Office Hours with Angelique and Toby. Released September 22, 2026. 21 minutes. This episode is sponsored by Classical Pearls.
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About this episode
Toby brings a case from his teacher, Dr. Angela C. Wu: a patient with a history of recurrent miscarriage who is unsure whether recent bleeding is another miscarriage or a menstrual period. The case opens a broader discussion of a clinical principle: whenever possible, give patients the tools to recognize and understand their own bodies rather than taking that authority away from them.
Angelique and Toby also talk about the pace of practice: taking a few breaths between patients, slowing down enough to observe changes in complexion, expression, and relaxation after treatment, and a Daoist image of drawing back the bow before releasing the arrow. In the sponsor segment, Angelique describes moving from hesitation to using Classical Pearls formulas such as Wind Pearls and Bamboo Pearls in her practice.
Topics
A case from Dr. Angela C. Wu: recurrent miscarriage and uncertain bleeding
Letting patients become the authority on their own experience
Pausing between patients
Observing complexion and expression after treatment
Starting to use Classical Pearls formulas
A note for listeners: this is a conversation among practitioners, offered for education, not as medical advice. Patient details have been kept general to protect privacy.
Transcript
This transcript was generated automatically and lightly cleaned up. It may contain errors, especially in names and Chinese terms.
Toby: Angelique. welcome back to our office hours show. I'm really happy to announce that we have our sp our first sponsor, Classical Pearls. Yeah. later on in our show we'll be discussing a little bit about their products and their formulas that they do.
Angelique: Yeah, I've got some good stories.
Toby: Awesome. For sure. I was hoping we could get started with if you're interested in it. I meet with my teacher, Dr. Wu once a week and she often provides case studies for me. And I failed this one, so I was gonna I was gonna give it to you if you want to take a take a crack at it.
Angelique: Okay, preparing to be humbled. Let's do it.
Toby: Let'see. May maybe you'll nail it. it's a medical interview case study. Okay. So Dr. Wu, she's mostly treats infertility now in San Francisco. And so she'seeing a patient. her background, she's never been she's never delivered a healthy baby. She's her history is four miscarriages in a row. And she has a irregular menstrual cycle. Trying remember if there's any other key things for that. She's like in her 30s. you know, just so you can get a well-rounded view of her. Anyway, so she's coming to see Dr. Wu and she'six weeks out from her last menstrual cycle and she starts bleeding again. And so the patient asks Dr. Wu, is this a miscarriage or is this my menstrual cycle coming? And so Dr. Wu said, okay, if that was your patient and with all that background, how would you answer? I'll tell you my answer after you tell me your answer.
Angelique: I would wanna know the consistency of the menstrual blood fluid. Like what is what is she seeing?
Toby: She wasn't sure. she wasn't I think Doctor Wu I can't remember if she asked her that or not, but the patient wasn't sure.
Angelique: This is somebody who miscarried in history historically like first trimester.
Toby: Four times, yeah.
Angelique: In the first I mean, I don't know if there's a way to know. I would probably say there's no way to know. That's but I bet that's wrong. Doctor Wu was like, No, you would know and you would tell by this. So what did she s how could you tell?
Toby: I asked I'll I'll tell you what Dr. Mu knew at this point at the end. but she said to the patient, this is Dr. Wu's way. She always wants to give power back to the patient. So it's a little bit like what you were saying about what's the what's the consistency of the blood, you know, i can we tell something that way? But Dr. Wu asked her, now you've miscarred before and you've had so many menstrual cycles. What about in your body? How does this feel?
Angelique: That's nice. And what did the patients say?
Toby: Patient starting crying a little bit. and it was because nobody redirects backs to the patient, right? So again, it came back to the patient. this really is my body. It'so trustworthy. And if I pay close attention, it will tell me the answer to that. And so then she said, you know, it feels like a menstrual cycle. And Dr. Wu said, yeah. So it's good to know these kind things to differentiate these they feel differently in your body, and they had an interesting conversation about it. So I said to Dr. Wu, Dr. Wu, could you tell? From pulse reading, she's real pulse master and she said, Yeah, obviously it was menstrual cycle. But instead of just, you know, showing, I knew it was your menstrual cycle, she just always does that redirect back to the patient.
