Who’s On First?

Joe- What has been an exciting day of community acupuncture is looking to really heat up now as we move into the middle of the shift here at Zang Fool Community Acupuncture.And it hasn’t been a shift without controversy, has it, Tim?


Tim- No, Joe, it hasn’t.Just a short while ago there was a big dispute over whether Zang Fool should have pulled Juan Ortiz five minutes early or go to the couch and do the initial intake with Tara Jones, the rookie patient getting acupuncture for the first time here today at ZFCA.Fool decided to push Ortiz a little long seeing that Ortiz was sleeping and Fool knew he could buy some time there by getting to Jones early to prepare for the coming mid-shift rush.It paid off, and Fool was able to pull both Ortiz and the veteran regular Jane Oliver, who usually cooks for an hour, but was done in 40 today.


J- Fool has sat down eight so far, including one newbie, as he approaches the biggest talker on today’s lineup, Sam Smith.Now, ZFCA has its share of talkers.Every member clinic in the league does.But this guy, the 58 year old acupuncture veteran Smith, is one of the most dangerous talkers you’ll find anywhere.He has shut down some of the best needlers in all of CA, backing up schedules as much as 10 minutes with one-way conversational barrages covering everything from string theory, multidimensionality and simultaneous existences in parallel universes to new age astrology and Mayan calendar doomsday theory.He’s a serious threat in the chair.


T- That’s right, Joe.You just can’t get away from this guy sometimes.He doesn’t give you a seam in the conversation, and it is very difficult to close the interaction.


J- Well Tim, at least he speaks quietly.However his hurried, breathy whisper can be as equally annoying as loud talking up to three chairs away, unless the folks in the chairs beside him are hard of hearing, as they are today.


T- Well, good for them.


J- Fool opens by rolling up on his stool, saying “Hello” and taking hold of Smith’s wrist right away.That’s smart.


T- It sure is.He’s not only working fast with Smith, but just as important he’s dictating the nature of the interaction.It’s really important for Fool to establish this up front, or Smith will most definitely back him up.


J- Fool is working through the pulse positions quickly, nodding, smiling and proceeding with caution.He looks loose out there.Again, Fool is establishing control and dictating the nature of the interaction.


T- He’s loose, for sure, but he’s also being very careful here, Joe.As a needler, you want to ask few if any questions in this kind of situation.It’s an intake that can be done entirely with expressions like, “Really?” “Oh, I didn’t know that.” and “Wow, that’s very interesting.”


J- If you remember, Fool used that last line there at Smith’s previous appointment.However, Fool went too far and followed with, “I’ll have to check into that.”That’s where Smith hammered him, prolonging the interaction another minute and 15 seconds by detailing several online resources that would have more information on Illuminati conspiracy theory and UFO’s in the fifth dimension.


T- I do remember that, Joe.That was a powerful display by Smith, who already had Fool hung up for 8 minutes at the chair at that point.Eventually, Fool had to walk away from him in mid-sentence!There were two people just waiting to be pulled and they didn’t look happy!


J- Smith is that good.Fool has needled Smith once a week for five months now and their average interaction is hovering at 6 and a half minutes and climbing.Smith is far and away the longest talking patient in that time period and 2nd all-time since ZFCA opened for play some three years ago.We’re 3 minutes and 45 seconds in now.


T- Of course, the leading all-time talker is the dreaded Juliette McAllister, who for six months in the inaugural year of ZFCA racked up a talk average (TA) of 8 minutes and 18 seconds before relocating to San Francisco.The bay area has been under siege by the loud and long talking McAlister ever since.


J- Everyone must keep in mind that allowing 10 minutes for follow-up appointments doesn’t mean a needler can actually spend all or even most of that time with each scheduled patient.The needler needs to get out of each interaction with enough time for pulling needles out of other patients, refreshing chairs, folding blankets, greeting rookies at the couch and of course, reviewing the treatment plan for those newbie’s in the chairs after they are done cooking.It should go without mention that charting is the least important task during a shift and we won’t see Fool charting until the bottom of the 4th hour as he has a full lineup today.There is one newbie cooking here in the middle of the 2nd hour with five returns sleeping comfortably.


T- We go to back to the recliner and check into the action. Fool deals to Smith.It’s LI 11 straight into the right elbow of the droning Smith.


J- A little high and tight there, but it’s in for the first needle.


T- Smith isn’t breaking stride.He’s going on about hundredth monkey theory and his forthcoming book.


J- He’s good.


T- Fool reaches between the fingers of his left hand and pulls a needle.He loads it.He fires a quick insertion into right LU7 and there are now two needles in Smith!


