Losing the Gift of Bafflement
Originally published on Feb 11, 2020
Last night, I came across this quote, which I feel an urgency to share here, to ruminate on its relevance to the field of Chinese medicine as currently practiced, studied, and transmitted in the West. In his lovely little book On the Brink of Everything: Grace, Gravity, and Getting Old, Parker Palmer has this to say about the challenge of being a published writer:
"Speaking of fakery, one of the great temptations of being a writer is to absorb the projections of readers who think you're an expert on some subject just because you have written a book about it...
…When my ego becomes bloated with the illusions of expertise, I risk losing the gift of bafflement that has always animated my best writing. I stop asking questions and start believing I have answers."
Many practitioners, students, and teachers of Chinese medicine, in the United States in particular and definitely including myself, have an interesting relationship with expertise, and with the questioning thereof:
On the one hand, the healing profession, as an occupation that places the wellbeing of another human in your hands, obviously requires the development of expertise and authority, a certain presence that sets the healer apart as somebody who has spent many years studying the processes of the human body, which the patient is paying to receive the benefits of. In addition and complicating the situation in the case of Chinese medicine as the relative newcomer in the West and as a challenge to the dominant paradigm of biomedicine, it is of utmost importance for us as practitioners of this ancient and foreign medicine that we step into the power and greatness of this precious tradition, fully and proudly.
On the other hand, however, it has been a welcome, long overdue, and invigorating result of post-modernist critical thinking that we have learned to question and often reject the stodgy arm-chair knowledge of the wise old (usually white, male, upper-class, Christian) authorities in academia, for being imbued with racist, sexist, orientalist, colonialist, classist, religious and many other prejudices. I wholeheartedly agree with bell hooks’ vision of “transformative pedagogy” and her insistence, elaborated in her book Teaching to Transgress, that
“No education is politically neutral!”
As such, I constantly remind my students, readers, and listeners that the most important skill for me to transmit is critical thinking, as the ability to critically examine statements by so-called experts, especially when presented as “facts,” by knowing what questions to ask any presenter of such “facts,” to put the knowledge they transmit into the proper context. One definition cited in the Wikipedia entry on the subject, of all places, defines it in this way:
“Purposeful, self-regulatory judgment which results in interpretation, analysis, evaluation, and inference, as well as explanation of the evidential, conceptual, methodological, criteriological, or contextual considerations upon which that judgment is based" (Peter Facione in an article on “Critical Thinking: What it is and Why it Counts”).
This ability to critically examine any information presented to us is just as relevant for learning about Tang dynasty Buddhism as it is for learning about acupuncture point locations or clinical case studies.
Personally, I love it when students challenge me by asking questions that reveal a hole in my knowledge, or when readers give constructive criticism that reveals an unconscious bias in my thinking. It’s what I do with the knowledge of those who came before me, and it is only fair that I receive the same treatment. Instant karma, which is fine with me. Knowledge evolves, and sometimes devolves, especially in a field as young and vigorously growing as Chinese medicine as a clinical practice in the West right now.
In our rush to influence the direction of this development, often with the sincere intention of wanting to contribute what we consider essential information, we publish and transmit information that may end up being superseded quickly by other research. As an academic, I am comfortable with, and actively invite, this process of being challenged, questioned, and corrected by my colleagues, whether in the critical questioning at the end of conference presentations or in the review process of articles and books for publication. As a matter of fact, I consider it vitally important for the growth of our field that we preserve and celebrate this sense of what Parker Palmer so aptly calls “bafflement” as an essential mechanism for self-correction and as a stimulus to keep all of us learning, questioning, growing.
The establishment of the professional doctorate in Chinese medicine, whether as DCM, DACM, DAOM, DOM, or even the PhDs granted to Westerners through study-abroad programs in China, present exciting and rapidly expanding opportunities for students and practitioners of Chinese medicine in the West. There is no doubt that the new doctorate programs have created an important space for a deeper exploration that honors the traditional complexity of Chinese medicine. By developing specialized skills and expertise, carrying out more comprehensive and rigorous research projects, acquiring familiarity with non-English sources, but also all too often by deepening training in “real” (i.e. biomedical) science and medicine, this additional time spent in the pursuit of knowledge allows future “doctors” to step more fully into the authority of that big title, with the implied hope that we will finally be taken seriously by our biomedical colleagues. And this is a wonderful thing.
