Learning to cope with treating very ill patients has always been one of the hardest things for me to do, as it probably is for practitioners of any medical discipline. This is made even more difficult when I am asked to treat a long-standing patient with whom I have built up a close relationship over the years. This has now happened in the case of one of my patients.
This patient has been fighting a complex history of severe ill-health
over many years, and to the surprise of many has managed to stay as healthy as
she has through what she maintains is help not only from her Western medical
team but from her regular acupuncture treatments. The chance that she would continue to live as
productive a life as she has over the past few years must already have been rather
slim, but I always lived in hope that what I was doing with the needle might be
miraculous enough to stave off more serious illness. Sadly this has not been the case, and she is
back in hospital on a morphine drip, and has asked me to come and treat her
there. I have now visited her twice, and
at each visit I am faced with having to decide what treatment to give.
We all have a tendency to blame our own inadequacy when a
patient succumbs to ill-health so I had first to remind myself not to regard
what I had done so far as a failure. I
had to tell myself that I had done the best I could. Looking at the notes I made the last time she
came for a treatment a few weeks ago, I see that she told me that everything in
her life was going well and she was feeling fine. We were then neither of us to know that this
illness would descend upon her so suddenly like a tragic bolt from the blue.
It is always difficult treating somebody in hospital. We can’t use moxa because of the risk of
setting off the fire alarms, and access to a patient in a hospital bed,
attached to various drips, is always somewhat hazardous, and requires us to
move carefully round the bed, manoeuvring ourselves past the apparatus and the
bedside table with all its necessary paraphernalia. Then we have to consider how far it is fair
to ask an already uncomfortable patient to change position or to sit up to
expose the back. Bl 38 (43), that most
wondrous point which “helps every cell in the body”, as JR Worsley told us, is
therefore sometimes ruled out altogether, or is difficult to locate when
perhaps only a small area of the back is available to us and finding the
scapula proves difficult. Certainly the
many moxa cones it needs to do its miraculous work are unfortunately out of the
question. Luckily, at my last visit, my
patient’s husband appeared at just the right moment to help prop his wife up
slightly to expose the top of the back.
But I still had to send a prayer up to heaven asking for help in
locating the point, so little of the back could I see. There was no question of doing an AE drain at
either visit, as I would have liked to have done.
Then, because her lungs were very painful and her breathing
laboured, I decided I needed to clear what I assumed to be an VIII-IX
(Liver-Lung) entry-exit block, even though my pulse-readings did not absolutely
confirm this for me, pulses also being difficult to take and to interpret in
view of all the medication she is being given.
Again I could hardly find the ribs because of a distended stomach, and
hoped that I correctly needled Liv 14, and not some other point on the
abdomen. Lu 1 was much easier to find,
and I finished the treatment with command points on the Water element, her
guardian element. As I left, I was
delighted to receive confirmation that I had indeed got the points when she
suddenly said, with surprise in her voice, “I really feel better.” How long this improvement will last only time
will tell, but evidence of even the slightest relief was a gift to me, and sent
me home slightly happier, as I left her sleeping peacefully, her breathing less
I’m not sure which of the points I needled helped her feel
better, or whether it was a combination of all of them. I like to think that it is probably clearing
the Liver/Lung block which had the biggest effect, but it really doesn’t matter
and I will never know. The important
thing is that, as I left, she had a slight smile on her face which lightened my
At my first visit last week she was lying in such a position
that I was able only to reach the source points of Water on her feet, but again
these were effective, removing that desperate look in the eyes which very ill
patients have. I interpreted the change
in her to her Water element regaining control of her fear. This look of fear had not returned when I saw
her the second time, even though her physical condition had deteriorated.
The prognosis is not good, but I will continue to do whatever
I can to help the elements ease her pain and distress.