Cary of the Blue River

𝘞𝘩𝘦𝘯 𝘐 𝘴𝘵𝘢𝘳𝘵𝘦𝘥 𝘮𝘢𝘯𝘢𝘨𝘪𝘯𝘨 𝘩𝘦𝘳 𝘤𝘢𝘯𝘤𝘦𝘳, 𝘵𝘩𝘦 𝘮𝘶𝘭𝘵𝘪𝘱𝘭𝘦 𝘮𝘦𝘵𝘢𝘴𝘵𝘢𝘴𝘦𝘴 𝘩𝘢𝘥 𝘧𝘢𝘪𝘭𝘦𝘥 𝘵𝘰 𝘣𝘰𝘵𝘩 𝘤𝘩𝘦𝘮𝘰 𝘢𝘯𝘥 𝘪𝘮𝘮𝘶𝘯𝘰𝘵𝘩𝘦𝘳𝘢𝘱𝘺… ------------------------------------------------------- This was the story of my cancer patient from years ago. I had to see her in person before I left this town.

Due to the successful experience of modulating hematopoiesis in cancer patients, eliminating chemotherapy-induced peripheral neuropathy, and boosting immunity to reduce cancer recurrence rate, I do have high expectations of the possibility and potential of PONAMS for the treatment of intractable disorders. However, just because it can doesn't mean I will keep the door wide open to all without considering indications and limitations and saying yes to all cases.

PONAMS-based formulas' breakthroughs granted me more opportunities to engage intractable disorders. However, I am not the person who would have any intention of challenging the law of nature when it happens. All I do is be responsible for my patients by demonstrating careful attention, humility, and honesty.

On top of that, I still have the stubborn mindset of always telling the truth. I refuse to say, "You'll be fine," or "Everything is gonna be okay," kinds of things evidently to be fake. Yet, all knowingly pretend to be real out of comfort in their critical moments.

For people with intractable health issues who decided to try Chinese medicine and acupuncture at last, who wouldn't know what they had gone through? Who wasn't desperate to need a solution or a cure?

Misinformation is the last thing they need, and a white lie doesn't make you a better person, nor does it help at this time in their life. The only thing they deserve to know and what acupuncturists should be telling is nothing but 100% truth.

I want my patients to be the best judges of themselves and decide what's best for them based on what PONAMS can and can't do. Not for someone's anecdotal opinion, certainly not for the impulsive passion of overconfident, smattering practitioners who tried to talk you in.

Like all medicines, PONAMS isn't for everyone, and not all are into its ideas. Suppose patients don't appreciate what's been told for any reason, or the medical condition or time of intervening is inadequate for PONAMS to step in. In that case, it will cause issues for patients and practitioners if it is implemented. Both therapeutic effects and expectations matter at this time. The decision-making process of whether to take them becomes more challenging than it usually does.

Cary was the lady I finally said yes to after weeks of struggling with myself and debating with Carol, the acupuncture clinic owner, a number of times.

Cary had late-stage colorectal cancer with multiple distant metastases in the lung, liver, and kidney. Both conventional chemotherapy and the rising star — immunotherapy — had failed when I started the immune modulation protocol.

It requires no more words for most of you to see the extremely unfavorable outcome and prognosis for Cary's medical condition.

Cary was referred to us through Leslie, a massage therapist in town and Cary's best friend. I couldn't remember the call that had been made that day when I answered the phone until Leslie reminded me later. But I do remember there was a courteous yet long interrogating phone call. Leslie called for Cary to find out if acupuncture could be an option for her.

The call was pretty much like a background check. Leslie went through almost all my academic and clinical resumes and flipped them upside down. What health issues have I treated? What mindset do I hold on to acupuncture practice, what methods and techniques do I choose to apply to the clinic, the rationales, outcomes, etc.? We spent more than an hour on the line to ensure she got all the questions answered.

Days after the call, Cary's name appeared on the appointment list. It was August 2018, less than four months after I had returned to the US for my doctorate and to practice intractable pain management.