J- And how many times have we seen this sequence, Tim?


T- Well, Joe, over the past three years Fool has developed into one of the dominant needlers in the league by learning to rely on this one needle strategy.It is, of course, Miriam Lee’s 10 points. Learning this point combination and trusting it can be the difference between toiling in the minors, stuck with a low weekly average, and hitting the Big Show with weekly patient averages approaching triple figures.A good needler can make these points work for just about anything and for three years, and especially the past two, Fool has mowed down chair after chair with the same sequence, time and time again.


J- And that’s why they call him “Mr. Automatic”.He’s really used this strategy to hang out here with some of the best.


T- Well, let’s not count Smith out just yet.Fool has eight needles to go and Smith still hasn’t asked a single question about TCM theory in relationship to random signs and symptoms he experiences or of their relation to Fool’s point selection today.Smith has been able to push his TA into the stratosphere during his years in Portland and now here at ZFCA using this sort of strategy in the chair.We’re now at 4.5 minutes and there’ll be a lot more interaction here if Smith has his way.


J- As you just mentioned, Tim, Smith spent two and a half years honing his chops all over the city of Portland, home of some of the fastest needlers in the world.Pins and Needles, Seastar, and of course, that fabled powerhouse that started it all, Working Class Acupuncture.It was in Portland that Smith developed the skills that make him one of the most feared talkers in the league.Do you have the ART’s for Portland needlers handy, Tim?


T- Well, community acupuncturists in Portland are averaging just over 4 minutes of Actual Recliner Time per patient.WCA needlers are averaging an airtight 3 minutes and 55 seconds.


J- A low Actual Recliner Time, or ART, is the essence of the best needlers across the country.The league leader, Justine Matisse of Atlanta dominates at ACA with a 3.22 ART.She is, in a word, phenomenal. And she has needled over 3300 so far in the 2009 season, putting her in the top three in the league for volume.She’s on the short list for MVN this season for sure.


T- Fool moves in on the right leg and hammers in a bullet with an 18 by 30 directly into ST36.There was no doubt about that one. It was right on the money and you could actually tell Smith got good deqi even though his verbal onslaught continues unabated.


J- There is just so much that goes into a low ART.Schedule awareness, understanding class dynamics and the intention of CA, directness and of course the learned knowledge that comes from experience that so much can be done with so little.Not getting these things leads to a consistently high ART, can frustrate the most well meaning needler and end a career.


T- But that’s Big League Acupuncture for you.CA will break you quick if your head is not in the right place.So much of this game is about focus, both in and out of the clinic.Few aspiring CA prospects truly understand what being a successful big league needler entails.Focus. Attention.Intention.


J- What’s this?Gretchen is coming out from the desk.It looks like there is going to be a schedule change.


T- I think you’re right, Joe.There are two patients following her into the treatment space.It’s the Olsen couple and they’re headed to recliners.Oh, boy.


J- Gretchen is putting the charts onto the charting table, tucked discreetly in the corner of the space.She appears to be explaining to Fool that the Olsen’s thought they had an appointment.


T- Fool nods as they have an impromptu meeting in the middle of the space.Apparently, there is also a newbie walk-in waiting on the couch in the lobby.With this development, Fool has just around ten minutes before his next scheduled patient shows at the top of the 3rd hour.3 patients, including a newbie in ten minutes.How about that?


J- Well, I’ll tell you what, Gretchen is a pro.She’s as much a key to the success of ZFCA as anyone else.What happened was that she took the newbie walk-in before the unexpected arrival of the Olsen’s.But I don’t doubt for one moment that Gretchen would have taken that newbie walk-in regardless of the Olsen’s.She knows when and how to push Zang Fool.And that’s what makes her a pro.


T- So true.In any case, Fool has his work cut out for him.Gretchen is heading back to the desk and Zang Fool is really going to have to dig in now.

You know, this type of scenario arises all too often in CA.I have said it before, “Errors will cost you.”But, I have also heard it said, “The Universe provides.”


J- Whoa!That’s a bit new agey for you there, now, eh Tim?


T- (laughing) Well, this is acupuncture we’re watching here, isn’t it!


J- (laughing) I suppose you’re right!You also may have said something less spa and more medical-rational.Perhaps, “Chaos is the rule.”


T- Or maybe, “Shit happens!”


J- (laughing) Even better, given the state of healthcare in this country!


T- No doubt!Well, back onto the field, Fool is trying to nail down Smith who had a bad reaction to left LI4.  Just as Fool was finishing up his point sequence and it appeared that he was about to lower his ART against Smith, Fool may now need to go to the lobby and get Smith a cup of water.This could be trouble as the needling has come to a halt on Singing Sam Smith.


