Today we spent some more time at the Boai clinic. Everyone here has welcomed me so warmly and now the doctors and staff who do not speak English have figured out how to use WeChat to translate. Of course, I still had some trouble translating myasthenia gravis and hemobartonella.
My new veterinary friends
Dr. Qiu has a wonderful rescued clinic dog named MaoMao (毛毛) who wanders in and out of the clinic. Like our clinic cat, Bubba, MaoMao seems to own the place. He even plays with some of the patients in the waiting room!
Most of the dogs have clothes. I joked with Dr.Qiu that this was because of the one child policy! All joking aside, Dr.Qiu’s clients adore their animals. I am impressed with their dedication. I have seen evidence of it every day. One woman sits with her dog hooked up to an intravenous drip right in the waiting room. Another one is back by her dog’s cage feeding him as he recovers from rat poisoning. Another woman dropped off a feral cat to be spayed, a cause close to my heart. The doctors performed the spay through a flank incision which was very interesting to watch.
Today I also had the privilege of visiting a Moon Bear rescue center. Moon Bears are Asian black bears with white crescents across their chests (hence “moon”). A wonderful staff, including two Australian veterinarians, work at the center. Check out the website and support their very compelling work—www.animalsasia.org.cn .We saw a bear being examined for a luxated incisor and heavily worn canine teeth, all of which needed extraction. And I thought pulling a dog’s canine tooth was hard! While watching the bear, we were able to chat with Lesley Nicol who plays Mrs.Patmore on Downton Abbey. Can life get better than that?
The bears are rescued from the bile extraction trade. Bile, or really ursodeoxycholic acid, is used in Chinese traditional medicine. The western equivalent is synthetic ursodiol but some Chinese traditional doctors believe it is still best obtained in the ancient way, directly from bears. Unfortunately, this means bears are kept in miserable conditions for as long as fifteen years, hooked up to a tube for bile collection and stuck in tiny cages.
Actually, one of the reasons I was so excited about this exchange is I am very interested in finding out more about Chinese traditional medicine. My experience is, admittedly, limited and biased. On the one hand I know about Tu YouYou, the Chinese Nobel Laureate who came up with a lifesaving treatment for malaria based on a Chinese traditional medication derived from the wormwood plant. On the other hand, I have read descriptions in Chinese literature of strange treatments ranging from soaking wheat buns in the blood of executed prisoners to chewing on pearls. Many traditional medications come from poor places where people have no medical care and are desperate to find help for their love ones. In my opinion, some have merit and others arise from charlatans taking advantage of people in their weakest times. The placebo effect and coincidence can often perpetuate a perception that a treatment is effective.
Dr. Qiu and I are actually very similar in our approach this apparent dichotomy. I think we are both “open-minded skeptics”. We are scientists at heart, and would like to see concrete studies before accepting and fully understanding the effectiveness of a particular treatment. We also believe that almost any treatment that works, regardless of its source, has the potential for side effects and drug interactions. At the same time, we both acknowledge that the motivation to study the effectiveness of herbal therapy is not there because there are no patents involved. It turns out Dr.Qiu and I practice medicine in a very similar way. Based on our personal experiences and basically anecdotal evidence, we both use some herbal supplements in our practices and believe they work. In fact, we use the same supplements such as those derived from milk thistle and cranberries.
I am always concerned that, in the United States, our supplements are not controlled for quality, effectiveness or even if they have what they say they have on the label. In our practice we try to choose reliable and tested products but clients come in daily with treatments they have found online or in pet stores. It turns out that in China, official stores with herbal remedies are much more tightly controlled by the government than in the United States. Natural treatments are widely used by people so the government regulates that industry to avoid contaminants such as heavy metals and to ensure quality. Even so, in both countries, there are people who mix up concoctions and sell them as treatments without quality control. Dr. Qiu only recommends officially sanctioned herbal treatments. He does report that he has a lot of trouble getting pets to take them, though, as they are often in a form that requires large quantities of noxious tasting plants!
Acupuncture is another traditional treatment that is widely accepted as effective in both countries. We use “cold laser” at our practice in a similar manner to treat pain and inflammation. I asked Dr. Qiu how he thought these modalities worked. Specifically, did he think they rearranged energies or that targeting different points of the body would affect distant organ systems. He did not believe these often purported explanations. Instead, he thinks that when he performs acupuncture he is locally stimulating nerves and muscles. Thus, he has the most success using acupuncture as a treatment for neuro-muscular dysfunction such as paralysis.
It is a comfort to know my Chinese colleague and I are actually on the same page. It seems a lot of people want to romanticize Chinese traditional medicine and pit it against the Western approach. Dr. Qiu and I both believe a melding of the two, with a careful eye on documenting efficacy, side effects and quality of all treatments, would create the best of both worlds.