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HARMONIZING
EAST AND WEST ÊCOMPARING TCM IN CHINA AND THE U.S. AN INTERVIEW
ÊWITH DR.XIULING MA, Ph.D., O.M.D., L.Ac.
Edited by Jan Goldy, Yoichi Hasegawa, Julie Liu,Katherine Marks
and Martha Rolls
March
5, 1999
Background
Summary: Ê
Dr. Xiuling Ma attended the Beijing University of Traditional Chinese
Medicine for a total of twelve years, from 1982 to 1994. ÊUpon completion
of the Bachelor of Medicine program (which was then a six-year full-time
program). She graduated with the highest G.P.A. among her 120 classmates.
ÊIn China, the Bachelor of Medicine degree is all one legally needs
in order to practice either Traditional Chinese medicine or Western
Medicine. It equals Doctor of Medicine degree. Most physicians in
China do not go on to get advanced degrees.
Although
Dr. Ma could have begun practicing medicine upon graduation, she
chose instead to enter the three-year Master's program so that she
could study under a special Master in order to increase her knowledge
and expand her techniques even further. ÊSince the difficult entrance
examination for the Master's program had a very low passing rate
when Dr. Ma took it, her entrance into the Master's program was
an accomplishment in itself. Dr. Ma began the Master's program and
her relationship with her first Master, Dr. Zifu Chen, a professor
with special expertise in both her bology and acupuncture. ÊAlthough
each Mastert ypically has up to two students per year, Dr. Ma was
Dr. Chen's only student for the entire three years of her Master's
program, thus allowing her the opportunity to absorb his special
expertise on a one-to-one basis. By the time Dr. Ma had graduated
from the Master's program in 1991, she had also developed a master-student
association with yet a second Master, Dr. Jia-san Yang. ÊDr. Yang
is one of the two most highly respected TCM physicians in China
today. He is acknowledged in China as an international expert on
acupuncture and moxibustion, but he is also an expert in herbology.
ÊHe was so impressed with Dr. Ma that he encouraged her to enter
the three-year Doctoral program under his special tutelage, and
so she took and passed yet another rigorous entrance exam. ÊAt that
time, in 1991, there were only a few TCM Masters in the entire country
who were authorized to grant Doctoral degrees for acupuncture, and
Dr. Yang was one of them. Understandably, Dr. Ma enthusiastically
entered the Doctoral program as his student in order to gain the
unique expertise, experience and recognition that such a once-in-a-lifetime
relationship offered. ÊÊ
During
her Doctoral studies (and to a lesser extent during her Master's
studies), Dr. Ma also worked as an independent physician at the
Beijing University of TCM Teaching Hospital and Clinic.ÊIn addition,
she taught many students, not only TCM students who were working
on their Bachelor of Medicine degrees, but also physicians from
less prestigious hospitals who came to the Beijing University of
TCM from all over China for advanced training.
Following
her graduation from the Doctoral program in 1994, Dr. Ma began full-time
work in the Acupuncture Department at the Beijing Univeristy of
TCM, as a professor and physician.ÊIn the meantime, word of Dr.
Ma' s professional expertise as a professor and physician of the
highest caliber, and as a woman of great compassion, integrity and
down-to-earth common sense, had spread from Dr. Ma's Master, Dr.
Jia-san Yang in Beijing, to his son, Dr.Tiande Yang (a supervisor
at Emperor's College ) in Santa Monica. ÊAs a result, in 1995, Dr.
Ma accepted an invitation to join the ranks of Emperor's College
as a professor and supervisor. ÊShe has been at Emperor's College
since that time.
In addition,
Dr. Ma currently has her own private practice in Beverly Hills,
California where she treats patients with TCM acupuncture and/or
herbology, according to their individual needs.
Interview:
Ques:
Dr. Ma, before getting into the specifics of TCM education in China,
could you please clarify for us the basic differences in China between
TCM and Western medical education?
Dr.
Ma: Yes. ÊChina has separate TCM andWestern medical universities.
