POCA as a Knowledge Commons: POCAfest Keynote

I'd like to acknowledge that we're on the traditional territory of the Miwok people, and I'd like to acknowledge and thank everyone who made it possible for us to be here, including the people who built these buildings and who clean them and care for them every day, and the volunteers who have made this POCAfest happen.

Andrew Zitcer, a professor at Drexel University who studies co-ops, recently described POCA as a knowledge commons. So that’s what this talk is about — what does that mean? But before we get to that, I want to circle back to the very last presentation that was given here at POCAfest last year: Tyler Phan’s Smashing Chinoiserie Vases. By the way, Tyler sends his love to all of you and wishes he could be here. In his absence I'm just going to have to quote him a lot.

Tyler said:

Despite (white people) attributing Chinese medicine’s inception to the United States with the New York Times reporter James Reston …  Chinese medicine had already existed in America a hundred years prior. In fact, much of Chinese medicine’s beginnings occurred during the 1850s with Chinese immigrants moving to America for the Gold Rush. The oldest recorded practitioner was “Doc. Hay” (Ing Hay) who … would settle in John Day, Oregon. In John Day, Doc. Hay began treating patients at the Kam Wah Chung store where his initial clients were Chinese laborers. But by 1910, most of the Chinese relocated, leaving a significant portion of his patients to be non-Chinese white settlers.

This summer I got to go to the Kam Wah Chung store, which is now a museum in a state park. It’s an amazing place. There’s a lot to say about it and Doc Hay, but this isn’t a history lecture so I want to focus on just a few things.

Kam Wah Chung was a kind of community center for the Chinatown in John Day. The reason there was a Chinatown in John Day (which is quite a small town) was that the Chinatown in nearby Canyon City had suffered a mysterious fire and afterwards, the Chinese community wasn’t allowed to rebuild there. They were permitted to move to John Day; the space they were offered happened to be on a flood plain. Most of the Chinese laborers who lived there lived in tents. Sometimes at night, for entertainment,  local cowboys would ride through, shooting randomly into the tents.

The Kam Wah Chung store is a little wooden building, reinforced with tin. It has small windows and those windows are covered with shutters and the shutters are pocked with bullet holes. The kitchen in the living quarters of the store has an especially thick floor by the stove, so that Doc Hay and his business partner could chop wood without having to go outside, because it often wasn’t safe to go outside.

Inside the Kam Wah Chung store, it feels a lot like a small, dark fortress.

The oldest recorded practice of Chinese medicine in the U.S. was by marginalized people, for marginalized people. And a lot of the time, they were under siege.

As Tyler said, With the strength of the American Medical Association and biomedicine, “irregular” medicine was in the crosshairs and after the passing of the 1882 Chinese Exclusion Act as well as the sentiment of “Yellow Peril,” the perception that East Asians were seen as a threat to the rest of the world, Chinese medical practitioners were targets of persecution.

Inside the Kam Wah Chung store, next to Doc Hay’s apothecary, there’s a worn upholstered chair where his patients would sit while he took their pulses. It’s not clear exactly when, but at some point Doc Hay began treating people from outside the Chinese community. The first time he was brought up on charges for practicing medicine without a license, they were dismissed because he had saved the son of a nearby ranching family from tetanus, after the local medical doctor had given up on him. Until the store closed in 1948, he treated Chinese and non-Chinese patients from all over the country, often by correspondence. People would write him letters describing their symptoms, and he would make up prescriptions and mail them back.

A few steps away from the apothecary was Doc Hay’s bedroom. After his death, under his bed they found a box with $23,000 in un cashed checks, the equivalent of a quarter of a million dollars today. As far as we can tell, he didn’t cash them because he knew that during the Depression a lot of his patients, near and far, couldn’t really afford to pay him. 

The oldest recorded practice of Chinese medicine in the U.S. was inside a small, dark fortress,  shuttered tight against violence, but inside was this tremendous, far-reaching compassion.

So I would call Doc Hay’s work a praxis of liberation.

But let’s get back to our theme: what exactly is a knowledge commons? And why is POCA one?

According to Wikipedia, which by the way is also a knowledge commons, it means “information, data, and content that is collectively owned and managed by a community of users.”

And what do we mean when we say knowledge? As opposed to data and information?

Data means facts, a description of the world — LI 11 is here (point).

