Day 1:
Hi everyone from Guangzhao in south eastern china. I’m here for 2 weeks studying acupuncture in an acupuncture hospital which also has western medicine. We are in the middle of a city of 12 million people and it is all go 24/7.
The hospital is a bit smaller than the John Radcliffe and I am with a group of 15 acupuncturists observing various doctors in their surgeries. It is like being in the outpatients wing of the JR as people turn up all through the day and wait to be seen.
In the treatment rooms there are anything from 4-10 beds and couches and everyone gets treated together. They pay £10 per treatment of which £9 is paid by their compulsory insurance. Most of them come in every day.
So far I have been seeing people with paralysis of the face (Bells Palsey and other similar problems), neck spondylitis, back pain and various other pains. A lot of patients have chronic serious problems. Most of them get needles, anything up to 40 needles at a time, inserted in under 2 minutes! You may be grateful that this is not what we do in the west as a rule!
A lot also get tuina which is like strong massage and in some cases like osteopathy as they reset bones. Again, this can be vigorous and not for the faint hearted!
So far I am just observing but soon I shall be putting needles in under supervision and joining in the next episode of Casualty!
Day 2:
Hello again from Guangzhou. It’s now been 4 days in outpatients and they are still coming in thick and fast.
One thing that is different here is that the acupuncturists can also choose to train in tuina which is very similar to osteopathy as it includes bone manipulation as well as all the deep tissue massage. They are surprised that the two disciplines are separate in the UK.
We continue to see many serious cases and the great thing us that the patients can come in every day for treatment if needbe as it is essentially £1 a session ad I explained in the first blog.
Today we saw some young children being treated with acupuncture. Both were premature births. In one a young girl had misformed feet and ice cold legs. She had had operations on her feet to reshape them (in another part of the hospital – how good it is to have integrated medicine) and now she was getting acupuncture to connect up the lower body again. In the other a young boy could not speak and was essentially autistic. In amongst all the kisses and hugs he kept giving us he was given acupuncture to help him speak again, and had two words he could now say.
We see also amazing care given to these children by both parents and doctors and wonder how much this reflects the ‘one child ‘ policy and the preciousness of the only child.
I have attached a few photos of the treatment rooms where we observe to give you an idea of what it is like.
Day 3:
Hi again with more news from Guangzhou. A week has gone by and we have been on a short break on the Pearl River delta which connects the city to the sea and Hong Kong. This is the agricultural heartlands of the Cantonese speaking people and from where most Chinese have emigrated over the centuries. We are currently travelling through mile after mile of vegetable and fish farms – bit like the south of Spain but without the plastic sheeting!
Reflecting on the first week in the hospital, the main impression is of ralentless demand for medical help. This is mainly due to the population explosion in the city from 3 million in 1980’s to 12 million now. In this context there simply isn’t time to do individual consultations notwithstanding that it is fairly normal to have treatments in shared space in most of China.
The top professors here are seeing on average 70 people a day, 5 days per week. And they are working 9-5pm with a 2 hour lunch break which are not long days by UK standards.
We have seen a huge amount of stroke patients as well as lots of neck pain types. These seem the main specialisations here. It is very rare for an acupuncturist to be the first port of call for a stroke patient in UK. Here they treat these people with western medicine for the first 3 days and then refer them for acupuncture.
The advantage of this is that they use acupuncture to encourage blood and energy to keep flowing through the affected area (without getting into too much technical jargon here), once they have stabilized the patient. In UK we would be unlikely to see stroke patients within the first month of occurrence.
As always it is fascinating to see the two systems of medicine side by side. There is no attempt by the acupuncture doctors here to claim superiority.
Finally on a slightly humorous note we also observe the adroitness of the doctors putting needles in with one hand , on the phone with the other, directing photographs every few minutes, and all the time there is a patient below with a serious problem who sometimes is also on their phone!
All for now, more to come soon. I attach a few photos of life in outpatients including one of me having a walking Tuina treatment, and one with Prof Qin, aka the Flying Needle Doctor.
