Vive L’amateur

In the mid 90’s I started taking an Aikido class in Seattle’s Chinatown. The crisp throws and graceful falls were all I needed to become hooked. The school advertised itself as “Aikido taught by professionals,” and was affiliated with a larger school north of the city. The instructor at the Chinatown dojo was a clean-cut young man, and as typical in martial arts school from Japan, he had a stern, militant voice.

I started the class because I needed to break a life pattern. The artist’s undisciplined lifestyle had been taking its toll, and I had had enough. Martial arts had saved me when I was a kid, and I knew it would do it again. As I began going to classes, first three days per week, then five, I became addicted, as did the other 20- and 30-somethings in the class. The class had a bunch of young men and women who bonded around Aikido’s unique philosophy of non-violence and non-aggression.

The students got along really well, and we thought we’d found the perfect school for us. Then, after about a year, these “professionals” started to make some changes to both the curriculum and, more significantly for me, to the payment plan. It was a time in the martial arts world when signing yearly contracts became popular, and the head instructors decided that was a good business model. In addition to requiring a contractual commitment with a lump sum up front, there were also tests fees, new uniforms, and other added expenses. It became a hefty sum of money, one that my wife and I could not comfortably afford.

When I balked at the new expenses, asking if there was a way to avoid some of them, the instructor railed into me, saying I wasn’t serious about Aikido and questioning my priorities. His response made my next move easy. I never returned. I soon found another martial art and dreamed of opening my own school. But after much reflection, I realized that to be a “professional” means making money and capitalizing on the role as a respected teacher to persuade students to purchase contracts, uniforms, and anything else that can bring in a profit. This is not illegal in any way, but it doesn’t sit right with me for one reason: trust. At the end of the day, a professional’s job is to make sure he or she is in the black. So they have to devise ways to excite, inspire, and persuade students to invest in the school’s future and purchase things, things they might not actually need.

Since then, I have decided not to open a school for profit or to formally attend one. Instead, I occasionally visit teachers whose primary income is not from their martial arts classes. That squarely makes them “amateurs,” which gives me a sense of trust and passion—after all, amateur means “lover of.” The amateur passes on knowledge because it provides meaning to their lives and, they believe, to the lives of others. Long live the amateur!

Summary of the Canadian Health Care System

Canada is ranked as the second largest country in size but 39th in population (CIA, 2009). These two factors combine to make it quite unique. The Canadian health system is just as unique. Bordering the United States, which has the antithesis of a single payer health system, Canada has maintained one of the most successful health systems in the world for the past 40 years.

With more than 80% of the population living in urban areas, the health system can make primary and acute care accessible to a large population (CIA, 2008)(WHO, 1996). Life expectancy is among the highest in the world for both men and women at 79.6 (StatCan, 2001). The infant mortality rate (IMR) for 2005 was 5.4 per 1000 births, making it one of the lowest in the world (StatCan, 2005). Since life expectancy is so high and IMR is so low, 12% of the population is over the age of 65, a high percentage of older population. Added to the fact that fewer people are having children, this means that Canada is in the fourth stage of a demographic transition.

The Canadian health system has some of the best health outcomes in the world, with death and disease rates lower than most. Still, only 52% of Canadians say they are satisfied (Gallup, 2003). One of the major complaints is long wait times for special services such as MRIs and other high demand treatments.

In 1957, the Hospital Insurance and Diagnostic Services Act (HIDS Act) was passed, establishing single payer insurance that implemented universal coverage for inpatient hospital care. The HIDS Act set into motion a foundation on which the Canadian health system as we know it was built. It evolved into the national health system, which provides universal coverage to 10 geographically and culturally diverse provinces (WHO, 1996).

Funding and Spending

Many people call the Canadian system “socialized medicine” but actually it more closely resembles a Medicare system where the heath insurance is government sponsored. This means that physicians are not hired by the state but are privately employed and are paid fee-for-service by the government using taxpayer dollars (Davis, 1999). In 2006, Canada spent $3,672 per capita, and health costs were 10.0% of Gross Domestic Product (GDP). Seventy percent of total health costs are publically funded (WHO, 2006); thirty percent comes either from private insurance, employer insurance, or out-of-pocket (Davis, 1999).

Structure

The Canadian health care system has two main levels of power. The first is the provincial, in which the health ministries take on the day-to-day management of health services. The ministers of health plan, finance, and evaluate all types of care, e.g. hospital, physician, and public health. Provincial health ministries must also fund all public health activities and negotiate fees (WHO, 1996).

The second level of power is at the federal level. The federal government's role is to set and administer national standards for the health care system. Another federal responsibility is providing health care delivery to veterans, native Canadians living on reserves, military personnel, federal prisoners, and the police. The final function is disease surveillance, prevention, and health promotion (WHO, 1996).

Primary Health Care and Public Health

The lion’s share of primary health care is delivered by a general practitioner or a family doctor. Since they are the first point of contact in the health system they filter access to specialists, admission to hospitals, and other health professionals (WHO, 1996).

The original intent of public health was to control and prevent communicable disease. Since communicable diseases have mostly been ameliorated in Canada, public health has extended its mission to include health promotion and equitable distribution of health services to all members of society, as well as prevention of non-communicable disease and support for mental health services (WHO, 1996).

The Role of the Private Sector

Besides a single payer health system, there also exists a private sector. Canadians might opt to go to the private sector because of dissatisfaction with the public system or to seek an alternative and complementary treatment. The government is not responsible for payment of claims for those who elect to choose that option. There are many doctors, chiropractors, dentists, and such who operate outside of the government provided system. In addition, there are private insurance companies that can supply employers with supplementary health insurance (WHO,1996).

Conclusion

One admirable aspect of the Canadian health system is that it doesn’t rest on its laurels. Building on its foundation of universal coverage, Canada strove even further to insure all of its people. Using the public health system to focus on health promotion and health equity, Canada has achieved some of the best health outcomes in the world. Today’s topsy-turvy economy raises many concerns regarding sustainability. Even in that arena, Canada has created many ways of cost containment, thus promising a continued healthy future for its healthcare system.

References

CIA , World FactBook. (2009). Canada: people.
Retrieved from
https://www.cia.gov/library/publications/the-world-factbook/geos/ca.html

Davis, J B.. (2001). Canada’s health system. Croatian Medical Journal 40(2).
Retrieved from
www.cmj.hr/1999/40/2/400221a.pdf

Gallup. (2009). Healthcare System Ratings: U.S., Great Britain, Canada.
Retrieved from
http://www.gallup.com/poll/8056/healthcare-system-ratings-us-great-britain-canada.aspx

Statistics Canada. (2001). Life expenctancy.
Retrieved from
http://cansim2.statcan.gc.ca/cgi-win/cnsmcgi.pgm

Statistics Canada. (2005). Infant mortality.
Retrieved from
http://cansim2.statcan.gc.ca/cgi-win/cnsmcgi.pgm

World Health Organization (1996). Health Care Systems in Transition: Canada.
Retrieved from
www.euro.who.int/document/e72450.pdf

World Health Organization (2006). Canada: statistics.
Retrieved from
http://www.who.int/countries/can/en/

The True Power in Tai Chi

Recently one of my martial arts friends asked me to work out, and I had to decline because of the broken scaphoid bone in my wrist—an old injury—and two other recent injuries. My knee most probably has a tear in a tendon from walking on the broken sidewalks in India with 100 lbs of luggage this summer, and my shoulder tendon has been burning every time I reach for something. Alas, the sounds of a wimp! But, hey, that is the true state of my body.

My friend’s response, “Very problematic, there are more than a few pro (motorcycle) racers who had to retire just because they broke that bone [the scaphoid]. It wouldn't heal and that was it. Such a small bone, but it can be such a bitch!”

