Words: Dr Joseph KELLERSTEIN
Denise is a southern belle, if there ever was one. At least she sounds that way on the ’phone. That’s the nature of our relationship. We have not met in person. She has been seen by a good homeopathic practitioner locally who referred her because he was having trouble.
This 69-year-old has a warm heart and incredible resilience. “If unpleasant, fearful things happen to my family… if they hurt, I hurt. I lost my husband in a horrible way in 1980. There has been no closure. 2006 had been a bad year as well. We lost five people this last year. My son has been involved in a motor vehicle accident which has left him physically impaired. There have been divorces. My daughter is bipolar. I’ve had reconstructive surgery for the bladder and vaginal area, which took five months to recover from.”
“The joy is gone. When my kids hurt, so do I. It’s nonstop.” Her presenting complaint was acute bronchitis. There was a tight chest with lots of phlegm. Her eyes would tire easily, especially from reading. There was ‘hot water’ running from her nose. The left ear and the left eye were red. Teeth ached. When she sneezed, it provoked a deep cough.
Tiredness. Walking to the living room exhausted her. She felt anxious when the ’phone rang. There was no interest in talking. “It’s the disappointments. I am just a big baby with the disappointments.” There is a history of two serious car accidents in 1986 and 1987. “I had a near-death experience [NDE] with one and a huge amount of physical therapy.”
There is burning in the left shoulder blade area. Burning in the sacroiliac area, which has been worsening over the last year. This pain shoots over top of the left hip. Sweeping is a killer. “Seems like the heat of the summer makes me irritable. I like cool, flowing air.” “I enjoy people.” Now, I was eager to prescribe for the respiratory tract issues and, in fact, I did. The patient elected to use antibiotics simultaneously to the remedy, and so I will refrain from commenting on the inaccessible.
Two months later, the call was of a different nature. Now, the low back had aggravated. It was described as being, ‘so hot and burning’ that it felt like a piece of charcoal. As always, it was on the left, extending to the thigh. By late afternoon, it was unbearable and forced Denise to lie down with an ice-pack. The MRI showed multilevel spondylosis. Disc space narrowed worst at L2-3. Foraminal narrowing at the left of L2-3. Less on the right at L3-4 and L4-5. No evidence of associated stenosis. This certainly adds up to a bad back [brilliant deduction?].
I asked her how else she was doing and the flood gates opened. There were sad issues regarding her son and daughter and a multitude of other stresses on this gracious lady’s shoulders. She was right in the thick of things advocating and doing for everyone. When we spoke of such emotional issues, the weeping was loud and unstoppable. When taking a case take the whole case. Never [aside from first aid] settle for just the complaint, and here is a good example of why.
We can conceptually divide the case into several areas. The various complaints, or syndromes. The general chronic case. The hygienic environment of the person. Lastly, the observational field of the patient and behaviour [observed by the physician, and those who have attended]. The characterising element — those symptoms of illness that narrow the selection of the remedy dramatically can be in any of these data fields.
This is what draws our initial attention and guides us into the study of the homeopathic Materia Medica. In this situation, the pain is intense and striking, but nothing characterises it sufficiently to guide us anywhere. Even more striking is the preoccupation with others, despite her intense pain.
The mental symptoms — multiple grief episodes — especially, the unresolved death of her husband, years ago. The sensitivity to disappointment and lastly the spasmodic weeping that tend to implicate the homeopathic remedy, Ignatia amara. My reaction to this possibility was that I seem driven to it by the lack of evidence for something more compelling. There was so much physical degeneration in the spine that I intuitively wanted something that directly corresponded.
It helped.
