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Editorial: Integrating Eastern and Western Medicine: Mo, Hi, Ba ... Yo! (1, 2, 3 ... Go!)
I recently returned from another medical training mission (our fifth annual visit) in Vietnam. These missions are tremendously valuable for training my fellowship and resident physicians on how to educate and function in challenging medical environments. Over the years I have had a number of military physicians comment that their medical mission experience was the single most important training they received in preparation for working in a battlefield environment. Our Vietnamese hosts benefit from the exposure to modern American medical technologies and procedures. While this mutually beneficial relationship has been a medical education success for both parties, I often think our team comes away with far more benefit then we necessarily bring. This last trip was no exception.
This year we had the pleasure of visiting Central Hospital, Cân Tho, Vietnam. Cân Tho is the largest city in the Mekong Delta. We spent a week in Central Hospital working with our Vietnamese hosts, demonstrating the advantages of a regional anesthesia section and an acute-pain medicine team in support of their operating rooms. Halfway through the project, our Vietnamese hosts invited us to a Cân Tho restaurant to sample local food and celebrate our friendship.
These large, “family style” meals are a preferred method for social interaction in South Vietnam. The events are often accompanied by considerable toasting with local beer spurred on with the cheer, “Mo, Hi, Ba…Yo! (1, 2, 3…Go!). An ill-considered sense of maintaining American honor caused me to match my Vietnamese friends cheer-for-cheer and thus beer-for-beer. The fabulously foreign diet, long workdays, and excessive evening cheering conspired to produce a whale of a headache the following morning. Despite a dose of acetaminophen and lots of water, I was looking haggard on the last day of our mission.
My host noted my predicament and insisted we visit the hospital “traditional medicine” provider. This was significantly outside of my Western medicine comfort zone, but I had considerable speechmaking ahead of me this day, and my host was insistent. With my headache intact and untouched by the dose of acetaminophen, I schlepped off to the traditional medicine clinic with my Western medicine sense of skepticism on maximum.
Traditional Clinic Part of Hospital
My first surprise was finding the traditional medicine clinic as part of the hospital. Additionally, the clinic was clean and utilitarian, no mood music, incense, chanting or other silliness. This was a no-nonsense clinic, and the traditional medicine provider was professional and confident. Through an interpreter, I related the circumstances of my condition, and, with a wry smile ,the traditional medicine provider suggested acupuncture for my symptoms. Having never experience acupuncture, I was both intrigued and willing.
After a detailed discussion with the provider on where my headache was emanating from, he began to place needles on various spots around my cranium and at a point between my thumb and index finger on both hands. The needles burned slightly, but the sensation was mild and tolerable. This sensation was followed by a feeling of fullness in my head that was not unpleasant. The provider would twirl the needles periodically during the 20-minute acupuncture session. At the end of the session I had to admit (to my chagrin) that my headache symptoms had decreased significantly, and I generally just felt better. My wife, Pam, who had accompanied me on this trip, commented that my pale complexion prior to the treatment had also improved, with color returning to my face.
I was impressed with this experience but more fascinated that this traditional medicine clinic (what we would call integrated medicine) was an integral part of the medical system at this hospital. The traditional medicine provider noted that the hospital maintained a ward of patients undergoing traditional therapies for various medical problems. The clinic had a robust referral base from physicians within the hospital practicing Western-style medicine to support rehabilitation and recovery from a variety of medical conditions and surgeries. It appears that our Eastern medicine colleagues have achieved what Western medicine is presently actively pursuing, integration of integrated medicine techniques into our Western system of allopathic medicine.
Newcomer is Allopathic Therapy
Why has Eastern medicine been so successful at this integration that Western medicine is finding so challenging? In short, millennia of experience with traditional medicine. Allopathic medicine, a relative newcomer, is only now adding new chapters to the Eastern medicine tradition. This point was driven home when I visited The Museum of Vietnamese Traditional Medicine in Ho Chi Minh City (formerly Saigon). Here I viewed a diagram of the development of the Vietnamese medical tradition, beginning with folk medicine, followed by traditional medicine, and, at the bottom of the chart, a small box with an arrow that shows the introduction of Western ideas into the traditional medicine fabric of these societies. For these practitioners, traditional medicine was the norm and Western ideas the newcomer. As my Vietnamese traditional medicine provider explained, “We already know these techniques work. It is up to Western medicine to explain why.”
As federal medicine struggles to incorporate integrative medicine into our care systems, it appears to me that we could benefit greatly from the study of successful systems already developed in Asia. The no-nonsense approach of my Vietnamese hosts to traditional medicine was a refreshing viewpoint that is difficult to find within our system. There is much we can learn from their experience with traditional medicine, as they learn modern allopathic approaches from us. Like I said, I still believe we get the better deal out of the exchange.