my visit to a traditional chinese doctor

8/9/2019 My Visit to a Traditional Chinese Doctor

1/7

My Visit to a Traditional Chinese Doctor

David Moser

I have lived in Beijing, China for over ten years, and in that period of time I haveconsulted traditional Chinese doctors many times. This is not because I believe inTraditional Chinese Medicine (TCM), but because as someone with a Chinese wifeand numerous Chinese relatives and friends, I am constantly being urged to go see atraditional doctor when suffering with the usual vague but persistent health problemsthat we all have from time to time. Since I dont feel there is any harm in this, and for the sake of sparing feelings and face, I sometimes good-naturedly comply with their insistent advice, and consult one of these doctors.

One interesting aspect Ive noted about TCM doctors is that in their diagnostic

methodology and their overall doctor-patient dynamic, they employ the sametechniques as Western psychics and mind readers. One recent experience I hadillustrates my point.

I recently mentioned to a Chinese colleague that I had been experiencing someshortness of breath; nothing very serious, just a mild discomfort that I attributed to the

polluted air in Beijing and a lack of exercise. My friend, however, insisted that I seeher uncle, a TCM doctor who had legendary diagnostic powers, and had supposedlydetected and cured all sorts of diseases that Western doctors had missed or mis-diagnosed. At first I politely declined her offer, but after she took it upon herself tocontact her uncle and set up an appointment, I gave in to her well-meaning gesture.

Dr. Jias office was in a narrow back alley situated in Beijings Chaoyang District.The facility was clean but spare, with just a few examination tables and minimalequipment. In most Chinese hospitals, the patients have very little privacy, with theconsultation taking place in the examination room along with all the other patients,who can hear and see everything the doctor does. This day was no exception. (Whena patient needs to disrobe, the other patients are asked to wait outside, of course, buteven in this case doctors can be quite lax. I once had a flu shot applied to my buttocks

in full view or two old ladies in the room with me, who I could hear whisperingtogether about the alabaster quality of Caucasian bottoms.) So as I waited my turn, Iwas able to freely observe the doctors interaction with his patients.Dr. Jia was just beginning to session with a petite young woman who looked to beabout 25. She sat down on a bench in front of the doctor, and without a word heimmediately began taking her pulse. In the typical TCM consultation, the doctor doesnot begin by asking the patient about symptoms that would too easy. Rather it isthe doctor who is suppsed to tell the patient what the problem is. The better the doctor,the more he or she is able to determine the patients condition merely by taking the

pulse and observing outward signs. (The pulse-taking process is very complicated


2/7

and esoteric. The doctor supposedly can detect over 15 different kinds of pulses.) Dr.Jia took the womans pulse for a minute or so, then suddenly released her hand andsaid When did you have the abortion?

Now, this question was clearly designed to demonstrate the doctors nearlysupernatural skill at instantly divining intimate details of the womans medical historymerely by taking her pulse. But actually, in the Chinese context this question does notconstitute a particularly daring leap of intuition. In the PRC, abortions are cheap,encouraged (mandated, in many cases), and thus very common. The average Chinesewoman will have 1.7 abortions in her lifetime, and young, sexually active women arefairly likely to have had at least one. Thus, like any good psychic in the West, thedoctor was making an exploratory guess that had a pretty good chance of being true.It would similar to a psychic in southern California, where the divorce rate reacheswell above 50%, asking a middle-aged woman When did you get the divorce?

Despite all this, however, Dr. Jia actually missed on the first try. The woman said shehad never had an abortion. The doctor, not missing a beat, simply switched gears andsaid Then it was a spontaneous miscarriage. Did you recently miss a period and thenhave an unusual menstrual discharge? Bingo. Yes, this had happened just in the lastyear, the woman admitted. So that was a miscarriage? she said, voice trembling andsuddenly visibly upset. The doctor took advantage of this, adopting a doctorly tonethat Marcus Welby would have envied, telling her gently that this miscarriage haddamaged her spleen and kidney, and had also disrupted her blood flow, but he couldcure her. No one was bothered by the doctors shift from an abortion to miscarriage,since these two medical events seem intuitively similar in nature; i.e., the doctor atleast had been able to tell that a conception had taken place, and then terminated.

