Membership Drive Post #6: the View from the Shady Lady

A week ago Thursday I attended the second-ever meeting (my first) of the Cully Boulevard Business Alliance, at the Shady Lady Tavern at the five-way intersection of Cully Blvd, NE 60th Ave, and NE Prescott St. If you look on a map that shows the incidence of crime in Portland, this intersection is easy to find; it's got a big red circle around it. That's no fault of the Shady Lady (which is under new management); nor is it the fault of the tattoo shop, the Prescott Cafe, or any of other small business owners I met on Thursday. (It probably is the fault of Skinn, which is a strip club; people keep getting shot in their parking lot. They weren't at the meeting.)

I had a nice time. The Shady Lady is a good working-class Third Place, clearly the center of its own community, and now I know where to go if I want to play pool within walking distance. I liked the other small business owners. I got some good tips on how to remove graffiti, and what I should do if the graffiti included death threats. Some collective marketing efforts are in the works, courtesy of the organizers of the meeting, who work for the Native American Youth and Family Center. They employ grant writers, and they're working on a couple of grants to help our fledgling business district.

This is all part of a larger strategy to try to stop gentrification, otherwise known as displacement, in Cully, which according to the most recent census is the most diverse neighborhood in the whole state. It's not going to stay that way, though, without some effort, because according to other recent studies, our neighborhood is one of the last affordable places to live that is relatively close to downtown Portland. People who used to try to drive through our neighborhood as fast as possible on their way to the airport are now slowing down, looking around, and thinking, “Fixer-upper.”

What on earth does this have to do with the POCA Fall Membership Drive, you're wondering.

I feel like I belong here, in all kinds of ways I didn't expect. That has everything to do with WCA, of course. It also has a lot to do with St. Charles, my parish, the Catholic church in Cully.  St. Charles is pretty much the Portland equivalent of the parish where I was baptized in South Baltimore ( that would be St. Jerome's in Pigtown.) This past month our usual priest celebrant, Father Schwab, is on vacation, and so we've had a series of visiting priests, all of whom have made an effort to say nice things about St. Charles.  One of them said,  “Pope Francis says that we should be a poor church for the poor, and St. Charles is, ah, very good at that…” Um, thanks?  Anyway, my favorite comment, the one that made me cry, was by a priest who said, “This is an immigrant parish. For the last hundred years, people from all over have come here and found home.”

I love it here. I don't think of Cully as a blank slate, waiting for developers to fix it up so that it looks more like Portlandia. There are no trailer parks in Portlandia, no scruffy taverns, no Catholic churches with people speaking a dozen different languages.   I mean, I like artisan pie shops as much as anybody else,  but I would hate to see the businesses that are already here replaced by cute boutiques where the people who live here can't afford to shop.

Speaking of boutiques, I have been thinking about how things on the edge, marginal neighborhoods, marginal practices like acupuncture, become safe for more mainstream people to explore. We ended up in Cully because we could afford to buy a house here; we didn't have a lot of neighborhoods to choose from, and we needed a stable place to live. There is no way that we could have started a Big Damn Clinic in a less marginal neighborhood, because we couldn't have afforded the rent. This is what community acupuncture is like for a lot of our patients. They didn't select it off a long menu of healing modalities; it was on the very short list of what they could actually afford. It wasn't an abstract decision made for philosophical reasons — they needed help, and community acupuncture was within reach. A lot of our patients are socially marginalized in different ways: by their class,  by their disability, by their lack of English, by their chronic pain — the list goes on and on. Community acupuncture was designed by and for people on the margins.

Back when we started talking about the principles of community acupuncture, we mostly attracted people who needed help: acupuncturists who couldn't make a living doing what they were doing and who didn't have a trust fund to fall back on; acupuncturists like us who couldn't afford their own services, and who couldn't treat anybody they knew because those people couldn't afford them either. A lot of us had tried and failed to be boutiquers, or tried and succeeded but hated it. We didn't reinvent the wheel because we thought it would be cool. We reinvented the wheel because we were desperate. If there had been something easier to do we probably would have done it, just like if we could have afforded to move to a neighborhood that wasn't known for gang activity and too many bars per square mile, we probably would have done that too.  Of course now if I had a choice I would head toward community acupuncture and Cully like a homing pigeon, but it didn't start out that way.

