Combination of different practices benefits patients
By Alison Rooney
The worlds of “Eastern” and “Western” medicine are usually divided by a span greater than simple geography. Chinese herbal medicine (CHM) and acupuncture, despite thousands of years of efficacy, are sometimes dismissed as “new age” fads by some Western medical practitioners, although this perception is diminishing. In fact many hospitals have, in recent years, opened up what are often called “integrative medicine” units offering “complementary” care to patients using CHM and other non-Western modalities. The disciplines, quite different from each other, can indeed complement each other, as evidenced by a local medical practice.
Cold Spring internist and pulmonologist Dr. Cynthia Ligenza, whose busy practice is located in the Lahey Pavilion on the grounds of the former Butterfield Hospital, invited Ron Hershey, who holds an M.S. in Traditional Oriental Medicine and is nationally board-certified in both acupuncture and Chinese herbal medicine, to expand his Croton-based practice by seeing patients in her office one full day each week. Each works both independently and also in consultation with each other, depending on the patient. This arrangement has proved rewarding for both of them for over 11 years now. Hershey’s main office is in Croton, where he sees a larger number of patients, three days a week.
The two met as neighbors, soon after Dr. Ligenza had relocated from New York City to Philipstown. Ligenza had been working at inner city teaching hospitals and at a tuberculosis clinic, in pulmonary care. Her years spent on a set schedule of hours afforded her the opportunities to cultivate her interest in “alternative healing processes, including Jin Shin Jyutsu, energy healing and educational kinesiology—so I had a firm belief in integrated medicine.” Ligenza initially hoped to incorporate these processes into her own Cold Spring internal medicine practice, but “my time limitations soon became obvious, especially realizing how hungry this community was for regular healthcare. But I immediately met people here who did other healing modalities “¦ I was delighted to meet Ron, who has had some of the best available training. With integrated medicine practices, my feelings are that there are some who are well-trained and non-avaricious, while others get into a psychological whirlwind of the ‘only I have all the answers’ type. I have a great respect for those who are humble and whose solid training makes their work accessible. Ron studies continuously and really tries to be intellectually honest.”
For his part, Hershey has found Dr. Ligenza’s contributions to those in their shared care to be “enormously valuable. For someone with ailments but no diagnosis to hear ‘no, you’re not crazy’ from an internist and not from an alternate care practitioner — it’s priceless.” Front and center on Hershey’s East Mountain Acupuncture’s website is: “Treatment of any health issue with acupuncture and herbal medicine does not replace a physician’s care. It is important to utilize both medical systems, as each one has its own strengths and weaknesses.”
Philipstown.info recently sat down with both practitioners to learn more about the differences between the two forms of medicine and how they can inform each other.
Ligenza: I see patients with complex medical problems; those whose entire occupation is taking medications and surviving. These patients don’t go to Ron. Then there are the patients with complex medical issues, including significant issues like cancer and colitis, who are doing the best they can in allopathic medicine, but the way they feel leaves a lot to be desired. They may be at that point of taking a step and exploring other things. I say “you’ve already done everything right, and Western medicine has nothing more to offer you. Explore a different way” Often, subtle, yet dramatic changes can be made. I would never tell anyone to stop doing something if they need it, but I can tell them the other things the world has to offer. There is a third kind of patient I see: that person has symptoms or complaints nobody has been able to figure out. I can offer them the relief of saying “you are healthy by Western medicine’s standards but you do have an energy imbalance that cannot be measured by Western medicine, so maybe you need to consult and try Jin Shin Jyutsu (an ancient art of balancing energy in the body) or Bodywork or CHM.”
Hershey: What often happens is that people fall off the radar of Western medicine. The Chinese system has a way of linking together seemingly unrelated symptoms and making sense of it all.
Ligenza: Homeopathy does this too. I will never disparage anyone’s quest for healing and what they’ve tried. For example, with cancer, 99.9 percent of physicians will reject [alternative therapies] saying ‘you’re killing yourself and you’re psychologically ill.’ I say ‘this is your personal journey and you have to be true to your beliefs. I will support you. If it succeeds, I will applaud it. If it fails, I will be by your side and make sure you get enough morphine.’ That’s the approach I take. And I listen to what people have to say.
Hershey: I deal with many people who have chronic pain and also those with recent, acute, injuries. Many of those with chronic pain have trouble in managing [Western] medications. They see how helpful acupuncture is for the nervous system. I also see people whose motor is running too fast. It can be anxiety, insomnia — babies included, especially after trauma or difficulties in pregnancies — these are major, major sleep disruptions. Acupuncture can be miraculous for this. Certain problems relate more to the body’s energy. Energy imbalance can settle into the organs and not pass through. For those issues, CHM is of enormous benefit. If people have only used acupuncture and haven’t had success, the case may cry out for CHM.
