Passive Case Witnessing Problem

It’s a case of a 6 year old girl who consulted me on 18/12/08.

The very first peculiar thing we observe about the child is …she enters the consulting room holding mothers hand tightly.

M: She has made a drawing for you.

(Child’s sibling is also our patient. Every time when this child used to accompany her sister, she would draw and now also she has got the following drawings. This itself shows us the child’s intense connection with her subconscious through this form of art.)

M: She does not have any health problem as such but I wanted to start treatment for her overall development.

PASSIVE CASE WITNESSING PROCESS

D:        Tell me what’s happening to you..? Can I send your mother out?

P: No.

OBSERVATION: Clings tightly to her mother.

D:        Okay, tell me what’s your name?

P: OBSERVATION: Sitting in mothers lap with her hands around mother’s neck. N……P……

D:        Tell me more about you?

P: PAUSE

OBSERVATION: Smiles and clings more to the mother.

D:        Tell me what are your interest and hobbies? What you like to do?

P: I like to swim, like to draw, I like running…playing.

D:        Wow! What else?

P: I like to play on the computer, like to watch TV.

OBSERVATION: Now she removes her hand from the mother’s neck and sits leaning on the table, yet she is in her mothers lap.

D:        What else you like to do?

P: Like to go to school.

D:        Very nice, very nice you are talking?

M: You sit on the chair and talk to the doctor.

P: OBSERVATION; child sits on a chair next to the mother but still holding her arm.

As the mother starts to leave the room, the child jumps off the chair, starts crying and goes and hugs the mother, and goes out with her.)

(The mother comes in with her after some time but now the child sits on the chair and mother on the sofa behind her.)

D:        OK, so tell me what else you like to do?

P: I’ll like to play – go on a slide. Like to read books.

D:        Very nice. You are speaking so well. What else you like to do?

P: Like to dance… then I like to play, then I do homework.

OBSERVATION: Looks behind towards the  mother.

ACTIVE CASE WITNESSING PROCESS

D:        And what are you scared of?

P: Scared of lions, tigers…

D:        What else?

P: Bhoot.

The mother had some work and she had to go out of the room. Immediately the child said no.

D:        You are speaking so well. Just talk with me and your mother will come in 2 minutes.

P: No…no…(OBSERVATION: She gets up and clings to mother and starts crying)

D:        OK you don’t talk, but can you draw till your mom comes back?

(She sits on the chair and starts drawing.)

(Since she was not ready to communicate even after so much of encouragement and the fact that at the beginning she had brought drawings, we ask her to draw.)

OBSERVATION: She covers the paper with the hand and also draws at one lower section of the page.)

D:        Wow! What is this?

P: This is my sister & me, & this is my father and my brother.

D:        And what is this?

P: A heart.

ACTIVE – ACTIVE CASE WITNESSING PROCESS…

D:        What is this heart doing here?

P: I love heart so I drew it.

D:        Earlier also you drew hearts. What about this heart you love?

P: I love heart like that only.

D:        Heart with arrows what does this mean?

P: Looking into the drawing. (PAUSE)

D:        What are you all doing?

P: We all are looking at the heart and thinking what is it.

D:        What does the heart mean?

P: I don’t know.

D:        You like drawing heart huh. When do you draw it?

P: In school. In my drawing class. I draw heart and stars and one day I drew heart and star in the Christmas tree.

D:        In this drawing who is having the flower? (We spotted a flower in the drawing she had made.)

P: My sister- she is just holding it.

D:        She is going to give it to someone or what?

P: Me.

D:        And heart will go to whom.

P: To my brother and father.

D:        Why?

P: Like that only.

D:        Like that only. OK… Would you like to draw something more for me?

D:        Wow! What is this?

P: A drawing.

D:        Of what?

P: Drawing of a garden. This is me and my brother.

D:        What are you both doing here?

P: We have come here to play.

D:        What are you playing?

P: Running and catching.

D:        What is this?

P: Flowers.

D:        Which flower are they?

P: This is flower, this rose and…this …this is pink flower.

D:        Draw one more thing for me?

P: OBSERVATION:  She draws human figures and then joins all of them together.

D:        Wow! What is this? I don’t know what it is.

P: My family.

D:        What’s your family doing here?

P: Ring-a-ring-a-roses.

D:        Ring-a-ring-a-roses. What’s that?

P: I don’t know.

D:        Whom you like the most in your family?

P: My mom.

D:        What about mom you like the most.

P: (PAUSE)

D:        You like or your sister likes?

P: I like more.

D:        What else?

P: (PAUSE)

ACTIVE – ACTIVE IN DIFFERENT AREA – FEAR

D:        What are you scared the most.

P: Lion and tiger.

D:        What about them scares you the most?

P: Because lion crawls and eat us.

D:        What else do they do.

P: Smiles.

D:        You said previously that you are also scared of ghost. What about them scares you?

P: (PAUSE) … I saw the movie called Road side Romeo. (This is a bollywood movie)

(Here when we ask her about fears, she herself goes to the area of movies, so we become active- active to explore this area.)