Ê TheWestern medical universities have some TCM courses, but not
a lot. The TCM universities have a lot of Western medical courses,
plus many specialty internships. However, whether you graduate from
a TCM university or from aWestern medical university, you still
get a Bachelor of Medicine degree, and you can practice either TCM,
or Western medicine, or both. ÊNormally, a TCM university graduate
would practice an integrated form of both TCM and Western medicine.
Ques:
ÊHow is a person with Êa TCMBachelor of Medicine really
equipped to practice Western medicine in China?
Dr.
Ma: ÊIt's because of the integrated training at TCM universities.
For example, a TCM student in China not only takes a lot of courses
in Western medicine, but also spends several months in each of several
integrated TCM and Western specialties; pediatrics,gynecology, surgery
. . .
Ques:
Surgery? ÊDid you ever operate onanyone?
Dr.
Ma: Yes, under supervision. ÊI did a surgical internship
and performed some relatively minor surgeries with my supervisor,
such as an appendectomy, a prostatectomy and some others.
Ques:
Did you have a "major" while you studied for your Bachelor
ofMedicine?
Dr.
Ma: Yes. ÊTCM universities typically have three main divisions.
ÊThe TCM Department emphasizes clinical practice, mainly with the
use of herbs. Ê The Herb Pharmacology Department emphasizes herbal
research, especially for those wanting to become pharmacists. ÊThe
Acupuncture Department emphasizes acupuncture, moxibustion and tui-na
(Chinese style massage techniques). ÊFormy Bachelor of Medicine
degree, I was in the TCM Department. ÊFor my Master's and Doctoral
degrees, I was in the Acupuncture Department. ÊThat's why I have
interest and experience in both herbs and acupuncture.
Ques:
ÊBefore we get into more details about the Master's and
Doctoral programs, can you tell us what impact the government control
of Chinese universities has on TCM education in China, and how that
makes it differerent from TCM education in the U.S.?
Dr.
Ma: ÊSince the Chinese government controls all the universities,
Chinese students are given government grants, so they don't work.
ÊThey only study. ÊAnd, all classes are during the day. ÊThere are
no evening classes like there are in the U.S. ÊHere in the U.S.,
most students work at least part-time while studying. ÊThere is
more flexibility here, and students who don't work can finish the
entire program in less time--or they can take longer if necessary.
ÊThat wouldn't be possible in China. ÊIn China, the courses are
offered in a certain order, and that's when you take them. You go
through the entire program with your classmates, and you all graduate
together with the Bachelor of Medicine degree. ÊIn fact, you all
live at the University, and so do most of the professors.
Ques:
You all live there together at the University?
Dr.
Ma: ÊYes! ÊStudents get free rooms atthe University, plus
a living allowance from the government, and teachers get low cost
apartments. ÊThat's the way it was when I was there. ÊÊSome students
got smaller allowances if their families had more substantial financial
resources. ÊThere have been some changes in the last few years,
and I believe some students may now pay something toward tuition
or living expenses at some universities. Ê
Ques:
What's required to complete the Master's degree?
Dr.
Ma: After passing a difficult entrance exam, you then have
classes, research assignments, teaching requirements and clinical
training. ÊI was privileged to study with Dr. Zifu Chen as his only
student during the entire three years of my Master's program. ÊDr.
Chen has special expertise in acupuncture and herbology. ÊBy the
end of the three years, I had finished my classes, and I had presented
my research conclusions and my thesis.
Ques:
ÊSo, you had a Master all to yourself throughout your Master's studies!
Dr.
Ma: ÊYes, that was Dr. Chen, but actually, I was very lucky
and for the last two years of my Master's studies, I had two Masters.
ÊDr. Chen was my only Master during my first year, but he referred
me to another Master, Dr. Jia-san Yang, and I was fortunate to be
able to study with both of them during the second and third years
of my Master's program. ÊIt was an incredible experience, and I
had learned a great deal from both Masters by the time I got my
Master's degree in 1991. ÊActually, Dr. Jia-san Yang is the reason
I entered the Doctoral program. It was a special honor and privilege
to study with such a famous physician, so I took and passed another
difficul tentrance exam just to continue studying with him for the
three-year Doctoral program. ÊDr. Yang is one of the two most highly
respected TCM physicians in China today. ÊI believe that I learned
much more from my two Masters than I could ever have learned in
private practice, or from less experienced physicians. Ê
Ques:
What are the advantages of having Masters such as Dr. Yang and Dr.
