A Rise of Color

Lord of Thunder, unleash your fury, deep and black!

Fierce and flashing--lightning upon our tongues!  

We chant lions with ripped and roaring hearts, 

Beating back batons as tear gas glistens on the glowing road. 

Shadows give birth to white noise. We lynch our own color 

Foolishly thinking a story has two sides or one voice.

Evidence means nothing. I witnessed the beating of a heart.
And another heart stopped beating.

Dead daughters shiver and gasp, a cold choir with no voice.

Sons scream in soundproof booths--coffins for the living black.

"Can you hear me now?" David had to throw stones, too. 

Walk in the woods at night to see what you've become.

Velvet hollows haunt and holler, "Feel the fertile depth of black."

Now gather the blackness like berries, and be dyed by a rise of color.

__

This is fucking hard to write. Fitting that it should be such a struggle. I wrote a poem. It is tidy, pretty, punctuated. The poem lies. I woke up crying. My tears tell the truth. This is not a well-composed article with tidy distance. This is a storm with loose ends and no conclusion. 

Social justice teacher Verma Meyers says looking at pictures of strong black leaders alters our cognitive bias against African Americans. Let's look long and hard.

Clara Mae Luper was one of the early leaders of the Civil Rights Movement in Oklahoma in the 50s. She was arrested 26 times for her civil rights activities. She led sit-ins to end segregation all over OK. She was a candidate for the US Senate in 1972, and developed Black Voices Magazine in the the late 70s

I had a dream.

March 25, 2014:

I am trying desperately to hold an old African American woman's hand. We fight until I am in a cold sweat. We must fight together if we are to hold hands. She's dying. I have to struggle, not give up, knowing that my intentions are good, but my view is incomplete. She has the last word no matter what. I must listen. I will not give up. I am yelling, she is yelling. To hold hands with a black woman honestly requires an engaged struggle. Only she knows what it is to be a person of color. Finally, after wrestling from sun up to sun down, we can hold hands. Something is complete. She lies down to die. 

But nothing is complete. People keep dying. I am bewildered. I don't know where to start. So many voices. So much emotion. Such nuance and complexity. I get lost in the chaos. I retract my own statements fearing their inadequacy. Inadequacy is OK. We must all speak up, all of us who can. I return to my center. I breathe. I regain my voice, knowing it's just a note in the symphony, a fluid measure of music. Music is nothing without intentional pause, and less without listening. I want to lend beauty to our song. I try to write love songs but they always come out sad.

This is Mary McLeod Bethune 1875 - 1955. 
She was an educator and Civil Rights leader who founded the National Council of Negro Women, and served as an adviser to FDR on his "black cabinet." She promoted the education of African-American youth.

To know deeply who we are helps us stand with each other. To look at another human being and see ourselves is the litmus of truth. When we cannot see ourselves in the mirror of others, we endanger society, and kill people of color. What are we afraid of? We are afraid of ourselves because knowing who we are is at least as painful as it is powerful. We are Othering our African-descended family to protect our smallest selves, so that we of a lesser scale can continue to live and rule in fear. But true power roots down. If we don't build a tower, we can't fall from it. 

I don't identify as white. I stand in my tribes. You may think this doesn't matter because the system still caters to my color. But I can tell you that knowing where I stand makes a difference. My roots are deep and broad. They intertwine with yours. This is no theory. We are a family. Ask any elder who holds pieces of the ancient stories of humankind. (Did you know that African Chief Maui sailed from Libya to Polynesia, settling in Maui? Or that a man from the Siberian steppe carried a golden arrow all the way to Greece to initiate Pythagoras?) 

Great chief of Balé, King Fonyonga II of Bali-Nyonga, 1901–40. Cameroon, 1935

We hold pieces of each other, for each other. When we come together with open hearts, minds, and memories, we can know ourselves more fully. When we identify with each other, we act with a broader sense of self-preservation. We preserve our roots. We preserve our future. We preserve each other. Justice arises when we stop fearing who we are. 

At the same time, we can never know the experiences of another. Amid the protests in Oakland last week, a black man who lives on the street yelled at a group of us. "Nothing you do matters," he told us. "What does any of this mean?" ("We have no idea; please tell us.") "People have taken everything from me. I have nothing. They don't even want me back in Africa." Then, "I saw a dead black man rotting on the sidewalk for two full days before the police even bothered to come get him." 

Was there a funeral?

Booker T. Washington, president of Tuskegee Institute, is the first African American to be awarded an honorary degree by Harvard University. Born into slavery in Virginia, Washington moved to Alabama in 1881 to open Tuskegee Normal School. He soon gained fame as an educational leader among black Americans, a fact which Harvard recognized with a Master of Arts degree.

Apathy makes us an accessory to murder. Inaction makes racism our legacy. If we are tired of hearing about injustices against black lives, we almost surely benefit from institutionalized racism. We who have the luxury of ignoring this struggle are those who are now called to engage, to speak up, to avoid being complicit in systematic murder through silence. 

We who quibble over court cases and question who the victims are almost certainly have not walked in the skin of a darker hue. I can tell you with the certainty of a poet that we are standing on the wrong side of history, and missing the forest for the trees. 

In 50 years, if we are still alive, we will not want to say, "I didn't see what was happening right in front of me. I was blinded by my privilege [or my peers or my region], blind to the oppression of others because I had never experienced it myself." We will not want to tell our grandchildren that during this critical time for human rights, we did nothing. We have to make a decision. We can participate in a system that condones murder and oppression, or we can dismantle it. 

