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Herbal Explorations

Studying Abroad

By Joni Renee Zalk

This year marks the last year that one can get a license in acupuncture and Chinese medicine through the apprenticeship program. Many people don´t know, but for years there were three different ways to get your license. One way was to go to school full-time for four years and complete a Master´s degree, one way was to be an apprentice for four years full time, and the last way, which is the way I did it, was to complete 900 didactic hours at an accredited school and two years, or 2000 hours, as an apprentice to a mentor.

I loved this way of learning, especially being someone with learning disabilities; I have a different way of learning. I am more sensorial and need to be in a clinic setting to better understand concepts. Taking lots of tests and learning in a classroom setting is the least productive method for my brain.

As I was approaching my second (and last) year of apprenticing with my mentor, I asked him what he thought about me picking up and heading to Asia to study Chinese medicine at the source. He loved this idea, especially when I picked Chengdu University in China, where his mentor trained. In the end, I studied at two Chinese medicine hospitals, and one Western Medical hospital. I studied at Chengdu University in China, then at Tzu Chi hospital in Taiwan, and lastly at National Taiwan University Hospital (NTUH), which is the largest Western medical hospital in Taiwan, and has the same high standards as NYU or Cornell. I am very lucky to have had the support of my community to study abroad and have it count towards receiving my license in Acupuncture. This article is about my training abroad, and how it has affected my outlook on our medicine, as well as to encourage everyone to go themselves.

At Chengdu University Hospital in China, they will see over 3,500 patients a day. To walk into a hospital of this magnitude is both extraordinary and intense. You walk into the hospital and tell Reception what department you want, and whether you want acupuncture or herbs (The doctors are either acupuncturists or herbalists – but never trained as both), you pay, take a number, and go see the doctor in the department you requested. The doctors are so highly trained, they can feel what is going on by checking the pulses and tongue, asking questions, and within minutes, they have a diagnosis and write a prescription of 16-20 herbs. The patient gets all his needs met within these few minutes, and then is off with his prescriptions, and retrieves herbs from the pharmacy downstairs. The patient can either take them home to cook them or pay a little bit more to have the herbs cooked in-house to take home in liquid pouches.

Monday – Friday, I sat in a corner of the desk and felt the pulses on the opposite hand the doctor felt them, as my translator told me what was going on. He translated all the symptoms, and read to me the prescriptions. Occasionally I had a question for the patient or doctor, and when I asked a question, my translator translated it to the doctor, and the doctor responded in Chinese, then I got the English version a moment later. Sometimes I asked why or why not this formula? Why did you use that herb?

One of the most interesting things about studying abroad is the diseases you find that you wouldn´t normally see in America. I remember one day in Taiwan, I saw Polio (which would not be found in the US), Lung Cancer, Parkinson´s disease, schizophrenia, Bells Pallsy, stroke, a mentally retarded patient, all in one afternoon! Because acupuncture and Chinese medicine are covered by national health insurance, it is very cheap for people to receive treatments several times a week. (In some cases, the doctors had to tell the patient that they needed to cut down on treatments because the health insurance only covers acupuncture a few times a week, but not every single day)

The person with Parkinson´s disease was grateful because last year she could barely walk, always had to use a cane, and could not do much else. As with most degenerative diseases, she was going downhill fast. A year after receiving acupuncture once or twice a week, she brags that she can walk without a cane, and is back to cooking, cleaning the house, and doing things she thought she´d never do again.

On one of my first days in acupuncture school, I learned that schizophrenia is a disease that is caused by changes in serotonin and dopamine levels. (This is highly simplifying the disease) Oddly enough; serotonin is made in the intestines. With the schizophrenic patient, the doctor gave the patient herbs for food stagnation.

That´s it! How to treat schizophrenia according to TCM? Treat the patient for food stagnation, which means he is clearing out her intestines to balance the serotonin. The doctor of TCM had no idea about serotonin, or that it was made in the intestines. His training simply told him to prescribe her food stagnation herbs. It is amazing how intuitive our medicine is, given how young Western Medicine is in comparison.

One doctor loved his Sishencong, and needled all his patients with these points. Funny enough, all his regular patients who were older and graying would have new black hairs growing out near Sishencong at the roots of their hair on their scalp.

