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From the Townsend Letter for Doctors & Patients
October 2004

Pathways to Healing
by Elaine Zablocki
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Dillard Offers Unique View of Healing Process

James N. Dillard, MD, DC, CAc is the only person in the United States who is a certified acupuncturist, and a chiropractor, and an MD. This unusual combination of skills has given him a unique view of the healing process.

Dillard was doing research on the molecular biology of cancer cell lines at UCLA when a friend gave him an acupressure treatment. "I was amazed," he recalls. "I experienced significant relaxation and pain relief. I was startled by the power of this method." He decided to go to California Acupuncture College and train as an acupuncturist. At the same time, he studied chiropractic; after three-and-a-half years he was licensed in both modalities. "Once I began practice, as I heard about the medications my patients were taking, and the surgeries they'd experienced, I wanted to learn more about those aspects of care. Why did I go to medical school? You can just say I'm terminally curious." He got his MD at Rush Medical School in Chicago, and then trained in Internal Medicine, followed by Rehabilitation Medicine and Pain Medicine.

Today, Dillard relies primarily on his conventional medical training for diagnosis, since it's so important to rule out life-threatening conditions. "You always have to be on the lookout for signs of hidden disease others may not have recognized," he says. Next, he uses a mixture of methods, including conventional medications, botanicals, acupuncture and Chinese medicine, structural training from chiropractic, mind/body methods, psychology, body energetics, and psychosocial factors. "It's a stew," he says. "I use so many ways of looking at health issues it has literally taken me years to feel that I'm starting to get a handle on this process. At the same time, we always have to acknowledge the mystery of the human condition, human illness, and the power of healing."

It's very difficult to predict which methods will be most effective for a new patient, he says. "I continue to have abiding respect for other practitioners. I've learned that no matter how much training I get, I still won't have all the answers. In order to help my patients, I must continually think outside my own training, my own ideas and theories about how everything works. Both alternative practitioners and conventional physicians tend to have certain pet theories. The longer I practice, the more I see that willingness to think outside these prejudices can make a huge difference for the patient sitting in front of me."

Patient As Healer
Because there are so many different treatment methods, and it's so hard to predict what will work best in any specific situation, patients play a key role in determining their own treatment, Dillard says. The Nei Jing, The Yellow Emperor's Canon of Internal Medicine, written in 350 BC, says each patient must also be their first doctor. "When I talk with a new patient, I acknowledge their own intuitions about their situation. I ask, 'what do you think is going to help you?'"

In complex chronic illnesses, treatment is a pragmatic process of trying one thing and then another, to see what works. Even "far-out" unconventional treatments may turn out to be effective in certain situations. Dillard recalls a pain patient "nobody could fix." She'd seen the top conventional specialists in New York, and had tried acupuncture, massage, mind/body methods and diet. Nothing helped. "I was talking with her, and I just got a hunch, a feeling. I sent her to a really good Reiki master, someone who trains other Reiki masters. And she started to get better! It was just astounding to me, because after trying so many different modalities, this one was successful."

Each patient with a complex chronic illness needs to put together their own clinical team. It should include a good MD to ensure that the diagnosis is correct and no one has missed a serious illness. After that, it's a matter of giving different methods an open-minded try, and seeing which ones seem to help. Each time you try a new method, ask how long it usually takes to see results. Many CAM modalities do take longer than pharmaceuticals to have an effect, because they impact the whole body, not just one symptom. On the other hand, you don't want to continue indefinitely with a treatment that doesn't seem to be working.

"Depending on your circumstances, you may want to seek out a well-trained herbalist, a mind/body practitioner, a Reiki master, a Chinese medicine practitioner, an osteopath, a chiropractor, a massage therapist," Dillard says. "Ultimately the integration is done by the patient. Ultimately, each patient has to trust their own sense of what works for them."

As Dillard reflects on the special responsibility of helping others to heal, he says, "So many of us, in both complementary and conventional medicine, tend to get a bit serious and self-important. But this work requires us to be quiet and humble, to get ourselves out of the way. Especially if you work in pain medicine, you have to have some quietness inside yourself. Also, we need to lighten up, and find the humor in each situation. A good laugh is healing."

Resources
Dillard sees patients at Columbia-Presbyterian Eastside in Manhattan (212–326–8501). For those of us who don't live near New York, he's written a book, The Chronic Pain Solution: Your Personal Path to Pain Relief (Bantam). This is a wonderful resource for anyone dealing with health issues, not just for those experiencing chronic pain. See especially the section called "Take Control of Your Treatment." One key point, on page 61: set measured, step-by-step goals for yourself. We can learn to rejoice when our health improves, even if some problems continue.

Dillard also co-directs an annual Course in Integrative Pain Medicine at Columbia University Medical Center. This year it included evidence-based discussions of nutrition, mindfulness-based stress reduction, bioenergetic therapies, acupuncture, and many other topics. "We cover a lot of technical material, but we try to keep the presentations lively," Dillard says. The course is open to all healthcare providers, including acupuncturists, chiropractors, psychologists, physicians and nurse practitioners. For more information about the course, which is offered in April each year, go to http://cpmcnet.columbia.edu/dept/cme/PH-34–04/PH34–04.html

To find out about next year's course, call 212–305–3334 or e-mail cme@columbia.edu
It may also be possible for consumers with a special interest in pain management to attend this course; for more information, email Dillard directly at: <jndillard@mindspring.com>

Elaine Zablocki is the editor of CHRF News Files, a bimonthly emailed newsletter about the emerging integrative medicine industry, published by the Collaboration for Healthcare Renewal Foundation.

 

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