Cornel West, American philosopher, academic, activist, and author. The son of a Baptist minister, West received his undergraduate education at Harvard University, graduating with a bachelor's degree in 1973, and received a Ph.D at Princeton University in 1980, becoming the first African American to graduate from Princeton with a Ph.D in philosophy.

Every successful struggle has singular focus. The focus here is Black Lives Matter. If we are white-presenting, let's amplify the voices of the oppressed. If someone of color has something to say about justice, let us not criticize the tone or the content. Let us not speak out of turn. Let's. Just. Listen. 

Communities of color and their allies are coming together in creative and peaceful ways for restorative justice. People of privilege often criticize the media-emphasized violence. Let's stop pretending we know how we would behave in the context of a hundred years of oppression. Martin Luther King, Jr. said riots are the voices of he oppressed. Starwhawk says, "If we refuse to hold accountable those who speak with bullets, how dare we stand in judgment of those who respond with stones?" 

Doctor Martin Luther King, Jr. giving his I Have a Dream speech on August 28, 1963.

What can we do?

The truth is, everything little thing we do matters. We can speak up in an uncomfortable situation that promotes or condones racism. We can eradicate euphemisms for blackness, like "thug" and "inner-city." We can ask African American activists how to best serve the community. If we are used to defending privilege, we can momentarily suspend our disbelief, as an experiment in empathy. We can raise conscious kids. We can make art. We can cry. These are no small things. Every move shakes the system, and we are a system that needs shaking. Sometimes the softest touch causes the biggest earthquake. 

Life will conspire to engage us in loving justice. Let's remember who we are, starting with our own family history. Let's expand our social circles to include people of different classes, races, genders, abilities. Let's acknowledge each other on the street. Let's lean in to people of color. Let's register our biases, our inner racists. This is fiercely uncomfortable. Let's practice tolerating the discomfort. Racism is a strong thread in the fabric of our society. To change the fabric, we have to stop denying our involvement. As Verna Meyers says, "Stop trying to be good people. We need real people." 

So let's be real. To hold hands honestly with a person of color requires an engaged struggle.   Let's struggle till we're in a cold sweat. 

I'm all in.

"I have a great belief in the fact that whenever there is chaos, it creates wonderful thinking. I consider chaos a gift." Septima Clark (1898 - 1987), a teacher in South Carolina, established Citizenship Schools throughout the South to teach reading and increase voter eligibility.

Additional Outstanding Resources:

Cognitively Shifting Internal Biases by Verna Myers

Truth and Reconciliation by Fania Davis

Keep the Focus on Black Lives by Mia McKenzie

Admitting Our Collective Blind Spot by Tim Wise

Heart-Centered Activism by bell hooks and Thich Nat Han

The Stages of What Happens When There's Injustice Against Black People by Luvvie

Creating an Anti-Racist Agenda by Challenging White Supremacy Workshop

On White People, Solidarity, and (Not) Marching for Mike Brown by Mwende Katwiwa

Shredding the Case Against Michael Brown by Shelby Lawson

Chomsky

How to Parent on a Night Like This by Carver Wallace

Nelson Mandela, South African anti-apartheid revolutionary, politician and philanthropist who served as President of South Africa from 1994 to 1999. He was South Africa's first black chief executive, and the first elected in a fully representative democratic election. His government focused on dismantling the legacy of apartheid through tackling institutionalised racism, poverty and inequality, and fostering racial reconciliation.

In Sickness and in Health

In Sickness and in Health is adapted from a commencement speech for Acupuncture and Integrative Medicine College, Berkeley.

"Everything shines by perishing."—preacher, Albany, GA

Portrait of Ria Monk by Gustav Klimt

We are all going to die. Death is my most intimate companion. This is the only way in which my love life has been truly successful. What began as an arranged marriage has blossomed into a beautiful and thrilling relationship that I have only grown more certain will see me through to my very last breath. 

by Tom French

In some ways birth is the only true cause of death, and death is the only cure for being born. But there’s this middle ground, which is everything that happens in between. It looks like the people I see in my clinic. It looks like myself and my loved ones. It looks like you. I have noticed in my short time as a clinician and in my much longer time as a patient, that we inhabit a rather limited view of this middle ground, and of ourselves.

Sometimes we equate health with a prize for the merits of our own behavior, or sickness with personal failure. Sometimes we are so invested in making meaning from pain that we can’t just let a cough be a cough. Sometimes we insult people by making their disease into a metaphor for some hypothetical, unresolved issue.

I want to talk about these things because I see them happen over and over in my clinic, and in myself, and in the people around me. I’ve seen people break down and cry when I tell them being sick isn’t their fault. I myself have broken down and cried looking for reasons why I have had so many health issues. By the way, I am living proof that thinness is not a proxy for health.

We’re not just inedible meat compartments. We would all die quite suddenly if the room was filled with CO₂ instead of mostly nitrogen. Or if the temperature went up or down by just a hundred degrees. Or if the atmospheric pressure changed by just a little. But, if we’re in an ideal environment—and maybe for you it’s the beach, and maybe for me it’s the forest—we flourish. We experience health. And this is how Chinese medicine sees the world, too—as holistic. Where do we end and our environments begin? (Incidentally, this is what makes feng shui a logical treatment principle.)  

It is unscientific to deny the intimacy of our surroundings, whether oxygen, or temperature, or the way a piano sings our own musicality back to us. Why do we create this imaginary point at which we cease to exist, and become something Other? Our body is unimaginably vast. We co-evolved with all of this, even the stars—which by the way, are also going to die.  

by Joshua Petker

We have this platitude that we create our own reality. But who are we? And again, we’re this giant state of flux, a big old writhing mass of meat and miracle, and there are tropical storms and institutionalized racism and mass murderers involved, and we’re creating that, too. We’re creating our reality, but it’s more than just our singular input. If we’re really in touch with what we’re creating, it is as awful as it is exhilarating. Saying “we create our own reality” is like saying we control the vast and unpredictable sea by steering the rudder of our tiny boat. Of course, we can’t deny the rudder, but we can’t disavow the ocean, either. 

