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Acupuncture Today
January, 2010, Vol. 11, Issue 01
 
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When Good Practitioners Do Bad Work

By Felice Dunas, PhD

Have you ever blown a treatment? I mean messed up royally so that your patient felt worse as a result? I have. It's important to know that we all make mistakes. Even those of us who have been in practice a long time.

I thought you might get some relief by hearing how I have messed up my patients. If I can share my mistakes with the entire country, perhaps you can confide in a colleague who can help you get through it. As I learn to improve myself as a practitioner and can see the cosmic humor in my mistakes, perhaps you can be gentler with yourself when such events occur in your practice.

Three memories immediately pop into my head. The first occurred when I had been in practice 15 years, the second and third happened a few months apart and just a few years ago. That means I was about 37 years into my professional life and still being given the opportunity to screw up. My batting average has been really good for a very long time. But because I rested on my laurels a little too much, the spirits of our ancestors struck out and reminded me that I have a long way to go before getting cocky or even overly comfortable.

Charles was very tentative about his first treatment. He had asthma and his attacks were getting worse. He was on the strongest medications available and their effects were lessening. Desperate, he had heard about my practice through a friend and was willing to give acupuncture a try. This was back in the mid-80's. Acupuncture was not as popular as it is now. We were still considered weird voodoo doctors, and patients rarely came happily or optimistically. Most were at the end of their options and had still waited as long as possible before begrudgingly consenting to come for treatment. Charles was no exception. Because he considered acupuncture to be a slightly lower risk than not breathing, he was willing to give it one try, and one try only.

I didn't find him to be a complex case. He was a clear-cut, kidney-yang-deficiency asthma patient. The kidneys weren't heating his bodily fluids effectively. Thus the wondrous steam-like elixir that the lungs can easily distribute was not properly heated and prepared. The heavy, more viscous fluids would build up in his lungs, causing phlegm, hence asthma. His lungs were tired, but that fatigue was symptomatic, not causative. I gave him a kidney qi and yang treatment, adding some liver-organ points to enhance the effectiveness of his medications and a few local lung-tonifying points to address their fatigue. Nothing to it. I was confident that the vast improvement he felt when the treatment was over would inspire him to continue, which would lead to healing of the condition. He was just about gleeful as he walked out my door.

How surprised was I when I received a call from Charles at the end of the day. He was furious at me. "How could you?" he bellowed through the phone. "You left a needle in my chest (Kidney 22) and now I am so sick I can barely breathe. I have to go the hospital. I will never touch acupuncture again!" Had he just left that needle in a little longer, the cycle of tonifcation and sedation would have gotten to just the right place again, and his lungs would have cleared up. But he didn't know that and he certainly wouldn't have listened if I told him. I intentionally pulled the other lung-related needles out as the qi was nearing full dispersal for that cycle. Because I accidently left this point in, it began drawing qi towards itself once again. As the point was reaching full tonification, the excess qi was causing his symptoms to appear worse than ever. He was right to be mad at me. In my 15 or so years of practice, I never before had a patient walk out with a needle still inserted. His shirt was covering it, and I just forgot that it was there. I had forgotten to write it down in his chart. It was a simple mistake caused by a very human person. How sad that it was my destiny to turn him off to our work.

The mistakes that I made with my other two patients were caused by my not recognizing their sensitivity. I over-treated them, causing each to have symptoms exacerbate following treatment. These mistakes were out of character.

Kimberly was a young woman whose husband, Jack, was in medical school. I offered him a treatment as he studied for cumulative exams. His wife came along. After needles were inserted and he was resting comfortably, I offered her a treatment. She was young and strong, but under stress with her husband's schedule and family issues. She wasn't sleeping well and was getting mild but frequent colds as a result. I didn't give her quite the concentration I should have. Maybe I didn't listen deeply enough to her pulses. Perhaps she was too easy. The treatment was designed to be too superficial and gentle to be of any concern. Well, she got clobbered by that bare handful of little needles. She was awake for two consecutive nights and felt a dramatic exacerbation of her concerns. How is it that someone who relies so completely on her medical intuition can use it so incorrectly all of a sudden? There was no strange wind blowing, no blue moon. I didn't understand how I could have been so heavy handed. It's not like me to over-treat, and the work I did was so gentle. But I missed the mark.

The last was a treatment given to a woman in her 70s. Gayle was a psychotherapist and Taoist meditation teacher. She taught qi gong classes. I had known Gayle for many years and always wanted to have the privilege of working with her. I was flattered and honored when she asked me to help her.

It can be wise to treat older bodies with greater gusto as systemic qi weakness requires additional stimulation. I pulled out the stops and dove in to a strong pain-relief treatment using local, channel and systemic points. But her body was stronger than most women her age, and stronger than many younger women as well. Her qi gong work was successful in lowering her biological age. Her post-treatment experience was that her muscles tied up in knots and her pain dramatically worsened. She had to go see a chiropractor three times to relieve herself of all the pain I put her in. That really hurt my heart.

These errors reminded me of my humanity and inspired me to ask questions. Confusion is an important tool for teaching this medicine, and with each of these incidences I was righteously confused. Had I become too sure of myself? Perhaps I had forgotten that my job was to get quiet, listen and get out of the way of the ancestors who bless my work. I act on the wisdom that is softly whispered into my consciousness when it is time to insert needles. I am good at this. I am not lazy and I pay close attention. But the muses wanted me to remember humility. The medicine is bigger than I am, no matter how proficient my skills. "Never forget that you hold the medicine only momentarily as it passes from the tao through your hands and needles to those in need," my muses told me. "You are just the vessel for the wine. You are not the wine itself."

Be straight-up honest for a moment by asking yourself this question. Do you get more by being involved in the holiness, the genius, the blessing of this work than the world gets from your practice of it? I think I do. Even though I have participated in more miracles than I can remember, I am the winner, the grateful one. I get to live here while patients only visit. My truth, my path, my greatest joy and my destiny, like yours, is linked with this astounding phenomenon we call Oriental medicine. This stuff can't be an accident in one's life. It is too complicated. It requires too much sacrifice. Its presence can be demanding. But its gifts are countless.

All the same, making a big mistake such that a patient suffers doesn't feel good. Nor does it reflect well on one's practice. But, simply, you are not alone, you are human, and sometimes patients serve as teachers and give you more than you give them. Such is the way of things. Do the best you can as a practitioner, and listen to the words of your teachers and your intuition. Study the books hard throughout your career. You have it inside of you to be a brilliant doctor. And we all make mistakes. Every last, shiny, divinely blessed one of us.


Click here for more information about Felice Dunas, PhD.

 

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