Day 4:
We are into our last 3 days in Guangzhou and still the cultural differences are so interesting.
When we walk into a restaurant our guide will shout at the waiter to find us a table and then shout again for food and tea. No please and thankyou. But then it is considered rude if you don’t wash your cup, bowl and chopsticks before you eat. When you eat it is also ok to talk and eat at the same time and it doesn’t matter what falls out of your mouth!
It is also common to have Chinese youths want to have a picture taken with you, and they get in really close head to head as if you were a family member. No concept of English personal space here!
In the shops the clothes have obscure English slogans on them or American brand names. It is cool here to have a European or American style. Meanwhile back in the Uk it is cool to have a tatoo with a Chinese character on it…
Meanwhile our clinical observations continue in their strange and wonderful ways. We have seen patients hung upside down by their feet on an inversion board. Once vertical they are swung about to increase back mobility and some have had low back manipulation at the same time.
In the acupuncture department we have seen patients getting a red hot needle lightly touching the skin to remove cold from their bodies. There are no marks left on the skin from this. But with moxa treatments (a smouldering herb left on the skin) they do let it burn the skin and it leaves a scar. I have enclosed a picture below of this.
There is generally an obsession here with getting rid of cold and this has puzzled me given the subtropical climate in these areas. The answer however is that a lot of it is down to huge numbers of workers sitting long hours in cold air conditioning, itself a response to the unpleasant muggy atmosphere caused by air pollution on top of the humid climate (itself exacerbated by rapid population growth).
Ironically the same problem was around centuries ago when workers spent their days in cold damp fields and got pains in their joints. So there has been huge progress materially but same result!
There will probably be time for one more report before returning to some familiar place a long way away.
Last Day:
Hi again, just time to squeeze in one more report before we return.
We start our days here with taichi in the park at 7am which is a daily ritual for many city dwellers. You grab your spot under the trees and pretty soon you are surrounded by people doing sword dancing or fan fluttering or kung fu type moves. We regularly get locals joining in with us, some with transitor radios on and small dog alongside. Average age seems over 50. We are an obvious oddity going about our business quietly and with proper English personal space around us!
There is a consistent awareness of the need for good exercise such as taichi and diet advice in the hospital. Every department puts up big dietary posters which are changed each season as the Chinese medicine pays attention to changing seasonal energetics. Every patient can also get an individual dietary plan which addresses their specific complaint. I don’t think we do anything like this in UK hospitals.
There is of course the usual fast food on the streets, and whilst you can always get fried food there is also a lot of steamed food which is healthier. There are also intriguing and challenging options such as tortoise soup, toad casserole and deer antler and hoof pot.
One menu also had 3 kinds of snakes, or snake-three-ways as they say on Master Chef!
We continue to see integrated medicine in all departments. Today we saw how patients in the respiratory recovery section could also have bee sting therapy which can counteract autoimmune diseases or treat allergies or joint problems. Small bees are placed on acupuncture points and the sting activates the body’s healing. Yes the bee dies…not considered an issue here given that anything with 4 legs except the table is eaten!
We saw diabetic patients receiving insulin and also Chinese herbal treatment. Some of these herbs are given as a foot steaming treatment as diabetics often get numb feet. I managed to sample one of these foot tubs – see picture below – with herbs that increase the blood circulation. Whilst I was doing this one of the in-patients brought me his sandals for afterwards. Didn’t feel it was right to ask for a cup of tea!
We saw young children getting tuina/acupressure for breathing problems – gentle but firm rubbing on places on the hands, arms and back. Those with asthma were getting steam nebulisers which blew a herbal concoction onto their face. They also had steroids as far as we could gather.
Finally we sat and practised our flying needle technique with one of the acupuncture doctors. Safe to say I shall not be doing 40-50 needles in 2 minutes on patients anytime soon! But it is still amazing to watch a master in action, every needle put in like a dragon fly dipping to touch the water momentarily and the sensation for the patient virtually nothing despite the needle being one or more inches deep. Seeing is believing…and now it is time to say goodbye.