Part 2 of a two-part series.
Richard Sampson lies back-down on a table and rests the palms of his hands on the front of his thighs, fingers straight and relaxed. He props his head back and gazes up at the paneled ceiling.
Dr. Tom Archie kneels down next to the table and aims for the dome area of Sampson's left ear, where sound collects before cascading into the hole and splashing over the eardrum. He pushes the needle a millimeter deep into the skin.
Archie then pushes a second needle in, and another, and another.
"Are you OK?" Archie asks Sampson. "I mean relatively speaking."
Sampson's last cigarette was yesterday morning. That's when he had his first acupuncture treatment to help him quit smoking, cold turkey. This is his second. Tomorrow will be the last and, Sampson hopes, the end to a habit he started 34 years earlier in high school.
Archie squeezes the thick back end of a needle between his thumb and index finger. He steadily, slowly moves the tapered tip forward, breaking the skin. He mechanically takes another and repeats the motion one last time. Number 12.
It'll be the same for the other ear.
Archie, an acupuncturist since 2000, says it's standard "cigarette cessation" acupuncture. He says he's performed this exact treatment about 200 times and has seen about 70 percent success.
Archie tells Sampson to rest there for 30 minutes, needles in. Another patient already waits in a room two doors down the hall at the St. Luke's Clinic in Hailey.
Archie's not only an acupuncturist but also a conventional doctor, board certified in family medicine. He was a doctor before training for acupuncture, as were the others at UCLA's six-month acupuncture program, he said.
He is also the medical director for St. Luke's Wood River Medical Center's Integrative Therapies program.
The program was initiated in May to "integrate" non-Western treatments into the standard hospital repertoire to support health of mind and spirit in addition to that of the body. And acupuncture was the first newcomer. Since then, St. Luke's has come to offer weekly meditation, the C.A.R.E. Channel (a closed-circuit pair of TV channels that roll through serene scenes of nature accompanied by soothing instrumental music) and healing touch, which most of the time involves no touching at all but an interaction with a person's energy fields to encourage well-being.
As medical director, Archie oversees the program's physicians and is responsible for quality control, among other things. He's also a tangible representation of the program's melding of medical disciplines.
Archie dresses like most doctors, clean and semi-formal. A button-up, long-sleeve shirt tucks into his khakis. But he also has long, wavy hair tied into a ponytail and an inch-long beard obscuring his jaw line. In his office, a wind chime hangs from the ceiling air grate over his chair, and on the wall hang two framed pages of a book. A poem, part of it reading, "We shape clay into a pot, but it is the emptiness inside that holds whatever we want. ... We work with being, but non-being is what we use."
Like his appearance, Archie often calls on both influences to treat patients, as to a lesser extent do many other St. Luke's doctors, whose referrals are mandatory for any patient to receive acupuncture from one of the five acupuncturists.
Archie said some physicians were a little skeptical at first, but there have been no obstructionists.
"When doctors see the results on a continued basis, they develop their own opinions," Archie said.
Because of the physician-approval rule, the Integrative Therapies program can't survive in a sphere separate from conventional medicine, but needs physician cooperation and support. That was always the intention and for good reason, said Erin Pfaeffle, an administrator whom the hospital commissioned in January 2007 to conduct a feasibility study of such a program after hearing community interest.
Hilary Furlong, director of the St. Luke's Wood River Foundation that bankrolled the feasibility study and the program through donations, said the demand was definitely here before the program was started in May.
"I have a friend who met their acupuncturist in the parking lot before surgery because it wasn't available at the hospital," Furlong said, adding that Integrative Therapies allows physicians to know of all the treatments a patient is receiving, conventional or otherwise.
But before the hospital would invest in such an undertaking, it wanted reassurance it would work.
For that reason, Pfaeffle and Dr. Andrea Girman spent seven months investigating other hospitals that had implemented integrative care.
"You could clearly start trending what worked and what didn't," said Pfaeffle, who also manages St. Luke's Center for Community Health.
Come August 2007, they presented their phonebook-thick feasibility study along with a potential model for Wood River Medical Center to the hospital's board of directors.