Having proved his awesome diagnostic powers, Dr. Jia no longer had to maketentative probes. The medical condition had now been identified; the only task remaining was to fit the symptoms to the disease. The woman, having been surprisedand shaken by the doctors ability to penetrate her most intimate secrets, was nowcooperating with him fully. She said that she had come that day to complain of extreme migraine headaches and dizzy spells, but suddenly she also remembered that,

yes, she had been having some menstrual irregularities lately, and could that berelated to the miscarriage? Dr. Jia assured her that dizzy spells and headaches were

precisely what one would expect in a situation like this, and that the menstrual problems were, of course, directly related to her condition. None of this informationwas supplied by the doctor, of course, but he had coopted the symptoms almost as if they had been a part of his diagnosis. He even added a small confirmatory touch:And youve been having some blurring of vision, right? The woman nodded,amazed again at his predictive powers though blurred vision would not exactly bean unexpected co-symptom of migraine headaches. As Dr. Jia wrote out a

prescription for Chinese medicine, he offered some avuncular admonitions about her sex life, speaking in a whispered voice that was still quite audible to everyone in the


3/7

room. He handed the woman the prescription, and warned her to avoid cold food anddrinks as well as acidic fruits and vegetables.

Then it was my turn. I opened my mouth to say something about my symptoms, but

he simply waved his hand to silence me, and began to take my pulse. He started withthe left wrist, shifting locations slightly and applying slight pressure to the vein, allthe time staring vacantly off into space as if contemplating the mysteries of thecosmos. The whole examination couldnt have lasted more than three minutes.Then his face suddenly brightened and he said triumphantly, Ive got it! Its your heart. He then looked me in the eyes for the first time and said About a year agoyou had had some great shock, or stress, that damaged your heart, causing it to beatand contract in the wrong way. What was that shock? I sincerely tried to think of some emotional catastrophe that might have befallen me a year or so earlier, butnothing came to mind. Seeing that no answer was forthcoming, he simply shrugged

and said Dont worry, youll think of it eventually. We tend to block out unpleasantevents from our memory. This was a clever move, I thought; my drawing a blank was construed as confirmation of his theory!

Since his first tactic yielded no fruit, Dr. Jia turned to my symptoms. Have younoticed your heart beating irregularly after mild exercise? he asked. Not really, Ianswered, offering no additional information for him to work on. He continued to

pursue this line. But surely youve noticed that your heart takes an unusually longtime to return to normal after exercise, like running? This seemed an obvious

plausible guess. What man of my age (49) would not notice that his heart is workingharder than before? I decided to help him out, and told them that I had beenexperiencing some shortness of breath.

This was all he needed. He proceded to lecture me about the connection between theheart and lungs, reminding me that shortness of breath is the first sign of heart trouble.To give him credit, he had indeed zeroed in on the chest cavity as the problem (thoughhe may have simply noticed me taking a few deep breaths while I was waiting myturn). As he wrote out a prescription for me, he said Western medicine has a historyof only a few hundred years. Chinese medicine has a history of thousands of years.

There are some very deep principles that we have discovered that your culture doesntknow about. He then cautioned me to avoid cold, raw foods, acidic fruits, and colddrinks same advice he had given to the young woman before me. This is a

problem with you foreigners lifestyle. Too much cold water, cold salads, and thelike. Disrupts your energy flow. 1 Thus concluded my examination.

Heres an important bit of information I had not shared with Dr. Jia. Just two monthsearlier I had had some minor surgery. Would there not be all sorts of blatant1 Chinese folk medicine is obsessed with issues of heat and cold. A host of ills from fever blisters to premature

balding are attributed to the untranslatable condition of shang huo (meaning something like an excess of internal bodily heat). Menstruating women avoid anything cold, newborn babies are wrapped up like mummieseven in the heat of August, and a bewildering list of foods are to be restricted at certain times because they increaseor decrease internal heat.


