John Aguilar, Jr., L.Ac., R.Y.T., M.S.TCM

Licensed AcupuncturistChinese Medical HerbalistYoga and Tai Chi Instructor


Appropriate Medical Care

It is important to know when to seek appropriate medical care and what constitutes such care.

In general, there are three situations requiring varying levels of professional medical care. One is medical emergencies, where there is an immediate and serious threat to one's health (physically or emotionally). (In my opinion, this is where modern Western medicine is most appropriate.)

Second is where there are obvious symptoms of illness, and third is when there are no obvious signs of illness, but there is 'room for improvement' in general quality of life, energy, and other less tangible aspects of living.

It is these last two areas where this discussion is primarily aimed.

The types of care in consideration, generally, are standard Western care and prescription medication, chiropractic medicine, bodywork/massage therapy, acupuncture, herbal medicine, exercise therapy (eg. Yoga, Qi gong, etc.), physical therapy, diet therapy, counseling/talk therapy, etc.

There are two areas to evaluate - the system of care (underlying medical theories, diagnostic and treatment capability, etc.) and the individual practitioner. The former is a far easier discussion so we'll begin there.

Theory

Ideally, the medical system you utilize has a well developed theoretical foundation that is capable of giving explanation for your discomfort.

For example, a massage therapist may speak to a structural imbalance causing muscular tension resulting in your pain, whereas an MD may use the theories of biochemistry and endocrinology to explain your suffering, and so on.

This theory needs to be backed by clinical evidence of safety and effectiveness. The word 'clinical' is used, specifically, to differentiate between what a 'friend of a friend' reports and evidence derived from scientific investigation.

(Not to downplay the usefulness of the opinions and experiences of friends and family members; in deed, these are very important, but they are so based more on your trust in that person and their being honest about their personal experience, than in their critical evaluation of what they went through.)

Modern medicine relies heavily upon controlled clinical trials to evaluate safety and determine efficacy. The main point in these trials is to isolate the specific 'thing' having the therapeutic effect (drug, intervention, etc.). There is heavy emphasis on limiting what influences the outcome, that is, on 'controlling' as many variables as possible. The idea is to reduce the influences down to just the therapy, therefore enabling one to claim that therapy was responsible for the outcome.

These trials are strict in their design and execution. This does, in fact, increase the reliability of the logical statements one is able to make following the experiment. If the person had these specific symptoms and all they did was take this drug, it's reasonably safe to say the drug is responsible for symptom alleviation.

One of the downsides to this approach is rooted in the very fact that the tests are so highly controlled. The more you alter the testing scenario, limiting variables by reducing outside influences, the more unique you make the scenario, and thus the less applicable the results are to other scenarios (especially 'real-world' situations where there is hardly any 'control').

As the idea of creating such narrowly defined testing situations is fundamental - the aim being to absolutely isolate the thing having the effect - this is simply a big sacrifice of this approach to medical investigation.

The only other option - to not create such artificial situations to test therapies - is to simply observe treatments in actual clinical situations. The downside here, of course, is that you have no 'control' over the set up and therefore can only make relatively weak connections between treatment executed and outcome.

For example, in a typical acupuncture treatment there are numerous influences on the treatment outcome, including:


Observing a single treatment gives very little wholly reliable information on what, exactly, had exactly how much effect, and of what type. It would take, literally, hundreds of thousands of these interactions to create a complete and reliable base of information.

Fortunately, Chinese medicine has billions of patient interactions upon which to base claims of treatment efficacy and safety.

As opposed to modern scientific investigation, the clinical evidence behind Chinese medicine is its long history of use. Over the last several thousand years, Chinese medical physicians have collected experience from actual clinical interactions..

Three Realms

Next, for chronic and more severe disorders, the medical system should be able to discuss the influence and effect of the issue in all three of the following realms -


For example, migraine headaches are often related to the Liver/Gallbladder systems. When they are, the headaches are likely due to the obstruction of qi in the Liver and Gallbladder channels (physical realm). This is a concrete manifestation of frustration and anger (possibly repressed)(mental/emotional realm). This also reflects deep obstruction to this person's spontaneous attempts to express/manifest inner potential out into the world (spiritual realm).

Individuality

Your chosen medical system should also be able to see (diagnose) and treat you as a unique individual.

The modern Western medical paradigm is a disease-oriented model. The patient's symptoms are matched against a list of potential abstract diseases. When a close enough match is found, treatment is given for that disease.

In Chinese medicine, a patient's symptoms are collected into a unique 'symptom pattern'; treatment is then based on this specific symptom pattern. This allows for much more individualized treatment. (Though, it does make studying the medicine extremely difficult.)

(There are a few downsides: When asked 'Can you treat back pain?', because treatments are necessarily based on an individual presentation, it is difficult to speak to abstract - no actual patient presented - diseases or issues.)

Treatment should also respond to a patient's changes. Nothing stays the same, including illness.

For example, a Chinese herbal formula may vary in constituent herbs and individual dose of herbs.

Do No Harm

Picture of Chinese medical sage Zhang Zhong-jing The first rule is 'Do No Harm'.

Side effects should be minimal to none and be short lived(eg. they should go away as treatment is adjusted to the patient's unique presentation).

Perhaps, in severe cases, side effects my be great, but, again, these would be short lived.

Also, treatment should not lead to the need for further treatment. Where it does, it is likely not the most appropriate treatment.

Beyond Symptoms

Your chosen medical system should be able to do three things:

Empowering the Patient

If required, medicine should be able to 'step in' to fight a battle the patient was unable to handle on their own. However, this needs to be a temporary situation. This healing power needs to be turned back over to the patient as soon as possible. Ultimately, good medicine assists, guides, and facilitates.

One of the main ways it does this is by assisting the patient in increasing their awareness of what's going on. (It needs to be understood, though, that ultimately, no one can know the situation better than the patient.)

X-rays are one good example. You fall and hurt your arm. The pain is severe, but you're not sure how bad it is. An x-ray can increase your awareness of what's going on.

Effective talk therapy is another common avenue for increasing awareness by providing a safe place for the patient to fully and consciously experience whatever they are feeling.

Good medicine also should be able to explain how the patient's thoughts and actions have led to the current illness, thus empowering the patient to avoid repeating or worsening the situation.

The more knowledge of the human being a system of medicine has the more assistance it can be to the patient.

Your Individual Practitioner

Your individual practitioner can make or break the whole deal. A profound practitioner of a poor system can effect miracle cures. A poor practitioner of a great system may be very limited in how much they can help.

Fundamentally, your practitioner should be soulfully invested in their style of medicine and in you. Their practice of their medicine should be an extension of their life and personal development.

Lastly, there should be open and honest discussion from the very beginning, through the treatment, and at the conclusion of your interaction.

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