Teaching + Textbooks

[Guest guest]

Hi,

 

First of all, I appreciate the fact that you're doing good work, and I wish I'd been in a position to appreciate it when I was in school. But unless everybody has a good teacher the profession stays scattered. I think it comes back to some kind of standard; on the side of books (in terms of what constitutes a minimum of cultural and theoretical knowledge with which we can swim in more "primary source" [both classic or modern] information), teachers and institutions (who are responsible for forming the language used to describe things in the classroom and clinic and need to set a high standard for themselves) and the students themselves (who most of the time will follow the course of least resistance unless given a good reason not to).

 

I went to graduate school at St John's in Santa Fe. While the graduate program left some things to be desired, the undergrad program produced an amazing bunch of people. The program is based on a great books format, where everyone reads and discusses ad nauseum a deep selection of classical literature. Greek and French were mandatory, and while most everybody had cribs in English, you had to be able to do a certain amount in the original languages. All the textbooks for math and sciences are classical authors. When everyone has not only the same vocabulary, but a huge core of common intellectual building blocks to work with it produces a very high level of communal thought and draws people who are marginal students to a much higher level. I think a classically oriented education in Chinese medicine could be the same way, but standardization of language and textbooks would be essential. The thing that really blew my mind about this school was that the students, who hadn't cracked a book less than 150 years old, frequently went on to advanced science degrees, mathematics, and, obviously, some of the more woodsy areas of the academe. In many ways it is not the content, but the context of education that produced this result, but the foundation is in the ability to have a dialog based on large common pools of information.

 

Another aspect of that education was that the tutors (professors) rotated subjects, and were obliged to be as well rounded as the students. When I was in acupuncture school two of my teachers had been teaching the same classes for over a decade, (apparently with very little variation and no apparent desire to strive for improvement). The language used was a hodge podge of Porkert, Wiseman, scary little sui generis phrases, butchered pinyin, graftings of western medical concepts, and poorly pronounced English supplemented by characters banged up on the board which flew over the heads of anyone who hadn't spent allot of extra time on Chinese. The lecture format was: step one: open book, step two: flap lips. When you speak of going further I admire it, but I also feel like we need to establish the parameters of where we have to get in terms of basics. Does everyone need to know what chronological stems and branches are? Yes? Put it in the book! Basic ba gua theory? Yes? Put it in the book! I feel that a lot of the people who were instructing me didn't know or care about "advanced" basic information. In first year I asked if the cou li were connected to the san jiao and was told: "that's a kind of academic question... ummm...". We need basic texts that plow through this information not to support teachers who know it, but to force teachers who don't know it to get with the program. I don't know that many of these concepts are required to make us better as clinicians... it is not at all clear to me that intellectual rigor and good practice go together at all in terms of acupuncture (obviously it is more clear with herbs). But in order to advance beyond the personality cult seminar circuit where we are as a profession we need rigorous intellectual guidance from somewhere. The fact that there are good teachers implies that there are bad ones, and writing better books raises the bar for them, and allows the good ones to move ahead instead of being tied to remedial work. Imagine an herb class where basic concepts were a given, or even debatable, but on a level where it wasn't a question of whether a student understands, but what they think is right. It seems to me like the profession is somewhat nucleated around good teachers and communication between various groupies is limited. Offering good basic information helps that communication, and allows us to create a grander more stable thought architecture.

 

Maybe we need a more academic PhD for a teaching degree. It doesn't seem like we have the infrastructure to support it right now. While the rubber meets the road in a teacher student interaction (and we assuredly have a group of dedicated professional teachers, bless you all), all those roads have to be connected to one another, and you need good maps, which are represented by common language and intellectual frameworks. Students will learn what they are required to learn, sometimes they will go beyond. Teachers will teach in the same way. If a PhD becomes mandatory for practitioners it will probably dumb it down. If it's just about our status in terms of the medical profession (how shallow is that?) make a clinical degree and a teaching degree separate.

 

All that said, is there some sort of committee to determine what sort of information would be useful? Would that make sense? Does anybody want to do it? I don't consider myself in a position to determine any of this beyond a gut feeling that things could be better than they are, or at least were in my case. I realize most everybody is very busy and producing the information that they think is important right now, but some reflective thought in terms of basics is always a good thing. Right? Consider it a character building experience. I'd be happy to work on this with anybody who is interested, if only to bring myself up to a standard I felt reflected the level of a masters degree, let alone a PhD.

 

Substandardly yours,

 

Par Scott

 

 

 

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Marnae Ergil

Thursday, June 19, 2003 10:41 AM

Re: Re: Teaching

Par - I dont think that your book idea is a pipe dream. It is something that I and others have also been thinking about for a while. Almost none of the books that we have available are really textbooks - Maclean & Lyttleton come the closest - and, I agree that it should not be written by one person - chapters by individuals who can really talk about a particular topic. and, yes, as a series rather than one book - one book is too big and too much. However, an integrated textbook series would be great. Again, however, in some ways the teacher is even more important than the text. It is a teacher's job to elucidate and expand upon what is in the book. When I teach Fundamental Theory, we spend time talking about what is in the book but then we go further, we look at the type of thing that Sharon talked about ("yin yang in right relationship"), we look at the ba gua, we look at history. It is a teacher's job to go further and offer his/her students more than is in the book - Certainly having a text to support this would be great, but because the text doesn't exist yet doesn't mean we shouldn't be doing it. MarnaeAt 11:04 PM 6/17/2003 -0700, you wrote:

