The Western College of Homeopathic Medicine (WCHM) has a unique student clinic format. Starting in the first year of studies through to their final fourth year, students attend and participate in clinic practice, working with live cases, video and sometimes paper cases. By the time the students graduate, they will have seen at a minimum 100 initial consults.
If time allows on a student clinic weekend, themes of the case are discussed. Places of energy, repetition, modalities of the main complaint, hand gestures…all are considered. The students then work on the case and submit their analyses to be marked. In a following clinic, the remedy given is revealed and a review discussion is held.
With this particular case, the Sensation Method as developed by Dr. Rajan Sankaran, was used to find the remedy needed to help support healing. Because of the high volume of cases in the four-year program students are able to use other approaches as well, so their clinical experience is quite broad and inclusive.
This case has been edited but the main consult points in the patient’s words have been kept so that the themes of the Conifers as presented in Dr. Rajan Sankaran’s work with Sensation are apparent.
HS/SH=Student Homeopath, P=Patient, H=Homeopath, HG=Hand Gesture
The Student homeopath takes the case for the 1st hour and then the Homeopath takes the case for the last 30 minutes.
P: Pain everywhere in my body, feet, ankles, my knees, back in my shoulders, fingers, in my wrists, everywhere. I thought at first the pain would go away, but it got worse and worse and worse. I still don’t have full range of my wrists, my fingers. I can’t squeeze things really hard like I used to. I used to be such an athletic person. I used to work out 7 days/week. Now I can’t do that anymore, cause my hips and my knees can’t stand it. I’m a nursing student and I started a really, hard, stressful class working at the hospital for 12 hours on Saturdays and Sundays. It’s a really busy unit. Either stress or being on my feet, my symptoms have gotten so much worse. I have pain everywhere now. Pain in my hips, knees, swollen ankles. When I come home I’m so tired. I can barely walk at the hospital, even at 1pm. I used to be able to get up, now I can barely get up in the morning. I can’t function normally (tears). I don’t feel like a 21 year old, I feel like a 90 year old. (crying) It’s really hard because I used to be so active and now the Dr.’s tell me I have fibromyalgia.
It’s dull right now, if I move in a certain way, the pain in my knees will get a sharp pain that shoots. It takes a while to get better and recover from that. In my elbows right now I can’t bend too far because it hurts too much. In my wrists, I can’t push against something because it hurts too much, feels like it’s gonna break.
In my hips, it’s like it’s so weird. I’ve felt like this for so long it’s hard for me to explain. In my hips the pain, it’s all in my hip, it radiates throughout my hip but it doesn’t’ go down, just stays in my hip. I almost have to waddle. Usually you can bend your knees to 90°, but I can’t do that because it hurts too much. My feet and ankles get swollen. I can see that they’re visibly swollen and I can feel that they’re swollen. My fingers in the morning get so stiff that I’m unable to flex my fingers. It just feels like you have your hands in thick pudding or cement and you can’t squeeze them.
Same with my back and the muscles in my back. I never had problems in my back, but I think my muscles are trying to compensate for what’s going on. I get lower back pain and it’s dull and it’s always there and if I bend my back in certain ways, then it hurts really bad. My shoulder blades, I can’t take off my shirt because it hurts my shoulder blades too much. I have to put one hand through my shirt and then take it off. My neck, I can’t do shoulder checks sometimes because the muscles in my neck are so stiff.
Basically the only way I can explain it is if you had gotten beat up really, really bad and someone kicked you so bad everywhere on your body and then you got up and tried to walk. I felt like someone took a bat and beat my legs, beat my hips, beat my back, beat my knees, shoulders, elbows, fingers, wrist, everything. Dull, then when it’s really bad, it’s shooting pain.
When I go to the gym and I’m in my own world, I feel like I can just…I feel so powerful. Most girls don’t like lifting weights, but I love lifting weights. I feel so powerful when I lift weights. I feel so strong. When I’d look in the mirror and see muscle definition I’d know I was getting stronger and it made me feel so good. I’m not as strong as I used to be. I worked so hard to get to that point. Within a matter of months this working out for 2 ½ years just went away.
Working out, I feel like a totally different person at the gym. I’m a strong, independent person.
I do a lot to try to help people, why I became a nurse, even if I can make the smallest difference in someone’s life, then I feel like I’m happy. Even at the hospital, it’s our job to take care of patients who’ve had bowel movements, and some of my peers, they hate stuff like that, if I can make someone feel comfortable, make someone feel more human, I feel like I’ve done a good job. I feel like I’m a really good person in that way. To talk to them, tell them what I’m doing, ask them if the water’s too cold or warm, if they’re comfortable, and ask them if they wanna to use the toilet even though they’re incontinent. That’s how I can make them feel more human and not like an animal.
