Reverse Culture Shock and TCM

Hello everyone. I'd like to share some of my TCM experiences abroad and observations since coming back to Vancouver. The following article may be helpful, raise some eyebrows, or even get your liver fired up, however, I hope it will stimulate discussion and clearer understanding of what Traditional Chinese Medicine is all about. I also hope to dispel some TCM misconceptions that are floating out there in Qi Space. As I am reacquainting myself with Canadian culture, I hope my opinions are toned to an appropriate level. If not, please forgive me, as I slowly try to fit in again.
Let me start by introducing myself. My name is John Blazevic and I graduated from the ICTCM in 1999 as a doctor of Traditional Chinese Medicine. Following graduation, a few of us brave souls ventured East for practicum in China. After a couple of wonderful months of study in the acupuncture, herbal medicine, and massage departments, I made my way to Japan, where I met an incredible practitioner and person, Edward Obaidey. Edward Sensei accepted me as his student and put up with me for 5 years. Yes, I entered an apprenticeship which lasted 5 years in Japan and I'm proud to say, this student-teacher relationship still continues today. Until recently (thanks to reality T.V.) apprenticing after graduation had been difficult to understand for most Westerners. And although I missed out on the whole genre of reality programs, I can say to Donald Trump that I lived the apprentice for 5 years!
Note 1: Being accepted by a teacher as their student is a cruel punishment and a difficult relationship to say the least. However, it is also extremely rewarding and really, the best way to learn. If the student is open, willing to change, and genuinely respects and trusts the teacher, then the art can be passed down. Calling someone your teacher puts a lot of pressure on the student to learn, since the ability and understanding of the student reflects greatly on the teacher. Ask yourself, if my teacher is so great, why aren't I? I can only assume many difficulties are experienced by the teacher as well.
Yes, my direct teacher is a fine British gentleman! (I describe my teacher this way so as to create a new prejudice in your mind, which will be dismantled upon meeting Edward Sensei. The old prejudice being: "He's not Japanese, or even Chinese!"). Edward Sensei is a master practitioner who can back up his theoretical understanding with clinical practice. I have met very few individuals who can do this and also have something to give, while completely being themselves. Those special individuals will always be my teachers.
Note 2: There is incredible prejudice in the world and plenty within the TCM profession. Here we are, supposed to be keen observers of nature, seeing things as they really are (objective) and not how they always appear to the naked eye. But, when presented with something that doesn't fit our image (subjective), we tend to count it out. How objective are we? Furthermore, if someone has to look the part, it's usually because their skills are not good enough to speak for themselves. Therefore, the image is created to make up for the deficiency. Edward Sensei once said to me that "we are energetic beings first", so what does it matter what someone looks like? Don't allow yourself to be controlled by your prejudices or the ones passed on to you from others.
Edward Sensei's teacher is Ikeda Masakazu Sensei. Ikeda Sensei is, in my opinion, the foremost authority on classical Chinese medicine. Yes, he is Japanese, so please see Note 2. Although, I have attended Ikeda Sensei's seminars several times in Japan, Australia and the U.S., and have also spent time observing at Ikeda Sensei's clinic, I will mention Ikeda Sensei briefly as I feel you should discover this master for yourself. Edward Sensei is much more qualified to talk about Ikeda Sensei, since Edward is Ikeda Sensei's top student, translator, and interpreter for seminars abroad. Now don't be fooled into thinking that because Ikeda Sensei is Japanese, he is doing Japanese acupuncture. Ikeda Sensei practises medicine according to the classical Chinese texts. He has practised this way for years, spoken extensively on the subject and has written over 20 books and numerous articles. In Ikeda Sensei's clinic, I noticed a note on the wall that said among other things, "Ask yourself what kind of medicine you practise?" This is very poignant nowadays because although we practitioners say we are doing Traditional Chinese Medicine, we rarely do it. It's mostly just dogmatic treatment and if acupuncture is involved, it is needling points with point prescriptions in mind. Perhaps we get hooked on some style of acupuncture, or worse yet, the latest acupuncture fad!
Note 3: In a future article I will explain why there is no such thing as a style of acupuncture. For the time being just trust me when I say Chinese-style acupuncture, Korean-style acupuncture, Japanese-style acupuncture, or even my own made-up style of acupuncture don't exist. (John's Angels on the Head of a Needle Style: amplify the qi in your treatment by calling on your angels?I will probably put on this very expensive and exclusive seminar some day!). If you can go beyond the type of needle and depth of insertion, what are you left with?
Studying in Japan brought the passion and life back into my practice. The initial excitement of first year in school in Vancouver gave way to a lack of interest, often due to lectures where we were sometimes read to from a book. There was really not much practical experience. Massage was the exception, but even in student clinic, there were not enough patients to practise on. I realized later that I should have been practising more on my own and then going to my teachers with questions and confirmations. My mistake. In China, although there was much more practise, I didn't see much traditional medicine. Only in the herbal department did we actually look at the tongue and pulse. In the acupuncture department, patients brought in their x-rays and were needled from there. What happened to the traditional in TCM I thought? At that time, I wished I could have stayed longer in China to find the real traditional stuff. Fortunately, my life path led me to Japan where I found what I was looking for--real traditional medicine practised according to the classical texts of Chinese medicine!
Studying under Edward Sensei was great! We studied, practised and tested out theories to see if we understood them correctly. This allowed us to develop our skill and understanding simultaneously. Specifically at Edward Sensei's clinic and generally in some parts of Japan and Asia, I saw a kind of practice where people actually practise. Students repeated the basics and fundamentals until they were mastered. Perhaps students in Asia have more respect for their teachers and therefore do what they are told until they have gained a measure of ability and understanding. Perhaps it's because they don't question enough. Whatever the case, in Asia, students seem to work harder than over here. I can honestly say that with respect to acupuncture and massage, we need to practise more because our skills are lacking.
