Welcome to the Insurgency

As you all know, we're working away at the requirements from the Oregon Department of Education to open POCA Tech. We've reached the “handbook” stage: student handbook! Faculty handbook! Employee handbooks! A lot of what goes into them is excruciatingly boring, so I took a break and tried to work on something that might have a somewhat broader application than, say, POCA Tech's annual employee review policy. I'm pretty sure I'm going to put this introduction into all the handbooks, so let me know what you think.

Dear prospective POCA Tech students, new employees of Big Damn Clinics, new POCA punks and volunteers, and everybody who is just finding us one way or another, welcome, we are very glad to have you with us. Sometimes what POCA looks like from the outside isn’t quite what it feels like once you’re on the inside, and we’re always trying to minimize unpleasant surprises. It occurred to me recently that it might be better if everybody thought of what they were doing here as not so much going to acupuncture school/getting a job in a clinic/being in a cooperative as joining the insurgency.  I wish I had a non-military metaphor, but so far I don’t. So bear with me, OK comrades?

Acupuncture is beautiful medicine for people who don’t have much money. It’s simple, it’s effective, it costs almost nothing in terms of materials. According to some historians it’s been considered a lower-class form of medicine (relative to herbs) for a long time. Back in the day, you didn’t become an acupuncturist because you wanted a well-compensated professional position or because you wanted to hobnob with wealthy people; you did it with the expectation you’d be treating a hundred peasants a day in your living room, and that was OK because you were a peasant yourself, and acupuncture was a good way to be useful to your community.

For the last 30 years in the West, though, something entirely different has been happening to acupuncture. People got involved in it who wanted to make money, and those people subsequently took control of the profession itself. Many of their efforts have revolved around how to “elevate” the image of acupuncture and how to limit both who could practice it and who could receive it. They did this in the name of increasing professionalism and public safety, but the result has been that many people who could benefit from acupuncture are suffering because they can’t afford its elevation.From the perspective of people who don’t have much money, when acupuncture education costs $100K or more, and acupuncture costs $100 a session or more, it kind of looks like acupuncture’s been taken from us.

And we kind of want to take it back.

Certainly, individuals can take it back in individual ways. An acupuncturist can pay $100K for acupuncture school and once he graduates, he can charge whatever he wants; he can charge $15 or $20 per treatment and nobody can stop him or force him to pay back his exorbitant student loans. A patient can maybe find an acupuncturist who ordinarily charges $100 a treatment and persuade him to make an exception just for her, work out a trade, figure something out. These individual solutions are fine in themselves but they do nothing to take back acupuncture for the hundreds of thousands of other people who need it. That’s where the insurgency comes in. Some people read WCA’s red fist as just an individual business doing some clever marketing, just another example of winking Portlandia hipster irony and that’s great — we’d prefer that they didn’t recognize an uprising when they saw one.

Whatever part of POCA you’re involved in, or considering being involved in, try thinking about it as a small, organized,  guerrilla force, dedicated to liberating acupuncture from the capitalists and returning it to the people. I know, that sounds romantic and silly, but it actually works pretty well because it fits with many elements of reality for POCA. Such as:

1) The resources that you might think “should be here” probably aren’t.  
Newcomers to our world often think that providing acupuncture to lots of people of ordinary incomes is such a great idea that surely we must have all kinds of institutional support, help, and resources! Here’s the bad news, comrades: nobody with power, either in the acupuncture profession or outside of it, cares about access to acupuncture for people who don’t have much money. (Yes, we’ve tried to get them to care. You name it, we tried it.) A barista with a migraine is no concern of the people who run acupuncture schools or distribute public health money. Nobody wants to help us get acupuncture to all of the people who so obviously need it, and nobody is going to make the task any easier for us. We are ON OUR OWN. And since none of us have much money, that means all our resources are bootstrapped or scrounged or borrowed or held together with duct tape — and odds are good that we had to teach ourselves, by trial and error, how to do the taping. So if you are expecting nice new equipment, or automatic raises every year, or well-padded budgets, or any kind of security really, you’re going to be disappointed. Whatever resources we have, we have them only because somebody worked really hard to get them, and we can’t take them for granted. It’s rough out here.

2) We’ve got serious, hostile opposition, and it’s not going away.  
Not only do the powers that be in the acupuncture profession not care if we succeed in making acupuncture accessible, some of them really want to see us fail. Some of them will help us fail if they get the opportunity, so we can’t give them any opportunities. If you want to live in a world where everybody’s nice all the time, and there’s no risk, this isn’t it. If you wonder why some of us are a little scarred-looking, it’s because we’ve been taking big risks and up against opposition for years. See above: it’s rough out here.

