My Visit to a Traditional Chinese Doctor

David Moser

I have lived in Beijing, China for over ten years, and in that period of time I have
consulted traditional Chinese doctors many times. This is not because I believe in
Traditional Chinese Medicine (TCM), but because as someone with a Chinese wife
and numerous Chinese relatives and friends, I am constantly being urged to go see a
traditional doctor when suffering with the usual vague but persistent health problems
that we all have from time to time. Since I don’t feel there is any harm in this, and for
the sake of sparing feelings and “face”, I sometimes good-naturedly comply with their
insistent advice, and consult one of these doctors.

One interesting aspect I’ve noted about TCM doctors is that in their diagnostic
methodology and their overall doctor-patient dynamic, they employ the same
techniques as Western psychics and mind readers. One recent experience I had
illustrates my point.

I recently mentioned to a Chinese colleague that I had been experiencing some

shortness of breath; nothing very serious, just a mild discomfort that I attributed to the
polluted air in Beijing and a lack of exercise. My friend, however, insisted that I see
her uncle, a TCM doctor who had “legendary diagnostic powers”, and had supposedly
detected and cured all sorts of diseases that Western doctors had missed or mis-
diagnosed. At first I politely declined her offer, but after she took it upon herself to
contact her uncle and set up an appointment, I gave in to her well-meaning gesture.

Dr. Jia’s office was in a narrow back alley situated in Beijing’s Chaoyang District.
The facility was clean but spare, with just a few examination tables and minimal
equipment. In most Chinese hospitals, the patients have very little privacy, with the
consultation taking place in the examination room along with all the other patients,
who can hear and see everything the doctor does. This day was no exception. (When
a patient needs to disrobe, the other patients are asked to wait outside, of course, but
even in this case doctors can be quite lax. I once had a flu shot applied to my buttocks
in full view or two old ladies in the room with me, who I could hear whispering
together about the alabaster quality of Caucasian bottoms.) So as I waited my turn, I
was able to freely observe the doctor’s interaction with his patients
.
Dr. Jia was just beginning to session with a petite young woman who looked to be
about 25. She sat down on a bench in front of the doctor, and without a word he
immediately began taking her pulse. In the typical TCM consultation, the doctor does
not begin by asking the patient about symptoms — that would too easy. Rather it is
the doctor who is suppsed to tell the patient what the problem is. The better the doctor,
the more he or she is able to determine the patient’s condition merely by taking the
pulse and observing outward signs. (The pulse-taking process is very complicated
and esoteric. The doctor supposedly can detect over 15 different kinds of pulses.) Dr.
Jia took the woman’s pulse for a minute or so, then suddenly released her hand and
said “When did you have the abortion?”

Now, this question was clearly designed to demonstrate the doctor’s nearly
supernatural skill at instantly divining intimate details of the woman’s medical history
merely by taking her pulse. But actually, in the Chinese context this question does not
constitute a particularly daring leap of intuition. In the PRC, abortions are cheap,
encouraged (mandated, in many cases), and thus very common. The average Chinese
woman will have 1.7 abortions in her lifetime, and young, sexually active women are
fairly likely to have had at least one. Thus, like any good psychic in the West, the
doctor was making an exploratory guess that had a pretty good chance of being true.
It would similar to a psychic in southern California, where the divorce rate reaches
well above 50%, asking a middle-aged woman “When did you get the divorce?”

Despite all this, however, Dr. Jia actually missed on the first try. The woman said she
had never had an abortion. The doctor, not missing a beat, simply switched gears and
said “Then it was a spontaneous miscarriage. Did you recently miss a period and then
have an unusual menstrual discharge?” Bingo. Yes, this had happened just in the last
year, the woman admitted. “So that was a miscarriage?” she said, voice trembling and
suddenly visibly upset. The doctor took advantage of this, adopting a doctorly tone
that Marcus Welby would have envied, telling her gently that this miscarriage had
damaged her spleen and kidney, and had also disrupted her blood flow, but he could
cure her. No one was bothered by the doctor’s shift from an abortion to miscarriage,
since these two medical events seem intuitively similar in nature; i.e., the doctor at
least had been able to tell that a conception had taken place, and then terminated.