And yet….I see these new doctorate degrees as double-edged swords, with the possibility to cut down not just our detractors and critics but also the experts in our own field, if we are not careful and keep both eyes wide open. Much has been written about the financial issue and the fact that the primary benefactors appear to be the private CM schools that are able to charge ever more tuition to students who are being crushed under a student loan debt that many will never be able to repay. My concern in this essay is, however, with another issue, namely what we can frame as the loss of bafflement described by Parker Palmer in the quote above. Too often, recent graduates of these doctorate programs immediately proceed to publish their work, teach in the very same programs they just graduated from, or go on the lecture circuit as experts of much-needed specialized information that was previously not accessible in the English language. All of this is of course understandable and perhaps the inevitable result of a rapidly expanding profession that lacks access to enough genuine experts. In doing so, however, these recent graduates, who immediately step into the role of authority, risk losing out on the humbling yet essential experience of years of clinical experience and continued research, on the one hand, and, on the other hand, on the critical professional discourse that allows new graduates to slowly develop into experts over time, as is still happening for new PhDs in traditional academic fields.
For Chinese medicine to mature as a profession in the West and to do justice to its historical roots, we need to create and improve mechanisms that preserve the sense of “bafflement” in the so-called “experts” in our profession, as the awareness in all of us that no single person will ever have all the answers in this complex field. We must embrace the fact that we all benefit by listening to those who question us and present us with the gift of genuine and constructive critical feedback, especially when that feedback comes from somebody with many more years of experience as a researcher and clinician or with a background and training that differs from our own. In order to write and teach in a meaningful way, we simply must preserve our own sense of bafflement at all costs, because otherwise we shut the door to learning, and our expertise becomes stale as cheese that has been hermetically sealed in plastic, or milk that has been pasteurized for a long shelf-life instead of cultured for continuous and sometimes unpredictable transformation. I absolutely speak from personal experience here, both as a cheese maker and as a university professor.
At the danger of repeating myself, I once again cite Sun Simiao with what I consider one of his greatest contributions in this terse statement from the first volume of his Beiji qianjin yaofang:
There are fools in the world who have studied the formula texts for three years, and it is said [of them] that there is not a single disease in the world that they can treat.
And after treating disease for three years, they finally even become aware that there is not a single formula in the world that they can use.
To take this statement apart, the first “fools” are the scholars, the bookworms, those of us who have cloistered ourselves away in a little library cubby. And here it is important to note that during Sun Simiao’s lifetime, these three years looked very different from our modern CM education programs: On an already existing solid foundation of decades of academic study in history, philosophy, literature, language, and cosmology, this would have implied putting the nose to the grindstone day after day, from the rooster’s first crow until the lamp ran out of oil at night, with no outside occupation or family to take care of, no cellphones or Facebook for distraction, and no vacation trips, tirelessly studying, analyzing, memorizing, dissecting formulas with the rational brain. We all can probably appreciate how an exclusive study of formula texts, no matter how long and intense, with no clinical training and experience, cannot possibly teach anybody how to treat an illness.
The second part of Sun Simiao’s statement, however, is where the true gem is hidden: After this rigorous scholarly training, which would most likely be the equivalent of at least five times that length in our modern age of distractions and outside obligations, Sun Simiao continues, it still takes such scholarly experts three years of professionally practicing medicine before they even begin to realize the extent of their ignorance, namely that “there is not a single formula in the world that they can use.” And of course, as anybody who has observed clinical practice in China will tell you, this does not mean seeing patients for a few hours a day for a few days a week…
Let that sink in for a minute!
This is precisely the sense of humility and bafflement that our beloved Chinese medicine needs and deserves if we are to do it justice as the deep complex practice of life-long learning and study and growth, ideally sustained over multiple generations, that our historical predecessors in traditional China modeled for us. For the sake of this tradition, let us preserve bafflement!
P.s. As always, I welcome your constructive critical comments (:
