So I got several hundred words into this evenings post when I realized that it wasn’t a blog post, it was a PAPER. Like, the kind of thing you get published in the Journal of Chinese Medicine. I’m going to blame this on time spent reading “Dragon Rises, Red Bird Flies” lately.

Anyway, I would like to make a few points here in, well, significantly less stultified tone, and I might as well borrow from the aforementioned work to do so. I’ve been asked to talk about the emotions in Chinese medicine this week, so I’ll do that.

In my opinion, you absolutely cannot get anywhere with the modern patient (at least here in America) without addressing their psychological “physique”  in some way. Now unfortunately the brand of standardized professional Chinese medicine that is currently in vogue in this country really doesn’t get much further along than stress, nebulous concepts of depression, and “shen disturbance”. The truth of the matter is that modern patients are so screwed up that they don’t even realize how bad they’re screwed up. To top that off, even when their problems aren’t due to the Five Emotions being completely out of control, their relatively minor physical complaints are obstructed by the lack of communication outward from the Heart so that if you go directly at their shoulder pain, nothing happens, no matter how correct your treatment would otherwise have been.

The oft-quoted here Heiner Fruehauf has stated numerous times that in the very ancient Chinese medical writings the Heart was considered to be an Earth organ in the Five Phase model, and that it contained the Fire of the Shen,the Shen being  the Thing that must not be disturbed, the Imperial Fire, the Emperor of the entire being. Daoist traditions (everything from scholarly to medical to martial) harp on the need to empty the Heart of all desires so that the Shen may reside there undisturbed. The  primary role of the emperor in ancient China (apart from being seen to be on the throne and in control) was, as a sort of high priest for the entire Earth, to enter the Temple of Heaven at the prescribed times and perform the appropriate rituals and offer the correct sacrifices in order to keep Earth in harmony with the will of Heaven. Some medical intuitive traditions teach that your best source of information will not be relying upon the chakra of the third Eye but rather the Heart and Wisdom chakras in the solar plexus and stomach. In our society we uses phrases like “getting to the heart of the matter” and knowing something in your “heart of hearts” or getting a feeling “in your gut”.

Our society in its very existence seems to go out of its way to espouse behaviors that disturb the Shen from its necessary perch in the Heart. When, really, are we ever calm, quiet, and stable? Despite being someone who supposedly knows better, as I type this I’m listening to music, clicking back and forth between web pages and applications to keep up on sports news and what my friends are doing, thinking about my patient schedule for tomorrow and who needs what, contemplating potential tactics for my strategy game of the moment, and so on. Throughout my life my state has been to be going in several directions at once, something that is far from the natural or preferred state of being. We are ALL like this and so are our patients. So many of our patients are afflicted with this need to be doing more than they did yesterday, to achieve more, to accomplish more or…what, exactly? Everyone has their own demons, I suppose. Our patients overwork to keep up with their bills then overexercise to keep up with the current standard of appearance and to offset the stagnation of the previously mentioned overwork. We overplan, overconsume,overindulge, overspend, and generally multitask ourselves into insanity. Insanity is the word here. If you were to talk to 25 people today, how many of them would seem to you to be calm, contented, healthy, of sound mind and sound body? Not many.

We need to remember that the Five Emotions (or seven, depending on your source) when excessive or deficient (meaning not exactly right) become known as the Internal Pathogens, and since not as many of us have our life-forces frittered away because of exposure to a harsh outdoor environment we can look at them (along with environmental toxicity) as the primary cause of disease in our age. Our minor emotional difficulties are forever getting in our way, causing minor illnesses in the short term and adding up to much worse things in the long term. Our major emotional difficulties (meaning traumas) set us up for extremely difficult lives emotionally and physically and make us vulnerable to all the worst sorts of diseases, from mental instabilities all the way up to autoimmune disease and cancer. We also have the difficulty of past emotional trauma blocking the Heart from receiving the Shen properly, or from expressing the mandate of the Shen so that things become almost impossible for us to treat until these traumas are dealt with. All too frequently our patients have no idea what the real trouble is. As I tell my students, any time someone comes in with shoulder pain (especially if it centers at LI-15) I immediately have them turn around so that I can find the massive knot at UB-14 or 15, the Back Shu points of the Heart and Pericardium, which is always there.