Information means captured data that we learn — for example, the functions of LI 11, according to Miriam Lee, are that it scatters wind and relieves the surface, stops itching and prevents infection, tranquilizes the spirit, reduces blood pressure, improves sleep, and relieves all kinds of pain.

Knowledge means our map or model of the world, patterns, understanding, information distilled into action. Data and information are something we can gather and collect from the outside; knowledge is the result of processes that happen inside. Knowledge has to be metabolized, integrated, built.

My knowledge of LI 11 includes that it’s usually the first point I would needle on a brand new patient who has never had acupuncture before, because typically LI 11 doesn’t hurt. It calms the spirit and relieves all kinds of pain, and it’s easy to put in. So if I’ve said to this new patient, let’s try acupuncture and see how you like it, and then their very first experience of being needled is OK, I’ve opened the door to trust between me and that patient. So LI 11 is part of the door to trust. That trust is also connected to the clinic being set up so that patients can see other people getting acupuncture, they can see that it’s safe and comfortable. That trust is connected to our model making it possible for them to bring their grandmother with them the next time they come, because she’s been looking for something to help with her arthritis pain.  LI 11 is part of a pattern. Knowledge is context and depth and all the ways that we integrate data and information until they are part of us, part of how we interact with the world. Knowledge tells us how LI 11 is connected to treating everybody’s grandmother.

Doc Hay had knowledge of how to practice in the context of a community with many tensions and challenges; he had knowledge of how to be a committed practitioner in the context of a severely inhospitable environment. Somehow he metabolized and integrated all that external hostility into his practice of healing.  We can’t ask him about the details, but he left us his example, his praxis of liberation, which is probably the most important thing anyway.

Let’s look at some more examples of information versus knowledge in POCA.

The business model is really just information. Low cost, high volume, recliners or LaFumas, invisible reception or volunteers, pros and cons, pretty straightforward.

Knowledge, on the other hand, is the awareness that the information in the business model, the low cost, high volume thing, translates into lowering barriers to getting acupuncture, and that means that you are creating the potential for a community to form around your practice, in the same way a community formed around Doc Hay’s practice. Knowledge is using the business model as a tool to build and reinforce that community. Knowledge is what happens as you metabolize and integrate the relationships you create. Knowledge has to do with how your participation in that community changes you. There’s a pattern, and you become part of it.

Information is the fact, which you can read in various places online, that some acupuncturists (still) feel that lowering the cost of acupuncture “devalues the medicine”.   We have our own version of an inhospitable environment — more about that in a minute. Information is also the data from our annual surveys, that shows that there are hundreds of thousands of patients out there who, regardless, want exactly what our clinics have to offer.

But knowledge is understanding that your own attitude about your fees will determine how comfortable people feel in accessing treatment at your clinic.  Knowledge is being able to recognize when someone needs more care than they can actually afford, and then figuring out what to do. Knowledge is connected to responsibility: you have skills that could make a huge difference in someone else’s quality of life. There’s a pattern, and you’re part of it, and Doc Hay was part of that same pattern too.

Speaking of patterns — who benefits from the data, information and knowledge that make up the practice of Chinese medicine?

Going back to Tyler’s talk, he made the point that the most problematic aspect of what we call cultural appropriation is not putting a statue of a Buddha in the bathroom of your clinic as decoration — though that’s quite problematic; the most problematic aspect of cultural appropriation is when laws are made, social structures are made, that limit and define who has access to a culture and its technologies.

Tyler said: To summarize American Chinese Medicine: a few, mostly white men, Orientalize the medicine, receive a brief education in Chinese medicine, and make (their understanding into) law.

He said: Chinoiserie is a result of a specific Orientalized gaze. It’s a mass produced product built on the imagination of a distant Other. Similarly, American Chinese Medicine is a mass produced product built on the imagination of a distant Other.

Most of us acupuncturists in POCA received our education in the context of American Chinese Medicine, which is profoundly shaped by institutional racism.

I want to argue that if POCA is really a knowledge commons, we have to collectively integrate that particular information too.  If Doc Hay could integrate getting shot at, I think we can integrate the awareness that we practice in a context of social injustice, institutional racism, and cultural appropriation. I think we can handle that.