As part of reinventing the wheel, we systematized certain practices that conventional acupuncturists strenuously disapproved of: quick intakes, distal protocols, symptomatic treatment, and of course, treating people in a room together.  Otherwise known as: doing acupuncture in ways that made it possible for our patients to afford it. Oh, the horror. We were called (by an AAOM Acupuncturist of the Year, no less) “the movement that will lower Acupuncture and Chinese Medicine respectability in the minds of the media,health care community,patients ,practitioners and future generations in America forever….”

But lately, the horror seems to be wearing off.

To wit:  recently there was a front page article in Acupuncture Today titled, The Value of Symptomatic Treatment, that exhorted acupuncturists to stop being so self-centered and make an effort to give their patients some relief for their symptoms. Sound familiar?  Then there's this description of pretty much all of our systems —  conveniently located within a high-end spa. And then there's this ( which probably deserves its own blog, but I don't even know where to start). And this.

Community acupuncture started out as edgy and marginal, but now it's safe for conventional acupuncturists to incorporate — conventional acupuncturists who don't need it as badly as we do, who have other options, who are treating people who also have other options. Things that are designed and built by people who don't have much money, if they turn out to have desirable qualities, become interesting to people who don't have the same financial restrictions and needs. These things — these neighborhoods, these practices — are seen as ripe for fixing up, repackaging, rebranding, turning a profit.  And the end result can be that the people who don't have much money lose their access to the thing that they built, because once it's been fixed up, they can't afford it anymore.

You could make the case that this happened to acupuncture in America already. Whose idea do you think it was to start treating people in individual cubicles and raise the prices? Miriam Lee, who worked in a factory and in her time off, had patients stacked up on her stairs? The Young Lords? The Black Panthers? Chinese and Japanese acupuncturists who learned to practice in group settings? You know what, I can't actually think of a single good clinical reason for the way acupuncture was changed in the West. I really tried, but I can't come up with any condition that gets demonstrably better results if you put patients in little rooms by themselves. So I think we can add “doing acupuncture in little cubicles for high prices” to the long list of Bad Ideas Had by White People.

 The irony is, that was probably an attempt to make it safer and more appealing to the dominant culture in the West, and it didn't occur to anybody that “safer and more appealing” for one group equals “inaccessible” for a whole bunch of others.  Seriously, though, there is nothing whatsoever to recommend the practice of treating people in isolation, or most of the other ways acupuncture has been up-scaled for a wealthier demographic. What we do works just as well, if not better. We shouldn't be surprised when other acupuncturists begin to notice. And we should expect that they will want to up-scale it again. They're not going to run out on to the street (or the Internet)  yelling, “You were right, POCA, we're sorry we've been looking down on you all this time!” They're just going to quietly start adopting the things we do that obviously work, and then they're going to try to repackage and rebrand them in the hopes of appealing to people with more privilege.

After the meeting at the Shady Lady, I walked out with one of the guys from the NAYA Family Center. I asked him, “So can we stop gentrification here? How do you do that, exactly?” He said, “The thing to do is organize. If the businesses here know each other, when a building comes up for sale, they can communicate and one of them can hopefully buy it, instead of a developer from outside. If the community is connected to each other, it's more resilient, harder to disrupt. There are lots of ways to be creative when you have relationships…”  He went on to talk about some creative relationship-based things that are happening in Cully, but of course I was also thinking about POCA.

The only way to make sure that community acupuncture stays accessible to people of ordinary incomes is for us to organize. We can't stop individual acupuncturists from treating our model like a fixer-upper within their own non-POCA practices, but we can treat what we have — what we have with each other — like it's valuable . We can put energy into our coop in a variety of ways — and a Membership Drive is one very important way.  We made POCA because we needed it. Now that community acupuncture has become less marginal, we need POCA more than ever.

Author: lisafer

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  1. More people are hearing of community acupuncture, but in areas where there is only 1 CA clinic and that clinic is $40 and up I worry that that message (CA is still expensive in the long-term) is what will stay with these people. It’s less expensive than private room services, but still too expensive to be a sustainable tool in these people’s lives. I’m not sure what’s sadder: not having access at all or having incomplete access despite the model.

  2. Thank you so much for this blog, Lisa.
    It helps with some of the heartbreak of seeing this thing we have all built with so much grit, pragmatism, innovation, cooperation and love get bastardized mostly for fashion and commerce. It’s like how hipster is an empty version of hip.