After reading that email I immediately felt the loneliness of retirement and even more so, the loss of identity. I have been managing pain by rationing my martial arts workouts literally for 20 some-odd years. My wrist can only take so much activity. But maybe it is time to face facts. I am a type A personality and not the typical kind of person you find at a meditation class. I love sparring and getting hit and all that, but being type A means that I push it too far too often. Even my wife has been getting on me for instilling the martial ethic into my young son.

All my life I have been type A. When I was picked on in high school by the football team, I didn’t just rollover and take it like everyone else. I started to box, I ran 8 miles a day, punched the heavy bag for hours per day, and I did push-ups and sit-ups. My workouts lasted for hours. My work reaped the success I sought, and by the time I was a junior, I was no longer being picked on. Then when high school was over and I had to get serious about something society valued, I chose to be an artist. Of course in typical type A fashion I again went over the top with drugs, alcohol, and all that comes with that lifestyle. These activities led me to have some minor health issues.

This was the original push to get me to seek out Tai chi, because it is recommended for type A personalities. Many of my injuries and heath issues were linked to this type A drive. I changed many of my habits, like my expression of anger, slamming my fist on a desk, which took a toll on my body. But in time I gravitated back to the more martial aspects of Tai Chi and found a way to keep the martial artist in me alive. In Tai Chi Chin Na I found Jiu Jitsu correlates, and in Tai Chi sword I saw similar characteristics with Kali stick fighting. Again I was using Tai Chi as martial training, not solely as a health exercise, further exacerbating my wrist injuries.

Maybe because of this persistent injury, I am starting to see Tai Chi from a different perspective, as injuries always have a habit of inspiring. I used to think that a Tai Chi master could heal broken bones and beat a 25-year-old professional fighter. When I first started Tai Chi I believed that by simply practicing Qi gong and Tai Chi I could heal my body to a superhuman level. I thought by developing Qi, I would be able to throw a football player 10 feet and that I would never get sick. In my 12 years of serious Tai Chi practice I see that it is not the cultivation of a superhuman ability but some thing far more simplistic. It is the opposite of type A—it is about yielding control and letting things come to fruition on their own. Accomplishing that is harder than breaking coconuts and throwing heavier opponents to the ground.

A famous Tai Chi master came up with a phrase that explains that the essence of Tai Chi; “invest in loss.” This simple concept has been a struggle for me since I began my practice. As a westerner in an eastern practice, I have a hard time reconciling the two approaches. The westerner in me asks, “how did the US become a superpower but by being type A?” Getting to shape the world in a major way is no small accomplishment. Eastern wisdom tells us this is short-term, it will pass. I wholeheartedly agree, but it is comfortable being on top even if it is for a relatively short period of time, like 500 to 1,000 years. Eastern wisdom is beautiful, and it is one of the best ways for all of us to coexist in a world that needs a way of curbing excessive human consumption. If we regulated our desires, many of the issues surrounding global warming could be attenuated.

Giving up martial arts is really hard. It is addictive for me because in martial arts you gain victory by defending against would-be attackers—and to give up creates a certain cognitive dissonance. The whole point of your martial life is to defend yourself. Not being able to do that is to deny everything that you worked so hard to acquire all your life. But just as a champion’s life is so short because there is always going to be someone younger and stronger willing to knock you down for the glory, one must eventually yield.

At this stage in the game for me, Tai Chi is not a miracle cure or a superhuman growth supplement but a form of exercise that can keep me active, which is a miracle in itself. It is also a means of managing pain and that translates directly into living an active life. As it is now with my wrist I could easily stop working out as working out brings pain. Tai chi allows me not to quit and to avoid that slippery slope of inactivity but instead to persevere.

The true power of Tai Chi is a far cry from the hype of internal martial arts promoters for one simple reason: there is no mysterious, esoteric secret. It is the practice of overcoming the part of you that looks for short-term victories and instant gratification. It helps you understand the bigger picture, but with that comes responsibilities and sacrifices. It comes by letting go of your desire to win.

Is there an inverse relationship between tradition and regulation? A Comparison between Canada and India

Indian culture is one of the oldest if not the oldest living culture still going strong. Without a doubt, one of the factors that generated that kind of longevity is tradition. Regardless of how we might judge tradition with a 21st century lens, a strict family structure with rigid social and cultural norms has got to be one of the reasons for India’s perseverance.

One of the hardest to understand cultural differences between India and Canada is the tradition of marriage. “Dr. Sanjay” (not his real name) is in his 30’s and a typical upper-caste Indian man. He is very handsome and tall but yet single. He is a senior resident doctor of community medicine at PGI. He led a tour of the community health center in Kheri for a group of doctors from North Koreans and myself. The North Koreans doctors, Dr. Sanjay, and I discussed each of our country’s courtship rituals on our way back to PGI medical center. The North Koreans asked if he was married. He said, “no.” As we were discussing this, a beautiful young rural woman passed by our van. I said, “in Canada, if we found her attractive we could approach her and ask her for a date, and if things worked out it is possible to get married. “ Dr. Sanjay said, “That would be next to impossible here.”

Another part of our tour was to observe a public health class. During the class discussion about private and public health, I was invited by the teacher to speak about the Canadian healthcare system. Being an American who lived without health insurance for many years and who now resides in Canada I had a pretty good personal perspective on each system. After sharing my experiences about the Canadian system, the students discussed the Indian health care system. I was impressed by their description of India’s far-reaching delivery of health to its people, but this interaction prompted me to ask an important question: why does Canada have generally very good health outcomes but India has some really poor outcomes?

I began to try to think of reasons and issues besides the obvious ones like population and colonization. This led me to a peculiar realization. India has one of the most rigid social structures on earth, yet the ability for the people to follow government regulations seems like a monumental task. And paradoxically Canada has very little real tradition, and there is no rigid social system. You can walk out of your house and marry anyone you please, and yet if you drive without a seatbelt or on the wrong side of the road you would be severely punished maybe even lose your license. To me the striking difference is a culture of safety—seemingly simple safety regulations that most people in Canada have no difficulty following are almost non-existent in India.

This difference makes me wonder if the health system is the most important way of preventing mortality. This question led me to develop four ideas that, in theory, could take the burden of prevention out of the hands of the health system. These include 1) a general culture of health awareness, 2) stronger regulations, 3) definite and immediate accountability for infractions, and 4) improved infrastructure like clean water, safer roads, sidewalks, etc.

While these are challenging and sometimes expensive endeavors, I have noticed an improvement in some of these areas since my last trip to India, in 2001, in things like public smoking restrictions and at least minimal seat-beat laws. Changing culture is rarely easy, but it won’t happen without starting somewhere. Public safety has to be assimilated into construction, food production, the work place, transportation and any business where people can be harmed by products.

Canada has great infrastructure. Water for human use is filtered and treated to a high degree of purity, roads are safe, and building construction is highly regulated for safety. Contractors and developers can get arrested if they cut corners on building codes, there are elected officials in charge of checking on zoning and building codes of safety, and they have the authority to stop construction or penalize a contractor if unsafe construction practices are used. These regulations are designed for both the construction phase, to protect workers and the public, and for the completed phase, to ensure that buildings don’t collapse or require nearly immediate repairs.

In addition, driving in India is a high-risk activity. On the 5-hour drive from Chandigarh to the Delhi airport, I saw two immediate wrecks probably involving fatalities, three trucks overturned, and numerous automobiles driving on the wrong side of the road. To a North American observer, this disregard of road safety seems to be a point of pride with many Indians, as if they see any demonstration of fear about daily driving habits to be a sign of weakness. This type of cultural myopia is hard to change. When I discussed road safety with many people, they often laughed at our concern and shrugged off the seriousness of accidents. But road accidents in India are extremely high.