Chen?
Dr.
Ma: ÊThere are several advantages, and all of them are very
important. With a Master, you learn the Master's unique techniques
and herbal formulas, some of which have been handed down in families
or close relationships for generations. ÊThese techniques and formulas
are often closely guarded, or at least they are not well-known.
Another advantage is that a Master has had extensive experience
over the years in treating a broad range of conditions, so he can
quickly and effectively diagnose and treat even very complicated
conditions. Without this special association with a Master, who
is like your own personal advisor with great expertise, physicians
learn while they practice, often by trial and error. Also, getting
a higher degree and working with a Master is quite impressive in
China, since Masters have high positions and are very highly respected,
so it means you'll have better opportunities in the future from
the government, not only in terms of position, but also in terms
of research grants.ÊI should also point out that there's a lot about
acupuncture that you can't learn from books because you simply cannot
describe techniques in words. ÊTechniques are art, not literature.
I feel that the best way to learn an art is to observe a Master
while he's performing his art, and let him observe you as he advises
you and teaches his skills to you.
Ques:
What about the advantages to being a TCM physician in China?
Dr.
Ma: An important advantage in China is the integration of
TCM and Western Medicine in the hospital, so a TCM physician is
involved in a very holistic approach that combines the best of both
disciplines. Also, we have a team approach there, including physicians
like my Masters.ÊLess experienced physiciansc an learn from them.
You don't have TCM hospitals and that kind of teamwork here. Since
TCM physicians in the U.S. generally have their own practices, they
tend to be more competitive, because each one naturally wants to
keep his or her own patients.
Ques:
How does the internship program between Emperor's College
and Daniel Freeman Hospital compare with practicing TCM at a TCM
hospital in China?
Dr.
Ma: It's very different. ÊIn China, TCM physicians know
both TCM and Western Medicine, so we can treat the patients with
both. ÊBut in the U.S., the M.D.'s don't know TCM, and the TCM physicians
don't know very much Western medicine. ÊIt's not integrated here.
Ques:
ÊDo you have any suggestions for improving the TCM curriculum here
in the U.S.?
Dr.
Ma: I think it would be good to provide more specialty courses,
including internal medicine, gynecology, pediatrics, orthopedics,
ophthalmology, dermatology and the other specialties I mentioned
before. Also, the Chinese classics are so important that I think
they deserve much more study. It's also extremely important, even
critical for the future of TCM in the U.S., to establish Doctoral
programs here as soon as possible.
Ques:
What do you mean by "critical?"
Dr.
Ma: ÊI feel strongly that the TCM Doctoral progam will elevate
the practice of TCM faster and more effectively than anything else.
ÊIn the U.S., we are at the beginning of a new era in the way medicine
is practiced. It's going to be a much more integrated system between
Eastern andWestern disciplines. ÊThat's what patients are demanding.
ÊThere's no doubt that TCM will play a major role in this new integrated
medicine, and no doubt that TCM Doctoral programs will accelerate
the process. ÊI feel so strongly about this that I would very much
like to be involved in establishing and implementing TCM Doctoral
programs here.
Ques:
ÊDo you think U.S. students of TCM should also study for
awhile at a TCM University in China, either as part of the Master's
program now, or toward a Doctoral degree in the future?
Dr.
Ma: ÊYes. ÊActually, one of my future goals is to help facilitate
those programs. ÊA lot of international students are naturally attracted
to TCM study in China, and they can receive credit for study at
TCM universities there.
Ques:
ÊWhat about the language difference? Do U.S. students have
to learn some Chinese first?
Dr.
