Treating patients in the acupuncture clinic, I’ve had some definite successes, some moderate successes or ongoing projects, and a few failures. Of course the obvious successes feel great, and the ongoing projects feel, well, like ongoing projects. The failures feel like a blow to my ego.

I define a failure in this context as the inability to get a good result, resulting in the patient deciding not to continue treatment.

Of course every doctor, even a good one, will encounter cases that he or she is unable to treat. Sometimes the diagnosis is incorrect, or the treatment techniques are applied poorly or inaccurately. Sometimes it’s just that the modality one practices is unsuited to the patient. But sometimes you just don’t know why it didn’t work.

A lot of this process is detective work: figuring out exactly what’s going on, collecting clues, sifting through evidence, coming up with a hypothesis or a story. A lot of it is technical: choosing the right points, inserting needles to the right depth, stimulating them the right amount; or, choosing the right herbs, calculating an appropriate dosage.

But so far, the outright failures that I’ve seen actually seem to have nothing to do with these things.

Recently a patient came in with pain in her shoulder. She was jittery and sensitive, and very anxious to be rid of her pain so she could get on with her life. I didn’t blame her — constant pain is difficult to ignore. And yet, something strange happened to me when I encountered that anxious energy she brought with her: I absorbed some of it. I found myself making her concerns my concerns.

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Life is impermanent.

I find my days passing in a schizophrenic way. Either I am moving quickly in a series of endless little tasks that add up to what people call a normal life. Or I step back and open to a vast, complex, and utterly frightening world. The former is comfortable and familiar, shouting loudly that all is well, filling the world with the illusion that safety endures day after day, and that everyone is, for now at least, immortal.

The latter speaks quietly to the constant dying of things.

I’m not quite sure how this awareness sidled its way up to the forefront of my consciousness. Maybe it was the grief of missing my wife, who was recently out of town for a week and a half — the shock that I am not even able to endure her absence for one night without missing her. Maybe it was the strange and peculiar shock at the news that actor Heath Ledger died — strange, because I expect people who are so distant as to be practically fictional to mean nothing to me; and yet this man did make stories that sat in the privacy of my living room and touched me. Maybe it is the progressive awareness that my parents are getting older, and that my thirtieth birthday is less than a year away. Maybe it’s the fact that I thought school would take forever, and yet in just one more year it will be over forever and I must leave this place and everyone I know here and find the next place where I am meant be in this life.

So much change. So much transition. It frightens me. It makes me want to know: What is real? What is permanent? And, looking, I find nothing. Everything shifts, everything moves, everything changes. I grieve when I try to hang on, while everything dies around me.

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I’d like to announce the opening of my new blog, which will be hosted on its own domain. It’s called Health Beyond Civilization, at HealthBeyondCivilization.com.

Health and medicine have long been interests of mine, especially since my struggles with my own body during the yearlong. I’ve learned so much since I began my studies in Oriental medicine and other forms of alternative health, and many times I’ve wished I could have gone back in time and given myself advice, to save me the grief.

Well, I can’t do that, but I think I can help other people in my position. People who don’t know where to turn, don’t have much clue or much time or money to visit even an alternative health practitioner regularly, but want a variety of information to help sort things out.

I’m in a healing profession, not just to make a living, but to serve. I think I’ve just found a small way I can begin to serve a larger purpose.

I invite you to visit my new website.

Things have gotten kind of crazy lately. Attending classes, treating patients. Going to extracurricular seminars. Trying to network for more business. Starting to orient myself toward starting up my own practice next year. And, considering where to live after I graduate (still no clear idea), what the timeframe is. More broadly, considering peak oil and the economic and societal “destructuring” or collapse that may (or may not) come in the near future.

It’s a lot to contemplate, and a lot to get anxious about, and I was getting pretty discouraged, beat up, and burnt out about it.

Then a couple of nights ago I had a dream. It was a long and complex dream, but the centerpiece of it was a brief interaction with an old Native American man. The elder was wearing a plaid shirt and blue jeans. He gave me a simple test: He was smoking tobacco, and he blew smoke in my face. I breathed it in, and felt fine — that is, until I started psyching myself out, tellin gmyself that this stuff was bad for my lungs. Then I started coughing, and the old guy laughed at me.

Tobacco is an interesting symbol that has a dual meaning. In the civilized world, it stands for addiction, pollution, and health problems. In the indigenous world, it is a sacred herb used for a variety of purposes including spiritual communication.

The meaning is this: Whatever calamities may befall me, whatever difficulties I encounter, they can all be taken in one of two ways. They can be something that I learn from and help to purify me spiritually. Or they can bog me down and cause tremendous suffering.

It’s my choice.