Having proved his awesome diagnostic powers, Dr. Jia no longer had to make
tentative probes. The medical condition had now been identified; the only task
remaining was to fit the symptoms to the disease. The woman, having been surprised
and shaken by the doctor’s ability to penetrate her most intimate secrets, was now
cooperating with him fully. She said that she had come that day to complain of
extreme migraine headaches and dizzy spells, but suddenly she also remembered that,
yes, she had been having some menstrual irregularities lately, and could that be
related to the miscarriage? Dr. Jia assured her that dizzy spells and headaches were
precisely what one would expect in a situation like this, and that the menstrual
problems were, of course, directly related to her condition. None of this information
was supplied by the doctor, of course, but he had coopted the symptoms almost as if
they had been a part of his diagnosis. He even added a small confirmatory touch:
“And you’ve been having some blurring of vision, right?” The woman nodded,
amazed again at his predictive powers — though blurred vision would not exactly be
an unexpected co-symptom of migraine headaches. As Dr. Jia wrote out a
prescription for Chinese medicine, he offered some avuncular admonitions about her
sex life, speaking in a whispered voice that was still quite audible to everyone in the
room. He handed the woman the prescription, and warned her to avoid cold food and
drinks as well as acidic fruits and vegetables.

Then it was my turn. I opened my mouth to say something about my symptoms, but
he simply waved his hand to silence me, and began to take my pulse. He started with
the left wrist, shifting locations slightly and applying slight pressure to the vein, all
the time staring vacantly off into space as if contemplating the mysteries of the
cosmos. The whole “examination” couldn’t have lasted more than three minutes.
Then his face suddenly brightened and he said triumphantly, “I’ve got it! It’s your
heart.” He then looked me in the eyes for the first time and said “About a year ago
you had had some great shock, or stress, that damaged your heart, causing it to beat
and contract in the wrong way. What was that shock?” I sincerely tried to think of
some emotional catastrophe that might have befallen me a year or so earlier, but
nothing came to mind. Seeing that no answer was forthcoming, he simply shrugged
and said “Don’t worry, you’ll think of it eventually. We tend to block out unpleasant
events from our memory.” This was a clever move, I thought; my drawing a blank
was construed as confirmation of his theory!

Since his first tactic yielded no fruit, Dr. Jia turned to my symptoms. “Have you
noticed your heart beating irregularly after mild exercise?” he asked. “Not really,” I
answered, offering no additional information for him to work on. He continued to
pursue this line. “But surely you’ve noticed that your heart takes an unusually long
time to return to normal after exercise, like running?” This seemed an obvious
plausible guess. What man of my age (49) would not notice that his heart is working
harder than before? I decided to help him out, and told them that I had been
experiencing some shortness of breath.

This was all he needed. He proceded to lecture me about the connection between the
heart and lungs, reminding me that shortness of breath is the first sign of heart trouble.
To give him credit, he had indeed zeroed in on the chest cavity as the problem (though
he may have simply noticed me taking a few deep breaths while I was waiting my
turn). As he wrote out a prescription for me, he said “Western medicine has a history
of only a few hundred years. Chinese medicine has a history of thousands of years.
There are some very deep principles that we have discovered that your culture doesn’t
know about.” He then cautioned me to avoid cold, raw foods, acidic fruits, and cold
drinks — same advice he had given to the young woman before me. “This is a
problem with you foreigners’ lifestyle. Too much cold water, cold salads, and the
like. Disrupts your energy flow.”1 Thus concluded my examination.

Here’s an important bit of information I had not shared with Dr. Jia. Just two months
earlier I had had some minor surgery. Would there not be all sorts of blatant
1
Chinese folk medicine is obsessed with issues of heat and cold. A host of ills from fever blisters to premature
balding are attributed to the untranslatable condition of “shang huo” (meaning something like “an excess of
internal bodily heat”). Menstruating women avoid anything cold, newborn babies are wrapped up like mummies
even in the heat of August, and a bewildering list of foods are to be restricted at certain times because they increase
or decrease “internal heat”.
indications of such an intrusion into the body cavity? Would not such a medical event
play absolute havoc with my qi? Surely such a procedure would disrupt my “energy
flow” in some way? Yet Dr. Jia had said nothing to indicate an awareness of this
aspect of my medical history.