Note 4: Oriental medicine and indeed Oriental philosophy is not something that can be intellectualized. What I mean is that we have to study the theory and then practise like crazy in order to understand what the theory means. Only then, can we say we understand. If not, we end up inventing our own styles. There is something very alive in this medicine when practiced by someone who is on the right path and free of styles. That living quality to the medicine is the life energy, which can be seen and felt in the practitioner, the practice, and the patients treated.
In Japan at Edward Sensei's clinic, I had the fortunate experience of observing, assisting and performing many successful treatments. Acupuncture, herbal medicine, massage, and moxibustion were employed according to traditional theories. I came to realize that this was real traditional Chinese medicine and that very few others were actually doing it. It was wonderful to see how acupuncture, massage and moxibustion techniques developed out of a necessity to help the patient. It was also wonderful to learn how to use acupuncture, herbal medicine, massage and moxibustion appropriately, depending on the condition of the patient. It seems as though appropriate treatment is disappearing. Seeing the state of moxibustion in parts of Asia, Australia, Europe, and America, I feel that the art of moxibustion has almost been lost, when compared to acupuncture. I learned enough about moxibustion to be able to discern by listening, those who do and do not know anything about moxibustion. Here's a false claim for you: "You can't use moxibustion for heat conditions". Not true. For yin deficiency and blood stagnation, I have used moxibustion successfully a number of times. However, the type of moxibustion and location to administer the moxibustion is very important.
Note 5: The reason real moxibustion is becoming a lost art can be easily seen when you actually perform it. It requires plenty of skill so that your patients will trust you enough to do it to them. Only through hard work and practice can one develop this skill. It is dirty work. You are dealing with these little pieces of moxa wool which turn to black ash upon burning. Your fingers become black and stained. A lot of smoke is produced. Who wants to be in a smoky, dirty, black mess? It certainly is easier to wave a stick of moxa above the needles. Even easier is the smokeless moxa and beyond that is the heat lamp (allowing the practitioner to leave the room and head out for a smoke or coffee). But here's a little secret: Real moxa is effective and worth the effort and your patients will love it! The people who say you can't use moxa for heat conditions are generally the ones who have no experience or skill in performing moxibustion. Just ask them to show you.
In a similar fashion, the art of acupuncture is being lost when compared to herbal medicine. Shocking isn't it! I've heard it said that herbal medicine "goes deeper" than acupuncture. This is simply not true. If we are dealing with energy, why would one modality go deeper than another? Could it be that our acupuncture skills are at such a low level in this day and age? Also, no offense to the herbalists, of which I am one as well, but it is easier to become a good herbalist than it is to become a good acupuncturist. Why you may ask? Well, just think about it. Both disciplines use the same theory and diagnostic methods, but one relies on the herbs and the other relies on the skills of the acupuncturist and nothing more. With acupuncture, the patient goes away with nothing to drink, leaving the acupuncturist to tonify deficiencies. If your skills aren't par for the course, then you won't get much result, especially for difficult conditions. That is why it is falsely said "you cannot tonify with acupuncture, only disperse" or "acupuncture doesn't work for internal conditions". Tonification can be done and internal conditions treated with the appropriate acupuncture. If we continue to believe the current non-traditional and mistaken views, in the future acupuncture students will be taught that acupuncture only treats musculo-skeletal sports injuries.
Note 6: If you think "De Qi" is the sensation of energy, think again. This is more like the mechanical wrapping of tissues around the needle causing a sensation. The real sensation of energy can not be experienced by the novice practitioner so quickly. And why should it? If one cannot insert a needle with the basic mechanics, how could one progress to the energetics right away? It is the same in any art. Look at music or tai chi. It starts with learning the basic movements and correct posture. Once a measure of skill has been gained, then one can progress to more difficult movements and then on to being free / creative / feeling and directing the flow of energy.
Well are you ready for one more? Some people say you shouldn't treat yourself or your family. I'm not sure of the reasons why so I can only take a guess. Perhaps the problem in treating oneself is the difficulty (Only recently have I successfully needled my own sacrum, but the abdomen and legs are no problem.) It certainly is nicer to have another practitioner treat you, but failing that, every practitioner should be able to pop a few needles into their own legs and abdomen. Also, direct scarring moxibustion can be done daily to maintain health. As we know, there is no concrete dividing line between food and herbs so herbal medicine can be taken often (In Japan so many of the herbs we studied in school were readily available. Many of the herbs were used in everyday cooking.) How about daily tai chi and chi gong? With respect to treating one's family, it is a great opportunity to practice on someone very regularly. Family members will be extremely honest as to your skill level and efficacy of treatment (Any practitioner who has treated his own Mother-in-law will agree). Why not help out the ones you love the most? If the objectivity issue lies in the way, meaning, "how can I possibly make an objective diagnosis when I'm so close to the person?", I say, what better way could you find to become more objective? Treating yourself and your family forces you to become more objective. It is possible to give successful treatments to your family members. To the students out there, practicing on yourself and your family is a great way to improve your skills, confidence and health.
Well, I've said a lot (maybe too much), so please think it over. Let's look at what we are doing in Chinese medicine and how we are practising. It's time to set a higher standard for ourselves, our patients, and this fine art. We need to ask questions and search for the answers. If you feel so inclined, get back to me about what you've read here. I'd love to hear from anyone with questions, comments, and opinions. Qi space is a great forum for this! Finally, thank you to Edward Sensei and Ikeda Sensei. I owe you both a great deal!