cost, other times it is due to time availability. Here they come multiple times a week, walking great distances, and get results very quickly, even though they have limited opportunities to change their daily habits, or take herbal medicines long term. I am yet again astonished by the dedication the Nepali people have to their own, and their families, healthcare. I cannot tell you how many times I have heard the story of trying other forms of medicine and pills, but not getting results, it being too expensive or difficult to understand, then coming for acupuncture and end up feeling heard and healed! My heart swells to know they have found one part of the puzzle, and that I have the honor to help!
I have also witnessed the community style offering a chance for social healing. People from different castes, age groups, and language dialects all sit around together, talking, making jokes, helping the doctors or each other’s children, all the while with needles sticking out of various parts of their body. This type of medicine is invaluable to care! However with any great thing there will be difficulties.
Earlier this week, a man came in to the clinic to get help for his family. There were a few things going on and while I consulted with him it became clear that he was looking for acupuncture to help his mother come back from Alzheimer’s. While I have been in many end stage situations, including suicide, I have never had to tell a patient (in this case the son of someone) that acupuncture could not make them better. I explained that acupuncture could offer relief of some symptoms and medication side effects, but not reverse this particular condition. The man looked lost and turned to one of my colleagues for a different answer or confirmation to my words. I could feel tears welling up in my eyes delivering the news , while also feeling frustrated I could not follow through with the conversation. I had to leave him in the care of another due to the three patients I had upstairs with needles in for Bells Palsy. Thankfully, my fellow colleague, Jessica Maynard, had the afternoon off and was able to visit the family and explain the situation with greater care.
It was in this moment that I suddenly felt the weight of being a doctor and primary care physician. People come to us with their health and trust that we can help them, or at the very least inform them of what is happening and offer some suggestions. Back home this responsibility is neither required of us or given to us, and when opportunity presents itself we rarely take it on due to liability, or scope of practice. Yet, we pierce their skin with needles, manipulate muscles, joints, qi and blood with massage, cupping, or gua sha, and give them internal medicines with light, severe, or no side-effects, all which should be followed up with adequate care. On top of this, they get miraculous results for diseases they were told had little to no cure! It is because of my trip here that I feel very strongly that we Chinese medicine practitioners should be considered doctors and primary care physicians throughout the world. Not just because our medicine deserves this respect and recognition, but because our patients deserve the same respect, trust and care they give us with their permission to treat.
While I had come to this decision living in the United States, it is here in Nepal, where my knowledge, wisdom, skills, and compassion has been tested, and what we do reveals just how effective these intricate (and yet simple) techniques can create a better quality of life. Being depended on as the go-to care because other avenues have failed to provide adequate solutions, or cost-effective medicines with minimal side-effects, is not a burden, rather a great honor. It is not that Chinese medicine is just cheap, therefore making it effective (although that does contribute to the answer), but rather it works with the individual body to create homeostasis and health for that person. While some people may present with the same pathology, they do not necessarily share the same symptoms 100% due to underlying conditions or constitutions. Treating here has taught me these skills more than 4 years of education; however the chance to study the medicine in the first place, and pass it on, leaves me with an extreme sense of gratitude.
On a lighter note, the same day I was met with the reality of having to deliver bad news from time to time, a woman patient of mine came back to tell me with glowing, shen filled eyes that she was healed and could now travel back to her village. She bowed several times, saying “Namaste” over and over, and then handed me a bag of fresh fruit as a parting thank you gift. Nothing could have pleased me more. She felt remarkably better, and completely empowered, to tell me she felt our healing sessions had come to an end. That simple exchange reminded me why I became a “doctor”, and instilled in me a profound thankfulness for all that I learn from my patients. As one patient said to me “you do what you do, I do what I do, but we both make the world go round”. Truth to that! --- Seven Crow