Angelique: It's really valuable.
Toby: It's extremely valuable. I she trained me so many years to do that kind of thing. And I just I often forget, right? Because I want to be technically correct or you know, not mislead the patient in a certain way. It's really nice to give the power back to them. That's really where everything's gonna happen inside their body. Yeah. And so the more you can empower them and then bring them back into their body, then just everything gets better from there. So yeah. yeah, that's that's one of our main teachings and I again forgot it.
Angelique: Yeah. Well, thank you for sharing it with me. Okay. And with everyone, 'cause I think that's really a valuable a valuable thing to do. Especially
Toby: I think so, yeah.
Angelique: With the biomedical system. There's not a lot of empowerment. I feel like, you know.
Toby: They always want to tell you. Right. And again, I think that's what I want to, you know, when she put me in that in her shoes, right? I also want to tell her and you know, give her some medical authority. it's like this or like that. But truly, you know, it should go back to the patient, right? And especially if they can learn something from it and be embodied again. Again, that's that moves their health along and helps their body functioning better, much better than, you know, from the outside imposing something.
Angelique: I wonder what Doctor Wu would have said if the patient was like, I don't know.
Toby: Yeah, but I think that's that's another invitation, right? To say, well, you know, try and feel about how this is feeling and then later on you can see like, this feeling and then try and match it to future menstrual cycles and see if that was right or not. You know, something like that. I mean again, she would just she just all that's a good speculation, but I that's my sense. She just always likes to bring it back to the patient.
Angelique: Mm. No, that's great. I like that. Yeah. Yeah.
Toby: So thanks for going through that with me.
Angelique: Yeah, sure. I knew. Humbled again, you know.
Toby: That's it that's me.
Angelique: Yes. Well, it I think it's it's helpful. It's helpful. I think this practice is humbling in a lot of ways.
Toby: Yeah. It's hard to be arrogant and a clinician that pays attention. I think I think that's incompatible.
Angelique: Yeah. And one thing that I've been really trying and I have not always been successful, but breathing between patients, like you've mentioned, I actually even wrote myself a note on the desk where I sit. It was like breathe between patients, like underlined because I'm in this flow of like I'll come out of the room, I'll sit down, I'll do some charting and then I'll go into the next room. But I found that when I do just sit, and it's like sometimes only for five breaths. And I try to do ten, like ten sometimes isn't it feels uncomfortable, like I start to feel like antsy, which probably means I should just sit there for twenty breaths, right? Like that's the whole adage with meditation. But it is it is helpful. It's like a I don't know, spiritual squeegee in a way, just kind of like clears the clears the glass a little.
Toby: Yeah. It that pause in between patients. Yeah. I feel like I really get up to see a patient. And then it's nice to just pause and then everything can kind of go down and then get up to see the next patient rather than just I used to I think I might told you this. I used to see almost 30 patients a day and I'd just be up. And then by the end of the day, I was just kind of wacky. but so now I feel like just as I see patients, right? See a patient and then let down and then see a patient and let down. Again, it just it yeah, it did everything the my flow was much better rather than just ratcheting up my whole day.
Angelique: Yeah. And we haven'talked about this yet, but I saw I went out to visit you in May and got to watch that in action. And I think you had fourteen to sixteen patients between the two, like each day. And it did not feel that way. Like I've I've seen up to fourteen fifteen in my own clinic and did not it did not feel the way the fourteen fifteen felt in your place. And I mean, in fairness, you have Stephanie who's amazing and just takes care of the whole front of the house business and changes the rooms over and stuff. And I think that, you know, speaks volumes when you have a person that's her seeking her clone on the East Coast, you know, 'cause my person is now in acupuncture school. But it was really and it was nice and being able to sit and I remember being uncomfortable at first even then because I was like, I had questions and I wanted to know stuff. And but then I got used to that. And it really does sort of like let you down, like in the best way. It just kind of shinks you in and then okay. And then proceeding. And the day went by quickly and without stress and frenetic energy, which was really nice to see. It's like, that's possible. All right, cool.