Sometimes we just get sick, and we don’t know why. It is ok to stop looking for a reason. We can dig for meaning, and at a certain point it is the digging for meaning that becomes the pathology. “I don’t know” is hard, and it is honest. Understanding causality can be like unraveling the wind, invisible and indivisible.

So I am here to tell you that illness is not your fault. It is no one’s fault. If you are healthy, you have not won. If you are sick, you have not failed. To take credit for our health or to take blame for it is, at a certain point, absurd. Like giving a prize to “a single cell” when the body performs well, or blaming the same cell when we get cancer. 

We also do this thing where we make illness into metaphors. For example, if you had a kidney stone, someone might ask, “What are you holding onto so tightly? What beliefs are obstructing you? What isn’t going with the flow?” By the way, I dare you to ask this to someone who’s passing a kidney stone.

At best, these questions acknowledge a fuller range of factors that lead to or away from health. At worst, they are accusations: "You got a kidney stone because you’re not going with the flow.” Dear reader, let us discontinue this commonplace offense, of which I am certainly guilty. (Full disclosure: I chose the word "offense" over "douchery" at the last minute to appear more professional. The thesaurus also offers: blooper, faux pas, misstep, gaffe, impropriety, blunder, error, boner, and indiscretion.)

Dorothy Howe

Or take the question, “How’s your diet?” which is a great question, obviously, but I want to look at why we’re asking it. Just think about when we see people on the news who make it to 106 years old, and the news anchor asks, “What’s your secret?”, and the answer is inevitably something like, “Bacon and cigars.” A thousand people can have a terrible diet, and maybe just one or two of them get cancer. On the other hand, a person with a terrific diet who hears this question might start looking at her lifestyle in terms of infractions. She might blame herself for having cancer because she ate a wheat cracker last Wednesday. 

no offense, Louise Hay (bless your heart)

We assume that if we understand the mental, emotional, and dietary “causes” for disease, and just stop doing those things, we’ll be well. We’ll be absolved. And sometimes this is the case. But very often, it is not. 

Health is not a binary to begin with. Healthy or not healthy. Health can look proud as a personal trainer, or it can look like a woman who’s about to die from cancer, like my friend, teacher, and colleague Suzanne Friedman. In the days leading up to her death, we can say with certainty that though cancer had consumed her body, she was completely healed. She was so lucid and so alive in her last hours that she told her community she was giving us her death as a gift. She told us to study it and to learn from it. Thank you, Suzanne.

by Kindra Nikole

Suzanne checked all the metaphors. She knew all the right herbs, all the cutting edge western drugs and therapies. She ate whole foods, exercised every day, didn’t drink or smoke. She had a positive outlook on life, a wonderfully supportive spouse and community, and all the best doctors. She did all this in a relaxed, undogmatic manner, her signature hilarity always intact. 

At a certain point, people may encounter this unspoken implication that if we fail to defeat an illness, it must be from a weak will, or a wish to be sick, or even a desire die. Because in this storyline, which sees illness as a failure of our own efforts or maybe even of our own creation, we might conclude that sick people are asking for it in some way.

by Citania Citizen

But I’m saying that people with all manner of health concerns — and that includes all of us — are expressions of normalcy, given the condition of our larger body. We are responding naturally to what we are creating. We can’t blame GMOs or corporations or pollution, because we are these things, too. Acknowledging this frees us from taking pain and sickness personally, and it also safeguards our relationships by making us more mindful of them. 

It’s ridiculous to think it’s just about us, the inedible meat compartment. That eons of forgetfulness, war, famine, poverty, pollution, oppression, colonization are all happening right now in the continuous process of our body, and we think there’s something wrong with us when we get sick, or if we feel sad. When we do not feel sad is perhaps when we are the sickest. And I’ll say it again, we can’t blame a person on Wallstreet any more than we can blame a person in a hospital bed. 

by temporary-peace

But when we are aware of the ocean, and when we are aware of our mortality, we are living a life that is already healed no matter how we find ourselves. In happiness or despair, in sickness or in health. This invokes enormous inspiration. It also involves a lot of “I don’t know,” a lot of tolerating discomfort and embracing ambiguity, a lot of relinquishing dogma and forsaking the need for self-improvement. We have already arrived. 

Right now a thousand stars are being born. The scent of flowers rides the wind. A million new mothers are nursing their babies. A man is speaking on behalf of those with less power. Someone, somewhere is writing a symphony. Young people are falling in love for the first time. A woman has just received a clean bill of health after her last chemo treatment. On every continent, we smile. We do not need to take happiness and health so personally, either, but simply share in it when it arises.

Gerard McNamee

My wish for all of us is that we live a life that is already healed. That we recognize our terminal diagnosis without literally receiving one. That we see ourselves in the ocean so that our deeply-natural self-centeredness assumes value. There is nothing to lose, except the things that took up too much space anyway. Until death gives us his fond wave of equanimity and the only true cure, we share this body. This astounding feat of biology, this writhing mass of meat and miracle. This is who we are, absolutely replete and undeniably whole, in sickness and in health, till death do us part.

Ria Monk on Her Deathbed by Gustav Klimt

___

Artists unknown for all unattributed images. 

