All Things Considered

What’s new?

Yesterday, as I was driving into the day I heard an interesting radio report on National Public Radio’s “All Things Considered” program. The program was about this guy in New York that is a Jazz Musician, Medical Laboratory Assistant and is also involved in medical research.

His area of research is in cardiac rhythm dysfunction. He says a “normal” heartbeat follows a 4-4 rhythm. As a jazz musician drummer he has been listening to rhythm for more than 60 years I would have to give him the benefit of the doubt and agree he knows rhythm.

“A healthy active heart follows a triplet rhythm, 1-2-3, 1-2-3, 1-2-3. A less healthy heart follows a four part rhythm, 1-2-3-4, 1-2-3-4, 1-2-3-4.” He believes that his research can address and correct the rhythm of the heart. Some time’s he uses physical sounds to accomplish this; sometimes he uses acupuncture and induces the rhythm through the needles. I would love to know how he does that!

I hope that you have read enough of my pages to know that I do not mean to sound disrespectful of his work or his intention. I am sure he is deep into what he is doing and I am sure there will be some good from his work. I just want to explore my thoughts that got stirred up when I heard this report.

What I thinking about is the connection between sound, rhythm and the heart.

In TCM the Heart is seen as the Emperor, the Sovereign that has overall responsibility for the smooth function of the entire organism. The Shen, or the Spirit, resides in the Heart and when one goes to sleep at night it is said that the “Shen comes to the Heart and the Yin energy embraces the Yang energy and the Spirit is allowed to rest in the Heart.” I think it is also interesting to remember that for a LOT of the history of TCM one could not treat the Heart directly as that was seen as implying that there was something wrong with the Emperor. There is nothing wrong with the Emperor, EVER. This explains why many of points on the Pericardium meridian are used affect the physical function of the Heart organ complex.

Nowadays we can and do treat the Heart meridian directly, however the energetics of the Heart meridian applies more to the ethereal nature of the Heart organ complex. By this I mean if I am treating for more physical substrate issues I will choose the Pericardium meridian but if I am treating more Shen or Spiritual aspects of a patient’s concerns I will usually choose the Heart Meridian.

Life is a continuous rhythmic dance, it ebbs and flows; it is dynamic, like a jazz rhythm. I find my balance and flow when I allow that dance to follow its own rhythm, not my mentalization of that rhythm. If I am forcing the rhythm I am not flowing with the rhythm of the Tao. If I am allowing the dance to flow through me I am not interrupting the flow of the Tao, my qi is vibrating and I am in vibrant health.

The rhythm of the Tao is, in my mind’s eye, like a spiral. A spiral expands and contracts, continuously; what is on the inside now comes out to the surface, what is on the surface now in-folds to the interior. The same is true for our lives. What is seen on the ‘outside’ is a hologram or reflection of what is true about our ‘inside.’ Any one part of a hologram that is exposed to light reflects the entire image of the source in three-dimension; if the entire source is lit the image is more ‘substantive’ and will appear to be more complete. The same is true for what we see in each other, if I can only see a part of you all of you is represented in that part, but it does not have all of the substance it would have if I could remove my blinders and see the rest of you. What I feel in the reflection of your pulses is “all of you” however if I can remove my blind spots I will see a more complete or holistic reflection of your beingness.

The pulses are the closest I can get to the physical substrate of the heart. The images of the pulses are described in poetic terms; scallion-stalk, bowstring, slippery, hidden, deep, vacuous, etc. But to someone trained in pulses each one has a unique, specific interpretation. The quality of a pulse can and does change from things as subtle as a frown from someone you love to the backfire of your neighbor’s car as it starts in the morning. Should it be any wonder if a pulse changes by a difference in rhythm?

There is another deeper, subtler aspect to Sound. But this is not the format for that discussion; if you have questions what I am referring to please e-mail me and I will be happy to explain.

In my evolution I am seeing more and more how everything is connected. What rhythm or vibration my physical body is exposed to is going to have an effect on every other part of my beingness. That is one reason I play very soft gentle music during my treatments. It mask’s the noises from the other rooms and it calms my patient down. But I still don’t think the only reason the pulses change during the course of the treatment is because of the music…

Then again, as I just said it is all interconnected. But that is nothing new.

