I briefly apprenticed with an acupuncturist who was doing something extraordinary. One of his patients was dying of pancreatic cancer and was in terrible pain, but he could not afford to stop working. The acupuncturist — Dr. B — would insert a single, thin needle at a particular point on the abdomen once per week and leave it there for twenty minutes. That one needle reduced the patient’s pain by 90%, and it had been doing so for months. I left that apprenticeship, so unfortunately, I don’t know what happened to that patient. 

Events like this led the Japanese to say long ago that “the master treats with only one needle.” But Dr. B could not do this with his other patients. Most people coming to the clinic received ten needles or more, and some still did not have the same level of result as that one patient. Striving to have a great medical effect with minimal intervention is part of what makes being an acupuncturist infuriating — and maybe also a bit addictive.

I have long thought of needles, herbs (and medications) as communications to the body. It’s possible to think of them as spoken words. Have you ever encountered a complicated situation in real life and said exactly the right thing — or exactly the wrong thing? Finding the right words takes practice. In the case of the pancreatic cancer patient, Dr. B was able to “say” exactly the right thing to that person’s body, in a way that helped him move forward.

When it comes to certain digestive conditions — SIBO being one example — early cases don’t have to be complicated. The definition of SIBO is relatively clear: bacteria are in the wrong place. That naturally leads to treatment with antibiotics or antimicrobial herbs, and to diets designed to reduce microbial load in the GI tract.

It’s like kicking someone belligerant out of a party. The question is: Does this automatically fix the party? Do things automatically go back to being a good time, just because the party-wrecker was removed? We can’t count on it, because by that time, the state of things has changed. The belligerant person has influenced interpersonal dynamics — it had a rippling effect that reached everyone — and besides, even the act of throwing someone out has consequences on the system. Things do not simply return to the state they were in before.  

So, if you were the host of that party — after the person was removed — would you be able to find the right words and do the right things to get everyone back on track and having a good time? 

This analogy isn’t limited to bacteria and antibiotics. When a problem doesn’t resolve with a straightforward fix, many people begin searching for a new root cause — low stomach acid, bile dysfunction, vagal tone issues, pelvic floor dysfunction, motility disturbances — hoping to find the single pivot point around which everything turns. The hope is that if the right point can be found, the right action can finally be taken.

As someone who has seen many cases, I can say what most people already sense: this is very difficult. And the reason may not be what’s expected. In chronic illness, the state of the body has shifted — just like the party with the unwelcome guest. The dysfunction is distributed across systems, at the level of the whole person. Broad adjustments have taken place, attempts to maintain homeostasis under strain. That’s why it’s so difficult to find one issue, one intervention, one drug, one point, or one word that brings everything back into order.

Another way of putting it is this: the root cause is often not a thing — it’s a dysfunctional process. To understand a process, you have to step back. When people talk about “motility,” for example, they’re already doing this. Motility is not one molecule; it’s coordinated activity across tissues, nerves, and signaling pathways.

Some people improve by taking pro-motility agents like ginger or artichoke without fully understanding the molecular biology behind them. In clinical practice, this is perfectly reasonable. It’s empirical observation. Looking deeper doesn’t always create clarity; sometimes it creates more complexity without better direction. For the same reason, detailed laboratory data can have limited applicability in chronic cases. They are a zoom-in when what may be needed is a step back.

Personally, I believe in stepping back far enough to see the whole person — not just motility, dysbiosis, or dysfunction within a single axis.

Stepping back reveals a layer of information that is often overlooked. What I learned from that apprenticeship wasn’t how to use fewer needles. It was that sometimes the most powerful intervention comes from seeing broadly — from understanding interlocking processes rather than chasing a single problem. It doesn’t make things simple. But it can make them coherent. And sometimes coherence is what allows a person to move forward again.