ACTIVE – ACTIVE IN DIFFERENT AREA -MOVIES

D:        What is there in that movie?

P: There’s a dog, many dogs but 1 dog’s name is Romeo.

D:        Go on?

P: There is a girl called Leila and she loved…. and that dog he loved Leila..

D:        I don’t know what they do? Love means what?

P: I don’t know.

D:        What about the movie do you like the most?

P: I like Leila.

D:        What about Leila you like?

P: (PAUSE)

OBSERVATION: leans on the table and hides mouth behind both palms.

D:        Which other movies you like?

P: Romeo & Jaane tu… (It’s a Bollywood romantic movie.)

D:        And what is there in that movie Jaane tu…?

P: I forget.

D:        Anything else about you.

P: Nods no.

D:        So you like all movies with love/

P: Nods Yes.

D:        What about it you like?

P: I don’t know… because nice things happen.

D:        What?

P: Like they don’t shout, they don’t hit and all.

D:        Anything else.

P: No.

Child goes out and comes back with another drawing along with the mother.

MOTHER’S OBSERVATION OF THE CHILD

She is very affectionate child.  She will go and give big hugs even to strangers. She is very fond of her younger brother and she will make him understand things by saying you can win this or that and she lets him win. Actually she is friendly with anybody and everybody.

END OF THE CASE

—————————————————

UNDERSTANDING OF THE CASE

OU OF PLACE/ OUT OF ORDER

Passive case witnessing process

Verbally the child didn’t speak anything peculiar but our observations regarding the child were very peculiar…

• Her clinging.
• Sitting in the mother’s lap.
• Holding mother tightly.
• Holding her hand while talking.
• Hugging the mother.

Active case witnessing process

• Clings to mother as she tries to go out of the room.
• Covering the paper with hand while drawing.
• A heart.

Active-Active case witnessing process

• I love heart .
• I drew heart and star in the Christmas tree.
• Drawing of a garden
• Flowers.
• Draws human figures and then joins all of them together.
• Too much family attachment.
• Ring-a-ring-a-roses.
• That dog he loved Laila Leila
• Like they don’t shout, they don’t hit and all.

WHAT IS THE FOCUS/CENTRE/ESSENCE OF THE CASE

• Love, attachment and togetherness.
• Love for heart.

This is very evident from her body language and all her drawings. Also this further gets confirmed from the mother’s observation of the child.

WHICH KINGDOM?

• Pure sensitivity seen.
• Drawings of garden, flowers.

This clearly points to the PLANT KINGDOM.

WHICH FAMILY?

This tremendous attachment to the mother, togetherness of the family, hugging and clinginess, love for hearts is very suggestive of the MALVALES family.

WHICH MIASM?

We observed that whenever she draws she covers the paper with her hand. This gives a hint of the SYCOTIC MIASM.

WHICH REMEDY?

The remedy from the Malvales family with Sycotic miasm running in the centre is TILIA EUROPA. BUT in the case we observed that along with the general theme of the Malvales family, the child’s focus was “Heart”. So when a further inquisitive search was made keeping focus on the “Heart” interestingly we found out a remedy TILIA CORDATA which also belongs to the same family where the leaves of the tree are heart shaped.
Thus the remedy given was TILIA CORDATA.

WHICH POTENCY?

At the end of Passive case witnessing process, verbally the child seemed to be at the ‘Name and Fact’ level but the peculiar body language which we didn’t understand initially and which got connected later on with the whole phenomenon, represented the child’s complete altered energy pattern. Thus the child (non-verbally) vibrated at the Delusion level. Therefore the potency given was 1M, single dose.

A follow up drawing

END OF THE CASE

Emergency and Homeopathy



Hpathy Ezine, July, 2009 | Print This Post |

Emergency and Homeopathy

INTRODUCTION

Emergency and…Homoeopathy? One cannot escape the derisive nature of the question. The  average layman has this perception and so do some of our patients who, while on homoeopathic treatment for their chronic condition, resort to modern medicine to tide them over critical moments. The general medical fraternity undoubtedly believes in this as well. One suspects that most  homeopaths also agree with this general belief. This belief has had little challenges from within the group of homoeopaths. Only after mounting the challenge can we test ourselves in front of the medical fraternity and society, and evaluate ourselves.

I have been hospital-based and practically living on campuses of various hospitals for the last ten years. I can assure you that this is not exactly pleasant; nor has it been a necessity forced on me by circumstances; I have done it only to experience firsthand and at close quarters the power of homeopathy in critical moments of life and death. The experiences have destroyed the last vestiges of doubt about whether homoeopathy works in critical situations. I believed that the Law of Similars of the chronic conditions should work in acute situations too. If it did not, then there were only two conclusions. Either we do not know the way of practicing homeopathy in critical situations or the science of homeopathy was incomplete and had a serious limitation.