Philipstown.info asked both practitioners to more fully describe what the term ‘energy imbalance.’
Ligenza: Sometimes you don’t know you have it and you accept it as normal. Maybe another family member will feel that the person is “out of tune” and they’re worried about them, or even annoyed at them. Sometimes people come in whom I would perceive as “not comfortable in their own bodies.”
Hershey: I would think a lot of people focus on issues that are not the problem. For example they have a neck or digestive problem, but there is actually some other big piece they’re not dealing with. It could be psychological, could be depression, or could be related to excess caffeine, sugar or an alcohol addiction. In medical practices today, just sitting down and asking the person questions is unfortunately not nearly as common now as it should be.
Ligenza: In our medical records system we have a section on diet consumption and exercise. These questions should get asked at the beginning of the doctor/patient relationship but sometimes more immediate issues get addressed and these questions aren’t asked right away.
Hershey: In a lot of ways this is what I call ‘common sense medicine.’ Rather than starting, in the Western way, at the extreme end — life-threatening disease — and working our way to lesser, we start with the building blocks of health: proper self care, diet, sleep, exercise, and working from that. I personally think that these things are far more important than herbs or acupuncture. There is a Chinese saying, ‘The highest form of medicine is the way you live your life on a daily basis.’ I don’t immediately think of what herbs or what [acupuncture] points, I think of ‘what does this person need?’ I have the luxury of spending more time with each person, the luxury of hearing what’s going on. Some things take longer to come out. Maybe I don’t hear in words what the problems are. If, for example, the person’s suffering doesn’t seem commensurate with what they think the problems are, then bells go off , that it may be something else— this is the holistic approach — excavate what’s going on.
Acupuncture still more accepted than Chinese herbal medicine
Both practitioners see many patients independently, but occasionally confer with other about a patient who is not seeing both. Ligenza also refers patients to many other healing modality practices, “not just those here in the building,” and her practice also includes Jin Shin Jyutsu practitioner Claire Posada, who, like Hershey, comes in at set times during the week.
Ligenza says there was little or no discussion of Eastern medical practices during her medical school years in the 1970s. She believes that there are probably “short reviews of these modalities” now. Describing how major hospital centers such as Memorial Sloan-Kettering and New York-Presbyterian now have complementary medicine departments, she feels that respect and credit are now given, though in some instances it is just “jumping on the patient-driven bandwagon. I’d rather refer to a local practitioner.” Hershey adds that “the sad truth is that in most cases [this type of] integrated medicine is a small step only, because it aims at the most cautious, least controversial, massage or whatever, approach. Acupuncture is much more accepted in the Western medical world than CHM. Although so much research has been done on herbs, in China, herbs are not patentable and therefore drug companies can’t make enough money to recoup the high cost of research. It’s interesting that lots of research for herbs now comes from Germany where for a long time CHM was covered by the national health care there. In reality, there is a lot of scientific information available on Chinese herbs, including a modern textbook, complete with all the pharmacological actions of each herb, written by a third or fourth generation herbologist who is also a doctor in pharmacology.
Payment for non-traditional treatment
Many of Dr. Ligenza’s patients are on Medicare, which does not pay for Eastern medicine treatments, although many private Medicare supplemental insurance policies do cover a portion of the costs, as do many insurers in general. This precludes some of Ligenza’s older clients, who are on fixed incomes, from seeking treatment. Hershey does try to keep things affordable, however. He notes that, “It isn’t always a long-term treatment, either. Especially when we use herbs. Sometimes we try herbs partly for their cost-effectiveness and use phone contact guidance for follow-up. I aim to be as affordable as possible. I want this to be a long-term relationship, and if they get resolution for their issues, they’ll be happy and return to me in five or eight years when something else pops up. It comes down to cultivating trust and communicating thatI have their best interests at heart.”
Both Ligenza and Hershey prize their collaboration deeply. As Ligenza puts it, “We just really appreciate, value and delight in our relationship here. It’s a small-scale collaboration, but one that is momentous in a way.”
Dr. Ligenza and Ron Hershey’s practices are located at 1756 Route 9D in Cold Spring. Dr. Ligenza’s phone number is 845-265-1006 and Ron Hershey’s is 845-265-0088. Hershey’s comprehensive website can be explored at www.eastmtnacupuncture.com
Ron Hershey recently presented a talk/demonstration on acupuncture to the entire 9th grade class at Haldane, something he has been doing for the past seven years. A follow-up story will detail this presentation, which included more information on the Chinese medical principles of energy flow.