Interview with a Chinese Medicine Provider
My sister in-law, Heidi Warren, asked me some questions regarding my experience with alternative or complementary medicine. The themes are topical for the current crises we face, so I thought I would share.
1. What is your training? Where did you get your training? Why did you go into this field?
I studied acupuncture and Chinese herbal medicine at Daoist Traditions College of Chinese Medical Arts in Asheville, NC. The program was a double-masters, and included a large portion devoted to Western pathophysiology and pharmacology. The last two years of the program included a clinical internship, working with patients in both student clinic and offsite capacities. I got into the field through my own health. I was on track to start a music therapy program, having devoted most of my life to the study of sound. I decided not to go forward with the masters, and spent a good amount of time soul-searching and somewhat confused about the trajectory of my life. A close friend had just started acupuncture school in Maryland, and suggested that I receive acupuncture. After going to a community acupuncture clinic for a few sessions, I wasn’t that impressed, nor did I experience noticeable change. However, I started to read about the theory of Chinese Medicine, and the theory of the Five-Elements, and I felt the medicine capitulated a lot that I’d come to believe. I also happened to work, at the time, at a coffee shop a floor below a community acupuncture clinic, and so I was able to engage with an acupuncturist regularly, who answered my questions. Not long after, I came to the conclusion that I could pursue this as a meaningful career, as well as one that could support me financially, while also making space to enjoy what I love, such as music, writing and art.
2. How do you define holistic health?
I define holistic health as a modality whose central approach is based in compassion. This involves commitment to understanding the individual’s health as a whole expression of their life, rather than as a collection of signs and symptoms, or that they are even “solveable”. I’ve come to accept that I cannot answer for a person “who” they are; I can only work with them to develop more efficient ways to regain that for themselves, when it has been lost, and disease ensues.
3. How do you feel acupuncture works in conjunction with traditional medicine? Or not?
Acupuncture and herbal medicine are tremendous tools that can fill in several gaps in the conventional medical approach. For instance: Western Medicine does not emphasize the importance of nutrition in health, though food is a medicine that we encounter 3-4 times every day. It is preventative medicine. At the same time, Western Med. often will not, even in medical school, emphasize this aspect of health, as it is considered moot to have a conversation with a patient about their diet. Sometimes, this is due to time constraint, sometimes there is no excuse. As a result, it does not treat digestive issues that well. Many major pharmaceuticals have long-term unseen side effects on the system, that lead to a high price for their intervention. Chinese Medicine carries the same principles regardless the modality. For acupuncture, there are points that are said to “Clear Heat”. There are also foods, herbs, movement exercises, essential oils that “clear heat”. This means that regardless the tool we are using within the auspices of the medicine, our treatment strategy remains the same. So long as the diagnosis is clear well-deduced; the treatment strategy will be effective, because it is in line with the diagnosis. The patient has heat, so you clear heat. Patient has stomach heat, or heat in the digestive system. You can send them home, after acupuncture, with lifestyle modifications such as specific changes in nutrition habits, that will reflect your strategy. After the acupuncture, they have a tool they can incorporate to emphasize what is being accomplished in the clinic, outside of the clinic.
Pain is another area that CM treats effectively, where WM’s major avenues are: pharmaceuticals that can be damaging to the liver, as well as addictive; and surgery as last resort. There is a lot of clinical evidence that supports the use of acupuncture for pain. There are ready instances where acupuncture doesn’t simply reduce or manage pain, but corrects it, showing promising results as a low-risk, virtually non-invasive intervention. With that said, WM can still do what it does best (often emergency medicine), while CM can successfully fill in the gaps, and in many cases, serving as a safety net when conventional treatment is too risky or too costly.
The last thing I’ll say about the two modalities’ complementary quality is this: I think it would be a disservice for the Western perspective to turn its interest in CM into simply trying to translate CM medical concepts into the conventional.
