To correctly diagnose our patients is one of the most important parts of formulating a successful treatment plan. The ability to listen to our patient attentively, without judgments or projections is as vital as having knowledge of all the different identification of patterns. Many patients we see in clinic these days present with very complex, and sometimes contradictory patterns. Prescription drugs, which some of our patients may have taken for years, often distort the natural signs that their illness should manifest. I remember a child who me in with diarrhea and severe chills, but he had red cheeks and a bright red tongue. This was clearly a case of internal cold, with misleading external heat signs.
In cases such as these, we need to tune in with our patient at a deeper level and look beyond the gross manifestation of the illness for subtle or more hidden clues such as a grayish hue on their face, or the tone of their voice, their body language, or their likes and dislikes ... any of these examples can reveal a deeper layer of disharmony. Halls is where the theory of the five elements comes in. It can help determine the patient's constitution and possibly one main element involved in the illness.
I would like to share the story of one of my patients in order to illustrate this point Mr. M., a strongly built man in his mid-forties with a reddish complexion came to my office complaining of tremors of the head and high blood pressure. The tremors had started a few years prior and were connected with social anxiety. He had been experiencing states of heightened social anxiety and panic attacks for a number of years, but had managed to live with them When the tremors started, he was prescribed an anti-depressant, which seemed to control the symptoms. The anti-depressant and the blood pressure medication had side effects, which made him feel terrible. In order to avoid taking the anti- depressant too often, he had become a recluse, using it only when he absolutely needed to face a social situation. He had been living this way for many years and although the drug could keep his symptoms under control, he was deeply unhappy and started to question the verve meaning of his existence.
When I delved into his emotional life, I discovered that he had been married earlier on in life, but his wife had left him soon after. He had been living alone ever since. He experienced deep feelings of loneliness, but felt he could never handle another relationship. I also found out that he hated his job, (He worked in construction.) because it was rough, dirty and messy. However, he never had the courage to look for another job. He smoked a lot of cigarettes and was concerned about the smell on his body and clothes when he came for his sessions.
Besides his symptoms and the obvious signs his body manifested, these psychological and emotional factors gave me some insights into his condition However, something that he shared with me in passing gave me the biggest revelation: "When l go to San Francisco, he said, I come back to life". One thing I personally dislike about San Francisco is its weather. Throughout the year and especially in the summer, it's cold, damp and foggy. This helped me to realize how hot and dry this man's internal environment was. Further talks also revealed that he had a strong dislike of water and never drinks it. Now, I was able to clearly determine the best way to help this patient. Coming up with an herbal formula and acupuncture points prescription is just one part of the treatment and maybe the easiest. Helping him to realize what he was doing to himself and make the necessary changes in his life was the real challenge. I decided to give him some understanding of the five elements and drew him a picture of his condition according to this theory.
The theory of the five elements provides wonderful insights in the body-mind connection and into the inter- relatedness of our total body system. First, I explained that the sense of self is connected with the Wood element. Each major organ in the body belongs to one of the five elements; both Liver and Gallbladder are classified under Wood. High blood pressure and tremors are two disorders related to the Liver in Chinese medicine. In the psychological realm, a Liver imbalance can manifest as lack of self-esteem, self-confidence and sense of direction in life. The courage to change is attributed to the Gallbladder. In the generative cycle of the elements, Wood is the mother of Fire. The Fire element has to do with communication, sociability, joy and feeling of ease with others. From this we can see how an imbalance or weakness in one element can affect another.
In the cyclic phase of the elements, which represents the rhythmic dance of the universe, Wood and Fire are both related with heat or Yang energy. When this energy is not controlled, it easily becomes excessive. Water is the element, which moistens, cools, nourishes and controls heat or Fire. The fact that Mr. M.'s internal environment was so hot and dry clearly indicated a long term depletion of fluids. Emotionally, he exhibited a lack of will power to change unwanted situations as well as a sense of resignation. These two characteristics are both symptoms of Kidney disharmony, which belongs to the Water element. Water is the mother of Wood and Wood is the mother of Fire. Here again, we see an example of elements affecting each other in the generative cycle. This is called the "mother" not nourishing the "son".