According to a Boston Globe article using World Health Organization statistics, “road accidents now are the number two killer of young people age 5 to 29 worldwide…. [In India], an estimated 270 people die each day from road accidents, and specialists predict that will increase by roughly 5 percent a year.”

Many cars do not have operable seat belts, and children ride on motorcycles and scooters without any protection. In Canada this practice is illegal. In fact, it is also so culturally abhorrent that people would call the police and look down on such a person. Because I am a cultural relativist, I don’t judge Indian people who chose to ride a motorcycle with a child, as I understand there are many factors that influence behaviors. But I am concerned about safety. My biggest fear in India is seeing an accident involving a child being slammed onto the asphalt—if I witnessed such an incident I would never forget it.

Much of India’s charm is its stalwart retention of its culture, even in the face of westernization. In Canada, without the long tradition and strong culture, sometimes there is a loss of identity, as people seem to be grasping for something to believe in. Also, such stringent regulations can sometimes be claustrophobic and create a backlash. It is precisely in this dilemma where the public health worker inside me, who believes in safety and longevity as a human right, and the dedicated traveler, who believes that culture is what makes us unique, collide. But I do think a happy medium can be achieved slowly.

Personal Paradigm Shift

Spending 11 weeks this summer in India, where the heat is 109 degrees and walking 4 days per week, administering surveys door-to-door, negatively affects my daily routine of Tai Chi. It is simply too hot to move. I have been doing some Chi Gung at night before bed. But I still feel like I am missing my daily one-hour routine of Tai Chi. I have felt jealous of my friends back in the US who aren’t missing a beat in their own practice. Then I had an epiphany that led to my own personal paradigm shift.

My choice of going into health research as opposed to acupuncture or some other health care delivery was just the beginning of incorporating my research into my life. Scientific research is a systematic method of adding knowledge about the world around us by collecting data, lots of data. My research here in India is trying to ascertain how people’s dietary habits impact their physiology. What I am finding thus far is that small, simple choices in an individual’s and a culture’s diet can negatively impact their life span. In short, people’s cultures are killing them slowly.

My research in India takes me door-to-door asking people in their homes about their lifestyle choices. Everyday I meet people who are overweight, with high blood pressure, not exercising, making poor dietary choices and of the age where their first MI (myocardial infarction, or heart attack) is not far off. So many of them think that they are healthy and that they are eating just fine. They truly are in a state of denial. The stats tell another story: About 17.5 million people die from cardiovascular related deaths every year. That is 30% of all deaths in the world, which means that CVD kills more people than any other disease.

Although I haven’t been doing as much Tai Chi as I like, I am seeing first hand through a scientific lens that, overwhelmingly, lifespan is determined by the choices people make day in, day out, many of them based on cultural norms. The average life span in India is 64 years of age. The people I meet here are creating a pattern of behavior that will affect their child’s life span as well. Science has given me the tools to see this. By collecting data from hundreds of people I can infer whether a certain behavior is rampant or not. If you just follow a tradition or culture that is orally interpreted or passed down in books you might not notice what is actually happening on the ground. A state of denial is created because tradition is kind of like a rule book or a map following it confirms you are doing well. Unfortunately, many of the directions are flat out wrong or not appropriate to the present time frame. I am finding that the people of India follow their traditions and are very devout, much like people of other places, but unfortunately without that scientific lens they can’t see where the health outcome of their tradition leads. The Hindu religion states the eating of meat is forbidden, with beef strictly taboo. Although the attitude toward chicken is more casual, many people proudly don’t consume it for religious reasons. However, chicken is a more efficient protein, with less fat, than the daily consumption of whole milk (in tea and drunk plain), paneer (a type of cheese), and whole milk yogurt that makes up a big part of the Indian diet.

Even in my beloved Tai Chi there is very little information on dietary behaviors. There is some wisdom on the balancing of the 5 elements and their dietary correlates: sweet, sour, salty, pungent, and bitter. Unfortunately, it doesn’t give any measurements or of course the wise sages could not fore see the transition from a rural old world diet rich in whole grains to a modern diet full of processed refined grains heavy in salt and sugar. Consequently, Tai Chi instructors without training in western science do not pass on that kind of wisdom. The Tai Chi literature also says to avoid any type of cardio activity. Although there is some wisdom within those words when applied to elderly people but it is poor advice for middle-aged adults who are in need a cardiovascular exercise for their heart.

Absorb what is useful, discard the rest

It is difficult not to be influenced by cultural traditions. Tradition gives many of us meaning in life and even makes us aware of many positive activities as well. The Tai Chi literature is full of all kinds of awesome behaviors to follow, that is why I love it and read so much of it but there is a fundamental lack of precision. Following the scientific method gives me the insight of what is actually happening on the ground from the data collected. The choices I make of which many come from the Tai Chi literature are tempered and corrected by the large body of literature amassed by the western science paradigm. So I can as Bruce Lee has advised, “absorb what is useful, and discard the rest.”

IS there such a force as CHI, QI, or PRANA?

At the very end of the day, this is what we know: physical activity is one of the best activities for preventing a whole array of diseases. Greeks, Indians and Chinese knew this but did NOT or could not empirically prove it. They all created an energetic system of healing. Greeks had Pneuma, Indians have Prana and the Chinese, Chi. But we also know it is it is really hard to exercise everyday, maybe those ancient teachers knew this too?

Until someone actually does a study like one I have designed which isolates Chi practice from physical activity then there can be NO proof of any single activity that people claim cultivate Chi is valid. In other words, all the positive effects of 'Chi' could easily be explained by physical activity. My study would not prove the existence of Chi itself but it could prove that activities which claim to cultivate Chi are more efficacious than running on a trend mill. Maybe one day I will find myself in a situation where I could run that experiment. Or maybe a new technology will come along that measures Chi?

One of the biggest issues in discussing, explaining or even harder, proving Chi is that we have to fuse together two explanatory models about the world. An explanatory model is a structured thought or diagram or paradigm, which attempts to make sense of our world in a simplified way. Hence the only way to explain Chi must be in terms of physics and biophysics. The Chinese had no knowledge of what we would call modern physics but they did understand how to make use of it. This is where we run into problems, I could say Chi is energy but there is a whole field called thermodynamics that also deals with energy. I could say, Chi is the movement of neurotransmitters in the body; again there is a whole field of science that researches this. Unfortunately by applying an old language to a new science much gets lost in translation. Then why use Chi at all? Part of me thinks it is not necessary and part of me thinks that the concept of Chi gives us something to grab onto when explaining complex bodily functions. While leading a lesson on Tai Chi I can’t say, "now let’s feel the release of dopamine and serotonin." It is so much more convenient and accessible to say, "let the Chi sink into your belly." But I also feel it serves another purpose.

The activity of learning and exploring through being thoughtful or mindful is also extremely beneficial towards living a long and healthy life. Many cognitive psychologists are finding that if humans learn something new and complex they are less likely to suffer severe memory loss. Being thoughtful about Chi and its interactions with the complexities of our physiology serves two purposes. One, it keeps my mind active reading higher level material instead of playing video games, which have not proved to prolong memory and two, it motivates me to return to practice, day in and day out. The outcome of which is a highly functional system of cognitive and physiological benefits both inspiring each other. If the mystery of Chi keeps me practicing for 50, 60 or more years than that is quite an achievement by itself.

