7 Ways to Keep Focused on a Lifelong Journey
Today, I truly start my experience as a practitioner of Classical Chinese Medicine. It’s my first shift at Pettygrove Classical Chinese Medicine clinic in Portland. I have the honor of learning from David Berkshire, LAc - a local practitioner who specializes in a variation of Worsley style five element acupuncture. I have been excited about this for a long time. At the same time, I’ve been anxious about my abilities and worried that I’ll do something horribly wrong! :) Also, as I enter Year 4 of this medical training, I am beginning to feel a little fatigued.
My situation is familiar to many of you. Anything worth doing takes time. This medicine is complex and worth working on for a while. Nonetheless, I have a family and a life and hopes and aspirations and sometimes I’d like to just get on with it. :) Regardless of your profession or stage in life, I think you can appreciate this sentiment and the situation that inspired it. Consider this got me thinking about how to keep energized when the road before one is long and potentially bumpy. I figured I’d share my thoughts with you. Please share your reactions and your own words of wisdom in the comments.
1. Inspiring literature : One of the easiest ways I have found to stay focused is to maintain a small library of books that easily inspire me. For my part, I choose writing that is closely related to Classical Chinese Medicine. A partial list of my “inspiration library” reveals:
- Dao De Jing
(Star Version)
- Huangdi Neijing
- Learning to be a Sage
- Notes from classes taught by Arnaud Versluys, Heiner Fruehauf and others
- The Web of Life
- Wholeness of Nature
2. Old journals/writing : I’m not super reliable in my journal writing, but it is consistent enough that I can read back through and get a sense for where I was in the recent and distant past. It is helpful for two reasons. First, I can see how far I’ve come and become energized by my progress. Second, I can sample my youthful (!) enthusiasm and use that to propel me through.
3. Go back to the source : Everyone came to their profession/topic for a different reason. When I get a little distant from my passion, I just think back to what motivated me in the first place. For me, the essence is twofold. First, I love the Classical Chinese way of thinking about human beings and the natural environment we live in. Also, a deep desire to be part of a profession that demands of me total integrity and closeness to nature has always been part of my driving force. To revisit these, I need to simply sit in a beautiful place (Portland abounds with them) and consider those things. I might spend 20 minutes considering the interplay of Yin and Yang in everything around me. Alternatively, I might vision the kind of practitioner I see myself being.
4. Talk to people further along on the path : Talking to experienced Chinese medicine physicians goes a long way in keeping me energized. When I am privileged to hear someone like Heiner Fruehauf talk about his method of treating patients and the beauty of those interactions, I feel renewed. When I make time to talk with my friend Abdallah B. Stickley about his prolific and inspired practice, I am buoyed. It’s also been helpful shadowing with some of the recently graduated interns during their rotations - watching the effortless way they interact with patients and wield the needles helps calm my fears and excite me about my future.
5. Talk to people further back on the path : Nothing gets me going quicker than talking to folks new to the field of Classical Chinese Medicine. It’s one of the reasons I love being associated with an institution of higher education. Every year, new students come in - full of enthusiasm and wonder. It lightens the heart and makes me forget my worries about my future or my irritation with the present. At NCNM, we have a mentoring program where older students take on the responsibility for helping out new students. That has certainly been a good experience.
6. Brainstorming : Sometimes none of the above seems to work. So, I start mindmapping. I’ll put my central concern or question in the center of the page and just start working from there. For instance, I might put the question, “Why become a physician?” in the center of my page. From there I let the ideas flow. “To have the privilege of accompanying fellow human beings on their path through life,” “To alleviate suffering in those who need it,” “To get paid to consciously work with my own energy,” and the list goes on. From there I often get sparked to think of my chosen profession in new ways. In fact, many of my blog articles come from brainstorming sessions like that one.
7. Spiritual practice : Certainly there is nothing better to align me with my purpose as a student of Classical Chinese Medicine than my spiritual practice. Whatever tradition (or no-tradition) you come from, simply dwelling in that place of spirit can deeply nourish every part of your life. I find that when I am doing meditation, prayer, Qigong and reading sacred texts, peacefulness about my path comes without my forcing it. If I sat down to meditate with worries on my mind or heaviness in my heart, I scarcely remember it when I stand back up.
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Tags: clinic, Learning, ncnmRelated posts
Learning from Chinese medicine masters : Liu Lihong visits Portland, OR
Since arriving in Portland to study acupuncture and Chinese herbalism, I have been unbelievably lucky with regards to the teachers to which I have been exposed. In fact, not a day goes by that I don’t find myself pretty much floored when I consider my good luck. You know that old adage that “When the student is ready, the teacher will come?” Well, I must be ready - because I’ve got some pretty incredible teachers. I’ve talked about only a few of them on the blog, but hope to feature more about them - even in their own words - in the coming year.