Ma: It would naturally be helpful, but English is spoken
there. ÊThere are even classes in English for foreign students,
and a student can pay for a translator to follow him or her in the
clinic and hospital, and to help translate in other ways that the
student might need. There's actually a special department with translators
at the Beijing University.
Ques:
Would you recommend that U.S. students study only at the Beijing
University of TCM?
Dr.
Ma: No, not only there. ÊEach TCM hospital in China has
different specialties, a different atmosphere and a different group
of professors. ÊEach U.S.student should be matched with the TCM
university and professors best suited to the student's needs and
goals. ÊIf I were involved in that matching process, I would draw
on my friendships with my former classmates and colleagues who are
now spread all over China at the different TCM universities and
hospitals.
Ques:
ÊIs there anything else on your professional "wish-list"
for the future?
Dr.
Ma: ÊYes. ÊI'd also very much like to be affiliated with
a hospital so that I could do more for patients who develop serious
illnesses that require hospitalization. ÊI already have the necessary
training and experience, since I spent so many years studying and
practicing medicine in a hospital setting where an integrated form
of TCM and Western medicine was emphasized.
Ques:
ÊInaddition to teaching TCM at Emperor's College, what else are
you doingprofessionally at this time?
Dr.
Ma: I have a private practice in Beverly Hills which I enjoy
very much.
Ques:
ÊAs a practicing TCM physician, do you have any special treatment
protocols or techniques that you tend to favor? Also, do you tend
to favor herbs over acupuncture, or vice versa?
Dr.
Ma: I prefer combinations of herbs and acupuncture most
of the time, although sometimes I use more of one than the other.
ÊMy goal is to tailor the treatment to whatever the patient needs,
and to do my very best for each patient. I apply the knowledge and
techniques that I've learned throughout all my years of academic
training and professional practice, including the special techniques
passed on to me by my two Masters in China. Ê Also, I read a great
deal, and I attendprofessional seminars whenever possible so I can
keep current with new developments, not only in TCM, but also in
Western medicine to the extent applicable.ÊI feel that one of the
advantages of my broad experience and my openness to new modalities
is that Ihave accumulated an extremely wide variety of treatment
options to choose from in order to give each patient the maximum
individualized benefit. Ê I believe this kind of broad diversity
is especially important in TCM, since the very essence of TCM is
being able to design, with sound medical knowledge, along with compassion,
creativity and flexibility, uniquely individualized treatments for
each and every patient.
Ques:
ÊOn the subject of herbs, can you tell us a bit about which herbs
are most commonly used in Chinese homes, and particularly, in your
own home, not only when you were a child in China, but also in your
home now as an adult?
Dr.
Ma: ÊSome of the most common herbs used in Chinese homes
include Cong Bai (scallions), Hua Jiao (Szechuan pepper), Hu Jiao
(black pepper), Sheng Jiang (fresh ginger), Da Zao (Chinese red
dates), Lian Zi (lotus seeds), Rou Gui(cinnamon), Ding Xiang (cloves),
Xiao Hui Xiang (fennel), Chi Xiao Dou (adukibeans), Hei Zhi Ma (black
sesame seeds), Dan Dou Chi (soybeans), Bai He (lilybulbs), Bai Guo
(ginkgo biloba), and Yi Yi Ren (barley). ÊThese herbs are used in
home cooking for taste, and they are also used as remedies for various
conditions. ÊFor example, when I was a child, if I was coming down
with a cold, and also to prevent colds, I would drink an extra large
cup of hot water with 5-6 slices of fresh ginger and about a teaspoon
of brown sugar in it. ÊThis is a typical Chinese home remedy for
early "Wind-Cold" symptoms. ÊIt's also used for teenage
girls to help alleviate menstrual cramps.
Ques:
ÊAs an adult, are there certain herbs that you now use frequently
in your own home?
Dr.
Ma: Yes. ÊFor example, I use scallions(Cong Bai) and fresh
ginger (Sheng Jiang) almost daily. ÊAnother example is one of my
favorite dishes, a rice and aduki bean (Chi Xiao Dou) soup.
Ques:
Will you share the recipe with us?
Dr.