J- It sure could be as this has the potential to really get him backed up.The Olsen’s are ready and are relaxing in their chairs with their eyes closed.It’s a good thing for Fool that they are low maintenance.


T- It sure is.If he can effectively manage this one, it will be because the Olsen’s are regulars and he’ll be able to move quickly.He must keep his ART with the pair down around 2 minutes each in order to greet the new patient walk-in with a little time to spare.But first, he’ll have to finish off Smith.


J- Fool’s ART is over 5.20 with Smith already at this point, but it looks like Smith is going to be ok.He is being quiet and Fool is going to get a blanket.He just may be able to get Smith covered without further incident, and get to the Olsen couple with 8 minutes until 3 o’clock patient Roy Davies gets in the chair.It is going to be tight, but this is what community acupuncture is all about in the postseason.


T- I tell you what, you never what to see a sharp needle.However, a sharp sensation can shut down and quiet even the most oblivious talker.It makes you wonder if Fool threw that at him on purpose.


J- Oh, I don’t know about that, Tim.That’d be quite a risk in this situation, not to mention an unethical decision.Fool is no stranger to controversy, but I don’t think that he’d go that far.


T- I’ll have to agree with you.In any case, Smith is done at 5.45, eyes staring wide at the ceiling, way under his TA.I think Fool won this round.


J- No question there and he’s on to the Olsen’s.Rolling slowly on his stool he makes his approach toward the right side of the recliner.Again, he sneaks his hand onto the left wrist while the patient begins speaking.He’s not wasting any time here.He’s listening intently and moving quickly on to the other wrist.


T- Nancy Olsen is already done speaking as Fool makes his move to that right wrist.


J- I have to say, Joe, this lady “gets” CA.Over time, a successful clinic environment will end up drawing the right people.People that will make the place work.It is as if the patient pool can reflect an accurate or poor understanding of CA principles held by the clinic staff.In a big way, a CA clinic requires that not only the needlers and administration staff “get it”.Patients must “get it” as well, or they’re liable to stop coming in and the clinic will suffer.


T- It really is a community partnership that we’re witnessing here.I mean, Nancy Olsen has 37 visits in seven months, and she probably says less in three visits than Sam Smith says in one breath!


J- Well, it takes all kinds, Tim.But your point is well taken.Nancy Olsen is a pro in that recliner and the clinic runs smoothly because of folks like her.Fool is finishing her up in 2.08, having selected the 4 gates and ST36 bilaterally, with a deft Yintang to seal off the encounter.She declines a blanket and Fool is moving on.


T- Fool checks the room.All eyes are closed, even Smith’s.He can move on to Ted Olsen.


J- Cutting his needle count and using the intention of a “prayerful heart”, Fool delivered a quick and effective CA treatment almost 2 minutes under his ART.


T- A “prayerful heart” was the intention of the great Bambina, the legendary Miriam Lee and it is Lee that as much as anyone has had a hand in creating a generation of CA needlers that are intent on raising the bar of American acupuncture, lowering ART’s and seeing more people in need.


J- Yeah, Fool’s mantra in clinic is “Paying Attention to Intention” and he credits this philosophy in no small part to the late Lee, a women whom he has never met.Lee, who passed on this year, virtually invented American acupuncture, at least in a legal sense, with her pioneering efforts in California in the early to mid ‘70’s.Her career ART?Get this, Joe.1.12!!1 minute and 12 seconds!No one even comes close!Forget Richard Tan.Just forget him.Her ART makes him look like molasses in clinic. But he sure can work the CEU circuit.Lee never did that quite like him.


T- That’s incredible.Just incredible.1.12.Many CA needlers are devising plans to make adjustments to challenge Lee’s ART mark and truly step up league play in the states.We’ll see what happens.


J- Of course, Lee expounded on her elegant and effective 10 point combo in her seminal work, “Insights Of A Senior Acupuncturists”.This combo that Fool uses so often here was something that she developed in order to “think fast, treat fast” and see as many people with “ordinary” problems as she possibly could in order to devote more time to complicated cases.Just keep in mind, that whatever “extra” time Lee spent with a so-called “complicated” patient, she still maintained that unprecedented ART of 1.12 over the life of her career.In thinking fast and treating fast she was seeing some 14-17 patients an hour, five days a week for 7 hours a shift.Then she would work the line at Hewlett-Packard!This was before the legalization of acupuncture in California, which happened as a result of her intense work at that time.A spectacular needler.There’s been none better.