2a) POCA Tech isn’t a school, it’s a raid.
If you’ve read Fractal, you know that part of what we originally started organizing around is what the acupuncture profession calls “the First Professional Doctorate”, or FPD. The FPD represents a new standard for acupuncture education, even more expensive and time consuming than what we’ve got now. The people who are pushing it claim that it won’t replace the current standards of a Master’s degree or Master’s level certificate, which is what POCA Tech is going to offer. That’s like a logging company saying that the road they’re laying down into an old-growth forest is, really, just for the birdwatchers!  We need to get into the business of providing acupuncture education so that we are included in these discussions about standards, and we need to get in QUICK.
So if you are going to POCA Tech, you need to understand that a big part of your responsibility is helping us to get the school accredited so that not just you, but more people in the future have access to affordable education. You’re in the raiding party, and we need you to be really serious about it. POCA’s not going to get multiple chances to liberate acupuncture education before they lock it away for good.

3) We’re not your parents, we’re your comrades.
 We may have to fill the roles of boss or supervisor or teacher or Circle Operational Leader or Board member or executive director, but that doesn’t mean we really want to. There’s a lot of responsibility that needs to be taken in POCA, and no real perks for taking it, and so we try to spread it around. What we get out of POCA is pretty much exactly what you get out of POCA: the happiness and the nourishment of having a community. The difference is that most of us in leadership positions came along when the community had to be built out of nothing. Which also means we’re a little more tired than you, so please take that into consideration. We love it when you offer to take responsibility or initiative, but don’t expect an invitation on a silver platter beforehand or a gold star afterwards — we’re too busy for that, we’re just picking up projects ourselves.

And speaking of projects, don’t take this wrong, but we really didn’t want to make a school. We really didn’t want to be employers, either. We wish somebody had been around to do those things for us, but nobody was. We do enjoy redeeming our bad experiences in acupuncture by making it better for you — but only up to a point, so don’t push it.  Our job is not to make sure that you have a beautiful experience being a student or being a clinic employee — that’s your job, actually. Our job is to make acupuncture available to more people and our primary responsibility is to the movement itself. Guerrillas don’t whine — I’m pretty sure Che wrote that somewhere.

4) Guerrillas can’t afford to make things any harder for themselves, or each other.
 We need you to have some self-discipline, because we sure don’t have the energy or the desire to discipline you. We need you to be able to be calm under all kinds of circumstances. We need you to be effective, and if you’re not, to figure out why. We can’t afford chaos or self-defeating patterns.  In your particular guerrilla outfit, what you do really matters to everybody else.

 See #1 above: we don’t have abundant material resources; all we really have are great people. Like you. You matter, a lot. Your energy counts. Your actions and words set the tone. Your comrades need you to be present, calm, and centered. We can’t afford for you to screw around, be irresponsible, or make more problems for us than we already have; if you do, we have to kick you out. Did I mention that it’s rough out here? You’re either an asset or a liability, and we can’t afford any more liabilities.

5) We’ll use whatever we’ve got at hand.
That includes capitalism. The clinics are all little capitalist enterprises because that’s the structure that was easiest to implement in the West.  We’ve systematized the clinics, kind of like a franchise without the profits, because that made it easier for more people to make more clinics. No, we’re not into capitalism or franchises; we just use the hell out of whatever we’ve got, because we don’t have much.  Guerrillas can’t be picky. See #1: if we were waiting for somebody to come along and give us an ideologically pure way to provide acupuncture, we’d still be waiting for jobs and a lot of patients would still be waiting for pain relief.  The Marxists might be disappointed, but there’s not much we can do about that.

And just because the clinics are using capitalism doesn’t mean they’re winning at capitalism. This can be hard for people on the other end of the ideological spectrum. If your dream was to be a successful businessperson, the insurgency is probably going to disappoint you too.

If something can work at all for us, we’ll use it, and we won’t do something more complicated just because in an abstract sense it’s somehow “better”. We can’t afford complicated things. POCA is the most pragmatic organization you’ll ever meet.

This has to do not just with impersonal things like business but with personal things like motivation. Since so much of what we do gets done by volunteers, we have to think about what motivates volunteers and whether or not we have that to offer. One thing we have to offer is unlimited work to do. Sometimes that work demands skills we don’t really have. Some people love to learn new skills, though, so instead of waiting around for an expert to show up, we’ll encourage somebody to teach themselves how to do what POCA needs. That implies a tolerance on our part for errors on a learning curve. It’s worth it, though, because our volunteers are often having a great time teaching themselves — and each other — all sorts of interesting stuff. Guerrillas can’t afford to be perfectionists.

Similarly, a lot of our volunteers are motivated by what you might think of as negative emotions about the inaccessibility of acupuncture — from irritation on one end of the spectrum right up through disgust, hatred, and  seething volcanic rage on the other. This aspect of POCA bothers some people. They are disturbed by the us-and-them dynamics, by the not-infrequent snark, and by the open hostility a lot of us have towards the acupuncture profession. (Also, the military metaphors.) Sometimes people tell us that we should be nicer — more like Gandhi or Mother Teresa.