A lot of white people gravitated to acupuncture as a career because consciously or unconsciously, we were looking for an escape from the problems of our own society, and we hoped to find it in that imagination of a distant Other. There’s a big difference between escape and liberation. Escape is something you can do individually — tunnel under the walls of the prison at night — but liberation is something we can only do collectively. Liberation is when the walls come down and everyone goes free. Even if we can’t have that right now in our physical reality, we can keep our hearts and minds focused on it.  It’s understandable that what we want is escape — but liberation is what we need.

Doc Hay wasn’t trying to escape. He was practicing liberation, extending himself despite the dangers all around him, extending himself beyond all kinds of walls.

And our praxis of liberation, I think, is also to extend ourselves: to preserve a technology that was developed by marginalized people for marginalized people, and by “preserve” I mean, preserve access for marginalized people to that technology.

Because access is a crucial part of the pattern of knowledge. Without access, all of our data and information about acupuncture is just words on a page. It only comes to life when people use it. And I’m arguing that we have a particular responsibility to pay attention to which people can use it. So POCA’s role as a knowledge commons shouldn’t be limited to keeping track of the best place to buy LaFumas online, though of course that’s a good thing to know.

Let’s talk about our inhospitable environment.

How many of you have ever used Wikipedia?

How many of you use Wikipedia regularly?

How many of you have ever given money to Wikipedia?

How many of you give money to Wikipedia regularly?


Maintaining any kind of commons is very challenging in capitalism. Because there are always going to be a lot of people who want to take as much as possible from the commons and give as little as possible back. Our society is structured to reward and reinforce that.

Our society isn’t going to reward us for maintaining a knowledge commons, especially if its purpose is to preserve a technology for marginalized people.

For a lot of acupuncturists, their primary question about POCA is, what’s in it for me? (And apparently free CEUs aren’t enough, unfortunately.) A lot of us are hoping there is some magic formula that will allow us to personally escape the suffering that comes along with capitalism. If there’s no personal escape to be had, what’s the point of extending ourselves? Why bother with any kind of collective project?

It can be very discouraging, encountering that attitude of what’s-in-it-for-me. And the temptation in our inhospitable environment is, I think, either to give up on the project of having a commons, to decide it’s just too hard; or to lose sight of what the purpose of our commons is, and cave in to the demands of the people who only care about what’s in it for them. To do neither of those things, and to stubbornly insist that a commons is worth maintaining for its own sake, is not unlike being holed up in a small shuttered building in the middle of a vast unfriendly landscape.

The difference of course is that nobody’s shooting at us. No laws have been passed declaring us unwelcome in this country. Compared to a lot of the people who came before us, we’ve got it pretty easy. We’re trying to do something profoundly countercultural, and the fact that we can do that without being the targets of state violence is part of our privilege.

What we’re trying to do is very hard to do, but the point is, we’re free to do it. We’re exercising our human capacity for liberty. To choose to do what we feel is worth doing, even when society doesn’t reward us for it. To step out of the Matrix. I would call that a privilege also.

As I think everybody’s heard, POCA Tech got into Candidacy. Which means we are finally, really truly, able to grow our own punks. But this was only possible because a lot of people were able to look beyond their immediate self-interest to invest in the co-op’s future. We collectively exercised our freedom and we did something tremendously creative.

But getting POCA Tech into Candidacy is just the beginning. The school is potentially the gateway for people to become punks who otherwise would never be able to, people who can serve and represent communities that would otherwise never have access to acupuncture. And we’re going to have to do a lot of work to keep tuition low enough for that gateway to stay open, and even open up further. In the long run, it won’t be enough to wait for the right prospective students to come to us, we’re going to have to go out and find them. That will be a lot of work, on top of what’s already a lot of work. None of it is going to provide an individual escape for anybody. If we succeed, it’s going to be all about collective liberation.

It’s a difficult and uncertain undertaking. But still, nobody is shooting at us. So I think we owe it to Doc Hay to try.

Author: lisafer

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  1. Thanks so much for all these insights! Its always a relief when someone is able to uncover and put into words the dissonance we feel.

    “A lot of white people gravitated to acupuncture as a career because consciously or unconsciously, we were looking for an escape from the problems of our own society, and we hoped to find it in that imagination of a distant Other. There’s a big difference between escape and liberation. Escape is something you can do individually — tunnel under the walls of the prison at night — but liberation is something we can only do collectively. Liberation is when the walls come down and everyone goes free. Even if we can’t have that right now in our physical reality, we can keep our hearts and minds focused on it. It’s understandable that what we want is escape — but liberation is what we need.”