Guest guest Posted April 30, 2008 Report Share Posted April 30, 2008 Andrea, The fact that you are asking this question and sharing the case at all shows you to be a practitioner of rare conscience and a caring soul. These conditions are very difficult to diagnose correctly, and often escape, as you saw here, detection even with the most sophisticated high-tech diagnostic procedures and treatments. And they can slip through the cracks of our diagnosis as well. To find something like valley fever in this case would be very difficult indeed. If anything, you probably helped relieve his suffering and live longer. If one stays in the field of Chinese medicine for an extended period of time, you inevitably come across cases like these. They are given to us for the privilege of caring for these people, and to learn even more about medicine. Our patients are our teachers, and when their health fails, it sends us back to our books to study even more, reflect and meditate, and grow as human beings. On Apr 30, 2008, at 7:14 PM, wrote: > Dear All, > > I am trying to sort something out. A previous patient of mine passed > away last week, apparently the result of a series of misdiagnoses > and proper treatment that was too little, too late. > > He came to see me 2 summers ago for severe pneumonia, which he had > been hospitalized for, for several weeks. In the following months, > he very slowly regained his strength, appetite, and weight, but had > tremendous difficulty breathing every time the weather became hot or > dry. Last fall, he came to see me again, with the same symptoms. > Since the local medical community took months to diagnose him > initially, he figured he just had contracted pneumonia again. Only > this time, he quickly deteriorated, and in a couple of weeks was > diagnosed (at a better hospital he had to travel out of town for) > with leukemia. > > A bone marrow donor was found for him, but during the tests to > determine whether he was fit for the procedure and immunosuppressive > drug therapy, it was determined that the real cause of his pneumonia > was valley fever. It led to the development of a mass in his lung - > surgery and healing from the surgery were necessary before he could > undergo the bone marrow transplant. > > He did poorly after the transplant, and was put in to a medically- > induced coma. When he regained consciousness, he was diagnosed with > graft vs. host disease. He was on dialysis. Eventually, his liver > failed while he was awaiting a donor liver for transplant. > > All along my points of contact with him, I encouraged him to seek > medical diagnosis and treatment, which he did, yet the local docs > and clinics failed to provide a proper diagnosis until too late. > With my training, I had no way to diagnose either valley fever, nor > leukemia. > > I am trying to sort out what part I played in my patient's demise, > if any. I take my responsibility for my patients' welfare seriously, > and am trying to determine whether I failed him in some way. > > I'd appreciate any input, especially from other practitioners who > have wrestled with similar scenarios. I have had other patients die > in the past, but these were all frail elderly. This guy was only 48, > and before he became ill, he was fairly robust. > > Thank you for your thoughts. > > > > Be a better friend, newshound, and know-it-all with Mobile. > Try it now. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 30, 2008 Report Share Posted April 30, 2008 Hi Z'ev, Thank you for your thoughtful comments. Indeed, I am reflecting on how I can strengthen my diagnostic skills, and have been recalling lectures with you about diagnosis with regards to time (I'm not sure I'm wording this correctly). At the same time, I am also aware that it has become a state issue here in Arizona, to require doctors to obtain training on how to diagnose valley fever; more often than not, it is misdiagnosed - or worse - patients are told they are making a big deal over a bad cold and sent home to develop a more chronic and entrenched illness. I like what you wrote below, particularly the part I italicized: " If one stays in the field of Chinese medicine for an extended period of time, you inevitably come across cases like these. They are given to us for the privilege of caring for these people, and to learn even more about medicine. Our patients are our teachers, and when their health fails, it sends us back to our books to study even more, reflect and meditate, and grow as human beings. " Before reading these words, I had not thought of this experience as a gift. Thank you for that beautiful, uplifting perspective. Andrea Beth Be a better friend, newshound, and know-it-all with Mobile. Try it now. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 Dear All, I am trying to sort something out. A previous patient of mine passed away last week, apparently the result of a series of misdiagnoses and proper treatment that was too little, too late. He came to see me 2 summers ago for severe pneumonia, which he had been hospitalized for, for several weeks. In the following months, he very slowly regained his strength, appetite, and weight, but had tremendous difficulty breathing every time the weather became hot or dry. Last fall, he came to see me again, with the same symptoms. Since the local medical community took months to diagnose him initially, he figured he just had contracted pneumonia again. Only this time, he quickly deteriorated, and in a couple of weeks was diagnosed (at a better hospital he had to travel out of town for) with leukemia. A bone marrow donor was found for him, but during the tests to determine whether he was fit for the procedure and immunosuppressive drug therapy, it was determined that the real cause of his pneumonia was valley fever. It led to the development of a mass in his lung - surgery and healing from the surgery were necessary before he could undergo the bone marrow transplant. He did poorly after the transplant, and was put in to a medically-induced coma. When he regained consciousness, he was diagnosed with graft vs. host disease. He was on dialysis. Eventually, his liver failed while he was awaiting a donor liver for transplant. All along my points of contact with him, I encouraged him to seek medical diagnosis and treatment, which he did, yet the local docs and clinics failed to provide a proper diagnosis until too late. With my training, I had no way to diagnose either valley fever, nor leukemia. I am trying to sort out what part I played in my patient's demise, if any. I take my responsibility for my patients' welfare seriously, and am trying to determine whether I failed him in some way. I'd appreciate any input, especially from other practitioners who have wrestled with similar scenarios. I have had other patients die in the past, but these were all frail elderly. This guy was only 48, and before he became ill, he was fairly robust. Thank you for your thoughts. Be a better friend, newshound, and know-it-all with Mobile. Try it now. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 Andrea: When we are put on the earth in a human body, we are all dealt a death card. It is part of the process. The trick is to live life to its fullest for as long as we have. This patient happend along your way. It appears what you did was make his life more comfortable while he was going through these medical procedures. I would consider that a gift to him; and, I am sure he helped you grow through the process. Anne -- Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. www.SouthernMDacupuncture.com -------------- Original message ---------------------- < > Dear All, > > I am trying to sort something out. A previous patient of mine passed away last > week, apparently the result of a series of misdiagnoses and proper treatment > that was too little, too late. > > He came to see me 2 summers ago for severe pneumonia, which he had been > hospitalized for, for several weeks. In the following months, he very slowly > regained his strength, appetite, and weight, but had tremendous difficulty > breathing every time the weather became hot or dry. Last fall, he came to see > me again, with the same symptoms. Since the local medical community took months > to diagnose him initially, he figured he just had contracted pneumonia again. > Only this time, he quickly deteriorated, and in a couple of weeks was diagnosed > (at a better hospital he had to travel out of town for) with leukemia. > > A bone marrow donor was found for him, but during the tests to determine whether > he was fit for the procedure and immunosuppressive drug therapy, it was > determined that the real cause of his pneumonia was valley fever. It led to the > development of a mass in his lung - surgery and healing from the surgery were > necessary before he could undergo the bone marrow transplant. > > He did poorly after the transplant, and was put in to a medically-induced coma. > When he regained consciousness, he was diagnosed with graft vs. host disease. > He was on dialysis. Eventually, his liver failed while he was awaiting a donor > liver for transplant. > > All along my points of contact with him, I encouraged him to seek medical > diagnosis and treatment, which he did, yet the local docs and clinics failed to > provide a proper diagnosis until too late. With my training, I had no way to > diagnose either valley fever, nor leukemia. > > I am trying to sort out what part I played in my patient's demise, if any. I > take my responsibility for my patients' welfare seriously, and am trying to > determine whether I failed him in some way. > > I'd appreciate any input, especially from other practitioners who have wrestled > with similar scenarios. I have had other patients die in the past, but these > were all frail elderly. This guy was only 48, and before he became ill, he was > fairly robust. > > Thank you for your thoughts. > > > > > > Be a better friend, newshound, and know-it-all with Mobile. Try it now. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 Thank you for your thoughts, Anne. I did help him with the initial pneumonia and the second appearance of it, but once he was diagnosed with leukemia, he relocated to Phoenix for treatment. True, we all die, and it is easy to say this was his path, just as it is my path to question the series of events and the way they played out. anne.crowley wrote: Andrea: When we are put on the earth in a human body, we are all dealt a death card. It is part of the process. The trick is to live life to its fullest for as long as we have. This patient happend along your way. It appears what you did was make his life more comfortable while he was going through these medical procedures. I would consider that a gift to him; and, I am sure he helped you grow through the process. Anne -- Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. www.SouthernMDacupuncture.com -------------- Original message ---------------------- > Dear All, > > I am trying to sort something out. A previous patient of mine passed away last > week, apparently the result of a series of misdiagnoses and proper treatment > that was too little, too late. > > He came to see me 2 summers ago for severe pneumonia, which he had been > hospitalized for, for several weeks. In the following months, he very slowly > regained his strength, appetite, and weight, but had tremendous difficulty > breathing every time the weather became hot or dry. Last fall, he came to see > me again, with the same symptoms. Since the local medical community took months > to diagnose him initially, he figured he just had contracted pneumonia again. > Only this time, he quickly deteriorated, and in a couple of weeks was diagnosed > (at a better hospital he had to travel out of town for) with leukemia. > > A bone marrow donor was found for him, but during the tests to determine whether > he was fit for the procedure and immunosuppressive drug therapy, it was > determined that the real cause of his pneumonia was valley fever. It led to the > development of a mass in his lung - surgery and healing from the surgery were > necessary before he could undergo the bone marrow transplant. > > He did poorly after the transplant, and was put in to a medically-induced coma. > When he regained consciousness, he was diagnosed with graft vs. host disease. > He was on dialysis. Eventually, his liver failed while he was awaiting a donor > liver for transplant. > > All along my points of contact with him, I encouraged him to seek medical > diagnosis and treatment, which he did, yet the local docs and clinics failed to > provide a proper diagnosis until too late. With my training, I had no way to > diagnose either valley fever, nor leukemia. > > I am trying to sort out what part I played in my patient's demise, if any. I > take my responsibility for my patients' welfare seriously, and am trying to > determine whether I failed him in some way. > > I'd appreciate any input, especially from other practitioners who have wrestled > with similar scenarios. I have had other patients die in the past, but these > were all frail elderly. This guy was only 48, and before he became ill, he was > fairly robust. > > Thank you for your thoughts. > > > > > > Be a better friend, newshound, and know-it-all with Mobile. Try it now. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 Andrea, because you encouraged him to pursue further diagnostic testing, you did nothing wrong. This is a tragic case, with a tragic ending. Although it is not in our scope of practice to make a western diagnosis- and here in PA we cannot order tests there have been many times that I have urged patients to pursue diagnostic tests. I have ³diagnosed² cases of celiac sprue, HPB, torn rotator cuffs, even cancer. It comes from years of clinical practice and a careful intake. Sometimes, in the patients medical history, something just doesn¹t add up to me. So I urge them to contact their physician, or I refer them to a specialist. Ted Kaptchuk gave me the best career advise (25 years ago!). He said: pay attention! Warmly, Cara < Wed, 30 Apr 2008 22:36:12 -0700 (PDT) Re: misdiagnosis and responsibility Hi Z'ev, Thank you for your thoughtful comments. Indeed, I am reflecting on how I can strengthen my diagnostic skills, and have been recalling lectures with you about diagnosis with regards to time (I'm not sure I'm wording this correctly). At the same time, I am also aware that it has become a state issue here in Arizona, to require doctors to obtain training on how to diagnose valley fever; more often than not, it is misdiagnosed - or worse - patients are told they are making a big deal over a bad cold and sent home to develop a more chronic and entrenched illness. I like what you wrote below, particularly the part I italicized: " If one stays in the field of Chinese medicine for an extended period of time, you inevitably come across cases like these. They are given to us for the privilege of caring for these people, and to learn even more about medicine. Our patients are our teachers, and when their health fails, it sends us back to our books to study even more, reflect and meditate, and grow as human beings. " Before reading these words, I had not thought of this experience as a gift. Thank you for that beautiful, uplifting perspective. Andrea Beth Be a better friend, newshound, and know-it-all with Mobile. Try it now. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 Thank you, Cara. As I read the replies I am getting from my original post, what is coming clear to me is that I want to use this experience to help me evaluate whether I am being the best practitioner I can be. I think we can all benefit from this sort of periodic evaluation - and so will our patients. I like what Ted said about paying attention. Thank you for caring enough to write. Andrea Beth Cara Frank <herbbabe wrote: Andrea, because you encouraged him to pursue further diagnostic testing, you did nothing wrong. This is a tragic case, with a tragic ending. Although it is not in our scope of practice to make a western diagnosis- and here in PA we cannot order tests there have been many times that I have urged patients to pursue diagnostic tests. I have ³diagnosed² cases of celiac sprue, HPB, torn rotator cuffs, even cancer. It comes from years of clinical practice and a careful intake. Sometimes, in the patients medical history, something just doesn¹t add up to me. So I urge them to contact their physician, or I refer them to a specialist. Ted Kaptchuk gave me the best career advise (25 years ago!). He said: pay attention! Warmly, Cara Be a better friend, newshound, and know-it-all with Mobile. Try it now. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 Looks like the surgery killed him, surgery kills way more people than tcm...I knew a guy whom I was brokering acupuncture treatment for from a cancer specialist I know, he was getting chemo as well, he fell, weakened from chemo, broke his leg, they decided to amputate and he bled to death from the surgery. Certain people are so weak you can't operate on them, the immune system weak, etc...As far as treatment you should try to recognize when someone is really sick and weak, even if you can't diagnose leukemia, do a lot of moxa on the back shu points and give life-boosting tonics like dong chong xia ciao, turtle glue, deer antler, boost essense, marrow, kidney yin and yang as safely as possible... Chinese Medicine , Andrea Beth Damsky < wrote: > > Thank you for your thoughts, Anne. I did help him with the initial pneumonia and the second appearance of it, but once he was diagnosed with leukemia, he relocated to Phoenix for treatment. True, we all die, and it is easy to say this was his path, just as it is my path to question the series of events and the way they played out. > > > > anne.crowley wrote: Andrea: > > When we are put on the earth in a human body, we are all dealt a death card. It is part of the process. The trick is to live life to its fullest for as long as we have. This patient happend along your way. It appears what you did was make his life more comfortable while he was going through these medical procedures. I would consider that a gift to him; and, I am sure he helped you grow through the process. > > Anne > > -- > Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. > > www.SouthernMDacupuncture.com > > -------------- Original message ---------------------- > > > Dear All, > > > > I am trying to sort something out. A previous patient of mine passed away last > > week, apparently the result of a series of misdiagnoses and proper treatment > > that was too little, too late. > > > > He came to see me 2 summers ago for severe pneumonia, which he had been > > hospitalized for, for several weeks. In the following months, he very slowly > > regained his strength, appetite, and weight, but had tremendous difficulty > > breathing every time the weather became hot or dry. Last fall, he came to see > > me again, with the same symptoms. Since the local medical community took months > > to diagnose him initially, he figured he just had contracted pneumonia again. > > Only this time, he quickly deteriorated, and in a couple of weeks was diagnosed > > (at a better hospital he had to travel out of town for) with leukemia. > > > > A bone marrow donor was found for him, but during the tests to determine whether > > he was fit for the procedure and immunosuppressive drug therapy, it was > > determined that the real cause of his pneumonia was valley fever. It led to the > > development of a mass in his lung - surgery and healing from the surgery were > > necessary before he could undergo the bone marrow transplant. > > > > He did poorly after the transplant, and was put in to a medically-induced coma. > > When he regained consciousness, he was diagnosed with graft vs. host disease. > > He was on dialysis. Eventually, his liver failed while he was awaiting a donor > > liver for transplant. > > > > All along my points of contact with him, I encouraged him to seek medical > > diagnosis and treatment, which he did, yet the local docs and clinics failed to > > provide a proper diagnosis until too late. With my training, I had no way to > > diagnose either valley fever, nor leukemia. > > > > I am trying to sort out what part I played in my patient's demise, if any. I > > take my responsibility for my patients' welfare seriously, and am trying to > > determine whether I failed him in some way. > > > > I'd appreciate any input, especially from other practitioners who have wrestled > > with similar scenarios. I have had other patients die in the past, but these > > were all frail elderly. This guy was only 48, and before he became ill, he was > > fairly robust. > > > > Thank you for your thoughts. > > > > > > > > > > > > Be a better friend, newshound, and know-it-all with Mobile. Try it now. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 Andrea, Thanks for sharing this case with all of us. I'm sure this has been traumatic for you and caused much soul-searching on your part. From my point of view, this case underscores the importance of (correct) Western medical disease diagnosis. The disease diagnosis of CM is very simplistic and underdeveloped when it comes to understanding the natural history of specific diseases. You don't mention this patient's CM disease diagnoses, but they may only have been cough (ke sou) and/or vacuity taxation (xu lao). While the hallmark of professional CM is that treatment is primarily predicated on pattern discrimination, we must always take into account the disease diagnosis as well, bot the traditional CM disease diagnosis/diagnoses and the modern WM disease diagnosis. In other words, a patient presents a pattern or set of interlocked patterns of a specific disease. In such as case, knowing the WM disease diagnosis helps to determine the severity of the patient's condition, the likelihood of red flags, and the patient's overall prognosis. These are things that CM patterns do not tell us but which we must know in terms of comprehensive and competent medical care. I understand that the patient's WM disease diagnosis may have been botched right from the start. However, that does not change the fact that a correct WM disease diagnosis is extremely important in the contemporary practice of standard professional CM. This means that integrated Chinese-Western medicine (zhong xi yi jie he) is both the inevitable and desirable wave of the future. Therefore, I support the U.S. doctoral programs that are doing so much more in terms of understanding the natural history of Western diseases. Woiuld that these programs also improved the quality of the CM pattern discrimination at the same time. Bob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 You are not responsible for making a medical diagnosis, you are only responsible for referring to MD when appropriate, at least in california. You need this clearly documented on your chart, in the future its even best to make the referral directly. Since he was under medical care your exposure is minimal, except that you may be named together with all his providers at the start of proceedings. You will be dropped quickly 400 29th St. Suite 419 Oakland Ca 94609 alonmarcus Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 Bob I want to thank you for emphasizing this point so often dismissed by people in our profession. 