Pfaeffle said other hospitals that didn't get physician support from the get-go saw their programs fail miserably. Therefore, she said, St. Luke's had to "make sure all stakeholders were on board from the beginning."
And that's just what it did. Integrative Therapies received formal approvals from the hospital's planning and facility commission, board of directors and medical staff commission.
"What you often see in those cases is this new program, all these services, and no one's referring to you," she said. "It's an amazing model, but if people aren't walking in the doors."
She said Archie was integral to this since he has a foot in both worlds.
"Archie is one of their own they can respect," Pfaeffle said. "Coming firsthand from another physician really helped gain their confidence."
But an even bigger reason for keeping the Integrative Therapies program integrated into hospital operations is money. And, Pfaeffle said, these kinds of programs don't make much, especially at first.
In fact, St. Luke's' program will cost $300,000 for its first three years, and Furlong said the vast majority of that is coming from donations to the foundation. Patients pay for acupuncture, covering those costs, but not for healing touch or meditation.
Even though acupuncture comes with a price tag, Furlong said most insurance companies refuse to cover it, which drives down patient numbers. Mary Kay Foley, program coordinator, said about 20 patients have had acupuncture treatments—usually more than one—since May. She admits it's a low number.
Foley said healing touch has had more than 100 patients, even though it started three months later than acupuncture. But it's free.
Furlong said that when the money dries up in three years, the program will need more donations to keep it running.
"There will always be some philanthropic component," she said.
She said administrators hope the gap between donations and revenue will eventually narrow.
"Covering costs would definitely be the goal," she said.
But, Furlong said, it needs more ways to make money, like yoga, which started on Tuesday. After the New Year, yoga classes will be a weekly affair at the hospital and at the Hailey clinic.
Despite money concerns, Pfaeffle said the program is a step in the right direction.
"I would like to think we're innovative," she said. "But hospitals are doing it all across the country."
Archie said the new treatments represent a move away from just treating bodily ailments after the fact and toward preventative medicine and treating the mind.
"It used to be that stress was not seen as the cause of chronic problems," Archie said, adding that doctors now understand that stress can exert itself on the body, contributing to high blood pressure, ulcers, hair loss and weakening of the immune system.
Meditation instructor Valerie Skonie said this is where her practices can act as medicine, to create "space between thoughts."
"When you're in stress, you don't really cope with your problems," she said. "You worsen them by drinking, eating or punching a wall or someone. Meditation is a benign way to release stress."
Jeremy Fryberger, 44, attended a few of Skonie's classes, but had been meditating beforehand, and said the goal is to get away from the "constant buzz of thinking" and to transfer one's mind to somewhere else.
"First, you quiet the mind by stripping away the layers of thoughts, memories and perceptions until it's just quiet," he said. "One way to do that is by focusing on something mundane like breath coming out."
Allene Niehaus, 74, was another class attendee and said Skonie told her to "pretend bees are buzzing here (the heart) and creating honey from past mistakes."
Fryberger said meditation is not about reaching enlightenment or a higher power, as many think.
"I have had very brief glimpses of the tranquility and strength of a quiet and focused mind," he said. "It's essentially healthy."
And, Skonie said, meditation isn't religion-based.
She said meditation is "physiology, it's health."
Determining whether the mind actually leaves the body and provokes a higher degree of consciousness or spirituality remains a matter of contention. And poking needles into the skin to release built up Qi—pronounced chi, meaning vital energy—may not do anything more than the prick one feels. And the effects of someone's influencing another person's energy fields are just as unproven to the scientific community.
However, verifying these therapies doesn't matter, said acupuncture patient and meditator Judy Foster.
"All of this could be psychosomatic," she said. "I believe in the placebo effect. But if it works, let's use it. For example, meditation gives us some time to be reflective, to be in a state where we're not treading on the treadmill of life, so to speak."
Trevon Milliard: tmilliard@mtexpress.com
Doctor and acupuncturist Tom Archie inserts 12 needles into each ear as part of Richard Sampson’s smoking-cessation treatment.
Photo by David N. Seelig
