Thursday, February 20, 2014

Introduction to Way of the Caveman Healer


When I was a boy growing up in western Japan, I liked to explore the hills behind my house.  One of my favorite places, past the junior high school and the bamboo forest, was an archeological site where I would play in the reconstructed prehistoric dwellings of the people who lived in my area a long time ago.  What was life like for them?  I imagined myself as a caveman, making fires, pretending to hunt game and gather greens.  There was a river not too far away, and I would make excursions to wash myself in a small waterfall, to drink the sweet water.  When it got dark I would head home, and as my eyes took in the setting sun I wondered what the cavemen [1] thought and felt when they gazed at the sun or contemplated the starry sky.

Many years later, I studied anthropology as a university student.  I wanted to understand the phenomenon of human beings, why we do the things we do, how we got to be the way that we are.  I would say that the single best thing that came out of my anthropological education is the evolutionary perspective – the idea that we, along with the rest of life on our planet, are constantly evolving: not evolving towards some kind of physical or spiritual perfection (that would be the outdated medieval view, which places humans at the pinnacle of earthly creation and closer to God at every step, as well as the current New Age view, both of which I reject), but simply adapting as a species to our changing environment.  Based on the evidence, I came to the conclusion that the cavemen were basically just like us, minus the cars and supermarkets and iPods.  They were smart, they almost certainly used language, they solved their problems using their large brains and opposable thumbs, just like we do.  I’m convinced that cavemen loved their children just like we love ours.

Growing up in Japan, and through the practice of martial arts, I was exposed at an early age to some of the ideas behind East Asian healing arts – ideas like qi, the universal energy, and tsubo, or places on the body where one could access the qi flowing through the body to affect health.  After college, I became a high school teacher and spent a couple years teaching in a school district that was about to go under, and subsequently (as one of the younger untenured teachers) lost my job.  The pressures of teaching in a moribund school in an intense urban setting, and the trauma of losing my job, left me with the conviction that I should to switch careers and help people one-on-one in some capacity.  Encouraged by my taiji teacher, who was an acupuncturist, I ended up getting my master’s degree in traditional Chinese medicine, and became a licensed acupuncturist in the state of California.

I loved school and I continue to love Chinese medicine!  I was fascinated with herbal medicine, with how leaves and flowers and bark and insect parts could affect the human body.  It boggled my mind that over thousands of years, the ancient Chinese healers figured out the properties of these hundreds of substances, and that what I was learning was a body of knowledge that had been passed on uninterrupted for so many generations.  When I first pierced the skin of a hapless classmate with a metal needle I experienced an intense initiatory rush, like I had just stepped into an ancient tradition with roots planted firmly in Paleolithic times.  In fact, as I immersed myself in this healing system whose medical terminology consisted of words like wind, dampness, fire, and earth, I found myself transported back to an earlier time when humans related to their bodies and their environment in a direct way.  By considering themselves to be an integral part of nature, rather than separate from and above nature, the ancient Chinese doctors created a superior system of healing that to this day helps millions of people with their pain, their menstrual cramps, their indigestion, their insomnia, and many other ills.  I am convinced that one reason for its success and survival is that Chinese medicine retains a connection to its prehistoric heritage, that it incorporates the awareness that early humans had for their bodies and their environment, an awareness that many of us have since lost.

Now, don’t get me wrong.  Chinese medicine is a sophisticated rational medical system that has been through continuous refinement since its earliest days.  I’m sure there are practitioners and scholars of Chinese medicine who would take offense at having the word “caveman” associated with this jewel of Chinese civilization.  But I would remind them that from its earliest days, Chinese medicine has looked back to a golden age in which people were healthier and wiser.  Earlier in my career I dismissed this veneration of ancient times as a Chinese cultural trait that only existed to legitimize the present by linking it to a glorious and more perfect past.  Now, I wonder if in fact this backward-looking is a yearning for a time prior to war, prior to agriculture, prior to civilization itself: a distant memory of the time of the caveman.

And, at a fundamental level, it’s hard to deny that the logic and methods of Chinese medicine hark back to the medicine men of old.  In fact, according to Richard Grossinger in his far-ranging Planet Medicine, “It is no exaggeration to think of the Yellow Emperor as one of our only guides to late Stone Age medicine [2].”  Cold stomach? Warm it up!  Hot blood?  Lance the skin to let it out!  Wind and dampness penetrating the hip?  Burn a pile of dried mugwort over it and drive out the evil influences!  When I treat and advise patients, it is easy to find myself channeling some Central Asian shaman, scraping the skin with a water buffalo horn or patiently waiting for the qi to arrive between my fingertips as I hold a gold needle to their skin.

From an anthropological standpoint, traditional Chinese medicine and the other nonconventional healing methods that are so popular today present a cultural critique of our modern world and its healthcare.  So many of our health problems stem from the strains placed on us by modernization.  From the epidemic of metabolic syndrome and diabetes that has resulted from our inability to adjust to the massive influx of sugar and processed foods in our diet, to the host of stress-related illnesses that afflict us because we have to work so hard in highly artificial environments just so we can place a roof over our heads and food on the table, to the disruptions to our delicate endocrine systems due to minute amounts of hormone-like chemicals in our plastic food containers and in the water we drink, we suffer from the consequences of our rapid industrialization and modernization.  When a healer - or a patient - embraces Chinese medicine, he or she admits on some level that there is something wrong with conventional healthcare.  Often, this admission leads to a realization that there is also something wrong with the modern society that produced it, and that produced our bad habits and bad health.

So the common sense health advice of the Chinese medicine practitioner can be taken as a gentle reminder that we should get back to our caveman roots and live more balanced lives.  Simply stated, the Way of the Caveman Healer is an approach to managing the ill effects of civilization to regain your health and sanity.  My hope is that, regardless of your current state of health, the Way of the Caveman Healer will provide you with ideas and tools to cope with the stresses and strains of modern living and help to increase your appreciation and enjoyment of life.


[1] When I write “cavemen,” of course what I mean is prehistoric humans of both sexes.  But “cavemen and cavewomen” is quite a mouthful, and “cavepeople” just doesn’t sound right, so I have it as “cavemen” and “caveman” for the sake of convenience and easy reading.  I am not writing specifically about the Cro-Magnon or the Neanderthals or any other single type of early humans, preferring instead to use the term “cavemen” to refer to prehistoric humans generally.
[2] Richard Grossinger, Planet Medicine: From Stone-Age Shamanism to Post-Industrial Healing, North Atlantic Books, Berkeley, 1980. Grossinger is referring to the Huangdi Neijing, or The Yellow Emperor’s Classic of Internal Medicine, one of the oldest preserved books of traditional Chinese medicine, dating back some 3,000 years.  It still forms the basis of the Chinese medical theory that acupuncturists use today.

