Monday, June 20

We are all headed towards a state of ignorance which comes from the pursuit of knowledge.


For a long time now I have been privy to brilliant and articulate writings and research on the efficacy or lack thereof of traditional Chinese medicine.  You can find all the research you want on the Internet.   Some research shows efficacy in treating certain pathomechanisms of infertility and some research denies efficacy.

In Western medical approaches to the treatment of infertility there is much research that points to the efficacy of PGD and much research that denies its value. Many doctors promulgate intercourse the night before IVF, many don’t. Many doctors give patients antibiotics before a transfer, many don’t. Many doctors believe in IVIG or intralipid therapy, many don’t. There is lots of research on the deleterious effect of autoimmune mitigators of infertility including natural killer cells but there are many doctors who think this is all hogwash.

Many doctors believe in going straight to IVF after two failed IUI’s, though many believe that one should do four to five IUI’s before engaging in the first IVF.

Many IVF doctors believe in this protocol and many believe in that protocol. Many doctors believe that obesity interferes with fertility outcomes (there is research attesting to this!) and many doctors will do an IVF on a three hundred pound woman.

There was a time when I was very interested in research, which would prove the value of acupuncture in the treatment of the infertile patient. 

There is a parable that tells the story of a Zen master talking to his student and pointing at the moon. The student looked at the master’s finger and was summarily dismissed by the master.  Have we, as practitioners become too focused on the finger?

It is my contention that we are all headed towards a state of ignorance which comes from the pursuit of knowledge; an incorrect type of knowledge.  Knowledge or lack thereof of regarding why something works does not confer or negate efficacy.  I remember when I was a student at Pacific College of Oriental Medicine in Dr. Yan Wu’s class when a student asked Dr. Wu a question as to why, when a needle was inserted at a particular point, did it have the intended effect. Dr. Wu’s reply was “who cares – it just does”.  Dr. Wu is a master physician with more than 30 years of clinical TCM experience under his belt.  It is in the West that we care about cause and effect, but in TCM the effect is what counts.

I am now less inclined to be interested in research regarding TCM and it’s efficacy.  I am interested more in learning TCM and its theories and applications.  Those of you who are spending years and years doing research on how TCM mitigates a pro-inflammatory state may be fooled into thinking that you are learning something of value.  This is debatable.  True value is measured by our success rates. The way to higher success rates is attained through learning the medicine that we practice. Most of you, and certainly I, know very little about TCM just as reproductive endocrinologists know very little about why women conceive and why they do not.

 
If you want to help patients to conceive then learn your medicine.

Want facts? Here’s one:  I can look any patient or doctor in the eyes and state that acupuncture and herbal medicine have been used continuously for the past three thousand years to treat infertility; sometimes successfully.   It was used in China before the advent of Western medicine and is now used in China in conjunction with Western medicine to treat infertility.

I think that many of us (including me when I was a mere tadpole) felt that we needed the nod from Western medical practitioners and researchers to validate TCM.  Now that I am a frog, I realize that my own legs are strong enough to propel me forward.

Study Chinese medicine and study Western medicine and then integrate the two in a way that works for you. 

Be able to defend your ideas and treatment protocols; be sure that your ideas have integrity.

 Treat as many patients as you can so you may positively impact many lives.

I am through with sitting on the edge of my seat waiting for an REI to say, “Acupuncture seems to offer some value to those trying to conceive” and jump up and down shouting yea!  I don’t mean to seem trite or competitive, I assure you, this is not my intention, but here goes: we were successfully treating any and every pathology which existed long before Hippocrates was a twinkle in his momma’s eye.

I believe in the value of IVF – but not for all its research. Indeed with all its research it still has far more failed cases than successful ones. But it does have some successful cases, and that demands respect – as do acupuncture and herbs. So don’t show me research – show me take home babies.

Knowledge is doing.  You can study martial arts for years and analyze the dynamics of kicks, punches, thrusts and parries, and take - downs, and joints locks – but that does not mean that you can fight.  If you can’t fight, then you do not know martial arts – you research them only. Outcomes are all that matter. 

I have not renewed my memberships with AFA and Resolve. When they honor an acupuncturist for his or her work in the field of reproductive medicine I’ll re-join.  In the mean time, they will, one again, undoubtedly honor Zev Rosenwaks.  Dr. Rosenwaks, what is your success rate for the thirty-nine year-old women with ovarian resistance? Is it any better than mine? I don’t think so. 

I’m going to study herbs now.