The Scientific Method, and Other Mass Delusions

"When the anthropologists arrive, the gods depart." --Haitian saying

image from coromandal.wordpress.com

The scientific method has become so influential because it works, sometimes. We constantly extol its virtues in our beliefs and daily conversations. We even rely on clinical studies to steer us back toward common sense. (A patient just told me he started napping because a study said it would make him feel more rested.) Medical science can be straight-up miraculous. It has saved our lives, enabled our children to survive into adulthood, given us tremendous surgical capability, and even made it painless. I won't be talking about any of this because so many other people already are. 

I am an acupuncturist. You might think I have a vested interest in promoting so-called alternative medicine, but I don't. I don't care if you like it or "believe in it." My disinterest in selling you anything is probably my only selling point. I became an acupuncturist because it gives me a vocabulary and means to express the way I naturally move in the world.

I will not be talking about about how acupuncture works, or why I think it's silly to put it under western scientific scrutiny. (Square peg, round hole.) Nor will I address the myriad and often divergent systems of classical Chinese medicine that evolved separately over millennia. I won't talk about the problems of reducing these medical ideologies through a singular Communist lens, or about  further subjecting this fabrication to our Western, Eurocentric "Enlightenment" ideology, fraught with its own set of loopholes, errors, and ulterior motives.  Authors such as Paul Unschuld¹ and Heiner Fruehauf² have given due attention to these complex topics, and I have discussed it briefly in the article Herbal Medicine on Its Own Terms³.

If science values neutrality, we need to do a little self-reflecting. Think of this as an elegy to scientific dogma, which we think makes us practical and rigorous, but actually decreases our capacity. I will be pointing out some of the discrepancies of modern experimental science, illustrating the importance of context, and describing the major delusions that compromise our scientific integrity.

Limitations

telescope eyeglasses for the blind, c. 1933, image by gizmodo.com

Scientific observation has confirmed the interdependence of all life. Everything, it turns out, is joined at the hip. But for some reason, our scientific practices do not acknowledge interdependence. The act of observation changes that which is being observed, from the medium-sized science of clinical trials to the infinitesimal realm of quantum oddities. How can we not affect stuff? How can stuff not affect us?

Yet when we design experiments, we reinforce our first major delusion: that we are separate from the universe, and that the universe itself is made up of other, separate things, which can be studied in isolation to further isolate more things. Enter René Descartes, who taught us that the world is made of discrete parts. If science is the observation of phenomena over time, then the only agreed-upon result that any enduring observation yields is that things are temporary. We can even say that they do not exist at all, at least not in any solid way. I'm not talking Nihilism here. I'm talking endlessly-bursting-forth-in-every-moment life. I'm talking about the exhilaration of groundlessness with no parachute. 

Phenomena exist in the way that constellations exist, patterns generated into contexts by shared hallucinations, repeated. Imagine far-flung stars hundreds of millions of light-years apart, made of an arrangement of interactions we have named "light," which is literally ancient history. What we are seeing has often already exploded, and transformed into its next phase of being. Yet we construct a relationship we can hold onto, grasping for a 2-dimensional Orion in an infinite expanse of space that is often "too chaotic to be noticed or named."⁴ As Vi Hart says, "I wonder if a proton plus an electron making a hydrogen atom […] is any more real than these stars making Orion. I mean, is it an atom, or does it just look like an atom?"⁴ 

(Of course, these versions of the story are brought to us by science. Is science really much different from connecting far-flung dots to create imaginary pictures?)

cartoon by Gregory Kogan

But let's come to our senses. Western scientific mythology holds that we have five of them. Among these, vision tends to dominate. Examining something with human eyes already involves many layers of interpretation--perception of color, depth, dimensionality, contemporary connotations, beliefs about the world, visual acuity, not to mention our brain's oddly filling in visual gaps with made-up information that seems to fit, but isn't necessarily accurate. We can't conceive of most alternative ways of viewing the world because we're human beings with human eyes. We think that telescopes and microscopes alter the scale of our capacity by orders of magnitude, when really they just extend our insular view with mechanisms that resemble the human eye, to be viewed by--you guessed it--the human eye.

image by maria534 of deviatnart.com

If our sight were infrared and five-dimensional, for example, or our point of view included 360 degrees, or if we were blind, we would be observing something else entirely. Don't get me wrong. Limitations are great. It's so nice to wake up in the morning and not have to figure out whether we're a human being or a lamp. But can you imagine how many ways we've burdened phenomena by the time we have put our (non-existent) "objects" of study through scientific analysis? Who knows how various natural phenomena experience reality, but it's far-fetched to believe that nature exists on the terms that human beings create for it.

aka, The Decline Effect

Perhaps some of these limitations also help explain the decline effect. Jonah Lehrer wrote an article about the decline effect in the New Yorker that describes how scientific facts erode over time. Joseph Banks Rhine first used the term in the 1930s to illustrate a disturbing trend in his findings: results of well-conducted scientific research tended to receive decreasing support over time. In other words, when scientists repeated the same experiment under similar conditions, the results became increasingly uncertain.⁵

This brings us to our second grand delusion: That phenomena, including "facts," are permanent. Replicating findings is a cornerstone of modern research, so we can see how problematic the delusion of permanence can be. In a solidly-conducted clinical trial, researchers found that second generation antipsychotics worked better than first-line antipsychotics in people with schizophrenia.⁵ The study was documented, confirmed, and widely accepted. Then suddenly, subsequent trials showed steep, incremental decreases in the validity of the initial findings. Apparently, this happens all the time in many fields. Scientists have even found discrepancies in the law of gravity.⁶ Yet we still use second generation antipsychotics, and the law of gravity is found today's textbooks.