Simple Horse


My people are a simple people.  We are strict, but we laugh a lot.  We have tender hearts and cry easily.  We are quick to anger and have a righteous streak.  We are stubborn.  We are more about raising children and vegetables than building empires.  We like to work with our hands.  More than a hint of OCD.  A bit on the nerdy side.  Though I am a Horse by birth, I am of the Bear Clan on all sides: the Bernese bear on the Swiss, the ancient waguma totem on the Japanese, and of course the NorCal grizzly through and through.  My wife says I walk like a bear.  Since she is also a bear (a mighty Mama Polar Bear) perhaps she knows it when she sees other bears.

(I am also a Monkey, but for today let's focus on just one of my Multiple Animal Personalities).

I was born in 1966, which makes me a Horse.  A Fire Horse: dangerous yang.  Lucky for me, my wonderful wife is a Water Tiger, which balances my recklessness.  I like to think that the Fire fuels my imagination, keeps me going, and warms those I love.

As a Simple Horse I do not like being corralled.  It is hard for me to get with the program, unless it’s my program.  When I am doing what I want to do, I am enthusiastic and fun to be around, and, I like to think, good at what I do.  When I’m not doing what I want to do I get grumpy and people around me start to complain.

Simple Horse likes to wander the margin, the hinterlands, the zone where society and family and work on the one side lap up against the vast wilds of Nature and Mind on the other.  Maybe I am an Edgetarian.  I believe that this in-between world is a source of great healing power, and that while being healthy has a lot to do with genetics, personal awareness and good habits, it also has to do with resonance and flow and ease.  When I am in the zone, those around me flow easier too, with an overall positive impact on their health and well-being.  At least, that is part of my narrative about being a Stone Age healer in the 21st century.

As a Simple Horse, my attitude towards medicine is very straightforward.  I do not hide behind esoteric theories and white coat attitude. Where there is Stagnation, break it up!  If there is Cold, warm it up!  If there is Heat, cool it down! Drain what is Full and nourish what is Empty.  If you are stuck in your head I will get you in your body.  If you are stuck in your body I will get things moving again.  I’ll probably tell you to take a hike or roll around on the ground.  If you are eating crap I will tell you to stop it, and maybe share some recipes. If you are running around like crazy I will tell you to take a break.  For most people, slowing down is the important thing.  That’s why my clinic is more like an inn than a clinic – a place where you can take a break, enjoy a cup of tea or some herbal liqueur, lie down and relax.  Tell me what is bothering you and I will roll up my sleeves and do my best to help you feel better.  Once you have rested, and feel better, you are better equipped to be on your Way.  And so, you leave the inn and continue on your journey.

Broadly speaking, Simple Horse does not believe in Riders.  Why would I let someone ride me around?  How undignified! Some say the Animal somehow creates the Rider, and that when the Animal dies the Rider vanishes.  Others say the Rider sneaks onto the Animal at conception, when the Animal is still a little jellyroll.  Some believe that when the Animal dies the Rider flies away to a special beautiful place where Riders go to live forever.  I am a Simple Horse.  All I can say is that here I am, it’s pretty great much of the time and not as great other times, and no sign of a Rider anywhere, or of the vast shining retirement home where they all go when we die.

(Some would point out, is it the Animal or the Rider who is writing these words?  Touché.  I would respond that a Brain may equal a Mind, but that a Mind does not necessarily equal a Soul much less a Spirit or even a Self.)

But I do not like to spend too much time pondering existential or theological questions.  My approach is entirely postmodern and phenomenological.  You don’t have to believe anything!  God, qi, the five elements, the authority of doctors or states, it’s all irrelevant.  You just have to embrace the responsibility and experience of having a body, of being an Animal on this amazing Earth with its self-renewing creatures of green and red that eat each other, constantly becoming each other in this ever-transforming thin film of life.  Sometimes I am in awe.  Mostly I just try to appreciate.

My ancestors were awesome!  They were civil servants, newspapermen, tinkers, and farmers. In the last few centuries it seems there was a lake involved.  My Japanese side are Ikeda and Ikeshita, the “Rice Paddy by the Lake” and “Below the Lake,” respectively, and the Swiss side has long resided on the shores of Lake Zurich, wandering there over several generations from Walkringen in the Bernese mountains.  They foraged for mushrooms, they picked and dried flowers and berries, they made liquor out of hardy alpine roots and crisp apples, traded with the folk who came by river from the lowlands.  My Japanese ancestors traveled to the city, they paid in gold and silver for precious powders made by priests who had learned the medicine in China.  My ancestors were bathhouse tenders, preachers, innkeepers.  At some point they were millers.  But mostly farmers and herders.  And before that, for a long, long time, my ancestors – and your ancestors too! - were tracking and hunting other Animals and digging in the dirt for tubers.  They were warming themselves around the fire, they were snuggled together in furs, they washed and reveled in the cold water of the stream, they looked up at the starry sky and wondered.  We are still basically them, plus a bunch of technology and brainwashing.

My ancestors were awesome.  Yours were awesome too; all their adventures and love affairs resulted in you. 

So, I say, learn what we can from our awesome ancestors!  Don’t take so seriously the trappings of status and society.  They’re not what make you happy, and they’re certainly not what make you healthy.

Fortunately, there’s no need to turn into an obsessed and fanatical extremist.  This is not paleo-nonsense, it is not juicing and colonics and 100% organic grass-fed buffalo meat.  It’s just common sense.  One could say, Horse Sense.  Eat real food.  Move your body.  Play.  Love.  Stuff like that.

I am Simple Horse.  I invite you to join me on the Way of the Caveman Healer.

Happy New Year 2014, Year of the Wood Horse!  May you gallop free and strong!  May the rains fall and the plants grow!  Blessings blessing blessings to all!

Monday, October 07, 2013

Prayer for Ingrid

Thank you sun

Thank you earth

Thank you universe

For creating Ingrid

That she could experience your wonders


So sweet, so bright

Such light!

Flower in the summertime


Return to root

Till the new spring

Become the flame

The rain

The wind


Such light, so bright

So sweet

Thank you

For being

Ingrid

Wednesday, July 17, 2013

How to Make We Qi Fermented Pickles


A fun thing to do in the summer is to make your own fermented pickles.  These are the directions we attach whenever we give away a jar.

