At least once a month, I get the question from a patient: "So ... did you have to go to school to do this?" No, I think to myself. I was just unemployed, and it was between this, Starbucks barista or UPS delivery. I'd never handled a needle before, or studied physiology, but who needs to know physiology, am I right? This is just acupuncture.
"Yes," I answer aloud. "To do this, we need a master's degree in science and Chinese medicine. It's four years of school – five if you're like me and had to work concurrently as a Starbucks barista (while also pursuing an artistic passion). Then there are quarterly boards and national exams."
"Really?!" the patient is astonished, predictably so in consideration of the question in the first place, and it takes all of my patience to not insert the next needle just a tad more aggressively.
I kid, of course; but it is a blow to the ego to realize the percentage of the population that figures what we do doesn't require any education, let alone a master's degree. My wife is an MD, which means people meet her and assume she's an amazing person of great brilliance. When they meet me, they assume I am a fine person of great faith.
"Does that stuff actually work?" they ask. Then they ask my wife if she can offer any insight on some recent medical issue they're having. She recommends acupuncture, because she happens to be an amazing person of great brilliance.
I've put enough thought into all this to have an idea where peoples' shock and frustrating inquiries come from. (Almost) no one understands what acupuncture is – or more specifically what it is not.
What It Is .. and What It Isn't: What Every Patient Needs to Know
First, acupuncture is not a new modality used just to treat pain, which is closer to the definition of chiropractic, which might explain why society erroneously lumps us together – in spite of the two practices coming from different ages in history, opposite sides of the planet, and different paradigms of thought.
Acupuncture is an ancient modality, more than 2,500 years old, originally used to treat all of internal medicine, and it is only one of the many parts of traditional Chinese medicine. Other parts are herbal medicine and moxibustion, tuina massage, cupping, and qi gong exercise, all combining to form a profession that in my opinion, gets sold rather short by the simplified title, "Acupuncturist."
"Acupuncture" is one of the many forms of holistic medicine, but what does that even mean? Few people are able to define "holistic medicine," most figuring it to imply "not pharmaceuticals." It's true, holistic medicine might employ herbs, vitamins and supplements instead of drugs; however, this has nothing to do with its distinction.
Holism means we diagnose and treat the whole person instead of a biomedical diagnosis. This doesn't mean biomedical diagnoses don't offer helpful information, but for us they are only a starting point. We have to spend time getting to know each patient's unique physiological "pattern" in order to get an idea of how to treat.
Five people with asthma may show five different patterns and get five different treatments. The lungs are their problem only part of the time, whereas other times they are only the branch/victim of the root issue, which may be the kidneys, stomach, liver or any combination of the four. There is no such thing as "the acupuncture point for asthma," or "the herb for weight loss," etc. This is why prescribing some "natural herb" for any one disease, such as turmeric for arthritis or ginger for indigestion, is not holistic medicine, as it disregards our primary principle – the treatment of patterns.
The bad news is this is more challenging to practice. The good news is it means there is always hope, no matter the diagnosis.
"Can Acupuncture Treat...?"
This brings me to another favorite question: "Can acupuncture treat...?" I enjoy always cutting them off with an emphatic: "Yes!"
My answer is not a business move, nor is it pie-in-the-sky naiveté, but instead based on logic. Every condition, whether the common cold or Parkinson's disease, must exist within some physiological pattern, so the question is never whether or not something is treatable, but simply to what degree.
What IT Takes to Be Good: A Practical Example
In my first year out of school, I was treating a 60-year-old woman whose chief complaint was panic attacks, recent onset, though her health was otherwise poor, which should tell any health care professional this had been brewing under the surface for quite a while. She was anemic, pre-diabetic and overweight, but her main concern was this newly constant, terrifying anxiety.
In spite of holistic principles, there are certain conditions that are easier to treat than others. Gynecology and orthopedics, for example, are more straightforward, whereas psychology falls on the opposite end of that spectrum. It requires an exceptional practitioner with extensive experience, which did not describe me at the time.
Still, we owe it to ourselves (and our employers when applicable) to try our best with every patient who walks through our door, just as we owe them our full transparency and a referral for a "second opinion" whenever we are unable to help.
Over the few months that this patient came to m,e she had a few improved weeks of relief, but most weeks were bad, with symptoms unchanged. Finally, I conceded confusion and recommended she visit another practitioner. She glared back at me in despair.
"You don't want to see me anymore?" she asked, as if I were breaking up with her, surely offering a small window into a possible color of her panic disorder.
"No, it's not that," I explained. "But we've been working together long enough now that you should be better. I just think you should give someone else a try."
She looked as if I'd told her what we have to do is travel to the moon and engage in some ancient mud wrestling ritual to heal her condition.
"What is somebody else going to do that you're not doing?" she asked. Ahh, of course, I realized... she doesn't understand traditional Chinese medicine – and why should she? She thinks I've been doing "the anxiety points" or the panic protocol, and it's "just not working."
Editor's Note: Part 2 of this article appears in the February digital issue.
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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