Joseph, Why not criticize them? Sorry, I guess I don't mean to knock them entirely (except for CAM), but I found it very frustrating to find so little information available. For instance, many ideas about yin yang theory become clearer if you study ba gua trigrams. I suspect one could write something that would run four or five pages in a textbook that could present the basic theory of yin and yang interaction as expressed by trigrams which express the six basic interactions of heaven and earth, but you have to go a long way from any basic TCM text to find good information on this. The structure of Chinese medical thought is to some extent culturally contextual, especially in terminology, but it is also based on a variety of theories like yin/yang-ba gua, five element, etc. It seems like a cop out to say there is no way to introduce that information if it would greatly enhance the way students learn and understand. In a way these would reflect physics and chemistry in terms of western medicine, in that they reflect the roots of TCM physiology. If you really want to understand western medicine, it helps to have a very good handle on chemistry etc. In fact, they don't let you study it until you have gotten a basic grasp of it. If you really want to understand Chinese medicine, it would seem to obligate one to study these other systems to a slightly greater extent than learning the grain that represents water element. I don't think you could make a full course out of TCM herbal five phase/yin yang pharmacokinetics, but it could certainly be a very interesting couple of chapters in a basic textbook. There seems to be a gap between basic level texts and most of the rest of the literature. I was surprised there was no second level theory class when I was in school. Students in the acupuncture track were woefully unprepared to diagnose in terms of TCM, and herb students had to struggle, and frequently totally fail to understand what was going on in terms of single herbs and formulas (by the time internal medicine rolled around they either quit or got with the program). I have spent some time thinking about how to structure a TCM textbook; one could have sections in each chapter which present successive layers of theory: Basic explanations of terminology, basic ideas of pathology/physiology, explanations of treatment principles related to the physiology/pathology mentioned, more elaborate and interconnected physiological theory, points and herbs that relate to the functions mentioned with discussions of the qualities that make them function the way they do. Steven Clavey's excellent book on body fluids is something like what I'm thinking about, but you would sort of have to cram it sideways into Giovanni's fundamentals and clinical books. First year students read sections coded by color, second year read those to refresh the idea and then go deeper, herb students read as it pertains to herbs, etc. By creating depth in the book you remove what ends up being endless restatements of basic theory which seem to occupy about 50-75% of professional/non-basic level texts. Students could use the same book, and cover the same information at deeper levels each term. It would also insure that there was a theoretical continuity from basic to advanced information which is really lacking right now. This could be done as a series, with a point manual, materia medica and formulary which are keyed to the text and specialty skills texts could be added as produced. It is a frequently expressed opinion that the study of TCM is iterations of the same information which gathers more depth at each pass, why not write the book that way? Additionally, I haven't seen to many medical textbooks written by one person. While I'm not sure we could find a specialist in every aspect of every thing we'd have to cover, it makes sense to get people who have plumbed some depths to bring back what they consider the meat of what is there. I realize this whole idea is somewhat pie in the sky, but I think that it would work for the job. Best of all, we could get Churchill Livingstone to bind it so it would fall apart in a month! In some ways this draws us back into the language debate, which I'm sure nobody wants to get started again. The longer I spend grading papers for this herb class the closer I am to buying everyone in the class a Wiseman dictionary and forcing them to read it at katana point. Basic terminology seems to be very muddled and we have a tool, which admittedly is in need of some refinement, that can address the problem. I agree we are obliged to use it. Sorry if I sound like a cranky crank, my sciatica is acting up... grrr Peace in all seasons, Par

 

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acugrpaz

Tuesday, June 17, 2003 6:19 PM

Re: Teaching

Par,

I really do not mean to belittle the textbooks. They are a serviceable introduction to the subject. They just don't go quite far enough in thoroughly elaborating the basics of yin, yang and their relationship to clinical reality for Westerners, in my opinion. The cultural references are just that, references from Chinese culture and history and their way of thinking and make sense in context. I agree that more Chinese cultural/historical background might help Western students decipher things better.

I imagine when people steeped in Chinese tradition were first introduced to Western ways, they probably thought we were all weird. Apparently they did, because they called us barbarians. I also imagine it would be difficult to write a textbook for a pre-modern Chinese person about modern medicine that would adequately explain all the scientific sophistication underpinning the medical paradigm. In terms of Chinese medicine, Western society is out of the loop, so we are "pre-modern" to CM in that sense.

Joseph Garner

>>>Yeah!

I remember sitting down with Chinese Acupuncture and Moxabustion the day after I went to school to buy my books and thinking, "holy crap, you've got to be kidding!" Unfortunately they weren't...

 

It would also be nice to compile some encyclopedia style articles about various pertinent aspects of Chinese culture that often help to give places to put all of these new ideas we learn in school. Green dragons and white tigers abound, metaphors about irrigation and imperial court life run rife.

 

PS, what in heck is a straightened [sp?] spleen? Is it like little spleen in korean theory?

 

Par Scott<<<

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