School's in session! Here is my class: Dr. Mao is front and center. We study at his clinic, but he is also a teacher at the TCM University in Nanjing. Currently, he is in Germany, practicing TCM at a hospital there. Next to Dr. Mao is Dr. Lu, our current teacher. She came out of retirement to teach us and specializes in herbal medicines. In the back are Michaela, a German midwife, and Rita, a German homeopath doctor. Then there's me, the tall one! (I feel like a giant most days.)
I never really expected to be studying TCM. I never really expected to live in China! "My" plan when I started nursing school was to complete my degree and get some hospital experience while I looked around at the job market and explored possible job options for a nurse with a public health background, with international experience and interest, and 4 kids at home. Funny how life can throw us curve balls!
So, here I am in Nanjing, China, and this great opportunity almost falls in my lap--study TCM with Chinese doctors using an English translater and meet 4 hours a morning only on the days the kids are in school. How could I refuse? I am studying with 2 German women: Rita, a doctor who practices homeopathy in Germany, and Michaela, a midwife. They will continue for 2 full years and become certified practioners of TCM (which is generally the use of acupuncture and herbal medicine). They were very open to letting me join them for as long as I wish. I am planning to continue through Christmas, and then will decide if I want to continue into 2009. Because we are here only 1 year, I am debating my options! There are many opportunities and I want to be sure to make the most of the time I have in China.
You are probably wondering what we are studying. Our first few weeks have been focused on philosophy and theory of TCM. We have covered the history of TCM, including learning the titles of some of the classic books of TCM. We are painstakinly going through each of the major organs and learning how TCM views their function in the body. Most of the information is similar to what we have learned in Western medicine, but not all. For example, did you know the function of your heart is directly connected to your tongue? Or that the lungs control water transformation and distribution in the body? In TCM, they believe each organ is connected to a specific emotion, so a "hot" liver is related to the emotion of anger, i.e., a sick liver can make a person angry, or an angry person can make their liver sick.
We have learned that diagnosis is based on "syndrome differentiation" not a specific disease, so different diseases may receive the same treatment based on how it is manifesting in the body. The foundation of diagnosis is examining the tongue (size, shape, coating, color) and pulse-taking (3 pulses all at the wrist), and question-asking of the patient. We had a great opportunity to see one of our teachers apply this in the clinic. We study in the clinic of Dr. Mao each day, and on one morning, 2 women came in needing to see a doctor. Our teacher, Dr. Lu, was the only doctor available so we were all invited to come into the exam room and watch her in action.
Dr. Lu started with one woman first. She listened to her complaints, and then examined her tongue and pulses. Then she spent a good 20-30 minutes "interviewing" the patient. She listened to her describe her symptoms--a fast heart rate, difficulty sleeping, and then noted that she had dark rings around her eyes. She began asking her about her mood. The patient said she was generally an optimistic person, but Dr. Lu kept probing. Ultimately it came out that the patient had a stressful home situation and was worried about her health and finances and was angry that she might have to move with her husband so he could find work. She also had concerns about her health related to giving birth 17 years ago! Dr. Lu encouraged her to get over her anger and worry because it was affecting her health. She prescribed a long list of herbal medicines and they agreed the women would come back to the clinic tomorrow and the staff would "brew" the herbals into a tea for her to take (brewing one's own medicines is a long process that is messy and smelly--now we know why we smell funny odors during our classes!).
The second patient involved less time. Dr. Lu checked her tongue and saw tell-tale signs of spleen involvement (tooth indentations on the edges of the tongue, indicating a swollen tongue and therefore spleen issues). The woman said that she ate a pear out of the refrigerator one day and has since had a "cold stomach" and had problems with her digestion. (TCM strongly connects each food with heat or cold and ties that to health problems in the body.) I think this woman just wanted a second opinion because she said she had already seen a doctor and was cooking her own "tea" at home. Dr. Lu pretty much agreed with the previous doctor's diagnosis and told the patient she needed to strengthen her spleen.
The world of TCM is quite mysterious to me. As with most things, some of it makes perfect sense and some of it seems "out there!" I do appreciate the holistic approach the doctors take to treating a patient and looking at factors in the environment, diet, activity, emotional state, etc., before they make their diagnosis. Just being in Dr. Mao's clinic is a lesson in holistic living. In addition to the typical treatment rooms, he has a small restaurant where he will "prescribe" meals for groups based on the season and typical health concerns (we have yet to eat there, but hope to do so one day with our families). He has a room full of tiny drawers of herbal medicines, and a sauna, and he has a large room devoted to the art of calligraphy! He encourages people to come learn and practice Chinese calligraphy as a way to relax and enjoy life. How's that for a prescription!
We are taking a break from our studies for 10 days; our kids are out of school and next week is a national holiday. When we return to class, we will begin learning the meridians used in acupuncture. Dr. Lu warned us to be ready--they are difficult to understand. She stresses to us that practicing TCM is very much an art and requires years of experience to master. No matter how far I study TCM, I am thankful I am getting this overview to learn a new perspective and to better understand the Chinese culture.
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