Where Do I Draw The Line?

I had an interesting experience today that I am still digesting and attempting to discriminate what is my truth about it. Let me explain.

I have been attempting to find some way to interface with Western Allopathic medicine in some format that is both useful to my patient’s, while being one that benefits my own journey. In this adventure I contacted a local cancer center, attempting to offer acupuncture and Chinese herbal therapy as a complimentary therapy for patients undergoing chemotherapy. This is one of many area’s that I think these two medicines can work in a synergistic fashion to enhance the power and efficacy of the therapy. Today I had a meeting with the Director of Supportive Services.

What amazed me were two things. First of all I am amazed that he is supportive of my ideas (that is always a welcome surprise). The next area is the one I want to explore here, writing a research grant about using acupuncture in the treatment of cancer.

The issue that I have to get clear about is: Do I want to be involved in “research” acupuncture? The issue at hand is that in order to do acupuncture research I have to treat by ‘protocol’ (same points every treatment with no variation permitted) not based on what I feel in the patients’ pulses or actual current symptomatology. Is that truly following my Path, is that truly nourishing my own Destiny?

I do see value in doing research acupuncture. If I can be a part of the process of getting acupuncture into allopathic medicine it might be worth dealing with my own frustration of not giving my best treatment to each patient every time I see him or her. But the questions looms: “Is it really worth it? Is this real medicine, or what is it really?”

In my world-view it is my responsibility to give every one of my patients the best possible treatment every time I have the honor of giving her or him a treatment. If I am truly applying the lessons I have learned over the years then using a protocol does not fit into my idea of giving a treatment. My patient’s are constantly changing, just as everything else is. While I can appreciate the intent of testing to see if particular acu-points are scientifically, verifiably decreasing the patients experience of nausea; how does that fit into my perception of giving a patient the best possible treatment I can? Then again if a patient accepts undergoing acupuncture for research does that change my Karmatic responsibility of giving the best treatment I can? Or if I can force a wedge into the Western allopathic paradigm is that worth my own uncertainty or uncomfortability of the process?

JUST WHERE DO I DRAW MY LINE?

The Truth of my medicine

Today I have been reflecting on what is the TRUTH of my medicine. By that I mean why do I practice and study acupuncture? What is it that I want to accomplish in my interactions and treatments? I am deeply contemplating this issue as I sense that it has changed, or my relationship to the medicine has changed, or my awareness of and need to be clear about my unique approach to this medicine has come to the forefront of my consciousness and I have to get clear about what my intention is.

I do believe that this medicine is very powerful, but it is also very subtle. I feel that one area I may explore is trying to develop more of an interface with Western medicine and work to develop a truly 'complimentary' practice.

I enjoy working with my patients and seeing the changes in their lives. I also enjoy seeing how I change through this interaction also. I try to learn from every patient I have the honor of working with.

In time I am sure I will get more clarity about how I want to "be" with this medicine, but for now I am just beginning another level of exploration into the truth of myself as it is being expressed in the practice of Traditional Chinese Medicine.

Boundaries: A Function of the San Jiao Meridian?

This week I have been thinking of the San Jiao Meridian. The San Jiao is unique in many ways, but the most intriguing is that is does not have an organ system complex associated with it in the same manner as the other meridians. There is a physical substrate for the Heart, Lungs Spleen, etc, but not so with the San Jiao.
The name San Jiao translates as the “Three Openings;” a reference to the three ‘burner’s’. The Nan Jing, an ancient classical text refers to the San Jiao as “having a name, but no form.” Instead the Nan Jing seems to attribute the functions of water metabolism to the San Jiao, it is said that the “Upper Jiao is like a mist, the middle Jiao is like foam and the lower Jiao is like a sluiceway.” In Chinese medical theory the San Jiao is integral to the transformation of qi and the free flow of fluids throughout.
The San Jiao is also used, clinically, to diagnose externally contracted febrile disease. By accurately assessing how deep the pathogen has penetrated the practitioner will determine the course of treatment. The upper burner (Lungs) is the first to be affected and the lower burner (Kidneys) is a more serious condition. Using the upper, middle or lower burner as a classification for the disease ‘center’ is useful, but in the clearest of definitions that is not a “San Jiao” classification, remember the San Jiao has a name, but no form. It does give the practitioner a practical way of addressing the condition, though not through the San Jiao meridian.
As an example lets say a patient has digestive problems, loose stools, fatigue after eating, bruises easily, his tongue is pale and scalloped. In TCM this is a very simplified pattern of Spleen Qi Deficiency. One could also say the middle burner, or middle Jiao is affected. But the treatment would not be focused on the San Jiao.

