"Treat Every Patient As A Relative" were some words of advice we received today. Our group was having tea and casual conversation after doing some rounds with our groups Rheumatology doctor when she gave us this advice. We all agreed and then a student in our group then asked about an earlier incident where an older patient came into the doctors area and was asking questions. The patient didn’t seem to startle anyone, however our group was slightly surprised because in the U.S it would be rare to have such free access to the doctors.
Other doctors have mentioned personal relationships with patients during our trip. When our group was on the GI Inpatient floor during a lecture the doctor mentioned that psychology and helping patients overcome emotional issues is important for GI diseases like IBS, where emotions can be the cause of the syndrome or simply exacerbate the syndrome. He said the doctors all have to take that into account.
In our school, PCOM, I feel like this is emphasized by some teachers and many of us are on the same page. But it was different for us to hear this type of message in a busy hospital. Each of the doctors mentioned above oversees about 20 patients on their floor at a time. So it’s not like they are hanging out with patients for a long time. But it seems the warmth and support they advocate is conveyed in small but noticeable ways: a gentle tap here or there, a few friendly words of exchange , etc. At least that’s what I’ve noticed. In general it seems the borders between patient and doctor seem slightly less rigid than in the U.S. But what I like about it is that warmth and peace are conveyed with small messages. The doctor’s mentioned intend to be nice and don’t feel they need to compensate for other areas of the health field where the experience might be different. Therefore it seems they do this without any over the top and/or manic attempts to pamper the patient. But that’s just my personal opinion based on differences I’ve noticed. I’ve only been here two weeks, so take my opinions with a grain of salt because I have hardly any experience here.
Again, it’s not that everyone walks around with a smiley face :), not at all, but there is a way that some doctors go about their business that I respect. When we were in the eye acupuncture outpatient clinic the doctor probably had seen 20 patients before we got there and another 30 or so after we arrived. Besides his patients he had his interns hovering around him, our group as well, plus another group of American students. We were on all sides of him. But he worked fluidly and calmly without seeming agitated by all the people. I feel that a few doctors we’ve met have had this type of demeanor. I appreciate these things. Again, I’m not trying to create a naive image of a place where no one gets flustered and is always nice (not at all), I just wanted to point out some positive things I’ve noticed.
On the flip side, there are things I like better at American hospitals. In my opinion, rigid rules can be beneficial when it comes to some things like smoking in the hospital or outside of it. - DH
This past Sunday our PCOM student group traveled to a wholesale Chinese Herb Market inside the city of Shenyang, Liaoning. This is the first herb market I’ve been to in China and I personally had a blast.
If you like herbs, it was nice seeing large bundles of herbs right out in the open and being able to compare them with what the next store had as well as with the cuts and quality you are used to seeing in the U.S. Plus the prices were great compared to the United States.
Shenyang is in the northeast of China just above North Korea (see map here http://www.travelchinaguide.com/images/map/liaoning/liaoning.gif ). While at the market I got the feeling that we were in ginseng country. I’ve heard Ginseng grows best in cold weather with some of the best being wild ginseng from North Korea. Most of the herb shops in the market specialized in Ginseng, Deer products, and sea cucumber (Liaoning is also near the sea). While a few others had selections of pretty much all the same herbs we would use in the United States plus a few others that we don’t yet use, Rhodiola for instance.
I’m not sure how many tourists come through the herb market but based on some of the wide eyes around I’d guess not many. That said, I will say that the store owners were pretty nice and welcoming and they also seemed pretty honest. Between Lilly C., Bob D. and our translator Austin we were able to communicate and chat about the herb selection and prices. When they saw that we knew something about Chinese herbs they opened up more dialog with us They also showed us their selection of prized herbs.
After showing some interest in buying we were also gifted a few rounds of tonic wines as well. I wasn’t around when the first tonic was served and I’m not sure what was in it, except that it was a Yang tonic. My cup came down the line and I gladly drank it down. Later on we were served some Ginseng wine. The same would happen at a few other stores we stopped in. Forget having Sunday morning brunch and a mimosa. I’d take walking around an herb market looking at wild ginseng while drinking Ginseng wine any day. I have no doubts about that.
