Chinese & Asian Medicine

Working in the Realm of Really Sick Patients

Bruce H. Robinson, MD, FACS, MSOM (Hon)

Last year while visiting a large hospital in the Midwest, I made rounds with Michelle, a licensed acupuncturist who had hospital privileges to receive referrals by medical doctors for their inpatients to have acupuncture. While on rounds, we visited with Tamara, a 32-year-old registered nurse who was receiving daily acupuncture treatments. This outgoing and appreciative young woman had recently come back from death's door. She had developed a staph infection under her skin in the back of her neck that had abscessed and formed a carbuncle. We can surmise that she got this infection as a result of working in the hospital taking care of patients, as it was a resistant staph; the kind that tends to hang out in hospitals.

The infection from the back of her neck then spread to her heart, causing an acute bacterial endocarditis. Staphylococcal bacteria growing on the heart valves then spread throughout her body, causing multiple brain abscesses which led to a massive stroke, and also embolizing to the major arteries of the body, causing expanding bacterial aneurysms of her right internal iliac artery, right femoral artery and right popliteal artery. All of these aneurysms had to be resected before they burst, and replaced with Gortex grafts. She went unconscious following her stroke and her heart began to fail. Treated aggressively with the strongest IV antibiotics, proper supportive care with a volume respirator, and drugs to strengthen her heart and reduce swelling in her brain, she recovered. It was in her recovery phase, when she was still pain-ridden, tired, partially paralyzed on one side and depressed, that her doctor wisely called for acupuncture treatments.

I observed Tamara's acupuncture treatment on the day I joined Michelle for rounds and heard Tamara sing the praises of her Oriental medicine treatments. "These treatments have made all the difference in the smoothness of my recovery," she said to me. Her voice was strong and her outlook bright. Her discharge was scheduled for the following day, where her husband and two young children awaited her return.

There is a vast number of acutely or chronically ill patients that need the help of an Oriental medical practitioner who are not yet receiving it. We all know about the extraordinary benefits of Oriental medicine in treating patients who come to the clinic with chronic diseases. The next phase of Oriental medicine practice in America will be in treating more seriously ill patients; those who are too sick to walk into a practitioner's office. You must go to them.

As a surgeon, I spent my professional medical career working in a hospital setting, because that's where major surgery is usually performed and that's where patients are admitted who are in need of such surgery. Many of my patients suffered from acute abdominal problems such as appendicitis, acute cholecystitis, intestinal obstructions, bleeding or perforated peptic ulcers, or complications of Crohn's disease or ulcerative colitis. In these patients the need for surgery was clearly apparent. It was often urgent, or even immediate. A high percentage of these individuals would have died without this surgery.

Other patients admitted to the hospital on my service had a newly established diagnosis of cancer, such as carcinoma of the colon, ovarian cancer, breast cancer, thyroid cancer, or other types of malignancy. Such patients have their best chance for a cure if the cancer can be completely removed surgically, and that's where I came in. I performed thousands of such cancer operations during the 30 years of my practice. Many of these patients were cured of their otherwise life-threatening tumors. In other cases the surgery was too late because the cancer had already spread to other areas. In such situations, I always did what I could to ameliorate later suffering and prolong life.

Hospitals are crowded with such people, as well as many other non-surgical patients who would benefit greatly from Oriental medicine. Many suffer from severe heart disease, strokes, COPD, pneumonia of various types, pulmonary fibrosis, widespread autoimmune problems, labile high blood pressure, severe diabetes mellitus, complications of pregnancy, as well as many other conditions. Those who are coping with these aggressive illnesses are often very frightened and frustrated.

More heartbreaking still are the children's hospitals which are sadly populated with patients suffering from leukemia, brain tumors, osteogenic sacoma, brittle bone disease, cystic fibrosis, juvenile cancer of the kidneys, and other severe medical conditions that are mostly found in the very young. It is sadly true that next to the elderly population, the most likely group to develop cancer is infants and small children.

There is an indescribable pathos in dealing with these unfortunate individuals, but also much satisfaction in being able to comfort them, and genuine elation when they are cured. One of the greatest achievements of Western medicine in the past few years has been the discovery of cures for many childhood cancers, including acute leukemia, which used to be rapidly fatal. Such cures, when they occur, are miraculous. Many other children are not so lucky, as there is no cure for them.

Whether adults or children, our goal should be to see that all these acutely ill patients are able to receive Oriental medicine in addition to their Western medical treatments. They all need acupuncture and/or Chinese herbal treatments. All of you who are Oriental medical practitioners should ask yourself: what can we do to pave the way so the seriously ill can receive our treatments?

The more an OM practitioner knows about Western medicine, the better they will interact with the professionals who care for these really sick patients. Such an informed practitioner can then successfully reassure doctors and the patients themselves of their competence as a OM practitioner; one who also knows what's going on in the world of biomedicine. If a patient has lupus, the doctor will be more likely to ask for your help in pain management and improvement in the patient's stamina if they realize you know something about the biomedical aspects of lupus. Gradually, the doctors in your community will come to realize that you are able to synergize with them for the benefit of their patients. Their fears will be resolved that you might steal their patients away from them. They will see you as an asset; not a liability or a threat. This is when your own practice will become more fully successful. This is when it will have the greatest potential for helping others.

Your should seek out and attend seminars that are given by Western medical doctors specifically for Oriental medical practitioners, in order to expand your knowledge of biomedicine. Textbooks are now available that also bridge this gap, written specifically for licensed acupuncturists, that explain biomedicine in the appropriate depth for it to have the most meaning and the greatest retention by an LAc practitioner. Distance-learning modules, which include CDs that can be listened to while driving in your car, are also available. Time spent in studying such materials will be rewarding to you and your patients.

When you feel ready to do so, apply for privileges in a local hospital near you. Hospital administrators are now more open than ever to admitting licensed acupuncturists on their staff, and others who are not yet open to granting such privileges stand ready to be enlightened. The time is now to expand our noble profession of Oriental medicine into this new arena where it is so needed.

October 2010
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