Cary came in for the numbness in her feet. The immediate and significant improvement in the first session made her a loyal customer ever since. The conversation between us, not surprisingly, turned quickly into the possibility of cancer management.

She was a registered nurse and was disappointed at the results that the hospital had caused. On top of chemotherapy's severe side effects that prematurely terminated her cancer treatment, the tumor size somehow grew bigger than it had been. All the drug's adverse effects were counteracted by administering the second batch of medications. The secondary side effects, foreseeably, were managed by a third group of pills.

"The cancer treatment was a total failure! I am in a vicious cycle of the pills I am on," Cary complained about it with evident resentment.

She said she wanted to reduce the number of pills and help her with the cancer treatment. Though predictable, Cary still put me in a moral and practical dilemma.

Most people wouldn't let the matter rest regarding their personal concerns and interests. Cary's medical background may have facilitated communication between us. But, it doesn't necessarily make her rational enough on her matter of life and death.

I understand the firm intention of seeking alternative resolutions to her illness after being impacted by conventional medicine's negative results. However, PONAMS's high consistency and reproducibility may have prevented her from realizing that a tiny fish hook can be too small to catch a gigantic shark.

Assuming is the root of all disappointments. But the fact is, whenever there is hope, it comes with the possibility of disappointment. And the greater the expectation, the greater the unpredictable emotional reaction it triggers. I have seen and gone through many instances as a dentist in Taiwan for 22 years.

Many people heard that I always try my best to save their teeth from being pulled with great success. A prejudiced mindset has often been established before the consultation visit, regardless of their unique presenting situation.

Yes, it was a wrong expectation. But, no, not the medicine nor the doctors work things out like that in the medical society.

For those who couldn't keep their teeth, some of them burst out with anger and fought over the undesired outcome. A doctor was sued for malpractice in early times because the patient had not been informed about polyp removal, which biopsy proved to be cancerous later if the doctor found one during a colonoscopy procedure.

The world has gone to the dogs for way too long, and the moral value isn't what it used to be any more Friendly gestures and courtesy can end up in a despicable manner as quickly and as easily as flipping pages of a book. One instance is all it takes to change the game rules forever to protect practitioners more than patients.

Cary clearly indicated that she had very high expectations of PONAMS due to the successful and positive responses to numbness treatment. There were several times during our discussion that her eyes welled up with tears, and she said,

"I want to live…."

I couldn't tell you how deeply moved I was by the strong will to live that she showed in front of me. But, I was also aware that it wasn't the time to act impetuously without considering the big difference between numbness treatment and cancer management if I wanted to do the right thing.

None of the lab work or exam reports made me optimistic about Cary's medical condition. The multiple distant metastases of cancer complicated the situation to a very challenging point. I certainly had more in-depth and cautious thoughts on Cary's case.

My work partner and the clinic owner, Dr. Carol, insisted and wanted me to give it a try. After years of observing me treating patients with PONAMS, she is confident that I can change the course of cancer and do good for Cary. There is no reason for me not to do things that benefit the patient.

I shared with Carol the lesson I learned as a dentist in Taiwan. Saving lives is so much more than preventing a tooth from being extracted. The emotional disturbance would be way much more vigorous when it fails. I was also concerned about the possibility of raising a legal plaint against me by someone I barely knew back then, let alone I was doing a procedure that was not within the scope of acupuncture practice. Can saving lives with unapproved approaches waive any liability?

I don't know, quite honestly.

Carol wasn't opposed to my concerns and said she wasn't asking me to cross the line. All she wanted for me was to be more flexible when I could make this world a better place.

I told her that PONAMS has its limits, even though it has made the impossible possible numerous times. So maybe she didn't ask me to cross the line, but she asked me to move the line.

We had multiple serious and harsh arguments opposing each other over Cary's case.

The last straw that crushed me wasn't Carol's observation or the moral-driven persuasion. Instead, it was the words said when noticing Cary always fell asleep deeply on the treatment table during her session.

She said that when she was in Iraq, she saw too many soldiers who couldn't sleep well, panicked, and even fell apart the night before the military operation, not knowing if they would be returning to the base alive again.

