Compassion as the driving force of Classical Chinese Medicine practice
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A while ago, I began a series of posts designed to describe my experiences with Dr. Liu Lihong, renown Classical Chinese Medicine clinician and scholar. He visited NCNM in Portland just about a month ago, delivering powerful lectures and teaching us all with grace and simplicity. Many folks have asked me to share what he had to say about the Fire Spirit school of Chinese herbalism, a school that takes the use of Fu Zi (aconite) and Gui Zhi (cinnamon) to be its guiding methods. Unfortunately, I didn’t take written notes – only a recording – and it is taking me some time to transcribe. It may have to wait until school is out in a couple of weeks, when I have time between clinic shifts.
The truth of the matter is that the most powerful information that Dr. Liu gave us really had nothing to do with the practicalities of herbal formulations. I would like to share what I learned about a lecture he gave in our Medical ethics class about compassion in Classical Chinese Medical practice. I will soon share more of what I learned from this contemporary master of our medicine.
Medicine as the Bodhisattva way
Dr. Liu started out by talking about the concept of a Bodhisattva in Buddhism. In my reading, I have discovered that not everyone agrees on the definition of this concept. A basic understanding of Bodhisattva reveals a being who is either enlightened or well on their way who decides to hold off Nirvana in order to help other human beings reach enlightenment. By this definition, they embody the purest compassion and service to humanity. Certainly a noble goal for anyone, particularly a physician.
Dr. Liu wanted to help us understand what it would mean to live as a Bodhisattva. He explained that for him living this principle in daily life certainly involves living life to its fullest while striving to deeper understanding of what it means to be alive. Living a full life was explained to involve coming to a state of balance in health both in body and in the emotions. That way both Xing (form) and Shen (spirit) will be unified and harmonious. This allows us to be a great resource of inspiration for our patients while also allowing us the ability to walk our path with strength and purpose.
How do we do accomplish this task? By following the guiding hands of the ancients. 文化 (Wen Hua) is a Chinese term that’s something like “culture.” Dr. Liu related to us that the deep meaning of the term encompasses more than what the normal American interpretation might reveal. It isn’t just a collection of wheres and whens and whats, but a body of knowledge produced by great people that can be used for transformation of human lives. The study of culture and cultural artifacts, like the Classical Chinese texts, is more than an empty academic exercise. Or, at least, it should be.
The ancient texts, like those written by Kongzi (Confucius) are part of the Wen Hua that we can use in our quest to follow the Bodhisattva way. It isn’t important that we analyze the texts in an analytical manner. The important thing is that through our study of the texts, we allow them to Hua – to transform us. I think I understand from what Dr. Liu was saying that he believes Chinese medicine knowledge is this way as well. Many of us know a person who has nearly encyclopedic knowledge of Classical texts or Zangfu differentiation or herbs or acupuncture, yet remain a mean-spirited and uninspired person. This is a waste of the information.
So, our goal should be to allow what we are learning to transform us. Our program at NCNM, I believe, really takes this matter to heart. The whole first year is all about breaking you open to receive the teachings fully. It’s a tulmultuous year for many. My experience was truly a birth process. I felt the pain and the subsequent release of that pain only to be shot into an unknown world that is both breathtaking and a little frightening! On the other hand, these last two years have been a lot of information, taking it in and trying to figure out how to use it. I feel that it would be easy to become obsessed with the consumption and reproduction of information, forgetting to be transformed. Now that I look closely at the next three weeks, I realize that it is another birthing process. Our finals are pretty laid back and my mind and spirit naturally turn to cultivation. I find myself wanting to do Qigong, wanting to spend time in nature, wanting to read texts that inspire me. I find myself reading back over my first year notes, reconnecting to the symbolism we were steeped so heavily in during our first year.
Words to live by
I realize the truth of what Dr. Liu was teaching us as I’ve described above. But, there was more. After talking to us about the process by which we can get closer to enlightened awareness, and the purpose of that in turning us into superior physicians, he let us in on what he believed to be the highest truth of the Way of the Bodhisattva. It’s a simple statement, echoed through many cultures in one form or another. In this instantiation, it is expressed in a slightly different form than most Westerners are used to – by Kongzi (Confucius):
子曰、其恕乎、己所 不欲、勿施於人
Zǐyuē, qí shù hū, jǐ suǒ bù yù, wù shī yú rén
The master said, it’s perhaps “Shu”, do not place upon others what you would not have placed upon yourself.
