:: to the teeth ::    thoughts on social justice, medicine, race, hope and beats

"Another world is not only possible, she is on her way.
On a quiet day, I can hear her breathing." :: Arundhati Roy ::

"The most common way people give up their power is by thinking they don't have any." :: Alice Walker ::
Friday, September 17, 2004  

Integrating Health Paradigms

i was a disbeliever for years, all thru medical school and most of my residency, alternative medicine was a shi-shi woo-woo wealthy person flirtation with touchy feely expensive self-delusionary forays into mind-body misconnection. well, okay, i wasn't really that skeptical but i never saw myself as doing anything more than learning about all "those modalities" so that i could offer "neutral" advice to my patients about utility and efficacy.

during my FP residency training I was impressed and depressed with how little we could do to help the huge number of people with chronic pain, PTSD, depression, anxiety, fibromyalgia, chronic fatigue, etc. then, over the last few years working in the other real world (the world after residency ends when there isn't a huge corporate-academic medical complex hanging over your head) i've had a chance to spend alot of time working with traditional pratitioners of various "other" medical systems from places far and wide and old. it's a life long learning to study many of these traditions, so i just started by incorporating some of the pressure points and massage work into my practice, skills which are fairly easy to pick up for those of us trained in physiology and anatomy.

let me set the scenario for you. i work in rural ER's where the volume of patients seens is fairly small in any given 24 hour period but the problems presented are typical of all ER's. I see 'migraine' patients, drug seekers, auto collision victims, stroke, MI, etc. After seeing the fairly toxic way that pain patients are treated in inner-city ER's I was hoping that i would be able to find a more humane way of engaging with these folks. guess what. there are other ways. if you can take the time, approach non-judgementally, and aren't afraid to risk exposing your limitations as a human being learning how to help other's in their suffering, you can work your way past the thick prejudicial relational patterns that exist in most chronic pain patients to something akin to the root of their understanding of their pain and from that point, instead of throwing narcotics at the person, a few well placed pressure points, or trigger point therapy or even massage, can bring a "migraine" headache from a 10 to a 3 in a few minutes. just with your fingers and some non-judgement. there are pressure points on the hands, the ears, the feet, behind the knees, on the calves. the body is full of reflexes to treat all kinds of symptoms.

i had a really fun experience on a plane. there was a brand-new stewardess, airsick with nausea. i wound up sitting next to her in the back row of the plane on a short flight home. we talked a bit and after getting her permission, i held a point on her wrist for nausea. she promptly fell asleep and rested the rest of the flight until we landed with nothing but gentle pressure, symptoms totally relieved.

in the rural ER, I spent an hour with an elderly lady with a terrible headache, "for days," and high BP. after assessing her neuro status and checking some labs to rule out hypertensive emergency, i worked some points on her hands and back of her head. this was a really interesting case for me. this lady was in the process of learning how to help people in her community with pressure points for pain, and she recognized what i was doing fairly quickly. it started a conversation between us about the limitations of allopathic medical training and her own journey to learn some health skills. after her headache resolved with pressure points only, she was even more resovled to continue learning how to help her people, and help them stay out of the ER. no cost medicine... I wonder how the AMA will feel about that. If history is any indication, they don't like it.


so all you skeptics, I encourage you to learn a few points for pain and nausea and try them out on the wards and in the ER's. just realize that aside from the empirical reality of the pain, there is usually a huge layer of disbelief and fear of judgement. people tend to think that if their pain resolves easily with simple things, then their illness isn't real. you gotta explore this belief system until you feel comfortable challenging yourself and patients past the prejudices and fears already part of our world.

it's a much bigger world than our AMA father's would have us believe. and thank god for that cause our shit don't work for alot of the suffering out there. and it causes a fair amount on it's own.


posted by andru | 9/17/2004 10:36:00 PM | |


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