A Blue Poppy blog post by Bob Quinn
One can sit on a one-legged stool; it is a bit of a balancing act, but it is possible. A two- legged is a bit easier but also not really so relaxing. It is not until one gets three legs on the stool that real comfort and stability is possible. The triangle is after all the smallest stable structure in nature. This is a big part of what Buckminster Fuller used to formulate his ideas on how the universe works.
What does this have to do with Chinese medicine, you might ask? I think we are faced with a similar situation with our own three-legged stool. Our three legs are:
- scholarship
- self-cultivation
- manual skill development
Chinese medicine is simply too vast to acquire all the information we need to know in our 3-5 years of education at a school. We need to know much more than that, and ongoing study is thus essential. Ideally we develop a relationship with a teacher who gives our study some direction; otherwise there is the danger of being a bit willy-nilly about what we focus our studies on. Very few of us are cut out to be genuine scholars (I am certainly not) who work long hours in primary texts, comparing commentaries and so on; but the scholarship leg of the stool does not require that. It merely requires a commitment to stay in touch with the old and the new in Chinese medicine. Keep reading, keep thinking, keep exploring.
By cultivation I am not simply referring to personal qigong and taiji training (or other martial arts), although that sort of training can be a big help. I am also talking about the cultivation of our senses. I have had the great good fortune to study with a few master practitioners. They all have this element of heightened sensory awareness. They see what I cannot yet see; they hear something in the patient voice that I miss; when they touch they pick up a story in the flesh that I, in my not-yet-developed state, pass over. This is the sort of cultivation we need to advance our skills.
William Blake wrote: Singular and particular attention is the foundation of the sublime. If we want to practice at a level that our patients describe as sublime, and this is certainly possible in Chinese medicine, then this is our path: The details, the particular. If we pass by three different types of tree and see simply “leaf,” then we have missed the details. If we have three patients in a row that are all diagnosed as exhibiting LR Qi Constraint, do we see them as the same and treat them in a protocol-driven way—just like with the three different types of leaves seen as simply “leaf?” Or do we pick up the subtle individual differences and treat each patient as the unique being s/he is? This is what cultivation of the senses can do for us and for our patients.
The third leg of the stool is not sufficiently appreciated in the US. Most American students of Chinese medicine seem to fail to appreciate how many hours of dedicated practice are necessary before the needles come alive in our hands. Any person on the street can be taught in a few minutes to tap a needle in. It is not difficult. Acupuncture is much more than that though, much more. Let’s create a thought experiment: Let’s say you study precisely where a master inserts a given needle and you have a machine duplicate it in every way, including angle, force, speed, twist, and so on. I contend that the effect the master achieves will not be duplicated by the machine. There is an added something, so hard to define, that comes with a lifetime of holding a needle in one’s hand. A master has that, and a machine will never have it. A student who has not practiced sufficiently will also not have it in his/her hands.
We need to commit to regular practice of needling, of palpation, and of our various assessments. This should not end when we graduate from TCM college. It needs to be ongoing. Anyone in a craft understands how many hours of practice are needed before mastery is attained. It is no different in acupuncture. You have to make of your current hands the hands of an acupuncturist, and this takes years. That is the reality, as simple as it might seem to simply get the needle in.
When we touch a patient, it is a two-way communication that is set up. It is not the case that we are simply gleaning information from the patients’ bodies. They also get to take our measure, whether we want that to happen or not. What does our touch communicate? Uncertainty? Lack of confidence? Lack of really practicing enough? Or have we done our work, and our touch communicates competence, confidence, and compassion?
My hope is that students of TCM read this blog and take it to heart. All three legs are important. Our schooling emphasizes the knowledge base of Chinese medicine, and, as I mentioned above, that is of course important, but it is only one leg. There are two others. We need the cultivation, and we need to practice our manual skills regularly. For the sake of your current and future patients, please consider putting a plan in place that engages all three legs.
Best wishes all around,
Bob Quinn