“When, within our souls and psyches we are made aware of a safe but insistent drum beat, repeated like butterfly wings in motion, we sense the message…that our inner self has begun its search for freedom.” – Mary Meeker1
Given the name Vanessa, which I share with a genus of brush-footed butterflies, I was destined for metamorphosis. From a psychology and fitness background, I pursued a Master of Science in Acupuncture to practice a timeless medicine admired for seamless integration of science, art, religion, and culture. Once in practice, I regularly witnessed patients’ transformations, yet my own was just beginning.
Chinese medical theory details each meridian’s functions and associations, which can be extrapolated for metaphorical significance.2-3 For example, the Large Intestine (LI) meridian expels physical and emotional waste, supporting systemic purification and renewal.3-4 Its anatomical trajectory, which traverses the index finger, upper extremity, shoulder, neck, and terminates at the contralateral nasolabial groove, also serves as a narrative metaphor, eloquently illustrating my journey from acupuncturist to colon and rectal surgeon.2,4
LI 1 (Shangyang; Metal Yang), the Jing-Well and first LI acupoint, reflects qi’s emergence, its flow into the meridian, and a revival of consciousness.2-4 LI 1 symbolizes my transition from the yin of studying acupuncture to the yang of clinical practice.5-8
LI 2 (Erjian; Second Space) on the hand reflects a digestive pause – a stage in which water’s fluidity facilitates elimination.2,7,9 At this juncture in my acupuncture practice I achieved a rhythm, which prevented inflexibility and permitted flow.
LI 3 (Sanjian; Third Space) reflects the subsequent digestive phase, including carrying the energy of rebirth and clarity of vision of the path forward.2,10 As my patients and I inquired more about the connections between Eastern and Western medicine, this self-reflection elucidated my exploratory path.
Synthesis of the aforementioned experiences occurred at LI 4 (Hegu; Joining Valley), which joins all energies, collects debris and releases toxins.2,8 I gathered multifarious resources about pursuing a medical career alongside my acupuncture career. The positive options remained while the unfavorables were released.
Yang fire acupoint, LI 5 (Yangxi; Yang Stream), adds lighted warmth and energetically cleanses so vitality flows.2,8 It also benefits the wrist, an essential joint for fine-tuning my acupuncture needling techniques and surgical technical prowess, propelling me toward surgery.
LI 6 (Pianli; Veering Passage), the Luo point, enables emotional recognition along one’s journey while focusing on backup prevention and unclogging waste.2,8 This is a testament to releasing doubts about pursuing Western medicine and steadfastly prioritizing my East-West integration.
LI 7 (Wenliu; Warm Flow) allows for continuous flow, evidenced by my medical school admission.2,10 LI 8 (Xianlian; Lower Angle) symbolizes the first two years of medical school and foundational learning as a physician.2,10 LI 9 (Shanglian; Upper Angle) alludes to progression from lower to upper, correlating with advancing from the first two years to the final two years of medical school and ascension toward my purpose.2,10 Shanglian harmonizes the LI, marking a pivotal harmonization of my educational and professional aspirations.
This is a precursor to LI 10’s (Shousanli; Arm Three Miles) symbolism of a long, arduous journey requiring perseverance and grit.2,9 Successful medical school completion requires the same, yielding an invigorated graduate reaching for Match Day’s promise.
LI 11 (Quchi; Pool at the Crook) provides Earth’s grounding energy to release fear of the unknown and unlock growth.2,8 Match Day is analogous, as graduating medical students pool together awaiting this poignant student to physician transition. On my Match Day, I was honored to match into general surgery residency.
LI 12 (Zhouliao; Elbow Crevice), positioned at the lateral elbow, resolves LI channel obstruction, allowing freedom to develop surgical technical skill.2,9 This also facilitates the arm’s reaching for and carrying essential teachings, while also releasing what no longer serves us. Residency, too, requires continuous discernment between that which benefits versus harms.
