Читать книгу Bridging the Gap - James Eugene Munson - Страница 8

Prologue

“Maintaining order rather than correcting disorder is the ultimate principle of wisdom. To cure disease after it has appeared is like digging a well when one already feels thirsty or forging weapons after the war has already begun.”

Neijing

“I ate a piece of cake a few weeks ago, and I’m sure that’s why my cancer came back.” Samantha sat across from me confessing this indulgence with wide eyes and an expression of fear and frustration. Just two years prior, Samantha was an energetic, vibrant young woman, successfully balancing a career and motherhood. Although recently divorced, a natural sense of optimism guided her toward a better life with her eight-year-old daughter. It was during this period of time that she began to experience unusual abdominal cramping and diarrhea after meals. At first thought, she attributed it to food poisoning, maybe a low-grade flu. The symptoms persisted beyond a few days and Samantha, being one never to ignore her health, went to her doctor. Having been given a diagnosis of gastritis, Samantha understood it would likely resolve within six weeks and left with an anti-diarrheal prescription. True to character, she followed the doctor’s orders and trusted the symptoms would resolve. She was too busy in a new job and multitasking as a single mom to give these symptoms much attention otherwise. However, Samantha spent another few weeks in increasing discomfort; she found no relief from the abdominal pain and frequent loose stools. She later explained in my office, “Why would I have thought anything as absurd as cancer was the reason for my digestive problems?”

While Samantha’s cancer journey was at its starting point, so was my Chinese medicine practice. Having completed the rigorous four-year didactic and clinical coursework, as well as passing national and state acupuncture board exams, I was an eager new apprentice to a seasoned Chinese medicine practitioner whose specialty was Chinese medical oncology. This was the gateway to a practice specialty I had never before considered. My exposure to cancer, both professionally and personally, was limited. Graduate schools emphasize the general practice of classical Chinese medicine, with almost half its coursework in Western medicine. After all, we are Eastern physicians practicing in a modern, Western-dominated medical paradigm. I was prepared for general practice. I was not prepared for oncology.

While I began post-graduate training, Samantha’s symptoms worsened. Her appetite decreased and energy declined, but most notably her abdomen was hugely distended. She would recall, “It reminded me of being pregnant, but I knew I wasn’t!” Several weeks later while still searching for answers, she returned to the doctor, who suggested irritable bowel syndrome, attributing this new diagnosis to stress related to navigating a new job and being a single-mother. This seemed logical enough. Samantha made attempts to manage her stress, watch her diet, and practice mindful meditation. Samantha had never experienced such an ongoing illness and was stubbornly intent on establishing the balance she assumed was lacking in her life in order to fully recover. However, the symptoms were relentless and eluded her. Despite conscious decision-making, time-management and a careful diet, her body further declined, and she felt increasing fatigue along with excruciating abdominal pain.

Not only did the discomfort and bloating persist, but it worsened to immeasurable levels. She later mentioned, “I went from seeming five-months pregnant to nine-months, in just a few weeks. I knew something was wrong.” The third visit to the doctor’s office led her to a gastroenterologist who recommended an endoscopy six-weeks later. She refused, not only because her capacity to endure the pain for several weeks longer was impossible, but intuitively, she knew it would not yield a correct diagnosis. It was at this point, two months after the initial symptoms that Samantha asked if perhaps it was a gynecological concern. This question changed her life almost immediately. Within an hour, she met with her gynecologist. As Samantha recalls, “As soon as my gynecologist looked at my chart, and me, she knew what it was and sent me directly to the lab for ultrasound and blood work.” Within twenty minutes of this appointment, six weeks after her initial digestive symptoms occurred, Samantha was diagnosed with stage IIIC ovarian cancer.