Emotionally, he presented the triangle formed by Water, Wood and Fire. We have another relationship between Water and Fire, which is based on control. This is called "husband " not controlling the "wife" in the controlling cycle. The lack of communication between Water and Fire manifested physically as too much heat in the body, and psychologically, as his social anxiety and panic attacks. The Fire imbalance also showed itself in his lack of social skills and inability to keep a relationship. In Mr. M.'s case, the Water element was at the root of the disharmony. Hence, the treatment principle from the five element theory is to nourish the Water in order to nourish the Wood and control the Fire.
We can also look at this scenario from the Zang-fu perspective: In Chinese Medicine, it is said that the Liver stores Blood, which is the nourishing substance for both our activities and our rest periods. During activity, the Blood goes out to the extremities; during rest, it regenerates our internal system. Good, deep sleep, for example, which is a must for rejuvenation and healing, is dependent on Blood. If Blood is deficient, the Spirit cannot rest and our sleep will be interrupted or disturbed. Deficiency of Blood can also affect the state of our muscles system, making our tendons drier and our joints stiffer.
There is a saying in TCM that Blood and Yin share the same root. Smoking cigarettes dries out the system and in the case of Mr. M., led to a state of Yin deficiency, which pushed the disharmony to a deeper level. The Kidney is said to be the reservoir of both Yin and Yang in our bodies. When the Yin of the Kidney is affected, it further affects the Liver Yin and Blood. A deficiency of both Kidney and Liver Yin can bring about empty heat and the rising of Yang.
High blood pressure is a typical symptom of this pattern. In time, this condition can give rise to the stirring of Liver Wind, which manifested as the tremors. The fact that the tremors were associated with social interactions, clearly showed the emotional cause of the disorder. Our treatment principle from this perspective is thus: Nourish Kidney and Liver Yin, subdue hyperactive Yang, extinguish Liver wind, clear Shen and calm the Heart.
To free this man from his dependence on drugs and stop his tremors is the goal of the therapy. To help this man gain the courage to face his deep feelings of inadequacy and unworthiness and to find the will to face the world instead of hiding from it - this is where true healing begins. To help this man become aware of the mental, emotional and psychological tools and empower him to take care of his own health.
The Albuquerque Campus is excited about its new library and study facilities. Southwest Acupuncture College recently leased an additional suite to expand its library. Within the suite there are three rooms. The first room is the library for which new furnishings have been purchased. The second room is set up as a study room with tables, chairs and a bookcase filled with journals. The third room is the computer room, which has three computers, (2) iMac and (1) IBM all with high speed Internet access. The iMac are equipped with printers and a zip drive for students to save their work on their personal zip disk. Plants and artwork have been added throughout the three rooms to give them a comfortable environment that is enjoyed by all. A special thank you goes to students, Jaclyn Odd and Hilary Broadbent for packing, moving and re-shelving all the library books and To Robert Nuttall for moving the heavy oak bookcases and setting them up in the library.
Demonstrate Compassion and Professionalism
I had intended to write an article on The Circle of Preparedness, a concept introduced through the teachings of Tai Chi. Instead, I would like to recount the evening of August 29, 2002.
The 29th was the first Thursday evening Japanese Clinic of the term in Albuquerque. Student interns Yvonne Corcoran and Brodie Welch arrived early. Student Steve Scolnik was working the front desk, and the interns had one patient each scheduled at 7:00. When their patients arrived they escorted them to their treatment rooms, completed their intakes, and met with me in the consultation room. After consulting with me, both returned to their patient to begin treatments.
At around 7:20 Brodie came to me stating that something was wrong with her patient. I followed her into the treatment room were I found the patient crying and looking very frightened. I immediately removed the needles and began questioning the patient. Brodie administered hand therapy attempting to calm her. This patient has been coming to the clinic for the last two years and I was well aware of her history. As I continued to question her, I realized she was heading for a full-blown manic attack (psychosis). Brodie remained calm, continuing hand therapy and talking to her patient. I, on the other hand was not nearly as calm as I needled every point I could think of to calm her emotions and tremors. The points I was needling didn't seem to affect the condition, so I began hand therapy. I noticed that Brodie had not stepped back from the treatment table or left the room, but continued to try everything she could think of to help.
By 8:15, my thoughts were moving towards a psychiatrist and Thorazine drips. Suddenly the patient grabbed my hand, looked up at me, and pleaded for us to help her. I looked at Brodie, still trying, not giving up.
It was 8:30 and I had not checked on Yvonne. As I left the room, I told Brodie I would be right back. There was a sense of calm in the clinic as Steve sat behind the desk reading. Yvonne was standing in the waiting room. She looked at me and asked if I was all right. I must have looked like I needed a Thorazine drip. I told her I was not sure, but she could leave if she would like. I knew that she was a competent practitioner and if there had been a problem earlier, she would have told me.