Some people assume that the decline effect can be chalked up to "regression to the mean." This means as the experiment is repeated, early statistical flukes get cancelled out. But the brightest people in data analysis, such as researcher Jonathan Schooler, say that the data sets that end up declining seem statistically solid. He explains, "The odds of them [sic] being random are typically quite remote, like one in a million. This means that the decline effect should almost never happen. But it happens all the time!"⁵  Schooler refers to the problem as "cosmic habituation" to describe the decrease in response that occurs when individuals get used to certain stimuli. For example, the overprescription of antibiotics has compromised their effectiveness. 

Scientific trends offer another explanation. The rise and fall of intellectual fads occurs frequently. Following scientific fashion has been our modus operandi for a several hundred years. Liu Ming calls our religious adherence to science "scientism," a mythology in its own right. Scientism is an engine of doubt that runs on disproving itself. Here is a 16th century example: The Earth is the center; the Sun is the center. And a 21st century example: the brain is the seat of memory; the brain is not the seat of memory.⁷ Science fads show up in the results of clinical trials, as early peer-reviewed processes tend to confirm positive findings. When scientific incentives shift, however, the most notable results are those which disprove the original theory.

image from plazamoyua.com

This leads us to publication bias. Journals usually only publish "significant" findings over insignificant ones. Significant, in statistical terms, means that the results of a study have less than a 1/20 probability of being due to chance. Refusal to include subsequent studies on exciting new research "breakthroughs" keeps the decline effect hidden from public view. It is a problem among scientists, which most scientists don't want to acknowledge. Publication bias is a form of data selection that skews every field of thought contained in research journals. Richard Palmer, a biologist who has noticed and studied the decline effect in his field, explains, "We cannot escape the troubling conclusion that some--perhaps many--of our cherished generalities are at best exaggerated in their biological significance and at worst a collective illusion nurtured by strong a-priori beliefs often repeated."⁵ 

Acupuncture research conducted in different countries shows us a noticeable example of how our beliefs inform our results. While many Asian countries acknowledged acupuncture as effective and incorporate into their medical infrastructures, people in the west tend to view it with skepticism, at best. These differences of opinion, which millions of people uphold in their respective countries, also show up in scientific research.

Between 1966 and 1995, China, Japan, and Taiwan conducted 47 acupuncture studies. Every single trial concluded that acupuncture was an effective treatment. During the same years, the United States, Sweden, and the UK held 94 clinical trials, and only 56% of these studies found any therapeutic benefits.⁵  Without realizing it, scientists confirm their preferred hypothesis and disregard what they don't want to see. (We all do this, by the way.) Another reason for conflicting results could be that Eastern researchers design studies that better reflect the medical worldview they're analyzing. Studying acupuncture in a country that developed acupuncture could be less susceptible to colonial douchery--er, dominion.

Evidence-Based Medicine

image by statistically-funny.blogspot.com

Now let's move onto Evidence-Based Medicine (EBM), which is the self-proclaimed gold standard for medical decision-making. EBM treats individual patients based on the outcomes of huge medical trials.8 First we need to be able to understand the language that these studies use. (If you don't care, skip the next three paragraphs.) 

Clinical trials call a result significant if its "p-value," or probability value is less than or equal to 0.05. We can take two groups of people, a control group and an experimental group, and measure the difference between them, with the p value being the threshold that indicates whether or not the results are supposedly important. Let's pretend the control group gets usual allopathic care for [X disease], and the experimental group receives acupuncture for [X disease]. We are looking for a significant difference in the health of the two groups after the trial.

images from xkcd.com

If, after the trial, the group receiving acupuncture is measurably healthier than the control group, this finding would support acupuncture as a valid treatment option for the disease. Or, if it turns out that the control group fared better, acupuncture would be dismissed as an ineffective treatment for the disease. Often, results describe something in between, in which case we will probably never hear about them. Significant-sounding results might make for more interesting reading, but it is not a very scientific practice.

Hillary Roberts, PhD and Steve Hickney, PhD wrote a brilliant piece on the pitfalls of EMB, which I will plagiarize--I mean, paraphrase--below. They explain, "Evidence-based medicine fosters marginally effective treatments based on population averages rather than individual need."8 Large trials detect small differences. For example, if we have two groups, and measure the blood pressure of individuals from each group, we will find no significant difference between them. If we take a hundred people from each population, we get a low level of significance (p < 0.05), but if we take a thousand, we now find a very highly significant result. However, the magnitude of the small differences in blood pressure remains the same in each case. So, we can demonstrate a highly significant result with very little meaning. In a large trial, highly significant effects are often clinically irrelevant.8 

EBM proponents can make their findings sound even more impressive by using relative rather than absolute values. A common example is the statement, "[X drug] halves your risk of developing cancer." This sounds like a great case for taking the drug. However, the reported 50% reduction may lessen your risk by just one in ten thousand from two in ten thousand. These are the absolute values to which the statement refers. Such a small benefit is negligible, but it sounds important when expressed in relative terms.  Hickney and Roberts use the analogy, "Buying two lottery tickets doubles your chance of winning the lottery."8 This is technically true, but the odds are minuscule either way.

by Mark Parisi

Imagine the government wants to give a new pair of shoes to every American based on the average American foot size. We achieve a mean result, and impose it as a standard, which we apply to the whole population.This describes a typical clinical trial. Obviously, this solution would not work for many people. As Roberts and Hickney point out, "Individual responses to medical therapies vary by at least as much as their shoe sizes, yet despite this, EBM relies on aggregated data."⁸ This is an error in logic, since group statistics cannot predict an individual's response to treatment. 