To give credit where credit is due, We Qi is very much like the Korean national pickle known as kimchi.  But We Qi (pronounced “Wee Chee”) is a process, not a product!  Most importantly, you shouldn’t make it all by yourself.  Make it with your partner, with family, with friends, and your Qi (“breath” or “energy”) will alchemically merge with the Qi of the ingredients, and create a remarkable living food: We Qi. 

Make some, eat some, give some away!  Join the We Qi Revolution!

Ingredients:

            2 medium to large heads nappa cabbage
            2 daikon, peeled and cubed
            ½ cup sea salt
            5 - 10 cloves garlic
            10 green onions
            powdered red pepper or chopped fresh red peppers (adjust to your desired level of heat)
            juice from previous batch of We Qi (optional)
            2 large buckets
            plate
            big rock

Procedure:

  1. Set aside several large outer leaves of cabbage
  2. Chop up rest of cabbage, coarsely, and divide into two buckets for easy mixing
  3. Add half the salt to each bucket, mix well by hand
  4. If you have juice from your previous batch of We Qi, add it to the mix to hasten fermentation
  5. Combine into one bucket
  6. Cover with large whole cabbage leaves
  7. Place upside-down plate over the top
  8. Place large clean rock on top of plate
  9. Cover bucket with moist cloth, bungee-cord it closed so critters can’t get in
  10. Set aside in a cool place for three days, mixing occasionally
  11. Add crushed fresh garlic, coarsely chopped green onions, red pepper, daikon cubes
  12. Cover with moist cloth and set aside another three days – let it get good and bubbly
  13. Transfer to clean jars and keep in refrigerator until ready to enjoy
  14. Adjust for over-saltiness (if necessary) by adding more daikon; adjust for under-saltiness by adding salt
  15. Give away some jars along with these directions so that others can experience the Way of We Qi!

Variations:

Add other vegetables, like carrots, kale, turnips, radish, etc., or other interesting things like kombu seaweed slices or watercress

Add fresh herbs like ashitaba leaves or gotu kola and let them ferment along with the cabbage.

If you are the adventurous type, add anchovy paste, fish stomachs, or other funky matter.

Instead of starting anew each time, just keep adding fresh vegetables, sea salt, garlic to your bucket of We Qi.

Om We Qi Yum!

Tuesday, December 25, 2012

Incarnation

Incarnation
Here we are
  on the cross of space and time
Contemplating the miracle
This precious pause

Saviour
Heaven
Future lives
Enlightenment, even
Comforting speculations
In the face of a single undeniable fact:
Here we are.

Wanting to be off the hook
Wanting to be somewhere else
Easier to dream of a sunnier place
Than to enjoy the rainy here and now

Meat-bodies run amok
In this once-great land
Run by corporations for the corporations
Work work
Buy buy
We are the herds
We follow the songs
  of an invisible shepherd
  who seduces us with things we want
And we don't even notice
The browning of the pines
The dying of the squid
Everything surreal, unreal
When viewed on a tiny screen

When I go
I will be grateful for those I have loved
And who have loved me
And that will be enough.

Incarnation
Here we are
Let's make the best of it



Merry Christmas 2012 Happy New Year 2013!

Thursday, September 20, 2012

On Mushrooms

One morning not too long ago, I woke up early and, unable to go back to sleep, decided to head out for a hike in the pre-dawn chill. As I walked uphill towards one of my favorite dells, I savored the crisp morning air and basked in the light of the recently-full moon setting in the west. I felt myself slipping into that state of mind which only a rhythmic entrainment with nature induces in me: energized yet calm, introspective but wide open, happy and fully alive.

Call it a hunch, call it the effect of a few stray spores floating in the moist air and alerting the olfactory centers of my brain, call it what you will - but for whatever reason I veered off the path and followed a deer trail into a damp area of tan oak, bay, and poison oak. There, as the first rays of the sun hit the leaves on the forest floor, I found my first chanterelles of the season. With the combination of the recent rains and dropping nighttime temperatures, the forest had produced a beautiful little crop of golden-orange manna for me to gather. After picking enough for breakfast (I left the babies for another day, or perhaps for another mushroom-lover), I headed home and made a delicious buttery mushroom omelet for me and my family. What a way to start the day!

Here in Santa Cruz, many people share my passion for mushrooms. But in much of this country, indeed in much of the Western world, mushrooms are looked upon with great suspicion if not revulsion. The great mycologist G. Gordon Wasson divides the peoples of the world into two classes: the “mycophiles” and the “mycophobes.” Fortunately for me, my parents both come from strongly mycophilic cultures. Growing up in Japan, I grew to love the plentiful shiitake, the long and skinny enokidake, the rare and fragrant matsutake which evoked for us the joys within the sad beauty of autumn. My father, who is Swiss, is an avid mushroom-hunter who goes foraging in the hills of Binningen, where he lives outside the city of Basel. His father, a civil servant in the town of Thalwil on the shores of Lake Zurich, served as the mushroom inspector for the community. If people were unsure about the edibility of the mushrooms they had collected, they would bring their harvest to my grandfather to have it checked out.

Aside from a genetic propensity to dwell on mushrooms, to long for them when they aren’t around and to cook and eat them with great gusto when they are, I have maintained a longtime professional interest in fungi. As an herbalist, I prescribe them daily in my practice, usually in the form of the mildly tonifying fuling, sometimes as the more strongly diuretic zhuling, often as part of a formula containing the immune-strengthening, spirit-calming polypore known as reishi or lingzhi. From the Chinese point of view, mushrooms are a yin phenomenon, growing as they do in dark, moist places. The biggest part of the mushroom’s body is the mycelium, a fine network of thready matter that grows through the soil of the forest floor. But the above-ground sexual organ bursts out into the yang of daylight to spread its spores into the greater world. Thus the mushroom when eaten nurtures the dark wet places within us, but also animates our creative and libidinous energies – what Chinese medicine calls “tonifying yin and yang.”

Mushrooms are the great alchemists of the forest, transforming tons of dead and decaying matter into beautiful, edible, perhaps even spiritual morsels. From the delectable morel to the medicinal lingzhi to the psychedelic ‘shrooms that have spread like spores on the wind from the huts of obscure Mazatec medicine women to living rooms and raves around the world, mushrooms have shared with humans a symbiotic intimacy since the dawn of time. When we forage for fungi in the wild, cook them with a few simple ingredients and eat them, we get a taste of Eden. Something in us remembers a time before supermarkets, a time before we left the safety and abundance of the forest for the open plains, a time when a field was just a field and not a place where we planted stuff. When we eat mushrooms, we embrace the long lineage of hunter-gatherers from which we are descended. And, embracing what we truly are, we feel good, and we are healthy.