I have honestly reached the point where almost all of my acupuncture efforts are aimed at dealing with psychological and emotional issues and leaving any denser and more material issues to an accompanying herbal formula (which is not to say that I don’t use those for psychological treatment too).

Our job increasingly involves creating awareness in the patient of their particular plight and encouraging them to take an active interest in achieving proper balance in their lives. As one first century text puts it, “emotion is that which is meant to be kept quiet while nature is that which is meant to be active and to unfold.” A kingdom in which the Emperor is out of control has no chance whatsoever of peace and instead finds itself in civil war. The bulk of our job currently is getting the Emperor back on the throne. Until that happens, there’s really not a great deal of use obsessing over crop prices or tinkering with delivery of goods to outlying provinces.

Internal Dragons

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This is my first weekly YODA update.

It was a tumultuous week, there’s no doubt about it.  I’ll be talking about the details on my personal blog and the Deepest Health forums, so won’t prattle on here.  However, I will provide a summary and the most important insights that have come from my work during this initial phase of the project.  Remember – the whole point of this thing is to see whether devoting myself to a rigorous program of study and self cultivation will result in my becoming a more effective practitioner of Chinese medicine.

There’s no doubt that my clinical practice changed for the better this week.  The reality is that the process was a long and winding road.  What I’ve noticed is that as I focus on really living up to the oath I took as a graduating Chinese medicine practitioner, I am aware of the many ways in which I have FAILED to live up to that oath.

Now, let’s be clear, I’m not berating myself for being a bad person.  I’m a good practitioner, my patients improve, I work hard.  I think that I just became aware of the degree of dedication, focus and commitment that is embedded in the oath, as well as most of the classical discussions of what it means to be a great physician.  I realized that if I can slide, I let myself slide.  I don’t find myself wholly engaged in the process of learning more about the human body, the planet, this medicine.

Becoming aware of that sent me on a bit of a voyage of discovery.  As I investigated, I fell in love with the medicine all over again. I became excited and moved to study, to work.  I ended up looking into some things I hadn’t looked into before.  This had a variety of consequences, but again, I won’t go into details here.  However, there is one important point that I wanted to bring up.  I know that the way that I will word it, as well as the content itself, will cause all kinds of problems.  That’s ok with me.

I found myself investigating a lot of more contemporary takes on self-cultivation and personal development philosophy.  I looked into more modern exercise programs, things like Integral theory and Evolutionary Enlightenment, contemporary philosophical works concerning the relative importance of physical, mental and spiritual work and so on.  All of these things have roots in ancient wisdom traditions, but are working to reinterpret those traditions and, in some way, combine them with more modern ways of looking at things.

I want to emphasize that, in principle, I have no problem with this. I think that a sort of dogmatic religious fervor settles over people like me sometimes.  By “people like me,” I mean people who consider themselves to be “Classically minded” in some way and who are studying a tradition deeply.  This fervor drives us to reject any modern retelling of our cherished stories and to have a hard time questioning any of the principles or conclusions of the tradition in question.  I can’t think of anything more damaging in my quest to be a great practitioner of this medicine.  So – attempts to look at the traditions I love from a new angle, to question their assumptions and outcomes – these are welcome.

But the questioning and retelling will be rejected if it doesn’t work any better than the original tradition.  As far as medicine is concerned, I need to see that a contemporary (or even just post Han dynasty) reworking actually helps patients get better, and more importantly, live more vital and engaged lives.  *I* need to see that in my own patients.  As far as self-cultivation is concerned, well that’s a little trickier.  The reality is that some things pass muster and some don’t.  It’s a gut-check kind of thing, I suppose.

For me, the self-cultivational theories and practices I was investigating just… didn’t work out.  They felt unnecessarily distancing, intellectual and sometimes self-gratifying.   They demanded that I embrace a  way of looking at the world that is actually something I spent a lot of time investigating and ultimately rejecting.  I was left thinking that sometimes progress for progress’ sake is regress.

Ultimately, I went back to the stable center where I have been living and thriving for years.  Rooted deeply in my practice of Qigong and basic meditation, reading closely classical Chinese texts like the Yijing and the Dao De Jing, and working closely on learning medicine.  Again, more about the details on those other sites I mentioned above.  However, I wanted to put this out there just to see if anyone resonates with what I’m saying.

Have you done a similar investigation?  Where did it leave you?  Disagree with what I’m saying here?  Let me know about it!