I designed a tattoo that I wanna get after I get better. I’m gonna get the day that I start feeling better and the day that I can bend my knees without any pain or open my mouth and yawn without having pain in my jaw, I’m gonna get this tattoo and I look at the tattoo and it just gives me strength but at the same time what if I never get to that point?
It’s the word strength with a dumbbell on the back, cause I really like working out so then I thought “Strength” if I look at it, I’ll always know, I went through this really incredible time in my life, it was painful, but I learned so much about what I can handle as a person and what doesn’t kill you makes you stronger and I think I’ll always have it as a reminder that I went through this, so I can go through anything. But I can’t get it yet.
I have a fear of never falling in love. I really cared for this one person. It just didn’t work out. I tried my best with him; I tried everything except telling him that I like him. He didn’t really respond, so it scares me to think -what if every guy is like that? What if I don’t find the true love that you see in the movies? I imagine it being like in the movies, just look into the person’s eyes and you just know you’re in love. Being really happy, someone caring about you so much and you, caring about that person, not knowing how you ever functioned without them.
I found someone like that already, we’re best friends. I joke around with her that maybe I’ll find the man of my dreams, but I’ve already found my soul mate. She’s my soul mate. She makes me really happy; she’s the best person in my life.
*Now, the Homeopath takes over from the student Homeopath*
H: Tell me about the pain that’s affecting your life quite profoundly.
They don’t understand how agonizing this pain is!
It’s something I’ve never felt before. The pain is just so unreal! I’ve never felt anything like it before, I almost wish it was something physical, like I cut my arm or I broke my arm or something that someone could have a quick fix for, rather that it being so systemic, so internal that nobody really knows what it is.
It’s just so painful, it just feels like someone beat me up and I just get up and I feel like, if I went to the hospital, I feel like they’d say; “Oh, you have a broken arm or this or that”, and I don’t!
H: But it feels broken?
P: It doesn’t necessarily feel broken, it just feels like, feels just not normal. Like I don’t know how to explain…
H: Not broken, but beat up?
P: Like beat up, ya I feel just really tired, like I know normally on a 12 hour shift I would feel normally tired but this is just totally different tired. Like ya, my feet would be swollen, cause it’s 12 hours on your feet, but my then knees are swollen and my hips are swollen and my back and my shoulders and my wrists and I think that’s not normal!
H: Right, and what’s the sensation with the knees swollen, hips swollen, fingers swollen?
P: Well, last weekend I took Tylenol and it numbed the pain, but I could feel that my knee was so swollen, it just feels so tight and it feels almost like the skin’s gonna rip (HG) and you, like when I flexed my knee, I didn’t have pain, but I felt so tight in my knee.
H: So, like the skin is going to rip?
P: Basically, like on my fingers, when my fingers get swollen, the same feeling, I feel like my skin’s gonna rip. And even when I try to bend my finger I feel like even if I bend, if feel like it’s gonna, like when you have something really tight on, it’s gonna rip apart. (HG of bending/pulling and ripping/snapping apart) That’s what I feel like with my fingers.
H: So like something tight, and rip apart? Say a bit more about this tight and rip apart.
P: Like when you’re wearing really tight pants or tights or pantyhose and you bend and your panty hose rip -that kind of sensation. I feel that in my fingers and my knees. My knee, I’ve only felt that this past weekend. I’ve never felt the swelling in my knees before, but my fingers and my wrists, I’ve felt that.
H: You actually did this (HG) this tight and rip apart. Just talk about that. It seems kind of weird, but you were giving us this gesture…this is what it’s like. Think about the gesture more, not so much about your physical part, but just this (HG)…
P: It’s like pulling something apart (HG) Like when you have something that’s together and you pull it apart, like when the skins together and when I bend, it’s just gonna pull apart. Like that’s obviously not going to happen, but that’s what I feel like on my skin.
H: Right, so just talk in general about something that’s together and then it just pulls apart, just very general. Just the idea of something that’s together and pull apart
P: like when you break something in half, like a cookie or a stick, or when you rip a piece of paper in half
H: or paper in half, keep saying more about that…breaking something in half…like something’s together and pulling it apart or breaking something in half…the first thing that comes to mind…
P: I’m trying to think of things that are together…like chocolate, when you break chocolate in half, but I can’t think of any chocolate that comes together but you break in half, or like Caramel or something like that,
H: But it’s the idea of something that’s together and you break it
H: What else comes to mind?
P: Breaking celery in half, I don’t know, uh, (lots of silence) I can’t think of anything else.
H: So, when you bend your knees or your fingers, there’s this tightness and then you bend…
P: I can’t bend all the way though, like now I can, but even with this finger I feel resistance, but I can still bend, but like when they’re really swollen in the morning, like I can’t bend, like I can go that far, but this finger was really swollen the other day and I could only go like that far and I can’t bend any further.
