Stephanie Tyiska holds up the needle for my inspection. “It’s really just a piece of sharpened wire,” she says, contrasting the little thread in her hand to the wider, hollow syringes hospital workers use to draw out or adulterate a person’s precious bodily fluids.
“Adulterate” is my word, not Tyiska’s. But when she compares the tools and philosophy of her trade to those of contemporary Western medicine—which she does a lot during my 90-minute visit to her Center City, Philadelphia offices—it’s clear she feels the treatment many people receive from doctors and hospitals often does as much harm as good.
That’s not to say Tyiska is combative. Just the opposite. She is warm and articulate—both in person and on the phone.
We’d spoken briefly the day before, and I’d told her stress and a little joint pain were my only real health concerns. She’d recommended I cut from my diet “nightshade plants”—a group that includes tomatoes, eggplant, potatoes, and all peppers save the kind that comes in a grinder or shaker. “Nightshade plants contain mild toxins that can cause joint pain,” she’d explained before saying she was looking forward to seeing me the following day, and that I should “take good care” in the meantime.
Before our call, my experience with acupuncture was nil, and my understanding of the practice was limited to the knowledge that it was old and Chinese, and involved sticking people with pins.
After arriving at Tyiska’s office, I’d filled out a questionnaire regarding my medical history and personal habits. Apart from the usual inquiries about allergies and past surgeries, it also included questions about the details of my birth (Long labor? Forceps delivery?) that I couldn’t answer.
“Sometimes if forceps were used to grab a shoulder or a limb, that part of your body can affect you for the rest of your life,” Tyiska had explained to me as she led me to a room that looked a lot like a typical doctor’s office exam space, except that the padded bed resembled a massage table and one wall held shelves stacked with jars containing different herbs and supplements. The room also smelled like a head shop.
The smell, Tyiska told me, was a substance called moxa—or mugwort—that she would be placing on my skin, and also on top of one or several of the needles she’d insert into me. “I know, it smells like cheap dope,” she’d said, smiling.
Now, after showing me one of the needles, she also displayed two different forms of moxa—one small chunk that resembled a miniature Mason jar cork, and also a crumblier sample that resembled old and degraded wall insulation. She said that, along with the needles, the moxa would improve the flow of my qi.
Qi is a tough concept to define, but Tyiska called it a mixture of blood flow, systemic circulation, and the natural streams of energy that coarse through the human body.
To illustrate this, she traced the path of my digestive system from my mouth down through my throat, stomach, and digestive tract to my legs and toes. “Downward flow is good,” she said. “Upward flow results in problems like indigestion.”
Pretty much any ailment—physical or psychological—stems from the disruption or deregulation of a person’s qi, she said.
For a guy who spends a lot of his professional life speaking with clinicians and research scientists—people firmly entrenched in the world of Western medicine— this talk of “energy flow” was jarring, though not sneer-inducing.
I’ve written enough about arthritis, fibromyalgia, headaches, and other pain-related conditions to know modern medicine is largely befuddled by this stuff. See a doctor for a sore back or a nagging headache—the kind of pain that doesn’t stem from a specific injury—and the best he can usually do is prescribe drugs or surgery. The former just masks your problem, while surveys suggest the latter is often ineffective.
For these reasons, a lot of people in pain turn to the world of alternative medicine for relief. Research suggests some find it.
A recent JAMA Internal Medicine review on acupuncture concluded the practice is an effective treatment for chronic pain. Even when researchers set up dummy acupuncture treatments designed to fool study subjects into believing they were getting the real McCoy, legit acupuncture outperformed the BS treatments, which suggests the benefits can’t be chalked up solely to a placebo effect.
At the same time, acupuncturists claim the therapy can treat many other maladies—everything from erectile dysfunction to addiction and infertility—for which the supporting evidence is spotty or nonexistent.
Complicating matters: Most acupuncturists also employ other forms of traditional Chinese medicine. Tyiska, for example, mixes in herbology, “cupping,” moxibustion, and gua sha—a kind of intentional bruising or scraping of the skin thought to be therapeutic.
