Editor's note: This is the first in a series of articles discussing the provision of acupuncture and Oriental medicine to indigent patients in the clinic/hospital setting. This article provides background information on the author and how his unique career path evolved.
In a sense, I started working in the recovery field in May 1970 in Olongapo City, the Philippine Islands. Three jeeps filled with shore patrol, the military police and the Philippine constabulary surrounded the jitney my friends and I had hired to take us to a secluded area to get high.
I managed to get out of the U.S. Navy with a general discharge under honorable conditions and no jail time, but that is another story. Like some veterans of every war, I had lost myself to alcohol and drugs in search of the elusive, ultimately unattainable bliss of forgetfulness.
In 1980, I graduated from a Veterans Administration Hospital program in Menlo Park, Calif., for sufferers of posttraumatic stress disorder (PTSD) and chemical dependency, and was gainfully employed in a working-class job. In 15 years, I had gone from a stoned working-class drone to a stoned military drone to a stoned, long-haired freak drone, and then back to a working-class drone - although this time I was clean.
In 1983, I was newly married, a new father, enrolled in the San Francisco College of Acupuncture and Oriental Medicine and on my way to a new life. At least half the people I went to acupuncture school with came to the path late in life. I was 36 years old when I started: a new father with a 9-month-old son, a part-time job in a hospital storeroom and a very tolerant wife who supported me (literally and figuratively) for the 45 months it took me to graduate. I alternately worked part- or full-time and went to school as much as we could afford.
I come from a lower working-class family, which is the polite American way of saying we were poor. Neither of my parents has a high school diploma. My mother worked at the soda fountain in a drug store and my father worked in produce at a grocery store. Two low-wage paychecks and three children meant I went to work as soon as possible, at age 12, with a paper route. The money from the paper route, such as it was, went to help with bills, rent or food. I was the only Vietnam veteran (another lower-working-class poverty experience) in my school. To this day, I have yet to meet another American-born acupuncturist who is a veteran. My past has given me a unique perspective on the path of my acupuncture career. For starters, I was the first in my family to have a career and letters after my name, rather than just a job.
About six months after I got my license, I had the opportunity to bring the National Acupuncture Detoxification Association (NADA) protocol to a methadone clinic in Oakland, Calif. This was very convenient, since I lived just a couple of miles from the clinic. I had started nada certification before I even got my license because the idea of working in a community-based clinic with patients who couldn't afford acupuncture appealed to me. So did a steady paycheck.
I started my NADA training at the Bayview Hunter's Point Foundation in San Francisco just before I got my license. I finished the NADA training right afterward. The Bay View clinic had four to six acupuncturists who not only offered services to the drug and alcohol program, but also performed general medicine acupuncture for anyone who walked in or - as was occasionally the case - was carried in the door. It was quite an experience for a new acupuncturist.
I had a part-time private practice, but I never liked it. I had a hard time with the money part. I found it difficult to ask people who reminded me of my family for enough money - sometimes for money at all. But we were in deep debt. I had gone to school on credit cards. The school I attended had not been around long enough to satisfy the state requirement for duration. Students did not qualify for loans.
Most of my private-practice patients were poor, hard-working laborers or just plain poor. Whenever the opportunity to work a wage-earning job doing acupuncture arose, I jumped at it. Consequently, the bulk of my career has been (and remains) working with the medically indigent and the poor; first with addicts and probationers, then with AIDS, HIV and hepatitis patients and eventually with general medicine patients referred by doctors with privileges at the Alameda County Medical Center hospitals and outpatient clinics.
Most acupuncturists I know who work in the detox field string together part-time jobs with a private practice. Six months after starting at the methadone clinic in Oakland and one year after licensure, I was hired part time at Bayview Hunter's Point. I stopped my private practice as soon as I could and have never gone back. I was working 40 paid hours a week doing acupuncture. The methadone clinic eventually lost its funding, just as BVHPF got more money, and I worked 35 hours a week there.
For the past 16 years, I have been employed as an acupuncturist at Highland General Hospital in Oakland. Highland General Hospital is part of the Alameda County Medical Center, which comprises two general medicine hospitals, a psychiatric hospital and five community clinics in various cities of Alameda County. I am a permanent employee with almost full benefits: sick leave, vacation pay, paid holidays and COLAs (cost-of-living adjustments). My position is listed in the "Memorandum of Understanding," the contractual agreement between hospital management and the Service Employees International Union [SEIU 1021], as #5887, Acupuncturist. As a union employee, I receive medical, dental and vision benefits, and an illusion of job security. I have all the seniority in the classification because I am the classification, although I am clear that no other union member is going to go on strike to save my job - not with a classification comprised of one person. One of the more pleasant union benefits is that they reimburse 80 percent of my CEU costs.
I now only work part time (20 hours) in the chemical dependency unit, but I have worked for various periods of time for Children's Hospital in Oakland with pregnant women and mothers and their children (newborn to age 2). I also have worked for the probation department of Alameda County and various chemical-dependency clinics (methadone, 12-step, harm-reduction and dual-diagnosis, all in various combinations). I have been able to offer treatments to the medical center/county staff and provide general-medicine acupuncture to patients referred from the outpatient clinics located at all three county hospitals and the five community clinics. I have worked in the Highland Hospital Outpatient Adult Immunology Clinic. Through this clinic, I have provided services to the HIV, AIDS and hepatitis patients, as well as to patients of this outpatient clinic when they were hospitalized. To summarize, I have been able to treat outpatient, inpatient and staff, sometimes all in one day.
When I was about to graduate from acupuncture school, I had no idea what I was going to do with my license. This path has been a turbulent but pleasant surprise. It is with these credentials that I offer this continuing series of observations on indigent acupuncture and working in a hospital setting.
May Quan Yin smile on you and yours.
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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