The paradox of physical exercise is that our minds know it is good for us but the mind has to motivate the body to get up and do it consistently for there to be any benefit. What if the mystery of Chi Gong is so complex that is can not be empirically 'figured out' as so many of us try? That makes it the ultimate cliffhanger created by a most wise sifu. If you ever have a chance to meet one of these people after-death or otherwise, and you finally get to ask that one burning question that has been tugging at you for years, "is Chi real?" Sifu would say, "the mind is dumb and the body is the smart." "Ah ha," you say, "I knew it was a trick all along." And before that smugness has a chance to settle, the sifu responds, "But the mind always has to be right."

Tai Chi below Shannon Falls in BC

The practice of the Tai Chi form reaches its apex for me when performed in nature. The first step in learning the Tai Chi is the basics. Once the body mechanics are understood, the applications of each posture need to be comprehended. This develops an ability that demonstrates good structure. Structure is how the body handles pressure. Bad structure collapses under pressure and good structure does not. Once these elements are understood on a general level the most satisfying part of Tai Chi is not being able to defeat multiple attackers, but simply moving and interacting with nature. When you feel you are able to follow nature and understand it as if you were the rider and it was a horse, you are in a place to realize a deeper part of yourself and to improve upon the many weaknesses you endure while living in this complicated world.

Please do not take these words as some type of fixed idea that you complete one step, the basics, then another and so on to the final stage of development, rather take them as a process. By looking at your learning as a work in process, you can shed the idea that there is some kind of fixed state, and you might be easier on yourself.

Sometimes we work the basics and move on to realization, and back to applications, then realize that you totally forgot the basics and have to start all over. The process of Tai Chi can be frustrating but it is important to be easy on yourself and remember to love what you are doing and then do it often.

My letter to Barack Obama about Health care in America

I am a 44 year old American in graduate school in Canada. I am seriously considering applying for citizenship there. The major justification for this decision would overwhelmingly be free health care.

Since I have been there I have not had to battle ANY health care request, whereas my experience in the United States has been quite the opposite. I have had wrist pain for the past 20 years. I have been to multiple doctors in the US. None of them ever addressed the issue without first suggesting pain killers as the solution. While the idea of relying on painkillers is good for the pharmaceutical industry, it is repugnant to me. I then retreated to alternative health care as so many Americans do. Alternative treatments brought me some success but the pain continued. Finally, in Canada, a doctor had a novel idea, a CT scan. I was finally correctly diagnosed, after 20 years with a broken scaphoid bone in my wrist.

I know that a small broken bone doesn't sound like a traumatic disease that has ravaged my life, but I have made major changes to my life because of it. I have been physically active all my life and there are many enjoyable activities and some jobs that I can no longer perform. It is also significant in that it is so small but yet for America so large and expensive.

I have an appointment this September with an orthopedic surgeon in Canada. I feel confident that if he thought he could repair my wrist with a costly surgery, there would be no obstacles in my way. Unlike his American counterpart who would gladly offer the surgery, but then I would have to figure out how to pay for it. In the US, I had to drop health insurance because the $500 per month was too high and my policy probably didn't cover it anyway, because it would have been a ‘preexisting condition.’

The irony of all this is that the injury happened while I was working my way through college in my 20's. I find it ironic because while contributing to the economy I was injured. I was too young to realize the implications of my injury. As an older man the pain from my wrist has a place at the table when decisions are made. I have to listen to it before I engage in certain activities and even certain jobs. Amazingly, even conservatives in Canada realize the importance of single payer health care. The irony continues because here I am at the peak of my ability to contribute to the economy but my country will not assist in my health, and a country not of my birth will gladly do what it is right. As I get older health increasingly becomes a top priority, so how can I resist an excellent opportunity that will insure my health into my golden years?

Why I Chose a Career in Public Health....

When I re-entered University at age 39, my purpose was to get a better job in the health-care field. My top choices were physical therapist, psychological counselor, or acupuncturist. During my first semester I began to see that physical therapy was much like a car mechanic and that the daily work would be fixing people's knees and other parts that were broken and, most importantly, that PTs don't have as much autonomy as I'd like. The doctor diagnoses the injury and prescribes the regime. I was much more interested in the mind's role in healing and prevention. In psychological counseling the therapist works with patients on a number of behavioral issues, not just physical health. I began to research health psychology. Around the same time, I found some studies on acupuncture that questioned its ability to heal any disease, and there was no real emphasis on prevention. After many years of studying Taoist healing practices that focus more on prevention than acute repair, I wanted to help prevent disease from beginning in the first place.

Near the same time, a friend passed on a book entitled The Status Syndrome by Michael Marmott. In it the author explained that diseases manifest themselves in a population differently with regards to social class. People at the top of the social hierarchy live longer than people at the bottom, including the radical discovery that people with PhDs generally live longer than people with a Master's degree and right on down the line. The issues raised in that book caused me to have a spiritual crisis and led me to pursue a career that relies less on religious faith and more on personal empowerment and education. It also sparked a strong desire for discovering an empirical basis to substantiate claims about efficacious healing practices.

In addition, I grew increasingly frustrated about our western health system, which is based on a model designed to combat acute trauma and infectious diseases. Unfortunately, that model is ineffective in preventing non-communicable diseases (NCDs) because they are about lifestyle choices made by the individual, heavily influenced by cultural norms and pressures.

The western medical system approach is top-down, meaning that doctors tell patients what to do. Because of medical advances over things like bacteria—which have been great in reducing infectious diseases and the burden of those on hospitals and communities—doctors and the medical establishment have been given too much power over areas where they are not particularly effective. This kind of power has a tendency to narrow people's vision, so that the current model is excessively preoccupied with physiology and the view that everything is biologically determined. So the focus is on high-ticket items like surgery rather than cost-effective, preventative, lifestyle changes.

For non-communicable diseases such as cardiovascular disease and diabetes, the need is greater than ever to create a system that can raise awareness and motivate people to change high-risk behaviors. This approach aims to keep people out of the hospital for things like heart surgery by keeping them healthy in the first place.

This is why I look to other, decentralized health systems as a model for dealing with education and prevention issues. Systems like those at various times in Bangladesh, Cuba, Pakistan, the state of Kerala in India, China, and the parts of the Philippines have designated roles for ordinary people to become community health educators. These people function as disseminators of information to rural regions where doctors are unable to access. These decentralized systems accomplish two amazing things. First, the distribution of medical knowledge creates a less hierarchical system in which more people can share in the decision making process. Second, and most important, these community educators more easily reach marginalized groups, which often have a heavy burden on healthcare systems. Using education programs between people who are on the same status level is an effective tool alongside a top-down authoritarian approach.

When it comes to many diseases—particularly non-communicable ones—awareness is an essential ingredient in preventing a disease from becoming a major player mortality rates. And so much of maintaining good health is about having access to information. For example, we are seeing a reduction of cigarette smoking in developed countries because more people in those places have become educated about the overwhelming evidence about the dangers of cigarette smoking. In less developed countries, there has been an increase in smoking because those places have not been able to enact effective campaigns about the ills of cigarette smoking. But in due time, we will see a reduction in cigarette smoking in those places, too, as health education systems have time to catch up. As with cigarette smoking, condom usage, diet, exercise, clean water and clean hands, many other preventative behaviors can also be taught and learned.

All these issues combined to lead me to a degree program in public health, with an emphasis on non-communicable diseases. For me, public health can be the “ounce of prevention [that] is worth a pound of cure.”

What’s the Buzz about Mindfulness?

In America, mindfulness has been a buzz word since the 80’s and it is just as strong now as it was when it first appeared on the scene. Usually, a buzz word’s life span is pretty short. There is no doubt that mindfulness has staying power. Even though mindfulness has only been in the USA for a few decades, it has fascinated cultures around the world for thousands of years. Currently, there are a group of scientists who are trying to understand what exactly it is about mindfulness that makes people feel so good. The purpose of this essay is define and draw a distinction between mindfulness and meditation. 

