The foundational theory of Acupuncture is like Noodles rests on a strong class analysis of the U.S.. Specifically: In the U.S., one of the richest nations in the world, why are so many people doing without health care?
Although Rohleder centers her answer to this question around acupuncture, in all reality, her answer is one that can very easily be fleshed out to understand the bigger picture of health care in the U.S.. For example, to start off with, Rohleder asserts that with class comes values–and with different levels of class comes different values. Rohleder very effectively brings home the point by painting a scenario of a woman getting ready to go out to a party. If she is rich, she more than likely will have gotten a nice glossy invitation and will have been invited by higher ups in her job. She will be going to the party because it will be a great way to network (i.e. make connections that will help her career) and because her boss will expect it of her. She will bring along her partner (if her partner is a “he”) and have a nanny stay with the kids. She will buy a new business outfit for the occasion and maybe go out to get her hair and nails done.
By way of contrast–Rohleder asserts that a working class woman would get a word of mouth invitation from a friend she works with. The party would be more “personal” in that it would probably be a baby shower or a wedding shower. She would more than likely not buy new clothes for the occassion and would bring kids with her rather than a partner (partner probably has to work and there’s no place to leave the kids otherwise).
By fleshing out this scenario of two women from different classes going to a party, Rohleder makes the conclusion that each of these women and their communities *value* something different. Rich(er) women value elegance, status, personal service, refinement, individuality, beauty, exoticism, and uniqueness. In other words, how can you get that promotion or raise if you aren’t unique? How can you show you are unique if you look like everybody else in blue jeans and a t-shirt?
Working class women value interdependence, creativity, hard work, resourcefulness, personal relationships, directness, and loyalty. Or, in other words, how are you going to get to that party and have a good time if you don’t figure out what to do with the kids? How are you going to figure out what to do with the kids if you don’t have a community of women to depend on?
So if you flesh out these values into the world of health care, you begin to see that health care is about a lot more than “getting insurance.” That it’s also about *values*. That, as Rohleder asserts, rich(er) communities are going to feel more comfortable going to a doctor that wears a white jacket, has an expensive stethoscope, uses big words, spends a lot of time asking questions and filling out paper work, and makes the patient feel as if s/he is the only patient that this doctor has or cares about (Individuality, uniqueness, etc, right?).
By way of contrast a person from a working class background will more than likely feel patently uncomfortable in those types of surroundings. Answering hundreds of questions? Filling out tons of paper work? All that attention on “me” when “me” knows from experience “we” is the only way to be creative and resourceful?
As a result of this class critique, Rohleder implemented the Community Acupuncture business model in her own practice. The community acupuncture model of practice has been around for a while (it is considered “normal” in China and was brought to the U.S. by various radical practitioners like Miriam Lee and NADA and the Black Panthers), but it is not necessarily recognized as a sustainable or “normal” way of practicing even within the acupuncture community. The main way most people in the U.S. learn acupuncture is through acupuncture schools–and acupuncture schools teach a business practice that encourages practices that model rich(er) class values: individuality, exoticism, multiple services in one place–and above all else–hugely expensive prices.
Community acupuncture models, on the other hand, center working class values. Interconnectedness is supported through multiple people in the treatment room. Mothers can bring kids, caretakers can bring loved ones, friends can bring friends. There is limited paper work. Few questions. The work is done by the needles and the client–so there really doesn’t need to be much talk between the acupuncturist and the client.
As I read this section of the book, I was really excited to see so much of my own personal experiences with health care acknowledged and respected. The number of times I have felt intimidated by all the questions and paper work of a doctors visit have been innumerable and have often led to bad situations where I was answering what I thought the doctor wanted me to say, rather than what was real for me. And I have definitely NOT gone to the doctor because I didn’t feel like dealing with the inevitable questions around weight or sexuality or drug use: when the hell was I going to lose weight? Oh, I don’t know, maybe when the doctor paid for my gym membership!
But at the same time, I also come from a background of organizing that prioritizes intersectionality (race, gender, class, citizenship, all intersect and can not be seperated out of a person’s body. For example, you are NOT just white. You are a white upper-class white male citizen.), and so I constantly wondered, how might some of the “values” be changed according to other identities? In other words, a person who is in the U.S. without documents will really appreciate the lack of questions, the lack of paper work. At the same time, a woman of color who has been ignored and shunted aside by health care workers her entire life may find the lack of questions to be alienating. Or, just another example of health care workers not caring about her (I am thinking, by way of example, of the black woman who was ignored when she fell out of her wheel chair and then went into seizures, all while right in front of hospital workers). I also wonder at how many older people who have lived under the “doctors know best” rule would feel uncomfortable, or even stressed out, by the more free flowing “stand back” values of community acupuncture. If you don’t have the skills or strategies to trust yourself and what your body is doing to heal itself (because those ARE skills–skills that are purposefully challenged and destroyed by authoritarian structures that are modeled on “control” and “obedience” [i.e. schools, doctors, the army, police, etc]), it can be like free falling into hell to be told “trust yourself.” What happens when the last time you trusted yourself, you wound up being beaten until you passed out? What happens when what you really need to trust yourself is the presence of a person?
But in the end, I think that these are questions of practice. That is, they are questions that need to be dealt with on an individual level within the practice rather than incorporated into the actual theory. The *theory* of Acupuncture is like Noodles is sound, and can function on its own even without the race/gender/citizenship/etc analysis added in. But I do think that if community models of acupuncture are going to be working with very specific communities (for example, native peoples who have gone through boarding schools, or older black folks who lived through apartheid in the U.S., Hurricane Katrina survivors, etc), it would be really good to open up the community acupuncture model just a bit–to allow the space to say, working class people of color who went through Hurricane Katrina may need a hand to hold onto while they work on recovering and healing themselves.