"Do you know, Eric, what it means if Cary could sleep well on that table at this critical time in her life?" I shook my head.

"She felt safe with you." Carol chimed it like a ringing bell that lingers in the breeze.

At that moment, my time and space around me froze and ceased. Those five words became my momentum of responsibility for Cary a few days later.

Cary had become a test subject of an immunotherapy clinical trial in the hospital when I was about to launch the PONAMS immune modulation protocol in October 2018. In order to not skew the trial results, the trial conductor and I agreed to skip the herbal formula to rule out any additional variable that might affect it. Acupuncture needling during the trial did not concern them because they didn't believe it would influence the outcome.

Cary was excluded from the trial two months later without completing the first phase due to severe side effects. Taking anti-colorectal cancer pills became her only active cancer treatment at the hospital.

From December 2018 to January 2020, Cary kept visiting me 1-2 times weekly for acupuncture and formula management. As many as her appointments, she was late for her sessions regularly during the whole management course. When she finally appeared in the clinic, she wanted to chat with us for 20-30 minutes before the session started.

My family in Taiwan was the first of her must-topic in the conversation. She was seriously concerned about the trip I had to make each month between two States for my 12-hour-a-day, four consecutive days doctorate program. She cared about the rushing between cities to treat patients one after another the next day after returning from the program. I clearly felt the profound, heartfelt, and genuine sincerity from the bottom of her heart without any words being said. There were no hypocritical affections or boundaries between Cary and me.

To a practitioner like me, with English being my second language, it is very challenging to chat with patients while treating them simultaneously. In addition, the immune modulation protocol requires accurate sequencing and proficiency to reach the desired outcome. All sorts of distractions include talking, therefore, slowing the entire process down. "Open the mouth" was all it takes for a dentist to shut patients up, but this is not the case for acupuncture sessions since there is no cure for talkativeness.

Cary was one of the very few individuals I could talk to and treat simultaneously without difficulties. It wasn't because I wanted to, nor because my self-taught English was proficient enough to do so, but because the way we got along relaxed me so much that I felt like she was such a close friend and a family.

During cancer management, Cary kept going back to the hospital to follow up. All the exam reports and lab work came back better and better over time. The sizes of all tumors in the involved organs kept shrinking continuously and significantly.

The doctor claimed that the fantastic results must have been the delayed drug effects from the incomplete phase 1 immunotherapy.

Cary inquired me about my opinion on that statement. I told Cary I genuinely didn't know what happened inside her body. But she should be happy about the good news, and we agreed to stay on track for as long as possible.

In September 2019, 10 months after quitting immunotherapy, Cary's doctor told her it's been puzzling.

The doctor said that they had thought the terrific progress came from the delayed effects of immunotherapy. However, it's been ten months and way beyond the time frame. They admitted that there was no reasonable explanation for such a dramatic improvement following incomplete immunotherapy.

They were happy for Cary but reminded her that nothing could be done to help if it recurred, as they had no clue what made the difference.

Cary seemed not to care about it and said she liked the doctors there. But what did those arrogant and ignorant doctors know about acupuncture? So, it would be a waste of time arguing with them.

"But I know it must be the work you did to me."

Is it? Again, I don't know, honestly. I have never stopped educating Cary that I wasn't treating cancer. Instead, I modulated and boosted her immunity so that her body could find a way out and know what to do, how to do it, and when to stop. That's the power of the human body's healing ability triggered by pressing the buttons correctly.

There is no better way to validate our treatment success in Chinese medicine and acupuncture than patients' feedback and assessments/exam reports. Their words are the only proof we have to approve or disapprove of our hard work and credit.

Cary's medical condition turned incredibly in the right direction. She looked well in every way and engaged herself in a lot of the farm work. For a period of time, Cary brought us bags of vegetables and eggs from her farm. She was energetic, happy, and full of hope.

The adverse effects that Cary had experienced in conventional chemotherapy and immunotherapy were instructive to see that her body functioned and reacted distinctively from others. During the PONAMS-based formula trial stage, I noticed a similar reaction that her system could only manage lower than the average treatment dosage. During the whole course of cancer management, accumulative dosages resulting from long-term medication made preexisting diarrhea worse over time. It then became very bothersome in the late stage of the course.

When applying immune modulation protocols, acupuncture needling is like switching the power on. It drives the immune system to start functioning again the way it should. The PONAMS-based formula provides non-stop and stable electricity to keep the immune system working consistently. Yet, in Cary's management's late stage, she could only take one-eighth of the optimal treatment dosage every other day. How can a factory with power on yet lacks stable electricity manufacture the same sound quality products? Can her immunity still sustain by such a low dosage? For how long?

Like all intractable disorders, it would be biased, insufficient, and far from being well-handled if I squeezed Cary's medical condition into a preformed, fixed frame and viewed it from a one-sided perspective. Modulating immunity requires all resources to work together to adequately manufacture the desired end product. The integration of conventional and Chinese medicine, the know-how to boost the acquired immunity with needles and formulas, carefully controlled point location, needling depth, and the timing and strength of tonification/reduction. All are required to treat complex cases like Cary.

Yes, Cary's exam reports excited all of us. However, before the subsequent follow-up, all I could do was make sure the protocol covered everything and modify it accordingly each time she came in.

The formula's dosage reached a record low level between September 2019 and January 2020 due to Cary's upset intestine. However, the tumor sizes were still shrinking, and the tumor marker readings fell perfectly within the normal range. I should have felt comforted with the good results, yet my gut feeling said the other way.

Without warning signs and symptoms, a soft, painless lump appeared out of nowhere in Cary's left neck in mid-January 2020. The biopsy proved it was again the metastasis of colorectal cancer.

Cary's physical condition and exam reports went down from heaven through the real world, like hitting the self-destructive button accidentally, initiating the countdown procedure, and falling straight into hell.

I could tell that Cary had known very well about what was about to happen. Despite the regression, Cary kept following up at the hospital and coming in for management. The conversation between us remained the same, but the words spoken were less. She smiled as usual, with less laughter. I saw her body's suffering and the deep sadness in her eyes for the first time.

At the end of February, Cary surprisingly showed up at the clinic on time. The second surprise was that she wanted to have the pain stopped. I knew it wasn't a good sign, and the suffering had driven her to a point where she needed the care in a timely fashion.

As she again fell asleep on the treatment table, I thought of Carol's words to me.

Does Cary really feel safe with me? I guess I will never have an answer because it was a question that I couldn't spit out and bring up during a conversation with her. I can see Cary struggles with her life at this critical moment before it ends. Coming to the clinic is the humblest request for quality of life and dignity before the day comes.

I left Cary in the room for additional 30 minutes before waking her up for her chores. Cary hugged me before she walked out of the door — a hug that knew something would be gone soon yet unwilling to let go of.

One day in early March, my phone rang before I left for the clinic. It was from Cary.

"Eric...where are you now?" I heard her weak voice with hurried breaths on the other end of the phone. I told her I was on the way to the clinic.

"Can I come to see you now? I am not feeling well…."

It was March 4th, 2020. The door was pushed open when Cary unprecedentedly showed up at the clinic 30 minutes early. She was pale, couldn't walk steadily, and fell straight into a chair next to the door.

"Help me...Eric...help me…."

I have never seen Cary act or talk like this before. I saw desperation and vulnerability in her for the first time in a long time.

When Cary fell asleep again on the table like she always did, I left the door open to monitor any changes she may be exhibiting. Another reason was that I wanted to see her more that day.

I have treated Cary for one year and nine months. She was the only patient who went through almost the entire time of my acupuncture practice in this town. I was once very much bothered by her habitually being late for the appointment. But she ended up being the one with that I was happy to extend the treatment time.

She cared about my family sincerely, worried about my worries, and laughed with my laughter. She often asked me when my family would visit because she wanted to spend time with them. Cary told me repeatedly not to book a hotel room if they came. There are more than enough spaces on the second floor of her farmhouse to host them. So we will have more than enough and an unlimited amount of vegetables and food for months if we want to cook.

