I don’t want to distract any attention from the conversation going on below, but I’ve only got 2 more days to finish this 2010 retrospective on the CAN blog, before we’re into 2011 and retrospectives start to look a little silly. So! Not only was this past year full of fascinating interactions with the acu-establishment, but it was a great year for making media.
I don’t mean being IN the media. We’ve had better years for that, for instance, I’ll take our Marketplace story over the New York Times one any day. I mean making our own communication materials that help establish and reinforce our own culture. This year WCA made and posted a video of Dr. Michael Smith’s talk at last year’s CAN Board meeting; Jessica of the Turning Point and Jackie Cutler of Media Awakenings created the fabulous CAN video; Andy and Manchester Acupuncture Studio produced their splendid book, Why Did You Put That Needle There — complete with a free AUDIO download version; and Brian Lindstrom, an honest-to-God award-winning filmmaker, started work on the CAN documentary. And so many of you comrades kept buying (and selling) the Noodles book that WCA was able to contribute $2000 towards the filming of the Philadelphia segment of the documentary.
It’s starting to seem like a long, long time ago that I used to lie awake at night and despair of ever being able to explain to anybody what this was all about.
It’s easy to underestimate the value of materials like books and videos and films and blogs once you have them; it’s easy to take them for granted. But they are building blocks for the movement, and looking back, it’s amazing how they build on each other. The first real means of communication our movement had was the original Little Red Book, basically a zine, written by me and Skip in a burst of frustration after reading this article. We copied them at Kinko’s and I used to go to the post office and mail them out one at a time; I couldn’t wait until I got a bunch of them because I was just so excited about each individual order. The Little Red Book led, indirectly, to the articles in Acupuncture Today; I figured if I could write this zine-like thing in a few weeks, I could write a 1,000 word article every other month. The articles in Acupuncture Today led to the idea of CAN and the CAN website, which led to the CAN blog (that was entirely Skip’s idea, by the way). The more stuff we made, the more it became clear what pieces were missing, and dedicated comrades stepped up to create what we needed. And then they shared them! The CAN video is free for anyone who practices community acupuncture to put on their website so that patients know what to expect. $1 of every sale from Why Did You Put That Needle There goes to CAN. The agreement that CAN has with Brian Lindstrom is that half of all sales of the completed documentary DVD will also go to CAN — which will, of course, help us create the next round of media.
Media supports culture. Community acupuncture as a movement, without its distinctive culture, would mostly be about the business model, and that isn’t enough. Obviously the business model is important when you are talking about the difference between acupuncturists being able to make a living by being acupuncturists, as opposed to barely working at all and having to support themselves with other non-acupuncture employment. And the business model is what provides the reality of acupuncture, as opposed to the idea of acupuncture, to our tens of thousands of patients (we might be getting towards hundreds of thousands of patients at this point). But what always mattered the most to me about the business model was the vision of it being implemented widely, which would mean — as Jade wrote — that acupuncture could truly become a common everyday thing in our communities. And for the business model to be implemented widely would require the support of a culture which was radically different than anything that existed in the acupuncture world at the time that I was lying awake and fretting about how to communicate the vision.
We needed a culture that promoted transparency, simplicity, and sharing. We needed a culture that was charged with passion and enthusiasm and a willingness to try stuff out; in which acupuncturists were genuinely free to celebrate each others’ successes and cheer each other on and learn from each others’ mistakes. We needed a culture that FELT completely different from the professional culture we had. Because culture isn’t just about concepts and conversation; it can make things happen, or prevent them from happening.
And lo, we got the culture we needed. This makes me teary, comrades. I wanted this so badly and I had no reason to believe it could actually happen and yet here you all are. Thanks to you, I live in an entirely different world than I did when we wrote the first Little Red Book.
So that’s mostly what I wanted to say when I was originally thinking about this post last week, but now I have an addendum based on the conversation that happened as a result of Larry’s post. An idea occurred to me.
