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The Novice

How to Perform Acupuncture

Those who can’t do, learn. In this installment of our series in which the clueless apprentice with the experts, we try our hand at needlework.

Photograph by Sarah Caufield

I’d been experiencing shortness of breath. Riding my bike uphill left me gasping and, after a brisk walk, I’d pant like a tired dog. Maybe something was wrong.

I went to see my primary-care physician. She listened to my chest and asked me to breathe deeply. She suggested the problem was slight asthma, possibly brought on by unusually high concentrations of allergens in the air this year, prescribed an inhaler called Ventolin, and sent me on my way.

For all this I never saw a bill and the inhaler cost me $1. I have Medicaid and can go to my doctor pretty much whenever I need to.

Although my doctor happily refilled my prescription six weeks later, I never used the inhaler. While town-hall meetings over public health care threaten mob violence, I’m looking for healthier options, or at least something with less risk of gunshot wound. I’m well aware that as a Medicaid recipient, my wellbeing is dependent on health care that is accessible, affordable and effective. But maybe what I needed was a little vacation from Western medicine. I asked my friend Jonathan, a licensed Acupuncturist, or L.Ac., to teach me how to poke people with needles and cure what ails them and, to my great surprise, he agreed.

Because removing splinters with safety pins is the closest I’d ever come to acupuncture, Jonathan and I figured I should experience it before administering treatment to our dear, sweet, compliant friend Brian. Since my breathing has returned to normal, I have had no discernable health problems or emotional stress. I’d been feeling pretty good lately, but I do occasionally get wicked hangovers and have a history of migraines. At his apartment one muggy Sunday night, I told Jonathan about this, and continued, saying I was looking for more than just a cure for obvious ailments.

A few minutes into the treatment, the needle in my toe had started to feel like, well, a needle in my toe.“Can acupuncture make me stronger?” I asked, picturing myself, no longer a hundred-pound shrimp, winning arm wrestling contests at sports bars and hustling beer money.

“Well, it can give you more energy,” he replied cautiously.

“What about smarter, can it make me smarter?”

Jonathan shifted uncomfortably and looked away. “In theory, I guess…” I sensed I was missing the point.

Acupuncture made me think of transparent candy jars filled with mystery roots and pouches of herbs pulled from tiny drawers in a dusty apothecary shop. Technically, I knew it wasn’t spiritual or mystical in that derogatory way people imagine Wiccans casting spells for world peace or to cure unrequited love, but I figured in order to experience any benefit from the treatment, I’d have to have some sort of faith. Until now, I’d unquestioningly accepted my doctors’ diagnosis and prescription medications with names like science fiction characters. But, to Jonathan and hundreds of millions of others, acupuncture isn’t “alternative” medicine; it’s just medicine—different in many ways from Western health-care practices, but not a last resort and definitely not a magic charm.

I lay down on the mattress in Jonathan’s room and he pulled a handful of needles fitted in plastic tubes out of a chest against the wall.

“How does that feel?” Jonathan asked as he gently flicked a long, thin, shiny needle out of the tube and into my skin just below the second toe on my right foot.

It was a pinprick, followed by pressure, I told him. I’d flinched in anticipation of the needle, but it didn’t really hurt.

I barely noticed the points at the top of my head and in my forehead, but, a few minutes into the treatment, the needle in my toe had started to feel like, well, a needle in my toe. Except, the stabbing pressure was a ghost pain in my toe’s second knuckle, an inch above where the needle was sticking me. But I toughed out the ache. If Brian was going to let me stick him, I’d had to be willing to go under the needles myself.

The spots where he’d inserted the needles for treatment grew warmer. I was starting to feel a little distracted.

“Why are you doing what you’re doing to me?” I asked him, vaguely aware of my incoherence.

“Not everyone gets a headache when they have a hangover—some people get nauseated, some get a sore throat. It depends on the way that energy is going through your body. This treatment is to circulate yang meridian energy throughout your body.”

What I’d described to Jonathan, hangovers with lethargy and migraines, suggested an imbalance and a stagnation of yang qi and an accumulation of yin substances. Yin and yang are the energies that circulate in and regulate the body. Yin is related to the liver, spleen, and kidney and can be associated with heaviness and lethargy. Yang, related to the stomach and intestines, brings lightness, energy, dynamism, and metabolism. I needed more light and less heavy.