As I re-entered the room, the patient seemed a little better. Brodie was at her side still treating and calmly reassuring her that everything would be alright. The patient kept talking about the evil dragon and the black feeling. It became clear that to calm the patient we must calm the dragon. I placed hand over hand on NIN MYAKU 6 (CV 6) and began breathing deeply. Immediately I sensed darkness, then I saw a black serpent with yellow eyes and a fan shaped head. The serpent was striking every time the patient had a tremor. Brodie was massaging the patient's feet, which seemed to reduce the severity of the tremors. Slowing my breathing also seemed to be calming. I continued while Brodie moved around the table placing her hands under the lower back of the patient. The combination seemed to be working. As the serpent began to fall asleep, the patient became much calmer. The patient said she would be able to put the dragon back into its cage. By 9:20, the serpent had fallen asleep, the tremors stopped and the patient was coherent. I left the room and Brodie helped her patient get dressed.
The clinic had been closed since 9:00, however I did not sense the typical rush of the front desk person, turning lights off, closing doors, and rattling keys. Instead, as I entered the waiting room I found Steve relaxing behind the front desk. I apologized for the time, and Steve responded, "I'm here as long as you need me."
Brodie's patient emerged from the treatment room exhausted, lightheaded, and thirsty. Brodie got her a cup of water and Steve said he would watch her while we completed paperwork and cleaned the treatment room. By 9:40 the patient felt better. Steve escorted her to her car and we all left the clinic.
This all seems quite dramatic, however the point of this story is the professionalism and compassion demonstrated by three student interns. I have no doubts that within the walls of this institution there are others like Brodie, Steve, and Yvonne. I thank all of you who make us proud to be in this profession.
Santa Fe Students!!!
If you haven't
done so already, check out the new "Hall of the Scholars" where the PC
computer has been moved to make room for more library holdings and......
The new beautiful
college catalog and the brochure for the first time in color, which details
the new 3000 hour program, and.....
I would hazard a guess that the biggest news from the Boulder campus is that we have gone through the summer semester and into the fall without moving our facilities! We are at last home and very, very glad to be staying put. We have completed the pharmacy expansion in our new clinic so that in addition to raw herbs and patents, we can now supply our patients with powdered formulas. The improvements within the new clinic facility and attached five-element garden have been credited with an entire shift in solidity, professionalism, and student satisfaction.
I am constantly amazed at the resourcefulness of our students. As part of several of our core classes, students are asked to create a project that reflects their interpretation of an aspect of Chinese medicine. In herb classes, these projects involve the materia medica. We have had puppet shows, skits, poetry, performance art, music, paintings, you name it. One student made stunning jewelry out of herbs (the Blood Nourishing/moving Pendant my particular favorite). Another made a dragon costume that had Chinese herbs covering the face that we have used a few times in relevant processions. A student in an herbal class has created soap, there have been many medicinal cordials (which after a few ounces are reported not to taste half bad), and of course our all-time favorite from our first graduating class, cooking delicacies with insects. As we have matriculated over 200 students through their first year of the program, the array of versatility and creativity nearly knocks me over every year. If that weren't enough, every Halloween we have had a come-dressed-as-your-favorite-point parade throughout the school. We use the class projects as a time to express a bit more of our spirits, build community, and flat-out have a little fun.
The Midsummer Night's Walk
Last June marked the second year that the Boulder Campus has been involved in Boulder County AIDs Project fundraiser called A Midsummer's Night Walk. Hundreds of walkers from all kinds of Boulder businesses and institutions raise money through sponsorships and send a team to a 3K walk through downtown Boulder in support of our local organization that supplies assistance to HIV positive clients in Boulder County. Our college has had an extern clinic in the BCAP facility since early in 2001, and so we have been motivated to walk our talk, so to speak, in support. Both years we have raised over $700 from essentially starving students, so the support shown has come from big hearts with a limited budget. The walk, as you can imagine, can be done in costume if desired, so the first year we took our Herb-Dragon costume, and the second, some faculty and staff were dressed as wood nymphs (you'll have to guess who!).
