This is a two-part post about the fractal. Part one is about something that happened recently at WCA: we made a mistake and a patient got mad at us.
Statistically speaking, this should happen a lot more often than it actually does. In this case, the mistake was that the punk did not realize that the patient was in another room of the clinic, waiting to be treated, so she didn’t treat her. After waiting 20 minutes or so, the patient went out to the front desk and demanded her money back. She was so upset that she raised her voice to the receptionist, and the receptionist was so taken aback that she just silently handed the patient her money. A few days later, the patient wrote a letter to our Human Resources Department (that would be John), complaining not just about being overlooked but about the receptionist’s attitude.
I will not return to that location as long as she is employed there. Her apathy and galling rudeness are not acceptable in any service job, much less one that promotes holistic health and wellness. (And no, it wasn’t Ilse.)
When we got the letter, we did what we had to do: checked in with the punk and the receptionist, got their side of the story, and then sent a very brief, very neutral response to the patient, apologizing for the inconvenience and offering a free treatment at one of our other locations. And that was that; though I suspected there might be more to this episode than the HR logistics. Experiences like this are hard on everybody because of the adrenaline involved, but often something useful emerges from them. In this case, what emerged for me, a couple of weeks later, was a new perspective on our fractal.
The receptionist with the unacceptable attitude and I were discussing what happened and we got to talking about the range of people who come in to WCA. Given how wide it is — young to old, radical left to far right, speaking a range of languages which doesn’t always include English — it seems like there ought to be more conflict than there is. There’s hardly any. We don’t expect trouble, so when it does happen, we’re surprised. When I first read the letter marked “Attention, Human Resources”, I was tempted to write not a brief, polite, sensible response, but a long diatribe of my own about how little all of us get paid and how hard we work and how if everybody treated us this way when we made a mistake, we’d quit. The conversation turned to people’s tolerance or their lack of it. She told me a story about a friend who had spent decades in the women’s community, calmly tolerating various quirks and foibles, who finally lost patience with one particularly difficult woman and said: “You know, some people are just not meant to live in community!” And a light went on for me.
We originally used the term community acupuncture to describe the clinical setting in which treatment happens: everyone in a room together instead of in individual cubicles. And we had talked, especially in workshops, about the need for punks to think of themselves as community organizers doing something with their patients instead of professionals in white coats doing something to their patients. But I don’t think I had ever quite realized that a POCA clinic, especially a Big Damn POCA Clinic, is a lot more like an intentional community than it is like a business. And that explains a lot, including a lot of things I’ve had a hard time explaining.
Skip and I both spent years living in intentional communities, and I guess we somehow took that experience for granted and forgot that not everybody does that. Skip lived at Pendle Hill, a Quaker community, and I was a Jesuit Volunteer, and both those experiences involved training about how intentional communities work. Later, we both lived in group houses with people who had similar backgrounds and who made an effort to be more than just housemates. Think brown rice and nutritional yeast, Diet for a Small Planet and Rise Up Singing, chore wheels and house meetings.
Don’t be misled by the gentle ideals of voluntary simplicity; intentional communities are not for the faint of heart. They will kick your ass. A lot of them require you to make a minimum time commitment of at least a year, because at some time before then, you are definitely going to want to leave. You are going to want to slip away, or storm out, or run screaming, and silently or aloud declare that you are never going back as long as THAT PERSON is there. And at some point, you are going to be THAT PERSON for somebody else.
Of course we don’t want to demand that kind of intensive commitment from our patients or our volunteers or even our coworkers. However, something of that spirit is what animates Big Damn Clinics. As the receptionist observed, the patients who get the most out of WCA are the ones who get that it’s a community. A lot of them, of course, would never use that term, whether or not they speak English. A lot of them have never eaten nutritional yeast or attended a house meeting. It doesn’t matter. What matters is that they instinctively know how to be — with the staff, with each other, with the acupuncture, with themselves.