She even grabbed my hands and said that if I ever felt unsafe for who I am at any time in this extreme atmosphere, I just come and use her farm as a sanctuary.

"I can promise you that no one could find you if you are in my farmhouse unless you expose yourself," Cary said out loud with confidence.

I am just a nobody from Taiwan, a middle-aged acupuncturist who hates social activities and has not much sense of humor. What did I do to deserve such a warm and heartfelt friendship from Cary? When she suffered that morning, the first call wasn't made to the ER or 911; it was me. The trust Cary had for me has touched my heart so profoundly and left a mark that out-weight the number of patients I have seen and my success from others.

By the time Cary woke up from her sleep, she had much more color on her face than she had come in, and her eyes were glowing again. She once more gave me a big hug that somehow made me feel the same as the one my mother had given me before she passed away three days later.

It was the last time I saw Cary. She never stepped into the clinic again. Finally, on April 15th, Cary willed Leslie to let go of her.

I have practiced PONAMS in the US for more than eight years. So many people moved, vibed, and rooted in me so deeply that I would call them family. It puts smiles on my face as well as tears in my eyes when I think of those beautiful moments. When vulnerability and strength interwind together and presented in our shared path, it was the most glorious radiance that shone up my days and soul.

Cary is so much more than just a patient on the appointment list. She is a close friend and a dear family who will be missed so much but not forgotten. Four months after the cremation and before I leave the town, I have to see my family and home in the US.

Leslie led me through the winding sandstone path to the farm with the rose rock Cary gave me in my pocket. I was at Cary's farm, the home I had never been to. She was right. I can dodge the world by hiding out here.

Leslie left me alone in the room with Cary's remains. Cary, resting peacefully in my hands, fell asleep as she did six months ago when I last saw her. The only difference was that she would never wake up ever again.

The sun rays shone through the window, landed on one side of the urn, and left the other with a dark shadow. It could be the portrayal that best describes the last few years of Cary's life. There were darkness and shadows of struggling with pain and suffering and brightness and light of caring for and laughing with others.

Leslie asked me why I needed to do all this before I left.

I told her the profound impact Cary had created in me. She nodded and said that Cary never trusted people easily. But, yes, that was exactly what Cary would do and say when she genuinely trusted someone.

Cary's family and friends couldn't make it to town due to the pandemic. Leslie planned to have a service when it was safe to do so and would sprinkle the ashes into Cary's favorite place — the beloved Blue River in front of her house so that she could accompany her husband forever.

On our way back to town, Leslie and I stopped on the side of the road, saying goodbye. Leslie stood on tippy toes and put her arms around my neck tightly for quite a while. I can feel the strong and fluctuating emotion passed on to me through her arms.

She said she would follow the road, and I needed to make a turn here going home. Leslie thanked me for extending Cary's life so she had more time with her best friend.

"Remember that Cary brought us together. Don't forget to visit if you come back, okay?" Leslie's words drove my eye into tears.

Yes, I will, for sure. The Blue River was Cary's favorite and the destiny of her other life. Cary of the Blue River is the person staying in my heart forever and a story that will be remembered and told over and over again.

p.s. 1:

Leslie informed me that Cary's service would be held on November 22nd, 2020, Cary's birthday. Due to the pandemic and the thousands of miles of distance, I couldn't make it there. May Cary rest in peace under the watch of her beloved husband and God.

p.s. 2:

I had treated an infertility lady in town who gave birth to a healthy baby boy in September 2020 while composing this article. Both the mother and the child are perfectly well. I praised the beginning of a new life on one hand as I grieved the end of one on the other. I believe there is a reason for that, and for me to ruminate it over.

The Blue River

Leslie, Cary's best friend. The one who interrogated me.

Cary's farm.

Cary's farmhouse.

The rose rock Cary gave me.

In here lies Cary.

My dear friend and family Cary.

Cary and her dog, Teddy.