Just in case you were wondering if we actually do any teaching of Chinese medicine in Boulder, I want to extend my congratulations to our students who have taken the national boards over the summer. Once again, we are happy to report a 100% pass rate among our students for both the Acupuncture and Chinese Herbology exams. They worked really hard, and have every reason to feel the accomplishment they deserve. Our graduating class this summer was a full twenty-five students strong, with four more to graduate this December and next May.
Our graduation ceremony was graced at both the beginning and end with artful expression, with first-year student Ming Der Liu with his son, Henry Liu, performing the Lion Dance to begin the ceremony, and esteemed faculty member, Whit Reaves and his acoustic band providing music for the end. We are very lucky to have been the recipients of their gracious contributions.
September 11 Remembrance
The morning of September 11 we gathered in the Five Element Garden for a remembrance for all of us who were naturally carrying a sense of loss on the anniversary. About twenty-five of us gathered for a few moments and acknowledged the common experience of grief and loss. After a moment of silence for the remembrance of the victims of the attacks, people were invited to speak the names of those who were directly affected by the loss that day. I was stunned at the number of the names spoken here in seemingly far- off Colorado, one of which was the name of one our new students who came from New York and lost over 35 friends on that day. I was struck with a sense of immediate connection through space and time, and very grateful for those who participated in allowing the circle by holding all those who had no community to express their loss within our hearts.
The Financial Aid Department at Southwest Acupuncture College consists of Donna Gurulé, Financial Aid Officer and Allayne Scott, Financial Aid Director. Please feel free to stop by or call with any questions you have concerning financial aid.
Some web sites containing helpful financial aid information for students are:
The financial aid office has information regarding alternative/private loans by Bank of America, Chela, and Teri. We have recently researched Nellie Mae, another source for private loans; information is available in our office.
If you need further information concerning other aspects of financial aid we will be happy to assist you! Hope you are having a prosperous and fulfilling school year thus far.
The Santa Fe Campus would like to welcome our new Database Administrator, Colette Martin, Donna Gurulé, Financial Aid Officer, Jennifer Brown from Rhode Island and Kari Sullivan from Chicago, Illinois our new full-time Administrative Assistants. Lynda Longacre, Administrative Assistant, Carolyn Stanton, Bookkeeper, Allayne Scott, Fiscal Officer, and Charlene Wunderlich, Clinic Manager complete our staff. We would also like to welcome our new teachers this semester, Dr. Walter Eddy (Chinese Medical Theory 203) and Dr. Roddey Cohn (Clinic).
For the last six weeks in Santa Fe we have been conducting weekly staff meetings. Each meeting had a focus subject relating to office or campus policy and procedures. We have reviewed the Catalog Fact Sheet, Prospective Student Tour Protocol, Library Collection, Inventory, How to keep your Computer Organized, and Phone Etiquette all in an effort to improve our operations, especially student services.
Albuquerque students, Josi Ashe, Nancy Huber, Cherie Mensching, Serena Sundaram and Sean Tuten took the NCCAOM Acupuncture and Herbal exams this past year and... PASSED!! Congratulations!
So that they may pass on and share their "secrets" of success, they were asked by Albuquerque campus Administrative Director, Pam Weber, "What would you recommend to students preparing to take the National Board exams?"
For the Acupuncture exam:
Nights before the exam:
China 2002 was a uniquely challenging trip: 26 students from 3 campuses; an an initial 10 hour delay at LAX with a consequent unscheduled overnight in Shanghai set the tone.
Thankfully, most of the students bounced back with resilience and demonstrated an ability to 'go with the flow", a cardinal must if one is to survive and thrive in China. This year we stayed at the Hui Qiao Hotel located in the Dongzhimen district, a short distance from the International Academy. I was in Beijing just a year ago and found Dongzhimen barely recognizable given the level of demolition. Once home to a thriving Hutong neighborhood, Dongzhimen is largely in rubble. Hutong architecture, a signature of Beijing, is rapidly disappearing from the landscape. Beijing in general seems to be in the grips of reinventing itself both physically and psychologically.
There appeared to be more foreigners, more cell phones, and considerably more MD's participating in acupuncture programs. Germany in particular seems to be leading the European vanguard.
With 26 students, 6 different hospitals and a new herb program, we found ourselves asking more of the academy than perhaps ever before. For their part, they worked hard to accommodate our requests. Under the leadership of Jing Wang, the herbal program came into its own and surpassed our initial expectations. Presentations by Dr. Wang Dai and Dr. Lu Ding-Hou were especially memorable. The assistance of Boulder student Andrew Nugent-Head as impromptu translator added exponentially to the learning experience. A heartfelt thanks goes out to him for his enormous contribution.
