Continuity

In 2006, I had the opportunity to visit the museum at the Shanghai University of Traditional Chinese Medicine. This experience impressed me with just how powerful the connection is that exists between the practices of ancient sages and the practice of acupuncture in modern times. True, there has been an evolution that has brought us electroacupuncture, microsystems, French Energetics, and other powerful tools, and there has been much research aimed at connecting the dots between modern, Western science, and the teachings of the Huangdi Nei Jing. (I should add that as a consequence of this evolution, no one still warms needles in their mouth.) Yet, that ancient paradigm, the origin of which is lost in the mists of time, still serves us well. Despite some countervailing opinions, the idea that nature prefers a balance—a balance between Yin and Yang, and that symptoms and disease occur when the balance is disturbed—remains as the most basic tenet in an intellectual framework that has guided healers from the time of the Huangdi to the very present. This concept underlies Five Elements theories, theories of channels and collaterals, Zang-Fu theories, and theories of Qi and Blood. The reason for its success is that classical acupuncture works. Please keep this in mind for, were it not so, there would be no medical acupuncture.

A key difference between Western medicine and Traditional Chinese Medicine (TCM) is that Western medicine, as a consequence of science, is constantly reinventing itself whereas Chinese medicine (including acupuncture) has, by its nature, changed much more gradually and over a much longer period of time. Each trajectory has its advantages and disadvantages.

In the case of Western medicine, sometimes we get it wrong—consider hormone replacement therapy as an example. But, often, we get it right and take great strides in reducing suffering and prolonging life. Consider advances in treating acute coronary syndrome and myocardial infarction. Unfortunately, in many cases, it is not clear whether the current standard of care is any better or any worse than what came before. We can only count on it costing more. So, even though we have the weight of the scientific method behind us, including the “gold standard” of randomized, placebo-controlled, double-blinded studies—whether because of poor methodology, investigator bias, or just plain bad luck, results can sometimes be deceiving.

The body of knowledge pertaining to acupuncture, empirically derived over literally thousands of years, is what it is … There are no standards of care, only a multitude of options to try, and approaches that have worked well for some and, no doubt, not so well for others. Ultimately, treatment choices are made on the basis of experience—and, yes, that inner voice, call it intuition, that guides all healers, even those who restrict their practices to Western medicine. The ancients called it penetrating divine illumination.

Medical acupuncture, through a blending of science and tradition, has added significantly to the options available for treatment. However, we should not delude ourselves into thinking that we have all the answers. In the acupuncture world, we are in the minority, and ours are not the only patients that get better.

In medicine, we make a life-long commitment to learning. We do that, not just for professional satisfaction, but also for the benefit of our patients. As physicians, through personal study and continuing medical education, we generally can maintain a good handle on what we need to know to practice our respective specialties. As acupuncturists, we also know a great deal, but, just as with Western medicine, there is always much to learn. Complacency will limit our potential.

Our commitment to life-long learning also implies the role of teacher. We teach our patients, support staff, medical students, residents, colleagues, and all others who would benefit. It is what we do … this is no different from the ancient sages of Chinese medicine who passed their knowledge along from generation to generation. In fact, the knowledge of acupuncture we have today, we owe to them.

As physician acupuncturists and as lifetime students and teachers, perhaps we should make a pact to be in continuity with all of the students and teachers who have gone before us, and to honor their contributions to the health and well-being of mankind. In like manner, let us commit to honoring all others who draw upon the same healing traditions, those who at times may be our teachers and at other times, our students.

My personal concern is that our professional identity as physicians might pose a constraint to both learning and teaching opportunities as acupuncturists. We tend, after all, to be a tightly-knit group. This form of segregation, however, is not immutable. By widening channels of communication and by sharing educational programs with TCM physicians, licensed acupuncturists, and acupuncture researchers both here in the United States and abroad, we will become instruments of mutual benefit and the ultimate beneficiaries will, of course, be our patients.