After all the needles had been inserted, Jonathan leaned back to examine his work and I felt a sudden wave of relaxation. Everything slowed down and my head began to pulse pleasantly.

“Whoa. I feel this. It’s intense.”

Jonathan nodded knowingly and started twisting the needles.

Step One: Diagnosing the Patient

When we were finished, I felt a little light-headed, but altogether more relaxed. I sat down on the couch next to Brian and he laid back lazily with his feet on my lap. It was his turn.

“We should probably look at his tongue and take his pulse,” Jonathan told me.

“All right, but, I’ve been drinking wine and smoking cigarettes, so…” Brian stuck out a wine-stained tongue. His pulse was, according to Jonathan, “wiry.” Mine, on the other hand, was steady and strong.

“OK, B, what’s wrong with you?” I said, putting my hand on his knee and trying to exhibit my least condescending bedside manner.

“Well, I think I’ve been having trouble with my digestion. And my energy is low. I’ve been having problems with flexibility.” Brian stretched, languidly, and sighed for emphasis.

“It sounds like your qi is stagnant,” Jonathan said. “We can fix that.” He shot an encouraging look in my direction. “Yeah,” I chimed in, “of course we can. Go lie down!”

Step Two: Treatment

On the couch, Jonathan handed me a three-inch plastic tube with the tip of a needle poking out of a hole in one end. A white stopper kept the needle in place inside the tube. He held out his hand, palm down.

“You’re going to try to put the needle in here,” He pinched the crook between his thumb and index finger.

I took the tube, needle inside, and pushed it gently onto his hand, so it left a slight imprint. Jonathan nodded.

“Now take out the stopper and tap the needle into my skin. Make sure it goes in straight.”

Jonathan handed me the needles and together we found the point in his toe between the first and second metatarsal bones on the top of the foot.The top of the tube prevented me from going too deep, and kept the needle from going in sideways, but all of the sudden my normally steady hand was shaking.

Like hitting a single key on a piano, I slapped the needle in with the tip of my finger; my timing was off, though. It jiggled feebly into his skin and I winced as though it had pierced my own hand.

I must not have brutalized him too badly, though, because after I pulled it out gently, he gave me a new needle to try again.

This time, I applied the correct amount of force, hit my mark, and the needle sunk in easily. Jonathan smiled at me, likely relieved I hadn’t mangled his hand any further.

We went into the bedroom, where Brian lay on the bed in his boxer briefs, Jonathan explained the proposed treatment to me.

We started with the points on the tops of his feet just above the gap between his first and second toes—the points that gave me ghost pains. Jonathan handed me the needles and together we found the point in his toe between the first and second metatarsal bones on the top of the foot. I positioned the tube, Jonathan moved it imperceptibly to the left, and then I smacked the needle into my best friend’s foot with my index finger. He winced, almost reflexively.

These two toe points are called tai chong, Jonathan told me, meaning “great surging.” The thumb point I’d first practiced on (and the matching spot on the other hand) is hegu, or “merging valley” in English. Together, these points are known as the four gates. According to Jonathan, they open circulation in the body. “If there’s a stagnation, it’s a common combination to use,” he told me.

In high school a friend told me that staying up all night will throw off your qi for two months minimum. The same friend also studied Esperanto and believed that evil was a force in the world just searching for a person or place to call home. Everything I knew about qi before giving acupuncture I’d gleaned from his drunken ramblings. Now, I know that qi represents energy, direction, transformation, metabolism, and movement. Brian didn’t have enough in the right places. It was blocked and we were trying to get it moving by using acupuncture on specific parts of his body.

“We want to use as few points as possible,” Jonathan showed me how to find the point, one quarter of the way up Brian’s leg from his ankle bone. “The body has a geography. Because it’s all relative, and people aren’t the same size, you have to measure the distance of the tibia, find the halfway point, and then half it again.” I held the needle steady, Jonathan corrected the location slightly and I knocked it in with a fluid motion. I had no idea what I was doing, but by now I had a sense of how to insert a needle.

“Here’s a three-yin meridian meeting point. We’ve got the liver and the spleen and the kidney. You can strengthen all three meridians and, therefore, all three organs with just this one point.

According to Chinese medicine, there are five major organs responsible for the body’s functioning. They are the liver, the kidneys, the lungs, what is called the spleen but is actually the pancreas, and the heart. Each organ or system controls or is closely related to a particular emotion. The liver is the center for malaise or anger, the kidneys for fear and shock, the lungs connect to sadness, the spleen to anxiety, and the heart is joy and happiness.