Mindfulness is a good term because it implies that people can control their bodily drives by applying their mind in a particular way. It shares many qualities with self-regulation, and all people need that kind of reassurance. In fact, many human pursuits attempt to impose some type of regulatory principle over the body’s “evil” defaults of carelessness and selfishness. In Eastern mindfulness practices, there is a place for the mind to share in the internal regulation of bodily functions not just simply behavior modification. Unfortunately, many people confuse the terms mindfulness and meditation. They are often used synonymously but there are major differences. Mindfulness has been defined many ways. The most common definition is by Jon Kabat-Zinn, who defines mindfulness “as paying attention in a particular way on purpose, in the present moment, non-judgmentally.” Ellen Langer and Herbert Benson were some of the first people to explore this phenomenon. In her 1974 bestselling book “Mindfulness,” she gives us many related phrases like “being open to process.” Later in her 2000 paper on the construct of mindfulness, Langer states her definition this way: “The concept of mindfulness can be best understood as the process of drawing novel distinctions.” Herbert Benson went a different route. He looked at the physiological measures of meditation and found that meditation lowers the heart rate. He called this process the “relaxation response” (Benson & Wallace, 1972). Langer’s and Kabat-Zinn’s definitions make similar points. Langer’s “process of drawing novel distinctions” and Zinn’s “paying attention to things we ordinarily never give a moment’s notice to” propose that the mechanism of action within mindfulness is a cognitive one, while Benson relies more on physiological correlations. 

As you can see, there is still a lot of confusion surrounding the definition of mindfulness. It is a relatively new concept to the West and there are many components to mindfulness. In fact, mindfulness is such a broad term that it maybe impossible to truly define. One important point to bring up is that there are two meanings to mindfulness. First and foremost, it refers to a state of being in which one is being very careful and focusing attention on the task at hand while still keeping the mind open to new possibilities (my definition). Secondly, when many people use the term they actually mean meditation. Meditation is defined as a technique for self-induced manipulation of awareness. When the definition says, “technique,” it is referring to any activity such as, walking, sitting, moving, doing the dishes, and even lying down; really any action that requires intense focus with the intended purpose of altering consciousness.  So when athletes mention “being in the zone” they are talking about a special moment when then are deeply focused and all actions seem effortless and coordinated. My definition of meditation is a category of techniques that build self regulatory awareness over the mind and body, while maintaining a mind open to new possibilities.   

While teaching Tai Chi for the past 7 years, I became interested in how Tai Chi could develop a type of control over the body’s movements. One could control the distribution of weight from one part of their body to another. This more subtle level of control is a skill and it takes time to develop which is rather useful when one has an injury. If the front of one’s knee has a strain, that person could redistribute the weight towards the muscles in back of their knee and avoid re-injuring the front. The interesting element here is that people can intentionally regulate which part of the body received the majority of force or weight. Based on my experience and research in mindfulness meditation, it appears to me that meditation is the same technique of dispersion that is done with the body, only applied to the mind. It has been demonstrated in psychology that people often focus on a small portion of reality when speaking about it in the past tense. That theory is called, focalism. If mindfulness allows a person the ability to shift the attention to other aspects and broaden or enrich the person’s perception of reality in the present moment, then it is a similar tool as Tai Chi. 

I believe that shifting attention happens because of the sensory systems of the brain. Humans have five sensory systems, an optical, auditory, olfactory, gustatory and finally, somatosensory or touch. It is here in the very order that these senses are listed in every scientific text published, is also where our problem begins. Our culture is so visually and auditorily oriented that we suppress or ignore the other senses. When we have a problem we deal with it in our limited ways. This happens so many times we develop a repetitive motion injury of the mind. Our thinking becomes fixated on a narrow set of information and then we have trouble seeing beyond our problem or obstacle. We remain inside a small box. Mindfulness allows an opportunity for the other senses to contribute to our perception of the moment. We feel things emotionally and physically, we also hear things from outside this narrow margin of reality that our cognitive resources confine us to. Mindfulness opens up that door to other possibilities. It brings us outside that proverbial box. Also, we have to mention other possible senses that are not yet recognized scientifically. Although, this might make some scientists wince it is important to understand that things like, x-rays and wireless were science fiction, not too long ago. So that wince could slow the advancement of science. We must remain open to the possibility of other senses if we are to discover them. 

Finally, we could sum up that mindfulness is a large umbrella term that entails many components—for example, some type of “special awareness,” an internal sensory awareness with an external cognitive lens that allows out-of-the-box thinking. There is also a relaxation component and some physiological skills as well, such as posture and breathing; these components of mindfulness work together to assist in regulating these powerful biological determinants. Meditations have a different focus, referring to a specific means, where as mindfulness is a general state of being; a tactics vs. strategy kind of thing, meditation being the tactic and mindfulness being the overall strategy. With meditation, one could be more cognitive in nature while another is more physical. There are many components of a meditation practice, such as breathing, posture, relaxation, and usually a lecture giving instructions on how to deal with thoughts, especially emotionally-charged ones but they are focused. In mindfulness anything could be done mindfully from throwing out the garbage to painting a wall to sitting in a temple in front of a statue of the Buddha. The meditation would be called throwing out the garbage meditation, or painting wall meditation if of course they were performed mindfully. So here we are, meditation is the vehicle with the aim of achieving a state of being called mindfulness. 

A New Art

When I graduated high school in 1983, there was this sudden pressure to do something. One either had to get a job or go to school or something. I got a job at a grocery and thought for a while about what would be the best position in society for me.

Being 18, I wanted the "job" with the most freedom. My parents had a friend who was a struggling artist and he had this really open-minded perspective on life. So I chose to become an artist. My parents were not too happy with this decision but they knew I wasn’t going to change my mind that easily.

I started drawing everything I could. I eventually went to a college for art. I was as passionate about art as anyone had ever seen. I specialized in painting and sculpting. I had even carved totem poles for a motel in Taos, NM.

As I explored art, I was continually amazed at the artist’s calling for pushing limits of what art is. One of my artist role models is Joseph Beuys, a German performance artist who really broke new ground. He was an artist in the academy before WWII doing representational themes in paintings, drawings and sculptures. Then he was called to serve in Hitler’s army as an fighter pilot. He was shot down a few times. The last brought him closest to death. He was shot down and was found by a tribe of people who saved his life by putting him into a felt cocoon surrounded by fat. When the war was over he knew standard academy painting would never be able to externalize his past experiences. He began doing elaborate performances, which set his career off and changed the art world.

After 12 solid years in the art world, I had a profound experience during a martial arts class. We were asked to make 100 Japanese sword cuts with a wooden Katana called a Bokken. I can’t remember what number I was on but I got myself into a state. Then all of a sudden a black passageway opened up and I felt hyper-aware. That experience of an altered reality changed my perception of the world. Art itself seemed pale and utterly cheap from that moment on. I tried to paint that experience for the next few years with some feelings reminiscent of that first experience but it wasn’t until I started doing T’ai Chi and Qi Gong that I was able to get back to that place.

Once this new method of altering my consciousness began my art production slowed to a trickle. I found that Qi Gong and T’ai Chi could replace and surpass any internal feelings that my art was able to do.

My next step was to share that feeling with others. After becoming relatively proficient in some Tai Chi and Qi Gong forms, I felt comfortable enough to teach other people. But I seemed to keep bumping into some obstacles. Many people in society viewed these forms as either, stale and static or just for old people.