In China, they do there what we would never see here in America. They autoclave their needles and reuse them on patients. The needles are so thick, and there is no tube, just freehand technique. The doctor walks up to you and asks why you are there. The doctor throws in about 50 needles and walks away. That´s it. That´s your treatment in China. There are just too many people to spend 20 plus minutes with each one. That is why I was shocked and impressed when I saw an acupuncture intern applying this protocol to a patient in the back of an acupuncture room: Using only two needles, start at the top of Huatoujiaji, and walk the needles down. This treats all the organs, and any pain in the entire back. Use it for the same reasons you would use a Huatoujiaji treatment, but only use two needles. Every patient I have used it on since has loved it. It is time consuming, but worth it. I never did understand why a practitioner would use 100 needles and do all the huatoujiaji points. Just walk them down instead. Two needles are all it takes.

One department that was very interesting was the Bells Palsy and Stroke department. I was personally invited by one of the doctors to view this department, and I gracefully declined, saying that it is not so common yet for people in America to view acupuncture as an effective means to treat Bells Palsy and strokes. He said that it is not common simply because most people in America don´t know exactly how effective it is. So I acquiesced, and went to study with him for a week. This department was fascinating. The doctors will start with traditional acupuncture, and for people for whom regular acupuncture (1-2 treatments per week) is not as effective as desired, or if someone lives too far away for regular treatments, the doctor will inject sheep tissue into the acupuncture points. The sheep tissue slowly dissolves over a period of two weeks, giving the patient consistent stimulation on the acupuncture points. One patient with constant back pain had this done two years ago in his back. Since the treatment, he was pain free up until two weeks ago, and wants a repeat of the same treatment. The man was young, about 21 years old. He was so thrilled to have the pain go away again, that he literally jumped on the treatment table to get new injections of sheep tissue.

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In Taiwan, I was lucky enough to study in a Western Medical hospital, and see "the other side." Because my passion in medicine is Endocrine disorders and ObGyn, I elected to study in the ObGyn department. Obstetrics and Gynecology are two different departments, and I was able to go back and forth. I will not go into too much detail about what I saw (although much is listed on my blog), but I will say I have a new relationship with Western medicine. After seeing brain surgeries, Cesarean Sections, in vitro fertilizations, egg retrievals, vaginal births, and so much more, I feel compelled to share that if – in America - a mutual respect was given to each medicine, we could radically revolutionize America´s health care system.

In China and Taiwan, it is not uncommon for a practitioner to prescribe Western medicine like antibiotics, anti-depressants, or diabetes medication for a very short duration if he feels it is absolutely necessary, while also giving the patient Chinese herbs to take to balance out the effects and to treat the root cause. Or similarly, if a patient is depressed and suicidal, the practitioner will give anti-depressants and also Chinese herbs to help the patient. The goal is to ease the immediate symptoms with Western drugs, while also working on the root cause with Chinese herbs. The doctor will take the patient off the anti-depressants within a few months of being cared for with both medicines, as the idea is that the Chinese medicine needed some time to work, and the symptoms were too strong to ignore what Western medicine can provide for a suicidal patient.

There is one thing I want to note: Studying abroad was so INEXPENSIVE!
At Tzu Chi, Buddhist hospital, I studied full time for free, and the hospital put me in a great dorm room for a whopping 75 cents per day! At NTUH, it cost me $75 per week to intern and study there. The doctors would walk me through surgeries as they were doing it, and took time out of their schedules to individually give me lessons. Their college and medical studies are in English, so their English was great.

I have heard people comment that many years ago, there were not as many texts that were translated, and a lot of Chinese medicine was unknown. Even in schools, the education was very limited. If you´ve been practicing for over 15 years, take the plunge, and run over to these amazing countries. I promise, you will learn so many new things!

I fear that staying in America and studying from teachers that went to the same schools we are attending leaves the medicine we are taught unchallenged in its isolation. We all got into medicine for different reasons, but we all want to make the greatest difference we can. This begs the question: Why aren´t more of us letting our curiosity of this fabulous medicine get the better of us and traveling abroad and study at the SOURCE?

Bio: Joni Renee Zalk studied at an accredited school in Colorado, while apprenticing at the Mandala Clinic with Marco Chung-Shu Lam, L.Ac. She then spent 8 months studying and traveling in Asia as part of her apprenticeship. As of the writing of this article, Joni will soon be taking her boards and upon completion will set up two clinics: one in Boulder, Colorado, and one in Westminster, Colorado. Joni hopes to have continuing education seminars and lectures set up around the globe, so she can continue to travel, learn and teach. Many videos of the surgeries and lectures are online at: http://www.travelblog.org/Bloggers/JRenee/