4/7

indications of such an intrusion into the body cavity? Would not such a medical event play absolute havoc with my qi? Surely such a procedure would disrupt my energyflow in some way? Yet Dr. Jia had said nothing to indicate an awareness of thisaspect of my medical history.

Later I mentioned to my friend that Dr. Jia had not even mentioned the surgery, whichwould seem to be a salient bit of information. That must have been the shock to theheart he was referring to! she said. So the doctor was right after all!

This experience is typical of my interactions with TCM practitioners. In the processof these visits, I began to notice a number of similarities to Western psychics I hadmet or seen on TV. This is a rather interesting cross-cultural parallel, and perhapsdeserves to be spelled out in greater detail. First of all, the psychic and the TCMdoctor have similar skills and use similar methods:

The TCM doctor, like the psychic, is considered to have an innate ability to perceive phenomena inaccessible to ordinary people. Though it is assumed that agreat deal of training and experience are necessary prerequisites, in actual

practice the TCM doctors diagnostic skill is treated much like that of a psychic,i.e., as a mysterious supernatural ability.The TCM diagnosis is similar to a psychic reading. For many traditionalChinese doctors, the examination process is as much for the purpose of provingthe shaman-like powers of the doctor as it is to diagnose the patient. Like

psychics, doctors use various psychological techniques and commonsenseknowledge to probe facts about the patients condition. If they hit pay dirt, theycontinue to exploit this nugget; if not, they back away and try another tack.The psychic and the TCM doctor both share the technique of exploitingemotional factors (fear of the unknown, guilt over perceived sins, grief over theloss of loved ones, etc.) to make the clairvoyant effect more striking. And, aswith the psychic reading, the TCM patient must enter into a collaborativerelationship with the doctor, or else the entire process falls flat. Faced with anuncooperative participant who does not volunteer or confirm details, neither thedoctor nor the psychic can carry out the trick to its conclusion.

The evaluations of both psychic and TCM doctor are sufficiently broad and vagueso as to leave a great deal of room for interpretive fudging of available facts. The

psychic does not make predictions like A man named Alan Chesney from acompany called NetWire will offer you a job at 3:00 tomorrow. Take it. Instead,they say A life-changing opportunity awaits in the near future. Be open to it.In the same way, a TCM doctor will not say Your cholesterol level is 240 mg/dl.Restrict the amount of fat in your diet. Rather they will say Your qi needs to beadjusted. Avoid cold things. Nothing is quantified or clearly specified, and fewspecific prognoses are given. Almost any symptom can be an indication of anycondition.


5/7

Secondly, there are a host of default assumptions and framing effects that tend toguarantee the success of both domains:

TCM and psychic practice both deal with domains in which causality is vague

and ill-defined, and where there is no clear criteria for success. In the XXdictionary, the indications for most of the drugs listed are for conditions likeheadaches, fatigue, malaise, abdominal pains, appetite and digestion problems,menstrual problems, and so on, all symptoms that are notoriously difficult todiagnose and often have psychosomatic origins. 2 The more serious diseases areseldom mentioned. (Chinese people are usually quite aware of the limitations of TCM. If somone has vague stomache pains, they might consult a TCM

practitioner; a patient with acute appendicitis will go immediately to a Westernhospital) Similarly, the problems psychics deal with involve intractable domainssuch as interpersonal relationships, romance, career, and, of course, the realm of

spirits and the afterworld.Most bodily discomforts, and to a lesser extent emotional ones, simply resolveand disappear spontaneously over time. When the condition improves naturallyover a period of weeks, the patient will naturally assume and the doctor willclaim that it was the medicine that did the trick. 3 In the same way, most

problems one might consult a psychic for will eventually clear up or be forgotten.Broken hearts, like broken bones, heal over time, and the psychic will get thecredit and the fee.When pain or discomfort arises, most people begin to focus attention on aspectsassociated with the pain, and will make changes in their activities to maximizehealing. If the patient has a knee pain, in addition to taking medicine or acupuncture, he or she will naturally alter his behavior in myriad (oftenunconscious) ways that will work toward correcting the problem, such as walkingless, or favoring the other leg. Similarly, someone who consults a psychic is alsosimultaneously working on the problem in other ways talking to friends,reading self-help books, etc. and thus the solution may arrive regardless of the

psychics participation.Finally, merely taking steps to correct the problem, and having a sympatheticauthority figure working with you on it, can have enormous psychological effects.