Lastly, EMB has strict rules regarding which data they use in the final crunch. Statistics that fall outside thetypical data spread get tossed. Pretty ironic for a model that denounces data selection. In this way, clinical trials provide snapshots of decontextualized information forced into a significant-seeming pattern. Given these circumstances, achieving similar results in a repeat trial is unlikely. The very nature of large scale studies makes any attempt at replication unlikely, as they are difficult, expensive, and time consuming. These factors combined really take a toll on the overall credulity of Evidence-Based Medicine.

image by Hilary Roberts and Steve Hickney

In Cybernetics, the principle of "requisite variety" holds that the solution to a problem has to contain the same amount of relevant information as the problem itself.¹¹ This is not so good in cases of large-scale clinical trials, which typically do not take into account different causes and expressions of a given health concern. Violating the principle of requisite variety is why researchers in most trials cannot predict who will respond to which treatments, and why results are so mixed. They simply do not take enough relevant information into account. A cold compress will remedy elevated body temperature due to heat exhaustion. However, a cold compress would do nothing to treat elevated body temperature due to infection. This person would need a different treatment altogether. 

Incorporating adequate relevant information in large-scale trials would be next to impossible. But requisite variety is integral to a healthy patient-practitioner relationship. Acupuncturists, for example, create custom treatments based on what a patient is presenting at the time of her appointment. Our real-time methods of analysis acknowledge human beings as complex, dynamic systems. Cybernetics and General Systems Theory, two scientific models that arise from our own western lineage, give us ways to examine living systems (biomes, physiology as a whole) rather than discrete units (molecules in a drug, genetic markers).

Open systems are alive, self-regulatory, and comprised of whole parts. We can apply systems thinking to any discipline, including medicine. A good medical practitioner is a good regulator; she will continually assess the interplay between change (toward balance or decline) and homeostasis (the self-regulation that allows for stability). In this light, one-to-one relationships between practitioners and patients, or even smaller clinical trials, help us determine the most accurate treatment for a health concern because they provide more context.

The Pharmaceutical Industry

image from NYTimes.com

The pharmaceutical industry plays a huge role in health-related clinical trials, including low-tech therapies such as acupuncture. Professor of neuroncology Mark R. Gilbert, conducted a large double-blind study with 600 brain cancer patients who were randomly assigned to two evenly-balanced groups, those who got the drug Avastin along with standard treatment, and a control group, who received standard treatment and a placebo. Some patients who took Avastin significantly beat the average, and some did not respond at all. The trial was unable to discover the "responders" or examine what might have accounted for the difference.⁹

The New York Times article, "Do Clinical Trials Work?" describes 26 randomized, controlled studies of high quality that were followed up by larger trials, in which the initial finding was wholly contradicted in three cases. In another six cases, the later trials found the benefit to be less than half of what was first reported. Journalist Clifton Leaf asks the question, "Are the diseases of individuals so particular that testing experimental medicines in broad groups is doomed more frustration than knowledge?" (Hint: yes.)

The following is a bit of a worst-case scenario, but it does happen. For a drug to go on the market, it has to pass three rounds of clinical trials.  Large drug companies often have a lot of influence in initial clinical victories by ghost writing the research. Pharmaceutical companies solicit  academics to publish their highly-constructed findings. In extreme cases, drug companies pay for trials by contract research organizations, analyze the data in-house, have professionals write manuscripts, and pay communication companies to usher them into publication in the best journals.⁹

The resulting articles affect conclusions found in medical literature, and are used in promoting drugs to doctors. After a drug achieves these early statistical wins, it endures more equivocal second-round results, due to many of the factors that I have described so far. Finally, they roll the dice in the third round, the round that determines whether a new drug will be introduced to the market. Drug companies do not imagine that the drug will suddenly work, but that the trial will make it appear to work.⁹

It does not take a conspiracy theorist to realize that if large pharmaceutical companies have a vested interest in promoting drugs, they also have an interest in suppressing low-cost, non-pharmaceutical therapies (such as acupuncture). Large-scale trials are extremely unlikely to be repeated in the field of acupuncture in the first place, simply because there are no financial incentives for validating acupuncture as an effective treatment. Though political backdrops are not always visible, we need consider them among the many factors that distort the landscape of published research.

Clifton Leaf looks for solutions to remedy this billion-dollar gambling industry. He has a good idea, limited only by a reductionist approach. He suggests designing small clinical trials that enroll only those who have the appropriate genetic markers or molecular signature. This is how Genetech developed the breast cancer drug Herceptin, which targets tumor cells that have an abundance of a certain type of protein.⁹ Certain molecules can destroy certain pathological cells. We use this knowledge routinely by isolating pathogens (cancer cells, bacteria) and seeing which drugs eradicate them most effectively. A building-blocks approach to scientific inquiry certainly narrows the population applicable for a study, but not necessarily in a way that will enable more appropriate therapies. We are still missing the bigger picture. Though it can be helpful to study the sum of our parts, we are not the sum of our parts, and neither are our diseases.

  Astronomical Variables

Life is not static. Time is an integral part of any living system. No experiment can be repeated exactly because variables differ astronomically, perhaps even literally. Many scientists actually consider time (hour, day, season, year, etc.) as an inextricable factor in their fields of inquiry. In my own ancestral literature, the Celtic sagas, people often asked the Druids for the best day, or even the best hour, to conceive a child or embark on a raid. These questions clearly demonstrate that our ancestors practiced the observation of phenomena over time. Their stone structures alone attest to this, as they archive extremely precise astronomical motions, and function as viable calendars thousands of years later. I imagine that clinical trials, too, can yield different outcomes depending on when they are administered. Researchers consider inevitable scalar changes that impede replicability, but they do not typically include time among these.

