As a child growing up in China, I was always
aware of Traditional Chinese Medicine (TCM).
TCM is what we refer to as Eastern medicine, in
contrast to the Western medicine we know from
U.S. hospitals. I never understood much about
TCM, only that it somehow involves herbs and
that many Chinese people used it. The more I
progressed in my medical training in major U.S.
academic centers, the more distanced I felt
from TCM. Why should I learn about something
that lacks evidence, when there’s so much to
know about for which there is good research?
Last fall, I went to China on a research trip.
While my study is primarily on its Western
medical system, I was so fascinated by what I
learned of Eastern medicine that I spent many
free evenings observing TCM practitioners.
There is so much I didn’t know. As a discipline,
TCM is far too complex for me to understand in
my short observation, but there are some very
important “lessons from the East” that are
applicable to our Western medical practice:
#1 LISTEN - REALLY LISTEN
The first TCM practitioner I shadowed explained
to me that to practice TCM is to “listen with
your whole body”. Pay attention and use every
sense you have, he said. I watched this doctor
as he diagnosed a woman with new-onset
cervical cancer and severe anemia the moment
she walked into his exam room, and within two
minutes, without blood tests or CTs, sent her to
be admitted to a (Western) medical service.
I’ve seen expert clinicians make remarkable
diagnoses, but this was something else!
“How could you know what you had and that
she needed to be admitted?” I asked.
“I smelled the cervical cancer,” he said. “I
looked and saw the anemia. I heard her speak
and I knew she could not care for herself at
home.” (I followed her records in the hospital;
he was right on all accounts.)
#2 FOCUS ON THE DIAGNOSIS
I watched another TCM doctor patiently explain
to a young woman with long-standing
abdominal pain why painkillers were not the
answer.
“Why should we treat you for something if we
don’t know what it is?” he said. “Let’s find out
the diagnosis first.” What an important lesson
for us—to always begin the diagnosis.
#3 TREAT THE WHOLE PERSON
“A big difference between our two practices,”
said one TCM doctor, “Is that Western medicine
treats people as organs. Eastern medicine
treats people as a whole.” Indeed, I watched
her inquire about family, diet, and life stressors.
She counseled on issues of family planning,
food safety, and managing debt. She even
helped patients who needed advice on caring
for the their elderly parents and choosing
schools for their child. This is truly “whole
person” care!
#4 HEALTH IS NOT JUST ABOUT DISEASE, BUT ALSO ABOUT WELLNESS
There is a term in Chinese that does not have
its exact equivalent in English. The closest
translation is probably “tune-up to remain in
balance”, but it doesn’t do the term justice,
because it refers to maintaining and promoting
wellness. Many choose to see a TCM doctor
not because they are ill, but because they want
to be well. They believe TCM helps them keep in
balance. It’s an important lesson for doctors
and patients alike to address wellness and
prevention.
#5 MEDICINE IS A LIFE-LONG PRACTICE
Western medicine revers the newest as the
best; in contrast, patients revere old TCM
doctors for their knowledge and experience.
Practicing doctors do not rest on their laurels.
“This is a practice that has taken thousands of
years to develop,” I was told. “That’s why you
must keep learning throughout your life, and
even then you will only learn just a small
fraction.” Western medicine should be no
different: not only are there new medical
advances all the time, doctors need to
continually improve their skills in the art of
medicine.
#6 EVIDENCE IS IN THE EYE OF THE BEHOLDER
Evidence-based medicine was my mantra in
Western medical training, so I was highly
skeptical of the anecdotes I heard. But then I
met so many patients who said that they were
able to get relief from Eastern remedies while
Western treatments failed them. Could there be
a placebo effect? Sure. Is research important?
Of course. But research is done on populations,
and our treatment is of individuals. It has taken
me a while to accept that I may not always be
able to explain why—but that the care should
be for the individual patient, not a population of
patients.
“In a way, there is more evidence for our type of
medicine than for yours,” a TCM teacher told
me. “We have four thousand years of
experience—that must count for something!”
There is so much I have not covered about
TCM. Its practices vary regionally, and no
doubt, there are more and less capable
practitioners (as there are in Western
medicine). More research into TCM methods
will be important. However, regardless of
whether we Western doctors want to prescribe
TCM treatments, we should recognize there is
much to learn from Eastern medicine, including
what it means to be a physician to really care
for our patients . Upon my return from China, I,
for one, have a new-found appreciation for
Eastern medical practice a renewed
understanding of holistic medical care.
For more on holistic practice and the
importance of partnership, please read my new
book, When Doctors Don’t Listen .
Dr. Leana S. Wen, M.D. , is an emergency
physician at Brigham & Women’s Hospital and
Massachusetts General Hospital and a clinical
fellow at Harvard Medical School. She is the
author of the new book, When Doctors Don’t
Listen: How to Avoid Misdiagnoses and
Unnecessary Tests . For more information, visit
her blog The Doctor is Listening or her website.
You can also follow her on Twitter at
@DrLeanaWen.
copas from http://www.emperors.edu/qiblog/2013/02/lessons-from-chinese-medicine/
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