Malia's note:

After reading a recently published article through the New York Times entitled, Does Your Language Shape How You Think?, Shawn and I have recently reopened and rehashed a discussion that has continued off and on since our days as OM students. Coincidentally, as this made its way into our conversations during our daily commute into work last week, the essay that follows below, written by Valerie Hobbs, L. Ac. and Campus Director of SWAC Boulder, also found its way into our discussions from its recent publication in The Luo Down, SWAC's quarterly newsletter. In it, Valerie beautifully sums up our thoughts on translating Chinese TCM terminology into English TCM terminology and finally into layperson's terms for full disclosure. Enjoy.

Glorious Nonsense
By Valerie Hobbs, L. Ac.

Do you know what Alice actually said upon reading the Jabberwocky? She said, “It seems very pretty…but it’s rather hard to understand!...Somehow it seems to fill my head with ideas – only I don’t exactly know what they are!”

When I’m gazing into the looking glass of Chinese medicine, I have to admit that my experience of the practice of it is much like Alice describes: my head is full of ideas, and sometimes I don’t know exactly what they are.

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Case in point: I’m supervising the treatment of a 32-year-old woman for premature ovarian failure. We have copies of her western medical lab studies, which include levels of FSH, estradiol, LH, Anti Mullerian Hormone (AMH) and antral follicle counts. She has had ultrasounds and a salpingohystergram. I look at her tongue, palpate her pulse, and ask the questions of inquiry to establish a bian zheng diagnosis. She dutifully fills out a BBT chart, for several months in a row. While I have a working diagnosis of liver blood/kidney yin deficiency, liver depression/qi stagnation with depressive heat harassing the heart, and spleen and kidney yang deficiency with blood stasis – I am confused for a moment by her deep, vacuous, slightly rapid, changing from slightly slippery to slightly wiry pulse picture. Even in the midst of this exquisitely crafted (and not every patient is this complex) diagnosis, even I wonder if I am not making all of it too complicated. And when it comes to picking points today, a simple TCM prescription is formed. An idea using a five element treatment next appointment is articulated. The herbs are a little trickier…and I have to admit…some modifications create in me an internal feeling of restlessness, a confluence of ideas that I cannot describe. I am an avid reader of texts, of blogs by TCM experts, of research. I am very careful to craft a formula from my diagnosis. It’s just that out of a cohesive formula, one ingredient keeps, how do I say it accurately? It keeps bugging me. I should know something else about it. I have an unformed idea that it isn’t quite right. And all of this occurs in collaboration with a hyper smart senior intern, who is looking naturally to me for some kind of cohesive logic in my process. In the end, my reasoning is clear but the path of pondering contained some distances that I still can’t describe.

I have a friend whose polylingual daughter is about to embark on a career path to study the effect of language on how the brain forms its thinking process. In short the theory describes that kind of language you learn, how many languages you learn, and at what age you learn them determines in some part how your brain develops, which synapses fire, and how you will view reality. Practicing a medicine with a language of origin made up of pictograms, I have to wonder if the very process of thinking about TCM is inherently different from concepts created by thought based on a western alphabet. Maybe it is my western interpretation and translation that creates my personal inner dialog about what I know vs. what I feel I should know and how to use both feeling and knowledge to help the patient in front of me in the treatment room.

If I am thinking this medicine has a bit of Glorious Nonsense to it, how on earth can I explain this to my patient, who deserves as much full disclosure as I can give? I keep coming back to the wisdom of Alice: “It seems very pretty…but it’s rather hard to understand!” If I use words like “damp” and “wind” have I really said anything more knowable than “mimsy” or “slithy toves”? And isn’t it reasonable for any patient, any student, and truth-telling practitioners of the medicine to sometimes wonder….does this make any sense at all?

And so I come to my best conclusion. On the outside, this looks very reasoned, but the internal process really feels just bit like Glorious Nonsense. When I remarked to a beginning student this week, that yes indeed, sometimes I do feel like I am making it up, his response was to express relief that he wasn’t alone in feeling that way.

I have come to think about the practice of the Chinese medicine in coexistent terms. These coexistent ways of thinking developed because I have a need to describe Chinese medicine in modern scientific terms as well as the language of TCM. However, modern science has evolved at its core a reductionist approach, which says that all phenomena can be scientifically explained by breaking down complex interactions into their constituent parts, each of which is knowable scientifically. Some theorists have questioned the logical outcome of scientific reductionism: if everything that exists can be known, does this mean if you can’t explain something scientifically, then it doesn’t exist?

The practice of acupuncture’s encounter with western science is something like that: if we can’t measure it, it doesn’t exist. In an amazing twist of reductionism, Physical Therapists in America are actively engaged in redefining acupuncture in western science terms, and then insisting that it is no longer acupuncture. Working in Western culture, engaging in collaborative integrative science with western medicine, and engaging western patients does sometimes mean you run out of scientific terms and you have to take your patient or your colleague with you down the rabbit hole. And it isn’t because TCM is an exercise in energetic medicine that can only be known intuitively; it’s just that we may not have words and measurements that make any western sense. Yet.

I can think logically, in both western science and TCM. And then there are these other times, when I know something, I have a glimmer of a concept, but it takes me some time and study to find the terms to describe it so I can move it out of Glorious Nonsense and into application in the treatment room.

What I have just described may only be a reflection of a very personal process. But I suspect that there comes a time for all students when they, too, have to work pretty hard at articulating understanding. Imagine being a patient. Perhaps the most courageous act I witness all day is when a patient willingly lays down on a treatment table even though the explanations sound a lot like the Jabberwocky. You might as well outgrabe.

The rubber meets the road however, when the medicine works. And how it works! Another case: I’m working with a patient to increase fertility. As part of her TCM workup, she had a noticeable weak pulse on her left as compared to her right. She describes the pulse as starting to be that way after a surgery to remove a fibroid. Can’t articulate why, but it seemed to me that the five element treatment known as a Husband-Wife or Ascending/Descending treatment would be appropriate. Two weeks after the treatment, her pulse is no longer unequal from side-to-side. Her internal experience is that the quality that made her feel “off balance” internally, is also no longer present. While it remains to be seen if this will contribute to increasing fertility, the case reveals in both practitioner and patient that there are processes that cannot be articulated, but that are treated anyway. This happens over and over in the treatment room. No matter how I try to reason with it, I would have to say that embracing this nonsense is the reason I practice this medicine.

Valerie Hobbs, MSOM, L. Ac., is the Campus Director at the Boulder Campus, the instructor for OB/Gyn and the supervisor for OB/Gyn clinics at the Boulder Campus.