Time affects our daily activities, and plays a vital role in many non-western sciences. This is especially true of acupuncture, as it co-arose with a calendar system called the tong-shu. Before the Communist takeover, Imperial China employed thousands of calendar experts whose analyses informed all major decisions.¹⁰ Many doctors practiced medicine and gathered herbs in the context of correct timing. People still use these calculations, which the Chinese classic, the Nan Jing calls Wu-Yun Liu Qi. For the sake of communication, I like to call it biodynamic acupuncture.

 geomantic compass, including calculations for the Wu Yun Liu Qi 

Practitioners needle the hourly "open points" if diagnostically applicable to structure a treatment around where the healthy life-force is most concentrated and available during a given hour. We also take the "meridian clock" into account, which has hourly associations with different sets of organs, and gives another framework for proper treatment. Some practitioners even administer treatments for chronic diseases only at certain times of day. For example, if a patient has Crohn's disease, which affects the large intestines, a practitioner could administer treatment between the hours of 5 - 7 am, the hours that correspond to the large intestines. As you can see, this is a very different model from Evidence-Based Medicine. Each treatment is alive, contextualized, and perfectly tailored to each client, assuming practitioner competency.

tongshu.com, a modern tong shu reference

 

Adherents of western science do not need to adopt ancient Celtic or Chinese ways to engage in dynamically-aware medicine. Western medicine has begun to use these principles, which they call Chronobiology. Allopathic doctors in China have found, for example, that side effects of chemotherapy are greatly reduced in people with liver cancers if chemotherapy treatments are given in between 1-3 am (which also happens to be "Liver time."¹¹

Toward Respect and Inclusion

Hale Makua, image courtesy of plnetpuna.com

Without romanticizing or making too many generalizations about indigenous cultures, I'd like to share a quote that speaks to one strand of indigenous science. Hawai'ian elder and ancestor Hale Makua explains, "Humility/reverence is the purpose of science and the goal of education." I love the idea of a science of respect and inclusion. Imagine scientists consciously engaging interdependence!

As we have seen, humility and reverence are not often the causative agents for clinical trials. Ulterior motives play a large role in the infrastructure of medical science. Even if our hearts are in the right places, our means do not often match the end. Now we study chemicals, cells, genes, and other discrete units on unwilling participants with nonhuman physiology. This does not demonstrate respect and equality among all life forms, much less reverence. 

Today, researchers conduct experiments on animals that were deliberately given toxic drugs or infected with disease-causing agents for the sole purpose of improving the lives of human beings. In even less justifiable cases, we incite suffering just to determine how or whether a therapy works. Here is our third mass delusion and scientific impediment: We believe that we are not only central to the universe, but also more important than any other life form. This is simply not true; I don't know how else to say it. If we are truly scientific, our concept of self includes all phenomena. The notion of self-preservation naturally expands to respect all of life in our scientific decisions. 

image from mysharecafe.com

Some elementary errors in logic also arise from these research methods. First, we apply animal research findings to human beings. That's the whole point, right? But it doesn't always work. An unfortunate example of this occurred in the early 20th century when a scientist fed rabbits a high fat, high cholesterol diet, which gave them atherosclerosis. Of course it did. Rabbits are designed to eat vegetables. Nothing about their physiology is equipped to handle lots of fat and cholesterol. He then generalized these findings to human beings, and published the results.¹⁴ Fat and cholesterol quickly became four-letter words, to be avoided at all costs. This huge misunderstanding around human fat and cholesterol consumption is still very alive in our contemporary medical culture. Now the pendulum is swinging back, and new studies show the health benefits of (good) fat and cholesterol.¹⁵ Observe the decline effect.

by atheistcartoons.com

Another error occurs when researchers confuse causation and association. This is a symptom of reductionist thinking. If scientists study the brains of humans or animals when an acupuncture needle is inserted, they may attribute the effects of acupuncture to changes in the limbic system¹⁴, or increased cannaboid secretion¹⁵, or development of new synapses¹⁶. In other words, they will find physiological changes in the areas they are studying because acupuncture is a whole-systems approach that yields systematic effects. Studying physical responses in isolation shows only a singular association, and certainly not causation. (This can show up in statistics in very funny ways: We can accurately say that 75% of heart attacks occur within 24 hours of taking a shower. But eliminating showers does nothing to promote heart health.)   

Just like western science, indigenous science relies upon direction observation. Tests exist to ensure validity, and data are used for forecasting and generating predictions. For example, the principle of Triangulation requires scientists to verify information by waiting for its content to be legitimized three times in three different ways. Let's say I have a dream that a deceased family member wants me to travel to Ireland, and then I receive an invitation to come stay with the people of Ireland, and finally, a friend offers me all of his frequent flyer miles with no knowledge of the prior events. Triangulation keeps subjective science practical, and ensures correct timing of action.

traditional herbalist Atava Garcia Swiecicki

Native scientists receive training in various specializations, such as herbalism, weather observation, navigation, mental health, and time keeping. Subjective science acknowledges our role in inquiry, and requires technologies such as feeling a sense of balance, or trusting our instincts. We in the west consider these technologies unreliable, perhaps because we no longer rely on them.

