Help (Buffy, Season 7, Episode 4)

Welcome to Buffy’s first week of actually interacting with the students! In this episode, we are treated to a variety of student problems, from the real and serious (a student whose older brother has joined the Marines during the US-led invasion of Iraq in 2002) to the surreptitious (a student who says he thinks he’s gay proposes that Buffy go on a date with him to disprove his feelings) and the amusing (Dawn sees her counsellor to complain how Dawn’s older sister steals her clothing). The principle focus, however, is on Cassie, a beautiful girl who writes poetry, creates art, speaks eloquently, and has a sincere presence. She also ‘knows’ things, and something she knows is that she will die the following Friday. The rest of the episode sees Buffy and the Scoobies trying to untangle the mystery of how she’ll die.

(Willow uses the term ‘pre-cog’ to describe Cassie, a reflection of high school and college abbreviation of terms like ‘pre-cal’ for pre-calculus, or here, ‘pre-cognitive’. However, I like to think of the term as being analogous to Pink Floyd’s ‘Brick in the Wall’ — a ‘cog in the machine’. Cassie is ‘pre-cog’ in that she hasn’t been molded to fit the machinery of society yet.)

Unfortunately, although Buffy manages to disrupt a demon-summoning group of students, and even catches a crossbow bold before it strikes Cassie, Cassie still dies. It turns out a heart condition ran in her family. The final scene shows the Scoobies on the couch, mourning the death of this beautiful girl. Buffy asks the question, ‘What do you do when you can’t help?’

That will be the topic of today’s post. How does Chinese medicine know when it cannot help, and what does the practitioner — or patient — do then?

First, I want to stress that this post is not about how Chinese medical practitioners know when to refer their patients to biomedical or other medicine practitioners for treatment.  Rather, the focus is just within the scope of the Chinese medical tradition’s diagnostic and prognostic paradigm.

In some medical traditions, learning how to identify what diseases and conditions can be treated and which are terminal is the first lesson a medical student studies.  The quintessence trantras of Tibetan Medicine, for example, put it as the second lesson, after a cosmological introduction to the medical tradition.  (‘The whole world is a garden of medicine if prepared properly’, is the short version of that cosmology.)  Chinese medicine, though, has its references to death as a prognosis scattered throughout its medical texts.  In general, however, the the patient’s pulse, hara, and shen tell the practitioner whether the patient will live or die.

The most commonly understood pulse pattern indicative of death is a separation of yin and yang.  This happens in terminally ill patients as they approach their final days.  However, Cassie would not have had such a pulse; rather, in her case, the Heart or Pericardium pulses would have felt different.  In Contemporary Chinese Pulse Diagnosis, an area on the wrist just to the side of the HT pulse is related to diagnosing the quality of the heart valves.  The practitioner in this case, could make note of it, send the patient for biomedical measurements, and then work as part of a team to address the underlying issue.

With hara diagnosis, even if a patient has stopped breathing or is turning blue, if a stirring near the umbilicus can still be felt, there is hope the patient will live.  The ‘moving qi’ between the kidneys is still active, and can still deliver the necessary qi to the organs and spirits of the patient.  If this moving qi is absent, the prognosis leans towards death.

The shen, or affect, is also a means for assessing whether a disease can be treated.  If the shen and qi does not correspond to the patient’s bodily form, the Jia Yi Jing states, the prognosis is death.

So what happens if the patient is going to die and medicine can not cure them?  Is there nothing medicine can offer besides pain-killers?  (As a side note, Chinese Medicine avoids the use of opiates as pain-killers, and instead relies on qi moving medicinals like Yan Hu Suo, Wu Ling Zhi, and San Qi, none of which impair mental functioning.)

In Cassie’s case, she is resigned to dying early; but this does not mean she gave up on living, nor did she try to rush her life experiences before their proper time.  In a moving monologue, Cassie tells Buffy that Cassie would like to fall in love, go backpacking, see the Mona Lisa… but she knows it will not happen.  She knows she must live her life as it comes to her, and right then, she was in high school, dividing her time between her parent’s houses.  She was cultivating the life she had then.  Her self-cultivation took the form of introspective poetry, expressive artwork, and an online gallery in which to feature it.  She cultivated a world that would outlive her.

As I’ve mentioned earlier in these posts, the highest calling of Chinese Medicine is on the cultivation of destiny.  If a technique allows a person to continue completing their relationship obligations to family, to themselves, and to the world; if it helps them honour or hone their talents, even when life is ebbing away, Medicine still has a place.  For many, that place is called hospice care.  Acupuncture has a place here.  Points used to comfort the dying include BL-62, CV-17, Yin Tang, and Du-23.  PC-6, HT-5, and LU-7 are also useful to open the heart and free the tongue, to work through grief into acceptance.  ST-25 (Heavenly Pivot) and various Kidney points are also commonly used to move the metal-qi of death into the stillness of water.

In the past, most people died through the metal meridian:  Lung conditions and Large Intestine (dysentery, cholera) conditions were rampant.  Now, people die through other meridians, often HT and PC for men; PC and LV for women.  Following five-phase and six-channel theory, expression through Tai Yang and out into the world (and proper closing off of some outer-worldy factors), or a movement to experience joy would be recommended for PC and LV cases (as, for example in various gynecological cancers).  A gathering to earth and society is the energetic movement to aim for in cardiac cases.  This was how Cassie herself achieved the serenity — a sad serenity, to be sure — that she did.  She focused on friends, even when she knew some, like Dawn, had initially become friends with her just to keep an eye out or get more information.

It is the role of the practitioner to know and understand when each of these movements is the next step on the patient’s path, and to arrange for support in guiding the patient there as necessary.

As always, these posts are for educational and entertainment purposes only.  If you or a loved one feel that Chinese Medicine may provide a means to helping make peace with life and death, please see a qualified practitioner.


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