We have been blessed to have the presence of a true modern day master, Dr. Liu Lihong, at NCNM for the past couple of weeks. He gave a public lecture along with his colleague, Dr. Tang Nong, about the state of Classical Chinese Medicine in China and has since lectured on a number of other topics in an impromptu fashion. He also gave a more structured lecture to a small group of people with connections to Heiner Fruehauf and NCNM on the topic of the “Fire Spirit” school of herbalism of which he is a part. Every single opportunity I have had to listen to Dr. Liu has been a treasure. As someone new to the field, I appreciated his simple, yet deep, explanations on topics that mean a lot to me such as: What is a lineage and what is its meaning? What does it mean to be a physician in this day and age? What is the meaning of calling one way of practicing Chinese Medicine “Classical?” He also discussed more in depth topics such as the appropriate use of Fu Zi, the essential salient features of treating in a “Fire spirit” school way and a way to understand the theories of the five elements and six conformations.
To tell you the truth, it’s been so much information, I’ve almost willfully avoided going back over it because I’ve got so much on my plate already! But, I would like to share with you some of what I’ve learned and what it has sparked in me in terms of new ways of looking at Chinese medicine. It will likely take a few articles. I’ll try not to make you wait. :)
I’ll actually have to start with first things first - the series of talks was kicked off by Dr. Tang Nong, who is the chair of the Institute at Guangxi College of Traditional Chinese Medicine, where Dr. Liu is a senior professor, medical director and co-chair. The Institute they co-chair is the only of its kind - solely devoted to research into the clinical applications of Classical Chinese Medicine. Here patients are treated with Chinese medicine only. In other hospitals, even those that seem to be “Chinese medicine” oriented, patients are often treated more with Western medicine with Chinese medicine only as adjunct or supportive therapy. How then, are we supposed to know what Chinese medicine can do in a clinical context? This is the very question that Dr. Tang Nong addressed throughout his lecture.
Dr. Tang was a very charismatic speaker, full of energy and clearly very passionate about the medicine. I understand he is a skilled clinician in his own right and, further, understands the basic philosophical principles underlying the medicine in a nuanced way. I really enjoyed hearing him speak.
I was particularly interested in his discussion of the essential failing of TCM as it is often practiced. Dr. Tang told us that the trend in Chinese medicine research and development is towards increasing:
1) Modernization
2) Standardization, and
3) Internationalization
These three words aren’t inherently bad. Certainly moving forward and keeping our minds open to greater efficiency and clarity are all good things. It’s the way that these principles are understood and executed that creates problems - at least that what Dr. Tang seemed to be communicating to us. He spoke most against the effort towards standardization. In standardization of Chinese medicine, efforts are made to create “standard” diagnoses based on “typical” symptom pictures. These diagnoses are attached to “standard” formulas and point prescriptions. I expect that even the modifications are standardized (if x, then y). Thus, anyone with skill enough to understand the basics can simply match up a + b + c and come up with a treatment plan that can easily be supported by everyone else trained in the system.
What is the point of standardization? Dr. Tang didn’t address this much during the lecture, but I found myself thinking about it quite a bit. Often, things that don’t turn out well started out as good ideas. The road to Hell, as they say, is paved with good intentions. I think the reasons behind wanting to standardize are many, but I feel that it all comes down to expediency and fear for safety. When the numbers of patients you are seeing increase dramatically, you need a quicker way to cycle through them. Further, you can see even more patients if you can quickly and easily teach others how to treat safely. This is expediency. With a standard system you can see more people in a shorter amount of time. Admirable.
Additionally, there is a fear for safety of patients. This is still related to an increase in numbers of patients coming through the system. If you want to train ever larger numbers of physicians, to see ever larger numbers of patients, ultimately a quick way to do this is to reduce standards for entry into the profession. While some people would say that standards are still quite high for entry into the highest levels of Chinese medicine education in China, others would strenuously disagree. Certainly everyone can agree that it takes less to become accepted as a physician in China today compared to a couple of hundred years ago. Regardless, when you reduce the standards for entering into a potentially dangerous profession, you have to build safety valves into the essence of the system to avoid costly errors. In all, if we reduce professional standards and standardize sufficiently to ensure patient safety, we can see huge numbers of patients in a relatively short period of time. Why NOT standardize, one might ask…
Because Chinese medicine doesn’t work very well when it’s standardized. In fact, the system relies pretty heavily on individualization. While we can agree on certain basic sets of symptoms as emblematic of particular disease states or formula patterns, ultimately each person’s manifestation is likely to be slightly different and thus take a slightly different formula. Ultimately the creation of a formula or point prescription needs to be highly individual, based on the interaction between doctor and patient, the particular manifestation of the patient on that day, the particular weather patterns current and expected, the tendencies in any given year, the dietary habits of the patient and so on. While a “standard” prescription may lessen symptoms, it’s unlikely to have the kind of dramatically positive impact that a more individualized treatment would have. I’ve seen this in clinic many times, and I’ve experienced it myself.