In clinic, students worked in groups of 2-4. On average, the number of patients treated each morning ranged from 30-40 people. In these hospitals, students are exposed to treatment protocols and techniques rarely seen or practiced in the United States. Over the course of one month, we observed a side range of presenting problems. Sequela of stroke, facial paralysis and back pain, however, were the most prevalent complaints. With sequela of stroke, typically patients would start to receive acupuncture as soon as their conditions stabilized. It was amazing to see the results possible with timely and daily treatment. I witnessed some remarkable journeys from wheel chair to unassisted walking. In one hospital there was a neurosurgeon from the United States who kept commenting that there was nothing in his (western) medical model to explain "the miracle of acupuncture, but the results speak for themselves. We observed an unforgettable clinical case where a 2 year-old girl had been unable to walk for some weeks after a serious condition of encephalitis; after 3 consecutive treatments she was running.
I would highly recommend the China trip - it's an experience of a lifetime. There is no doubt in my mind that students come back richer practitioners, more confident in the medicine and elevated by the enormous clinical experience this program affords.
Sincere thanks to my colleague Dr. Jing Wang, to the students who made it so memorable, ant to Southwest Acupuncture College for the vision of creating a China program.
Recently the school conducted an Alumni Survey for the graduates of 2000 and 2001. Sixteen alumni responded to the survey. Four of them graduated in 2000 and twelve in 2001. Four alumni graduated from the Santa Fe campus 10 from the Boulder campus and 2 from the Albuquerque campus. The graduates reported doing very well.
Of the sixteen graduates that responded to the survey, fifteen are currently practicing acupuncture. Twelve of them have their own private practice. The other separate three work with other health professionals. Ten of them rent/lease office space. Three have an office in their home and two of them own office space from their home. The average number of patients they treat weekly are: two alumni see between 1 -10 patients a week, four alumni see between 11-15 patients a week. four see between 26-40 patients per week and one alumni sees 100 + monthly. $65.00 is the average charge per patient.
It cost four of the Alumni between $2000.00 - $2500.00 to start up their practice. Five of the alumni spent between 3000.00 - 5500.00 to start their practice, three between $6000 - $10,000.00 and two between $15,000.00 65.000.00. One of the graduates purchased an existing practice at the cost of $5000.00.
Nine of the graduates started practicing Acupuncture and Oriental medicine within six months of graduation: five within six months to a year. and one graduate took two years to start his practice.
The approximate percentage of the following categories of illness that the alumni treat are as follows: Gynecology: 15% -30%. Pediatrics: 5% - 30%. Internal medicine: 15% - 30%. Physical medicine: 50% - 90%. Weight loss: 5% - 10%, Sports medicine -10% - 45%. General: 35%-45%. Thirteen of the graduates felt they were well to very well prepared to begin their clinical practice upon graduation The areas they felt that they were well prepared in case history were, examination and intake, diagnosis, prognosis, acupuncture treatment, herbal treatment, patient counseling and practice management. Fourteen that sat for thE national exams and three that sat for the State exam fei the curriculum and training at Southwest Acupuncture College prepared them very well. Sixteen took the NCCAOM Exam and passed on the first try. Six took the NCCAOM Herbal Exam and five passed on the first try, one on the second try. Three alumni took the New Mexico State Exam; one passed on the first try, one on the second try.
Fifteen graduates hold the NCCAOM Acupuncture (Dipl Ac.), five the NCCAOM Herbs (Dipl. C,H.) and seven graduates hold a State license. Two graduates are in Virginia four in Colorado. one in New Mexico, Georgia. Montana Nevada, Iowa, Idaho and North Carolina.
The alumni were asked if they belonged to any profession al organizations. One alumni student belongs to Idaho State Association, four alumni to Colorado Acupuncture Association, one to the New Mexico Association of Acupuncture and Oriental Medicine (NMAAOM), one to American Acupuncture Alliance (AAA), one to American Academy of Pain Management, two belonging to the AMOA, one to CAA and one to the NSAA.
Southwest Acupuncture College asked the alumni. "If you wish to make any general comments or suggestions about the school or the training you received what would it be?" They suggested more herbal training, continued mentorship, more concentrated course in pediatrics, more Practice Management and overwhelmingly all felt they had an overall wonderful experience at Southwest Acupuncture College.
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