Note to mushroom lovers: PSYCH!  No, I did not find my first chanterelles this early!  I wrote this piece one October many years ago for my ACUPUNK column in the Good Times.  May the rains begin soon.

Monday, May 07, 2012

A Simple Treatment for Taxol Chemotherapy-Induced Peripheral Neuropathy

About six years ago I started working at a cancer treatment center whose principal doctors, bless their hearts, were open to the idea of their patients utilizing acupuncture as part of their supportive care.  Before I started, I had to attend an interview with the doctors.  One of them asked me if acupuncture could treat peripheral neuropathy.  I wasn't even sure what that was, but automatically replied "Yes!" because I really wanted the job.  Then I went home and read up on neuropathy.  As it turns out, peripheral neuropathy is the medical term for the the numbness, tingling, and pain that can be caused by a number of things, including certain types of chemotherapy.

Sure enough, pretty soon I started seeing patients who complained of exactly these symptoms.  Some got it in the feet.  Most got it in the hands, particularly in the pads of their fingers.  A few got it in their fingernails, resulting in loose nails that seemed like they were on their way to falling out.  Most of these patients were being treated for breast cancer and were on a regimen of the chemotherapeutic agent called Taxol.  A few had other cancers and were on other drugs, such as cisplatin or oxaliplatin.  I tried all kinds of approaches to treat the neuropathy, from standard acupuncture to non-insertive Japanese acupuncture to cold laser to electrostim.  Nothing seemed to help very much.

One day I was inspired to bleed my next neuropathy patient.  In the style of Japanese acupuncture that I practice, we are taught to make a tiny incision and draw a small amount of blood wherever we find "blood stasis."  Typically, blood stasis is indicated by small purplish venules, which we then prick and squeeze to extract a few drops of blood.  But, it occurred to me, the numbness and tingling that characterize peripheral neuropathy could also be symptoms of blood stasis, even with no obvious venules.  So, using a lancet, I bled my next patient, making a small incision near the center of each fingerpad, three or four millimeters from the fingernail.  Quite miraculously, this seemed to work quite well!  In some cases, the neuropathy decreased right there on the table.  In most cases, several such treatments eliminated the symptoms.  Some took longer, and those who had had chemo months or years before and still suffered from neuropathy took the longest.  This technique seems to work well for Taxol but not for the other drugs.  And it works better on the hands than on the feet, though I have had success with foot neuropathy as well.  It is less effective for nailbed neuropathy, even when the causative agent is Taxol (I still do bleed for nailbed neuropathy, though at the corners of the nails rather than on the fingerpads).

I'm not sure why it works, scientifically speaking.  I doubt that it's due to the elimination of toxic chemo agents from the flesh of the fingertips, since the amount of extracted blood is so small.  My suspicion is that the healing is a hormetic effect, which is to say a very small negative impact makes the body respond with a positive effect.  I theorize that the body reacts to the incision by sending chemicals to repel any microbial invaders and heal the wound, and almost as a side effect the affected nerves are also healed.  Perhaps the small capillaries in the extremities are affected by the chemo and work less efficiently than they need to to draw the drug away from the nerves there.  Then, when the skin gets pricked, they perk up and do their job better.

I am not a researcher and have done no true clinical studies on this method, though it would be easy enough to do with a large enough patient population.  But my own experience convinces me that this is a valuable and simple treatment method for Taxol-induced peripheral neuropathy, so I am putting it out there in the hope that it will help many more people.  If you are suffering from chemo-induced neuropathy, I encourage you to try it yourself, or have somebody else do it for you.  Just get a pack of lancets at the drugstore (the kind diabetics use to get a drop of blood), and disinfect before and after with rubbing alcohol to avoid any potential infection (especially if your white blood cell count is low).  Very quickly poke each affected fingerpad, then squeeze out 5-20 drops of blood and wipe with a cotton ball.  Do this a couple times a week for a couple weeks, to give it a fair shake.  Good luck!

Monday, January 09, 2012

Mangos and Pork

Mangos and pork

Who needs a fork?

Dive right in!

Life is for living

Friday, September 16, 2011

The Laboratory and the Real Work

Many years ago I started making herbal liqueurs and tinctures for fun.  Along the way I went back to school to learn more about herbs and healing, and ended up with a master’s degree in traditional Chinese medicine and state certification as a Licensed Acupuncturist.  For a couple of years I worked solely as a clinician, but then, to supplement my meager income and to get good benefits for my family, I  took a day job as a research administrator at the local university, and treated people in the evenings and on weekends.

I stayed at my university job for ten years.  It was a good job, with very little supervision and a lot of autonomy.  The scientists that I worked with came to trust and like me, and to rely on me to manage their grants.  We developed a ritual where, with every successful grant submission, we would share a glass of schnapps.  Over the months and years the drink would vary depending on what I had most recently produced: it could be a strong clear liquor made from the plums growing in my yard, or absinthe, or a mix of spring bitters.  Hanging out with my scientist friends, I came to admire them immensely for the work that they did as well as for the individuals that they were.  Many of them work in biomedical research, peering into the workings of cells and the molecular basis of life, and finding out things that are resulting in a deepened understanding of, and eventual cures for, diseases such as cancer and Alzheimer’s Disease.  But the work they did was so different from my work.  Seized by a problem or a question, they devised experiments to test hypotheses, they ran labs that were devoted to figuring out stuff they were interested in.  I distinctly remember once overhearing a researcher in the hallway, remarking incredulously to a colleague, “I can’t believe we get paid to fuck around!”  I knew immediately that he meant “fuck around” in the best sense of the word, as in trying things out, playing, experimenting, figuring out the problem that occupies you.  I wished I had a job where I could get paid to fuck around!

My administration job changed quite a bit in the last year or so.  With the economy tanking, the trend was for fewer and fewer people to do more and more work.  Plus, I had a new boss who managed to turn my job into that of a glorified clerk.  I used to feel like a valued consultant, advising my PIs (Principal Investigators) on grant-related issues, but more and more I felt like an overheated machine, scrambling to stay on top of never-ending bureaucratic tasks that the University would have done better to hire a student helper for.  While I still enjoyed working and hanging out with my PIs, I came to resent the middle and upper management who were, in my view, making bad decisions, ruining my job for me and diminishing the research enterprise at our university.  So, two months ago, I quit my job.