Tension between the modern and the ancient in self cultivation

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Here’s a quick listing of some of the best resources I found about Chinese medicine on the Internet this week.  Have other favorites?  Post them in the comments!

–

1. Discussion of the use of electro-dermal testing (like MORA) on the Deepest Health forums
2. A fantastic article about ecology and Chinese medicine by Dr. Leon Hammer
3. Medigogy (formerly known as TCM TV, among other names) an online webinar company who have hosted diverse speakers on Chinese medicine including Heiner Fruehauf have now made their online archives free.  You just have to sign up for an account!  This is an incredible resource!
4. A recent book getting a lot of advance praise from people I trust is Pulse Diagnosis in Early Chinese Medicine: The Telling Touch (University of Cambridge Oriental Publications) — I haven’t read it yet, but Elizabeth Hsu is someone I trust to do a good job.  If you’re interested in pulse, it’s definitely worth a look.  If you can’t afford it yourself, get your nearest school’s library to carry it!
5. A recent interview with my mentor Arnaud Versluys is in the European Journal of Oriental Medicine – definitely worth a read.

Interesting Internet Intersections #2 : Electro dermal testing, ecology, pulse and more!

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Recently I found myself “eavesdropping” on an online conversation between two professors at NCNM, namely Roger Batchelor and Ed Neal, on the subject of the Pericardium in the Classics. What came out of it was more than a little enlightening and inspired me to talk about the Pericardium a bit this week.

The essential point of the discussion was as follows: what we call Pericardium in the modern Chinese medicine disciplines is referred to as (quoting Ed’s translation here) “Mai vessel of the heart encircling luo vessel (network), following the hand (upper) Jue Yin six confirmation terrain, relating to the function whose (domain of responsibility) is the heart.” Usually this is shortened to Xin Bao, or Heart Wrapper or Heart Encirclement. Usually this is assumed to equal the Western anatomical structure of the pericardium, the membrane that protects the heart. However, what Roger and Ed pointed out is that in it’s discussion of the function of the Xin Bao, which is always the important thing to the Classical Chinese mind, it has almost nothing to do with the pericardium whatsoever and instead equates much more closely to the coronary artery network. This, to my mind, answers a boatload of questions about what the Hand Jueyin (and the not-particularly-easy-to-understand Jueyin as a whole) actually does.

First, for our TCM readers, let me clarify a misconception that seems to be prevalent: contrary to what we learn in school, Jueyin does not refer to a seldom seen and horrifying state where the patient is vomiting roundworms (something that the average Westerner can’t fathom) and occurring just before spectacular death.  Rather, Jueyin, which deals with-amongst other things-the Heart and Pericardium organs, is the “closure” of Yin, the function that causes Yin to shrink and decrease so that it may change properly into Yang. The Liver stores the Blood and supplies said Blood throughout the body. The Heart moves the Blood, but how does the Blood get there? Via the Jueyin network. The Liver feeds blood to the Heart via the Pericardium/Xin Bao. How much more sense does this process make if the Xin Bao is really the coronary artery network?

Also notice that the representative  true Jueyin formula, Dang Gui Si Ni Tang, is a Blood-oriented formula. If Dang Gui is the Emperor herb, you can bet the house that Blood is the primary issue at stake, especially given the construction of the rest of the formula: Gui Zhi to invigorate the Blood, Tong Cao to decrease vascular rigidity, Xi Xin to warm the Blood as it reaches the Lungs, Sheng Jiang to bolster Taiyin function in the construction of Blood and Da Zao and Zhi Gan Cao to supply material to the Blood and Yang to the Heart when used with Gui Zhi and Sheng Jiang. Blood, Blood, and more Blood. If the Xin Bao was just the wrapper of the Heart (something that always mystified me) this wouldn’t make a great deal of sense. However, if it instead is equated  with a) the coronary artery system that is responsible for feeding Blood directly to the heart and b) a more formless and function-oriented idea of the system of channels, Luo networks, etc. that encircle the Heart and supply it with Yin and material fuel, suddenly both Xin Bao and Jueyin make a lot more sense. Also if you consider that the Kidneys have to provide the ultimate Yin Water that nourish and protect everything in the upper Jiao from the overwhelming Imperial Fire of the Heart, it makes complete sense that this Yin would travel up through its child Wood (meaning the Yin Wood network of the Liver, but which the Chong Mai adds its influence to) and onto Wood’s child Fire (being the Xin Bao and Heart).

