An Open Letter to my Colleagues and My Profession

[I sent this to "Acupuncture Today," but they don't really do Letters to the Editor, so I decided to post it here...]

I've been going along practicing small town Chinese medicine for 26 years, and growing more and more dismayed at my profession's agenda and trajectory. My dismay is neatly illustrated by two articles in this month's (May 2026) Acupuncture Today: the first claims that using automated online scheduling is the way forward for acupuncturists within the VA; the second approvingly cites "the latest report from China regarding the constitution," as well as its claims that "By clarifying the relationship between constitution, disease, and pattern differentiation, the standard strengthens professional credibility, supports research, and enhances patient-centered treatment."

I can't tell you how much I think these are the wrong things for our profession to hold onto, and they are exactly the wrong direction for us to move in. Both are rooted in surrender to the biases and expectations of the intellectually unbalanced West, and if we have ANYTHING to offer at this moment in human history, it is to continue to steadfastly insist that, "No, balance of mind, body and spirit is more important than any trend of language, philosophy, politics or economy." This takes confidence, even stubbornness, but without holding our ground we just make ourselves into another "auxiliary" branch of Western medicine -- forever subservient to the allopathic approach.

For starters, TCM itself was such a ceding of ground to the West -- an attempt to make Chinese medicine more palatable to Western science and more consistent for the education of its practitioners. News flash -- it didn't work. The language of TCM is still too subjective and too dependent on context for the West's intellectuals to ever approve. AND the outcomes are less successful than the outcomes derived from TCM's organically-grown antecedent, Classical Chinese medicine. So just as in some Bronte sisters novel, we subjugate and debase ourselves and still don't get the attention of the lords and ladies. Now, in our desperate efforts to ingratiate ourselves with gatekeepers, we volunteer to give up autonomy by pushing forward with robotic scheduling? Will you next suggest that we allow AI to help us with treatment planning and pattern differential? You know, so the rich and powerful kids on the playground will play with us? THEY WON'T, no matter what we do -- we don't just speak a different language -- we pay attention to a different understanding of existence, and there's no getting around that basic fact. If we had any security, confidence or professional pride, we would continue to stay our course, providing excellent alternative medical care, and continuing to let people come to us in their own time, whether as individuals or as part of larger groups like the VA (which very much DO recognize our value). 

To be clear: I have been a VA Care in the Community provider for about 10 years; I participated in the Medicare study that resulted in acupuncture for LBP becoming a payable procedure; and I have accepted Workers' Comp and No-Fault insurance since the beginning of my career (in 2000). I am not suggesting that we remain peacefully in our hermetic caves, waiting for patients to fall from the skies, but I AM suggesting that our political and cultural lobbying efforts, which were looking promising for a while, have suddenly taken a foolish and fearful path which completely overlooks our actual power. Our power doesn't lie in aping Western medicine, speaking their language and essentially fulfilling their ideas about "dry needling." Our power lies in preserving and practicing the oldest continuous form of aboriginal medicine in the world, repeatedly demonstrating that it is safe and effective in situations where science and the intellect alone are not, and repeatedly seeking new arenas (like pandemic medicine) where our approach is plainly superior to Western approaches. Yes, they have all the money and all the power, but they also are making blunder after blunder after blunder by ALWAYS giving science the last word and ALWAYS choosing human-made, two dimensional symbols like numbers and letters rather than engaging with the complexity of the three dimensional world that we actually inhabit and that our medicine attempts to understand. 

Most controversially for the intentions of this letter, native-born Chinese practitioners are the LAST people we should be looking to for advice about the direction of our medicine. Given the sometimes murderous gyrations of their nation since 1949, the only certain thing that we can say about such providers is that they are survivors. I am big on survival myself, but surely we can aspire to something higher than simply surviving a despotic system and trying to guarantee ourselves, through political and bureaucratic means, a certain number of crumbs from the table? Acupuncture is engaged with eternal truths which will reasonably be expressed in different ways with different strengths and weaknesses by different cultures. American, or at least Western, approaches to acupuncture have little to offer in terms of tradition, but we are very ingenious and energetic, and we don't like taking "No" for an answer. Possibly we'd be better off leaning into our cultural strengths rather than trying to ape a different culture as we continue to work to create a bona fide American style of acupuncture. THIS DOESN'T MEAN CHANGING ACUPUNCTURE. Although Americans are seen by the world as being naive, brash and reckless, we Americans don't need to disrespect the actual practice and philosophy of the medicine. And I don't think we will, whoever or whatever we challenge. Indeed, it is more unfortunate for the profession to surrender to AI and the scientific method than it is to question, even uncomfortably, peer practitioners from our medicine's native land.  

