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DR. STEMMLER’S MONTHLY TEACHING ROUNDS

OCTOBER, 2000

(Copyright Stemmler 2000)

AS THE EMPEROR SAID…

FINDING PEACE AND HAPPINESS IN A SIMPLE LIFE

"Record of the Thatched Hall on Mount Lu" by Po Chu-I (Po Lo-t’ien), in 817 AD, a very popular T’ang poet---

"K’uang Lu, so strange, so superb it tops all the mountains in the empire!…In autumn of the eleventh year of the Yuan-ho era [816 A.D.] I, Po Lo T’ien of T’ai-yuan, saw it and fell in love with it. Like a traveler on a distant journey who passes by his old home, I felt so drawn to it I couldn’t tear myself away. So on a site facing the peak and flanking the temple I set about building a grass-thatched hall."

"By spring of the following year the thatched hall was finished. Three spans, a pair of pillars, two rooms, four windows – the dimensions and expenditures were all designed to fit my taste and means. I put a door on the north side to let in cool breezes so as to fend off oppressive heat, made the southern rafters high to admit sunlight in case there should be times of severe cold. The beams were trimmed but left unpainted, the walls plastered but not given a final coat of white. I've used slabs of stone for paving and stairs, sheets of paper to cover the windows….Inside the hall are four wooden couches, two plain screens, one lacquered ch’in [a stringed instrument resembling a zither], and some Confucian, Taoist and Buddhist books, two or three of each kind."

"And now that I have come to be master of the house, I gaze up the mountains, bend down to listen to the spring, look around at the trees and bamboo, the clouds and rocks, busy with them every minute from sunup to evening…happy with my surroundings, at peace within. One night here and my body is at rest, two nights and my mind is content, and after three nights I’m in a state of utter calm and forgetfulness. I don’t know why it’s like this, but it is."

"East of the hall is a waterfall, the water tumbling down from a height of three feet, splashing by the corner of the stairs, then running off in a stone channel. In twilight and at dawn it’s the color of white silk, and at night it makes a sound like jade pendants or a lute or harp."

"Long ago Hui-yung, Hui-yuan, Tsung Ping, Lei Tz’u-tsung, eighteen men in all, came to this mountain, grew old and died here without ever going home. Though they lived a thousand years ago, I can understand what was in their hearts, because I’m here too."

(Excerpt from "Record of the Thatched Hall on Mount Lu" by Po Chu-I, as in "Four Huts – Asian Writings on the Simple Life," translated by Burton Watson, Shambhala Centaur Editions, 1994.)

 

COMMENTS

Even though 1,200 years have passed since Po Chu-I’s beautiful piece in the Chi form ("record/descriptive" literary form), today, more than ever, we are all in need of our own "thatched hall near a mountain peak."

Even the busiest lawyer, physician, politician or corporate CEO needs a self-built place, real or virtual, where he or she can retreat throughout the day, and find time and space to relate to Nature and the Universe that we are part of, in a creature-to-creature dialogue. Walking on paved roads, sitting in concrete boxes, driving inside of metal vehicles, fighting the summer heat in closed-in "refrigerators" and rushing through overbooked schedules day in and day out, has moved us farther and farther away from our thatched hall.

There are no mountains in this town, but there is a wide open sky with an endless horizon; even in our cars on the road from-and-to, there are long stops at lights or during bottleneck intervals. The sky is always there – through our windows or sunroofs, before we leave home or right after we return in the evenings, we can nurture our spirits on its vastness and its beauty.

There are no forests in this town, but we have a large number of magnificent old trees connecting us to growth and endurance, to seasonal transformation and to the town’s past. We can all grow a little garden to help us come back to our centers, ground us with that rooting so often lost in contemporary life. If you only have one outdoor pot and watched its leaves and flowers transform and grow as it absorbs the raindrops and the sun’s energy, you could also capture a glimpse of Po-Chu-I’s message every day of your life. Perhaps you would prefer to sit outside, early in the morning or late in the afternoon, watching your backyard birds searching for food and building their nests. This Spring a dove built its nest inside one of my hanging plants, right in front of my living room window, where I play the piano. I was able to watch the whole process from egg-laying to hatching, to flying lessons for the little ones, from my ladder, at a distance, so as not to disturb Nature’s magnificence. Later in the summer, the dove returned twice, and two more birdies were born and initiated each time. I felt blessed with such a gift from Nature!

There are multiple opportunities for each one of us to find our thatched hall, and it may be one of the best preventive measures for warding off hypertension, anxiety, depression, gastritis and ulcers, irritable bowel syndrome, insomnia and a multitude of pain syndromes and other ailments.

Find your own daily refuge and, when you do, devote yourself fully to it -- without other distractions -- so that at that special moment every day, you and Nature become one as you mutually recharge and enjoy each other.

CHRISTINA STEMMLER, M.D.

