Is There Room for Us Here?

You guys, I miss blogging. An awful lot has changed over the last year, and so much of it’s for the better (infinitely better), but it’s been like being swamped by a huge tidal wave. I want to make sure things that are important to me haven’t gotten swept away completely.  This past weekend at POCA Tech made me remember that blogging used to keep me sane and feeling connected to a lot of people I rarely get to see in person. And even to people I haven’t ever met.

Last Tuesday I had a conversation with a POCA Tech student who is the same age I was when I went to acupuncture school and comes from a similar class background. We talked about being straddlers and how confusing it is.  I blogged about this awhile back right after a telemarketer, who was ostensibly trying to sell me something, lectured me about why the target demographic for Working Class Acupuncture was — in her opinion — composed of people who were not worth treating.

The big question for straddlers is always: are you going to forget where you came from? And it’s confusing because it often feels like people are eager to help you do just that. They would be much more comfortable if you could forget, if you didn’t mention it, if you made an effort to strip yourself of all the patterns of speaking and thinking and being that are class-based. And of course you might be more comfortable also if you could do that, so it’s very tempting to try  — except wait! They might not let you forget after all! Just when you are least expecting it, you might get smacked in the face with the reminder that you and your kind are inferior.  Like that telemarketer, or like a local acupuncturist who said to me in a Facebook discussion recently about Working Class Acupuncture’s payment policies: “Why am I not surprised?  The lowest common denominator just got even lower.”

That’s me: the lowest common denominator. Always. You can take the girl out of Southwest Baltimore, but you can’t take Southwest Baltimore out of the girl.

One challenge for straddlers is keeping perspective, making sure you’ve got your head on straight so you don’t get derailed or demoralized and end up doing things you don’t really want to do, and/or not doing the things that you do. Blogging helped me with that. I still need help in that department because the things I’m doing now seem to have a lot more moving parts than they used to.  After this weekend, which included not only the conversation about being a straddler but POCA Tech’s first official visit from ACAOM, I realized that there is only one question I’ve been asking for the last 12 years: is there room in the acupuncture world for people like me? In 2002 I was asking, is there room for people like me as patients? In 2014 I’m asking, is there room for people like me as practitioners?

Every blog post I’ve ever written has basically been about that, from one angle or another. I think my posts got read and the model took off because there were a lot of people who either identified with that question themselves or who thought it needed to be asked, period, even if they didn’t personally identify with it. One working-class trait I figure I’m never going to get rid of is that I prefer the concrete to the abstract. So the answer to my question is there room? will only be meaningful if it’s concrete. The answer to the question about room for patients was my clinic, Working Class Acupuncture, and then 2 more of them, and the Community Acupuncture Network, and eventually POCA. My question got  answered with a thousand second-hand recliners. I love that.

The Community Acupuncture Network also tried asking the question, is there room in the acupuncture profession for people like me? Is there room, when the cost of acupuncture school tuition keeps rising and when acupuncturists want to have the same status as doctors?  CAN asked the question in ways that got us labelled hooligans and troublemakers (synonym: punks). After a while, a lot of us realized that the problem with asking the question the way we were asking it was that there was never going to be a concrete answer.  We made POCA a cooperative because we needed to ask the question in a different way: with structures. With infrastructure.  If what we wanted was room, we were going to have to build it ourselves.

A side note: in the current national discussion about for-profit schools and gainful employment, sometimes this comes up as a justification for letting for-profit schools have unfettered access to federal student loan money. Federal student loans = upward mobility, right? Without loans, education is only for the wealthy, right? Speaking as someone who would never have gone to acupuncture school without taking out student loans,  I’m here to tell you it’s not that simple. It’s not just getting into school, it’s what happens after you get out.  I learned the hard way that despite my degree, the acupuncture profession hadn’t really made room for me because it was going to require me to cut off my working class community in order to have a practice. At least, I’d have to cut them off if I didn’t want everyone to think of me as the lowest common denominator. We all know how that turned out. But the point is that federal student loans don’t equal upward mobility because degrees don’t equal work, especially not in this economy. You can’t eat your degree or pay your rent with it: for that you need economic infrastructure to support your practice, which is what POCA has been building.

But to fully answer the question is there room?, we needed to build an acupuncture school as well. So we did. And wow, since we opened, it seems like the classism has been coming out of the woodwork (not that it was exactly well hidden before).  Remember this comment, also from a Facebook conversation about POCA Tech?

“So, I'm curious what Lisa's definition of “general public” who can't afford regularly rated acupuncture treatments. To me, those are the people (in majority of the cases) who refuse to prioritize their health over other things like booze, eating out, shopping, recreations etc. Who are your target patients and what is your goal of acupuncture treatments to people beyond making acupuncture accessible to MORE number of people? I'm already sick of people who think acupuncture is a cheaper, and more natural version of steroid shots and/or SSRI, while they have no intention of changing any part of their lifestyle, job selection, relationship, sleeping schedule, eating habits and lack of exercises etc. $15 a pop acupuncture treatment, I think, only supports most people's bad habitual patterns to continue because they tend to “feel better” after needling without changing anything else in their lives. And it's affordable to do that! But is that what you are going for? What is the meaningfulness of making acupuncture treatment more affordable financially?”