Toby: Yeah. And let'say let'say you're you're two minutes late for the next patient, but then you're totally you know, let down from the patient before. I mean, that's a little bit of a gift to the patient. I mean, you want to try and be on time as possible, but if you're just a couple of minutes late, but then totally present for the next case, I feel like that's that's one of the better moves you can make.
Angelique: Yeah. And you're doing it without pulling from a reservoir. Cause I think I think when I have I like to believe that I'm present most of the time, right? The majority of the time. But I think sometimes there's a lot of effort behind the presence, which is less effortful when you've actually allowed yourself to be at ease before going in to see a person.
Toby: Like in Dao's image, right? If you want to shoot the arrow forward, you have to pull back first, right? Right. Yeah. That's that two minute of pull back. So then yeah, you can really be sharp for going to see the next patient.
Angelique: And it really does feel different. So I'm not perfect at doing it, but it'something that I've been conscious of. And when I forget, I just the next time it happens, I go back to it and I've got the little note to remind myself. And now that my assistant person has gone to acupuncture school, which will be great for our profession, but it'sad for me. I have my patients spaced in a way where they're close enough together, but not so close together that I feel the push.
Toby: Yeah, but that's an easy that's an essential. especially Chinese medicine clinicians, right? It's not pure algorithm, right? There's there's a lot of things we have to pull from. And so to look things up, to just ponder something for a little while, you need that little bit of space.
Angelique: Which is good. And one of the one of the nice things about being able to watch you practice is being able to see Saam working and you're not the one doing it. Like myself personally, I wasn't doing it. So I was watching you and still like diagnosing alongside of you and like writing it down and seeing how I was doing throughout the day in terms of channels and watching you do it and then watching the patients and watching the faces. Like I didn't realize how important. Like I kinda got it. Like the watching people's complexions change, watching their faces relax, watch just so there's the quiet that comes over people. There was just it was so great, so Or not relaxed.
Toby: Yeah, or not relax, right? Again looking for both of those, right? yeah, that's been great. I have an interim with me this week and it that's been really valuable too, looking at faces.
Angelique: Yeah, it's it's a subtle thing. But it and it's easy to I think it's easy to not pay attention to as closely. But I know since going and visiting with you, like I am much more aware of people's faces now than I was before.
Toby: I think psychologically too, right? We're we're, you know, and socially we're designed not to like kind of stare at someone's face. Right. So you have to you have to be a little bit careful with that because yeah, you gotta be creative and I mean you wanna help them. So that the I think the vibe is totally different, right? Because they know you wanna help them, but still you've gotta you've gotta really take in that complexion. So yeah, that's it's that's I think that's hard for people to look at other people's faces, right? There's there'something about that makes that difficult. So And then especially and then and then to note, you know, I think yeah, you're right. They can be subtle, but sometimes they can be really significant. Sometimes it is especially anything really significant, we want to be able to notice that. So
Angelique: I just remembering prior to watching how you did it, which is just like you'd look and then you'd kind of like fuss with something on like a side table and then like look again. And like I remember kind of trying to position myself, like looking at people, you know, and then like having them like look at me. Yeah. And being like, It's okay. I'm just I'monitoring, you know. And then realizing like, I can just go fuss with other stuff in the room and go back to them. Like I don't have to sit there and like laser focus on their face, which is too super weird. I always thought like that's part of the reason why I sort of like didn't do it as much because it was such an odd like, how do I do this without being a weirdo? You know? And so bussing about in the room is a way to do it.
