Leukema revisited

January 27, 2000

Thank you all for your comments and insights.

The story has a happy ending as the boy responded to

antibiotic treatment.

The points made are, of course, still valid.

The main point I was trying to make was:

1. My giving a Dx on the spot without a detalied

intake was not the main problem, if I had asked a few

questions to the boy I would have quickly verified the

heat signs (he was not my patient and I was not

treating him. I would never perform a cursory exam and

provide treatment. That would be negligent). What

shocked me was the awsome responsability we hold and

how we must always be thorough and vigilent, 100% of

the time. It is like driving down the highway and

looking at your rearview mirror and not seeing any

cars. All of a sudden a porcshe comes barreling down

the RIGHT lane at 120 mph. 99% of the time sports cars

are noticed, they do not pass on the right and not at

lightning fast speeds. But, it's the 1% that can kill.

In clinical practice a swollen gland is 99% of the

time phlegm/qi/xue stag or a pattern thereof. If we

are lazy we will miss the 1% when it is not.

That was the point I was trying to make.

2. As for intuition, the only feeling I want in the

treatment room is that of empathy for the patient. I

want nothing else but to relieve their suffering. They

make themselves vulnurable to us, with our sharp

needles and exotic medicinals. They trust us. I need

to use every Dx tool at my disposale. Thankfully,

there are over 2,000 years and countless physicians

before me who have left me the tools neccesary to Dx

and Tx. As for my own intuition, I'll trust it when I

can play like Keith Jarret.

Talk to your friends online with Messenger.

http://im.

January 27, 2000

Dear Yanky,

I wish more practitioners would share their cases like this. . . .this

is how we all learn together! As you said, the only point here is that

anything is possible in that small percent! Believe me, there have been

cases where I've missed important stuff over the years! It is part of

being human! The Shang Han Lun, for example, is largely about physician

screwups, and how to rectify those mistakes. The only point here is that

nothing should allow us to be rushed or perfunctionary. . . .our patients,

colleagues not withstanding. Often times, people will come up to me in

classes, in the street, socially, asking me to diagnose them. . . .I won't,

they have to come in and make an appointment so I can concentrate fully and

not make mistakes. Students and colleagues ask me questions about their

patients. . . .they have to send e-mails, with as complete a history and

diagnosis as possible, for me to be of any help. It is very hard to be

accurate with missing pieces. . . .or giving medical advice on the phone

while you are with other patients. Yesterday, I had a phone message from

someone in Greece, who I never met, who wanted advice faxed to his hotel!

I try very hard to avoid being pressured into giving advice without being

in the space to do it properly. Although we love to help and be of

service, there is a time and place for everything.

>jacob gerlitz <jacobgerlitz

>

>Thank you all for your comments and insights.

>The story has a happy ending as the boy responded to

>antibiotic treatment.

>The points made are, of course, still valid.

>The main point I was trying to make was:

>1. My giving a Dx on the spot without a detalied

>intake was not the main problem, if I had asked a few

>questions to the boy I would have quickly verified the

>heat signs (he was not my patient and I was not

>treating him. I would never perform a cursory exam and

>provide treatment. That would be negligent). What

>shocked me was the awsome responsability we hold and

>how we must always be thorough and vigilent, 100% of

>the time. It is like driving down the highway and

>looking at your rearview mirror and not seeing any

>cars. All of a sudden a porcshe comes barreling down

>the RIGHT lane at 120 mph. 99% of the time sports cars

>are noticed, they do not pass on the right and not at

>lightning fast speeds. But, it's the 1% that can kill.

>In clinical practice a swollen gland is 99% of the

>time phlegm/qi/xue stag or a pattern thereof. If we

>are lazy we will miss the 1% when it is not.

>That was the point I was trying to make.

>2. As for intuition, the only feeling I want in the

>treatment room is that of empathy for the patient. I

>want nothing else but to relieve their suffering. They

>make themselves vulnurable to us, with our sharp

>needles and exotic medicinals. They trust us. I need

>to use every Dx tool at my disposale. Thankfully,

>there are over 2,000 years and countless physicians

>before me who have left me the tools neccesary to Dx

>and Tx. As for my own intuition, I'll trust it when I

>can play like Keith Jarret.

>

January 28, 2000

Dear Folks,

As I sit here and read these message (a special thanks to Jacob for it), I feel

overwhelmed by the medicine (I am sorry if I am not able to put my words right).

It is a great and humbling feeling. Thanks also to all the folks out there who

have given input. I also know that I have to practise a long time before I can

even try to play like Coltrane.

Laxman, Dipl Ac., CH.