The sympathy of families and friends, the lowered expectations and lessening of daily pressures, etc. can also have tremendous psychological healing effects. Thevery act of taking the medicine or calling up the psychic gives the sufferer a senseof hope that can speed the healing process.

These cross-cultural similarities suggest the obvious fact that human beings from any

2 TCM has an added advantage here, namely that expectations for cure are lower, and more subtle than for Westernmedicine. The Chinese say that Western medicine treats the symptoms, but Chinese medicine treats the gen , thesource/root of the problem. Thus Western drugs like aspirin are expected to work almost immediately, whereasChinese medicine is not expected to have any noticeable effect right away. The patient is instructed to take themixture for weeks or even months, in order for the root cause usually considered to be some kind of imbalanceof bodily functions to be corrected. Thus the lack of any ameliorative effect is not considered evidence of failure.3 Of course, this is a problem for Western medicine, as well.


6/7

culture are universally susceptible to the same kinds of chicanery and deception. Theaspects Ive sketched above are shared to some extent by any number of other charlatans, including TV evangelists, faith healers, and mind readers. Some of thesefactors even play a role in more legitimate domains such as Western medicine and

psychotherapy, and this is an issue that warrants more research.

Not all TCM doctors are like my Dr. Jia. Many have knowledge and training outsideof the traditional practice, and often can provide sound and helpful advice concerningaspects such as diet, exercise, and lifestyle. TCM remains essentially a vast body of folk knowledge, but many of the remedies and physiological principles contained inliterature have been shown to be efficacious in Western medical terms. It would not

be surprising to find that centuries of TCM practice had stumbled upon herbalmixtures that do indeed have salutory effects, but none of these have been rigorouslytested.

As mentioned above, TCM doctors will tell you that the advantage of TCM is that itadopts a holistic approach to healing, addressing the complex root of the problemrather than merely alleviating symptoms. That is the theory. Yet the almost fetishisticemphasis on Chinese herbal medicine itself as a cure-all potion tends to negate thissupposed advantage. A friend of mine recently developed symptoms of fatigue,lymph node swelling, and a constant sore throat. Friends and family suggestedeverything from Chronic Fatigue Syndrome to hyperthyroidism. The Western doctor he saw ran a few tests, could find nothing obviously wrong, and said The body iscomplicated, and the parts are interconnected in many ways. He simplyrecommended more exercise, good diet, rest, stress reduction in short, invoking the

bodys natural healing processes. By contrast, the Chinese doctor he consulted simplysaid Your liver and spleen are not working properly. Take this medicine. Strangethat it was the the Western doctor who spoke of holistic processes, and the Chinesedoctor who merely prescribed a magic pill.

TCM has some official sanction in the PRC, mainly for nationalistic reasons. TheChinese government characterizes TCM as a treasure of ancient civilization, andeven wrote it into the constitution in 1982. The vast majority of Chinese people

profess to believe in it, whether or not they actually consult a TCM doctor.

The fact is, however, that TCM is dying out Though mainstream Chinese doctors stillcombine Western and Chinese medicine to some extent (all hospitals have both aWestern pharmacy and a TCM pharmacy, separately housed but used in combination),the tradition is quickly being replaced by standard international medical practice.Some doctors say the prognosis for TCM is not good, and predict a rapid demise over the next decade.

Ironically, the last bastion of Chinese medicine may very well be the West, whereattraction to Eastern exoticism is still strong, and people are searching for alternative


7/7

forms of medicine.

my visit to a traditional chinese doctor

Documents