For the first time in a while, I feel a tremendous sense of freedom.  I still treat patients, but now I have some free time to fuck around!  The place I do it is in my lab.  When I left my university job, my PIs gave me a beautiful apparatus for extracting the active constituents from medicinal herbs.  I set it up in my garage this summer, and have really been enjoying experimenting with it.  I should clarify right away that would I actually do in my lab is quite different from what my scientist friends do.  They seek to find out new things: the application of nanomaterials to the detection of cancer, for instance, or figuring out how tRNAs move on the ribosome during protein synthesis.  I am interested in very old things: medicinal herbs and fungi that were first described a couple thousand years ago. My PIs use very expensive cutting-edge technology to arrive at their results, whereas my equipment is very low-tech, consisting of glass columns, jars, grinder, recycled pressure cooker, and coils of copper tubing.  And, they are way smarter than me, have tons of education, and are eminent in their respective fields.  (I myself am something of a hermit and an unknown).  And, my lab is far dirtier than any of theirs (Environmental Health and Safety would probably frown at my spiders-to-wall-space ratio).

Nonetheless, the spirit of fucking around is the same.  Will the MAO inhibition caused by the beta-carbolines in passionflower increase the antidepressant or sleep-inducing effects of some of the other herbs in this formula?  Should I change the ratio of ethanol to water in the solvent to better extract the active polysaccharides from the ganoderma fungus I just harvested?  Or would it be better to do two separate extractions, one in boiling water and one in pure ethanol, and combine them later?  Should I add some fennel seed extract to the absinthe after distillation, to soften and sweeten the final product, or some fresh melissa? How will it affect the final product if I don’t first decarboxylate the herb with heat prior to extracting it?  These are the kinds of questions that occupy me, and that I can play around with on my equipment.  There is also a more sensual aspect to this fucking around.  Tasting my herbal extracts, combining them, mixing them until they taste right to me and make me feel good, this is also an essential part of the process.

There is a sign that hangs over the door that leads from my office to my lab.  The sign says LABOR.  On the one hand, “labor” is the German word for laboratory.  But there is a double and even a triple meaning.  Labor, of course, also means “work.”  And labor is also a special kind of work – the hard work that leads to birth.  I like to think of my laboratory as the place where I do my “real work.”  It’s not that I don’t consider treating patients to be real work, or unimportant work.  But it’s a very different kind of work, so much so that it doesn’t feel like work to me.  I am fortunate in that I have wonderful patients who are more like old friends.  When I see them, we get to catch up on each other’s lives, chat and hang out while I am cupping their backs, sticking them with needles, or what have you.  My work in the lab is different.  There is a certain rhythm that I get into when I am measuring out herbs, grinding them up, mixing them, packing them in the percolation column, mixing solvents, controlling levels of heat and rates of drip.  There is something ritualistic about it that speaks to me at a very deep level.  I am doing real, time-consuming, physical work, work that takes preparation and clarity and an unhurried sense of purpose.  Making a formula is an all-day, or even a multiple-day affair.  At the end there is a final product – an amber-colored or deep green elixir that, when imbibed, has some sort of predictable effect on one’s body and mind.  I think of myself as an essentially creative person, and when I have created a medicine, it feels like a kind of a birth to me.  The labor has produced something unique, and useful, which then goes out into the world, into my community, where it can do good.

All this talk of labor may seem odd for someone who professes to embrace an easygoing kiraku life philosophy.  But, in fact, I am not opposed to working hard.  It’s just that there has to be a balance.  The kind of work that many jobs entail – forty or more hours a week of brain-frying stress while sitting in front of a keyboard processing tasks with little or no relevance to your day-to-day life aside from the fact that they put a roof over your head and food on the table – is just not healthy.  But to do work that you enjoy is a good thing.  My goal is to work hard in the lab to produce herbal medicines for my patients and friends, continue treating patients in a leisurely and enjoyable way, and have time left over for gardening, hiking, and other fun things. 

Thursday, September 01, 2011

Kiraku: Health and the Take-It-Easy Attitude

Kiraku-An, the "Take-It-Easy Hut"
When people ask me what I consider to be the single most important factor in maintaining health and dealing with disease, my response is simple: Attitude. On the one hand, this may be so self-evident as to not be worth saying (OF COURSE the better your attitude, the better you can handle life and everything it throws your way). On the other hand, it may sound like I’m blaming the victim (“if only your attitude were better you wouldn’t have gotten your illness in the first place”). So I’d like to take a few minutes to explain what I mean.

The fundamental core belief of traditional Chinese medicine is that in health there is flow, and in illness there is a blockage of flow. This “flow” refers to the flow of qi (energy) and blood in the body. By feeling the pulse, palpating the musculature, looking at the tongue, and asking a lot of questions, the acupuncturist diagnoses where the flow of qi and blood is blocked, and applies needles to help restore proper flow. This is why patients almost always feel better after an acupuncture session: they are nudged back towards balance, they experience less pain and discomfort, their overall sense of wellbeing increases. This unblocking and rebalancing allows the body to rise to the occasion and apply its own innate healing force to confront whatever health challenge it faces.
What are the things that can impede flow in the body? Traumatic injury certainly can, as can exposure to environmental toxins. Unhealthy foods “gunk up” the system, as do drugs and alcohol. Various diseases cause their own particular stagnations in the channels and organs. But life itself can create stagnation. Stress, worry, chaos are some of the biggest contributors. Stress causes the qi to stagnate, and over time, if the stress doesn’t let up, this qi stagnation goes deeper and turns into blood stasis, turning less energetic and more material. Eventually the blockage can manifest as a physical accumulation – a cyst or lump, or in the worst case a cancerous tumor.

There is certainly a random element in illness; you can do all the right things and still get sick. Nevertheless, it behooves us to do everything in our power to stay well or get well: eat healthy foods, avoid bad fats, exercise regularly, sleep enough, have loving relationships, a supportive community, and a rich spiritual life. But the single most important factor is your attitude, since without the positive attitude you wouldn’t do those other things in the first place!

Another way of looking at it is that the biggest culprit here is modern living. We have to pay our rent or mortgage, we have to put food on the table, we have to raise our children, go grocery shopping, pay the bills, but in order to do all those things we have to work, and that takes up most of our time, leaving precious little time for all the rest. Fitting it all into a 24-hour day and a seven-day week means we get stressed out. Getting sick on top of it all stresses us out even more. What can you do to break the cycle? Not everyone can afford a radical fix, like quitting your job or moving to Tahiti. But what you CAN do, right now, is take a deep breath, let it all the way out, take a break from whatever you’re doing, relax, get some sun on your face and fresh air in your lungs. Sit and enjoy. Maybe chat with a friend, have a glass of wine, share a simple meal. You may not be able to change how the world works, but you can change your attitude towards it.