For instance, there is a lot of push to directly translate diagnosis and diagnostic codes. Liver Qi and Blood stasis might look like Hepatitis, or liver cirrhosis, but the diagnosis and treatment depends on the individual’s presentation. It doesn’t always directly translate and there is a nuance. WM has to be willing to accept CM as its own medicine, and this is directly reflective of people who see the world in a completely separate way. Even in fields such as neuroscience, scientists are beginning to understand that there may never be a fully unified theory on the brain, what it is, what is does. Instead, they are accepting that how the Chinese or even the French conceptualize the brain is different than the American researcher. CM describes the body as a phenomenon very differently that how it is seen in the West. In that way, it is a different language, and working together, the modalities might need to accept that there is no equivalent explanation for how a disease progresses, or even for tangible concepts.
For instance, there is no Western equivalent to the concept of “Qi”, a pivotal concept in CM theory, and the Western tendency is to reject the medicine outright. Rather, they need to be able to coexist without necessarily having to have everything equally translatable. This is where CM is very strong, as it finds paradox, contradiction, and the unknown as powerful tools for dynamically navigating an individual’s disease.
4. What advice would you give to someone who is looking to go into this field?
Primarily, it is not something you are going to understand in a short amount of time. The medicine is designed to deepen and become more embodied and dynamic the longer it is practiced.
Second, be open. Most of the time, you are going to learn information that appears conflicting or confusing, sometimes wrong. Being open, and absorbing the information kind of osmotically trains you to hold space for the patients and presentations that are the exception to the rule.
Third, don’t make it something it is not. Chinese Medicine is a modality based in observation, cultivated, curated, argued, compared, and organized by thousands and thousands of devoted practitioners. The medicals texts, schools and and exhaustive studies were built out of individuals who realized that to observe a patient with compassion and genuine interest, they had to become better observers in all aspects of their life. The efficacy of the medicine is contingent upon the cultivation of the practitioner. If you don’t like how Qi is conceptualized, don’t try to change it. Try to understand it see how the rest of the medicine uses it. Try to objectively observe what the medicine is “doing”, and then do that. CM isn’t about being the best. There is no best flower or leaf; everything has to contextualize. By not making CM something it is not, the practice naturally contextualizes you.
5. Do you treat cancer patients?
I don’t specifically work with cancer patients, but I have worked with them in the the clinic several times.
Though cancer might be considered a more advanced disease, the method of diagnosis and treatment protocol would remain the same regardless of the perceived severity.
6. What do you feel are the benefits of acupuncture for cancer patients?
There is a lot of evidence coming out right now showing the promise of acupuncture in oncology care. Acupuncture is exceptional in treating and managing pain, and is strong in improving psychoemotional health.
With that said, apart from the cancer itself, a cancer diagnosis and treatment can take an almost holographic toll on a patient’s life, including their mental health. In addition, they are often navigating not simply their own anxiety, but the reinforced anxiety of those in their life, who either struggle with the concept of death and dying, or have never confronted it. As a result, these patients are often managing a lot of unforeseen auxiliary factors in their healing journey.
Acupuncture, from my experience and perspective is exceptional for aiding individuals in transition. The medicine utilizes potent metaphors to observe and interact with the body and the environment. Metaphors, in my mind, are especially profound because they help us deal with death. By including two disparate or unrelated images together in a single image, you are trained to accept the unseen gap between both of them, or that space. It is hard to see how a person dies. It is easy to see how a blade of grass among others can die, but the grass remains. Cancer is often seen as an issue with cells that are unable to mature and experience apoptosis. They are children, and they want to play with more children. The cells proliferate, and there’s too much heat. In a body that understands, it can accept there are childlike aspects of the self that, due to issues or stress in pivotal life transitions, were unable to mature, and also transition and die away. In other words, this may not actually be the case, for this person with cancer, or that person. But the medicine is designed utilizing this kind of tool, and therefore by nature lends itself to reducing the intensity of that transition, or maturing process.
Therefore, I could argue that there are significant benefits in acupuncture for the cancer patient. At the end of the day, it is about the individual, and really seeing “them” – “who” they are.
7. Many people do not believe alternative medicine has any real advantages for overall health. What would you say to those people to help them understand the value of complementary health services?