H: How does that feel?
P: I feel, weird, like I should be able to use my hands, like I tried using a garlic press like a while ago and I couldn’t even squeeze it, cause I don’t have that sort of strength in my hands per say anymore.
H: So you can’t squeeze?
P: I can’t squeeze, I couldn’t even squeeze a dish rag, like squeeze the water out of a dishrag, cause my hands, I can only squeeze so far until they start hurting.
H: Ya and what’s that sensation?
P: Pain! It’s just pain in my fingers, pain in my hand right here, like it’s just a pain. I can squeeze like this (closes hand into a fist), but as soon as I start actually trying to squeeze, I can’t.
H: And what is the pain like?
P: It’s a sharp pain. It’s in my fingers and then it goes in my hand right about here, and then it starts going in to my elbow.
H: And the sharp pain is like what? How is the feeling of the sharp pain?
P: Just like someone’s sticking something through my hand,… like something’s poking through my hand, like something sharp…I wouldn’t say like a knife poking through my hand, but something really sharp and painful.
H: Not a knife? P: Not that sharp
H: Is that the one that concerns you the most?
P: I said initially my knees and my back, but my wrists and my fingers, I use those every day. Not to say that I don’t use my hips and my knees and my back, but this is…this has been like the longest and this has never changed, whereas the knees pain, back pain, shoulder pain has gone and come, whereas the pain in my fingers and the pain in my wrists has steadily always been there. It’s not been so much as painful, but the loss of function, I would have to say. Like the swelling in my fingers has gone down, the swelling in two of my fingers, they’ve been like that for 6 months now. I feel like my fingers, the way they are now; are they never going to go back to normal?, but as far as being able to squeeze things and having full range of motion in my wrists, I haven’t. Not since the 6 months have started, since this stuff has happened.
H: And what’s the pain in the wrists?
P: It feels like they’re going to break. Like if I push against something, like if I push against this wall and if I go past a certain point, they feel like they’re gonna break.
H: Can you describe this sensation like they’re going to break?
P: It just feels like my wrists are so brittle. It just feels like I used to have such strong wrists before and now my wrists just feel so week.
H: Say about this brittle sensation?
P: Like when I push up against the wall and I feel that pain, I try to sometimes go past it, but I can’t because the pain, I’m just so scared because I think what if I actually do go too far and I actually break my wrists.
H: What’s the feeling of this, as if they’re going to break?
P: it’s just a really sharp pain
H: So a sharp pain as if they’re going to break…. And it feels brittle?
P: I don’t know if that’s the right way to describe it, but it just feels like my wrists are just so weak. Like I used be able to do stretches where I could go past 90° in my wrists and I could go further, but now I can barely do 90° with my wrists. And I feel like when I bend my wrists, there’s parts of my bones stick out right here. (Pointing to the inside of her wrists) I don’t know if that’s normal or if I’m just picking on it, but I’ve noticed that. I don’t know. I don’t know if that was there before, but when you have stuff that’s wrong with you, you kind of over analyze certain things.
H: Setting the overanalyzing aside, what’s the actual feeling of what might happen, the sensation of what might happen if you go beyond…?
P: I’ve never broken anything, but it feels like I’m going to break my wrist. That’s the best way I can describe it. It just feels like I’m going to break my wrist if I go past a certain point. Like it’s when you have something you can only bend to a certain point. Like when you have something that you can bend only to a certain point, like a plastic ruler per say, and you’re bending it, and bending it and you know you’re getting to that right point where you’re gonna break it, and you bend it too much and you break it. That’s what I feel like my wrists are gonna do.
H: so bending it and bending it…
P: I’m scared of bending it to the point where it’s too much that it just breaks.
H: too much and then it breaks. So you’re doing this bending and bending and what happens?
P: And you just get to a point where you break, it just breaks.
H: And this has been the part of your body that has been the most consistent?
P: My fingers and wrists. It hasn’t gone away, it’s gotten better as far as swelling goes, but one of my fingers is always swollen. These two of my fingers have constantly been swollen since day 1. My wrists, this wrist has gone down in swelling, as far as bending it, same thing. It got a little bit better cause I started stretching it, so I was getting a little bit of mobility back in to it, but since this class has happened, I haven’t had time to do any of that stuff, it’s gotten really bad. I tried stretching it but I can’t, nowhere near what I used to be able to before. And I couldn’t do very much before.
P: As we were talking, I was thinking, what if it was the flu shot that gave me all this? Cause I got my flu shot in November and maybe I didn’t start feeling stuff right away, but it was around that time. I never thought about that before cause I’ve never got the flu shot before, this was the first year. I knew I never wanted to get it! It was a friend of mine that said “You’re nursing, you should get it”. I always felt like I was invincible, like nothings ever going to happen to me.
