East Meets West
Monterey's Meridien Institute of Integrated Chinese Medicine is poised for a harmonious revolution.
Thursday, November 19, 1998
Twenty years ago, you''d be hard pressed to find someone who went regularly to chiropractors, was using Chinese herbal remedies, or would allow accupuncture needles near their body. Today, these "alternative" medicines are fast becoming mainstream, with the public leading the way and the American medical establishment racing to keep up. Just last week, the Journal of the American Medical Association devoted an entire issue to alternative medicine, in response to demand from physicians who wanted information on treatments so many of their patients are asking for.
The Journal released the findings of a Harvard University study showing a sharp increase in the use of alternative medicine by Americans--from 61 million people who turned to some form of alternative medicine in 1990, up to 83 million in 1997. The study also reported good results from four alternative treatments tested: Chinese herbs used for irritable bowel syndrome, saw palmetto (an herbal product) for prostate enlargement symptoms, yoga for carpal tunnel syndrome and an accupuncture-related "cupping" treatment to cause fetuses in the breech position to turn in the womb.
That interest is no surprise to staff and students at the Meridien Institute of Integrated Chinese Medicines, a small Chinese medical college and clinic that opened this fall in Monterey''s Heritage Harbor is touting itself as the only school of its kind in the entire country. So far, no one is disputing that claim.
The Meridien Institute offers a 10-trimester (3 1/3 years) course of study leading to a Master of Science in Traditional Chinese Medicine, which qualifies graduates to sit for national and state licensing exams in acupuncture. Students learn the basics of the Chinese language, and must be conversant with more than 300 herbs used in traditional Chinese herbal medicine, samples of which are kept in the institute''s second-floor "herbal pharmacy."
What''s unusual about the college is that the 24 students in its first-year class, who are studying acupuncture and traditional Chinese medicine, also learn many of the basics of Western biomedical science from practicing M.D.s affiliated with the Institute''s clinic. While certainly not enough to admit them to a Western medical school, this knowledge enables them to read a patient''s medical chart, discuss treatment with M.D.s from a Western standpoint and recognize when a disease or condition is beyond their capability, so they can refer the patient to a Western physician or hospital.
The staff of the Meridien clinic, which serves the public, is half M.D.s and half-licensed acupuncturists (L.Acs). Patients are examined by an M.D. and an L.Ac, who then work together to come up with appropriate treatments. Students at Meridien''s school get their clinical experience by working with both kinds of "doctors."
The concept of integrating Western and Oriental medicine is mainstream in China, and fast gaining currency in Europe. According to this viewpoint, both medical traditions have their strengths and weaknesses, and should be viewed as allies rather than competitors in the battle to keep people healthy.
But in the U.S., medical doctors and practitioners of alternative medicine tend to view the other with suspicion. "It''s difficult to get people to share information," says Dr. Shelley Brown, a general surgeon and Meridien''s vice president. While Brown knows of other clinics like Meridien, where patients are evaluated by both M.D.s and practitioners of Chinese medicine working side by side, she knows of no other school in this country where prospective acupuncturists also study Western medicine to this extent, as a tool for their future practice. "There''s a great deal of skepticism," she explains, "especially from the Western medical establishment."
That skepticism may be on its way out. Last November, in a ground-breaking statement that left many medical mouths gaping, the National Institutes of Health (NIH), the nation''s premier medical authority, gave its formal endorsement to acupuncture.
The NIH did not endorse other kinds of traditional Chinese medicine, such as herbs, diet therapy and tuina, or traditional Chinese massage. Acupuncture, as a technique, creates effects which are measurable, which lend themselves to the kind of "double-blind" controls Western science uses to test theories, Robinson says.
"The NIH considers acupuncture the most ''mainstream'' of alternative medicines," says Meridien''s academic director, Kaz Wegmuller. "Something about the needles makes it stand apart-- the reports of surgery performed without anesthesia, and so on." It''s ironic, he notes, that in China, herbal medicine is considered more important, more "central" than acupuncture. "But the effects are harder to measure," he adds.
Marilyn Nielsen, executive officer of the California Acupuncture Board that controls licensing of acupuncturists in this state, says there''s been a groundswell of interest in Chinese medicine since last year''s NIH endorsement. Three new acupuncture schools, including Meridien, have opened this year, bringing the national total to 28. More and more insurance policies are adding acupuncture to their list of reimbursable procedures, including Blue Cross/Blue Shield, Kaiser Permanente and various HMOs, Nielsen says. And the California Board has had to add a second annual licensing exam to accommodate the growing numbers of acupuncture students.
The Meridien Institute seems well positioned to take advantage of this national "attitude revolution."
Meridien is also unusual in the world of alternative medical training in that it is headed by two physicians with years of surgical practice behind them: Brown, a former general surgeon in Buffalo, N.Y., specializing in breast surgery; and Meridien''s president, Dr. Bruce Robinson, who retired in 1993 after a successful career as a vascular surgeon and turned to the study of acupuncture.
Robinson first heard of acupuncture, like many Americans, during former President Nixon''s groundbreaking trip to China in 1971. During the trip, journalist James Reston underwent emergency surgery in Beijing; he was fully conscious, with only acupuncture needles used as anesthesia. It was 22 years before Robinson would turn his interest into a second career. After his retirement, Robinson became academic director of an acupuncture school in Santa Cruz, but decided to set up his own school and clinic here in Monterey this fall in order to more fully integrate western and Oriental practices.
This February, and again in May, Robinson went to China--the only country where integrated medicine is the norm rather than the exception--to look for academic partners. "They gave me the red carpet treatment," he says. "They were so thrilled to see a Western doctor who wanted to bring these studies together."
Meridien Institute now has sister-college relationships with the Shanghai University of Traditional Chinese Medicine and the First Teaching Hospital of the Tianjin College of Traditional Chinese Medicine, two prominent medical establishments in China. Robinson also met several times with the head of China''s state medical administration, who wants to work with Robinson to set up a training center for Chinese doctors at Meridien; the doctors would come to Monterey for three months at a time to study the English language and Western medical culture, and would then return to China to help "Westernize their hospitals," Robinson says.
Robinson is also working with the Chinese government to create a Website that would disseminate Western and Oriental medical information, and to organize an international conference of integrated medicine to be held in Monterey in the year 2000.
Robinson is excited about the possibility of Monterey becoming a center of integrated Chinese medicine. It''s the wave of the future, he believes.
Most people accept the efficacy of acupuncture in treating pain, but there is a wide array of other conditions, Meridien''s staff points out, that respond well to Chinese medicine. "There are many areas where Chinese medicine works well together with Western medicine, and other areas where it works, and Western medicine does not," says Wegmuller.
"Western medicine is great for things that have already broken down," he says. "If your appendix is inflamed, it should be cut out." Chinese medicine, on the other hand, focuses on keeping the body in balance to maintain good health before problems crop up. "There''s a saying in Chinese medicine," Wegmuller relates. "''It''s too late to dig a well when you''re already thirsty.''" cw