Let’s also look at the Xin Bao/Pericardium from psychological perspectives. The Pericardium is normally seen as the Heart protector, a point of view I agree with fully. However, I think in the context of viewing Xin Bao as a network instead of reducing it to just one physical entity (as is our modern wont) the protective membrane of the pericardium is only a small part of the story. In the primary lineage I have been trained in (Leon Hammer’s Contemporary Oriental Medicine which, despite the name, is actually very classically informed) as the Heart pulse begins to tighten there is both a restriction of circulation into the Heart proper as well as a decrease in communication with the outside world. The patient is often quite far into nervous exhaustion and is beginning to close off and isolate himself emotionally from society, loved ones, possibly also even himself, especially if a Slippery quality is also found. The tighter the pulse gets the more the constriction develops on every plane, introducing emotional rigidity (frequently accompanied by the “character armor” of muscular rigidity) and impeded circulation in the chest, frequently with sharp pains over the heart. It’s much easier to see this constriction mirrored by a constriction of the arteries that feed the Heart rather than what amounts to a lubricated bag somehow constricting.

I would also add in a comment from Arnaud Versluys on this subject in a lecture where he stated that the Heart’s job is to primarily serve as a container for the Shen and that in fact the Pericardium-which is also represented by the entirety of the vascular network-does the actual beating, “squeezing the heart” as it were. Again, the coronary artery network theory really works well.

So what does this mean practically? To begin with, this really clarifies the (manifold) uses for the Pericardium channel in acupuncture. Given the usage of Pc-4 for treating acute myocardial infarction, we can see its power over the physical structure of the Heart and its Vessels. However, we can also see the benefits of providing nourishment to the Heart via the combination of K-22, Pc-1, and Pc-2 using the Exit and Entry points of the Kidney and Pericardium channels to bring the Yin influence of Water to the Fire networks, essentially mimicking the natural activity of the Jueyin. This combination is very useful for patients whose Imperial Fire is beginning to run amok causing insomnia, flight of thought, anxiety, and other symptoms.

This does however raise interesting questions about the true function of Pericardium-oriented herbs such as Zhi Mu, which is frequently used to cool down and protect the Heart and Pericardium, relieving cases of delerium as well as less serious psychological difficulties along the same spectrum.

I would love to hear from our more experienced practitioners on this subject in the comments section.

Regarding the Pericardium

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I’d like to announce a new project here at Deepest Health.  We like projects.  This one is called the Year of Diligent Action, or, YODA.

Project motivations

It’s not enough to believe that something is true.  It’s not enough to read an oath every morning.  It’s not enough to know what you must to do be what you want to be.  You must act.  Honestly, though, when one is pursuing excellence – even simple action is not enough.  One must develop a regular habit of action in line with principle.  It was Aristotle who said, “We are what we repeatedly do.  Excellence, then, is not an act, but a habit.” This project is all about finding the truth in that statement.

So what excellence?  What principles?   Since beginning school at NCNM, I have sought to become the best medical practitioner I can become.  As I’ve progressed through school, graduated, and begun my own practice I have learned everything I can about how to live an excellent life.  I’ve not always managed to apply what I’ve learned, but I feel ready to do so now.  I’m sure I’m not alone in any of this.

In essence, then, we are pursuing excellence within the realm of our development as medical practitioners.  We are seeking, with some amount of hubris, to become Great Physicians in the style of Sun Simiao, Zhang Zhongjing and others.  We may not reach such heights – but to aim in that direction seems a noble enough pursuit.

We’ve done other projects here on Deepest Health, most notably the Year of Sagely Living.  This project will be different than that one, but undertaken with the same spirit – to delve deeply, to soar to great heights, and to learn something about ourselves.

There are man ways one might undertake a project like this.  Models for excellence abound.  Here, we seek to emulate the spirit and focus of two main models.