From a repertorization the Conifers are well represented with the physical symptoms presented. Thuja, which has been routinely used for adverse effects of vaccination is worthy of note. Whether her ailments were from the flu vaccine we cannot know for sure. For entrance into a medical program many shots are given besides the flu vaccine. She had received them all.
Not only was the sensation method used, a repertorization was also used to show the students that there is more than one way to analyze a case and come to a well chosen remedy. The actual proving of Sequoia added to the materia medica knowledge for the students.
From the Redwood Proving by Birch and Rockwell
Pains all over the body, are gripping, constrictive, aching. The body feels stiff and tight. Over all, there is either great exhaustion or a feeling of well-being. The fluid balance is affected either by absence of fluid being collected or more fluid retained. In the mind there is difficult concentration or clarity of thought. Emotional sensitivity especially as to feelings of love, grief, rage and calmness.
General Symptoms: overwhelming feeling of being old. Feels all the trials of being 40 years old. Complete exhaustion. fatigue, total collapse Weakness. Trembling in all of body. Sensation that he has burned out the fires of life (2). Feels cut down
Very energetic. Feeling of well being. Feeling of great personal strength.
Pains in body are more defined. Pains better heat. Pains all over body so much so that he can’t walk. Sore aching pains.. Body aches. A physical immobility. Stiffness all over body.
Student clinic was closed for the summer so email was used for check-ins.
Email Check In
I went to the specialist earlier this month. He examined my fingers and toes and told me that there was nothing physical that he could find wrong with me instead he thinks that it might have just been an abnormal reaction to the flu shot that I got in November last year. I asked why it took so long for my symptoms to present themselves and he said that sometimes it can take a while before I can feel the effects of the vaccine. He said that it’s just a waiting game and gave me some more blood tests that I need to complete before seeing him again in September. After I came to student clinic I really felt that it was the flu shot but I wasn’t sure but now it makes more sense. He said he’s not 100% sure that the flu shot is what is causing this to happen to me but he has a good feeling it is.
I have started to feel better in my knees and hips even my back and shoulders are doing a little bit better. Just my fingers/wrists and feet still hurt and the skin on them can be very sensitive sometimes.
I also have been taking less pain medications when I need them, which is an improvement. Even though I have my moments where I am still in pain I can tell you that I am feeling a lot better. Just want to get the strength back in my fingers and wrists again. The doctor also mentioned that if this is a virus from the flu shot it could take anywhere from a year to two years for me to recover. I hope in taking the remedy that is not the case.
Sorry I haven’t written to you in so long just been really busy. I am having a very good summer so far. I am feeling so much better. I still get occasional swelling in my wrists, fingers, elbows, shoulders and ankles. I have started to exercise again but am nowhere near the level I used to be at. I have tried to start running again but my muscles in my legs are very sore so I think I just need to wait for a little longer or take it easy for a bit. I went to my family doctor this morning and he told me that I most likely have scar tissue build up wherever there was a lot of swelling (fingers and knees). Ha said that I probably won’t go back to normal 100% which makes me sad. I hope I will eventually get the use back in my fingers and knees. I miss being active so much, I think I am pushing my body too hard so I’m going to try and ease into working out. One thing that is really good is I don’t take any medication anymore and when I am on my feet at work walking around I’m not in pain. Thank you so much for everything that you’ve done for me. I can’t wait to see you all again in September!
In the follow up in November the patient reports that the joint pain is totally gone. She is back working out and has her tattoo. In the past she had acne and this has returned as well. Her medical doctor has put her back on birth control pills and recommended Accutane for cystic acne on her chest and back. The acne has returned but not as severely as before.
The student homeopath has asked the patient to describe what the difference was between the time when she had the joint pain and now when the joint pain is gone.
“This made me stronger. I came back from chronic pain where I was a 90-year-old lady and I came back. It means I was strong enough. The opposite is weak. I was so vulnerable. So fragile. If someone pushed me I’d fall over. Now I’m in charge. Before I was sad, not optimistic, fragile and vulnerable…like a vase where the glass is thin. Push too tight and it’ll break. I felt I would break. Now I do not have that feeling. The acne makes me feel vulnerable a bit.
I have this guy I’m dating. He hasn’t seen me in person. I am going to see him in December and I am hoping the acne gets clear enough. He’s the guy of my dreams. He’s athletic and values education.”
The themes of the Conifers are still present – the fragility, the strength and its opposite weakness. The theme of feeling old and the longing for a soul mate, which were in the proving of Sequoia are still there.
In March 2014, the young woman wrote to say that she did take the Accutane treatment and as a consequence, her hair began falling out as a side effect. Her dermatologist said that the temporary side effect would subside but offered her a lifelong medication for hair loss. She was asked to book a follow up appointment but we never heard from her again
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