 

CLINICAL STORY OF THE MONTH

(COPYRIGHT STEMMLER, 2000)

A HEADACHE WITH A BIG NAME

Sammy Bellis had just closed her shop on a cool February evening in a fashionable uptown Houston neighborhood. As she checked the glass door one more time she felt lightheaded. "I’m working too much," she thought immediately. At thirty-seven and a mother of three, her days were packed with family activities such as cooking meals for five, baseball games and PTA meetings. As she walked to her car, she felt dizzy and feared that she would fall. She made it home without incident, but noticed a headache that whole evening.

Sammy had battled a weight problem since her teenage years and had just about given up after a series of unsuccessful diets, which only added a bonus weight every time she went off each diet. Lately, she had not been feeling well, but she kept pushing. Being a woman of strong work ethics, she did not give in to her symptoms, continuing to work her 10 hours-a-day, 6 days-a-week schedule at the shop while also attending to her family life. Yet, three months later she became unstable enough to trip and fall at home, hitting her head against the piano. Thereafter her chronic headaches became intolerable, and she was forced to visit the ER at the medical center. Seven hours of gruesome work-up followed without a diagnosis: blood tests, EKG, EEG, x-rays, 2 spinal taps, a CAT scan and an MRI. One week later, a neurologist reexamined her and reviewed all her tests – the diagnosis was now obvious: Pseudo-Tumor Cerebri or Idiopathic Intracranial Hypertension. This is a condition which, although rare, occurs 75% in young and middle-aged women who are often overweight. The cause is generally unknown, but the condition may be associated with certain drugs such as oral contraceptives, tetracycline, vitamin A overdose and Danazol. The latter is frequently prescribed for endometriosis, uterine fibroids, fluid retention and breast pain.

I had seen Sammy’s father at my office a week before her appointment. He seemed very concerned then. "Sammy has been in and out of the hospital, Dr., and they don’t know what to do with her. She has terrible headaches and is dizzy and unstable. Now they’re talking about a ‘shunt,’ a tube going between her spinal cord and her abdomen, as they explained to us. Apparently, she has all this fluid in her head, and it is putting pressure on her brain." He was on the verge of tears – "Could you help her, Dr.?" "Yes, I can. Why don’t you set up an appointment for her? We’ll work her in as soon as possible."

Sammy came within a few days. She was in severe pain and complained of dizziness and unsteadiness. She was taking a diuretic and an antidepressant, but she did not think they were helping. She had used analgesics and barbiturates for several months, without results. She had lost 26 pounds on a high protein/low carbohydrate diet. When I evaluated her from a Chinese medical perspective, she showed signs of Yang activity, which allowed me to choose the correct extraordinary meridian to treat her illness. I knew, with certainty, that she would respond, a degree of certainty one rarely has with drug trials, such as she had been on. Her tongue examination showed a midline crack, which healed within three treatments as her symptoms resolved.

After one treatment, two days later, she reported one good day – her first one in months. Four days later, when she came for her third treatment, she reported that her dizziness was gone and her headaches were now of a milder nature. She was also urinating much more than usual, indicating a reshifting of her body fluids.

Two weeks later, after only three treatments, she was happy to tell me she had been headache-free for five days, not dizzy and feeling "normal." She quantified her improvement at ninety percent. Ten days later, on her sixth and last visit, she continued symptom-free and had lost an extra eight pounds. She was discharged from my care and encouraged to resume her normal activities but, of course, avoid overexertion.

I wrote a letter to her neurologist, informing her of the patient’s progress – the same neurologist who had advised the patient not to undergo acupuncture treatments "since it wouldn’t help." It is important for physicians to understand the complementary benefits Chinese medicine may add to each of their specialties, so that patients do not suffer unnecessarily by being held captive to a particular medical system and its limitations.

A follow-up call to the patient eight months later found her in good health, off all medications and without a single headache episode since her last visit. This clinical story illustrates how the prognosis of certain illnesses can change, depending on the medical model one uses to understand the clinical dilemma. In traditional Western medicine we call Sammy’s illness "idiopathic," which literally means "with an unknown pathological explanation" or simply, "we just don’t know how and why." Although we often find an association between certain factors and a particular illness (in this case obesity and/or drugs), we still do not have a clear explanation of "how and why" some people develop the illness and others, with similar associated factors, do not. So, when we do not understand a condition clearly, we "try" this, that or the other and hope it works. Often we try more of what doesn’t work, which is a conceptual paradox often seen in medical practice.

Sammy had not received any benefit from various drug trials, and she was facing the fairly invasive, risky and expensive option of a shunt insertion. If her neurologists or her neurosurgeons had also been educated in Chinese medicine, she would have been spared several months of pain, medications, side effects and unnecessary fears. I hope that over the next few decades physicians across all specialties will incorporate the valuable contributions of Chinese medicine into their basic and graduate training.

Christina Stemmler, M.D.


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