The Dodo Verdict: A Concept Borrowed From Another “Soft” Medicine

“You cannot be tied down to one theory without also knowing that another surely exists.” — Wang Zizhong, Classic of Nourishing Life with Acupuncture and Moxibustion

One of the strong points of traditional Asian medicine is that it does not discredit or deny its existence when confronted with new information. Instead, it absorbs and assimilates the information into the rich tapestry of knowledge and tradition. Look no further than our materia medica for many examples of this. Frankincense, myrrh, and American ginseng are the first in a long line of borrowed herbs.

This openness to new concepts and practices applies to including modern technology in practices. Electric acupuncture, acupoint injection therapy, lasers, and even microneedling devices are great examples.

We know that traditional Chinese medicine (TCM) is not one singular practice, but an attempt to be inclusive of various styles, systems, frameworks, and ideologies. This medical “stew” does not water down the medicine; instead, it gives a practitioner flexibility to adapt to the patient’s needs with a near-endless array of techniques.

The challenge is appropriately employing the correct techniques for the patient’s maximum benefit. With thousands of years of theory, method, and ideologies combined with modern research, new techniques, and an ever-expanding knowledge base, how is it possible to know which strategies and theories are the “best” for that patient at that moment in time, with that particular collection of signs and symptoms? Most of us, myself included, answer this question with our cognitive biases on full display.

In the past 20-plus years of practice, I have often heard colleagues condescendingly speaking of systems they do not practice while suggesting that their system, training, and lineage are superior. How often have you said or heard phrases like, “TCM just treats the symptoms,” “That Japanese stuff is OK for emotional issues, but can’t treat pain,” or “Our system treats the spirit”?

With some reflection and a deeper study of multiple systems, it appears that none of these statements reflects any system’s actual practice and reveals more about the practitioner making said statement.

I remember being at a seminar by Shudo Denmei and hearing a student questioned about another system. His response, via Stephen Brown’s masterful translation, was one of the most enlightened I have heard. He said, “I tried it for three years, and I believe it has some good value.” This was followed by the Japanese expression “three years on a rock,” which is similar to “walking a mile in another’s shoes.”

Before judgment, Shudo Sensei spent three years learning and trying the system out. Shudo Sensei has attained a level of curiosity and interest in expanding our clinical knowledge and skills I hope to achieve one day.

So, Which System Is the Best?

While this question is inherently flawed given the scope and breadth of East Asian medicine, perhaps we can borrow some answers from other sources, much like practitioners of yore learning of a new herb or medical procedure.

First, let us look at martial arts. Many martial arts have literally come to blows deciding which system was the best. Today, many martial artists respond to the question with, “The one you train.” While individuals may possess different innate abilities and strengths, training in a formal system gives the practitioner a solid base to operate. Each system has some deficiencies and strengths, but diving deep into a particular style allows you to understand better when to employ other techniques and borrow from different systems.

Enter the Dodo

A year ago, I enjoyed networking with a licensed clinical social worker, whose profession is arguably less concrete than ours and does contain plenty of zealots of particular practice styles. Arguments about which philosophy plague the mental health care field as well. The social worker mentioned that their field dubbed this phenomenon the dodo verdict nearly 100 years ago. The term was instantly intriguing, and I asked for a deeper explanation.

The dodo verdict comes from Lewis Carroll’s Through the Looking Glass. The dodo was a large, flightless bird hunted to extinction. It was docile and slow-moving, which made it easy to kill. Hunters anthropomorphized a lack of intelligence to the poor bird, as it usually wouldn’t run from humans even while seeing others getting killed.

There is a scene in Carroll’s book in which the dodo is hosting a race, but fails to watch the finish line and cannot tell who won. The dodo, being the judge, decides that all the racers are winners.

A psychotherapist named Rosenzweig promoted the dodo verdict theory in 1936. Based on his observations of psychotherapy as a whole, as long as a patient received mental health treatment, regardless of the style, the patients had positive outcomes. This observation was highly controversial and has fallen in and out of favor, but empirical data over time points to plausibility.

Are We Running the Dodo’s Race, Too?

The argument of the superiority of one system over another exists in East Asian medicine. Many systems, even neo-classical systems (which started circa 1950 with a basis of the classics), have a rich history, and many clinicians and patients support these techniques. Systematic reviews in mental health attempted to define the superior system, leaving more debate and confusion.

While we have quality research on many East Asian medicine practices, studies rarely compare side-by-side techniques and systems. The scope of these studies would be nearly impossible given the variety of methods used and theories for even the most straightforward conditions.

Let the Dodo Set You Free

If we accept the dodo verdict as plausible for our field, we no longer need to waste hours on social media debating colleagues. We can spend more time delving deeper into our particular systems framework, and when necessary, we can expand our knowledge base by leaning into the knowledge of other systems. Developing a mindset of curiosity toward other systems will deepen us as individual practitioners, and help strengthen and unify the field as a whole.