Unlike western science, the data from indigenous science are not obtained by an attempt to control the forces of nature. Instead, both the methodology and its purpose are geared toward accommodating nature. Dr. Apela Colorado, Frank-Oneida elder and one of my personal teachers, offers several other distinctions. Here they are, in her own words:

1. The indigenous scientist is an integral part of the research process, and there is a defined process for insuring this integrity.
2. All nature is considered to be intelligent and alive, thus an active research partner.
3. The purpose of indigenous science is to maintain balance.
4. Compared to Western space-time notions, indigenous science collapses time and space with the result that our fields of inquiry and participation extend into and overlap with past and present.
5. Indigenous science is concerned with relationships. We try to understand and complete our relationships with all living things.
6. Indigenous science is holistic, drawing on all the senses, including the spiritual and psychic.
7. The end point of an indigenous scientific process is a known and recognized place. This point of balance, referred to by my  own tribe as the Great Peace, is both peaceful and electrifyingly alive. In the joy of exact balance, creativity occurs, which is why we can think of our way of knowing as a life science.
8. When we reach the moment/place of balance, we do not say we have transcended--we say that we are normal. Always we remain embodied in the natural world.
9. Humor is a critical ingredient of all truth-seeking, even in the most powerful rituals. This is true because humor balances gravity.¹⁷

New Rules

tribute to Vi Hart by eversalazar of deviantart.com

We have seen some ways in which our made-up rules fail us, and foster practices that damage life. When our commonly held beliefs and behaviors lead away from balance rather than toward it, then we can simply examine our old, harmful delusions, and create new ones that are fun for everyone. This will take some time. But don't worry--the decline effect reaches everything, endlessly. When we take a look at something, it appears to be very solidly one thing, at least at first. But as we keep looking, we see that it's not what we once thought. In fact, it is difficult to pin down in any way at all. Not only does the decline effect describe the results of scientific inquiry, it describes scientific inquiry itself--an everchanging body of assumptions subject to change.

Mathemusician Vi Hart asks, "Can you see this without reading it?"⁴ The mythology of modern science embodies some of our society's constantly-traversed delusions, preventing us from seeing phenomena without assigning them meanings that hold little value beyond the scope of our own conjecture. Yet to be a decent health care practitioner requires good pattern recognition (as a means of diagnosis) and pattern formulation (as a means of treatment), just as to be an effective sea voyager requires knowledge of the constellations. Maybe it is as important to dismantle patterns as it is to make use of them. Freedom from these constraints can exist only marginally, but it is the effort that dissolves the dogmas of bad science. The prospect of a scientific model that builds interdependence into its methodology really appeals to my sense of self-preservation. Inquiry borne of this inclusion is bound to respect and reflect the life that it seeks to understand. Now that's a science I can get behind.

image by smero.tripod.com

References 

[1] Unschuld, Paul. Medicine in China. University of California Press: London, England, 1985

[2] Freuhauf, Heiner. "Science, Politics, and the Making of 'TCM': Chinese Medicine in Crisis." Journal of Chinese Medicine Number 61. October, 1999.

[3] Langley, Erin. "Herbal Medicine on Its Own Terms" www.wakeworldwanderings.blogspot.com, 2013.

[4] Hart, Vi. "Twelve Tones." youtube.com, 2013.

[5] Lehrer, Jonah. "The Truth Wears Off: Is There Something Wrong with the Scientific Method?" The New Yorker, December, 2010.

[6] Thomas, J, Vogel, P. "Testing the inverse-square law of gravity in boreholes at the Nevada test site." Physical Review Letters, vol. 65, Sept. 3, 1990, p. 1173-1176. 

[7] Fields, Tina. "Brain Deposed as Seat of Memory." July, 2013. based on the original research by Shomrat, Tal and Levin, Michael. "An automated training paradigm reveals long-term memory in planaria and its persistence through head regeneration" Tufts University. June, 2013.

[8] Hickney, Steve and Roberts, Hillary. "Evidence-Based Medicine, Neither Good Evidence Nor Good Medicine." orthomolecular.org, 2011.

[9] Leaf, Clifton. "Do Clinical Trials Work?" New York Times. July 13, 2013.

[10] Ming, Liu. "Year of the Water Snake" lecture, February, 2013.

[11] Sismondo, Sergio. "Ghost Management: How Much of Medical Literature is Shaped Behind the Scenes by the Pharmaceutical Industry?" Plosmed.org, 2007.

[12] Heylighten, F. "Principles of Systems and Cybernetics: an Evolutionary Perspective." Cybernetics and Systems, 1992. 

[13] Xu, Hua Ling. Lecture Notes, Modern Diseases, 2012.

[14] Finking G, Hanke H. "Nikolaj Nikolajewitsch Anitschkow (1885-1964) established the cholesterol-fed rabbit as a model for atherosclerosis research." Department of Internal Medicine, University of Ulm, Germany: www.ncbi.nlm.nih.gov/pubmed/9395267

[15] Harvard School of Public Health. "Fats and Cholesterol: Out with the Bad, In with the Good." http://www.hsph.harvard.edu

[16] Hui KK, Liu J, Makris N, Gollub RJ, Chen AJ, Moore Cl, Kennedy DN, Rosen BR, Kwong KK. "Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies in normal subjects." MGH-NMR Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, 2009.

[17] Chen L, Zhang J, Li F, Qiu Y, Wang L, Li YH, Shi J, Pan HL, Li M. "Endogenous anandamide and cannabinoid receptor-2 contribute to electroacupuncture analgesia in rats." Department of Neurobiology, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Peoples Republic of China. Epub 2009 May 5.

[18] Chin J Integr Med. "Study on the correlation between synaptic reconstruction and astrocyte after ischemia and the influence of electroacupuncture on rats." www.ncbi.nlm.nih.gov, 2011.

[19] Colorado, Pamela. Indigenous Science and Western Science: a healing convergence. Presentation at the World Sciences Dialogue !, New York City, April 25 - 27, 1994.