Of course I want to look at it in a slightly different light.

Let’s also say that same patient has been working in a job that he truly does not enjoy, the work environment is demeaning to him but he is keeping the job because in another 18 years he can retire from it. You might say he is having trouble digesting that choice.
I also think of the San Jiao as being integral to ones boundary system. Boundaries are important not only in the physical sense, how close do I let someone get to me (physically, emotionally, spiritually) but also in a less concrete manner. Do I allow the words that someone else says to enter and lodge into my belief system? Do I believe what others may or may not be saying about me? I think that the ability to process and function as one navigates the maze of determining what to let in and what to throw out is a function of the San Jiao.
For this discussion it is also important to recognize the interior/exterior paired meridian complex, the Pericardium. In TCM the Pericardium is the “Heart Protector,” its function is seen literally as protecting the Heart from evil pathogens. What is the difference between an “evil pathogen” and an unhealthy thought pattern that affects the way you see yourself in the world? So if the Yang aspect of this interior/exterior paired meridian, the San Jiao, does not function at its strongest it will allow the unhealthy thought to penetrate into your beingness and then it is the job of the Pericardium to protect your Heart from the inclusion of that thought into your world view.
Now, back to our patient. If this man can choose to look at how his choice of staying at a job he does not like is affecting his health he might be able to determine if the cost (poor health that most likely will deteriorate) is worth the reward (“retirement” IF all things go as planned and the company does not close or out-source his job).
So part of the treatment might very well include San Jiao concepts as I am seeing them, but only if the patient desires to get into that depth of being. As I wrote about in a previous blog, if one is following his or her destiny the payoff for that is good health and a longer life. Who am I to decide that for a patient? Yet I also have an obligation to open the door to this type of a conversation and see if he or she is willing to enter into this type of a discussion.
As I said at the beginning of this blog the concept of the San Jiao is intriguing to me. Having a name, but no form, not being associated with a physical substrate organ, being paired with the Heart Protector; all of that is one of the interesting paradoxes of Chinese medicine. I am not sure if any of this will make sense to anyone that ever reads it, but it is an interesting perspective to consider. If you like it, great. If not, in the words of Bruce Lee “Pare away the unnecessary.”
Till next week. Write if any of this resonates with you.
Respectfully,

Qi

One of the interesting aspect of Chinese medicine is the concept of “Qi.” This energy has been called everything from vital-life -force to bio-medical energy. There are some allopathic diagnostic machines that can measure the amount of “energy’ that is in a person, but I do not feel that is “Qi;”I understand it to be a quantified measurement of the electro-magnetic force-field of the body. Qi is that and more.

Qi is the dynamic vortex of energy that flows through and around the body. It is the energy of life, an energy that is not measurable at this time by any machine. I hope it never is.

In TCM pain and or disease is the result of the blockage of the flow of qi. The body work, needles and or herbs are utilized to restore the flow of that qi; if the energy flow is restored the body will find its own natural return to health.

Last week I had the pleasure of working on a woman that was experiencing a severe pain in between the little toe and next toe in her right foot. I needled some points on the Gall Bladder meridian then went right to the painful area. When the needle got about ½ a cun into her foot I felt a big “ball” of energy/tension. As I needled this ball of energy I felt it release. After ten minutes or so I took the needles out and then did some tuina on her foot. I saw her a week later and asked for a report. The pain was gone and she was back to running again.