So my next challenge was how to change the way society viewed these activities. I went back to school and completed my bachelor's degree in psychology. Studying social psychology it becomes abundantly clear that people have many preconceived notions that are informed not from direct sensory experience but from socio-cultural norms they learn. Many people in society relegate art to a painting or a sculpture that is executed by “artists.”

T’ai Chi and Qi Gong are really not considered as anything more than an exercise for older adults who are in need of assistance. Even martial artists have been patronized by being Asian-philes who break boards and shout like cavemen. Our society has these narrow perceptions of what all these things are. Our whole society is compartmentalized so much that you would think nature is as well. Compartmentalization is a major flaw in our highly industrialized society. The problem is those of us in the West have to name everything, which seems harmless but limits the object once it is named.

Even fellow artists often ask if I still paint or make art. There is no possibility in their minds that the act of performing Tai Chi is the creation of art. Art to me has now become that amazing feeling when my body seems to open up and glide on the earth's crust weightless and painless and ready!

Holidays and Qi Gong

Holidays are an awesome time in American culture. I love Thanksgiving. It is a time when everyone loosens their belt and indulges more than normal. It was a great morale boosting necessity during periods like the Great depression and when our ancestors were building this country. Unfortunately our current lifestyle is too indulge everyday. So during the holidays we increase that base level of indulgence. The way your brain works is when it gets used to something it develops new neurons to accommodate that new level of being. This is called plasticity. It is a great adaptive tool which allowed humans to do so well on this planet, however there is a down side to plasticity as well, once you have lots of sugar and great tasty treats your body has already adapted to a new sensation so it will now crave them.

One really smart coping method is to be pro-active about this process. Accept the fact you are going to indulge yourself but make a commitment to doing a short Qi Gong routine every night. Put on a DVD and follow along. I am a teacher and I do it all the time. In fact, I will be doing just that at 6:00 am this morning. Forget about silly ideals that are unrealistic which then work to undermine your positive efforts to begin practice. If you start a self practice in addition to coming to class, you begin to reinforce that practice into a daily routine. When January comes along you will not be one of those people who join a gym as a band-aid for your guilt, then by February have already stopped. The gym workers just sit back and laugh when January comes along. All the new clients are so enthusiastic and the workers know that most new clients will stop by February.

An Ounce of Prevention......
I know everyone has heard that saying but now is the time to put that in to action. Start a little now and later it will be easier. In January when everyone is trying so hard to retrain their tastebuds and get themselves back into shape, I will be making a small effort to bring myself back to baseline. This is also the same as controlling your balance point. In the Tai Chi classics it is written, "Smaller movement is better than big movements." This is true because it is easier to control smaller movements it takes less effort.

So what is T'ai Chi anyway?

“Understanding [energy], how can one not be prudent in regard to such habits as sitting, sleeping, walking, standing, drinking, eating, urination and defecation in order to promote the best results?”
--excerpt from the Yang Style Family Manuscripts, compiled and translated by Douglas Wile


So what is T’ai Chi anyway? And how can it save America?

T’ai Chi literally means “grand ultimate point.” From my studies and readings, I define the grand ultimate point as being the balance point of any object. Every object on this planet must have a balance point unique to its mass and structure in relation to gravity.

T’ai Chi (formally known as T’ai Chi Chuan) is represented first and foremost by a symbol that we in the West know as the yin/yang symbol, which illustrates a balanced interrelationship of opposites. For example, night and day, hot and cold, etc. This symbol dates back to around 1100 BC. The oldest known writing that discusses yin-yang is the “I Ching,” or “The Book of Changes,” a book that describes the natural ebb and flow of energy in the universe and how that effects change. It was written about 3,000 years ago.

Eventually, someone got the idea that this concept could be used to defeat an opponent. Martial arts already existed, but someone looked deeper into the interplay of gravity and leverage. Out of this exploration was born a host of martial arts, including T’ai Chi Chuan, Judo, Sumo wrestling, Aikido and Jiu Jitsu. These arts all originate from the same starting concept (yin-yang energy). They differ in how each style trains and how they apply the concept. What sets T’ai Chi Chuan apart is that its creator incorporated Qi Gong techniques into the martial movements. So T’ai Chi also contains self-healing principles in its martial movements. (An essay explaining the healing art of Qi Gong is coming soon.)

The Chinese credit the celebrated hero Zhang San Feng with T’ai Chi’s creation. Legend has it that he observed a hawk attacking a snake. As the battle between the two animals ensued, the snake repeatedly used relaxed evasive movements to elude the aggressive attacks of the hawk. Finally, the exhausted and frustrated hawk flew away. There are several versions, using different birds, but this is the basic myth.

The Essence of T’ai Chi

T’ai Chi is a series of martial techniques that are performed slowly, with mental awareness of each micro-movement that puts the practitioner in the most advantageous position in relationship to gravity. They are low impact, which is good for the joints. The moves involve natural gross motor movements that every human is wired to perform. For example, Ward Off is a posture in which, while sinking your lower body to drop your center of gravity, you simply put your forearm horizontally in front of your body. Humans do this a lot as part of daily life—for example, when walking through a crowd of people or when a dog tries to jump on you. It is a basic movement that keeps your vital organs (or simply clean clothes) protected. Most of T’ai Chi’s moves have this kind of inherent practicality.

In the long evolution of T’ai Chi, practitioners sought to attain the biomechanical perfection of each position. They asked such questions as, how can one extract the most power from the simplest movement? They integrated the results of their research into forms, which tie all the moves together into a choreographed, martial, healing dance called T’ai Chi. This dance also uses the biological systems and rhythms of the body to increase both physical power and health.

Slow and Relaxed

Many westerners scoff that T’ai Chi can’t be “real” exercise because it is practiced so slowly. What they don’t understand is that T’ai Chi trains the nervous system, which develops the good habits best for living a longer, healthier, independent life. And by soothing the nervous system, one is more likely to train. The more relaxed you feel, the more your body craves practice. The hard working out of much western exercise often causes the body to revolt, eventually convincing the mind to stop the training altogether.

The nervous system is the network of communication for the entire body. A tense nervous system inhibits the flow of blood and other fluids, as well as all communication between body parts. By releasing tension, the nervous system can open up (relax) and flow with its natural cycles. The health of your internal organs, including your brain, is largely determined by the health of the nervous system. Just look at all the diseases that are related to too much stress. What is stress but the nervous system out of control? This alone supports my claim that T’ai Chi can save many Americans who suffer from high stress.

The United States has been a Super Power for a while now, fueled by coffee, fast food, and intense competition. We gulp down fast foods and high-sugar/low-nutrition soft drinks. We multi-task, rushing from one obligation to the next, driving through red lights. The “flight or fight” nervous system cannot sustain this pace without “burning out,” literally burning up the adrenals. This is what we as Americans are currently experiencing. Most of us are simply burned out. And, unfortunately, this is the standard we are spreading through much of the world.

Shake Things Up

We need something to catapult us out of this quagmire we have gotten ourselves into. This requires a serious shift in the way we do things. I believe we need to move away from short-term thinking and into sustained, steady, mindful living.

If you want to sustain power you must learn to carry it evenly for an extended period. And the more power you have, the more responsibility you have. You must be sensitive not to abuse that power, not to be “care-less,” which is the opposite of “mind-full.” I think one of the best ways to learn the skill of mindful living—including mindful eating, mindful relationships, etc.—is through practicing mindful movement, which is the essence of T’ai Chi.

Being mindful, sensitive, thoughtful, careful—these all mean pretty much the same thing. Paying attention to the details of a situation. Nurturing, growing, evolving. T’ai Chi is a proven method of training the mind and body (or mind-body) to be on the same page in their endeavors. T’ai Chi teaches the martial artist to resolve a situation using a win-win model. Instead of bullying the other guy until he agrees with me, I should practice a type of physical negotiation of energy and mass. And this process is as much mental as it is physical.