    Also, it makes me feel sad for the people who do it without really wanting to understand the philosophy and potential. It ends up being a flaccid shadow–“CA lite” systems without the heart and mind transformation, marketing over community building, another version of competition rather than collaboration, with no real willingness to be challenged– possibly even uncomfortably–and inspired out of the status quo thinking of classism, unexamined privilege, status and self-indulgence towards the freedom, grace and fun of being of service in a reciprocal community of equals. It’s such a sad missed opportunity to dabble in it instead of really living it.

    I love that the POCA membership drive feels like that meeting in Cully: neighbors in CA clinic communities all around the country gathering together to strengthen our cooperation and keep our interests well represented (soon there will be more patient/community members than practitioners!) to resist the gentrification of CA.

  3. Lisa, thank you for the most concise description of the gentrification of CA that I’ve ever read. And oh god, those links … this makes me think of a very financially successful fertility clinic specializing in IVF support in a large Canadian city. They dabbled in group acupuncture at one point. You could have your weekly $150 session with a Senior Acupuncturist (or your $300 laser acupuncture treatment on site right after implantation) but, you could also have a $20, 20-minute acupuncture stress treatment in the Spa Room from a JUNIOR acupuncturist. Chairs were lined up against a wall, eye masks and headphones-with- meditations provided, to minimize any possibility of it feeling like a group experience. (“Husbands are welcome in the Spa as well!” I’m not making this shit up.) But their Spa Room didn’t last long. And many of the patients at that clinic found their way to a CA clinic in town once their benefits ran out.

    I can’t help thinking that those who treat CA as a fixer-upper, by implementing some of our systems but not others, by throwing around some ‘hurray’ words like Accessibility and Community on their websites while remaining a flaccid shadow, as Melissa puts it, aren’t going to be successful, by their own or anyone else’s definition.

    Not that we shouldn’t fiercely resist the appropriation of our branding though. I certainly had to bite my tongue more than once when someone said “Wow, this group acupuncture is soooo different from that other place!”

  4. Thank you for the good writing. I appreciate it.

    I’m very glad you are very aware that many involved in Eastern Medicine are going into assimilation mode as they are surrounded by the popularity of Community Acupuncture. I’d prefer to just call those folks annoying greedy snakes, but the details are important.

    Your blog posting describes two very different economic relationships based on very different values and ethics. One approach to the world of acupuncture is based on extracting the most money from the most convenient sources of those monies. The other approach to this medicine is to apply the most healthcare to the most people. Rich people are a mark for their wealth and targeted by the “Extraction” businesses. People of modest means with under-treated conditions are the target of the “Healthcare” businesses.

    Extraction businesses always create messes that they leave for other people to clean up. Think of the Berkeley Pit. Healthcare businesses clean up messes. Healthcare businesses improve the quality of people’s lives. Extraction businesses leave people in debt and with their resources exhausted. Healthcare businesses give people a good deal. Healthcare type businesses allow people to form community in a sustainable way.

    I have written several postings while trying to “out” the folks running acupuncture schools for taking advantage of students. For-profit school businesses are extraction businesses and a student’s student loans are the mark of such a business. Trust funds, rich husbands’ bank accounts, and wealthy people are also succulent prizes for them also.

    Neighborhoods need strong covenants and the education world needs real public funding. Many people are unaware that education was once affordable. My father’s graduate education was paid for by the state of California 50 years ago.

    I watched the wannabe hipsters help gentrify places like East Austin. And in Minneapolis I’m watching the low self-esteem suburbanites (folks who can’t be seen in public without something that says “North Face” on it) tearing down modest or even large houses that are in perfect shape to build super ugly hardiboard sided McMansions with faux columns on the front. All of this is done because it is legal. But it isn’t sustainable, ethical, or artful. The shortsighted and the greedy build huge ugly houses.

    Coop businesses are the best development since the long term rollback of national investment in education, the arts, and social uplift. I’m stoked CA is so popular because it is one of the ways people discover business outside the culture of Extraction. Medicine based on a Healthcare model has a great voice and a place in the economy thanks to Community Acupuncture. I think it is an inspirational application of ethics in business.

