Here in Portland, Oregon even though our days are still warm, it is clear that we find ourselves firmly in autumn—fall air feels so different from summer air. The kids are back in school, and next week my teaching duties start again at NUNM with a new cohort of students eager to make Chinese medicine their career. There is a great poem from Rainer Maria Rilke that captures masterfully the feeling of the fall time (below is my translation):
Autumn Day
Lord, it is time. The summer was magnificent.
Lay your shadow upon the sundial
and on the plains let the winds howl.Command the final fruits to fullness,
give them two more southerly days.
Compel them to ripeness and then run
the last drops of sweetness into the heavy wine.He who has no house, will not now build one.
He who is now alone, will long remain so,
will lay awake, read, and write long letters,
and in the boulevards aimlessly
wander, while the leaves fall.
Rilke captures so amazingly the melancholy feel of the autumn. Look for your patients to manifest more weakness in the Lung organ-network—an ounce of prevention is worth a pound of cure. Starting about 2-3 weeks ago I started to find most of my regular patients with a weaker than normal Lung pulse. For your patients with a more deficient constitution it might be a good time to start taking a low dose of Yu Ping Feng San.
Shifting gears, two weeks ago I was in Boulder to teach a Sotai workshop with three colleagues, all three of whom were my own Sotai mentors: Stephen Brown, Peter Thompson, Jeffrey Dann. I took it as a rare honor to be included in this cohort of teachers. The two-day seminar was preceded by a three-day retreat farther up in the mountains that allowed us the opportunity to share ideas and exchange treatments.
Sotai belongs to what are referred to as the “indirect methods” of bodywork, which is to say that the movement in treatment is AWAY from pain, restriction, and discomfort and in the direction of ease. This, when one stops to think about it, ought to give us pause. How are good clinical results obtained by moving away from the problem? For example, in Sotai if flexion of the elbow is painful, we have the patient extend the elbow while exhaling. At some point the practitioner resists the motion while the patient continues her effort for a few seconds before we give the command to relax. The range of motion is then passively completed. Such a simple idea that it is surprising that it works at all, but it certainly does.
My point here is not the write about Sotai, but rather to bring up this idea of having accepted wisdom—let’s call it “common sense”— turned on its head. It seems obvious that to increase a limited ROM we need to go into that range incrementally, even though it is painful for the patient. Common sense, right? But it turns out we do NOT need to do that. Another way is possible. What other assumptions are we are making in our practices that might bear closer inspection?
Many people my age know who Buckminster Fuller was. He was an ever-present figure on the cultural scene in the 1960s and 1970s, going from college campus to campus like a troubadour of old. The younger of you will have to look him up to get a picture of the man and his work. (try www.bfi.org) Fuller hit a turning point in his life when he was on the verge of committing suicide. In his own view he had been a total failure at the game of life: a failed company, twice asked to leave Harvard, and his child had passed away. He had no money, no degree, and a record of failure. He decided ultimately that he did not have the right to remove himself from the earth, that perhaps he had acquired some unique experiences nowhere else duplicated, experiences that could be turned to the advantage of all humanity. He determined to work the rest of his life, not in the money game, but in trying to uncover some of nature’s organizing principles that might be turned to the advantage of all humanity. Where did he start? He spent a number of years going back over all that he had been taught in school and at home, examining the bedrock assumptions upon which it was all based. He decided that his experience told him that many of these assumptions were not true. What he arrived at was unique and valuable. I leave it to your investigations however to go into the details of his work (perhaps in a future blog post I will write a bit more about his ideas that have relevance to Chinese medicine). Here I use his example to make the same point I made above about Sotai and questioning our assumptions.
What assumptions might we look at, even if we are seasoned veteran practitioners? How many needles do we need? How deep do they need to be inserted in the patient? Do they even need to go into the patient? How long for needle retention? Moxa or no moxa? What kind of moxa? Should we combine bodywork with acupuncture or not? What kind of bodywork? Do we place our patient on a table or in a chair? How frequently do we treat a given patient? Should we give herbs or not to a particular patient? What dose? The truth is that we were taught many things in our TCM education that we simply accepted without ever giving it a critical thought. I am not suggesting that we should overnight turn our practice habits on their head, but I do think it a good practice to question our foundational assumptions.
Blessings on us all,
Bob Quinn