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The Diagnosis Dilemma
Part 1: I Say Potato, You Say Tomato

These days, healthcare practitioners from both modern and ancient traditions face an interesting challenge: Patients have become exceedingly savvy to the diverse world of available treatment options in the traditional and alternative medical genres -- often more so than the folks who are treating them. Many doctors are too busy keeping up with their own backlog of medical journals and requisite paperwork to go online and research the latest and greatest alternatives to what they’re doing.

In a sense, this is a good thing. The practitioner remains focused on honing their own shtick and staying up to date in their area of expertise. Patients owe it to themselves to become more aware and therefore, smarter consumers. A little education helps give the patient a sense of understanding as to what they are signing up for when they agree to follow a particular treatment regime. I’ve seen the downside to this phenomenon though. First off, some folks assume that they are experts because they’ve done some research (or heard someone mention someone else’s research). Secondly, some are quick to either embrace or reject anything that comes down the pike that may or may not fit into their current line of thinking. Thirdly, some collect diagnoses and bounce from practitioner to practitioner looking for more diagnoses, and for someone to treat them as they themselves see fit based on their (or someone else’s) research of the condition.

I recall a patient I saw a couple years ago who came to see me burdened with an arsenal of diagnoses. Her GP said she had fibromyalgia and irritable bowel syndrome. Her endocrinologist said she was “clinically hypothyroid”. The first acupuncturist she saw said that she had a Spleen qi Deficiency. The second acupuncturist agreed but said that Stagnant Liver qi was the primary cause of disease. Her holistic dietitian said that the issue was candida, and her spiritual intuitive said the cause of her problem was unresolved grief.

After discarding the other two acupuncturists, she had come to me to address the fibromyalgia specifically because she had read that acupuncture is effective in its treatment. The reason why she wasn’t seeing the other acupuncturists was because she thought that they had both misdiagnosed her - based upon her own research. As further proof of her expertise and their apparent lack of same, neither of their treatments had “worked.” To make matters worse, she had found an online diagnostic questionnaire for Chinese medicine, which she filled out and was then informed that she was a “Metal Type”, and, since neither of those acupuncturists had said anything about her classification as a “Metal Type”, they were further discredited.

And so it was she came to my door, overloaded with too much and too little at the same time and unable to see how clearly confused she was. Unfortunately, she was stuck in all three previously mentioned traps. In this case, a little doesn’t go a long way. And as always, you can’t see the whole puzzle’s picture by viewing one piece of the jigsaw. Though the story goes on, the point I’d like to make is this: Each of the practitioners that she had seen before may have been accurate from their perspective. Barring any misdiagnoses of course, there’s no reason why each viewpoint could not exist simultaneously. No one has to be wrong.

Every practitioner has their own lens or set of lenses that they look through when diagnosing and treating patients. Some lenses offer views into the psyche. Some look at a particular organ or aspect of a particular organ or system. Some look beyond the physical and into the energetic domain. Some lenses are technologically advanced, while others are based upon intuition. However, they are all used to observe, perceive, diagnose and then treat co-existing levels of the individual. The languaging may be very different. The imagery may seem to be worlds apart. The ideas may seem contradictory, but the phenomena behind these overlapping interpretations are perfectly reflected in one another.

We are creations of ourselves. Our structure is the resulting appearance of the radiance of spirit emanating outward from our core, through layers of ever-denser energies. Our energetic systems have been shaped via a lifetime of experience, memory and belief, and re-manifest back into a new us every moment - a unique and imperfectly perfect whole. Like human landscapes, we can be viewed from each of the four directions. Some are looking at the mountain from the east, others from the west. Others are looking out upon the lake. One might be studying the bark of a tree next to the lake. One may look from high above, able to take in the whole picture. Each perspective is potentially valid, and legitimate.

With this kind of understanding in place, we can now focus upon the kinds of questions that will truly serve us in the medical market place: am I willing to entertain this reality? Does it resound in me? Am I confident in this person and their treatment methods? Does this person listen and strive to understand me?

It’s perfectly all right if one practitioner’s viewpoint differs from another’s – even within the same tradition. It’s to be expected that one practitioner cannot interpret another’s perspective since that person may not have a frame of reference with which to address that diagnosis. Lastly and perhaps most importantly, it’s freeing to realize that we are so much more than any diagnosis. So, try not to let it consume you, and don’t be put off when your GP glazes over as you tell him about your “Stagnant Liver qi”. He won’t know what you’re talking about, and that’s okay.

November 2005


Click here for part 2 of The Diagnosis Dilemma.

Tending the Human Landscape is a must read for anyone considering Acupuncture treatment.