More Case-Taking

[Soroush Ebrahimi]

At the command of Dr Shahrdar, I am going to expand on a few points discussed in the last mail on case-taking.

Please also feel free to contribute to this as case-taking is such an important part of homeopathy. A case well-taken is half solved!!

One of the most important points is that you must establish a rapport with your pt. Otherwise they will not open up to you.
One of the reasons why they may not open to you is if they feel they cannot fully confide in you. One of the reasons may be that there is someone else present in the room.
You will have situations when the pt is accompanied with someone else (husband/wife or another friend or relative).
There could be many reasons for this - i.e. the pt was not well enough to get to you on their own, or is relying on the other person for a lift/emotional support, etc.

Depending on your reception area and your practice circumstances, it is best only to call the patient to your interview room.

If per chance the other person comes too, then welcome them and then after a very short while explain that you would like to interview the patient on their own. You need to say this firmly the first time so that there is NO argument. Unless the pt insists that they want the other person to be present. (But this is another sx for you. Is this a question of confidence or insecurity, what??).

I had a patient that I had inherited from a colleague.
She turned up with her husband who came into the interview room without being invited.

So after asking some very general questions I asked the husband to leave - and bless him, he did without a word.
Immediately I could see a sign of relief on his wife's face. It then transpired that she was an anxious patient and her anxiety was centred around her husband and the fear that something would happen to him. She went on to say that he had been a truck driver and she would listen to the road traffic news on the radio in case he had been involved in an accident.

So there was my case being served on a plate!!

Having been given the opportunity of having a close relative of the patient made available to you, with the pt's permission, privately interview them too (As per Hn's instructions). Their observations of the patient and what has changed in them are extremely valuable to you.

Sometimes the pt will present a completely different picture of themselves than that presented by their friend or relative!

If you inherit a patient from another colleague, please be warned.
You have two choices: Read the case notes and (become to a degree prejudiced) or
don't read them and appear to be 'uncaring'. (The pt may say: I have told all of this to XYZ - have you not read my notes?)
[This reaction in itself is of course worth noting!!!]

Of late I have had a few such cases and I have developed a strategy for this.

It all depends on the patient's call asking for an appointment.
They would inevitably tell me that they were XYZ's patient and because he/she is away they need to see me.
OK, How are they?
They would quickly let you know whether the remedy is helping or not.

If it has helped and there have been LOTS of improvements but a few dips recently, then I know that I need to repeat the remedy but have to decide on the potency.
I would read the notes to see what has been happening and also interview the patient and then decide on the potency having confirmed once again that they are on the right remedy.

If, however, the patient is struggling, then at the interview I would tell them that I have not read their notes because I wanted to have an open mind about their case.

In a recent situation, there had been a long history of professional abuse and hurt at the firm she had worked in a senior position at board level "I ran the company" and although she had resigned she was of the opinion that she had been kicked out.

She had called and left a 'desperate msg on my answerphone machine.
I called at 7 pm to make an appointment and was told by her husband that she was so unwell and very depressed and that she had gone to bed! Apparently her mother's 78 year old neighbour had been diagnosed with cancer and this had made her very depressed.

I saw her the next day. I had read her case! She had been prescribed Nat-m 1m which had only partially helped her but never held for long!

The more we went into this case the more I was being convinced that this was a Nat-m case but there was this nagging doubt - why isn't it holding? We eventually got to the point where she became emotional but was fighting the tears and even with my encouragement she only shed a few. (more pointers to Nat-m??)

She had spoken over several issues and in my mind I had enough information - the case was Nat-m and the thought running through my mind was why was I sitting here over such a case - perhaps she needs a higher potency than 1m (you see I was not an unprejudiced observer) - then I asked her how she felt towards her ex-boss?

And at this point all hurt, humiliation and injustice came out and wow a new case was disclosed.
Upon repertorisation the indicated rx turned out to be Staph.
I gave her Staph at LM01 potency and only one dose.

By day three her depression had lifted and her physical strength was returning. She has only repeated the dose three times - each time after some bad news or occurrence.

So on reflection, the key to this case was the way she felt she had been treated - not the way she was with others and how she looked after them and cared for them.

On a professional level, I think the lesson is that we must ask ourselves several times during the interview whether we are unprejudiced or not and if not why not - then quickly rectify it.

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As a homeopath firmly believing in God, I believe that the Almighty is The HEALER and I am only honoured to be the tool chosen for this case to be treated. An interesting thing happened which is worth a mention.

I had a male patient that had been adversely affected when he had heard that his fiancé had gone out to dinner with another man. The first time I interviewed him, after repertorisation I prescribed him Caust and it made very little positive change.

So after a month I interviewed him again.

What struck me was that there had been several communications between the two of them and she had explained that it had been all innocent and she had been lonely (She living in another country with him being in UK for some weeks) and only had meal with him 'as a friend' and in any case she was VERY sorry and had apologised profusely - but he was completely unmoved. He did not want to see her again. He felt that had been betrayed. He could not forgive her.

There I was sitting in front of this man - ignorant of my repertory - and wondering how I was going to resolve this case. Surely this was such a valuable bit of information that it had to be used, but how?

I just opened my synthesis - It opened at pages 124-125 and my eye went straight to the bottom of page 125 as if directed by some external force.
The last line of the page is "UNMOVED BY APOLOGIES"
The rubric was of course: Hatred - persons, unmoved by apologies." page 125
The only remedy listed is Nit-ac.

Wow - few open questions trying to ascertain Nit-ac all proved good and he responded very well to the remedy.

So the Lord moves in mysterious ways - wonders to perform!
May his power be with us and protect us and his light guide us.

Good healing to all of you.
Soroush
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