400 29th St. Suite 419 Oakland Ca 94609 alonmarcus Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 Hi Andrea, It seems to me that in terms of knowing when to make a referral and working along side the western doctors, you did wonderfully. And I so agree with Z'ev's comments regarding these types of cases coming across our paths. I would add though that, since you practice Chinese medicine, the most important thing to think about is your own diagnosis and treatment of him. I think it's true of every case we don't succeed in - it's just all the more intense feeling when the patient doesn't make it. Our failures (and I am not at all saying that his death was a result of your failure) can motivate us to study, consider and learn. When you look back at his case, do you have any questions or thoughts about your Chinese medical treatment of him? Were there any confusions or muddled areas that you want to clear up for yourself for the future? It is so good to have a good reflective conscience as you do and we shouldn't shy away from letting this push us into deeper levels of skill. Thanks for sharing this, Sharon Dear All, I am trying to sort something out. A previous patient of mine passed away last week, apparently the result of a series of misdiagnoses and proper treatment that was too little, too late. He came to see me 2 summers ago for severe pneumonia, which he had been hospitalized for, for several weeks. In the following months, he very slowly regained his strength, appetite, and weight, but had tremendous difficulty breathing every time the weather became hot or dry. Last fall, he came to see me again, with the same symptoms. Since the local medical community took months to diagnose him initially, he figured he just had contracted pneumonia again. Only this time, he quickly deteriorated, and in a couple of weeks was diagnosed (at a better hospital he had to travel out of town for) with leukemia. A bone marrow donor was found for him, but during the tests to determine whether he was fit for the procedure and immunosuppressive drug therapy, it was determined that the real cause of his pneumonia was valley fever. It led to the development of a mass in his lung - surgery and healing from the surgery were necessary before he could undergo the bone marrow transplant. He did poorly after the transplant, and was put in to a medically- induced coma. When he regained consciousness, he was diagnosed with graft vs. host disease. He was on dialysis. Eventually, his liver failed while he was awaiting a donor liver for transplant. All along my points of contact with him, I encouraged him to seek medical diagnosis and treatment, which he did, yet the local docs and clinics failed to provide a proper diagnosis until too late. With my training, I had no way to diagnose either valley fever, nor leukemia. I am trying to sort out what part I played in my patient's demise, if any. I take my responsibility for my patients' welfare seriously, and am trying to determine whether I failed him in some way. I'd appreciate any input, especially from other practitioners who have wrestled with similar scenarios. I have had other patients die in the past, but these were all frail elderly. This guy was only 48, and before he became ill, he was fairly robust. Thank you for your thoughts. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 Thank you for your thoughts, Jason. Andrea Beth jasonwcom <jasonwcom wrote: Looks like the surgery killed him, surgery kills way more people than tcm...I knew a guy whom I was brokering acupuncture treatment for from a cancer specialist I know, he was getting chemo as well, he fell, weakened from chemo, broke his leg, they decided to amputate and he bled to death from the surgery. Certain people are so weak you can't operate on them, the immune system weak, etc...As far as treatment you should try to recognize when someone is really sick and weak, even if you can't diagnose leukemia, do a lot of moxa on the back shu points and give life-boosting tonics like dong chong xia ciao, turtle glue, deer antler, boost essense, marrow, kidney yin and yang as safely as possible... Chinese Medicine , Andrea Beth Damsky wrote: > > Thank you for your thoughts, Anne. I did help him with the initial pneumonia and the second appearance of it, but once he was diagnosed with leukemia, he relocated to Phoenix for treatment. True, we all die, and it is easy to say this was his path, just as it is my path to question the series of events and the way they played out. > > > > anne.crowley wrote: Andrea: > > When we are put on the earth in a human body, we are all dealt a death card. It is part of the process. The trick is to live life to its fullest for as long as we have. This patient happend along your way. It appears what you did was make his life more comfortable while he was going through these medical procedures. I would consider that a gift to him; and, I am sure he helped you grow through the process. > > Anne > > -- > Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. > > www.SouthernMDacupuncture.com > > -------------- Original message ---------------------- > > > Dear All, > > > > I am trying to sort something out. A previous patient of mine passed away last > > week, apparently the result of a series of misdiagnoses and proper treatment > > that was too little, too late. > > > > He came to see me 2 summers ago for severe pneumonia, which he had been > > hospitalized for, for several weeks. In the following months, he very slowly > > regained his strength, appetite, and weight, but had tremendous difficulty > > breathing every time the weather became hot or dry. Last fall, he came to see > > me again, with the same symptoms. Since the local medical community took months > > to diagnose him initially, he figured he just had contracted pneumonia again. > > Only this time, he quickly deteriorated, and in a couple of weeks was diagnosed > > (at a better hospital he had to travel out of town for) with leukemia. > > > > A bone marrow donor was found for him, but during the tests to determine whether > > he was fit for the procedure and immunosuppressive drug therapy, it was > > determined that the real cause of his pneumonia was valley fever. It led to the > > development of a mass in his lung - surgery and healing from the surgery were > > necessary before he could undergo the bone marrow transplant. > > > > He did poorly after the transplant, and was put in to a medically-induced coma. > > When he regained consciousness, he was diagnosed with graft vs. host disease. > > He was on dialysis. Eventually, his liver failed while he was awaiting a donor > > liver for transplant. > > > > All along my points of contact with him, I encouraged him to seek medical > > diagnosis and treatment, which he did, yet the local docs and clinics failed to > > provide a proper diagnosis until too late. With my training, I had no way to > > diagnose either valley fever, nor leukemia. > > > > I am trying to sort out what part I played in my patient's demise, if any. I > > take my responsibility for my patients' welfare seriously, and am trying to > > determine whether I failed him in some way. > > > > I'd appreciate any input, especially from other practitioners who have wrestled > > with similar scenarios. I have had other patients die in the past, but these > > were all frail elderly. This guy was only 48, and before he became ill, he was > > fairly robust. > > > > Thank you for your thoughts. > > > > > > > > > > > > Be a better friend, newshound, and know-it-all with Mobile. Try it now. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 Dear Andrea Beth, I am sorry to hear of your patient and also of your struggle with it. I think that is natural and actually says a lot about your quality as a practitioner and person. When it comes, legally, down to it you recommended him seeing a western m.d. and that is all you needed to do. It is their responisbility to diagnose and provide correct treatment and they failed, not you - you are not trained for that nor expected to do it (although maybe in CA with acus being primary care that might be different?) but I know you are in AZ and I assume they don't see you as primary care. Please don't be too hard on yourself. Julie On Wed, Apr 30, 2008 at 11:13 PM, < wrote: > Thank you for your thoughts, Anne. I did help him with the initial > pneumonia and the second appearance of it, but once he was diagnosed with > leukemia, he relocated to Phoenix for treatment. True, we all die, and it is > easy to say this was his path, just as it is my path to question the series > of events and the way they played out. > > > > anne.crowley <anne.crowley%40comcast.net> wrote: Andrea: > > When we are put on the earth in a human body, we are all dealt a death > card. It is part of the process. The trick is to live life to its fullest > for as long as we have. This patient happend along your way. It appears what > you did was make his life more comfortable while he was going through these > medical procedures. I would consider that a gift to him; and, I am sure he > helped you grow through the process. > > Anne > > -- > Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. > > www.SouthernMDacupuncture.com <http://www.southernmdacupuncture.com/> > > -------------- Original message ---------------------- > > > Dear All, > > > > I am trying to sort something out. A previous patient of mine passed > away last > > week, apparently the result of a series of misdiagnoses and proper > treatment > > that was too little, too late. > > > > He came to see me 2 summers ago for severe pneumonia, which he had been > > hospitalized for, for several weeks. In the following months, he very > slowly > > regained his strength, appetite, and weight, but had tremendous > difficulty > > breathing every time the weather became hot or dry. Last fall, he came > to see > > me again, with the same symptoms. Since the local medical community took > months > > to diagnose him initially, he figured he just had contracted pneumonia > again. > > Only this time, he quickly deteriorated, and in a couple of weeks was > diagnosed > > (at a better hospital he had to travel out of town for) with leukemia. > > > > A bone marrow donor was found for him, but during the tests to determine > whether > > he was fit for the procedure and immunosuppressive drug therapy, it was > > determined that the real cause of his pneumonia was valley fever. It led > to the > > development of a mass in his lung - surgery and healing from the surgery > were > > necessary before he could undergo the bone marrow transplant. > > > > He did poorly after the transplant, and was put in to a > medically-induced coma. > > When he regained consciousness, he was diagnosed with graft vs. host > disease. > > He was on dialysis. Eventually, his liver failed while he was awaiting a > donor > > liver for transplant. > > > > All along my points of contact with him, I encouraged him to seek > medical > > diagnosis and treatment, which he did, yet the local docs and clinics > failed to > > provide a proper diagnosis until too late. With my training, I had no > way to > > diagnose either valley fever, nor leukemia. > > > > I am trying to sort out what part I played in my patient's demise, if > any. I > > take my responsibility for my patients' welfare seriously, and am trying > to > > determine whether I failed him in some way. > > > > I'd appreciate any input, especially from other practitioners who have > wrestled > > with similar scenarios. I have had other patients die in the past, but > these > > were all frail elderly. This guy was only 48, and before he became ill, > he was > > fairly robust. > > > > Thank you for your thoughts. > > > > > > > > > > > > Be a better friend, newshound, and know-it-all with Mobile. Try > it now. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 I would have to agree with Bob about the importance of knowing how to investigate a problem both from a western and an eastern point of view. The modern practice of chinese dermatology is very much like this and it works really well. The western dx helps narrow down the choices for treatment. For example some types of tinea can be very hard to discriminate from other skin lesions like psoriasis and eczema. Using a simple scraping and investigation under a microscope can help indentify that in fact the lesion is truly fungal and an appropriate remedy can be given. If the fungal condition was treated otherwise, there is the chance that the condition could become both masked and made worse. Another example for integration, or at least understanding a good level of western medicine, is in regards to gynecology. I recently saw a woman who had been bleeding for 3 months post chemical abortion. Her western doctor had given her shots of methatrexate because her HCG blood levels were still elevated. The shots did not work and this woman became very worried. I had asked her if she had had a proper ultra sound done to determine if there was any matter there and she said that her regular doc (who was an RE) had given her one in the beginning and found nothing. I decided to refer her to another RE, who quickly gave her a more thorough U/S and sure enough they found some matter. A few days later they did a very light and focused D & C and found that the matter was a piece of living placenta that was acting like a pump to draw out blood. The day after the procedure her bleeding stopped and she felt fine. Now I am giving her herbs to help nourish her blood loss and as well invigorate to prevent scarring. This woman was very happy that I knew what to look for. That I knew what kind of tests to have done, and who to refer to. As well as how to help her using chinese medicine. I cannot imagine how I could have properly helped this women had I not known any level of western medicine. To me I cannot seperate the two meds, they are needed together and are meant for each other. Trevor , " Bob Flaws " <pemachophel2001 wrote: > > Andrea, > > Thanks for sharing this case with all of us. I'm sure this has been > traumatic for you and caused much soul-searching on your part. > > From my point of view, this case underscores the importance of > (correct) Western medical disease diagnosis. The disease diagnosis of > CM is very simplistic and underdeveloped when it comes to > understanding the natural history of specific diseases. You don't > mention this patient's CM disease diagnoses, but they may only have > been cough (ke sou) and/or vacuity taxation (xu lao). While the > hallmark of professional CM is that treatment is primarily predicated > on pattern discrimination, we must always take into account the > disease diagnosis as well, bot the traditional CM disease > diagnosis/diagnoses and the modern WM disease diagnosis. In other > words, a patient presents a pattern or set of interlocked patterns of > a specific disease. In such as case, knowing the WM disease diagnosis > helps to determine the severity of the patient's condition, the > likelihood of red flags, and the patient's overall prognosis. These > are things that CM patterns do not tell us but which we must know in > terms of comprehensive and competent medical care. > > I understand that the patient's WM disease diagnosis may have been > botched right from the start. However, that does not change the fact > that a correct WM disease diagnosis is extremely important in the > contemporary practice of standard professional CM. This means that > integrated Chinese-Western medicine (zhong xi yi jie he) is both the > inevitable and desirable wave of the future. Therefore, I support the > U.S. doctoral programs that are doing so much more in terms of > understanding the natural history of Western diseases. Woiuld that > these programs also improved the quality of the CM pattern > discrimination at the same time. > > Bob > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 Andrea: You did all you could. We cannot do everything, and in this case even the docs, by misdiagnosing a rare contagious disease, made a probably inevitable error. It is easy to feel that