Working Class Professionalism
Did we mention anywhere yet that the recovery mentors make about $20,000 a year, working full time?
One of the major categories of deprogramming community acupuncturists has to do with understanding what professionalism really means. The acupuncture professional culture has managed to convince a lot of acupuncturists that their professionalism is defined by what kind of clothes they wear, what letters they put behind their name, how much they know (meaning the sheer quantity, regardless of whether or not it’s useful or meaningful), what other people think about them, and what their patients pay them. The acupuncture professional culture believes that all of these things are Very Significant.
The problem here is that I, as a working class person, suspect at a visceral level that those Very Significant Things are a load of crap. A bunch of working class patients feel the same way, which is one reason why it has been so difficult to bridge the gap between working class culture and acupuncture professional culture. If you find this observation jarring, ask yourself if these Very Significant Things are indeed very significant in the context of “Finding Normal”. Do the mentors put a lot of energy into what they wear, what letters are behind their names, the quantity of what they know, what other people think of them, or what they get paid?
In working class culture, professionalism is about your relationship to your job — your job itself, not all that other extraneous stuff. It’s about putting your job first, making sacrifices of time and energy and effort to become really good at something, and taking pride in that. A professional is someone who can put himself or herself aside, if necessary, to do his or her job really well, who can consistently rise to the occasion to do the job as it needs to be done. If you’re a working class professional, you believe that the work you do is worth doing, and that is why you do it, not just because you get paid for it. You care about doing it well, regardless of whether anybody is watching you or applauding you or thinking that what you do is important. If you’re really lucky, like David Fitzgerald, you can say you were “born to do this shit”.
In hindsight, I survived for as long as I did as an acupuncturist, long enough anyway to figure out the community acupuncture model, in part because I just loved acupuncture as itself. I loved handling needles, I loved taking pulses, I loved watching people fall asleep and wake up feeling better — hell, I loved restocking the cotton balls. I loved being in the clinic, period. Being working class was part of what made loving acupuncture enough to keep me in the field when a lot of my contemporaries were bailing out, because acupuncture was What I Did. And when you’re working class, What You Do is enormously important (in part, of course, because you don’t have that much else) . What You Do, as distinct from What Other People Think of What You Do. My grandfather was a gas station attendant — not a mechanic, a gas station attendant. He pumped gas, cleaned windshields, and never learned how to drive. I remember him telling me he loved the smell of gasoline. I did not grow up with the expectation that other people were going to respect what I did for a living. I did grow up, however, with the expectation that I would respect it, love it, take it seriously.
So a community acupuncturist needs to love acupuncture for its own sake, in part because the community acupuncture model was designed by people who just really don’t get why status is supposed to matter. (We have tried to care about status, and money, and respectability, really we have. We just can’t do it.) Which brings us to the issue of handling failure.
On my fifth or sixth viewing of “Finding Normal”, I realized how many times the mentors refer, directly or indirectly, to the issue of people’s readiness for recovery. Part of the success of the mentor program has to do with the mentors’ care in choosing people to participate who are ready to stop using drugs. (They can’t choose perfectly, as Peni’s example indicates, but they try.) The mentors realize that they cannot make anyone ready, they can only support what readiness is already there.
I think that the professional acupuncture culture’s unhealthy emphasis on status and respect has confused this element in the minds of many acupuncturists. On the one hand, we acknowledge that acupuncture stimulates the body’s own self-healing and self-regulating mechanisms, and we can’t make the body do anything it isn’t ready and willing to do. On the other hand, we think it’s part of our job to pressure, cajole or persuade people to value acupuncture, to give the treatment a chance, to follow through with what we suggest, and if they don’t do those things, we think we’ve failed. We think it’s our job to get them to want to come to see us. But we can’t get anybody to want to come to see us, or to want to try acupuncture; we can only welcome and support the people who already want to see us, who already want to try acupuncture. We can make it as easy as possible for them. We can lower all the barriers, at least all of the barriers we know about and can reach. But we can’t force readiness any more than the mentors can. And because so much of acupuncture’s clinical success has to do with people’s willingness to stick with treatment over a period of time, we shouldn’t evaluate our success or failure based on factors that are out of our control. Such as other people’s readiness.
Part of defining your job means defining what constitutes success or failure. This is where I think the idea of working class professionalism can be helpful to community acupuncturists, because it allows you to focus on doing your job well, and enjoying your job, rather than getting overly caught up in how people are responding to you while you’re doing it. Oddly enough, this makes it easier for people to relax around you and to trust you, because they can feel that you do What You Do for your own reasons, and you’re not depending on them for applause or approval. It also allows you to save your energy for the people who are ready for you to help them, and thus attract more of those people, rather than wasting your energy trying to make people ready who aren’t ready — and just making yourself tired, and less likely to attract anyone at all.
Michael Smith, the founder of NADA, once pointed out that you can teach anyone (anyone!) to do acupuncture in about 45 minutes. “There’s the sharp end, and there’s the dull end. You put the sharp end in the patient…” I laughed really hard at that, and not because he was joking. Mystifying acupuncture doesn’t help anybody. Complicating what we do doesn’t make us professionals. This is what an acupuncturist needs to do: be present, be respectful, communicate the treatment plan clearly, hold the space, give a fuck, put the sharp end in the patient, and get out of the way. And then let go of the outcome.
Those are all things that we can practice doing, and we can get better with practice. If we fail at doing any of them, we can practice until we succeed. We can take pride in doing those things well, regardless of how anyone responds. These are the things that are our job, these are the things we can take responsibility for; everyone else’s readiness, that’s their job and their responsibility. This is how we hold space for ourselves as professionals, while we hold space for our patients to heal.
(Coming soon — either the next installment or the one after that– is scene by scene commentary. So now might be a good time to order the DVD of “Finding Normal” — believe me, you won't regret it, even if I never wrote another word.)