Toby: Yeah, you do you take over your accu trash and then do something. Yeah, I really do have that kind of style, right? 'Cause again, we just need a few seconds. And then this tends to what happened to is we have patients too take three deep breaths and then they tend to close their eyes almost, you know, ninety nine percent of the people. So that's a little bit nice too. Then it's not it's not direct eye contact, just staring at them. Again, they've gone they've gone to their nice acupuncture relaxation place. So we can just monitor their complexion easily that way.
Angelique: Yeah, that was good. And then watching you use the Classical Pearls because I had previously been intimidated by them. And when we spoke to Heiner Fruehauf and he was basically like, use them. And I said, Okay, and I did. But it was seeing you use them first and looking in the book and you pointing out like Read this description and tell me what you think. And it was like a description of a formula, but it was also very similar to the patient we had just seen. And so then I started reading through that book and started thinking of patients that I had, but still felt really sort of intimidated. Like I need to have more education. I always think I have to have more classes or something. I'm one of those people. Like I must take 17 classes before I can actually do something. but I after talking to Heiner on that episode, I ordered several of them and I started using them. And, you know, I would say With pretty good success. Not a hundred percent some weird stuff's happened, but I've had pretty good outcomes with wind pearls, which is for allergies, and also with bamboo pearls for people that just have a lot of like joint pain, especially of like the rheumatoid arthritis type joint pain, or what might be but isn't fully diagnosed as that, but kind of presents as a little warmer and achy. So that's been really that's been really great. So I'm excited that we're being sponsored by them because I'm actually using their products. I'm excited by their products. And I tell my patients about them because I had used other patents that will remain nameless prior because that's what we used in school. And I just they didn't, I didn't feel like they hit the mark all that well. But these feel like good to give to people, especially because they're clean, you know, too. So that's my story.
Toby: Okay. So that's awesome. Yeah. That's that's maybe be one of our sponsorship things. One of us has to been using that product for 15 years really successfully and excited about it. That maybe that'll be our sponsorship mark for them to hit. Cause that's what I've been using that those classical reports for about 15 years. Yeah. So I feel like yeah, that's I gonna I'm really happy that they're they're wanting to sponsor our little show.
Angelique: Yes. You've been using them for fifteen years. I've been using them for fifteen minutes. So far, so good.
Toby: Yeah, maybe nice contact us. So I think they're gonna sponsor a few of our shows. So we'll you know we'll anyways we'll take a few minutes for each show to just talk about our experience.
Angelique: Yeah, and tell stories like real ones from our clinics with them for better or worse, right?
Toby: So that's next time episode for sure where you'll present one of your cases, especially with bamboo or wind pearls. I feel like those are both. Yeah. Those got some real clinic well, I maybe all the formulas have some decent clinical potency, but those tend to move things pretty quick. So
Angelique: Yeah, it was remarkable. I'm like actually ex I'm excited to talk about it.
Toby: All right. W hold on until next up.
Angelique: Holding on. I'm holding on. All right.
Toby: Anything else you really want to talk about today?