I can still remember, without having to go back and look it up, the first sentence of the original Little Red Book. It was, “There have always been a lot of different ways to practice acupuncture.” I guess it’s easy to remember because I still believe that’s one of the most important things about acupuncture — that there is no one right way to do it.
As you all know, because I keep talking about it, one of the other big things going on in my life is what’s happening with my church. We are grappling with the changes in the Catholic church as a whole and with what that means on the ground for our beloved, 100-year-old, working class, mind-bogglingly multicultural little parish. Obviously we are not the only parish or faith community that has to come to terms with these forces. There is an idea which is being talked about and written about extensively among Catholics, that a church is not simply a community but “a community of communities”. This is important because it suggests, among other things, that a strong and healthy church is not based on uniformity, a.k.a. people of color having to assimilate to the dominant white culture. Here is a really good article about it, written by a Mexican American priest, “When Worlds Collide”. It includes a short, clear, non-academic definition of “culture”, which I found helpful to read after wading through the discussion that followed Larry’s post. For another perspective on the idea of “a community of communities” here’s an article written by a Dutch priest about working to expand it into an inter-faith context, in a wildly diverse district of the Hague.
So I was thinking of these things when I read Michael Jabbour’s comment:
“In my view there are only LAcs. It is unfortunate that our community has
become so fractioned and communications have become so
difficult/intolerable that we have to classify ourselves as CAN-LAcs,
NADA-LAcs, Biomed LAcs, etc.
It is important that we work together to elevate the discussion and
re-establish a value system and professional infrastructure among those
that care that we can pass on to the next generation of practitioners.
It is not sustainable for any of us or beneficial to our patients to
pass on the 3 decades of in-fighting regarding educational and practice
model disagreements. Let’s find a consensus-building path and expand our
views on what we think is professionally possible, regardless of how
long it will take or what it looks like.
Our profession has gone through enough radical changes in the last 20
years, the lack of stability seems completely reasonable to me.
Regardless, I think it is completely possible for us to influence each
other globally as practitioners and find stability if we are able to
engage each other in an independent and publicly accessible discussion
group and stay in that room long enough to build respect for each
other’s humanity and professional achievements.
I would gladly welcome additional moderators to the AOM Community Forum
if you feel that is what is preventing contributors from joining.
Additionally, ACAOM is looking for commissioners, AAAOM is looking for
new directors, and state associations across the country are looking for
volunteers. The profession needs new leadership to take over and build
the future. Too few are willing to put in the time or energy to do the
work that makes our profession possible and everyone is willing to
complain ad nauseam, let’s change that together.
As I have mentioned before publicly many times, it doesn’t matter to me
which alphabetical configuration we use for our professional association
but we need to support and build one that will advance and protect our
profession (thereby our patients) according to the basic values and
structural considerations we can all agree on.
We need people who can moderate difficult discussions and hold people
accountable without excluding, censoring, or demeaning. Feel free to get
in touch with me privately if you or others have alternative ideas of
how we can dialogue with each other about controversial issues and
What if it’s NOT unfortunate that acupuncturists classify themselves as CAN-L.Acs, NADA L.Acs, Biomed L.Acs, AAAOM L.Acs, Tai Sophia L.Acs, or whatever else? What if that weren’t a problem? Maybe that’s just what diversity looks like, and is not surprising given the extremely diverse evolution of acupuncture itself; maybe we can’t build consensus around the things that other professions build consensus around. But maybe we could still find a way to become “a community of communities”.
So one thing I know is that the AAAOM would very much like to become a kind of umbrella organization, and count CAN and our 1,000 or so members under its umbrella. That makes sense. But clearly, it’s not going to happen. The cultural issues are a deal-breaker. Even though everyone in the discussion on Larry’s post was speaking English, we still don’t speak the same language. I am going to suggest that the AAAOM might contemplate what it would look like for it to become, not the one and only representative of the profession, THE organization for acupuncturists, but a community of communities.