everything can be cured if only we work hard enough, but the practical reality is that even the best healers miss things and make errors( or just don't have the time and resources to catch everything.) Neither of which you did in this case, unless you are also an infectious disease specialist as your day job. So let go of this and don't take it personally. And next time, if something similar ever happens again, you may be able to prevent it. Just not this time. -Ben Hawes, L.Ac. misdiagnosis and responsibility <Chinese Medicine/message/29077;_ylc=X\ 3oDMTJyNzRpOTNwBF9TAzk3MzU5NzE1BGdycElkAzk0OTU5NzcEZ3Jwc3BJZAMxNzA1MDYwODE0BG1zZ\ 0lkAzI5MDc3BHNlYwNkbXNnBHNsawN2bXNnBHN0aW1lAzEyMDk2MjY5ODk-> Posted by: " " <?Subject=%20Re%3Amisdiagnosis%20and%20responsibility> <http://profiles./> Wed Apr 30, 2008 7:14 pm (PDT) Dear All, I am trying to sort something out. A previous patient of mine passed away last week, apparently the result of a series of misdiagnoses and proper treatment that was too little, too late. He came to see me 2 summers ago for severe pneumonia, which he had been hospitalized for, for several weeks. In the following months, he very slowly regained his strength, appetite, and weight, but had tremendous difficulty breathing every time the weather became hot or dry. Last fall, he came to see me again, with the same symptoms. Since the local medical community took months to diagnose him initially, he figured he just had contracted pneumonia again. Only this time, he quickly deteriorated, and in a couple of weeks was diagnosed (at a better hospital he had to travel out of town for) with leukemia. A bone marrow donor was found for him, but during the tests to determine whether he was fit for the procedure and immunosuppressive drug therapy, it was determined that the real cause of his pneumonia was valley fever. It led to the development of a mass in his lung - surgery and healing from the surgery were necessary before he could undergo the bone marrow transplant. He did poorly after the transplant, and was put in to a medically-induced coma. When he regained consciousness, he was diagnosed with graft vs. host disease. He was on dialysis. Eventually, his liver failed while he was awaiting a donor liver for transplant. All along my points of contact with him, I encouraged him to seek medical diagnosis and treatment, which he did, yet the local docs and clinics failed to provide a proper diagnosis until too late. With my training, I had no way to diagnose either valley fever, nor leukemia. I am trying to sort out what part I played in my patient's demise, if any. I take my responsibility for my patients' welfare seriously, and am trying to determine whether I failed him in some way. I'd appreciate any input, especially from other practitioners who have wrestled with similar scenarios. I have had other patients die in the past, but these were all frail elderly. This guy was only 48, and before he became ill, he was fairly robust. Thank you for your thoughts. -- ATTENTION: Protected by Federal Law! The documents accompanying this transmission contain confidential health care information that is legally privileged and intended for the below-named individual or entity only. The recipient of this document is prohibited from disclosing its contents and is required by law to destroy this information once authorized fulfillment is complete. If you have received this transmission in error, please contact sender immediately. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 This is a good reminder for all of us, Alon. I always make sure to note in my charts when I recommend they see a doctor or specialist, even if they don't follow through and I keep making the same recommendation visit after visit... In this case, I am not concerned about a lawsuit. I am concerning myself with questions about whether I am the best practitioner I can be, and if I see an area where I can improve, how do I get myself to do that. alon marcus <alonmarcus wrote: You are not responsible for making a medical diagnosis, you are only responsible for referring to MD when appropriate, at least in california. You need this clearly documented on your chart, in the future its even best to make the referral directly. Since he was under medical care your exposure is minimal, except that you may be named together with all his providers at the start of proceedings. You will be dropped quickly 400 29th St. Suite 419 Oakland Ca 94609 alonmarcus Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2008 Report Share Posted May 1, 2008 Thank you, Sharon. You and Z'ev have captured the essence of the questions I am asking of myself. sharon weizenbaum <sweiz wrote: Hi Andrea, It seems to me that in terms of knowing when to make a referral and working along side the western doctors, you did wonderfully. And I so agree with Z'ev's comments regarding these types of cases coming across our paths. I would add though that, since you practice Chinese medicine, the most important thing to think about is your own diagnosis and treatment of him. I think it's true of every case we don't succeed in - it's just all the more intense feeling when the patient doesn't make it. Our failures (and I am not at all saying that his death was a result of your failure) can motivate us to study, consider and learn. When you look back at his case, do you have any questions or thoughts about your Chinese medical treatment of him? Were there any confusions or muddled areas that you want to clear up for yourself for the future? It is so good to have a good reflective conscience as you do and we shouldn't shy away from letting this push us into deeper levels of skill. Thanks for sharing this, Sharon Dear All, I am trying to sort something out. A previous patient of mine passed away last week, apparently the result of a series of misdiagnoses and proper treatment that was too little, too late. He came to see me 2 summers ago for severe pneumonia, which he had been hospitalized for, for several weeks. In the following months, he very slowly regained his strength, appetite, and weight, but had tremendous difficulty breathing every time the weather became hot or dry. Last fall, he came to see me again, with the same symptoms. Since the local medical community took months to diagnose him initially, he figured he just had contracted pneumonia again. Only this time, he quickly deteriorated, and in a couple of weeks was diagnosed (at a better hospital he had to travel out of town for) with leukemia. A bone marrow donor was found for him, but during the tests to determine whether he was fit for the procedure and immunosuppressive drug therapy, it was determined that the real cause of his pneumonia was valley fever. It led to the development of a mass in his lung - surgery and healing from the surgery were necessary before he could undergo the bone marrow transplant. He did poorly after the transplant, and was put in to a medically- induced coma. When he regained consciousness, he was diagnosed with graft vs. host disease. He was on dialysis. Eventually, his liver failed while he was awaiting a donor liver for transplant. All along my points of contact with him, I encouraged him to seek medical diagnosis and treatment, which he did, yet the local docs and clinics failed to provide a proper diagnosis until too late. With my training, I had no way to diagnose either valley fever, nor leukemia. I am trying to sort out what part I played in my patient's demise, if any. I take my responsibility for my patients' welfare seriously, and am trying to determine whether I failed him in some way. I'd appreciate any input, especially from other practitioners who have wrestled with similar scenarios. I have had other patients die in the past, but these were all frail elderly. This guy was only 48, and before he became ill, he was fairly robust. Thank you for your thoughts. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2008 Report Share Posted May 2, 2008 Thank you, Julie. I have received many of emails similar to yours - telling me I didn't do anything wrong, not to blame myself, etc. I am not so concerned about legal responsibility, as I am about professional responsibility - asking questions like, are my skills up to par? If there are any areas where are my skills could be stronger, how could I get to the next level? That sort of stuff. I feel these questions fall more in the arena of ethical responsibility - am I as good as I can be, and as good as my patients think I am because I know stuff they don't? Bottom line is, my patients trust me, and I am checking on whether I am worthy of the level of trust they afford me. When patients die in hospitals, there is an investigative process. In some complicated cases, like this one, I think it is a good process for us to also evaluate our actions and skills. Thank you for writing, and caring. Andrea Beth Julie Ormonde <cariadanam wrote: Dear Andrea Beth, I am sorry to hear of your patient and also of your struggle with it. I think that is natural and actually says a lot about your quality as a practitioner and person. When it comes, legally, down to it you recommended him seeing a western m.d. and that is all you needed to do. It is their responisbility to diagnose and provide correct treatment and they failed, not you - you are not trained for that nor expected to do it (although maybe in CA with acus being primary care that might be different?) but I know you are in AZ and I assume they don't see you as primary care. Please don't be too hard on yourself. Julie On Wed, Apr 30, 2008 at 11:13 PM, wrote: > Thank you for your thoughts, Anne. I did help him with the initial > pneumonia and the second appearance of it, but once he was diagnosed with > leukemia, he relocated to Phoenix for treatment. True, we all die, and it is > easy to say this was his path, just as it is my path to question the series > of events and the way they played out. > > > > anne.crowley wrote: Andrea: > > When we are put on the earth in a human body, we are all dealt a death > card. It is part of the process. The trick is to live life to its fullest > for as long as we have. This patient happend along your way. It appears what > you did was make his life more comfortable while he was going through these > medical procedures. I would consider that a gift to him; and, I am sure he > helped you grow through the process. > > Anne > > -- > Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. > > www.SouthernMDacupuncture.com > > -------------- Original message ---------------------- > > > Dear All, > > > > I am trying to sort something out. A previous patient of mine passed > away last > > week, apparently the result of a series of misdiagnoses and proper > treatment > > that was too little, too late. > > > > He came to see me 2 summers ago for severe pneumonia, which he had been > > hospitalized for, for several weeks. In the following months, he very > slowly > > regained his strength, appetite, and weight, but had tremendous > difficulty > > breathing every time the weather became hot or dry. Last fall, he came > to see > > me again, with the same symptoms. Since the local medical community took > months > > to diagnose him initially, he figured he just had contracted pneumonia > again. > > Only this time, he quickly deteriorated, and in a couple of weeks was > diagnosed > > (at a better hospital he had to travel out of town for) with leukemia. > > > > A bone marrow donor was found for him, but during the tests to determine > whether > > he was fit for the procedure and immunosuppressive drug therapy, it was > > determined that the real cause of his pneumonia was valley fever. It led > to the > > development of a mass in his lung - surgery and healing from the surgery > were > > necessary before he could undergo the bone marrow transplant. > > > > He did poorly after the transplant, and was put in to a > medically-induced coma. > > When he regained consciousness, he was diagnosed with graft vs. host > disease. > > He was on dialysis. Eventually, his liver failed while he was awaiting a > donor > > liver for transplant. > > > > All along my points of contact with him, I encouraged him to seek > medical > > diagnosis and treatment, which he did, yet the local docs and clinics > failed to > > provide a proper diagnosis until too late. With my training, I had no > way to > > diagnose either valley fever, nor leukemia. > > > > I am trying to sort out what part I played in my patient's demise, if > any. I > > take my responsibility for my patients' welfare seriously, and am trying > to > > determine whether I failed him in some way. > > > > I'd appreciate any input, especially from other practitioners who have > wrestled > > with similar scenarios. I have had other patients die in the past, but > these > > were all frail elderly. This guy was only 48, and before he became ill, > he was > > fairly robust. > > > > Thank you for your thoughts. > > > > > > > > > > > > Be a better friend, newshound, and know-it-all with Mobile. Try > it now. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2008 Report Share Posted May 2, 2008 Hi Edith, Good question about looking back over his charts, which I have not done. I remember his pulse very clearly, though, because it seemed so disproportionate to the rest of his presentation! While he exhibited profound weakness and fatigue - chest caved in, sometimes too weak too walk more than a few steps, loss of appetite and a great deal of weight, severe shortness of breath with speaking - his eyes were extremely red, and his pulse was the most excess pulse I ever felt - flooding, surging, superficial, rapid, strong, hard. I know he lived a high-stress life with many deadlines, but his demeanor was always calm - before and during his illness. I will check on the tongue presentation and post it. Thanks for this suggestion. This man was my car mechanic, and a good friend. He used to joke about acupuncture needles being like tiny wrenches, for fixing his broken motor so it could go again; sometimes he likened it to jump-starting his battery. " Edith Chan, L.Ac. " <chineseherbs wrote: Agreed whole-heartedly. Andrea Beth thank you for sharing your story about this patient. In between the words of sadness and sorrow there is so much love and tenderness in your email. I found it so inspirational. It reminded me to be more present, not because of legal responsibilities, but because life throws surprises and you can never know what will unfold. Thank you for sharing. I wonder, with the hindsight now, did you look back at your charts to see from a TCM perspective anything peculiar about the tongue or pulse. I would be so curious to learn from you. ~edith -- Edith Chan, L.Ac. Phone: 415.298.5324 www.EdithChanAcupuncture.com On Thu, May 1, 2008 at 8:50 AM, Julie Ormonde wrote: > Dear Andrea Beth, > > I am sorry to hear of your patient and also of your struggle with it. I > think that is natural and actually says a lot about your quality as a > practitioner and person. When it comes, legally, down to it you > recommended > him seeing a western m.d. and that is all you needed to do. It is their > responisbility to diagnose and provide correct treatment and they failed, > not you - you are not trained for that nor expected to do it (although > maybe > in CA with acus being primary care that might be different?) but I know > you > are in AZ and I assume they don't see you as primary care. > Please don't be too hard on yourself. > > Julie > On Wed, Apr 30, 2008 at 11:13 PM, > > > wrote: > > > > Thank you for your thoughts, Anne. I did help him with the initial > > pneumonia and the second appearance of it, but once he was diagnosed > with > > leukemia, he relocated to Phoenix for treatment. True, we all die, and > it is > > easy to say this was his