It’s interesting, because the problems that the acupuncture profession has — not enough people being able to get acupuncture, acupuncturists being underemployed, acupuncture education being too expensive, the profession in general being disorganized, discouraged, and apathetic — these problems have been brewing for decades, and the nice, non-angry people have done pretty much nothing about them. They’ll agree that these things are problems, but they’re not working on any solutions. Meanwhile, POCA is busy building infrastructure for an alternate universe where most people can afford acupuncture and acupuncturists have real jobs. Building infrastructure is long, hard work, and yet we’re getting it done with virtually no resources or outside support (see #1). Rage evidently makes great fuel; it burns hot and long, and there’s no indication we’ll run out of it.

We’re not saying our anger is perfect or even that it’s good; it probably would be better if we were more like Gandhi. Since we’re so flawed, improving ourselves would be a full-time job and we’re already working flat-out. So until the people who are more like Gandhi and Mother Teresa want to show up and deal with the risks, the opposition, and the endless amount of work here, we’ll use our rage to get things done. If you’re benefiting from the results, don’t complain about the fuel. And if you want to leave the insurgency and go find a more comfortable, more established institution that’s full of nice people who are motivated only by lovingkindness and working just as hard — but in a gentle, orderly fashion — on the same problems, please do, and make sure you give us a forwarding address, because we’d like to meet those people too.

5) You’re not in this for yourself.
Guerrillas don’t join up because they hear the pay and the retirement options are good. Desperation is usually involved, along with the recognition that, as hard as it is to be in the insurgency, being in other places is worse. Working in a POCA clinic is a great job for people who have had some experience of what it’s like to work in a soul-sucking capitalist business. Working in a POCA clinic is not a great job for people who feel entitled to have a perfect life.
Not just POCA Tech but every POCA clinic is, in a sense, a raid. Every time somebody gets relief from pain in a POCA clinic, it happens against the odds and as a result of somebody else acting out of something other than self-interest, as a result of somebody — or a lot of somebodies — taking acupuncture back for people who need it. If you go to POCA Tech or work in a POCA clinic for any amount of time, you will make a difference in the lives of thousands of people. That’s ultimately the only reason to be here in the insurgency. We’re fighting an uphill battle and when we win, that’s what we win: other people’s well-being.

We think it’s worth it and we hope you do too.

Author: lisafer

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  1. How is it that you can hit the nail on the head every time? Very inspiring.

    POCA is for people who understand that some thing is broken. The system needs fixing. Regular folks need each other. And talking about it is merely a bare first step. I like POCA cause we all agree that something needs to change and we all agree that we will do what we can together to fix it.

    bring it on.

  2. I often use the word ‘revolution’ (a tag line I use is “It’s a revolution, and you’re invited!”) but actually I like the word insurgency better.

    And what kevingermain said: how is that one person can be just so incredibly articulate every freakin’ time?

  3. “Guerrillas don’t join up because they hear the pay and the retirement options are good. Desperation is usually involved, along with the recognition that, as hard as it is to be in the insurgency, being in other places is worse. Working in a POCA clinic is a great job for people who have had some experience of what it’s like to work in a soul-sucking capitalist business.”

    so true. punking is truly the best job I have ever had.

  4. Wow! Solid and crystal clear—thank you Lisa!

    This should be required reading for all newcomer students, punk-employees, punk-owners and volunteers of every stripe in POCA clinics across the globe. I think of it as what’s on the POCA menu. If you come to the POCA table, you are first asking to serve; second, to be able to make a modest living by serving.

    Providing accessible healing to ordinary folks and participating in the POCA community are the big rewards.

    Serving folks once is simple. Serving them every week, all year long, year after year, takes all aspects of me working in the best alignment I can muster. It’s kind of like renewing my intention on a daily basis to help folks easily access profound self-healing. Providing this service is alternately predictable, difficult, tiring, risky, boring and as well transcendent in it’s feeling of gratitude, community-connectedness and inspiration. Some people are awesome! Community acupuncture patients and co-workers show me this over and over again.

    There is so much work to be done to form and sustain our POCAverse. Our volunteer force has great strengths and real world personal baggage from living life. It’s great to be clear about that part. We are all doing the best we can here, and we need your help! Sometimes that need comes across as welcoming and other times as jarring, but the need is the same. If you resonate with our message of access to care for ordinary people and you are ready to channel your energy into a service life, we welcome you.

    Thank you POCA comrades for your community and your willingness to work together to help the people we can help.

  5. This all is really great! I have definitely forwarded it some other (non acupuncture) community groups because I think the problems carry over and frustrations are nicely articulated here.

    I am new to POCA and keen to be more involved. I signed up to volunteer but if anyone wants to nudge me in the right direction on projects you need help with, I am here! I work at Brooklyn Open Acupuncture right now and hope to go to acupuncture school in the fall. I would love to be more involved so if I can help, please let me know.