There are, after all, a few things that CAN L.Acs and AAAOM L.Acs actually both need, and benefit from. I wracked my brains and I could think of exactly 3.
1) Independent licensure. I don’t care about MDs or DCs or anyone else doing acupuncture, but I do care that people should not have to become MDs or DCs or whatever else IN ORDER to do acupuncture.
2) Access to safe, sterile, affordable needles. Nuff said.
3) Infrastructure. More on that in a minute.
It’s important to acknowledge that most of what the AAAOM has currently and historically worked towards has little or nothing to do with what CAN needs. Insurance coverage? Insurance parity? The vast majority of our patients are never going to have insurance that covers acupuncture. Access to herbs? Important to some of us within CAN but not really necessary to a lot of others. Acknowledgement from MDs and the biomedical establishment? For what purpose? Access to patients? WCA gets tons of referrals from MDs and RNs and even hospital social workers. I got a fax the other day that I saved just because I thought it was so funny; it was a prescription for 8 acupuncture visits from a physician I’ve never met for a person who is not yet a patient at WCA. A prescription — it’s like they’ve figured out that we are like a low cost pharmacy, and so they send their patients to us for something they want their patients to have. I’m happy for WCA to be a low cost pharmacy. Respect from MDs leading to jobs in hospitals? We don’t want to work in hospitals, we want to work in our own communities, keeping people OUT of hospitals. And we can create our own jobs, thanks. So far, AAAOM, you’re not giving us much incentive to have a relationship with you. What exactly would we get out of it?
Ah, let’s talk about infrastructure. The needles and the laws are by and large non-issues for all of us at this point, but the infrastructure isn’t.
Infrastructure is part of what makes my church hold together as a “community of communities”. All of us Catholics who live in the Cully neighborhood need some of the same things, as Catholics. We need a place to celebrate the sacraments; we need a priest celebrant; we need the administrative staff and the infrastructure that allows us to be a church — to keep the lights on, make coffee after Mass, to teach the kids our faith, to organize the volunteers and the donations to feed the people in our parish who need food, and pay their utility bills when they can’t, and visit them in hospitals and nursing homes. And we all get it, that there are not enough European-American/white Catholics in Cully to do that alone; there are not enough African American Catholics in Cully to do it alone; not enough Eritrean Catholics, not enough Micronesian Catholics, not enough Hispanic and Latino Catholics, not enough Liberian Catholics, not enough Vietnamese Catholics — you get the picture and so do we. We need each other. Because infrastructure is expensive and none of us have any money to speak of. This is very different from an academic understanding of cultural competence, by the way; this is about depending on each other.
The equivalent infrastructure in the acupuncture world is made up of the NCCAOM, and the ACAOM, and the schools. I get that it was a big deal to create that infrastructure and that it’s expensive to maintain, and I get that plenty of people in the acupuncture establishment are mad that CAN isn’t grateful for it. The problem, of course, is that nothing about the infrastructure meets our needs. We don’t want to help support it or maintain it, give it money or volunteer energy, because it doesn’t do us any good. That could change, of course, if the people whom the infrastructure DOES benefit decided that it was worth it to them to adapt it enough so that it did serve us, and so that we would be willing to pitch in. The alternative for us, obviously, is to create our own infrastructure, which is expensive and labor intensive and time consuming. We can do it if we have to, of course — just like you in the establishment did.
That’s one big thing that CAN would need to participate in a community of communities with the AAAOM: some tangible, practical benefits. Another thing, even bigger, would be a structure in which we were not being asked to give up our culture, our ways of doing things and of communicating, as a condition for participating. We worked hard for our culture; we’re not interested in assimilating. This post is too long already, so I won’t go into more details. I’m just curious whether this idea of a community of communities for acupuncturists has any resonance with anyone. Thoughts?