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Inspiration
Acu. | Issue #30 | Spring 2021
‘It’s not working’ Locked down in a Lake District winter wonderland, John Hamwee decided to investigate why the practitioner-patient relationship can sometimes suddenly turn icy
John Hamwee Member: Cumbria Over the years many patients have decided to stop having treatment and they have given me a variety of different reasons for doing so. Although I have chosen to have regular treatment myself, I usually understand their reasons and I am perfectly comfortable with their decisions. Perhaps the symptoms cleared up completely; or maybe, after a reasonable number of treatments, nothing much seemed to have changed; or possibly there was as much improvement in a chronic condition as we both could have expected. However, sometimes a patient will say that he or she is stopping treatment because it isn’t working, even though I think it is. Assuming I am not the only practitioner who has
had this experience I thought it worth investigating. Looking through my notes, a few categories start to emerge. The most obvious one is that the treatment is working alright but I have made a mistake, or a series of mistakes, which undermine the patient’s trust and belief in me. I’m not thinking of mistakes in diagnosis or needling which, for me, are an inescapable part of normal practice, but times when I have failed a patient in some way. It can be apparently trivial. I used to treat two sisters who had a close relationship, albeit with some deep-seated resentments and jealousies between them. One day, by mistake, and not once but twice, I called one sister by the name of the other. A week later I got an email cancelling her
next appointment as ‘treatment wasn’t working’. So my first category is of patients who say this because they don’t want to tell me that I have hurt or upset them – and that is why they don’t want to come back. The next category is where patients say it isn’t working because, although treatment worked well for a while, the symptoms then start to recur or even get worse. I usually think that it is a temporary dip and say so; sometimes I think there is a perfectly plausible reason why it has happened, and I explain that too. In other words, I think it is worth persisting with treatment but the patients don’t. It makes me sad, of course. It also leaves me with some uncomfortable questions. Am I overconfident? And if so, is it overconfidence in my own abilities, in acupuncture itself, or indeed in both? A fifty-year-old man came to me with what he described as chronic fatigue syndrome following a viral infection three years earlier. After two months of treatment he said that he had had a particularly busy week but had coped