The reason I write about it in here is I could feel the qi as the needle approached it. It was like pushing in on a balloon with a pencil, springy and resilient. When I pulled the needle out it felt like any other point needled. Once the obstruction had been resolved the qi flowed and the area returned to its normal state. No wonder I like this medicine, IT WORKS. Even if Western science does not fully understand it.

Nourishing Destiny

This week I have been reading a great book, “Nourishing Destiny” by Lonnie S. Jarrett. I find this to be a very interesting book about the Inner Traditions of Chinese Medicine. I am still in the first 100 pages, its not one of those books I can just burn through. I read a paragraph or two and find myself sitting contemplating what I have just read.
I appreciate his writings about the ‘unnamed Tao’ as compared to the named Tao. The propensity of naming “things” is problematic for growth if one allows oneself to believe that one understands a concept because we think we understand its “name.” The words for the Tao, Yin, Yang, God, Heaven and everything else all convey specific concepts, yet to see beyond our limitations we have to see beyond our concept of words. As Mr. Jarrett says about the Tao, “The Tao is one when it is unnamed. As soon as it is named there are two, the named and the unnamed.” The difficulty anyone has that discusses this is that by nature of conversation we have to use the named to conceptualize the unnamed, yet ideally we are talking about the unnamed aspect. Keep that in your awareness. Or as Zhuangzi stated “Words exist because of meaning; once you understand the meaning you can forget the words. Where can I find a man who has forgotten words so I can have a word with him.”
Another intriguing idea he puts out in this book is that there is a destiny that is unique to each one of us that we have a ‘contract’ with the universe to fulfill. (I would word it slightly different than this but I did not write the book.)
Mr. Jarrett contends that at the moment of conception the Tao imprints a unique, specific destiny into each one of us. This portion of our existence is what he calls early heaven. At the time of our first breath we ‘disconnect from our potential destiny’ and start to manifest our own individual destiny, everything that occurs after our first breath is called later heaven and that is the part we are responsible for. Our own destiny is the result of our own unique, individual choices; however Mr. Jarrett believes that it is the Universe’s desire to have the destiny we were imprinted with fulfilled and if we will not do that then the Universe may remove us, into another life and imprint that destiny upon someone else (now that gives one food for thought).
Mr. Jarrett’s concept of health is based on discovering and then nourishing the destiny that the Universe has created for you. Part of this concept of health is dependant on understanding and assimilating in a positive way the experiences that the universe has sent to each one of us. Another way of saying this is to say that for every experience we have there is a reason that the universe has sent us this experience that will help us to fulfill our destiny. I find this to be an interesting concept, mainly because I too feel that each one of us has a unique reason for being in the particular incarnation we are in and it is to fulfill our evolution as a Spiritual Being that we are creating the experiences we create.
Learning to discern the destiny of a life is a search that is as old as consciousness itself, yet when we watch an infant that has not unlearned its connection to the Universal will and has not yet developed its own individual will we are seeing destiny manifesting as life. The infant is spontaneous and is in the eternal now; as the Tao De Jing says, “An infant can cry all day without becoming hoarse.” As we disconnect from the Universal Will and our individual will asserts itself we grow hoarse if we yell for more than a few minutes. There are many reasons for that; one is that it is our Individual Will that we would be manifesting if we were to yell for an extended period of time.
Learning to hear and follow the Inner messages does not have to be difficult; it is just that we have been taught to ignore these subtle messages. We pay for the choice of ignoring these messages with our health.
As a practitioner of Chinese medicine I find that one of the hardest lessons for myself as well as for my patients is to learn to discern what is the Universal Will or as I would term it God’s Will. These lessons can be as subtle as watching a butterfly land upon a flower, or as drastic as a tsunami devastating everything in your world. My martial arts teacher used to say, “Listen to the whispers and avoid hearing the shouts.” When I am taking the history of a patient I find, time and again, that it is the excess insistence of a particular behavior that is now manifesting as a disease. For example I mean that it is the fifty-year-old accountant that is insisting on playing in a handball game when his hamstring is pulled and he can hardly walk. I am sure you can fill in your own observation that would be just as valid.
Asking a patient to actually rest their body while it heals is fairly normal, but you can imagine the looks I get when I ask them to contemplate why they created this particular experience in their life at this time. “What is the lesson for you from this?” [“Damn Martha, you said he was crazy, but I didn’t know you meant it!!!] Yet from my perspective it is the value gained from assimilating the lesson that is the justification for the experience.
One more thought to contemplate for the week. Mr. Jarrett writes about how mankind is the ‘vortex’ of energy that mediates between the earth and heaven. I have used the same context in explaining my perception of our relationship in the universe. I see the state of being a human as the space between the manifest and the unmanifest reality. As a Spiritual Being we are striving to make the unmanifest reality manifest in our lives, that is Nourishing Destiny, in my opinion.

