It’s official. It’s mutual. It’s love.

A patient called a while back to make an appointment and left a message on our voicemail. She said something really nice. She said: “the sliding scale is love in action.” We’ve been open almost six months now, and the honeymoon is in full swing. I just love our patients, and I know the feeling is mutual. I can tell because they bring fruit.

Chico is a city surrounded by orchards – walnuts, almonds, and lots of fruit trees. I’ve lived here a year now, and as the fall equinox rolls around again, I’m aware how much the seasons here are marked by each new harvest: we have lovely sweet little mandarins all winter, and then the strawberries come out and last a good long while, and then the stone fruits – cherries, then later on plums, peaches, and nectarines. Now the figs are ready to be appreciated for all their decadence. (BRB, I need to go to the kitchen)

Four quarts of fresh-picked figs in a paper bag. That’s what our patients gave us Wednesday night, at the end of a long and successful free day event. I had just two nappers left at 6:58, and I sent a text to my business partner saying “I’m going to call this one at 29 txs for the day.” And then I looked up and in walked #30, 31, 32, and 33. I just grinned and ushered them into the treatment room. Round about quarter to nine, while they were enjoying the last of the muffins and tea in the reception room, is when the bag of figs showed up. It was our second gift of fruit in a week. The other day a patient brought me a melon from her garden. I love our patients. And love is a verb. Let me tell you more.

Very early on, when we were seeing – oh, about ten patients a week, a young man dropped in to the clinic and he said exactly this “I am a prince. Money is no object. If I give you a lot of money, can I have a private treatment?” No kidding. That happened. I just kind of giggled inside while I explained how it works, and that, in our community space, he would get the very best treatment possible. He was satisfied and I led him in to the (empty anyway) treatment room to find a recliner. Maybe it was the word “prince” that started it, but I just had to laugh at finding myself in the middle of what sounded like a fairy tale. Like a children’s book with a morality lesson to deliver. Something about temptation, or integrity, or the like. I still giggle thinking about timing, about the challenge to the sliding scale and the group treatment concept. It only got funnier when his check bounced.

But the story’s not over.

Several months later, he returned, cash in hand, to make good on the check. He gave a sincere apology and a perfectly satisfying explanation. Very princely behavior, and very sweet, too. He left and said he’d be back in for treatment soon. Has he been back? No, but the story’s not over yet.

Another one: A few weeks ago I treated a patient for some musculoskeletal pain. She came for just one treatment, so I never really knew whether I’d done a good job for her or not. I figured probably not, since she didn’t re-schedule. I decided that story was over, and I felt badly about it. Then, on a busy shift recently she dropped in. When she got settled in, I went over to check in, and after a few preliminaries I learned what she had come in for that day. She wanted help with stress and insomnia. Her mother had died. Yesterday. And today, she wanted to be – – in our clinic. I was touched and honored. I was reminded again of the finality of death – and only of death – and that our stories with one another are not over until they’re really, truly over. Until then, we have time to keep adding to the stories of our relationships.

Last one: We had a patient with hip and sciatic pain who came in regularly – twice a week for maybe 15 treatments. Each time, we would make more or less progress. Sometimes she would get out of the chair ecstatic at the pain relief. Other times, she’d feel the pain again right away when she put weight on it. We tried so much – we did Skip’s “wolverine,” we did GB channel local work, we had her walk around with LingGu/DaBai in… but we were never able to fully resolve the pain for her. She called one day to cancel her next appointment, and basically to say goodbye. She said she felt like she made some progress with us, but it had stalled, and she wanted to try other things. That she appreciated all the work and attention we put into her treatment. It was a pretty classic “It’s not you, it’s me” kind of call. I so appreciated her willingness to talk it through, and especially respected the courage it takes to engage so fully, even when things aren’t happy and hopeful anymore.

It’s difficult, but I’m trying to remember that the story is not over yet.

I’m starting to think that love as a verb – love in action – is leaving the stories open. I’m trying to remember that the meaning I decide on for any event – a bounced check, a one-and-done, an abandoned course of treatment – is just a guess. I’m working on expanding my sense of time and suspending judgment for longer and longer. When my ego asks: “How did it go?” I’m hoping love will answer: “I don’t know, dear. Not yet. Please just focus on your next patient now, okay?” That’s love in action.

And, of course, love brings fruit.

Author: MichelleRivers

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  1. It’s official

    This is my new favorite post (what is it with you people and your great posts?)  The last paragraph in particular… 

    I have the same experience with patients – folks that I think will never come back do come back, or refer people, sometimes eerily just after I’ve wondered how they are doing (this has happened several times this week, and so often that it doesn’t surprise me anymore).  And vice-versa; sometimes people come a lot for a long time and then stop (for awhile? forever? who knows?  It’s my job to try to stick around and see.)  It helps me to remember all the things I’ve tried once and not followed through on until later, if ever; or things that I’ve done for awhile and then stopped doing, for whatever reason…usually having a lot more to do with me and whatever else was going on in my life than anything to do with the experience itself.  Talk about an ego check.  