As you all know, we ran a short fundraising campaign around what is the meaningfulness?, and we got some beautiful answers from patients that are showcased on POCA Tech’s snazzy new website. But what I’d like to get back to here, for the purposes of this post, is the part about how a lot of the rest of the acupuncture profession can’t understand how what POCA Tech wants to do could possibly be worth doing.

Solidarity and charity are very different things, and I believe you can understand the difference most clearly if you’ve been on the receiving end. Before the community acupuncture model, there was no way for me to engage with my working class community as an acupuncturist in solidarity. There just wasn’t. For that matter, there wasn’t any way for me to engage with them in charity either.  The public health funding that existed didn’t extend to the people I knew, and even if it did, there wasn’t enough of it to create a steady job for me or anybody else who wanted to work  in places like my neighborhood. In part because of the attitudes reflected in the Facebook comment above: why bother?

Just like setting up POCA as a functional organization required a lot of mind-numbing detail, setting POCA Tech up so that it can get accredited requires a lot of painstaking attention to  an array of technicalities. Helping to create POCA was, hands-down, one of the most healing things I’ve ever done for myself because with every minute of effort I put in, I was saying (out loud, silently, and in the language of making things) I deserve an organization that gives me what I need. I deserve an organization that serves me in tangible ways while I serve my community with acupuncture. I deserve something solid, and big, and good. I deserve solidarity. (This is why a lot of us volunteer for POCA, because it feels great to say this with our time.) Creating a school that can get through accreditation says the same things, at an even bigger scale: our community deserves a sound, ethical, well-designed program that gives POCA’s clinics and POCA’s patients the acupuncturists they need, the acupuncturists who will serve them in solidarity.

The hard part about creating POCA Tech is that accreditation isn’t just about us plugging away at the details; it’s also about the judgment of other people in the acupuncture profession. It’s not clear to me that anyone outside of POCA believes that what we want to do is worth doing,  or that the people we want to serve are worth serving. And I don’t know what that will mean for POCA Tech in the long run.  But we can only ask the question, is there room for us in the acupuncture profession? by going through every step of the process.  There is no other way.

And — getting back to why I’m writing this post — there are so many tiny technical details to attend to, along with so many big picture changes, that I have to make an effort to keep my head on straight.  It helps me to remember that I’m still the same person I was in 2002, still a straddler, still asking the same question. I’m not really any different from the POCA Tech student I was talking to. She and all the other students in this first cohort didn’t enroll in POCA Tech because they wanted to be doctors; they enrolled because they wanted to be able to work for their own communities. They’re taking a risk because POCA Tech isn’t accredited yet, and to get accredited we’re going to have to have a lot of conversations with people who don’t necessarily understand us.

It helps me to remember that I’m not alone. All of you who have donated time and money and talent to POCA Tech have been posing that same question to the world: is there room for us here? And you’ve also been answering it: we deserve to be here. We believe in our right to do the work we think is worth doing, for the people we believe are worth the effort.

Author: lisafer

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Conference Keynote: Breaking the Ceiling

The theme for this conference is “Breaking Barriers”. You know, there are so many barriers to break in acupuncture that it was really hard to choose which ones to talk about for this speech. But since I’ve spent so much time talking about classism as a barrier, I thought it might be fun to shift gears a little and talk about numbers.


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  1. Dang wow.

    So the devil is in the details
    and so the angels are in the big plans ..
    and the lowest common denominators living everyday

    Wait do We have a count of recliners in operation?

  2. I was exercising some poetic license there…it’s maybe closer to 1600? Anybody want to dig through last year’s survey and count recliners?

  3. There will always be people in the acupuncture profession who are not pleased (to say the least) with the community acupuncture movement. We cannot please everyone. That is just not possible.
    We just have to keep doing what is of value to us, and the many patients who otherwise would not be able to get treatments.

  4. Whew. Every time you write about straddlers, I feel less alone. Every time I volunteer my tiny 30 minutes a week to POCA tech, I feel more hopeful. Every time I see my monthly email receipt for my clinc’s small POCA tech donation, I feel empowered.

    Concrete is solid, visible, tangible and strong. It is looking out at a roomful of nappers. It is giving a patient a biz card of a clinic across the country for her ailing sister. It is home.

  5. From 2014 Survey Data.

    The number of chairs, just from the surveyed clinics is somewhere between 1422 and 2201. (Average is 1811) Because clinics are asked how many chairs they have from within a range, we get a bit of a space in data, an unknowable quantity exactly. Should be close.

  6. i’m super excited about WCA and about POCA Tech. As a patient in WCA Lents and someone of Chinese descent, .. I always found medicine when we went to visit relatives in Hong Kong or Taiwan a much less elite practice and much less expensive but maybe because we visited community clinics if someone got sick. I like POCA because the community environment is actually more comfortable to me than a ‘spa’ environment. I like the model because i simply cannot afford health care visits when i had insurance and when i didn’t – when i had insurance, i didn’t have money enough to pay for co-pays and meds and whatever else. now without insurance, everything else is too expensive. WCA is affordable enough to go back for regular treatments to get the care i need. <3