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.
How Do You Define Success?
Winners get rewards. We like winners. People remember who won. Their success is ours. Most of all, winners get hired and have better jobs. Losers may get sympathy, but we quickly forget them. At best, losers have the chance for redemption if they win next time. Winners get candy at Halloween; losers get rocks. The identity of winners and losers is crafted early in life, shaped by family, school and community experiences.
Last fall, I witnessed one event that will certainly prove pivotal to the notion of success among a group of children. Thirty-eight middle-school students nervously waited at the base of the mountain. Adjusting their backpacks, checking their water bottles and comparing their snacks, the children gathered in "mountaineering" groups prior to the start of a daylong climb from 7,000 to 14,000 feet. Experienced climbers collected at the head of the pack with Mr. K, a former scoutmaster. Children of average ability (and higher-than-average enthusiasm) gathered with Dr. M, the science teacher who offered a gentler pace than Mr. K. Easier on the body but tougher on the mind, Dr. M began a seven-hour commentary on alpine wildlife and geology that sharpened our appreciation during the ensuing hike.
Geology indeed, I thought as I gazed above us. From the base of the mountain, all your energy directed "up." Looking above, clouds folded into the peak of Mount Celeste, a remote destination for hikers in a prehistoric mountain range. Looking at the ground, I anticipated how my middle-aged legs would fit into crevices created by ancient volcanoes. How the many forms of hardened lava would feel underfoot, how the shimmering gold of aspen leaves would look as autumn approached, and how we would ford waterfalls and streams. Celeste was a regal old gal, and we intended to hug her flank and slowly ascend her rocky north face.
Miss L, a sweet, pretty art teacher, pulled up the rear, saddled with hormonal teenage girls. Complaining can be an art form at that age. As the rest of us checked our gear, the girls nervously compared attire and groomed each other.
"I've never done anything like this in my life!" shrieked one pink-haired girl as she shook her green-haired friend. "Me neither," replied Green. "My mother said that this is soooo dangerous; she can't believe the school makes us do this!" "They make us pee in the woods!" screamed Pink in anticipatory discomfort. "I want to go home," whined Green. "I just got my period! What am I supposed to do up there without a bathroom?" she demanded while pointing up to the peak.
The peak, a white-capped summit, seemed an eternity away. We were about to begin a trip meant to evoke epic journeys of old. Most of the kids had never climbed this high or camped for so long. They were anxious and ready to move. Six adults accompanied the children: four faculty and two parents. Only half the staff had experience camping at high altitudes.
Elaborate preparations were made earlier, mostly by one of the teachers who sent a "packing list" home with each child. As a cautious mother, I examined the list with hopes of gaining clues about the hike. Each item evoked a maternal response:
- Two T-shirts (Will they be warm enough?)
- One pair of hiking boots (What if they get wet? No other foot gear?)
- A journal and one pencil (for sanity)
- One backpack (What about the little kids? Will they be strong enough to carry 30 pounds?)
- One sleeping bag for 30 F or colder (Will this be warm enough at 12,000 feet?)
- Four snacks stored in zip-lock bags (hard for bears to open or smell)
- Sunblock (UV rays are more intense at high altitudes)
- One light jacket or sweater and a waterproof parka. (Oh God, what happens on slopes if it rains? Are these clothes warm enough if it freezes?)
Each item on the list protected the kids from otherwise inevitable alpine disasters. Each item was necessary. No unnecessary items were permitted; select only what you need. We were glad the experienced mountaineers prepared a list we could trust. Nonetheless, I felt the urge to protect, blended with a desire for my own epic journey, so I went along as a class parent. Assuming capability among the staff and trusting the list, I set out with them.
Passing Pink and Green, I joined Dr. M's group. We passed Miss L, glancing at her sympathetically. I didn't envy her shepherding nervous adolescent girls. Somehow, I doubted that dogged persistence would motivate them when the going got tough. Nail polish can't substitute for electrolytes.
I could go on endlessly about the beauty of the climb - about majestic curves and unexpected caves. Determined oak trees clutching the cliffs. The shimmering gold of aspens giving us energy. The smell and sticky texture of pine sap from junipers, which refreshed us. The clarity of the water in the snaking mountain stream we crossed again and again. Lithely jumping from rock to rock, oblivious to the weight of our packs. And finally (after five consecutive hours), the view from above, not yet the pinnacle but at last a peak.
My journey was joy. For some children, however, it was suffering. Mr. K's group climbed to the base camp in three hours. For the next four hours, children slowly arrived in dribs and drabs - two or three at a time, mostly without adult supervision. We watched as children appeared, usually running to the camp, fueled by adrenalin at the sight of an "end" after hours of strenuous hiking, before collapsing to the ground.
Though elated upon arrival, many children were unwell by dusk, suffering from headaches, nausea, fatigue and fear. Many could not imagine a second day ascending an even steeper incline; lacking reserves, they had no hope of success. The staff assured them they would be fine by morning. Exhausted, they retreated to their tents.
That night, Mt. Celeste endured her first frost of the year. As the nighttime sky's deep blue turned to silver gray at daybreak, we saw shimmering silver on the ground next to us as we woke. Frost, in September! Groggily, the kids staggered from their tents, stiff, cold and hungry, hoping chai and bagels would revive them.
No such luck. Although a few of the walking wounded were able to rebound, most still had not recovered. Headaches, nausea, wheezing and exhaustion still plagued about a third of the class. One child had been vomiting throughout the night. As a medical provider, I brought this to the attention of the lead teacher. Mr. K, military to the end, replied, "Get them started on the hike; they'll get over it! They'll feel great in the end and remember the top."
In Chinese medicine, we think of symptoms as messengers - signs leading us to awareness, awareness leading to knowledge and knowledge leading to recovery. Denying symptoms often worsens them. Military thinking is great for discipline, but has its limits when your goal is healing. Listening to our conversation, Miss L moaned, "I don't want to be stuck with the sick ones today! I don't know what to do with them, and I want to climb to the summit!"
Looking at the children, I offered to stay at the base camp with those who felt they couldn't climb. This satisfied the staff, which looked at them with disapproval and left with the more vigorous kids. I called a meeting of our motley crew. "We have a job to do," I announced. "I want everyone here to rate their energy level. A "1" means you are spent. A "10" means you feel great." Each child self-rated, with most falling between 3 and 5. "Our goal," I continued, "is to raise your rating so no one is lower than an 8 by the day's end. Who's in? Who will accept this challenge?" Everyone bought in.
We spent the next few hours dividing into teams. The water team pumped enough water from the nearby stream for the next day's drinking water. The wood team collected kindling and cut dead logs into firewood. The fire team dug a huge fire pit and built benches around it for the evening meal. The earth team prepped food. And the metal team cleaned the campsite. Within two hours, we had a wonderful, attractive campsite and equally refreshed children. We rated ourselves again before the hikers returned, and all rated themselves between 8 and 10. The returning hikers and staff were delighted to see vigorous children who had made a contribution and now felt good about themselves.
We now ask: Who was successful? The children who climbed to the peak or the children who replenished themselves and others? In a sustainable world, replenishment is of equal value to expenditure. Yin is equal to yang ; maybe even a little more valuable when resources are low. However, in a culture built on unbridled use of resources, those who get to the top are the winners. You decide.