Many people do not believe conventional medicine has real advantages for overall health. There are people who don’t get flu shots, who refuse vaccines. There are those who don’t take any medications. My mother doesn’t typically trust doctors, and has good reasons for doing so. She rarely takes medicines for colds, never gets a flu shot – she is someone who doesn’t anaesthetise herself or seek outside answers for her issues. This is mainly because she is someone who believes in doing whatever she can in her own power to understand and improve her situation. She’s lived her whole life in the cold and hard winters of Western MA. A few years ago she had a major hip replacement, and not only didn’t take painkillers post-surgery, she also didn’t experience pain during her recovery. Is she wrong or right? It doesn’t really matter. A good and effective medicine is one that is effective and offers results. But it’s also one that isn’t based on the whims of people’s beliefs.
However, this does not mean you can’t meet a person in the space where they believe. CM as a complementary medicine is effective and viable because it seeks to understand the context out of which the individual and their disease springs. We are seeing now that the faith we place in our experts and the answers provided by research are insufficient for the COVID-19 pandemic. What is clear is that there is this gap between crisis and alleviation. Research is a form of faith, and sometimes it proves insufficient. It takes time and innovation. But in the meantime, all we have is faith. By nature, medicine is the reorientation of worldview according to what observed is changing. Medicine is always involved in crisis. People will always encounter crises in their worldviews, or what they think is possible or is or isn’t real. The current moment feels very “unreal”. The virus might be more deadly for those who resist what is changing on a larger scale. This doesn’t go to say that if you don’t believe in CM, you’ll be effected negatively or are stupid.
Instead, it is only to point out that rarely does medicine reflect what someone doesn’t believe in terms of health. Instead, it reflects precisely what people have to accept to get better. The most profound aspect of complementary medicine is that it is not a monoculture. It is, by nature, biodiverse in its view. Researchers suggest that the yellow and very sweet bananas that are in every grocery store will, in less than a decade, become extinct. The reason purported is that despite there being dozens of banana species, the species that have been cultivated and bred for modern consumption has led to its sole reliance. Because of this monoculturing, it becomes very susceptible to disease and especially blight; not unlike how COVID-19 is operating now. In a rainforest, there may be pockets of other plants, other bananas and overall greater biodiversity. When a disease comes through, the banana’s chances of surviving are higher.
The same can be said about complementary medicine. Western Medicine is a monoculture. The crisis in healthcare at this moment, you could argue, has a relationship to the fact that conventional medicine has championed itself as the singular authority on the state of the Western individual’s health – and this is further aided by its global presence, i.e. not merely of interest to the Western body. Here we have a moment where an unknown and especially virulent pathogen is significantly devastating not simply the medical worldview, but of nearly every system that supports the proliferation of the human being. Complementary medicine is significant because it, by nature, represents the biodiversity of worldview. It represents all of the perspectives, the plants if you will, that were unable to flourish, because one took the helm.
This does not mean WM is wrong, or not valuable or effective. With the current climate of the world, it does suggest that complementary medicine will be an absolutely crucial light, in a dark time. Chinese herbalists are chomping at the bit, as they are coming together to push forward formulas here in the US that were being used successfully to treat COVID-19 infections and to mitigate further spread through formulas designed to prevent transmission. The difference is that someone could continue to believe complementary medicine and Chinese medicine are bullshit. But if it saves lives, if it offers an effective avenue, medicine will continue to operate beyond what a person believes, including what is the common belief in conventional medicine. Only a medicine that evolves is one that can meet a disease that evolves.
8. Why is acupuncture controversial?
Anything that is unknown is controversial for someone. Even the things that are known are controversial for someone. A good practitioner of medicine is someone who is going to be able to operate through and beyond drama. Western doctors have patients who sue them because they look like an ex-wife, or because they used a word in the clinical setting that rubbed them the wrong way, on that day. Medicine is the place where you become very sober about how truly diverse people are. It is there that you realize to what profound extent you cannot take things personally. The person is suffering, is suffering, is suffering, is suffering. From a Chinese medical POV, it is relevant where the individual grew up, what foods they were being fed, whether or not they smoke, if they are sitting for long periods of time. But we are not gathering this information to demonize them for it. Drama would be antithetic to a healthy prognosis. Acupuncture is great because, in the simplest way of putting it, it is the gentlest way you can injure a person – you are piercing them, but without it being perceptible. When you injure another in a perceptible way, either through words, emotionally or physically, the drama turns on. The response is often worse than the original injury – yet another context for cancer.