But more importantly, these eminent physicians have seen this in thousands upon thousands of clinical cases and are adamant that standardization (as it is currently practiced) is a degradation of our medicine.
Dr. Tang talked about many other things, but it will have to wait for another post. For now, I’d be interested to hear folks’ thoughts about what I’ve said here. Why do you think people are so eager to standardize Chinese medicine? How do you see the benefits and costs? What are the alternatives? What are their benefits and costs?
Eric
Tags: classical-chinese-medicine, events, liu lihong, Portland, standardization, traditional-chinese-medicineRelated posts
Classical Chinese Medicine events in Portland, OR
I know not everyone is lucky enough to live in or around Portland, OR. ;) I would still like to announce these events - they are more than worth the travel cost and time, I assure you. Click on the flyers for bigger versions, you should be able to click on the flyer when it opens in another window to zoom in even more.
If you’re having a hard time seeing the flyer, you can go to the NCNM Continuing Education event website and scroll down the page to May events.
For those experiencing trouble, here’s a quick summary:
1. Dr. Liu Lihong and Dr. Tang Nong
- Classical Chinese Medicine in Modern China
- Pearls of Wisdom from the Shanghan Lun
Date: May 10, 2008 9:30 – 5:30 // Location: NCNM Ross Island Campus; Portland, OR, Great Hall
This 2-part,1-day seminar will feature the combined genius of the two founders of China’s first official research institute for the clinical application of classical Chinese medicine. Professor Tang, chair of the Institute at Guangxi College of TCM, is the charismatic leader who made deadlines as China’s youngest hospital director. Dr. Liu, co-chair of the Institute and its medical director, is the author of the highly influential “Sikao Zhongyi” (”Contemplating Chinese Medicine”), the best-selling plea for a renaissance of classical Chinese medicine that has reached more readers in China than any other modern Chinese medicine publication during the last century. Both are veterans of the Chinese medicine machine in China, who have a clear view of the limitations as well as the potential of TCM in our time.
2. Dr. Manfred Kubny
An Introduction to Chinese Medical Astrology
Date: May 24-26, 2008 930am -530 pm // Location: NCNM Ross Island Campus; Portland, OR, Great Hall
“Chinese Medical Astrology: A Systematic Introduction” May 24-26 (9:30am-5:30pm each day). This pioneering 3-day workshop will present, for the first time in the U.S., the highly sophisticated model of Chinese constitutional and medical astrology as researched and synthesized by the West’s leading authority, Professor Manfred Kubny (University of Berlin).
If you’re interested in other events pertinent to Classical Chinese Medicine you can check the following sites - note that events are all over the US and Europe:
1. Events page at Arnaudversluys.com
2. Events page at Classicalchinesemedicine.org
3. For the five-element acupuncture fans among you, check out the Portland based home of David Ford and David Berkshire - asomseminars.com
4. NCNM’s Continuing Education Department page
Tags: Acupuncture, classical-chinese-medicine, events, news, Portland, portland oregonRelated posts
On entering into a philosophical morass: Chinese medicine and Western science
Let’s get something straight. I’m very confused about the role of Western scientific research as it is currently practiced in verifying the claims of practitioners of Chinese medicine. Various studies, including the famous “sham acupuncture” study seem to challenge the premise that the theoretical bases of Chinese medicine are an accurate description of reality and our interactions with it. For instance, concerning the study referenced above, if any old needle through the skin will cure migraines - what of channel theory? What of our highly developed ideas about acupuncture techniques? Similar doubt is cast on Chinese herbalism by placebo controlled double blind studies showing no significant improvement in patient outcomes with the administration of various herbal extracts or even, in some cases, whole herbal formulas. What gives? Why spend all this money to learn a highly nuanced medical system if that system can’t stand on its own two feet? (Yes, I know, there are plenty of studies that verify CM’s efficacy, but that’s beside my specific point here).