There is a wonderful Japanese word, kiraku. Kiraku evokes a sense of leisure and enjoyment, of taking it easy and enjoying life. The word is composed of two Chinese characters: the first, ki, is the Japanese pronunciation for qi, energy or breath. The second character, raku, means enjoyment or pleasure. In its ancient form, the pictograph for raku depicts a drum and bells on a stand. So raku (actually its alternate reading, pronounced gaku) also means “music,” as well as the pleasure produced by listening to music. When your ki is raku, when your qi is flowing in a leisurely way through the channels, there is health. I imagine kiraku as the quintessential attitude of the ancient sages, enjoying an unhurried life and appreciating the qi pulsing in their own bodies and in all of nature. The kiraku attitude is the antidote to modern-day craziness. I believe that it is also the best preventative and treatment for all ills. My studio in Santa Cruz is called Kiraku-An, the “Take-It-Easy Hut” or “Qi Appreciation Hermitage*.” Maybe one day you will visit me there and together we will enjoy the music of leisurely qi. But even if not, that’s OK too. Because the beauty of kiraku is that it doesn’t require a doctor, or fancy equipment, or any money: it starts right now, right where you are, with you.


*An, “hermitage,” is an interesting character, consisting of a radical denoting a dwelling, plus a phonetic component consisting of a character meaning something like “to cover.” But a further breakdown of this component yields the image of a man, and below it the ancient Chinese character shen, originally derived from the image of two hands extending a rope, and therefore the idea of extension or expansion. And, indeed, a hermitage is a dwelling where a man sits in contemplation until he feels a sense of expansion. I prefer an alternate version of the an character, and a different interpretation: the dwelling radical is replaced with the grass radical, giving the image of a rustic thatched hut. And the character shen has long been associated in Chinese cosmology with the ninth of the twelve Earthly Branches, symbolized in the popular Chinese “zodiac” as the Monkey. So the hermitage (or at least my hermitage) is a place where a person (the human figure with arms and legs akimbo, in the middle) can ingest medicinal herbs (the grass radical on top) and enjoy the easy-going life of a monkey (the shen character, on the bottom, with its tail curving out towards the right). Or, if you prefer, the hermitage is a hut where a monkey sits down, and, expanding his consciousness, becomes a man.

Monday, February 28, 2011

In Memoriam: Gus Turpin 1963 - 2010

I first met Gus sixteen years ago as a first-year student of traditional Chinese medicine at Five Branches Institute in Santa Cruz, California. He was a couple years ahead of me, and with his long flowing hair and imposing stature (Gus is well over six feet tall), he made quite an impression. But what impressed me more was the depth and breadth of his knowledge. One afternoon during that first year of school, Gus led an herb walk in the alleys around the school. From the gnarled albizzia tree that greeted me every morning as I arrived for class, to the tenacious passionflower vines that took over entire neighborhoods and astounded passers-by with their blooms of alien ultraviolet, to the humble prunella that grew on the edges of dusty walkways, Gus knew the medicinal uses of all these plants. As a newbie to the world of herbal medicine, I was surprised first of all that these plants I had taken for granted had medicinal uses at all, and secondly by how much there was to know about them! For Gus possessed an encyclopedic knowledge of healing plants, and his unrehearsed lectures gave me a first glimpse of how his mind worked – synthesizing Chinese energetics with biochemical understanding and mixing in a dollop of Ayurveda here and a tidbit of medieval alchemy there.

As I got to know him better, I came to understand that Gus’ mastery of herbs came from his own intense curiosity about the world. His passion was the rich, deep realm where mind, spirit, and plants overlap and interact and play. His company, Shamanic Tonics, specialized in “spirit herbs,” and each and every one of his formulations was only offered up to the public after rigorous in vivo testing conducted on himself (and his lucky friends!). I remember one day Gus announced, quite dramatically for him, that he had “tamed the wild mahuang!” Back in those days ephedra was still legal, though the FDA was taking an interest in it due to a few unfortunate incidents in which people had abused it as an “herbal upper” to the point of death. Gus wanted to tone down mahuang’s stimulant properties, and hit on the combination of mahuang and reishi (a spirit-calming and immune system stimulating medicinal mushroom) to do just that. I remember some really fun and interesting hikes trying out that stuff. It came to market as Fungalore, and became quite the hit at dances and parties before mahuang was banned.

Gus was a very spiritual guy, a true seeker, whereas I was and am more of a skeptic. Yet, we had great discussions about everything from Tibetan Buddhism to Shinto animism to Amazonian shamanism. Regardless of our fundamentally different orientations, we shared a deep interest in religion and consciousness. I took an anthropological interest in history and religion as a record of humanity’s attempts to understand the world; for him spiritual traditions were a practical guide for his own explorations of mind and nature. He revealed to me once that he thought we had known each other in a past life. Though I would ordinarily shoot down such a statement in my usual rational way, at the time I paused and savored it, because I had to agree that we shared a bond that, whether or not it involved reincarnation, demonstrated some kind of karmic connection that I could not deny. And, not insignificantly, I took it to mean that he considered me his friend, and that made me happy.

In the years after we finished our master’s degrees in Chinese medicine, Gus moved away from Santa Cruz, settling in Northern California near Mendocino. I think the slower pace of life and immersion in lush forest suited him well. We kept in sporadic touch by email and phone, and every now and then I’d find a package in the mail stuffed with fresh matsutake (Gus and I shared a love of mushrooms), or a sample pack of a new herbal formulation, or an article on kanna or blue lotus or whatever else was occupying his interest at the time. This was typical of Gus: so generous, so giving.

Some years ago Gus gave me a piece of writing he had authored. It was about his fascination with the young god Dionysus. I wish I had kept it, so I could read it over again in my effort to understand him better, to try to understand why he is gone. Because I still don’t understand. I saw Gus a couple of months before he died. We went on a hike in the Berkeley hills with our friend Andy. He was in the process of moving from Mendocino to the Bay Area, and was excited about some new prospects for his company, about reinventing himself and his business. He seemed content. We had a great time; it was like old times, Andy driving like a crazy man, Gus with his long stride leading the way as we hiked, pointing out flowers, talking about plants. He would have made a really great teacher at any Chinese medicine or naturopathic school.

