Patient Accountability: It isn't the Lemon Water.

I once had a patient report extreme diarrhea. After we went through her diet she suggested it was the lemon water she just started drinking. I would have sooner credited it to her overindulgence of simple carbs, dairy, high sugar and high fat foods, that she had reported sensitivity to in her initial intake. She was insistent - it was the lemon water. That's so odd you might think, how did she not know it was actually the overindulgences? Hmmmm.. it’s actually quite common to blame something or someone else who quite frankly is unrelated. Taking a good hard look in the mirror is actually one of the most difficult components to healing. Part of my job as a Chinese Medicine Practitioner and healer is to be that mirror for my patients - generally, they maybe (sometimes) don’t love to look into. The way I see it, I had two choices with this patient. I could pretend it was the lemon water, or I could tell her the truth. I settled on this: It would be a huge disservice to this patient to go along with the story she created.

In Acupuncture school, I had a professor that would laugh at the ailments brought to her when they were self induced. She went by the name Queenie, the Americanized version of her name which is Qunce. In the sweetest, most sing-songy voice possible, she would say directly to the patient something to the extent of, "ha ha, you do dat to yo selffffff." Maybe she was treating someone who was hung over and clearly inflicted the ailment on themselves or perhaps someone intolerant to dairy who indulged in ice cream the night before. I always respected that she gave it to patients straight. No fuss - no muss: you must take responsibility for the contributions you make to your own ailments.

That expression of "you did that to yourself" has always stuck with me. It's kind of embarrassing to be called out and made to look at what you've done. Parents use this technique all the time with children. Like, "hey excuse me, you need to clean up that mess you just made."

So why is it so difficult as grown adults? I don’t think the answer is cut and dry. There could be many reasons why we lose accountability. Could it be age? our programming? our stories? Are we trying to protect ourselves? Do we even have awareness we are doing it? Accountability is hard. It's hard to keep yourself in line when it comes to the actions you take and what kind of impact they have on you.

Chronic pain is not chronic overnight. Maybe a traumatic injury started it but then what? What happened after that? What part did you play or not play in your own healing? I will always assist patients with all their health struggles, but Chinese Medicine is not a magic bullet. This statement is especially true when paired with non-compliance. So why not help yourself too? I believe this can be best assessed when you take a “zoom out” from your day to day operations and observe your life from a different angle without judgement. Evaluate the things you do everyday and ask yourself how you can assist in the process of healing. Yet again: Life isn’t happening to you - it’s happening FOR YOU.

My favorite stories are the ones where the athlete defies the odds because of the hard work and dedication, not the half-assery. When new patient’s come in with health struggles, Chinese medicine will start the ball rolling down the hill, but you must also help keep it rolling. It’s not that this medicine, “just doesn’t work,” you have to want to and try to get better too.

A Peak Behind the Curtain…

When I was first in practice, I found this to be very difficult. To be honest, I went along with people’s stories more easily. What if they didn’t like what I had to say? I knew from experience that the initial reaction to “calling someone out,” is usually defensiveness. As years went by, I realized I had to change my approach. I decided it would be best to just lead the conversation in a particular direction. I would try out leading the patient to come to the conclusion all on their own. I have learned this often has a lot more impact. “Do you think maybe the diarrhea isn’t the lemon water? What other things could have had an impact on your digestion as well? Do you usually digest processed/greasy/shitty foods well?” Even if I know the answer - it’s always better to allow them to remember the answer first.

It isn’t the lemon water.