Bridging the Gap. James Eugene Munson

      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