  5. I also think it’s sad to see this kind of “community” acupuncture. The individualism fractal is kind of feeble and small, like a plant that doesn’t really take and is only ever spindly and fungus-infested. To me that fractal doesn’t come close to begetting the beauty of the community fractal. I think one of the fruits of the community fractal that I love most is the accountability. It sounds so dry and even harsh, but I think it is the cornerstone. It makes us challenge and question the very heart of why we do what we do and I think that is where only real change can come from. We become transparent because everything we do is naturally scrutinized in the fishbowl of community, whether that be the community that snoozes together or the community that resists losing itself to gentrification. And what is gentrification, really, than an obliviousness to our effects on others? A lack of community, pure individualism?

    My belief is that people see through individualism. That people naturally want to be better human beings, be more loving, more connected. If someone’s way of learning that skill is to do a boutique version of CA it breaks my heart but so be it. For everyone else already hungry for what we do I have to trust that they will find us as long as our community ties keep us accountable and the fractal keeps growing.
    My belief is that people see through individualism. That people naturally want to be better human beings, be more loving, more connected. If someone’s way of learning that skill is to do a boutique version of CA, well it breaks my heart but so be it. For everyone else already hungry for what we do, here we are at the table already doling out the bounty that we have. I am glad to be at the table with you.

  6. I can’t resist adding my own “2 cents” to this dialogue. Since early August I’ve been working with Mike Gonzalez, at his shop in North Hollywood, to grow and connect his Center Point Community Acupuncture to people in Los Angeles who might want acupuncture but assume they can’t afford it. In 10 weeks, we’ve completed a simple and lovely environmental upgrade– making the space inviting and comfortable with nice lighting, green plants, framed botanical prints on newly painted, soft green walls, and sounds of nature playing in the background. Center Point has a new, friendly logo, new business cards and “punch-cards”, fliers in Spanish and English, and a new website, also bi-lingual. These tools in hand, I’m reaching into the community–to local cancer non-profits, the community health clinic down the block, a mental health center nearby, the school across the street for kids with learning disabilities, the community college a few blocks away, and canvassing small businesses and other organizations nearby.

    Mike’s numbers have stabilized, there’s much work to be done, and existing patients–almost to a person–love the changes, understand the business model, and are excited to take cards and fliers to share with family and friends.

    A couple that recently moved to LA from Boston found Center Point because they knew to “Google” community acupuncture. They’re Spanish-speakers as it happens, and very happy to have found Mike! Another new patient who’d been treated in Seattle at a CA center was equally thrilled to find Mike via the web. Once he sorts out his transport needs, we’ll see him more often.

    So like Mike, I’ve been wanting to thank POCA too! It’s thrilling to greet new patients who already know about CA and find their way to Center Point, one of the ONLY POCA-approved CA practices in all of Los Angeles (!!), a city where some neighborhoods boast more boutique practices than most states!

    Which brings me to the subject of “CA-lite”. Here in LA it’s pervasive. There’s no doubt in my mind that the people who run these practices “don’t get it”, “it” being POCA. They want to practice the way they want, without others telling them how or judging their motives. They know acupuncture is too expensive for lots of people but they’re not interested in serving lower-income folks. Their point of reference is the boutique model, so they split the difference, in pricing and setting. They make it “more” affordable and semi-private (with dividers of some sort or chair layout that create the illusion of privacy)–as if communal energy were something to be avoided.

    I’ve met the owners of some of these practices: nice, sincere people who are probably good punks, though they’d never use that expression and they’ll never join POCA. How do I feel about this? …It’s a free country and the more people who get acupuncture, the better. Since LA is so huge and travel so onerous, I refer people to these practices if they can’t make their way to North Hollywood. $40 is more affordable than $75-$100. It doesn’t make me feel all fuzzy inside though.

    The websites Lisa links in her post leave me a bit stupefied–absolute-silence acupuncture?! Really? Stating unequivocally that “one-on-one” acupuncture is better than being treated in a group-setting? Ridiculous!

    And it’s odd that these practices have actually raised their prices over time. They believe this is how to earn more money. I will never forget Alexa explaining that if you want/need to make more money, lower your prices so treatment is accessible to more people. $15-$35 in Los Angeles is a most extraordinary deal! $40, not so much.

    My goal is to make Mike’s practice “sing” so loudly and harmoniously that he has to expand and we can help other “punks” build “Locate-A-Clinic” CA practices all over town–practices that are proud to be part of the CA “movement”.

    POCA’s community of patients and punks who value affordable, sustainable healthcare, share ideas and support each other is awesome! The “CA-lite” folks don’t know what they’re missing. I think that’s okay.