Which end of the banana do you peel from? I asked this while presenting to a conference for Mongolians and Americans. How many peel from the stem end? All the American hands shot up. How many from the other end? Mongolians hesitantly lifted their hands. Which is the top? Our end. Really? Bananas grow up from the stem. Mongolians peel it from the top. They hold the stem like a handle. Very convenient, they say.
In the same way, Mongolian Medicine comes from the opposite direction from Western medicine. Both have health as the goal. Both have assessments, both have treatments, both have plans. Yet, Western medicine targets the symptom and assumes the system will heal. Eastern medicine targets the system and assumes the symptom will heal.
What does this mean? Let's take urine analysis, for instance. American doctors generally send a urine to the lab. They may or may not look at it. My teacher, Dr. Boldsaikhan, President of the Union of Traditional Medicine in Mongolia, looks for position of sediment, swirls the urine with a stick, watches the bubbles' size and how fast they disappear. He checks the color and smell. When we were teaching a class at the University of Vermont a few years ago, each of the 20 students brought a urine sample. He held up one urine, spun it with a stick, watched the bubbles, and said to the student, "You have a brain tumor." She gasped, "I didn't want anyone to know so it wouldn't affect my job."
When our Mongolian Medicine Project took laboratories to four rural hospitals, we taught 9 tests. One was a urine dipstick. A urine dipstick checks the possible components of the urine such as protein, ketone, blood, glucose, bilirubin, etc. It checks the parts, while Mongolian medicine checks the whole. When we visited our pilot project a year later, the urine dipstick was their most used test. Cost? $25 for 100 strips. We took laboratories because Mongolian doctors wanted "technology". Obviously, they did not need an MRI, but they found that breaking down the system into parts is also useful.
Eastern medicine does not separate the person or symptoms into parts. It puts the pieces together. It uses the gray area. One way this is done at Ulaanbaatar's First Hospital's Traditional Wing is to have patients stay for 14 days. Each day, the patient is assessed by palpation, observation and questioning. Palpation means the 12 pulses are taken. Observation means checking the urine, eye beds, fingernails, the color and moisture of the skin. Questioning means asking about bodily functions, sleep, and diet, as well as emotions and spiritual beliefs. Each day for 14 days, the diagnosis is adjusted toward balance of hot and cold (yin and yang). Each day the therapy is adjusted to bring the patient closer to the middle way between the extremes which are disease. Patients change their diet, behavior, medicine and treatments to balance the disease. Treatments include what some may call alternative medicine: massage, chiropractic, acupuncture, cupping, moxibustion, energy healing, Yes, there is a place in the overall plan of traditional Mongolian medicine for these modalities. In Western medicine they are complementary or extra.
Can Eastern and Western medicine be integrated? Integration assumes that they can be melded, that they can fit together. It would be like peeling a banana from the middle. Now that's not easy. Eastern and Western medicine are each a complete system in themselves. They are each intact systems. Western medicine does scientific research to prove that treatments work or don't work. Black and white. If you have this disease, you get this medicine and IT WORKS for the target symptom.. There are sometimes problems with this method, problems related to the body system—side effects, imbalances, unwanted changes in other areas of the body. For instance, if you have rheumatoid arthritis or fibromyalgia and take steroids, you may gain weight, which causes other problems, which need other medications. Alternative treatments help balance the rest of the system. But a local doctor once told me, "My patients get massage, but I just don't have the same data base as a person doing massage, so I have never discussed my patients with them.
What could help? May I suggest that each of us learn as much as we can about both systems, so that we can communicate with each other and become advocates for clients and ourselves. Stretch ourselves. Try peeling the banana from the other end. Really. If a client has tried all the options and still needs surgery? I offer to go with her and do therapeutic touch in the operating room and recovery room. Therapeutic touch creates a calm atmosphere and promotes rapid healing while surgery removes or adjusts the problem. The surgery deals with the symptom while therapeutic touch targets the balance of the whole system. In Mongolia, where they have various treatments, they need simple technology, so that they, too, have options. Why has our Mongolian Medicine Project taken laboratories to four rural hospitals? Because they asked for it. Without a laboratory in their local hospital, Mongolian nomads need to travel 9-12 hours to a larger hospital for tests. Imagine having a questionable appendicitis and traveling that far over rutty tracks for a simple lab test. An acute infection like appendicitis can be diagnosed with a microscope, slide and stain. Or imagine being reindeer herders in northern Mongolia and losing a child to an infection from a dog bite like they did this fall. Why? Because they didn't have access to basic first aid knowledge, equipment or supplies.
My vision is for patients to have knowledge of all the options available for treatment. Ones that treat the system and ones that treat the symptom. They can then interweave them in a way that works for them. If holistic practitioners and the medical community work together, patients will benefit. We are all lucky to have access to x-rays when we break a bone, white blood count when have an infection, and surgery when we need it. The medical establishment would benefit from working with complementary practitioners—patients would get well quicker, more completely and with fewer side effects. Mongolians in rural areas can use options, too. Basic laboratory equipment and supplies greatly expand their choices. Western medicine needs more balance, more common sense, more personal responsibility, more mind/body understanding and treatments. If patients heal completely from illness, the cost of imbalances left over will disappear. Much of the medicine and high tech health care needed today would not be necessary. In other words, we can lower cost by intervening at a low-tech level with interventions that treat the whole system. If Eastern and Western health care were interwoven, without losing the integrity of either, energy healing would be available with surgery here and rural Mongolian hospitals would be able to assess urine both with a urine dipstick and by watching the bubbles disappear.
So, the next time you peel a banana, pause a moment… May I suggest Mongolians peeling bananas from the stem end, while Americans from the other end? Your bananas will be peeled, I assure you.
Sas Carey, RN, MEd
Middlebury