I know nothing about herbs and determining their value is but I’ll try to explain to the best of my ability how the market was. The Ginseng came in many varieties of grade and price. The main categories being wild(very expensive), wild cultivated (planted or transplanted to a forest to simulate wild ginseng), farmed Bai Ren Shen – White Ginseng, and Hong Ren Shen - Red Ginseng. Of course within those categories there were large variations in quality and price. For example, I picked up some scrawny (but I think nice) wild cultivated ginseng for about 4 yuan a piece or about .80 cents. However, we also saw some wild cultivated Ginseng that hadn’t been dried and was still covered in dirt that went for 2,000 Yuan or about 300 dollars. The 300 dollar piece was maybe 4 times the size of what I bought but the quality and age is what made the difference in value.
Besides Ginseng there was plenty of Lu Rong and Deer penis at the markets. Not just slices of Lu Rong but big thick whole horns to buy. About half the group bought some bottles of Lu Rong wine that came in a nice box for 25 Yuan or like 4 dollars. Apparently many fathers will be receiving some Lu Rong on Father’s Day this year. I can’t say for sure but I wouldn’t doubt that the price would go up by at least ten times for the same bottle in the United States. (BTW when I say wine here, I mean distilled rice alcohol prob about 40 – 45% similar to vodka).
One thing I like about being in the herb market was that business was slightly old fashioned, in a nice way. Store owners tried to make connections with us. As we bought things, especially as we were a large group, the store owners were us small gifts. Besides the herbal wines that were being handed out we were also given things like boxes of Lu Rong tea. At one store we spent some time in the owner actually gave a small few of us some wild cultivated ginseng pieces (I’ve included a picture of the piece Bob D. was given).
Price coupled with lower quality usually discourages me from seriously examining Ginseng at herb shops in the United States. However now that I actually could afford the Ginseng I wanted to know how I might get the best quality for my money. Obviously, I know nothing about this and I had to depend on the collective knowledge of our group leaders and the store owners. The owners were actually honest about this. At one point some students were about to buy a pound of Korean ginseng. The owner honestly told us that the quality wasn’t the best. How can one tell? I’m not sure. The only thing I’ve ever read about it is here on one of Eric Brand’s blogs: http://www.bluepoppy.com/blog/blogs/blog1.php/red-ginseng-jpg I have also watched some video’s he made on the subject. Based on those blogs I was looking at the size of the head in relation to the body as well as the quality and evenness of the striations of the body.
Was I able to discern what was the best quality Ginseng? No. But I did notice that the lowest quality ginseng, like the Korean ginseng mentioned above, had very tiny heads while the higher priced ginseng had relatively large heads just as mentioned in Eric’s blog. It may not be clear in this photo, but the wild cultivated specimen that Bob D. was given also has very nice striations, and that was more expensive than others. As a student it was nice to have the opportunity to make the observations about quality myself after having read about it.
All in all it was a good day. I bought some Bai Ren Shen, Huang Qi, San Qi, Zang Hong Hua, Gou Qi Zi, and Bai Ju Hua. I may go back and buy some more before the trip is over.
If I’ve made any factual mistakes about anything relating to the Herbs mentioned in this blog please feel free to correct me in the comments section.
The last two days in Shen Yang have been quite eventful.
Yesterday, our students attended an inspiring lecture by a Doctor Dong, a senior acupuncturist and professor at Liao Ning University of TCM, who shared his very interesting clinical experience and theoretical perspective. In his view, many diseases have their origin in abdominal qi and blood obstructions, and can be treated by freeing stagnation and stasis of qi and blood from within the abdomen. He brought special attention to the role of spasms and/or weakness of the Psoas Major muscle and other muscles within the pelvic floor in creating and sustaining these obstructions.
For treatment, he emphasized the value of needling ashi points along the inguinal crease and points within the lower abdomen. His ideas brought to mind the Nei Jing based concept of the sea of blood (chong mai) as the repository of blood, and the pathway for the movement of blood. Arising from within the lesser abdomen, the chong mai has remarkable correlations to the arterial circulation within the lower abdomen.
Throughout his lecture, Doctor Dong emphasized the importance of thinking flexibly in clinical settings, and emphasized practical and effective diagnostics and therapeutics.
After a grueling but fun voyage to Shen Yang from San Diego, New York, Michigan, and Chicago, our group of 15 finally arrived in Shen Yang. After meeting with the Liao Ning TCM University officials and receiving a grand tour of the campus, we enjoyed a delicious and health-promoting Chinese herbal meal. Some of the expertly-prepared dishes we enjoyed included Ginseng and Du Zhong cooked with ox penis, pureed mung bean paste, and various mushroom dishes. In accordance with the season, many of the dishes were geared towards supplementing the kidneys. The amazing food was washed down with welcoming toasts with Cordyceps herbal liquor: An auspicious beginning to what we hope will be an excellent learning experience for the students in our group!