T- Now, that is a lot of patients, up to 100 a day!Treat ‘em and street ‘em, huh?


J- Well, what else would she do, treat ‘em and bed ‘em?Take them home for safekeeping?That seems like something incredibly stupid to say, Tim.


T- Hmmm, I guess you’re right.


J- Well, aren’t we going off on tangents?Fool finishes off Ted Olsen with an identical point script!Again, you do what you have time for as a CA needler and don’t create unnecessary complications. Following that code, Fool nailed down Ted in 1.22, his fastest of the shift!


T- Fortunately for Fool, Ted there talked even less than Nancy.Did he even, speak?


J- (laughing) Well, I think he grunted!I did hear that! Perhaps he is an All-Star!


T- You’d have no arguement from me, Joe!Still no sign of Davies and Fool is on to the top of the 3rd hour with 9 in the chairs.That needled newbie isn’t due to be pulled for another 13 minutes and after pulling out two more sets of needles from the first hour in just a moment, Zang Fool will go out to the couch to face that newbie walk-in with only a minor time crunch.His New Patient Intake (NPI) is just under 8 minutes and he can speed it up if he has to.


J- That he can, Tim.It has been an exciting shift thus far.We’re headed to the top of the 3rd.He’s needled 11 and is looking at 10 more.We’ll be back after the chairs are flipped and check into that new patient walk-in intake.Davies is on deck and may arrive any second now.Stay tuned.

The Zang Fool
Author: The Zang Fool

<p> This is a satirical blog post by a practitioner that is serious in his attempts to both increase acupunctures accessibility to the public and challenge practitioners preconceived notions of what acupuncture is and how it functions in society. It may make you laugh, but that is just a means to an end. That end is thought and ultimately positive change. This is what all good satire does: prick, prod and provoke thought and positive change within a community. </p> <p> Satire has long been a part of muckraking and this profession is teeming with muck.  So, in the wake of the nonsense spewed from the foul anus of the Acupuncture-Industrial Complex come my musings on life, love and the proposed doctoral program. </p>

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  1. The Acu Channel

    Please, please find a way to do a video clip of this.  The one I made up in my head using your genius script was good, but Youtube is so much easier to pass around! 


    Grateful, as always, for your cleverness.


    julia in berkeley

  2. I’m speechless

    not least because “take them home for safekeeping?” is going to make me laugh for MONTHS.

    You hit it out of the ballpark, ZF.

  3. Last night’s NLCS game was boring…

    But this one had me on the edge of my seat.  Like Lisa I too will be laughing about “taking them home for safekeeping” for a long long while.  Genius!

  4. “taking them home for safekeeping”

    …puts a whole new spin on “patient retention.”

  5. sort of like my chess game analogy

    but yours is funnier ZF. Good pep talk for a Monday morning.

    Well, I’m in the middle of my October inning and everyone in CommuniChi de la Raza Stadium is rooting for the home team to make a comeback. In walks the aging Ace and he’s definitely got his work cut out for him. Relatively empty lineup, both shoulders hurting him and a knee that is going to need a look by the trainer before this game is out…but fingers and mind still nimble. 

    And in walks the first batter without an appointment. Game on!


  6. Oh dear

    OCD/hoarding runs on both sides of my family; my grandmother didn’t bake anything because her oven was where she stored her thousands of tiny balls of tinfoil. I used to worry I might end up as a cat lady — like with 87 cats — but this could turn out to be SO MUCH WORSE.

  7. I’ve always wanted a role model…

    and now I have one. See, there, the Universe DOES provide.

    But still,  I can tell I’m going to have to put some work in. I have a six year old patient, I have a nine year old patient, I have various and assorted little old ladies, and I can probably get some good altitude there, no problem. But the bikers…I’m a little concerned about the bikers. Especially the ones that are bigger than me. And those boots, and the knuckledusters, you know those are not going to help. I guess I just need to start practicing with a biker or two.

    Hmm, maybe I just should have stuck with “treat ’em and street ’em”…it wasn’t so athletic.

    Drinking, of course I’ve been drinking! I’ve got to make sure the box wine is everything it should be, before the CAN Board shows up at my house.

    True confession: I inadvertently recycled my OCOM diploma almost immediately after graduating. I suppose that was a sign, wasn’t it?

  8. I’m With “speechless”

    and I pride myself on my dislike of sports metaphors!!

    This post rocks!!


    thank u!!


    Anyone think it is a good idea to hang it on my bulliten board, as a patient training tool??


  9. I’d say that if you hung it

    I’d say that if you hung it on your bulletin board you’d be batting a thousand.  Cool

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