The most difficult thing I have yet encountered in my professional life in Chinese medicine is not helping patients with illness. It is not wrangling with insurance companies. It’s not even keeping a clinic thriving in a highly saturated market. All of these things are comparatively easy, and less important, than the one thing that keeps me up at night, wrestling with myself to find a solution.
That challenge? Finding a way to continually work to develop myself into a better practitioner of this medicine while doing all of the above at the same time.
It’s a similar challenge as I met while I was in school. While getting my medical degree, I found myself constantly having to make difficult choices about which subject to focus on, whether to spend time with my family or do my qigong practice. It’s really the trouble of contemporary life, at least in reasonably affluent countries. With so many possibilities open to us, it’s hard to filter through and let those that are really distractions fall away.
It’s not just hard, it’s often nearly impossible. I have tried, and failed, more times than I can count. I failed this morning. I may well fail this evening. But each day, I recognize the problem and seek to solve it. And, yes, I do believe it is a problem. Why? Because while I do believe one should have multiple interests, I also believe that focus is the key to mastery.
Getting my 10,000 hours
Certainly you have heard about the 10,000 hours rule. I first learned of it reading Malcom Gladwell’s fine book “Outliers.” In that book, he discusses what it takes to go from good to standout in any given field. It’s a complex book, but so easy to read, I definitely recommend it.
Anywhere, it’s there that he discusses several studies that indicate that it takes approximately 10,000 hours of dedicated practice in a field before one gains some level of mastery over it. Doesn’t seem to matter whether we are talking about art, business, music or even medicine. Several years of careful, deliberate practice is a necessary, though probably not sufficient, condition if one wants to reach the top tier.
Chinese medicine is a complex field. It has a number of important zones of practice. To make this article a little simpler, I redacted my rather lengthly description of those zones and how they do, or do not, related to actually seeing patients. Let it suffice to say that seeing patients is probably the most important zone of practice for us, but that it is not sufficient, particularly if we are not prepared to actually see patients.
Learning a few formulas and point prescriptions by rote, and doing that with 10,000 patients will not a master make. Learning one’s lineage, following in the steps of one’s predecessors, engaging in scholarship – all of these are necessary. The point is not the 10,000 hours and certainly the point is not to seek out that one realm of practice that is more important than all the others.
The important thing is dedicated practice. And that is the difficult thing to remember when one gets out of formal schooling.
In my own life practice, as well as from what I’ve learned from my teachers, students, peers & the wisdom of so many wonderful texts – I’ve found the following five areas of practice to be the most important. So much so, I have dedicated myself to a particular daily work with each of the five areas.
Memorization is the key to mental alchemy. The ingredients have to share the bowl for the magic to take place. While there’s no shame in looking something up in a book, you will find your insights and effectiveness increase when you commit the critical data to memory.
My plan is to memorize at least one line of the Shanghan lun per week. It’s not a very ambitious plan, but it is achievable, and that’s more important. Some weeks, I might do more. But, I will never do less.
In order to have effective output (whether in teaching, writing, or practicing medicine) you must have plenty of good input. Sitting in lecture, discussion groups, and patient appointments are all wonderful sources of input. But, simply reading the thoughts of others is one of the best things one can do to obtain new material for reflection & use.
I use the popular program Instapaper to pull in interesting writing all over the Internet. I also, of course, buy & borrow paper and digital books on a number of topics. My interests are pretty closely arrayed around the field of Chinese medicine, so I’m never reading anything wildly “off-topic” but I don’t artificially restrict my reading material.
3. Write / Teach
In my opinion, this is the most neglected and most important item on the list. Reading is critical for healthy input levels. Memorizing enables input to undergo the magic of mental alchemy (and really, why read something twice unless it’s Ender’s Game?). But teaching and writing? That’s where you go from posessing someone else’s knowledge to making it your own.
When you write, you are forced to not just understand something for yourself, but arrange it in such a way that it makes sense to someone else. Hopefully. No single effort will be more richly repaid in your scholarly life. Writing FOR someone also helps – so blog – if nothing else. Teaching TO someone also helps – so lecture to your dog – if nothing else.
For my part, I do plenty of teaching. I slack off on writing, sometimes. So, as my current practice, I write 750 words every single day in my journal at a minimum. One blog article a week. One other piece of writing per month (article for Chinese Medicine Quarterly or something else).
4. Use my whole body in learning
As I’ve discussed elsewhere, I don’t think reading and writing are enough. You must engage all your human awesomeness in the processing of information. Partly, that just keeps you awake and probably improves your information retention. But it’s also a phenomenological thing. These senses – these eyes and ears and tastebuds and skin all over every surface of your body – they are delicate, highly refined instruments of knowing. Use them! Use your ears to learn acupuncture points. Use your mouth, tongue and nose to learn Chinese herbs. Use your ability to differentiate color, texture to experience those herbs as plants, as beings. Having trouble understanding a difficult concept? There’s one particular way to use your body to learn that I’ll mention…
5. Spend time outside
Our medicine is nature medicine. During the Han dynasty, they didn’t have shopping malls and sidewalks and Toyota hybrid vehicles. They had sand, and soot, and brick, and arrows, and forests, and oceans, and stars. Much of what they learned, knew and taught makes sense only when compared against those same types of things. So, when you’re really struggling to understand what it means in Chinese herbalism to “drain dampness,” why not go observe a creek or drainage ditch nearby? Why not look at the vegetation that grows near water, compared to vegetation that grows far from it? Even a five minute walk between study sessions can be powerful.
For my bodily learning practices, I do two things. First, I spend at least ten minutes in the morning walking around my neighborhood. Often, much longer. I don’t try to force anything, but do try to recall any particular patient, case, formula or text that has been giving me trouble. Then I let the rest work itself out. Also as part of engaging my entire body, I’m doing at least one complete tasting of an herb I don’t know well every single week. Because of my teaching schedule, often I do this several times a week, but I make sure to do it at least once.
Do you do any similar practices? Have others to add? Let me know in the comments!