I’m pretty sure that at no point during my yearly checkup did my general practitioner mention the phrase “heart happiness.”It seems less arbitrary if you think of the physical responses that accompany each emotion. Feeling depressed or angry because of drinking immediately brings to mind the liver; when afraid, you might pee yourself, hence, kidneys; when you’re sad, you cry and gasp, a response that involves the lungs; people get stomachaches because of anxiety or worry; and the connection between happiness and the heart, well, you know.

I thought I understood what these organs did. But I’m pretty sure that at no point during my yearly checkup did my general practitioner mention the phrase “heart happiness” or use the word “meridian.”

In case yours hasn’t either, meridians are the pathways of energy that travel across the body. Each corresponds to one of the major organs. We were stimulating points on a particular meridian with needles in order to draw energy there or free up coagulation. Sometimes they cross, as in the case of the three-yin meridian meeting point.

We finished placing needles in points on Brian’s legs below his knees, a point called zu san li, and a point near each of his elbows. Jonathan twisted the needles some to adjust how far in they went, and we left Brian, non-responsive except for the occasional murmuring assent, so we could talk in the living room.

Step Three: The Needles Work Their Magic

Jonathan explained that practitioners of Chinese medicine think of the body through a series of metaphors.

“What would be referred to as a invasion of wind-heat, is also what you might call an infection or inflammation,” he tells me.

“But now that we’ve done the treatments, what’s happening, physiologically to Brian’s body?” I ask.

“Well, acupuncture stimulates blood flow to the specific points, there’s a nerve reaction, and also a histamine reaction. Western research has found evidence of the histamine reaction, but my feeling is that if you’re going to do Chinese medicine, you need to really give yourself over to that method and not rely on Western medical evidence to prove it’s effective.”

Ideal care, in Jonathan’s opinion, involves a combination of both Western and Chinese medicine. In China today, doctors have embraced Western medicine in part because it seems more “modern” but still, he claims, if you go to the hospital for chemotherapy in China you will generally receive herbal treatment and acupuncture as well, and your body will heal much faster and the illness will have a much lower rate of recurrence. According to Jonathan, you’ll also often be able to get away with a much lower dosage of chemo and a shorter course of treatment.

I had been exposed. Rather than take the treatment on its own terms, Western medicine had brainwashed me to require acupuncture be justified by a philosophy I understood. But what Western medical practice is supported by 2,000 years of research?

Step Four: Removing the Needles

We crept back into the bedroom after about half an hour. Brian had been much more serious about his treatment than I’d been about mine. When we roused him, he yawned, smacked his lips, sighed, and gazed up at us with a dreamy look in his eyes.

“Unlike your treatment, which increased energy, Brian’s made him tired. It was about calming down and evening out the flow,” Jonathan explained.

Jonathan and I leaned over his feet and he showed me how to take the needle out, wiping off any drops of blood. “Totally normal,” he assured me. After we’d removed all the needles, Brian stretched and sat back down on the couch.

“How did it feel?” Jonathan asked Brian.

“My body felt like it was alternating between heavy and light and sometimes my body would feel like it stretched for feet.”

The next day when I called to check on him, Brian told me he was feeling “lovely!”

Though having a friend unclog your stagnant qi now and then is probably not a feasible solution to the nation’s health-care crisis, the homey, intimate care that night was preferable to waiting rooms and examination tables. Tea Parties against public health insurance options rage as the U.S. hustles for ways to lower health-care costs and provide better care, but maybe soon, effective, affordable treatments like acupuncture administered by trained and compassionate practitioners will become something more than an alternative.

Jonathan speaks Chinese and has a deep understanding of the major muscles, bones, and systems of the body. Mechanically, acupuncture is simple, though I would rather stitch a gaping wound than try to insert needles into Brian’s tai chong points without Jonathan’s help. Jonathan’s patient explanations left me inspired but when it came to understanding the treatment, I hadn’t scratched the surface.

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TMN Editor Nicole Pasulka believes she could beat a lie detector. When she sits in a chair she almost never puts her feet on the floor. Even though she likes the internet a lot, she is convinced that people will always read magazines and she is secretly building one in her basement. More by Nicole Pasulka