Later I mentioned to my friend that Dr. Jia had not even mentioned the surgery, which
would seem to be a salient bit of information. “That must have been the shock to the
heart he was referring to!” she said. “So the doctor was right after all!”

This experience is typical of my interactions with TCM practitioners. In the process

of these visits, I began to notice a number of similarities to Western psychics I had
met or seen on TV. This is a rather interesting cross-cultural parallel, and perhaps
deserves to be spelled out in greater detail. First of all, the psychic and the TCM
doctor have similar skills and use similar methods:

 The TCM doctor, like the psychic, is considered to have an innate ability to
perceive phenomena inaccessible to ordinary people. Though it is assumed that a
great deal of training and experience are necessary prerequisites, in actual
practice the TCM doctor’s diagnostic skill is treated much like that of a psychic,
i.e., as a mysterious supernatural ability.
 The TCM diagnosis is similar to a psychic “reading”. For many traditional
Chinese doctors, the examination process is as much for the purpose of proving
the shaman-like powers of the doctor as it is to diagnose the patient. Like
psychics, doctors use various psychological techniques and commonsense
knowledge to probe facts about the patient’s condition. If they hit pay dirt, they
continue to exploit this nugget; if not, they back away and try another tack.
 The psychic and the TCM doctor both share the technique of exploiting
emotional factors (fear of the unknown, guilt over perceived sins, grief over the
loss of loved ones, etc.) to make the clairvoyant effect more striking. And, as
with the psychic reading, the TCM patient must enter into a collaborative
relationship with the doctor, or else the entire process falls flat. Faced with an
uncooperative participant who does not volunteer or confirm details, neither the
doctor nor the psychic can carry out the trick to its conclusion.
 The evaluations of both psychic and TCM doctor are sufficiently broad and vague
so as to leave a great deal of room for interpretive fudging of available facts. The
psychic does not make predictions like “A man named Alan Chesney from a
company called NetWire will offer you a job at 3:00 tomorrow. Take it.” Instead,
they say “A life-changing opportunity awaits in the near future. Be open to it.”
In the same way, a TCM doctor will not say “Your cholesterol level is 240 mg/dl.
Restrict the amount of fat in your diet”. Rather they will say “Your qi needs to be
adjusted. Avoid cold things.” Nothing is quantified or clearly specified, and few
specific prognoses are given. Almost any symptom can be an indication of any
condition.
Secondly, there are a host of default assumptions and “framing” effects that tend to
guarantee the success of both domains:

 TCM and psychic practice both deal with domains in which causality is vague
and ill-defined, and where there is no clear criteria for success. In the XX
dictionary, the indications for most of the drugs listed are for conditions like
headaches, fatigue, malaise, abdominal pains, appetite and digestion problems,
menstrual problems, and so on, all symptoms that are notoriously difficult to
diagnose and often have psychosomatic origins.2 The more serious diseases are
seldom mentioned. (Chinese people are usually quite aware of the limitations of
TCM. If somone has vague stomache pains, they might consult a TCM
practitioner; a patient with acute appendicitis will go immediately to a Western
hospital) Similarly, the problems psychics deal with involve intractable domains
such as interpersonal relationships, romance, career, and, of course, the realm of
spirits and the afterworld.
 Most bodily discomforts, and to a lesser extent emotional ones, simply resolve
and disappear spontaneously over time. When the condition improves naturally
over a period of weeks, the patient will naturally assume — and the doctor will
claim — that it was the medicine that did the trick. 3 In the same way, most
problems one might consult a psychic for will eventually clear up or be forgotten.
Broken hearts, like broken bones, heal over time, and the psychic will get the
credit — and the fee.
 When pain or discomfort arises, most people begin to focus attention on aspects
associated with the pain, and will make changes in their activities to maximize
healing. If the patient has a knee pain, in addition to taking medicine or
acupuncture, he or she will naturally alter his behavior in myriad (often
unconscious) ways that will work toward correcting the problem, such as walking
less, or favoring the other leg. Similarly, someone who consults a psychic is also
simultaneously working on the problem in other ways — talking to friends,
reading self-help books, etc. — and thus the solution may arrive regardless of the
psychic’s participation.
 Finally, merely taking steps to correct the problem, and having a sympathetic
authority figure working with you on it, can have enormous psychological effects.
The sympathy of families and friends, the lowered expectations and lessening of
daily pressures, etc. can also have tremendous psychological healing effects. The
very act of taking the medicine or calling up the psychic gives the sufferer a sense
of hope that can speed the healing process.