path, just as it is my path to question the > series > > of events and the way they played out. > > > > > > > > anne.crowley > 40comcast.net> wrote: Andrea: > > > > When we are put on the earth in a human body, we are all dealt a death > > card. It is part of the process. The trick is to live life to its > fullest > > for as long as we have. This patient happend along your way. It appears > what > > you did was make his life more comfortable while he was going through > these > > medical procedures. I would consider that a gift to him; and, I am sure > he > > helped you grow through the process. > > > > Anne > > > > -- > > Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. > > > > www.SouthernMDacupuncture.com > > > > > -------------- Original message ---------------------- > > > > > Dear All, > > > > > > I am trying to sort something out. A previous patient of mine passed > > away last > > > week, apparently the result of a series of misdiagnoses and proper > > treatment > > > that was too little, too late. > > > > > > He came to see me 2 summers ago for severe pneumonia, which he had > been > > > hospitalized for, for several weeks. In the following months, he very > > slowly > > > regained his strength, appetite, and weight, but had tremendous > > difficulty > > > breathing every time the weather became hot or dry. Last fall, he came > > to see > > > me again, with the same symptoms. Since the local medical community > took > > months > > > to diagnose him initially, he figured he just had contracted pneumonia > > again. > > > Only this time, he quickly deteriorated, and in a couple of weeks was > > diagnosed > > > (at a better hospital he had to travel out of town for) with leukemia. > > > > > > A bone marrow donor was found for him, but during the tests to > determine > > whether > > > he was fit for the procedure and immunosuppressive drug therapy, it > was > > > determined that the real cause of his pneumonia was valley fever. It > led > > to the > > > development of a mass in his lung - surgery and healing from the > surgery > > were > > > necessary before he could undergo the bone marrow transplant. > > > > > > He did poorly after the transplant, and was put in to a > > medically-induced coma. > > > When he regained consciousness, he was diagnosed with graft vs. host > > disease. > > > He was on dialysis. Eventually, his liver failed while he was awaiting > a > > donor > > > liver for transplant. > > > > > > All along my points of contact with him, I encouraged him to seek > > medical > > > diagnosis and treatment, which he did, yet the local docs and clinics > > failed to > > > provide a proper diagnosis until too late. With my training, I had no > > way to > > > diagnose either valley fever, nor leukemia. > > > > > > I am trying to sort out what part I played in my patient's demise, if > > any. I > > > take my responsibility for my patients' welfare seriously, and am > trying > > to > > > determine whether I failed him in some way. > > > > > > I'd appreciate any input, especially from other practitioners who have > > wrestled > > > with similar scenarios. I have had other patients die in the past, but > > these > > > were all frail elderly. This guy was only 48, and before he became > ill, > > he was > > > fairly robust. > > > > > > Thank you for your thoughts. > > > > > > > > > > > > > > > > > > Be a better friend, newshound, and know-it-all with Mobile. Try > > it now. > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2008 Report Share Posted May 2, 2008 Andrea, I'm also in AZ. I though it might be helpful to remind you how long and confusing a process diagnosing Valley Fever can be. You did what you could do. Your patient was caught in a confluence of powerful circumstances. One acupuncturist can't stop a river equipped only with foresight and heart. Joe Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2008 Report Share Posted May 2, 2008 Andrea, While it is easy to ask ourselves what more could we have done, is it not possible that we have done more than was possible with the standard Western treatment? It is entirely possible that you extended your patients time on this earth with your treatments, without such they would have succumbed more quickly to their mis-diagnosed Western disease without your input. Be assured that you did your best for this patient, which is obvious by your angst that you did not, and learn the lessons that they were here to impart. Stay true to your medicine and don't be lead astray. From my perspective, I won't be a master until i am at least 80 (another forty years), if i am lucky. Douglas Knapp Doctoral Fellow, L.Ac. Full Moon Acupuncture 1600 York Avenue New York, NY 10028 212-734-1459 ______________________________\ ____ Be a better friend, newshound, and know-it-all with Mobile. Try it now. http://mobile./;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2008 Report Share Posted May 2, 2008 While he exhibited profound weaknessand fatigue - chest caved in, sometimes too weak too walk more than afew steps, loss of appetite and a great deal of weight, severeshortness of breath with speaking - his eyes were extremely red, andhis pulse was the most excess pulse I ever felt - A classic example of a pulse indicating impending death. Douglas Knapp Doctoral Fellow, L.Ac. Full Moon Acupuncture 1600 York Avenue New York, NY 10028 212-734-1459 ______________________________\ ____ Be a better friend, newshound, and know-it-all with Mobile. Try it now. http://mobile./;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2008 Report Share Posted May 2, 2008 Andrea Remember that legally it may not be enough to just tell them to go, you may need to actually call the MD and schedule the patient, at list this is the standard in western medicine. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2008 Report Share Posted May 2, 2008 Thank you, Doug. I hadn't considered the possibility that I actually extended his life - he could have easily died from the first pneumonia, almost 2 years ago, yet he improved dramatically with even the first treatment and was able to return to work 2 weeks later. Yes, I'm sure we all want to attain the proficiency of a master. As for myself, I really hate being a beginner (!), and even now in my 6th year of practice, I still feel very much a beginner - even though I generally know what to do and how to do it, I am aware there is a greater depth of knowledge and efficacy that I can attain. I guess it is no joke that it is called a practice - that is what we need to keep doing until we reach that level of mastery! Though I am embarrassed to think I am " practicing " on anyone - it sounds too much like experimentation! I'd rather think of it as a discipline rather than a practice. Thank you again for your thoughts. Douglas Knapp <knappneedleman wrote: Andrea, While it is easy to ask ourselves what more could we have done, is it not possible that we have done more than was possible with the standard Western treatment? It is entirely possible that you extended your patients time on this earth with your treatments, without such they would have succumbed more quickly to their mis-diagnosed Western disease without your input. Be assured that you did your best for this patient, which is obvious by your angst that you did not, and learn the lessons that they were here to impart. Stay true to your medicine and don't be lead astray. From my perspective, I won't be a master until i am at least 80 (another forty years), if i am lucky. Douglas Knapp Doctoral Fellow, L.Ac. Full Moon Acupuncture 1600 York Avenue New York, NY 10028 212-734-1459 ______________________________\ ____ Be a better friend, newshound, and know-it-all with Mobile. Try it now. http://mobile./;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ Quote Link to comment Share on other sites More sharing options...
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