This week we feature a story from Melissa Coats – one of our six students who is in China completing a three month scholarship at Henan University.
By Melissa Coats
There are many exciting differences in clinical practice here. Supervisors have very specific standards for students being allowed to needle patients. By the time students are clinic-level, all of them are very well-practiced and demonstrate true finesse – quick, straight, smooth, accurate needle insertions that are painless at the skin level. Though they allowed us foreigners to do some closely supervised needling of patients, if we were Chinese students, even those among us who are soon-to-graduate would not be allowed to needle here for our relative lack of skill (and unnecessary pain we cause patients). Guide tubes are not allowed to be used at all and are often laughed at and given to toddler patients as distracting toys. In the clinic down time, students practice countless repetitions on shared practice pads made of sponges or toilet paper sewn inside cloth.
The density varies; more loose ones for lightning-speed target practice, and dense ones to cultivate finger strength and insert without bending the needle. Many days here I’ve practiced a hundred or more practice pad insertions and seen my coordination and the techniques quickly improve.
While I recognize there are innumerable valid ways to insert a needle and diversity is part of the power of the medicine, I’m left with some questions. Why is the American standard such that we are allowed to cause patients unnecessary skin-level pain from slow and sloppy insertions, and also repeat insertions from inaccurate point location, when we can and should become proficient in these areas before subjecting patients to them? Why are our Chinese counterparts so much more competent with needles than we are– with the basic interface that we use on our patients bodies?
Another tremendous difference in acupuncture here is that average patients come in for treatment every day for 10 consecutive days. The standard we’re told in America is one treatment per week for 10 weeks.
Where did these frequencies come from and is one more effective than the other? What do the core classics have to say about this? To what degree are American cultural norms watering down the medicine?
Through the American TCM filter, treatments of Tuina, cupping and moxa are significantly underutilized and underrated, while here in China they are considered important, essential therapies in every treatment. In the hundreds of acupuncture treatments I’ve observed here, not a single patient has left without also receiving either Tuina and and cupping or Tuina and moxa. And my god do they use moxa. Tons of it. In giant boxes. Moxa here, by the way, gets it’s own ventilated room with multiple beds and the smallest box I’ve seen is probably 3 times the size of ACTCM clinic’s, typically used with two broken up sticks burning inside for an hour or more. (I’ll definitely be giving a brown bag on these things upon my return.)
The severe American emphasis on acupuncture alone seems like a carpenter whose only tool is a hammer–I’m sure you can be an expert at using that hammer but you can’t do all the awesome things you could do if you added a screwdriver, a drill and other tools. From my experiences here I have a growing belief that the standard Chinese medicine treatments in America are not utilizing the medicine fully: I’ve had many, many treatments at school over the last two years for severe, crippling, 11-out-of-10-pain dysmenorrhea with no change at worst and marginal progress at best. On the advice of our tremendously knowledgeable doctoral student translator here, I received two treatments on consecutive days of giant moxa boxes on my abdomen together with acupuncture just before my cycle and glory glory hallelujah–not a trace of pain, nor other typical uncomfortable symptoms. I attribute this tremendous success to the timing and especially the intensity of the treatments. If I had told him earlier, I would have been treated with a giant moxa box every day for that week before my cycle for more long-term effects.
For the last two weeks we’ve been following a renowned Tuina doctor named Dr.Song who does all kinds of neat spinal adjustments along with the regular Tuina we learn. Initially I was confused– How can he and his student interns do Tuina for 40 hours per week without injuring their arms, wrists and hands or becoming terribly fatigued? Their schedule is always booked solid and they treat 20-30 patients per day back-to-back. Then the interns showed us again and again and again and again and again how we were habituated to subtly doing techniques incorrectly and that we needed to start again at the very basics and it slowly became clear: When I’m doing Gun Fa (rolling technique) correctly, it feels genuinely effortless and I can do it effectively for hours without tiring, without getting sore. Until it becomes deeply ingrained muscle memory, it takes concentration to move from the correct part of your arm and to not unconsciously tense up and get worn out. I learned this the hard way, not understanding the technique’s subtleties, just trying to muscle through it sometimes and causing myself a bit of pain. One of many worthwhile lessons!
Just as the water of a spring is more pure the closer you are to the source, I’m coming to understand on an experiential level just how the TCM I’m learning in the states is specifically Americanized and is somewhat diluted relative to what I’m seeing here. American TCM has so much to learn and to catch up to and I fully intend to return here for future study.
My last tangential note: Here it’s not only legal for students to practice needle techniques on each other but an essential part of the curriculum, where after lecture and practice with teacher supervision, advanced students practice with newer students, offering them guidance in developing their skills. American law dictates that it is illegal for students to practice on each other without teacher supervision. How and why does American legal bureaucracy and fear-mongering shape TCM education in our country?
Other TCM nerd wonderland highlights:
The Henan University TCM library that can fit about 6 ACTCMs inside, research laboratories, herbal injections, family-secret herbal compresses, well-preserved specimens of fresh herb plants, herb preparation rooms with rows of pans for dry-frying/vinegar frying/salting and other herb prep equipment, museum displays of the evolution of Chinese medicine philosophies with giant flowery displays of patterns from the Shang Han Lun, a 3-story stone statue of Zhang Zhong Jing… etc.
Also check out Mel’s blog, Zhang Zhon Jizaang, with videos of Yang Lao Shi doing tongue acupuncture, the awesome speed cupping girl, nurses in the hall doing Ba Duan Jin qigong and more.