These cross-cultural similarities suggest the obvious fact that human beings from any
2
TCM has an added advantage here, namely that expectations for cure are lower, and more subtle than for Western
medicine. The Chinese say that Western medicine treats the symptoms, but Chinese medicine treats the gen, the
“source/root” of the problem. Thus Western drugs like aspirin are expected to work almost immediately, whereas
Chinese medicine is not expected to have any noticeable effect right away. The patient is instructed to take the
mixture for weeks or even months, in order for the root cause — usually considered to be some kind of imbalance
of bodily functions — to be corrected. Thus the lack of any ameliorative effect is not considered evidence of
failure.
3
Of course, this is a problem for Western medicine, as well.
culture are universally susceptible to the same kinds of chicanery and deception. The
aspects I’ve sketched above are shared to some extent by any number of other
charlatans, including TV evangelists, faith healers, and mind readers. Some of these
factors even play a role in more “legitimate” domains such as Western medicine and
psychotherapy, and this is an issue that warrants more research.

Not all TCM doctors are like my Dr. Jia. Many have knowledge and training outside
of the traditional practice, and often can provide sound and helpful advice concerning
aspects such as diet, exercise, and lifestyle. TCM remains essentially a vast body of
folk knowledge, but many of the remedies and physiological principles contained in
literature have been shown to be efficacious in Western medical terms. It would not
be surprising to find that centuries of TCM practice had stumbled upon herbal
mixtures that do indeed have salutory effects, but none of these have been rigorously
tested.

As mentioned above, TCM doctors will tell you that the advantage of TCM is that it
adopts a holistic approach to healing, addressing the complex root of the problem
rather than merely alleviating symptoms. That is the theory. Yet the almost fetishistic
emphasis on Chinese herbal medicine itself as a cure-all “potion” tends to negate this
supposed advantage. A friend of mine recently developed symptoms of fatigue,
lymph node swelling, and a constant sore throat. Friends and family suggested
everything from Chronic Fatigue Syndrome to hyperthyroidism. The Western doctor
he saw ran a few tests, could find nothing obviously wrong, and said “The body is
complicated, and the parts are interconnected in many ways.” He simply
recommended more exercise, good diet, rest, stress reduction — in short, invoking the
body’s natural healing processes. By contrast, the Chinese doctor he consulted simply
said “Your liver and spleen are not working properly. Take this medicine.” Strange
that it was the the Western doctor who spoke of holistic processes, and the Chinese
doctor who merely prescribed a magic pill.

TCM has some official sanction in the PRC, mainly for nationalistic reasons. The
Chinese government characterizes TCM as a “treasure” of ancient civilization, and
even wrote it into the constitution in 1982. The vast majority of Chinese people
profess to believe in it, whether or not they actually consult a TCM doctor.

The fact is, however, that TCM is dying out Though mainstream Chinese doctors still
combine Western and Chinese medicine to some extent (all hospitals have both a
Western pharmacy and a TCM pharmacy, separately housed but used in combination),
the tradition is quickly being replaced by standard international medical practice.
Some doctors say the prognosis for TCM is not good, and predict a rapid demise over
the next decade.

Ironically, the last bastion of Chinese medicine may very well be the West, where
attraction to Eastern exoticism is still strong, and people are searching for alternative
forms of medicine.