I acknowledge my translation could use work. :) But, you get the point. It’s another statement of the Golden Rule – in this negative form sometimes called the “Silver Rule.” Important within it is the character 恕 Shu. This character is composed of three radicals. On the bottom, we have the Heart. Above that on the left we have the radical for Woman and on the right the Mouth radical. So, “Shu” is something like a woman speaking her heart. Or the kind of speech that comes from the strength of a woman’s heart. Opposed to this elsewhere is the character for anger, 怒 Nu, which looks very similar. The only difference is the upper right radical which is a picture of a hand. The woman radical and the hand radical together as a character by themselves means “slave.” So, anger is when your heart is enslaved. We can look at this in an external way – as when someone is somehow preventing us from living our heart’s desire. But, Dr. Liu asked us to look at it differently. Anger is, he suggested, like not having a master within yourself – when one loses control. Shu is an antidote to this – it is living out our heart’s greatest desires, our heart’s purest desires. This gives us ultimate freedom and it allows us to arrive at our true nature which is always productive of behavior in line with the “Golden Rule” as listed above.
Perhaps you’re not sure what this has to do with Chinese medicine, but for me it was clear.
- To achieve mastery in medicine, we must not only learn from the Classical texts and the wisdom of our teachers, but also allow this information to transform us on a deep level.
- This transformation will be on many levels. Physically, we will “follow our own advice” and live in accordance with the ways that our teachers lay out for us. Emotionally and spiritually, we will walk the path of the Boddhisattva.
- This path is one that brings us into line with Shu – opening to our true nature through living the truth of our heart. This in part involves, and is productive of, behavior in line with the Golden rule.
- This Golden rule indicates that we should treat others as we treat ourselves, or that we should not do to others what we would not have done to ourselves.
- In some sense, all of this tells us to polish ourselves into the kind of doctors that can serve as great examples for our patients. But, we must also allow our patients to be a mirror for us – when we gaze into that mirror we must always be asking ourselves if we are treating our patients as we would want to be treated in similar circumstances.
I’d be interested to hear what you think about this in the comments.
Eric
Using the imagination in Classical Chinese medicine
The importance of the role of pattern differentiation in Chinese medicine cannot be overstated. Some go so far as to say that Classical Chinese Medicine is “pattern medicine.” What on Earth can that mean? I think about it in a few ways. First, Chinese medicine takes patterns very seriously. I don’t think most Chinese medicine physicians have theoretical discussions about what constitutes causality. Nor do they seem to be interested in carrying out complex calculations about the distribution of particular disease states across space or time. Despite this apparent failure, Chinese medicine practitioners through history have been interested in the correlation between disease states and other features of the human environment. They have taken a keen interest in the rise and fall of particular conditions in particular places at particular times. Second, a strong feature of our medicine is the perception of subtle patterns in a seemingly hopelessly complex tangle of symptoms and subjective feelings. Where other medical systems throw out the pieces that don’t fit, good Chinese medicine practitioners are always mindful of the “stray” symptoms. They always seem to come into play at some point. Finally, Chinese medicine relies on patterning to allow relatively quick training of practitioners. This can go too far, as it has in many iterations of contemporary Chinese medicine.
Taking all of this into consideration, I find the idea of patterns to be an interesting one. Recently in a class about pharmacology, we began to discuss the role of the imagination in medicine. All human beings have imagination – though some of us are more skilled in using ours than others seem to be. Our professor began to get us thinking about imagination as being especially useful in becoming aware of patterns. How does that make sense to me? Well, let’s look briefly into the meaning of “imagination”:
imagination |iˌmajəˈnā sh ən|
the faculty or action of forming new ideas, or images or concepts of external objects not present to the senses
ORIGIN Middle English : via Old French from Latin imaginatio(n-), from the verb imaginari ‘picture to oneself,’ from imago, imagin- ‘image.’