First, the Oath taken by Chinese medicine graduates at NCNM:

• I promise to follow the way of the great physician.
• I will strive to live in harmony with nature and teach my patients to do the same.
• I will stay calm and completely committed when treating disease.
• I will not give way to personal desires and wishes, but instead hold and nurture a deep feeling of compassion.
• I will be devoted to the task of saving the sacred spark of life in every creature that still carries it.
• I will strive to hold myself to the highest standards.
• It will be my duty to diagnose sufferings and treat their causes.
• I will not be boastful about my skills and not be driven by greed for material things.
• Above all, I will keep an open heart.
• As I move on the right path, I will receive great happiness as a rewards without asking for anything in return.

Second, an important chapter in the Neijing Suwen – chapter 25. Here is a relevant excerpt as translated by Maoshing Ni.

• There are five requisites for an effective practitioner.  Most physicians ignore these five edicts…

  • First, one must have unity of mind and spirit, with undistracted focus.
  • Second, one must understand and practice the Dao of self-preservation and cultivation.
  • Third, one must be familiar with the true properties and actions of each herb.
  • Fourth, one must be proficient in the art of acupuncture.
  • Fifth, one must know the art of diagnosis.
  • When one follows these five edicts, one will be effective.  With acupuncture one can tonify the deficient and sedate the excess.  But if one can observe the yin and yang laws of the universe and truly apply their essence to treatment, the results will be even better.

This project will begin now, August 9, 2010, and will extend for as long as it is deemed a useful practice. The key components of the practice with regards to its impact on Deepest Health are as follows (this list may be updated as time goes on and new elements are added):

1. Eric will undertake a specific program to help lead him towards living by the principles above.  He will talk about the details of his work on his personal blog – Ericgrey.com.
2. Eric will post weekly about his progress, summarizing any ups, downs, insights or revelations.  He will focus particularly on how his efforts seem to be impacting his clinical practice and his ability to learn Chinese medicine more deeply.  This will replace the promised Western philosphy + Chinese medicine column (sorry) which has been shelved for a variety of personal reasons.
3. A new subforum will be created on the Deepest Health forum where others can post their comments, express their interest in the project, and maybe even link to progress blogs of their own.

Simple for now, complexity added as needed.

Year of Diligent Action : A study in Chinese medicine excellence

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I want to start this post with a question.  What role does your spiritual life play in your practice of Chinese medicine? For those of you who do not acknowledge having a “spiritual life,” what role does your “inner life” play in your practice of Chinese medicine?  To say it another way, how does the development of yourself as a person, as a body, as a Qi sensing individual in the contemporary world play into your practice of Chinese medicine?

What I want in terms of answers is a focus on active practice.  I’ve asked this question of many people, and those whom I’ve not asked I’ve tried to “ask” by observing them carefully.  Many times, particularly when “asking” happens – the person will say something quite vague and usually related to what they BELIEVE and how this allows them to hold a particular intention, or something similar.

That’s fine as far as it goes.  But, just as I expect my practice of medicine to become an integral part of my entire life, I expect my spiritual development to become an integral part of my entire life. As such – they will influence eachother.  In my experience of working with patients, the more grounded I am in my own development and centeredness, the better listener I become.  But, there’s more.  I notice very distinct changes in my practice when I make overt attempts to – say – meditate during acupuncture treatment.

It is, of course, a different kind of meditation – being there with a person, focusing on their physical needs, focusing on the sounds and space around me.  This isn’t Zazen or anything.  But, going into a meditative place very clearly helps me to perceive, to respond, and to treat.  This isn’t a popular notion in all circles.  In those circles where it is popular, I think it frequently goes a little far.

I want to be clear.  Because I am grounded in my own spiritual and personal development does not mean that I am talking about this with patients, actively seeking to help them do the same, or anything else.  I’m not necessarily talking about “spiritual medicine” or even something like Worsley style five-element acupuncture as a model.  I’m just talking about your own effort to develop yourself and its influence on your practice of medicine.

I simply see my meditation practice, my Qigong practice, my efforts to actively root out my own insufficiencies and remedy them, and all the rest as the ground from which study of medicine and practice of medicine is possible.  But, I want to hear from others.  Have you had a difficult time integrating these parts of yourself?  On the other hand, have these parts of your life never seemed to be “parts” but instead seamless parts of a whole?

Comment away, my friends.  Note well that language is always, always tricky when discussing these things and if you are thinking with some degree of indignation that I’m not “getting” something – interrogate the language first.

