It’s not often that someone goes into panic in the office. Since the work is with needles and needles are sharp, I’ve tried to minimize the “clinic” component of the office. Although it’s clearly a professional space, it doesn’t look like a medical office. The only give away is the table. Fortunately then, the air of the room is of non-judgment and complete patience. The resulting absence of pressure on the patient to be in any particular state can be disarming in the most positive sense. People find themselves relaxing quickly upon entering the room, and very often a patient—even a new patient—will have a vitally important emotional release within a few minutes of sitting on the sofa while apologizing and being unable to explain it.
So it came as a surprise yesterday when, as I returned from washing hands ready to needle, I found my patient (who was supposed to be lying face down) with his hands on the table, arms straight, pushing his head up toward the ceiling. It was to be his third treatment. He had an anal fissure and was facing surgery. One my favorite things to do is help patients avoid surgery, where the surgery is to eliminate a symptom rather than the cause. Kathleen always forwards me those emails. Before his treatments started I had an email exchange with him in which he explained that he’d always had trouble with that part of his body whether it be constipation or hemorrhoids, and now this. I’ve treated anal fissures before and in each case, the patient had a Spleen collapse with painful, often bleeding, hemorrhoids, cold hands and feet, gas and bloating, a tendency to bruise, foggy thinking, and underlying the whole scenario, a diet of salads and cold foods from the refrigerator. Even though one of the most crucial things I remind practitioners about is the importance of never having even a hint of pre-diagnosis before you encounter a patient, I have to admit that before I saw the patient, in the back of my mind, I was thinking this one would be easy. Every time I do this, I am wrong, and yet, after all this time, I can still fall into the assumptions trap. I try to catch myself before I do it and then forgive myself for being a flawed human. As they say in the mafia, whachagonnado? I’m embarrassed to say that in the initial consultation two weeks ago, I had expectations about what I would find in the pulses.
The pulses were the opposite. The direct opposite. The Spleen pulse was robust, wide, confident, strong, the Kidney Yang pulse (right chi) was ebullient and contained in the deep level (below the 12 bean level). The Spleen ascended strongly to the Lungs. Wow, I thought to myself, what a surprise…no Spleen collapse here. No cold. No downward vectors. No sinking Spleen Qi here. After a private admonishment for breaking a fundamental rule, that is, never to make assumptions and never to diagnose by symptoms—perhaps the most important things my teacher gave me—I went to the left wrist. The Liver pulse felt normal, wide and generous, not tight. The Heart pulse was not dispersing— the first pathology I found in the pulses. The Kidney Yin pulse was slightly tight, which is normal as the Kidneys hold consolidated Yin. Can this be a Heart or Shen issue? And then I found it, the Heart and Kidneys were not communicating. If I pressed down on the Heart pulse, I did not feel a response in the Kidneys and if I pressed on the Kidney pulse I did not feel a response in the Heart. But something else happened as I was making that examination: the Liver pulse became extremely tight. If I stopped the examination, the Liver pulse went back to normal. And then as I retested the Heart-Kidney communication again, the Liver tightened again. It was time to get him to talk.
“Thanks for letting me take your pulses. Before I met you today I was thinking that it was likely that you had certain habits, but I see in your pulses that you don’t drink cold water, you don’t eat salads, you don’t eat directly from the refrigerator, you don’t have gas or bloating, you don’t have cold hands and feet, you don’t bruise easily, you don’t get cold easily, you don’t tire easily, your eyesight is good and you can think straight under pressure.”
“Yes, all that is true. Amazing!”
“It’s all right here in the pulses, and yes, pulse listening is amazing: you’re telling me all that. But what you’re also telling through your pulses is that there was some trauma somewhere. How long have you had hemorrhoids or constipation?”
During the conversation that followed, we traced back to the beginning. He had constipation in early elementary school. When I asked him what was going on in his family at that time he told me that he had been very happy and treasured as a little boy but suddenly, when he was six, his grandmother and grandfather died suddenly at the same time and his mother couldn’t cope and went into deep depression. His father traveled often for work and simply wasn’t there. He remembered trying so hard to keep his mother communicative, asking her to play and trying his best to stay by her side. I gently suggested that his anus might have been the only thing he could control. He raised his eyebrows and then nodded. It made sense to him. The hemorrhoids had nothing to do with Yang collapsing or dampness, but everything to do with trying to gain control. This would explain the extreme tightness, the hemorrhoids and ultimately, the fissure.
The first two treatments were for shock remaining in the body, dating back to the first cycle of 7 and 8, to correct the suspension of Heart-Kidney communication. For that I chose Yin Wei Mai. The first point is KI-9, The Guest House: like visitors to a guest house, events occur but then they pass and it is safe to return to peace and calm. After the second treatment he reported that in general he was feeling unusually calm. He was doing superbly.
When he came in today for the third treatment, I asked how he was doing. He said that on some days the pain was greatly improved and his anus felt much more relaxed and he had had some bowel movements that were not excruciating. I noted the intermittent nature of the improvement and asked him was the pain also moving from side-to-side. He said, “Yes. I thought that was strange because the fissure is only on the left.” When a patient reports symptoms flipping side to side, you’re in divergent territory. The pathology is finding its way to the exterior. In this case, the deep anxiety of the traumatic event in childhood is working its way into the sinews via the divergent channels. The only divergent that visits the anus is the Bladder divergent. That’s where we were going today. The pulses showed improvement in the HT-KI communication but Bladder divergent also treats that very communication. Everything connects so beautifully. I asked him to lie face down on the table and went to wash my hands.
When I came back and saw him arched upward, as in cobra pose, I asked was he uncomfortable putting his face down in the face cradle. He said he was frozen and couldn’t move at all and that he was overcome with panic. I offered to help him off the table. He said he’d be okay. I asked what had happened the last time he had a medical appointment while lying face down. “Oh that was the worst experience. A month ago, the proctologist examined my anus and it was so painful and the fissure got stretched and then he said they would have to do surgery to cut the muscle to relieve the tension otherwise the fissure would never heal.” I reassured him I would go nowhere near the anus. I hadn’t even intended to and I had told him I wouldn’t but he hadn’t absorbed it. What’s difficult to get across to people is that energetic medicine is elegant in that the channel is activated everywhere it visits. It makes its adjustments throughout its trajectory. Needling the actual site of pain can be crude and certainly would be in this case. In other words, you don’t need a needle anywhere near the anus to treat the anus. If we were in the desert with one needle and I had to treat this man, I’d needle BL-40 because that point releases the anus. Going there literally at, say DU-1, would be felt as such an invasion, and it would only serve to tighten it further regardless of the description of the point function. It’s never compulsory to treat the location of the illness—that’s completely optional—it’s the channel that matters.
I reassured him again but he was not convinced. After offering to help him off the table again, I repeated that I wouldn’t go anywhere near it. Then I went to the cupboard and pulled a dozen sheets, half unfolded them and put them over his body between DU-4 and BL-40 so he had a huge protective buffer, a reassuring weight. I put one hand firmly at DU-4 and the other firmly at BL-40 and told him I would not move the sheets covering that large area. Then I sat on the sofa and gently reminded him that the underlying cause was not anal at all. I let him do the calculation in his head. “I’d rather the needles than the scalpel, actually. Let’s go ahead, I’m just so surprised I panicked like that.”
Of course the panic could have been multifaceted, not simply the memory of the doctor’s exam weeks earlier. We could be seeing the pathology lifting, too. But we did get the divergent needled and he fell into such a deep sleep that when I woke him he didn’t know where he was. A true reset. We’ll see how this plays out. Every day is remarkable in channel land.
Practice like nothing else matters, because everything does.