Negotiating a win-win position is the way to get the best results from any team or partnership. As Dale Carnegie once noted, “Someone convinced against his will, isn’t.” Bullies might win for a short time, but as people start to evaluate the reality of the relationship, they begin to get upset. They feel robbed or cheated, which can make them be hostile or uncooperative. Or maybe they just won’t put real energy into the end result—be it a work situation, a marriage, or an international treaty—which jeopardizes the outcome or relationship.

Mindfulness and the Body

So what does all that mindfulness have to do with the fate of America?

As a cultural whole, Americans are so dependent on power tools and labor-saving conveniences that we are losing the skill of using our bodies. Most of us no longer do the kinds of hard physical labor that previous generations were used to doing on a daily basis. Sweating in public is only sanctioned if one has the proper exercise attire.

But hey, isn’t it good that we no longer have to do all that hard stuff? Yes, it’s nice to have the option of saving ourselves from back-breaking work. But the simple fact is that most people in this culture no longer know how to move their bodies to do work properly. This is dangerous to our bodies—because we end up hurting ourselves, not to mention the host of diseases and conditions that are caused or exacerbated by bad posture and poor body mechanics—and it is dangerous to our future generations. The so-called Third World has got something on us: hunger and the ability and know-how to do efficient hard physical work.

Working with elders who lived through the Great Depression has taught me a lesson. A few of them were candid enough to say that they don’t think my generation could make it through another great depression. Do we have what it takes to work seven days a week, maybe without adequate electricity, heat, or water? Could we make our own clothes, grow our own food, provide our own fuel? Now think if these things had to be fueled with your own body’s power. You would have to know which foods could sustain that kind of energy expenditure. And if you think healthcare is unaffordable now, how much do you think it would cost if there were an economic crisis?

Wait a minute, you say, America is Number One. There is no threat of another great depression. For now, no—but how long will it last? Even if none of us witnesses a swing in the other direction, future generations will undoubtedly have to face this kind of shift. Let’s just say something like that happens 100 years in the future. By then it will be too late—we will have severed the threads of physical awareness by not passing on this information to our children.

It is awfully short sighted to focus our children’s evolution strictly on mental skills—how to use a computer, or a video game, or even a garbage compactor—without giving them a solid base in knowing the proper way to use the body. Observing history and humanity tells us one thing for sure: abundance comes and goes, and the human animal must be adaptable to change. We need to prepare future generations for using both the mind and the body.

The T’ai Chi Solution

T’ai Chi is the way back to understanding human movement, while connecting it to exercising the mind. It prevents injury and disease. It is great for any body, including those who are “disabled” or have little physical aptitude. It sharpens the ability to listen. And if you can listen to the early warning signs, you can catch a disease before it builds a home in your body.

Once you learn to listen to your own body and identify the sources of disease, then you can extend that outward. When you can really listen, you become aware of how anger, prejudice, racial insults, exploitation, and lack of education feed disease in our society as well as others.

Such listening skills lead us toward being proactive. If a storm is coming, one prepares for the bad weather. Old farmers and homesteaders knew about living this way. If they didn’t put up crops for the winter or cut firewood, they either begged or died. Being proactive in our time means educating the poor, seriously addressing environmental concerns, developing healthcare systems, and making wise financial plans.

T’ai Chi as a mental-physical training holds the key to mastering the essential abilities a human being needs to thrive on this planet. Understanding body mechanics, controlling the nervous system, listening to your body, nature, and others—what more could you need to make good decisions for yourself, your family, your community, and your country.

How I healed my own knee

Let me start off by saying that I did not tear any tendons or ligaments. But I did experience chronic knee pain for about 8 months.

The injury began at a gym when I was doing an exercise incorrectly. Plyometric jumping is a great way to increase explosive power. The drill I was doing involved holding a 10-lb. medicine ball and jumping one legged onto a 24”-high box. I jumped a few too many times and was getting tired. Instead of stopping I kept pushing for more. I didn’t really notice any significant pain until the next day. Of course I still worked out the next day—which isn’t a bad thing per se, but again I pushed myself too hard. This is a great recipe for injury. Now I know when to back off and not feel guilty about it.

A knee injury is particularly bad for a Tai Chi practitioner. The whole point of Tai Chi is to have root or stability. How can you be stable with a bad knee? And to top that, I teach 6 Tai Chi classes per week. The pain in my knee was real sharp on the bottom right of my left patella. I talked informally to a physical therapist who comes to my workplace. He said it wasn’t torn but sounded more like a repetitive motion injury. He suggested a few leg curls on machines, which I tried, but it didn’t really help much. I tried Glucosamine-Condroitan for 2 months. That helped some but still didn’t take it to an unnoticeable level. I then tried eating a lot of cherries, which are reportedly good for inflammation. That worked pretty well, but there was still a missing link.

It wasn’t until I spoke with a friend who is in her 30’s who has been diagnosed with early arthritis. She had a book that helped her called “Heal Your Own Knee.” I read it in a day, as it is very short. The author mentioned a term called “proprioception.” I had heard of it but didn’t understand how it was related to joint injuries. Proprioception is the body’s ability to sense where it is in space, basically physically feeling, not emotionally or intellectually feeling. The author of the book drew the connection to not feeling enough to compensate with surrounding muscles; thus one is overusing one part of the joint. One of the proprioceptive exercises I used is standing on one leg for a few minutes throughout the day. That sent me right back to Tai Chi as always. This was a huge breakthrough for me because I understood at once how those exercises were going to heal me. When you are wobbling on one leg it is a sign your joint is destabilized. First it needs to learn how to stabilize itself and then build stronger muscles to strengthen the joint. Secondly you are going to be more in tune with your joint through developing awareness, thus adding to the stabilization of your injured joint.

I progressed with those exercises to a book called “Strength Ball Training,” which has proprioceptive exercises for competitive athletes. There were exercises like standing on one leg and tossing a medicine ball from the right to left hand, as well as others in this genre. After practicing these, my knee began experiencing less and less pain during classes. I kept this routine for 3 months, about 3 days per week. I also stretched 4-5 days per week, doing daily Qi gong self massage and icing my knee every night. All these brought my pain down from an 8 on a scale of 1-10 to a 1-3 depending on how much I used my knee.

The supplementation I use is milled flax seeds with omega 3 fatty acids and Curcumin. Flax seeds lubricate the joint and Curcumin reduces inflammation. It is a great combination.

In this day and age where people are looking for that one pill fix, my pain management solution is a good deal of work. But in doing it I got a few surprises. One, healing yourself is an incredible boost to your self worth. I learn to look at every injury or sickness as a puzzle to be solved and enjoy the whole process of exploration. Most importantly I have a deeper understanding of my body, which is a valuable skill in itself because you never truly heal, you always negotiate. Negotiating involves listening to your body so you don’t make the same mistakes again. Lastly, to master Tai Chi one needs to link up and stabilize the joints. Be sure energy transfers without wobbling. This injury has been a lesson I have learned deeply. Tai Chi philosophy clearly states one should never jolt the body too hard. My injury proves that pearl of ancient wisdom.

One day after class

A senior student of Fong Ha asked a question.
It was in reference to the movie “Crouching Tiger Hidden Dragon.” The student wanted to know if there were secret techniques to teach that type of superhuman jumping as seen in the movie. Fong Ha looked a bit annoyed but the student asked again.

Fong Ha replied “What other miracle do you need, other than we are all standing here together, isn’t that enough for you?”