Recognizing that I think of WCA as an intentional community goes a long way towards explaining a lot of the business decisions I’ve made. As I said in an earlier post, from the standpoint of business as usual, a lot of those decisions weren’t rational. (People have been eager to point this out.) But from the standpoint of growing an intentional community, they make perfect sense. Why didn’t we try to franchise the model from the beginning and make money off it? Well, there’s the obvious part about how most acupuncturists barely have enough money to open a business at all, let alone pay franchise fees. Aside from that, though, I’ve always had the feeling that the model wouldn’t work very well if you stripped it of the social justice elements, and how do you franchise those — but I’ve had trouble explaining that to the capitalists. I think that’s because when I’ve said “the model”, everybody, including me, thought that was shorthand for “the business model”. But it’s not. Yes, we have a business model, and yes, we have a clinical model, but really we have a model for an intentional community. Which happens to have business and clinical aspects.
I had a lot of fun, again, punking on Christmas day. I got to see a bunch of patients I hadn’t seen in a while. One of them told me that, earlier in the year, her sister had come to visit her from Wisconsin, and she brought her in to WCA to get acupuncture. Her sister was struggling to quit smoking. After she went back to Wisconsin, she and her boyfriend started going to Milwaukee Community Acupuncture — and they both quit smoking. Yes, you could call that a social dividend from a social business — but what struck me this time is that you could also see it as the intentional community reinforcing itself, getting bigger and stronger and more stable. Money is only one aspect of its growth.
A lot of us have been quite cranky with the way some acupuncturists use the term “community acupuncture” in such a way that it means nothing at all. They might simply slap the words on their business name so that it sounds better, and carry on charging market rates and treating one person at a time. They might use us as a loss leader: offer affordable acupuncture in a group setting for an hour or so a week, and make sure that they tell every patient that if they really want to be helped, they need to schedule a private treatment at $100/hour. They might decide that their community really needs acupuncture in heated leather recliners with eye pillows and iPods so that nobody can see or hear their neighbors, on a sliding fee scale of $75-150. We’ve been cranky enough to talk about trademarks. I’ve had cause to wish I’d named the thing Cheap Ass Acupuncture, because that might have slowed them down a little.
This perspective makes me feel better. Sure, you can call it “community acupuncture”. But actually making an intentional community — there’s no way to do that superficially. Intentional communities are the antithesis of superficial. And the more the fractal grows, the more clear it becomes that an intentional community is really what we are. We’ll become harder and harder to impersonate. So that’s one thing it helps explain: community means community, with all its splendid irritations. “Community” isn’t a fashionable tag to put on your individual business; community is being loyal to people who make you want to scream.
Some veterans of the CAN Board will remember our unofficial slogan of 2009. It started with a discussion in a Board meeting (in my living room) of how to get people to put little more energy into searching the forums before asking the same questions that had been asked a hundred times. Mainly what I remember is that I had gone into the kitchen for something, and then Ellen was suddenly shrieking at the top of her lungs, “DIG DEEP!” and people were howling with laughter. It was late and things got progressively sillier and by the next morning, Andy had revised the text of the entire CAN website to say, “Dig Deep!” every four words or so. CAN Board meetings were like that. But “Dig Deep” was so applicable to so many aspects of community acupuncture, it caught on and hung around for quite a while after we had all sobered up. It’s a great theme for an intentional community. A lot of what seems magical about what we do is actually a result of people quietly digging deep.
The receptionist with the unacceptable attitude doesn’t work at WCA because she wants a service job promoting holistic health and wellness. (Dear God.) She works at WCA because she’s devoted to the community. Same for me. Same for all of us who stick with it, year in and year out. We dig deep, and that’s an important aspect of our fractal.
I think that a lot of things I’ve struggled to explain could be answered simply by, “It’s in the best interests of the community.” Signing a 10 year lease on a building in a business district that was recently described publicly as “a dead point in a desert of misery”? In the best interests of the community. Bending over backwards to make sure that our punks don’t have to have second jobs? In the best interests of the community. Putting energy into first CAN, then POCA, and now both POCA and POCA Tech that otherwise could have gone to boosting WCA’s profits? Absolutely in the best interests of the community. WCA’s community of patients can’t be separated from the larger community of POCA patients.
Businesses often try to avoid making commitments, for fear that they will get in the way of profits. Communities, on the other hand, depend on commitment; sometimes, that’s all they’ve got. Part two of this post is about a new commitment we’re making at WCA, a new branch of the fractal, which I would have a terrible time explaining to any capitalist. You can read about it inside the forums, in a few days. Stay tuned!