LI 13 (Shouwuli; Arm Five Miles) resonates with Shousanli, but also carries resources to develop physical and psychological resilience to succeed. General surgery residency spans 5-7 years.2,9 Need I say more?
Most paths have intersections. Anatomically, the LI, Small Intestine (SI) and Bladder (BL) meridians intersect at LI 14 (Binao; Upper Arm).2,9 Similarly, general surgery residency exposes trainees to various specialties, highlighting interdisciplinary intersections. LI 15 (Jianyu; Shoulder Bone) embodies the shoulder joint’s and surgeon’s metaphorical weight-bearing ability and multidirectionality, symbolic of my pursuit of colon and rectal surgery fellowship.2,9 “Great” signifies shoulder joint support while “Bone,” a component of jing, reflects LI 16’s (Jugu; Great Bone) strength, structure and vital essence.2,9 It aligns perfectly with my fellowship acceptance, geared to cultivating expertise and mastering specialty-specific surgical approaches.
LI 17 (Tianding; Heaven’s Tripod) is the first acupoint to ascend from upper extremity to the neck.2,9 “Heaven’s Tripod” mirrors spiritual connection to purpose, and thus is reflective of my first colorectal surgery faculty appointment dedicated to introspection and honing specialty-specific surgical decision-making skills. LI 17 also benefits the throat, illustrating emergence of my voice and articulation of my surgeon identity.
The Window of Heaven acupoint, LI 18 (Futu; Support the Prominence), opens the flow of qi in the neck, and represents the anatomical and spiritual meeting of head and body.2,5 It releases throat qi obstruction, augmenting LI 17’s literal and philosophical voice cultivation – essential in developing as an independent female surgeon.
LI 19 (Kouheliao; Mouth Grain Crevice) marks the meridian’s contralateral crossover, reiterating the value of openness to a surgical career’s natural transitions.2,55 LI 20 (Yingxiang; Welcome Fragrance) in the nasolabial groove opens the nasal passages and ignites a “wake up and smell the roses” energy.2,6 It signifies the warm welcome and arrival at the fragrant smells of accomplishment, clear vision of purpose and contributions to the profession. As LI’s final acupoint, it invites reflection.
My journey from acupuncture to colon and rectal surgery has been long yet transformational. The LI meridian and its acupoints illustrate my metamorphosis while chronicling the perseverance, grit, and malleability necessary to navigate the meridian’s entirety and that of acupuncture and surgical training.
The synergy of these experiences informs my unique approach to healing as I diagnose via pulses or poop, engage with acupoints or anoscopy, utilize mugwort or Metzenbaums, and screen with cups or colonoscopes.
Although seemingly different, the parallels in going from needle to knife are striking. Just as stainless steel provides the material from which both acupuncture needles and scalpels are created, so too does my vital essence serve as the foundation from which I am honored to treat my patients with both variations of stainless steel. It is precisely in the midst of these moments, when the parallels are palpable, that I feel the insistent drum beat of my butterfly wings, reminding me that my metamorphosis continues.
References
One of the longest nerves in the body is known as the vagus nerve (VN). The VN is the 10th pair of cranial nerves that originates at the brain stem in the medulla oblongata. This nerve is part of the parasympathetic nervous system, which is a part of the ANS. Research suggests ear acupuncture can activate the VN.
Migraines are unilateral, throbbing headaches, often with concurrent nausea, photophobia, and phonophobia. Approximately 10% of the global population suffers from migraines, with women more than three times as likely as men to experience them. Medication remains a mainstay treatment option, making nondrug alternatives critical to safer practices. New research suggests auricular acupuncture may be one such alternative.
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How much training in gua sha did you get in acupuncture school? If it was not much more than an introduction, now is the time to revisit this powerful healing modality. I’ve found gua sha to be one of my go-to skills to address myofascial dysfunction, all sorts of pain, limited range of motion, and even to promote general well-being. Let’s discuss the keys to effective gua sha treatment, which I hope will get more acupuncturists using it in the clinic.