Ma: Sure. ÊThe ingredients are 100g rice, 20g aduki beans
(Chi Xiao Dou), 15 Chinese red dates (Da Zao), and 10 lotus
seeds (Lian Zi). ÊPut all the ingredients in a pot and add the appropriate
amount of water for the rice and beans. ÊBring it to a boil, then
turn down the heat, cover partially with a lid, and simmer for about
40 minutes to an hour.
Ques:
Thanks! ÊSounds delicious and easy! ÊÊSpeaking of ease, we're a
busy and sometimes lazy culture, and when we need a specific herbal
remedy, most of us don't want to take the time to cook the raw herbs.
ÊÊIs this the same in China, and if so, what alternatives are used
there?
Dr.
Ma: ÊIn China, most younger people in the cities are very
busy and don't have time to prepare the decoctions. ÊAs a result,
there has been a lot of research lately in China to find the easiest,
fastest and most effective ways of administering herbal remedies.
The various methods include IVs, injections, sublinguals, inhalers,
topicals (creams, liquids, plasters), tinctures, pills, powders
and decoctions (teas made from the raw herbs). ÊNaturally, IV's
and injections have the fastest results, but these are used only
in more severe cases. ÊIn general, decoctions are stronger and more
effective than powders, but powders are much easier and faster to
use.
Ques:
ÊWell, since we all want the best of both worlds, is it
possible to get herbal remedies that are strong and effective, but
also easy to use?
Dr.
Ma: ÊI think it is. ÊAs a result of the recent research,
many very fine Chinese herb companies have improved the strength
and quality of the powders that they make. ÊFor example, I'm dealing
with a company now that puts very high quality powdered herbs into
separate hygienically sealed packets to maintain freshness and effectiveness.
ÊThis enables me to design a formula containing several herbs for
each patient, and to change the formula as often as necessary. It's
very important to be able to change the prescription as the patient's
condition improves. ÊThe patient takes individual packets home and
simply mixes the powders together (according to my written instructions)
in a cup with warm water, and drinks it. It's easy and it's effective.
Ques:
ÊIn your own practice, do you use these packets exclusively
when you prescribe herbs?
Dr.
Ma: No, not at all. ÊPatients have different desires and
different requirements. In my office, my herb room actually contains
a large selection of raw herbs, as well as a wide range of herbal
medications as powders, pills, sublinguals, topicals, tinctures,
etc. ÊI like to have a lot of flexibility in treating a wide variety
of medical conditions.ÊI also like to give my patients more choices
in using the different herb forms.
Ques:
Chinese herbs have been getting a lot of attention lately in our
newspapers and popular magazines, but what actual scientific proof
is there that they are both effective and safe?
Dr.
Ma: ÊMost Americans probably don't realize that there has
already been an enormous amount of scientific research and analysis
of herbs in China, as well as elsewhere throughout the world. ÊFirst,
we have centuries of recorded history as to the usage of herbs in
China, and many herbs are still so commonly used by Chinese families
today, based on information handed down through the generations,
that their efficacy isn't questioned, because it is so well known.ÊDuring
this past century, however, China has become more "scientifically"
oriented, and there has been significant scientific research as
to every aspect of all Chinese herbs. ÊThere are numerous Chinese
books and other publications detailing this research and describing
the herbs in great detail. ÊI have several such books myself. ÊAs
just one example, I have a Dictionary of Chinese Herbs (published
by the Shanghai Scientific Technical Publishers) which describes
each and every Chinese herb in great detail, along with results
of extensive scientific research including lab tests, animal studies,
clinical research, hospital usage and various other research protocols.
This dictionary also includes indications, contraindications, the
chemical composition of each herb, and so on. It's somewhat similar
to the popular PDR (Physician's Desk Reference) that Western physicians
use for Western drugs.
Ques:
ÊIs this Dictionary of Chinese Herbs available in English?
Dr.
Ma: Not yet, as far as I know. For research on Chinese herbs
in English, however, you can go to any biomedical library, such
as the ones at UCLA or USC, and you'll find a great deal of ÊWestern
scientific studies on Chinese herbs in medical journals and books.