It was relatively better to have the first conclusion than the second, because if we did not know the art, that was because we did not practice it for years. We have a chance of struggling and reinventing. But if homeopathy as a science had limitations, that would have been the biggest disappointment for me. I was willing to accept limitations of a homeopath but to accept homeopathy, as a science with limited scope, would have been very sad indeed!

To apply homeopathy in crunch situations I had first to get training . I got myself trained and acquainted with emergencies by working in modern hospitals. Working with experts in this field I would become fit by heart first, then the brain and lastly with my hands. The training is still going on. It is a life-long process and only a decade has passed out of it.

The First Emergency

It was only after years of training that I got a chance to manage a crunch situations on my own. I received an emergency call at 1am from the Paediatric department requesting help to save a neonate. I had respiratory distress and convulsions  following a difficult and traumatic labour. I saw the scene, the mother was still in lithotomy as her perineal tears were being sutured. She lay exhausted and hardly in a position to speak. There was nobody to give the history except the resident who had delivered the baby. There were no relatives around. I stood there and examined the child and came to the conclusion that the child had cerebral concussion with cerebral edema. It was convulsing, had respiratory distress due to altered respiratory drive and impeding secretion in air passages. After clearing the air passages, the child still had shallow respiration. After supporting him with temperature regulation, oxygen and securing an intravenous line we sent for investigation. While doing this, simultaneously, I was observing the child. Some peculiarities in the pattern of the convulsions and its evolution were noted. The sequence of convulsive movements, like a Jacksonian March, and the areas of manifestation of the convulsive movement (predominantly in the face and around the mouth), were peculiar.  Connecting these peculiarities with the etiology (cause) and the pathology (Clinico-pathological co-relation) I could see a clear emerging totality of Cicuta, which I prescribed in moderate potency with frequent repetition. (Read this case here)

The result was astonishing and far better than what could have been obtained with conventional management. Before my ‘boss’ arrived on the rounds the next day the child was fit enough to accept the mother’s breast.

When the euphoria settled down and I analyzed my actions, I realized what had gone into the management of this situation. Clinical assessment, knowledge of symptomatology and power of observation. Information on pathology and investigations, knowledge of clinical medicine ancillary measures, life saving support systems and skills to use them, the knowledge of Materia Medica, repertory and susceptibility – all culminated and got synthesized at one point to manage the child out of which the prescription of Cicuta was just one crucial action. That was the time I realized the difference between prescribing a homeopathic remedy and managing the patient as a whole. All the knowledge that my teachers taught in my undergraduate days came into use. This happened because through my training I had learned to keep my anxieties and fear at bay and my senses intact, to make those crucial unprejudiced observations. This perceiving ‘saw’ Cicuta.


Sliding deeper into Emergency

I went through a similar experience when we managed to salvage a lady who collapsed due to hypovolaemic shock. She was pulse-less; the B.P. was not recordable due to sudden acute gastroenteritis, which was so profuse and fulminating that a few profuse stools and copious purging vomiting had sent her into a state of stock and collapse. Veratrum album helped the revival. All the knowledge and attitudes of the physician mentioned earlier, helped to salvage the situation.

In another case a challenge was thrown at us by nature and due to lack of ‘ASV’ in town, when an adult male with poisonous snakebite was brought to the casualty with gangrene, rapidly spreading cellulitis, toxemia and vascular shock. Clinical assessment, sound observation, clinico-pathological co-relation, support and life saving ancillary measures along with judgment of susceptibility (a powerful prognosticating tool!) helped the first prescription of Anthracinum  followed by Lachesis. Not only did we manage the acute toxemia, vascular shock, cellulitis and gangrene, his wounds and the ulcer on the leg healed completely without a skin graft! (Read this case here)


Dynamics of Emergencies: Role of the Self and Others

We are not necessary emotionally attached to the patients we treat, although we do care for them and sympathize with them. One is tested emotionally when one has to prescribe in critical moments for people to whom one is close.  I have a deep respect for one of our friends for his sincerely methodical approach and simplicity. He was going through a critical time with a myocardial infarct due to triple vessel disease and cardiac tachyarrhythmia. He was in cardiogenic shock. He was thrombolysed, was on life support system and drugs but with no apparent success. He was advised to undergo emergency coronary bypass which could not be done due to his state of shock. Intra-aortic balloon pump was barely able to maintain his vascular and pulmonary pressures. If he did not recover from this within a few hours, he would succumb, the cardiologist announced. He also openly invited help from us as he had exhausted his resources with limited response and time was running out.

Navin Pawaskar

Navin Pawaskar M.D. (HOM) Practice of Medicine Consulting Homoeopathic Physician Member Institute of Clinical Research Director Clinical Services, Dr. M. L. Dhawale Memorial Trust"™s Rural Homoeopathic Hospital, Palghar, Thane District Reader Department of Medicine, MLDMHI Mumbai

Comments

  1. Dr.S.K.KODECHA

    December 21, 2010

    Thanks sir,for cure the emergency cases, True homeopath can handel the emergencies cases by read the your articles. You r great.

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