Eric

Spirituality and the practice of Chinese medicine

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I’m going to do something a little different this week and write something a bit more personal this week, something a bit more, well, extemporaneous. I’ve been working on being sick for the last couple of weeks and of course the day it comes to a head is the day I have an article that needs writing. So, I’m going to aim for a little less polish and a little more from the hip this time, and my apologies if it’s not the most pristine bit of prose you’ve ever read because, well, I’m a bit under the weather. It’s likely to be more questions than answers today, but for some reason I felt that rather than pontificating I needed to show the other side a bit. Here we go.

A collection of thoughts about being in practice.

1. It’s hard being a natural medicine practitioner when you’re relatively sickly. I’m a fairly good sized guy.When I was

born my mom’s OB/GYN declared I was going to play for the Tampa Bay Buccaneers when I grew up. (This was not a curse, I’m from Tampa.) You don’t really think “poor health, very deficient” when you look at me. However, I’m kinda sickly and I’ve kind of been that way my whole life, for reasons multifarious. I feel like I’ve come a long way in the last few years, but I still tend to be on the weak side, not able to do all that much in the way of physical activity, coming down with things a lot, etc. (When I moved in January, afterward I was sick until sometime mid March). The point here is that I frequently find myself (like today, for instance) in the middle of a diagnosis with a patient thinking “How exactly is this person supposed to believe in my ability to improve their health when, despite my best efforts, my own personal health is so poor?”

2. Treating chronic disease is an exercise in patience and frustration management. Chronic disease is what I look for, my preferred type of case. The really difficult, chronic, life-crippling stuff. This is because these are the patients I most want to help, whose lives would be the most changed by a positive result. Despite having the tools at my disposal to do just that and making observable progress, it’s still a very frustrating process. Sometimes these things really do take four or five years to pull off, and that with hitting a home run every week. Patients get frustrated and drop out, really committed patients have other disasters befall them or are being crippled by their Western treatment regimens, patients that are doing absolutely everything right still continue to suffer greatly in the process of improvement. Some days it’s hair-pulling. Some days it’s heart breaking. This is part of the acupuncturists life that they seemed to have missed in school.

3. Doing things in the right order takes a lot of faith and self-confidence. I have multiple patients who have some sort of chronic pain who, to my mind, are great examples of the Neijing maxim that “all pain, sores, and itching come from the Heart.” They have chronic pain that

is being directly or indirectly caused by upper jiao blockage due to emotional distress followed by a walling off of the psycho-emotional energies of the Heart and Lungs. In both cases a powerful resistance to dealing with the loss of loved ones is crippling circulation and leading to a variety of additional symptoms, like dysmenorrhea. However, it’s not the easiest thing in the world to be charging a pretty good sized sum of money to someone who has come to you for elbow pain which isn’t really getting better and having to tell them “look, we gotta keep focusing on that emotional blockage first in order to get to your pain, otherwise we’re just knocking our heads against the wall.” Is it the truth? Absolutely. Do I still kinda worry that it’s going to make me and every other acupuncturist alive look bad and one day she’ll stop coming in and tell her friends about what a waste it was and…you bet. After all, you can’t have a good neurosis without a lot of work.

4. Some days you feel like you did everything wrong, and yet everything right happens. I’ll never understand this one. You needled these two points and…just didn’t “feel it.” Like there was no real connection. You had to more or less guess on the formula and just kinda threw it out there, not really knowing what would happen. You were too beat to take a proper pulse and so had to work out what to do from other angles, and even then things didn’t seem right. You were sure that what you did was going to fail utterly. However, the next time you talk to the patient, they’re thrilled with the results. Go figure.

5. Some days you feel like you did everything right and the case barely budges. See #2

6. You really do have to get used to the idea that patients are frequently so closed off, out of touch with themselves/reality, and self-unaware that they have no idea what’s really wrong with them. Frequently they can’t even tell you if things are better or worse because they literally have no idea. See #3

7. The practices of other practitioners is going to make you really mad some days. You’re going to hear about people who are essentially running a health food store/supplement supply under the guise of a medical license for all the hawking of goods they do. They will practice lousy medicine, though their patients probably don’t realize it. They will have evolved into the Monte Hall model by force of necessity, because their actual CM acumen is so poor. So in order to survive, they will pull in every modality, every product, everything in existence into their practice and sell it all. Their practice will be bigger than yours, they will be making more money than you, their car/address will be nicer, they will be in the local magazines. They will still not know what they are doing, they will not be reaching the level of results our ancestors expect from us, however they will be feeding the consumer culture of our society, and that is why they will be doing well. You will know this, but it will still make you mad.