Feeling the Pulses

One of the things I have always liked about acupuncture and Oriental medicine is the intricacies of arriving at a diagnosis. The art of the medicine has to meet the science in a way that is consistent, logical and straightforward. One of the first places this happens is when I feel my patients pulses. If you have never had your pulses examined by an acupuncturist lets start by saying it is different.
I am always amazed at the reactions I get when I feel a patients pulses and then ask a question based on the information I have gathered. "Do you have trouble falling asleep?" "Do you find yourself short of breath?" "Do you have pain in your low back or knee's?" "How is your digestive system functioning?" These questions are relatively easy to come to from even a rudimentary ability to diagnose pulses according to the Chinese medical paradigm. I have heard of practitioner's that are able to feel abnormalities that indicate brain tumors, or gynecological tumors. I do not have that ability, yet; but I am working on developing it. I have felt abnormalities that led me to refer the patient to a cardiologist, and the cardiologist then confirmed my suspicions, mitral valve prolapse.
Another interesting reaction is from allopathic medical practitioners when I discuss the changes in the qualities of a pulse from one position to the next. The pulses are felt, primarily, on the radial artery just above the wrist. I think what gets hard for the allopaths to accept is when I say there is a substantial difference between the pulses when the pulses being felt are only a finger's width apart. I have been told "There cannot be any difference between them, they are on the same artery and only a quarter to a half an inch apart." So what I did was give thim a quick explanation of how to feel the pulses according to TCM and let him feel the difference themselves as I explained what the pulses were reflecting.
I think the first area to explain is that whenever an acupuncturist refers to an organ system it is important to remember he or she is not referring to only the Western Bio-medical organ, but more specifically the “energetics” of that organ system as understood by TCM. So if I refer to the Heart, I mean more than, and not just, the heart as seen by Western science and medicine.
Each arm will have three pulse positions, and each position will have three 'levels' to the pulse. The right arm reflects the pulses (from wrist towards elbow, each one finger width apart) of the Lungs/Large Intestine, Spleen/Stomach, and Kidney/ Urinary Bladder. The left side reflects the pulses of the Heart/ Small Intestine, Pericardium/ San Jiao (we'll explore that organ system complex some other day) and Kidney/Urinary Bladder. I do understand the confusion when one feels a pulse that is closer to the heart, yet it is weaker than the next distal pulse. Part of that might be explained by the anatomical position of the radial artery. In this area the artery is changing depths from a position deeper in the musculature of the arm to one just under the surface of the skin. However part of feeling the pulses is pushing deep enough to occlude, or cut off, the pulse. So no matter how deep it is the practitioner finds that depth and feels the pulse at that level, so this anatomical explanation does not explain the difference in pulses felt by the practitioner and patient after I taught him how to feel the pulses. The only thing I can think of to explain this difference is the science of pulse diagnosis according to Traditional Chinese Medicine.
As I said earlier it becomes very interesting to me to feel a patients pulses and then ask questions based on those pulses. When I was attending Southwest Acupuncture College, in one of my clinic’s the primary form of information gathering was pulse diagnosis. The instructor kept emphasizing the importance of feeling the pulses and letting that be the guiding factor in arriving at a diagnosis. The questions asked had to be directed by the information gathered from the pulses, only.
I now see pulse diagnosis as the point where the science of TCM meets the art of Traditional Chinese Medicine. I know that I have a lot to learn and contemplate in the scientific art of pulse diagnosis, but it is always exciting and an honor to examine someone's pulses.
That is all for this week.
With Love & Respect
Michael