ACTCM in China: Week One at Henan University

“Bā chuáng, shì jiān [bed eight, start time],” she yells after slamming the last needle home.

Shao lǎoshī looks back at the symmetrical set of zhāzhēn (inserted needles) that she’s placed into the older woman’s back muscles, hips and between vertebrae–and gives one a quick last spin, the patient jumping as the sensation courses down their meridian. With a combined look of sly satisfaction and focused determination, she moves on to the next patient.

“Have compassion in your heart, but not in your hands,” one of my Chinese teachers at home is known to say.

She moves seamlessly from patient to patient, meeting each where they are with a smile and complete authority. She encourages them to relax, and insists that she will do them no harm. After the patient lies down, Shao lǎoshī bluntly adjusts their limbs, getting them into position and exposing the needed points. With total economy of movement, she places 10-20 needles from top to bottom in an ordered staccato–clean, insert, clean, insert, clean, insert.
Henan patients 1Everyone calls Dr. Shao “lǎoshī,” or “teacher,” but she’s really more like the admiral. And she runs a tight ship in her quarter of the acupuncture department at Hénán Zhōngyī Dà Xúe [Henan University of Traditional Chinese Medicine], Hospital No. 3. She started at 8AM, and she’s got 12 patients on beds and needled. It’s 8:45.

Four doctors and their attending Chinese medicine students (usually 3 or 4 at the bachelors level per instructor) share one large room that is the acupuncture department. In addition to their normal student assistants, our two groups of 3 ACTCM students a piece are working with Shao lǎoshī, and Dr. Yang–who, at 78 years old, works seven days a week (Sundays only in the morning). These twos’ treatment sections (which measure approximately 15 x 25 feet) are situated right next to the acupuncture pediatrics department–full of screaming hellraiser babies whose parents both soothe and hold them down for the greater good.

“Èr chuáng, xingzhēn [bed two, stimulate needles],” one of Shao lǎoshī’s students announces after referring to a running list of times to stimulate and remove needles for the current patient on each of the twelve beds. Another student pipes an acknowledgement and hurries over to said bed, squeezing past lǎoshī, other students, and patients coming and going with their friends/family. The “corridor” between beds is about 2 feet wide, each bed segregated by a thin drape from the ceiling. The effect is a modest amount of privacy, a clinical submarine.

Upon arrival, old patients check in with a student at lǎoshī’s office and simply walk back to their assigned bed, glancing casually over as another patient drops their shorts or gets needles in their face for Bell’s Palsy paralysis. Some patients know one another after seeing each other daily for some course of treatment. In any case, there’s a communal air in the tight space, and most leave with at least a new acquaintance. Also, the older the patient, the greater the entourage.

Patients will often lie and rest for a bit before Shao lǎoshī reaches them, and once the needles are in, she or her student will call for a wire cage of sorts over which to drape a heavy blanket to keep patients’ exposed skin and needles warm. The treatment ship is now populated by warm, healing cocoon tents.

Whether getting needles or moxa boxes, many patients are watching tv or texting on their phones–there’s a regularity to the loud, obnoxious ringtones . Sometimes lǎoshī also takes a call while needling patients, the phone pressed against her shoulder so she can use both hands.

“Wû chuáng, qīzhēn [bed five, remove needles]!” Another student slides past the many bodies, and begins carefully removing needles, stabbing them into the mattress near the patient, bunching them together for bulk disposal. Or they hand them to the patient’s chaperone to hold until they’re all out. There’s faint hints of old blood stains on the blankets, and needles on the floor near the sharps container. After needles are removed, students will offer–or patients already know to request–“báguàn,” or fire cupping.

Another students pushes a medical cart down the corridor, patients and onlookers jumping out of the way. On it are the tools of the trade–high-octane rubbing alcohol, lighters, hemostats, cups, and assorted jars that are probably from someone’s pantry. Our Chinese counterparts conjure a large torch from cotton balls and booze–I was taught that the bigger the flame, the greater the suction. Mimicking their teacher’s speed with needles, they swiftly place cups–as many as ten per body.

We work from 8AM-12PM, and 2:30-5:30PM. With a 2.5 hour lunch we can eat and rest, demonstrating some integrity in our medical practice which preaches balance, moderation, and self-care. As the day winds down and the last patients marinate with needles or cups, we students all sit around the break table. Shao lǎoshī bounces over with a smile and something in her arms. After having us clean our hands with alcohol (the first time I’ve seen anyone do so at the clinic, including hand washing) she hands us large strips of cotton, and instructs us how to create a funnel with our hands. In it, we jam pieces of cotton and peck at them with our other index finger–homemade cotton balls ready for clinic tomorrow morning.

As this day ends the next will begin–with us together in a circle, unsheathing and preparing needles for the day. It’s both a tribe and an assembly line in which each has their role in contributing to the service of others. Shao lǎoshī’s father was a renowned practitioner throughout China (amongst more than 1.3b people, only 200 docs receive awards/recognition every five years–her father has been one such recipient). Despite the fact that Shao lǎoshī continues his prestige and lineage, and patients travel specifically to see her, she nevertheless sits with us making cotton balls, laughing as we stumble over Chinese words and tones.

Once these tasks are done and patients are out the door, we remove our lab coats and don our street wear. We head to the mess hall for a well-deserved meal with the rest of the university community, on the way out expressing our gratitude with, “xièxie, lǎoshī…zài jiàn [thank you, teacher…goodbye!]”

“Bù kè qì [you’re welcome],” she says with a smile.

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