Angelique: I wanted to tell you about a case that I had with a patient that I've been treating probably for close to the full almost two years that I've been in practice now of my own, which is crazy to say out loud that in December it'll be two years since I opened my practice. That's great. And this person found me pretty quickly. I don't remember exactly how she found me, but she did. And she comes fairly regularly. She's kind of like an every two to three weeker person for like a tweak or whatever's going on. and I had tried she's I enjoy her very much that she's a very gallbladder excess person. So like super irritable and kind of, you know, cranky about the world and just sort of cranky in general and sort of comes like has gallbladder presentation, like really big, like eyes that are sticking out, you know, like kind of walks kind of forward almost like Du channel excess a little bit too. and You know, for the longest time I was like, I really want to try this. And so I had tried Saam once before, several months ago. And the needle pain was such that she like she actually started crying from pericardium nine. So I was like, Okay. We like reeled it back in and I stayed away from it. But she kept bringing it up because she was really curious because she cried, but then she felt better. And then she's like, you know, I'm really wondering about what you were doing before. I'm really wondering about that. And so I talked about like the Chinese medicine concept of the pericardium and like all those things. It was little a little while ago. I talked to her and do it again. I said, you know, I really think this would help you. And she has all kinds of body pain. She takes over-the-counter medication for and She has some like blurry vision and she sleeps kind of weird. She's got all this stuff going on. She gets a little short of breath from time to time. So I'm like, she needs a pericardium supplementation so bad. So she let me do it and I use the 25 by 30s instead of the 40 by 30s. And she tolerated it okay. And I sent her on her way. And when she came back in, she started crying because she was so grateful for how good she had been feeling for two weeks. She talked about how. And she keeps these little this little journal where she writes down like her days. And she flipped back to like before the acupuncture treatment and had me read some of the entries. And then she had me read the entries after. And it was like, today's actually a good day. I feel good today. No medication today. Wow, I feel pretty good today. Things are looking up today. And she was less irritable. Like it was profound the effect that it had on her. And she was like in tears, so grateful for. me doing that for her. And then of course I'm redirecting, like your body needed that. Like it needed the message to be able to correct these things. And yeah. But it was just it was interesting to me that I had tried it. It didn't work out 'cause she couldn'tolerate it. But she remained really curious about it almost like part of her knew she needed it. And then she let me do it. And it has really helped her.
Toby: That's amazing. Just have a few seconds of it and be like, I'm really curious about that pain I had, what I started to feel. That's that's amazing. And then and try and loop back on it. That is amazing. Yeah, I think you're right. Her body I mean, I we don't even have to speculate anymore. her body recognized what she needed. You know, that little that little glimpse of it. And then you came back around and we gave it gave her a big gulp of you know, what she was really thirsty for.
Angelique: And it was shocking. Like I didn't I didn't expect that either. Like I didn't expect that. You know, I expected her to feel maybe a little better because it was such a clear like that you're obviously gallblad excessive. Yeah. You know, gallbladder tension, channel tension, you know, just the whole the whole it's like a ticked all the boxes. Like and I'm not supposed to be a hundred percent sure about anything, right? Because then you're usually wrong. But it's I mean, probably ninety nine percent. I'm like, this is what this person needs. Like just I felt it in my bones. So that was really cool. I wanted to tell you about that.
Toby: Yeah. Every once in a while I feel like someone's read a Saam book and then come and present it that to me. You know, I'm like that's that's just too perfect of a map.
Angelique: As we won't like side eye them like really.
Toby: Shortness of breath and for sleeping, come on.
Angelique: And you're cranky and you're like kind of aggressive. Okay. All right. That's my big story. Anything for you?
Toby: Is working on that school. So that'seeing patients and trying to create a school. the welcome the first cohort a year from now. So that's a lot of prep for that. Yeah. Yeah.
Angelique: That's good. And I understand some acupuncturists have donated.
Toby: Yes, acumuncturists are donating to it. So this is the idea of the school is not burden the students. So the idea was to have, you know, take donations for the startup cost for the school. So a lot of patients have been really generous and starting to trickle in a few acumcurists also wanting to pitch into the school. So I really appreciate that too, because again, the whole idea is not to put it on the students. So the school itself is gonna have to write a hundred and fifty thousand dollar check very soon to accreditation. So yeah, we th we needed a few a few dollars to gather for that.
Angelique: Mm-hmm. Just a few.
Toby: Yeah. I'm acupunctures too, so I know yeah, I don't know, just have my hundred and fifty grand sitting around. So
Angelique: All right. Okay. Maybe we leave it here for today?
Toby: Read. Yeah. It's always nice to see you and talk to you a little bit.
Angelique: Yes, likewise. We'll see you next time. Bye.
Toby: Okay, I'm
Angelique: Bye.