On Thu, 27 January 2000, " " wrote:

>

> <html><body>

> <tt></tt> <tt>

> " " <zrosenberg</tt>

>

> <tt>

> Dear Yanky,

> I wish more practitioners would share their cases like this. . . .this

> is how we all learn together! As you said, the only point here is that

> anything is possible in that small percent! Believe me, there have been

> cases where I've missed important stuff over the years! It is part of

> being human! The Shang Han Lun, for example, is largely about physician

> screwups, and how to rectify those mistakes. The only point here is that

> nothing should allow us to be rushed or perfunctionary. . . .our patients,

> colleagues not withstanding. Often times, people will come up to me in

> classes, in the street, socially, asking me to diagnose them. . . .I

won't,

> they have to come in and make an appointment so I can concentrate fully

and

> not make mistakes. Students and colleagues ask me questions about their

> patients. . . .they have to send e-mails, with as complete a history and

> diagnosis as possible, for me to be of any help. It is very hard to be

> accurate with missing pieces. . . .or giving medical advice on the phone

> while you are with other patients. Yesterday, I had a phone message from

> someone in Greece, who I never met, who wanted advice faxed to his hotel!

> I try very hard to avoid being pressured into giving advice without being

> in the space to do it properly. Although we love to help and be of

> service, there is a time and place for everything.

>

> >jacob gerlitz <jacobgerlitz

> >

> >Thank you all for your comments and insights.

> >The story has a happy ending as the boy responded to

> >antibiotic treatment.

> >The points made are, of course, still valid.

> >The main point I was trying to make was:

> >1. My giving a Dx on the spot without a detalied

> >intake was not the main problem, if I had asked a few

> >questions to the boy I would have quickly verified the

> >heat signs (he was not my patient and I was not

> >treating him. I would never perform a cursory exam and

> >provide treatment. That would be negligent). What

> >shocked me was the awsome responsability we hold and

> >how we must always be thorough and vigilent, 100% of

> >the time. It is like driving down the highway and

> >looking at your rearview mirror and not seeing any

> >cars. All of a sudden a porcshe comes barreling down

> >the RIGHT lane at 120 mph. 99% of the time sports cars

> >are noticed, they do not pass on the right and not at

> >lightning fast speeds. But, it's the 1% that can kill.

> >In clinical practice a swollen gland is 99% of the

> >time phlegm/qi/xue stag or a pattern thereof. If we

> >are lazy we will miss the 1% when it is not.

> >That was the point I was trying to make.

> >2. As for intuition, the only feeling I want in the

> >treatment room is that of empathy for the patient. I

> >want nothing else but to relieve their suffering. They

> >make themselves vulnurable to us, with our sharp

> >needles and exotic medicinals. They trust us. I need

> >to use every Dx tool at my disposale. Thankfully,

> >there are over 2,000 years and countless physicians

> >before me who have left me the tools neccesary to Dx

> >and Tx. As for my own intuition, I'll trust it when I

> >can play like Keith Jarret.

> >

>

> </tt>

>

> <hr>

>

>

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January 28, 2000

--- jacob gerlitz <jacobgerlitz wrote:

> jacob gerlitz <jacobgerlitz

>

> As for my own intuition, I'll trust it when

> I

> can play like Keith Jarret.

As long as we're tossing around this metaphor (jazz

improvisation & clinical intuition), I maintain that

intuition, like improvisation, is a muscle that needs

to be exercised. Itzhak Perlman, as stellar a

musician as he is, is a lousy improvisor precisely

because he devotes virtually all his musical life to

reading notes off the page. No matter how many Andre

Previns or klezmer musicians he slums with, he is

still a straight player rather than a jazz player.

Of course Coltrane, Jarret, Parker, et al practiced

scales, knew theory, etc. But they were/are only

great jazz musicians because they spent a lot of time

blowing over changes, and giving themselves permission

to make (and learn from) their mistakes.

I humbly submit that clinical intuition is similar.

If you don't exercise it, you'll never really make

your mark as a clinician. Your above quote reminds me

of one of my favorite sayings of Fukushima Kodo:(to

paraphrase) " those who wait until they have mastered

pulse diagnosis to begin to apply it clinically will

never master pulse diagnosis " .

rh

=====

regards,

Robert Hayden, Dipl. Ac.

kampo36

Talk to your friends online with Messenger.

http://im.

January 28, 2000

Robert et al,

> I humbly submit that clinical intuition is similar.

> If you don't exercise it, you'll never really make

> your mark as a clinician. Your above quote reminds me

> of one of my favorite sayings of Fukushima Kodo:(to

> paraphrase) " those who wait until they have mastered

> pulse diagnosis to begin to apply it clinically will

> never master pulse diagnosis " .