Samantha and I initially met after her diagnosis, staging and her conventional treatment plan was established. She was pleased her oncologist recommended acupuncture to address the side-effects of chemotherapy, which was scheduled to begin in two days. Samantha nervously sat across from me with palpable anxiety and uncertainty. She had not been to a Chinese medicine practitioner and understandably, she was not sure what to expect. As with most oncology patients, the “cancer-folder” was in one hand, no doubt full of medical records and treatment schedules, a pen in the other, thoroughly prepared to ask questions and take notes. Samantha was organized. This was in part personality, but also strengthened by her career as a social worker, trained to manage and navigate resources. She was determined to do everything possible to beat her diagnosis, and if that meant trying acupuncture, she would. I would learn not to expect anything less of her over the four years that she bravely journeyed through her cancer experience.

Samantha’s story is not unique to modern day oncology. A patient seeks medical care and often presents with a myriad of physical symptoms that can create a bit of a guessing game for allopathic physicians. Stomach pain may be acid reflux, not a sign of gastrointestinal tumors; easy bruising and fatigue may only be anemia, not acute leukemia. Western physicians are questioned ad nauseam by patients wanting an immediate, accurate diagnosis from the minor to the complicated. One does not begin with an oncologist when there is abdominal bloating, nor should they. The phases of diagnosis have been predetermined by a framework and structure of care that physicians mandate and patients follow: first primary care, then specialty care. This was true of Samantha, digestive problems led her to her general physician, who referred her to gastroenterology, which led her to gynecology (by her own doing) and finally to oncology. It is from this point in her journey that Samantha’s experience broadens from the singular, reductionist method of Western oncology, and into the expanse of integrative oncology, including multiple holistic therapies, like traditional Chinese medicine (TCM), which she powerfully harnessed to extend and improve her quality of life.

“So, you had a piece of cake for your daughter’s birthday?” I remember responding to Samantha’s panic-stricken statement. Her eyes were welling up, and she was visibly shaken. We both knew it was not merely one piece of cake that triggered the recurrence. She nodded, took a breath, but still began a discourse on how she knows sugar “feeds cancer” and negatively impacts the immune system. She expressed guilt for enjoying this one piece of cake, attributing it in part to her current circumstance. While we both recognized the link between sugar and cancer, it was apparent these concerns were merely superficial facts secondary to her fear and disappointment. Throughout the four years she was a patient, Samantha endured numerous cycles of chemotherapy, periods of remission and relapses. Through the depth of our established rapport between patient and provider, we knew, once again, we were about to embark on the next phase and progression of her disease. This would require more refinement and deeper integration of body, mind and spirit: the truest essence of Chinese medical oncology.

After listening patiently to her confession, I smiled and asked, “Was it at least chocolate cake?” Her eyes glistened with tears, but she grinned and said, “Well, of course.” This early clinical experience with Samantha is imprinted in my mind, particularly as my career evolved from general practice with few oncology patients, to almost entirely TCM oncology. A vast majority of these patients had forged beyond the realm of Western medicine and were actively consulting with a myriad of complementary and alternative medicine providers to integrate with their conventional protocols. Samantha’s cancer journey illustrates this dynamic as she developed her own integrative treatment plan that included Chinese herbal medicine, acupuncture, Naturopathy, Reiki, Energy Healing, oncology-specific nutrition and dietary programs alongside chemotherapy. Despite this amalgamation of healing therapies, there was no communication among the providers, and I was not an exception. Each healthcare professional diagnosed and treated according to their own scope, but this occurred separately and without a unified, collaborative plan. This seemed a significant disservice to our shared patient, contrary to the main principles of integrative medicine that emphasize a sharing of information based on therapeutic, patient-centered care.

Thus, as the number of individuals with cancer sought Chinese medicine, my curiosity to learn more about the disease itself from both a Western and Eastern perspective piqued. In order to dialogue with a range of medical professionals, it was necessary to become more informed and prepared to communicate effectively. The exploration led me directly to the practice of integrative oncology (IO), which afforded an opportunity to examine its structural foundation, concepts and with equal importance, the role of TCM within it. Here I discovered an immense discrepancy between the philosophical framework and ideology of IO with its practical application. Ultimately, this illustrated a need for true integration of TCM in modern oncology.

This is where the journey began.

Dr. Di Giulio