Specialization; appropriate insurance reimbursement; standardized education. These are all reasonable, logical goals to strive toward, and we will always lose if we only aim at reasonable, logical goals. The scientific, binary West is better at logic than the philosophical, three dimensional East is; is pursuing logic at all costs; and fealty to logic is what is taking the West (and the rest of the world, which has largely bought in) straight off the edge of the cliff we all find ourselves upon.

Not only CAN our community do better; we MUST do better. Most of humanity agrees that we're on the wrong trajectory, and we practitioners of Chinese medicine are all about trajectories -- that's our thing! Yes, they're fuzzy sometimes and meander when you want them to go in a straight line, but if there is anything to our method it is rooted in understanding trajectories. The trajectory of American acupuncturists is currently toward an existence as medical factotums and technical assistants who can speak medicalese real good, but are no more effective or any different than the physicians they are aping, because we will merely be practicing a hamstrung, primitive and bastardized version of what physicians already endorse. And we will be mocked and blamed when our hamstrung, primitive and bastardized techniques don't work very well.

Happy to discuss it more, if anyone is listening, but finally wanted to get it off my chest. 

Thanks for your time.

Trey Casimir M.S., L.Ac.

Sharpshooters and Surfing

As an acupuncturist in the scientific, go-go modern West, one of my pastimes is to listen for things that science doesn’t understand and then attempt to explain those things using my education and experiences as a practitioner of breath-centered exercise and classical Chinese acupuncture. I heard a good one on the radio the other day.

There is an insect called a sharpshooter which has developed an effective evolutionary response to a big challenge it has. It drinks so much sap (80 times its body weight per day!) to get its nutrients that it has to pee like crazy, and it's so small that if it peed the usual way, it would constantly be inundated with its own urine. So the sharpshooter developed a unique and efficient way of getting rid of all that pee. Through a series of spring-like muscles and other structures, the sharpshooter flings urine away from itself like a machine gun, and here’s the interesting part: after it leaves the sharpshooter’s body, the urine droplets speed up! This shouldn’t be possible, according to the physical sciences – the stone can’t fly faster than the catapult’s bucket was moving. At the moment, scientists are hypothesizing something to do with the droplets being deformed and then springing back into shape – they think the rebound accounts for the increased speed.

However, an American acupuncturist says, “Surfing! And Frisbee! I bet rotation is involved, somehow.” In surfing, by traveling diagonally across a (rotating) wave a surfer can accelerate to speeds way higher than the forward speed of the wave. And a skillful Frisbee player can throw a disc so that it seems to pause and then speeds up (an air bounce, among other throws). In each of these cases, rotation applied against an existing plane of motion (a Frisbee against an air current) or leverage applied against a rotating plane of motion (a surfboard’s skeg against a rotating wave) results in acceleration beyond that of the existing plane of motion. Physics tends to only focus on the initiation of the movement, and assumes simple and predictable vectors of movement after it is initiated. However, life shows us other possibilities.

My bet is that the sharpshooter’s “buttflicker” (the technical term, believe it or not) also provides spin, or rotation, or a spiral in football terms, to the urine droplets. This spiral helps the droplets screw through the air, just like a football or Frisbee, helps the droplet regain its form, and combined with the rebound effect scientists have hypothesized, seems likely to add enough kinetic magic to account for the acceleration that has been observed. Because the droplets are tiny and essentially transparent, spin is probably very difficult to detect, but I bet it’s there.

Bringing things back to the human sphere, I don’t think it's an accident that we Frisbee players and surfers tend to be philosophical people who regularly live outside the mainstream, seek alternative approaches to common problems and tend toward being iconoclasts. We have been told our whole lives that there are immutable laws – of physics, morality, legality – but we have been able to see with our own eyes that those laws are NOT always immutable – there are various situations where they don’t seem to apply. When it comes to “immutability,” a single exception blows the whole thing out of the water, and we surfers/Frisbee players/acupuncturists are perverse enough to say, "Nuh, uh," and to keep on saying it.

This is the thing that surfers, Frisbee players and acupuncturists have to offer the Western scientific world, if it cares to listen: sometimes it is the movement that is meaningful. Science focuses on the structures, chemistry and mechanisms of life, but because that focus is especially trained on the pathological, actual normal function sometimes is overlooked. There are consistent, regular illustrations of nature’s ability to accelerate across a plane. Among other things, focusing study on this reality may unlock some of the mystery surrounding dark matter; may help with deep space calculations of star ship movements; and may help us better understand the way things work right here on our tiny, beautiful planet.

Including understanding more fully how bugs pee.