ÊStudents of TCM learn how to access these studies in a special
course on Oriental medicine research.ÊWhen you read about Chinese
herbs in the newspaper or magazines, it's very often a brief summary
of a research study that was reported in one of these books or journals.
ÊI think you'll see more and more of theseWestern studies in the
future, because patients are asking their Western physicians about
Chinese herbs, and because Western physicians are becoming more
interested in Chinese herbs, often for themselves and their families,
as well as for their patients!
Ques:
ÊJumping back again in time, when you were in China, did
you have any particularly memorable or significant experiences as
a student or a physician of TCM?
Dr.
Ma: Actually, yes. Two in particular. When I was doing
a rotating residency in the C.C.U. (Cardiac Care Unit) while working
on my Doctoral degree, a patient came in with an extremely Êsevere
heart attack, and the only thing that saved him was a combination
of TCM and Western medicine. He needed the herbs that we put into
his IV, as well as the Western medications, in order to survive
the attack.ÊThen, during his recovery, he had severe angina pectoris,
and the typical Western medications, including nitroglycerin, did
not alleviate his pain, so we used moxa on DU-9, which stopped his
pain. ÊIt was quite impressive.
Ques:
You said there were two memorable experiences. What was the other
one?
Dr.
Ma: ÊOn another occasion, I was also really impressed, actually
amazed, when a stroke patient who had been in a coma for quite a
few days was revived by using mainly TCM medicine. ÊSome Western
medicines were used to relieve pressure on the brain, but we primarily
used the"Open Orifice" category of herbs in his IV and
in his nasogastric tube, and we used acupuncture as well. Then,
after we had revived the patient with those techniques, we used
other acupuncture points (scalp acupuncture and body points) to
relieve the hemiplagia (partial paralysis) that was caused by the
stroke. When you see with your own eyes how effective TCM can be
in such extreme cases as these, you develop even more respect, even
reverence, for what it can do. It's very powerful.
Ques:
Have these experiences with TCM changed you or your attitude toward
life in any particular ways?
Dr.
Ma: Definitely. ÊEver since I became a medical student,
and especially when I began seeing patients and the ful lpotential
of human suffering, I came to appreciate and value my own life more
fully--everything about my life, and my own health in particular.
ÊI was, and I still am, extremely grateful for everything I have.
ÊThat's one change. ÊAnother change was realizing how very important
it is to study hard and always to learn as much as I possibly can
in order to help patients, and to relieve their suffering. ÊI was
already studying very hard, but these experiences made me realize
how especially important it is for physicians to do just that.
Ques:
Changing the subject a bit, we're curious to know what you
think of life in Los Angeles?
Dr.
Ma: I like L.A. ÊActually, I especially like being on the
West side because I like the ocean a lot. ÊThe ocean is very calming,
and it makes me realize how immense the Universe is, and that we
should all appreciate what we have. ÊI find it's a very good place
to relax and refresh myself.
Ques:
What are your main interests and activities?
Dr.
Ma: I enjoy jogging very much--that's one of my favorite
activities. ÊI was able to jog every day in China, but not as much
here. ÊI also enjoy bike riding. ÊAs to the arts, I like classical
music very much, both Western and Eastern. ÊI enjoy reading non-fiction
books, articles and essays, and also novels. ÊI also like classical
Chinese poetry.
Ques:
ÊAs a closing question, what special advice would you want to impart
to TCM students?
Dr.
Ma: The first is to learn compassion. To be a health care
provider, compassion is very important. ÊWe must care about our
patients with deep sincerity and humility. ÊOf course, knowledge
and technique are also extremely important. ÊEvery student should
take TCM very seriously and study hard. ÊIf you have the knowledge
and technique, you can actually save a patient's life in serious
cases, so it can even be a matter of life and death. ÊTCM is a very
important and powerful tradition, and students here are fortunate
to be learning it at a time when it is rapidly gaining more and
more acceptance from conventional medicine.
Thank you
very much, Dr. Ma, for sharing your thoughts with us.
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