Lesson 5: "You do the healing."
"Everyone needs chiropractic care. Not everyone needs YOUR chiropractic care."
Lesson 4: "It's not just knowing something to be true, you have to believe."
When I was an intern I had a rare opportunity to work with a well known chiropractor that was famous in our community .
He was responsible for creating the technique program at our university.
He literally wrote the book on chiropractic spinal manipulation.
He took muscle testing to a whole different level.
He was the man. (Big fish, small pond)
Everyone wanted this internship but I was one of the lucky five that got it.
Because I played basketball with someone whose family knew him. That's it.
I wasn't a stand out, top of the class candidate.
I didn't have some genius research paper that got me notoriety.
I wasn't even Japanese. ( Did I mention he was Japanese?)
I just played basketball...with a guy.
I just knew a guy.
So, yes boys and girls, sometimes it's who you know not what you know that matters.
Sorry, but it's true.
This internship was 6 weeks in his office.
We got to work along side him with real patients. Awesome.
We would spend the entire day with him as he saw patients and asked us questions.
It quickly became painfully clear to me that we had learned to be robots.
We had learned to memorize information in order to regurgitate it for tests.
We understood things at a textbook level but did not understand how to apply that knowledge to real humans with real issues.
In essence, we were book smart.
And book smart is great for books, not so much for doctors who want to be good clinicians.
I don't fault the schools for this.
Their job is to teach you facts and procedures and methods.
Unfortunately, it creates a degree of linear thinking where you follow a decision tree and check off all the boxes you were taught to check off.
Those checked boxes are supposed to lead you to a diagnosis.
That diagnosis is then the framework by which you start treating the patient.
So what's wrong with medicine 101?
Nothing if you want to be a robot.
Don't get me wrong, there are actually a lot of good robot doctors out there and they help people every day.
But I wanted to be a clinician; someone who understood:
what the patient was experiencing
why they were experiencing it
what was the root cause
how to correct it
Ask better questions
He asked questions like:
"What would you ask next?"
"What tests would you perform and why?"
"What would you do next?"
Two things I became aware of from this:
As physicians, we already have a guess at what is going on within a few minutes of seeing the patient and then spend the rest of the time trying to validate our guess.
Our view is often very narrow minded
Based on the complaint, we would assume the cause.
But it"s like that old saying,
"If you are a hammer, everything looks like a nail."
So, if you are a chiropractor, everything looks like it's local, physical and can be resolved thru chiropractic manipulation.
See where I'm going with this?
This guy, however, would ask a totally different, off the wall sort of question.
One patient was suffering from headaches.
She had seen other doctors and nothing seemed to be making it better.
After the typical headache focused questions, he asked if we would like to ask anything else?
What tests would you perform?
Well, the typical neck pain and headaches questions, of course.
What would you do next?
Feel which spinal segments needed adjusting and get on with it!
We were already thinking it was a muscular tension problem, needed to manipulate the spine in the neck, maybe take some X-rays.
You know? Just to make sure we were right.
He asked the patient,
"Did you or have you injured your foot/ankle lately?"
What in the world did her foot/ankle have to do with her headache?!!!!
Where was he coming from??!!
I am so lost right now.
Of course, her answer was yes.
Next, he felt her feet.
He looks over at us interns and asks,
"Do you understand why we are looking at her feet?"
Of course NOT!
"What would you ask next?"
Not a thing! I have no idea what you are doing!
We all had the same look; ignorance maximus. Again, I just made that up. ;-)
So then he asked about indigestion, reflux or heartburn, history of ulcers, TMJ issues, shortness of breath, cramping of the lower legs.
Yup! complete and utter confusion.
The way you feel right now, is exactly how I felt then... And I had 3.5 years of medical education already!!
Here is the kicker. He does NOT explain.
No explanation at all.
We are totally and unequivocally lost.
He accepts that we know nothing and have no further questions or insights and proceeds to adjust a joint in this ladies foot.
And, of course, in a few minutes, her headache has resolved.
What the _______!!!! (insert your word of choice here.)
Your ignorant questions will NOT be answered
Later, I asked the doctor, "What does the foot have to do with headaches?"
To which he stared and promptly ignored me.
No one would be brave enough to ask a similar question that day. So, we all shuffled off with one small piece of new information: Do not ask ignorant questions.
You gotta come with some knowledge.
I would learn that simply asking a question did not get you an answer.
I had to put work into it.
I had to research for myself what might be available in the foot that had some correlation, any correlation, with headaches.
Actually do work above and beyond my assigned curriculum?!
What was this guy thinking?
So I did.
Here is what I found.
The STOMACH acupuncture meridian travels through the foot area.
Now I was armed with some knowledge!
I would follow up with a better question,
"What does the stomach have to do with headaches?"
As you can see from the diagram, this same meridian flows up to the temple area of the head and eyes. A lot of headache sufferers complain of pain in this area.
But what about chiropractic?
What was the connection?
His response; "Go re-learn your neuro-anatomy."
In other words, apply your knowledge to a real person with real issues and figure it out!
After yet another day of "beyond my assigned curriculum learning," I discovered-
Stomach 36, (refer to image) is commonly used for gastrointestinal discomfort, nausea and vomiting, and stress and fatigue. Not only could stomach issues create headaches, but injuries to the area coinciding with with this meridian can do the same... foot=stomach=headache.
But I ALSO learned,
The nerve root that controls the STOMACH is thoracic level 4/5 in the mid-back and the diaphragm is innervated by cervical level 3/4/5 in the neck. Those same areas control the muscles in the neck, upper shoulder and mid back.
If the stomach is "irritated," it can create tension in those areas, as well as complicate breathing so small muscles (accessory breathing muscles) will overload, leading to tension in the back of head.
There it was!
Simple chiropractic functional neurology.
Now I was armed with even better knowledge and a better question.
"Wouldn't we have gotten the same results if we just adjusted the neck or mid back rather than the foot?"
Good question right!? (Excuse me as I pat myself on the back).
His response, "Now you understand what questions you could have asked of the patient."
It is not about YOU
Over the next 6 weeks he would help shape my brain and my perspective into a complete paradigm shift.
It was not only trying to get better results,
It was a fundamentally different way of looking at healthcare.
We were trying to figure out - "What was the root cause? "
The symptoms were not the problems to be eliminated but clues in a detective novel where you were in search for the true culprit. And that culprit was trying to gum up the works.
It sent you on wild goose chases.
It used distractions.
It was trying to create a greater level of dis-ease.
Our goal was not just to alleviate symptoms.
Our goal was to facilitate the healing process so that people could live a better life.
And that's what patients wanted- to live a better life.
Lesson 5: "You do the healing."
We all want a better life; a life free of dis-ease, more joy and time spent with loved ones. The body is constantly healing.
When we are able to find the culprit, the root cause, we help remove the interference of that healing.
And that was the most important lesson I learned from that internship; the doctors role it not to perform some magical healing. Our role was to be the detective and try to remove as much of the interference as possible so YOU could do the healing. So awesome.
Know that you have that healing power.
It is always there and it is always working.
But you have to keep asking better questions.
To be continued...