    Your definition of love also made me think of Detroit, which is by far the most overdetermined place I have ever lived, and has pretty much every problem except overcrowding.  People have all kinds of ideas about the city ranging from the classic “will the last one to leave Detroit please turn out the lights” to “it’s going to come back” – whatever that means.  There’s always something or someone (community gardens, a new mayor, more downtown retail, the film industry) that’s going to Save the City (kind of the way One Thing–one modality or one Perfect Treatment–is going to heal someone’s illness, right? as if we live in a petri dish).  I went to a community meeting about the mayor’s plan for the city the other day – they seem to at least be making a decent show of seeking community input.  For over an hour citizens got up to voice particular concerns and proffer possible solutions, and lots of very thoughtful, constructive ideas were put forth.  I just went to listen; I know perfectly well that folks usually have a pretty good idea of what they need (to echo Andy’s excellent post below).  I feel about the city the way I feel about my patients: I don’t know what the limits of healing are, or what exactly it’s going to look like.  Of course I have ideas (“how did it go?”) but I think practicing community acupuncture has really helped me practice hearing love’s answer, in and outside of the clinic.

  2. I should have learned my lesson!

    It is a very bad idea to read these blogs while I am at work. I should have learned my lesson a few months ago when I couldn’t stop laughing over a Zang Fool post. Now I can’t stop crying and my beloved patients are coming through the door.

  3. so beautiful

    oh my god, this is so beautiful, Michelle. thank you for sharing it and so, so glad you are feeling and harvesting the fruits of your love.



    Good health is not a measure of adapting to a sick society.

    When the power of love outshines the love of power, the world will know peace.

  4. love

    great stories…many more to come. sometimes I have people show up years later after a treatment or two, as if they’d never been gone – and turns out they didn’t come back because their problem was resolved and they absolutely love the work I’m doing.

    also, on a more practical note, I think it is really important for acupuncturists to get a handle on the limits of what we do. YOur sciatica patient for instance: a lot will depend on why exactly she is having this pain. As profound as it is, acupuncture isn’t everything. 

    LOVE your woodblock artwork, and your orientation towards love in action is right on. If it’s not about that, then I don’t know what it’s about.


  5. Moment of Truth

    Evelynne -Bordentown, NJ

    Way back, when I worked for the Saturn Corporation, we had a phrase “moment of truth”. Its meaning is loaded, but at that time it was about the employee and customer, THAT MOMENT when trust is raised and tension is lowered- an ‘ah-ha!’ moment if you will.  I am finding that phrase applies here…some patients are immediately prepared to heal, while others choose a more difficult, painful path.

    The true stories we hear every day are precious.  Few can appreciate and understand this unspoken-bond we have with patients – why this forum is SO appreciated for this sharing.

    Indeed the highs are high but the lows can be difficult…there have been many occasions when Ihad to find solitude, to cry, to release the hurt, darkness, injustice, and loss that others have dropped here.  Yet I find the blessing, as Ben Harper writes, ‘I am blessed to be a witness’.  It is the ‘unloading’ of a burden that often brings us to that truth of healing.  We all know patients that find it difficult to admit they feel better….they are wheezing prior to treatment but not after and report they “feel no better”!

    If you hold that space of love and truth, people will always find you [your office] and appreciate the medicine and wisdom of CA.  Some patients can’t see it now, but they may find themselves (in the future) more prepared…and you will meet them again. 

    You know the points, you know the medicine, just remember to be a space of truth.  You are wise Michelle for recognizing ego, enjoying the humor, sharing your heart and love.

    Continue to enjoy the stories and your journey!


  6. the love experience

    I am happy for all of you who are having the love experience, but sometimes I wonder which alternate universe you all live in, and how I got stuck in this one.  Many times this week I felt like I was treating the entitled for the rates of the working poor and that they neither noticed nor cared.  It is the second home owners who don’t come in for a treatment while here, because new folks pay $10 extra dollars, so they decide to just wait and be another clinic’s new patient when they get back home, and therefore pay that extra $10 only once.  I know that I ought not to let such things get up my nose, and that my sliding scale benefits me more than anyone else, because it allows me to have a practice I can believe in and love and be proud of, and where working folks can afford to be treated…..but if you all in Manchester and California and anywhere else with populations of the less entitled and those under 35 could ship a few dozen folks my way, I’d be grateful.

  7. Diana

    The working class is often invisible, and they don’t own second homes.  It sounds to me like you have an opportunity to rediscover your community.  Look for multi-unit apartment buildings, talk to waitstaff and cashiers, spend time hob-nobbing with shoppers at thrift stores.  Find them.  *See* them.

  8. one more thought

    there are a bunch of CAN clinics that did away with the initial visit paperwork fee and are doing well with that decision (any of you folks care to chime in about your experience?). it sounds like it might be something worth considering for your location, where folks may come to see you while they are visiting / on vacation.


  9. I was going to suggest the same

    I have never had an initial paperwork fee, and I don’t feel like I have suffered from it.  In fact, I love not having to explain two different prices (the sliding scale is hard enough for some people to grasp).

    I think we all go through cycles of inspiration and frustration, and sometimes it can be hard to read the ra-ra stuff when you are feeling down.  Hang in there, Diana!


  10. what a great reminder to put one foot in front of the other and let love handle the rest! thanks for sharing, michelle.