Middle Medicine

Question: Does anyone know what Trichotillomania is? My daughter was diagnosed with this recently. Any help is appreciated.

Response: Oh gosh. Trichotillomania. How obscenely stupid. I wonder if this syndrome is further differentiated based on whether it is the left or right hand that’s doing the pulling, or if there is a naming convention that takes into account how many strands of hair are in each fistful, and how many, thereof, are dyed, split-ended or glossy?

There is one good thing about this obsessive compulsion to give long, stupid names to diseases, and that is that the name for fear of long names is Hippopotomonstrosesquippedaliophobia.

Anyway, on to something useful, I hope:

Apart from being all technically technicacious about our patients, we shouldn’t forget to be human. While we must be very careful to mind our manners, ethics, scope of practice and personal limitations, be not afraid to be human. If someone is pulling their hair out, ask yourself, what in god’s dreaming heaven would cause ME to pull out my mane. Start from there, and you may find a way to delicately tease out (part, just enough) of a painful story to inform your pattern diagnosis, and perhaps give the girl and her family a better result than something who blindly, meaninglessly tries to treat for liver qi, or phlegm misting the heart.

In a case like this, it might be most important to find out what started it. I just had a patient in the other week with bad chest pain who responded not at all to western medicine, a very competent naturopath or a very heartfelt osteopath, and yet responded in my clinic (with a 100% reduction in pain after 20 minutes), in my humble opinion, because I asked her what was going on when this started (thirty years ago when she was 17). And when she said “nothing”, I gently said, “something”. And eventually she “mentioned”, by the by, that her boyfriend, when she was 16, had tried to kill her. I gently, over the course of our conversation, explained about some possible connections, placed some needles in her, and she seemed to relax, cry, and begin a new stage in her life. Not my credit, I credit it to being human, and trying to keep the old sages in mind.

(excerpted from an online forum conversation)