She also prescribes concurrent lifestyle and behavior adjustments—like advice to take a warm shower before bed to increase blood flow, and to cut out those nightshade vegetables.
Mix in psychosomatic factors and good old person-to-person variability—remember, even the most effective prescription drugs don’t work for everyone—and you see how impossible it is for researchers to say, unequivocally, whether or not something like acupuncture “works.”
Tyiska chats with me for a bit about my day-to-day life and personal habits. She then has me lie down on the padded table. She takes my pulse in three different places on my right wrist, which she says correspond roughly to my upper body, lower body, and gut. Then she does the same using my left wrist. “People think of the body as symmetrical, but inside our left side does not mirror our right side,” she explains.
Next she checks the temperature of my feet and hands—both warm, which she says indicates my blood flow is good. She also examines my tongue. “Two thousand years ago, they didn’t have MRIs or X-rays, so they had to find other ways to determine what was going on inside someone,” she says.
Holding up a mirror so I can see what she’s looking at, she points out some small indentations along the sides of my tongue. “These teeth marks tell me you’ve been working all day, but not physical work.”
Even though I walked into this appointment ready to buy in, a part of me is dissecting everything Tyiska tells me for aspects of fortuneteller-style sophistry. Along with linking the tongue indentations to my desk job, there are other moments when I feel she’s just feeding me stuff that makes sense based on what I told her about my job and lifestyle. “She’s cheating!” my mind shouts, comparing her to an adept astrologist or snake oil saleswoman.
But it occurs to me that many doctors would have asked me the same sorts of questions, and would have used my answers to form a diagnosis. So why should I fault Tyiska for it?
After the tongue inspection, she spends some time prodding various points of my stomach and asking me when I feel discomfort or pain. All of this, she says, is helping her determine where my qi could use strengthening or redirection.
One point on the right side of my stomach is sensitive, which—along with something she discerned in my pulse—indicates my immune system is a little out of whack, she says.
She has me lie on my stomach, and she tells me to exhale and inhale deeply as she inserts needles into half a dozen points along my spine and on my shoulders. It doesn’t hurt much, though some pokes are more painful than others. She then places some moxa on my back, and also on one or two of the needles. She lights one of these moxa plugs on fire. It smolders like incense, and produces a patchouli-smelling trail of smoke.
After about 15 minutes, she has me turn over. She performs the same needle pricks and moxa burnings at different points on my arms, stomach, legs, and ears. When all the pins are in, she announces she’s going to leave me for 30 minutes. “You’ll probably fall asleep,” she says. “Most people do.”
This strikes me as unlikely; I imagine my head falling to one side as I sleep, and the ear needles sliding into my brain. But when she returns a half hour later, I’m out cold. “There’s nothing like an acupuncture nap,” she says, laughing.
She removes the needles, and we spend a little more time talking. She says that, like any other form of medicine, there are well-trained and ethical practitioners, and there are also quacks just looking to make money.
“I know there are acupuncturists out there who’ll always try to sell you supplements, or who tell everyone they need to come in once a week for life if they want to stay healthy, but I don’t believe in that,” she says.
Sure, some people do have chronic problems that need ongoing therapy, she says. But for many others, lifestyle changes and short stretches of acupuncture will do the trick.
She says she’s also hesitant to recommend herbs or supplements until people have tried changing their diets or giving up some bad habits. “We have such a reliance on medications and intervention,” she says. “I’m less about taking something, and more about removing something harmful.”
When I leave her office a few minutes later, there’s no doubt I feel more relaxed and refreshed than when I walked in. And I want to believe my good vibes are the result of the needles and smoldering moxa correcting my out-of-whack qi.
But I know the powernap I took could also explain my happy state. So could the 90-minute break I got from work and email. Or the pleasant conversation I had with a nice lady who was willing to hear me gripe about my minor health issues. Or some mixture of all those things.
But really, who cares? The “mechanism of action”—to use a Big Pharma term—matters a lot less to me than whether the therapy works. And judging acupuncture solely by how I feel in this moment, it works.