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Self Care in Chinese Medicine




Fragile blooms. Mixed media. Discovery Bay, 2023.

Growing up in Hong Kong, Chinese medicine had always been a part of life. I used to accompany my grandma Nai Nai on her visits to the acupuncturist. I remember being captivated by the rows of gently twitching needles, each finer than a hair and attached to a tiny wired clip. These sessions were always followed by a visit to the herbal medicine shop, replete with pungent smells and fascinating wares like dried seahorses and sliced deer antler. 


In those days, Chinese medicine was considered by many even in Hong Kong to be a primitive form of folk healing that lacked scientific validity. The Chinese language describes a faith-based,  almost religious quality to our relationship with Chinese medicine - one is either a “believer” (信) in Chinese medicine, or not.  

 

Minding the gap


My conventional medical training in the 80s taught me to worship at the altar of evidence-based medicine, with the most powerful evidence coming from huge randomized clinical trials (RCTs) and expert consensus panels. But over the years, the infallibility of RCTs has diminished, after all statistics are still statistics and don’t always apply to individual patients. While still the gold standard for research evidence, RCTs are often prohibitively expensive and sometimes prove to be inconclusive. And perhaps more troubling, it can be difficult to unravel potential conflicts of interest on expert panels. 



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I was fortunate to have been mentored by Dr Ka Kit Hui during my residency training at UCLA (University of California, Los Angeles). At the time, Dr Hui was already practicing some acupuncture, and he went on to found the UCLA Center for East West Medicine. Under the capitated managed care payment model, he was gaining some traction in demonstrating better treatment outcomes at reduced cost. The gap between academic medicine and complementary/alternative medicine (CAM) was slowly beginning to narrow, at least in California. 


In Chinese medicine, mental health is inseparable from physical health

However when I relocated to start on the faculty at the University of Washington, I was told in no uncertain terms that pursuing my interest in Chinese medicine would be akin to academic career suicide. Even today, almost 30 years later, Integrative Medicine can be viewed askance by those in the purest bastions of basic science. Coming back to analogy with organized religion, there was definitely a blasphemous quality to stepping a toe outside the party line.


East meets West


Over the ensuing decade, more and more doctors all over the country were trained in medical acupuncture, and the CAM movement continued to gain momentum. Driven in part by the growing disenchantment with the limitations of modern medicine, patients and doctors alike began to look beyond for ways to reconnect and empower each other.


When I finally started my own training in medical acupuncture in 2005, I learned that acupuncture was just one of several treatment modalities nested within the doctrine of Chinese medicine. Acupuncture happened to be the one modality that lent itself to clinical trials research, but Western biomedical research techniques were an imperfect tool for trying to understand its mysteries. Turns out that it isn’t that easy to  develop a reliable control or faux acupuncture technique to even study the placebo effect.  


TCM considers the body to be like a garden set within the context of a broader ecology

Chinese medicine itself is nested in the broader tradition of Chinese philosophical beliefs about human life as related to the natural world. These ancient doctrines date back to 2600 BCE. Believe it or not, the Huang Di Nei Jing or the Yellow Emperor’s Classic of Medicine is still included as a foundation textbook to this day. 


At first I found it hard to wrap my modern scientifically trained mind around concepts like the five elements. It seemed impossible to reconcile the relationship between internal organs like the heart, spleen, kidneys, lungs and liver, with the mysticism associated with fire, earth, water, air and wood. 



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But I eventually realized that the point was not to reconcile modern biomedicine with TCM, but rather to understand how these different approaches to healing each have their strengths and weaknesses. Our job as practitioners was simply to share these different toolkits with patients and help guide them to decide how to best meet their needs. This kind of pragmatic and integrative approach, allows us to choose the best of both worlds without having to get locked into dogma.


TCM does have an internally consistent science and logic that’s based on careful observational study and meticulous documentation of patterns and theories over millennia. But in terms of what works for each individual, it will usually come down to what makes sense and feels comfortable for them.


TCM teaches us to see the human body through a completely different framework. Whereas Western biomedicine tends to see the body as a machine, with different parts like engine, transmission, tires, and so on, that need fixing from time to time. But TCM considers the body to be like a garden set within the context of a broader ecology. Climate, sun exposure, and soil conditions all factor into what may cause certain plants to thrive and others, with a lot of trial and error involved.   


Some TCM principles that I often find helpful to share with patients include:

  • Physical and emotional causes for disease are equally important in TCM, meaning that mental health is inseparable from physical health. 

  • TCM relies on the individual patient to guide the approach to diagnosis and treatment, rather than looking to statistics and odds calculations based on population studies.

  • Self care and treatment are aligned in seeking to promote the body’s innate healing mechanisms by enhancing the production and circulation of our life force or qi 气 to combat  and protect against disease.


It’s also interesting to observe that while most Western doctors know nothing about TCM, most TCM practitioners often have an excellent working knowledge of modern biomedicine when trained in China. 


Promoting autonomy


What I love most about Chinese medicine is its emphasis in empowering the individual to take care of themselves. Beyond its various treatment modalities, Chinese medicine teaches important lifestyle practices and principles of self care. TCM fundamentally respects our body’s innate ability to heal itself and encourages us to build a dialogue with, and listen to, our inner healer. 


The wisdom of Chinese Medicine is available to us as a daily practice

Chinese medicine precepts permeate every aspect of daily life for the Chinese in ways that are foreign to many other cultures in the modern world. For example most foods are valued for properties that extend beyond macro- and micronutrients. They are believed to have the potential to influence our life force or qi 气, which is thought to manifest through aspects of bodily function such as energy level, clarity of thought and immune function. 


Every day soups and stews may include functional foods or herbal ingredients like goji berries or huaishan yam 淮山. Mushrooms and spices like ginger used in cooking often have medicinal properties. Even desserts can have health-promoting ingredients like white fungus or red dates. TCM advocates exercise in moderation like light hiking in nature  or gentle movements that train for balance and flexibility like tai qi. Reflexology and tuina massage are also excellent health promoting practices.



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Medicinal mushrooms such as cordyceps and ganoderma are being studied intensively for immune-boosting and anti[cancer properties, as more research continues to emerge on herbs like panax ginseng and rhodiola that enhance our health as we age, The hope is that we may find more treatments that bridge the gap between the wisdom of Chinese medicine and modern biomedical science.


The scope and breadth of ancient healing practices like ayurveda and TCM are gradually being recognized and incorporated into wellness retreats and health promoting services like cupping and massage. But the wisdom of TCM is actually available to us as a daily practice, if we are willing to embrace it. Like when learning a new language, we get to challenge our brains to think in completely different ways, rewiring new neural pathways while also prioritizing self care.   




 


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