But acupuncture bypasses that layer or level, and allows you to have a conversation with the person’s body. You then use both the acupuncture and your diagnostic skills in listening, asking, taking the pulse etc, to streamline what questions you will ask. The major issue with asking someone what is wrong is that if you ask them preemptively, they may not have anything wrong, or depending on how it’s asked, they might sense in your words that something deeper is going on inside them and suddenly they are in an emergency, and have to figure that out.
In these moments, the individual can create on the spot, the suggested disease or issue. Questions can act as placebo. Our bodies are creative, emergent, for good or ill. It’s rare for a person to simply volunteer that something is wrong with them, especially in the day-to-day. As a culture, we are shown to reject feeling, to not trust emotion, and to suppress and repress. This translates to people who will not volunteer information unless they are coerced. Elsewhere, we collectively do a good job at talking “around things” rather than addressing them directly. With that said, we typically don’t admit something is wrong until we are in a state of emergency; because at that point something fundamentally has to change about us. We have to make a choice to move forward. We have the capacity to evolve from the micro to macro; but the implications of such a dynamic change in who we are, is terrifying. It is terrifying that it could be that easy. It’s safer to be difficult, to cling to the old, to remain static and hold fast to the familiar.
This is why Chinese medicine, and especially acupuncture are exceptional tools for this kind of person, because acupuncture can bypass the need to ask the person to explain their symptom or themselves directly. Explaining a symptom directly is one that is showing in emergency. In Chinese medicine, we talk about this in the context of a “shen-to-shen” or healing presence. This is where your listening ability and ability to be present with the individual carries into the needles that you are using for treatment. You have the opportunity to move past the surface of the body where the symptom is often showing itself, and to have a direct dialogue with an interior landscape that is reflective of the effected organ system. You then spend the majority of the treatment observing what changes in the patient’s body as you penetrate. Often, the patient will volunteer their story, or the underlying contributor to the symptom. But this doesn’t always come in the form of words.
In essence, the patient has their own dramas. The practitioner’s job is to acknowledge that they are experiencing it in precisely the way they are showing it. The next step is helping to reduce the physiological attachment the body has to those stories, events, traumas, replacing them with blood flow, qi flow, whatever you want to call it. At the end of the day, we’re helping return “who” the person is to themselves. Everyday circumstances invite in new material and comparison, but once in the body, those phenomena can get stuck, stagnated or trapped, and they can compete for the space and the body’s resources. A virus acts in this way. They say that viruses aren’t quite alive. They aren’t exactly a “who”, but once they’ve penetrated the exterior of the body, they suddenly have all of the resources and environment to allow a new “who” to proliferate. The body, in this process, suddenly senses a systemic conflict; their immune system, or body authority is in doubt.
Acupuncture works in the interstices, because by nature it is creating outlet where outlet has closed. The body is covered in outlets, or portals, whether the pores, mouth, nose, ears etc. But there are autonomic dramas that are based in survival mechanisms that marshal the major areas of the body to shut down, when there has been perceived invasion and compromise. These are fear, anger, grief, worry and even joy. These are the faultlines, the climates, the seasons, the altitudes, and the material earth. Acupuncture bypasses the dramas that are compromising these major influences in times of crisis. We are unable to ask the earth directly why it hurts. This is too great and complex a question, and too complex an answer. The earth has its own agency. Acupuncture penetrates the individual and says “You are here,” when the winds of change and crisis are too dynamic to navigate. It’s a way for the body to social distance from itself when your body believes change is so painful, you’d rather die. Politics are the global disease. Qi is the human being beyond the political. Complementary or alternative medicine is the needle. Acupuncture regulates the necessary and inevitable change of worldview.