8. Your practice is going to make you really mad some days. You will find yourself saying “if this stuff is so great, if I’m practicing such a superior modality, if my herbs are such high quality, if I have it on absolute fact that I am doing what my patient needs when they need it, then why in the hell aren’t any of them completely cured? If my way is better, then why is it such a small operation? If I’m so great then why do I ride the bus instead of my Mercedes/Porsche/whatever? Why aren’t I better at treating emergency/acute/chronic/mystery/women’s/men’s/children’s/animals illnesses? Why do I have so few answers?”  Again, neurosis takes work.

9. All of these things will come and go along with this thought: man, this stuff is really great and I feel good. Yin transforms into Yang and Yang transforms into Yin. Good days, bad days, they’re all part of it it seems. I personally think that people who only have good days (residents of Portland notwithstanding) need psychological evaluation and a lie detector test. Just try to remember that when things are bad that soon it will turn around and that when things are good that you don’t have all the answers just yet.

Thoughts from the Front Line

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I do.  I assume most of you do as well.  One of the funny things about going to school for Chinese medicine, at least in the United States, is that most of us end up in private practice.  While that’s all fine and good, what we don’t think about when we get involved with this medicine is the fact that we’re going to end up having to be business owners. For a few people, this comes naturally and is no problem.  For others (and I’d say a majority) – not so much.

Many Chinese medicine schools’ business classes aren’t as much help as we might like. They may cover the nuts and bolts, but folks still end up on the other side wondering why they don’t have many patients.  I think this is a pretty sad state of affairs.  I’ll be honest – I wish that I could be a wandering doctor, ministering to people in the countryside without restriction, without a license, without the need for Quickbooks.

Unfortunately, my reality doesn’t play out that way.  I think, mostly, I’d just get arrested if I followed that dream. I suppose I might be able to pull it off in another country – but I like it here.  Plus, my daughter would be more than a little annoyed with the whole wandering thing.  Maybe you’re in a similar position?  Ok, so we’ve got to learn this business thing.

Marketing is probably the toughest topic to deal with. Before you actually get out on your own, it may seem relatively simple.  You’ll get some business cards and flyers, give a couple talks, maybe start a blog – everything will be fine, right?  Well, my friends, maybe.  Some of you will be lucky.  But, for most of us, it takes learning some tricks of the trade, trial-and-error, and sometimes a couple of years of struggle.

Fortunately, I think I’ve found a pretty good way to avoid prolonging the process.

I talked about an upcoming course in Practice Building back in March.  I have since gone through the course, and can recommend it even more highly than I was before.  This is good stuff, people.  I would say it’s especially good for folks who are super motivated to learn the essentials of marketing in a supportive, energized atmosphere.  Brooke, the teacher, is a very successful bodywork practitioner who really makes marketing feel like something you CAN do in a way that doesn’t feel gross, pointless and painful.  In fact, she has inspired me to look at the way I talk about my business in a whole new way. I can’t really thank her enough for that.

In the course, you’ll learn the basics of marketing, how to get comfortable with pricing, how to figure out who you really want to reach and then a ton of tactics and how to use them.  It’s a complete course and I really believe that if you apply yourself fully to the material, your practice will undergo a significant shift into momentum and profitability.  Sound good?

I recently talked to Brooke about the course and hope you will take the time to listen to this podcast of our conversation.  You can also download it through iTunes, just search for Deepest Health and look for the most recent podcast episode.

If you’re interested in the course, and want to check it out – head over to Practiceabundancecourse.com – you’ll see a form where you can enter your information.  Once signed up on that list, you’ll receive information about the course with no obligation.  She’ll be providing a course outline, video tour and more.  If you’ve missed some info, she’ll provide a way to access all of the information at the end. The course opens for new students on July 22, and will be open until the 24th. The limited time window allows a particular group of students to move through the course together.

I’ll see you in the Practice Abundance forums!

* Yes, if you sign up, Deepest Health gets a portion of your course fee as a kickback.  This will help us keep developing the site and putting out great content.  As always, we only recommend things we actually have used, enjoy, and believe will be greatly useful to our readers.

Who wants a thriving, profitable Chinese medicine clinic?

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