Soon after we became friends, Gus gave me a baby gotu kola plant. Gotu kola is an Ayurvedic herb that is revered for its effects on the brain and nervous system, circulation, and skin. It has since become one of my favorite herbs. Gotu kola is easily propagated, as it spreads runners that put down new sets of roots and establish babies that can be dug up and given away. Over the years I have given away many such babies, to friends and patients, as well as tinctures and teas that I made from the harvested plant (I’ve eaten quite a bit of the fresh leaf as well). I think of the gotu kola as Gus’ good influence, spreading outwards in an infinite web, doing good, humans and plants working together for the betterment of all. Like I said, I’m not so sure about reincarnation. But if anybody would consciously reincarnate as a plant, it would be Gus. Perhaps his consciousness is spreading through the world as gotu kola. Perhaps, every time I take a nibble, I re-enter that Dionysian wave. Perhaps, as I graze, I will get my friend back, just a bit at a time, in subtle explosions of metabolism and neurology, as plant and mind merge and my grief (I hope) slowly diminishes to be replaced entirely by a love and appreciation that grows only deeper with time.

Tuesday, February 16, 2010

I Dream of Judo

A couple nights ago I had a wonderful dream: I was playing judo with my childhood judo teacher, Umeki Masaru Sensei. It's no mystery why I had the dream. The day before I had begun reading Higher Judo by Moshe Feldenkrais. Feldenkrais is best known as the originator of the school of movement education that bears his name. He was also a physicist and engineer as well as an early student of Jigoro Kano, the founder of judo. We see in his writing some early glimmers of how judo would inform his method, as in this passage: "Many people have never made any but the most primitive use of their feet, with the result that the only use and idea associated with them, is that of a plate-like support to the body. This being the only use made of the feet for many years on end, the muscles are most of the time maintained in a fixed state of contraction - precisely the one that makes the feet fit for the service demanded of them. In extreme cases the exclusion of other patterns is so complete, that the feet become frozen in the flat, plate-like position and are useless for any other purpose than motionless standing."

Reading Higher Judo, I was struck by the degree to which Feldenkrais was obviously influenced by Kano's vision of judo as something that went beyond martial art, as a physical/educational/developmental system with a unique pedagogy that helped the practitioner achieve a certain completeness as a human being: "The understanding Judo teacher does his best to further the maturing process of his pupils in this respect, showing them that it is essentially a question of learning and not of infirmity. He, therefore, literally helps his pupils on the way to adult maturity."

The introductory chapters of Feldenkrais' book helped me remember the impact that judo had on me as a child (the rest of the book, on judo groundwork, would have been better served by an instructional DVD, to my Youtube-generation mind). From age eight until fourteen, I strove to perfect my skills in judo under Umeki Sensei's tutelage. I was a skinny boy, something of an egghead, and not at all a natural athlete. I am convinced that, were it not for judo, I would have turned into an ungrounded intellectual with very few physical skills and very low confidence in my bodily abilities. As it was, I learned from an early age to fall and roll and throw and pin, and I believe that has made all the difference. Though I didn't get in fights often, when I did I would throw my opponent to the ground and that was usually the end of it. My favorite pin is a wonderful move called katagatame ("shoulder pin") that to this day nobody I have fought has ever escaped from, including a fellow soldier in the Swiss Army who challenged me to a friendly wrestling match and had at least twenty pounds on me. Judo fostered in me, as Feldenkrais puts it, "a degree of independence of gravitation" that demonstrated to me that, with the rational application of the correct method, one could free oneself of other types of restraints one might come across in life.

Which is not to say that the journey to be free from gravity or other forces was always easy. For instance, I had a natural affinity for leg techniques such as ashi-barai and osoto-gari, and was not very good at applying upper-body throws such as seoi-nage in competitive situations. Somehow I never overcame the mental block that kept me from using seoi-nage. I am not naturally very aggressive, and seoi-nage requires a certain chutzpah and quickness that I didn't think I possessed. In hindsight, I wish I had applied myself to push past this limiting self-definition.

Shortly before leaving Japan for the United States at the end of the ninth grade, I tested for black belt and didn't make it. Black belt testing consisted of entering a tournament of aspirants of the same age, and competing in round-robin fashion. If you won three matches in a row, you got your first degree black belt. I lost my first match, and over the following weeks was a little jealous of my friends Fujita, Wakamiya, and Arakawa, who got to sit up at the front of the class next to Umeki Sensei with their impressive new black belts on.

When it came time to leave Japan, I went to say good-bye to Umeki Sensei. I was surprised and honored when he gave me his black belt as a parting gift. I believe that what he meant by this was not "Here, you deserve this," but rather, "You may not be very good, but I've come to like you so here, keep this to remember me by."

In my dream, Sensei and I were doing judo on the familiar mats of the old dojo, he throwing me around and I occasionally throwing him when he deemed my technique good enough to work had I been matched with someone closer to my ability. The smell of rough cotton gi blended with sweat and Sensei's Mild Seven tobacco aroma, the feel of the cold tatami mats as I was slammed down time and again, the thrill of throwing my teacher, it all came back to me and I was just so happy. Thank you, Sensei, for playing judo with me again after so many years.

Tuesday, August 04, 2009

The Hokey Pokey: Acupuncture, Placebo, and the Persistence of Bias

Title of the front page article in the July 2009 ACUPUNCTURE TODAY: “Acupuncture Found Effective for Back Pain: Study finds it superior to usual care.”

Title of a June 1, 2009 article in NEWSWEEK by science writer Sharon Begley: “Hooked on a Feeling: This is your brain on a placebo.”

Believe it or not, these articles report on the exact same recent acupuncture research. As their titles reveal, they reach basically opposite conclusions. The research in question, conducted by Daniel C. Cherkin et al and published in the Archives of Internal Medicine, May 11, 2009, under the title “A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back Pain,” utilized a cleverly constructed experiment to try to determine whether acupuncture was effective as a treatment for low back pain. 638 adults with chronic low back pain were split into three groups. One group received “individualized acupuncture,” in which the acupuncturist could use any points he or she wanted, as long as the patient was lying prone. The second group received “standardized acupuncture,” an eight-point combination consisting of the points Du-3, UB-23, UB-40, K-3, and a low back ashi point (an excellent prescription, though the ashi point, referring to a tender point, makes this “standardized acupuncture” somewhat individualized to my mind). The third group received “simulated acupuncture,” or, as acupuncture detractors prefer to call it, “sham acupuncture.” In this group, the patient would lie face down as in the other groups, and the acupuncturist would press an acupuncture needle guide tube against the same points used in the “standardized acupuncture” group, then simulate needle insertion by tapping a toothpick gently against the patient’s skin. None of the patients in any of the groups knew which group they were in, and, presumably, all thought they were receiving some kind of acupuncture. All patients received ten treatments over seven weeks, and outcomes were assessed after eight, twenty-six, and fifty-two weeks using the Roland-Morris Disability Questionnaire and a 0-10 range “symptom bothersomeness” scale.