Qi Gong Lessons from a Retirement Community

Chapter 41 of the Tao Te Ching

A wise student hears the Tao and practices it diligently
An average student hears of the Tao and gives it thought
A foolish student hears the Tao and laughs aloud
If there were no laughter it would not be the Tao


This is a story that I have experienced through teaching Qi gong in a retirement community. It is a lesson about our own obstinacy.

There is an 82-year-old woman who attends my class—I’ll call her Franny. She is in top physical shape, with great posture, a clear mind, and a strong walk, though she is legally blind. She is a spitfire, is often very bossy, and usually blames others for her problems.

Franny has been one of my most loyal students, to the point of pushing the more sedimentary residents to come to class, sometimes even berating them if they miss. However, her daily complaint of my Qi gong routine is that it is “too easy.” She used to do vigorous aerobics and sometimes announces to the class how Qi gong is wimpy compared to aerobics. Many times Franny tells people what a great teacher I am, although she qualifies it by lamenting that I teach this “benign” exercise to old people. She also blames the other lame "inmates" for my "going soft" on the routine. Every one in the community fears her temper yet admires her physical prowess.

Yet she frequently asks me to correct her. Often I glance around as we meditate and see Franny nervously tapping her foot or hand, or moving her head half-heartedly. So my daily mantra during class is, "Listen to your internal energy," "Listen to your breath," "Listen to your heart rate," "Just listen to anything!" Although her external form is the best in my Qi gong class, and her posture is better than most with a military career, she is still unable to let herself go into meditation.

An important part of my class teaching is about moving from a balanced center. I explain that one fall for an elderly person can forever change the quality of their life. I go into great detail, demonstrating that simply reaching for a glass of water or answering the phone without moving consciously could be so devastating that you might never walk again. Elderly people must weigh the value of doing something quickly against the risk of falling. They must constantly ask themselves if rushing to a phone call is worth losing their ability to walk. I spend many one-on-one hours teaching Franny how to walk with a balanced center, especially since she is blind and needs to use extra caution. When in a group, she often laughs off what she’s learned, saying “See, my new ‘sexy walk’ Chris taught me!”

One day Franny’s bitterness and anger at the other “inmates” got a bit out of hand, and she lashed out at two other residents for petty reasons. The residents complained to the administrator, who spoke with Franny about it and told her that she was concerned that Franny’s anger was heading her towards a stroke. It was a legitimate concern, as excessive anger has been shown to push elderly people closer to a serious stroke.

Franny told me what the administrator said, and I knew that she needed some type of stress reliever as soon as possible. I took her to a local herbal shop where she trusts the owner, who spent time listening to her and then suggested an inexpensive bottle of Chinese herbal pill (total cost $4). The following day the administrator referred her to a psychiatrist, who prescribed a pharmaceutical drug that costs much more than the herbs. I worked with Franny on her breathing and explained how slow, deep breathing can relieve stress. Within a couple of days, four people had offered their help: me as her Qi gong teacher, the residence’s administrator, the psychiatrist, and her herbalist friend.

I returned to work three days later, and Franny immediately handed me the bottle of Chinese medicine, saying, “I won’t be needing this!” Her attitude was “This is who I am, I will not change.” She repeated it so many times I lost count. Later that day some university grad students arrived to give each resident a psychological evaluation test. I witnessed Franny’s responses, which were almost all extremely hard on herself. I have seen no equals in her physical shape at her age, and yet she still answered that she was mediocre at best. She was comparing herself now to herself as a young woman, an unfair comparison for anyone to make.

After the evaluation, Franny told me about her meeting with the psychiatrist. She reported that he said she is perfectly normal. (I suppose no one can know what he really said.) Then she berated the administrator’s assessment of her health, claiming the administrator was trying to gain control over her. In the meantime I spent hours talking with her, trying to help her cope with this long transition, yet she never yielded an inch.

Wednesday of the following week I went into work and was immediately sent to Franny’s room to take her to the hospital. She had fallen and broken her hip. But she quickly corrected me—she did not fall, she tripped over a wire in her room. It was the wire’s fault. The wire got in her way. There was subtle language happening. Blaming, not accepting. Tripping, not falling. Fighting the inevitable. She programmed her mind to deny the aging process by constantly changing terms, blaming others for her problems. She had stopped listening and sealed herself off from the inevitable truth of the human condition. On the way to the emergency room she constantly repeated, “I am not like those old people.” She could not admit that she was aging.

Franny’s hip has healed, and she returned to my classes. Still, she argues with other residents in class and insults people at nearly every opportunity. Sometimes her attitude makes me laugh out loud, but I know that her bitterness is only harming her and others around her. She is a lesson to me about how I want to age, how to accept the inevitable.

In T’ai Chi we seek to absorb the reality but then guide it safely away from us. If an energy comes towards us, we must communicate with it. This is the essence of Taoism. Most people fight energy straight on. If it is a bigger force, they lose the fight and that’s that. No dialogue. Aging is an energy, time and gravity wearing on our bodies. Taoists do not fight this process but instead speak with it, understand it, and yield to it. People who scoff at the Tao fight the inevitable head on.

Chapter 76 of the Tao Te Ching says,

“A man is born gentle and weak,
At his death he is hard and stiff.

Green plants are tender and filled with sap,
At their death they are withered and dry.

Therefore the stiff and unbending is the disciple of death,
The gentle and yielding is the disciple of life.

Thus an army without flexibility never wins a battle,
A tree that is unbending is easily broken.

The hard and strong will fall,
The soft and weak will overcome.”

Six Qualities of Mattie Cofer

While working as Activities Director for an assisted living facility, I became very close to a resident named Mattie Cofer. She was 100 years old, sharp as a tack, and fiercely independent. I knew her for only about a year and a half, but during that time she had a deep impact on my life. She died suddenly in May, just a few weeks short of her 101st birthday. I want to share some of the lessons that she taught me.

Humility: She was a devout Christian but was humble about her faith. She didn’t brag about being “saved,” rather she wondered if she was good enough for Heaven. She showed her humility through self-deprecating humor: “I am not worth a dime”.

Strength: Although she was 100 years old, Mattie had strong bones, the kind many 60-year-olds dream about. She spent most of her life working on a farm, and she thrived on drinking a lot of goat milk. She fell three times while living at the facility where I work. Only the last time did she break a rib. For someone who was almost 101, that is not too shabby. And her mental sharpness was exceptional even compared to residents twenty years younger.

Hard work: Mattie always said, “I worked harder than any man,” and she meant it, every word of it. She plowed fields, sewed her family’s clothes, taught generations of children Bible lessons, and was a longtime church elder. One of her frequent statements was, “Hard work—it won’t kill you!” She also ate healthy home-grown food up to the time she moved into our facility when she was 99. Yes, she kept her own garden until then.

Walking the line: Mattie said time and again, “You got to walk the line, Chris.” Her constant advice helped to keep many people straight. In fact, she walked the line so well God probably hired her as a crossing guard in Heaven. She would even say that preachers are not any closer to God than anyone else and that if anyone tells you they don’t sin, they are lying.

Fun: Mattie thought that having fun is good. She was a jokester, with a sarcastic kind of humor born of the Great Depression. She made fun of herself and anyone else and didn’t keep things too serious..

Teaching: She felt that it was a great service to be a teacher, in order to better the community. She was a spiritual mother, a great teacher, and a church elder. She helped others by her presence alone. She was one of those rare individuals with that inexplicable gift. Now that she is gone I miss her more than I can say.

As human beings age, we naturally conform to the ideals of T’ai Chi. The way energy flows through the universe: Water finds the lowest places, what goes up must come down, yielding is the way of the universe, we should observe nature and work with it, not against it. In living these principles, Mattie Cofer was a fine T’ai Chi master.