Taking this definition at face value, what my professor was saying makes lots of sense. The pattern is not present to the senses. Which is to say that I cannot point to anything that is, for instance, “Yang Ming disease.” I do take in a large amount of data (pulse, tongue, color, sound, odor, presenting emotion, symptoms, lab results, subtle information heretofore undefined) through my various senses, but this thing Yang Ming disease is never taken in. It is a concept, an organizing concept. In some real sense, Yang Ming disease is not there. It is an unbelievably useful structure that I can use to order the data I am taking in and craft a treatment that is a response to the disease state being presented by my patient. My ability to grasp this imaginative construct is crucial in my efficacy.
We can take this further, though I get a little weak in the knees as I depart from that relatively solid conceptual ground. We can use structures like Yang Ming disease in a way that is imaginative, or we can turn them into prisons from which no healing can escape. Let’s take Yang Ming disease as an example. The defining line of Yang Ming disease in the Shang Han Lun states:
In Yang Ming disease, the Stomach family is full.
Boy, talk about a range of possible interpretations. We can look deeply into the characters, we can look at all instances in the history of Chinese medical texts of those characters, we can look at all the Yang Ming formulas and see how they treat this “fullness” of the “Stomach family,” we can do many things in order to understand the statement. But, if we don’t let our imagination run free, our efforts may never bear fruit. Once we have obtained all of that data as I listed above, we must let our minds explore. What would the Stomach family being full do in terms of psycho-emotional disturbance? What images come to mind when we consider the Stomach family being full? What is our subjective experience of this disease state?
I believe this kind of activity, while perhaps not good material for scholarly publication, is crucial to my development as a Chinese medicine practitioner. It helps me to understand the formulas and point protocols more fully, not to mention nourishing me deeply as a human being. I also believe that the use of imaginative faculties is, at least in part, behind the brilliance of ancient Chinese medical theory.
I’m interested in hearing how others think about this issue. It’s a small thing, perhaps, but interesting to consider.
Eric
Blogger’s Choice Awards – Vote for Deepesthealth.com
Well, it’s time for the Blogger’s Choice Awards again. My friend Yael over at Chinesemedicinenotes.com helped remind me that Deepest Health is in the running. So, vote for Yael – vote for me – vote for any one of the other fine Health related blogs out there, but do vote! It only takes a minute or two to sign up and the winners get a pretty good traffic boost for their troubles.
What do you have to lose? Click it!
Eric
Eric Grey intern shifts at Pettygrove Classical Chinese Medicine clinic
Just a quick plug before I leave for a leadership retreat. Starting July 3, I will be providing acupuncture and Chinese herbal medicine services at Pettygrove clinic in Portland, OR. The address is 2232 NW Pettygrove., Portland, OR 97210. We provide top rate care, including the services of the city’s best Chinese herbal pharmacy. You can call 503-552-1552 to set an appointment and to find out more about prices. If you need to reach me personally, you can call the same number and ask for extension 5639.
My shifts are as follows:
Under supervising physician Dr. Qin (renown acupuncture specialist) during the first part of the summer on Monday from 12-4. That shift will be supervised by Dr. Arnaud Versluys, internationally known Shang Han Lun style herbalist, during the latter part of the summer at the same time. Under supervising physician Dr. Kou on the cancer-care specialty shift I will be working Monday from 4-8pm. Finally, on Thursdays from 12-4pm I will be honored to work with David Berkshire, a five element acupuncture specialist. I would be happy to see you on any of these shifts. Please contact me by phone or email if you have any questions.
Last but not least, I will be posting Twitter updates to the blog over the weekend – you can read those in the sidebar of the blog in the column closest to the content. Check out the link if you want to learn more about Twitter.
Eric
Fiddling with things : Deepest Health upgrade
A few quick notes:
If you read the site by feedreader or email subscription, the video on the last post might not have come through. It is worth your time to visit the site to watch the video. I promise
For everyone – you may notice some slight changes on the site over the next couple of weeks. I’m experimenting with different ad servers, placement of certain elements, as well as updating some of my pages (about the author, resources, etc). Please let me know if something looks terrible. :)
Thanks,
Eric
What am I up to?
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Updates from my personal blog (Ericgrey.com)- Some lyrics… May 12, 2009
- A bikeride into God May 8, 2009
- Quiet versus moving Qigong practices March 7, 2009
- A new perspective on the healthcare crisis February 26, 2009