I’ve talked in various articles on this site about my basic opinion about the relationship between Western science and Chinese medicine. At my school, NCNM, we talk about these things quite a bit in classes, in the hallways, in subversive meetings around Portland, Oregon. But, to be totally frank, the conversations don’t often delve deeply. This isn’t because we don’t want to go beyond the surface. Sometimes it feels like these concepts are coated with Teflon - the mind so readily slips off. It’s such work just to get through the program, I think most of us just don’t have the mental energy to work through this kind of analysis. Further, most of us weren’t attracted to the medicine because of analytical research indicating that it is effective. To some extent, it’s a gut level reaction. Or you could say that it’s a spiritual attraction - whatever you like.
I find, though, with my dual background in Western philosophy and Western science, I simply can’t let the matter lie. Believe me, I’d rather it be any other way. So, I’m going to attempt to unpack this issue - it’s going to take some time. It’s going to take a lot of reading and a lot of thinking and I’m not even sure what kind of result I can expect. I want to make it abundantly clear that I fully believe that Classical Chinese Medicine *does* stand on its own two feet, that it is deeply rooted in a science that needs no independent verification. I simply want to understand, for myself, what that means. In a sense, for me, this (long) journey will be an intellectual exercise. Perhaps an important one. We’ll see.
In a preliminary way, I can imagine that my exploration is going to have to go over some of the following terrain:
1. What is the nature of Western science as it is currently practiced? Essentially, what assumptions does Western science take for granted and how are they being challenged? My sense is that I’ll have to look pretty deep into the gaping maw of materialism in this part of my journey.
2. How do modern research standards grow out of the above assumptions? How are they independent from them? How have modern research standards evolved and how are they currently evolving?
3. How can the ideas of a non-material essence to the human being come back into acceptance by science? Is that desirable or necessary? What would that mean and what are the philosophical and practical implications?
4. Is there merit to the assertion that the scientific system that grows out of one world view cannot be adequately assessed or criticized by the scientific system that grows out of another? If so - what does this mean for an increasingly globalized world where many different worldviews are forced to interact?
5. What produces the most favorable patient outcomes and how would we measure those outcomes?
I’m going to have to look into a lot of disciplines in which I don’t have much expertise. That’s okay with me. I’ve come to accept that in any endeavor, there’s probably someone who knows more than me. That’s the benefit of this kind of public dialogue - lots of folks can contribute.
I’m interested to hear your thoughts in the comments.
Eric
Tags: Acupuncture, chinese-herb, classical-chinese-medicine, integrative-medicine, philosophy, philosophy of science, Theory, western research, western-scienceRelated posts
The development of first professional doctorate degrees in Chinese medicine
I must confess that the issue of accreditation of programs, levels of education within the acupuncture and Chinese herbal medicine profession(s) and all related issues sometimes evade my understanding. While the degree that I will get at the end of my training is a Masters of Science in Oriental Medicine, I will obtain a certification that will give me the title of Licensed Acupuncturists (LAc). At this point, further education is possible in accredited DAOM (Doctorate in Acupuncture and Oriental Medicine) but it brings with it no further licensure benefits. At this point, all Doctorate programs require the student to have their Masters degree and have some amount of clinical experience before they are considered for entry. The standards vary as to how much clinical experience is required. The Doctorate is clinically based and generally requires some amount of clinical research to be done.
NCNM, the school I attend in Portland, OR, has been working to create a first professional doctoral degree that focuses on Classical Chinese Medicine. I’m unclear as to whether other schools are seeking something similar. It’s been a long road, one that was started down long before I came to the school. Students, faculty, staff and community practitioners have been involved in the creation and refinement of the program. Most of the students currently in the MSOM program had high hopes that ACAOM (the Chinese medicine accreditation organization) would create a set of standards for first professional doctorates in time for us to complete our “first professional doctorates.” To that end, we have been taking the extra coursework necessary for our proposed Doctorate program. Some of us have been quite active in the process, attending committee meetings and submitting comments to the ACAOM in support of a certain set of standards.
On February 8, ACAOM released their recommendation - which is essentially that they feel they can make no recommendation because of lack of consensus in the community. If you would like to read the official document, read it at ACAOM’s website. I’m unclear what, exactly, this means for our program at NCNM. Almost certainly those of us in our third or fourth year that were hoping to graduate on time with our Doctorate will not be able to do so. That’s not my biggest concern - I’m simply interested in understanding what the essential disagreement is in the community.
So, I would like to hear from my readers. What is your stance on First Professional Doctorates? What do you feel needs to be in place before a program like that goes through? Do you have other thoughts about how education and licensing works in the Chinese medicine profession in the United States? Let us know in the comments.
Eric
Tags: acaom, Acupuncture, chinese-herb, classical-chinese-medicine, doctorate program, education, licensed acupuncturists, licensing, ncnm, organization, professional doctorates, students
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