I have stayed out of this discussion because I found myself in the minority,

or perhaps the only one to think it this manner and chose not to put myself

out there in this manner, BUT now that I have company I am compelled to

voice my opinion on this matter, and a little personal

experience/background.

First I believe that as Robert said the use of intuition is something that

is, at least to some extent, learned, getting better the more you use it.

When I first started doing clinical work in 1994 I couldn't trust such

inclinations that led me one way or the other, mostly because I could not

define a reason for what had come to mind. This was not necessarily because

they were incorrect or imprecise, but rather that I didn't have the tools to

understand how this inclination fit into the picture I was seeing. I would

ask my teacher, a practitioner of over thirty years and spiritually advance

man, about these intuitive inclinations and he would tell me that it was

very important to trust yourself and to look deeply at these and perhaps

even go with them, even without a rational basis. (Of course he also used to

tell me I had done this over many life times, more about that below.) This

was very difficult for me as I tend to want control of situations and the

thought of having uncontrolled intuitive inclinations was difficult for me

to rationalize, let alone " go with it " . However, over time I have learned to

trust myself and have found that in doing so tend to understand and " know "

when my intuition is on the right track (it most often is). I have talked to

many practitioners about this and have found that there are basically two

type of practitioners when it comes to intuition the kind that have it

(whether they have figured out how to use it is another issue altogether)

and those that don't. I don't believe either is better than the other, in

fact I have seen excellent and poor practitioners (in my opinion) on both

sides of this. Some who do have it rely on it and tend to make many mistakes

and don't seem to learn from them, only relying on the intuitive " powers " .

This is a grave mistake (again, in my opinion). Those that don't probably

have it but they are so stuck in their heads that they may never know that

it is there and will, perhaps, never get the benefit of knowing how to use

it, nor will their patients.

As to the many life times stuff that my teacher used to say. This may sound

like a bunch of new age/hippy/whatever you want to call it crap, BUT if what

Z'ev or maybe it was Todd said is true about intuition being no more than

your subconscious telling you things that you have learned but didn't access

consciously (I hope I didn't mis-paraphrase you to badly), then how else

could I explain these accurate " intuitive insights " . These things happened

so frequently in my early years of practice that I started to believe what

my teacher had said about me doing this in former life times. So I did some

family research. As it turns out, over the last 18 generations (that's as

far back as I could find) there has been herbalists/doctors/nurses right up

till my dad who was one of the first paramedics in the US, NOW

me................... some food for thought

Sticking my neck out...............don't cut my head off,

Chinese Herbology and Acupuncture

" Serve others and cultivate yourself simultaneously "

Lao Tzu

January 29, 2000

Dear Thomas et al..

Intuition is defined as following in the American Heritage Dicionary: The

faculty of knowing as if by instinct without conscious reasoning. A perception

based on this faculty. Sharp insight; impression.

The salient point being without conscious reasoning............

My point is that if the unconscious reasoning process can be uncovered, greater

good may come. This takes discipline. Below please find the quote of my text:

" Whenever we attribute clinical conclusions to " intuition " , we lose the

possibility of defining the process by which we come to the conclusion. If

this is lost, an important insight may pass away forever. The commitment to

uncovering those clinical perceptions we attribute to intuition is a

discipline worthy of consideration. "

Here the point is " possibility " . This does not preclude genuine psychic

phenomena of highly developed individuals or the blessings that masters in

spirit may bring to the clinical interaction......This is simply to highlight

the discipline that one of my teachers, Leon Hammer, has gifted me with.

Sincerely, Will Morris

January 29, 2000

I LOVE this saying. . . . .I'm going to share this one with my students!

one of my favorite sayings of Fukushima Kodo:(to

>paraphrase) " those who wait until they have mastered

>pulse diagnosis to begin to apply it clinically will

>never master pulse diagnosis " .

>

>rh

January 29, 2000

You know, reincarnation and lineage is part of my Jewish tradition and

upbringing. . . . .I don't consider myself merely a 'rationalist'.

However, I also know that the spiritual aspects of life, including medicine

are easily obscured or misunderstood without adequate experience in one's

field. This, for me, explains the 'medical psychics' I've seen diagnose

serious cancers and the like without any type of medical training, but,

then will fall on the floor to recognize an obvious ailment that any

layperson could see. . . . .Sometimes you may hit it, sometimes miss. In

medicine, obviously, hit and miss is not so great. . . ..this is why we

train in rational medical traditions, to try to improve when we hit the

target. In Chinese medicine, this is the train of lineage exemplified by

the medical classics, from antiquity to the present day.