Much to the delight of acupuncturists everywhere, the results showed that acupuncture “improved function and decreased symptoms,” and, furthermore, the improvement was significantly better than that resulting from usual care, even one year later. Interestingly - and here is the crux of the dispute between the pro- and anti-acupuncture camps – it didn’t make a difference whether a patient received “real acupuncture” of the individualized or standardized variety, or whether they received the non-penetrating “sham acupuncture.”

Now, this is food for thought. It is quite easy for the acupuncture-uneducated reader to leap to the conclusion, as NEWSWEEK’s Begley does, that “the most parsimonious explanation for that finding is inescapable: it is possible to think yourself out of pain.” In other words, if sham acupuncture works as well as real acupuncture, then all acupuncture must work because of the placebo effect.

Let me make my own bias clear: I am an acupuncturist. I believe that there is something going on other than mind over matter when I treat my patients and they get better. I think that acupuncture is a connective tissue therapy par excellence, and that the traditional East Asian approach to treating the human body’s ailments via the skin and connective tissue is far more sophisticated than the cutting edge of conventional medicine.

That said, I believe that there is also something to the whole placebo thing. Of course the placebo effect is part and parcel of how acupuncture works! Placebo effects are part of how any healing method works. It is a credit to the ancient Chinese doctors that they incorporated into their medicine methods that improve clinical outcomes through, to use the medical lingo, “nonspecific effects.” Yes, it helps patients to listen to them! It helps patients to palpate them, to look at them, to spend more than five minutes with them! My hope is that one of the outcomes of placebo research is that conventional medicine will reincorporate some of these things, to give it a softer edge, more compassion, less arrogance, and yes, better outcomes.

It appears to me that acupuncture has reached a tipping point in modern society. There are so many people who have benefited from acupuncture that it is simply getting accepted by the mainstream as a viable therapeutic method. Acupuncture poses a challenge only to those hardcore skeptics who cannot stand the thought that a method utilizing unscientific concepts like “qi,” “the five elements,” and “yin and yang” could possibly work. Their disbelief of acupuncture is akin to someone refusing to believe that a samurai sword can cut because their fundamentalist mind takes issue with the Shinto ritual that dictated the ancient swordmaker’s forging. Such people seize upon a study such as Cherkin’s as proof that acupuncture only works because patients believe that it does. They fail to consider alternate explanations, even though the authors of the study themselves spell out the possibility that “superficial acupuncture point stimulation directly stimulates physiological processes that ultimately lead to improved pain and function.” The research of MacPherson et al with functional magnetic resonance showing that superficial and deep needling elicit similar blood oxygen level-dependent responses in the brain suggest as much (Neuroscience Letters 434, 2008).

My strong suspicion is that acupuncture works not through a single mechanism but through multiple mechanisms. Something very physical happens when you insert a needle through the skin and tap at the surface of a myofascial trigger point until it releases with a palpable and visible fasciculation. Other acupuncture techniques are more “energetic” and mysterious but equally effective. There are entire schools of non-insertive acupuncture that rely on the practitioner feeling a pulsation or tingling where the needle meets the skin (the patient often feels something as well) to assess its effects during a treatment. I believe that this type of acupuncture is a means of interacting with a primitive electrical signaling system that utilizes the body’s connective tissue as a conductive direct current network. Deep needling may or may not utilize the same mechanism to produce its therapeutic effects. Ear acupuncture most likely utilizes yet a different mechanism – probably neural. For Sharon Begley or any other skeptic to decide for the public what “real acupuncture” is represents the height of arrogance. Perhaps there are many types of “real acupuncture,” and “sham acupuncture” is actually a type of real acupuncture!

There is an excellent quote in the book Herbal Emissaries by Steven Foster and Yue Chongxi, in which the authors state (about ginseng, not acupuncture): “Chinese researchers…have focused on how ginseng works, whereas western researchers focus on if it works. This reflects a fundamental difference in research approaches between the East and the West. In Asia, the efficacy of an herb is already established in a cultural context. In the West, we presuppose that traditional uses have no rational scientific basis.” The same could be said for acupuncture. There are already plenty of studies showing that acupuncture is effective for back pain, or nausea, or whatever. It’s great that these clinical studies are getting more sophisticated. But as the response to the Cherkin group’s research shows, people read into these studies what they already believe. The Acupuncture Today article never once uses the word “placebo” in discussing the possible interpretation of the results, and the NEWSWEEK article never once entertains the possibility that acupuncture works by a mechanism other than placebo.

I wish that instead of these sorts of studies, and in addition to better and more placebo research, scientists would do more basic research into how acupuncture actually, physically, works. It’s hard to argue with fMRI imaging that shows that the needling of points associated with the treatment of vision disturbances lights up the visual cortex of the brain (as Cho et al report in PNAS, vol. 95 no. 5, 1998), or that needle twirling at acupuncture points results in mechanical signal transduction in the connective tissue with far-ranging effects (Langevin, in the Journal of the Federation of American Societies for Experimental Biology 16:872-874, 2002).  I predict that the next generation of acupuncture research will demonstrate that acupuncture turns specific genes on or off to achieve its effects - and that these studies will be done on (presumably unbiased) non-human mammals.  I don’t feel any particular need to validate what I do to skeptics. I’m quite comfortable with the witch doctor element in what I do, and it’s good enough for me that my patients are satisfied with the care they receive. But I do realize that strong scientific evidence would ultimately result in more people benefiting from acupuncture. And I think that fundamental research in the biophysics and biochemistry of acupuncture would serve this end better than clinical research, which somehow just seems to strengthen one’s bias, whatever it might be. Perhaps I am being naïve, and no amount of studies will convince either camp that the other is wrong. For some reason acupuncture rubs some people the wrong way much like astrology or intelligent design do. But I predict that, with or without studies, acupuncture will continue to gain acceptance simply because more and more people are benefiting from it and its usefulness is becoming a matter of conventional wisdom in the same way that people accept the validity of many surgical procedures that have never been tested but continue to be used because of their self-evident efficacy.

If the placebo effect is hokey, then there is something hokey about acupuncture. The placement of needles at acupuncture points, with or without penetration of the skin, is certainly pokey. There is a magic that happens between the mind and the body, and between two interacting human beings, that unites and transcends the hokey and the pokey. That magic is called “healing.” When it comes to healing, maybe the Hokey Pokey IS what it’s all about. Just put your left hand out and I’d be happy to show you.