Does It Matter?

On Acupuncture, Doppelgängers, and the Contemporary Existential Dilemma

*This is a slightly edited version of the essay I recently wrote for the Winter 2024 issue of Medicinal Roots Magazine. 

Dedicated to my friend and classmate John Simmonds, L.Ac., a wildfire trapped in a human body, brilliant and wicked. 

In January of 2020, with the impending American election in mind, I wrote an article for Medicinal Roots Magazine about how I imagined “2020 may be a challenging year” for our patients which might require us to flex new clinical muscles and perspective. I titled the article “Acupuncture 2020: Rising to the Challenge of the World on Fire.” In January of 2020!

This was either a bit of prescient genius or completely moronic dumb luck, depending on how much credit you give me. I, like everyone else, had no idea what was coming.

Four years later, here we are. On the precipice of what will surely be another agonizing American election year; four years after the bang of the pandemic, and the resulting Surgeon General medical advisory about the public health crisis of loneliness and disconnection. Amidst more political upheaval–mostly portending the rise of global fascism–the least of which is a series of truly wrenching massacres and war whose divisiveness is pulling apart what little cohesion was left of the world. The center is not holding, and we all know it.

And yet we are still asked to do our work: to make pain better. To put our fingers on the pulse of our patients–to diagnose disease–and then to help people feel well, a concept which at this point feels entirely insane and archaic. What has become clear over these last years is that the disease which needs treating is all of it–the capitalism, the sexism, the racism, the imperialism, the digital existence of manufactured reality, the relentless onslaught of demoralizing bad news. The pain is this modern life.

If you are a practitioner who is even halfway paying attention, it is all too easy to lose hope and meaning. To doubt if the work we do even matters. It is the question I am always asking: what is acupuncture’s place, not just in the world, but in this world–in 2024– whose institutions are more fragile and rotted than we could have even imagined a few years ago, and the despair so palpable? Of course ameliorating pain, even on the smallest level, is helpful; but of all the modalities, of all the systems of health, why acupuncture, now?  I think about it all the time. I hope you do, too.

I am happy to report that having practiced and taught through these turbulent years, I am more convinced than ever that acupuncture–and its foundational principles–are medicine for the existential wobbliness of our times. But only recently have I come to understand their fundamental significance beyond just mere painkiller.

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Social activist Naomi Klein released a terrific book last year called Doppelgänger whose title refers to the mythological, literary, and psychoanalytic concept of the “mirror duplicate self”; an inverted anti-self which represents one’s hidden, rejected, and repressed parts. Klein’s book dismantles doppelgänger stories–Jekyll & Hyde, Jordan Peele’s Us, The Portrait of Dorian Gray–and applies their themes to digital existence and global politics.

All the great writers (Shakespeare, Le Guin, Butler, Poe, Taylor Swift–yes, I said it) feature them: a protagonist who is, without warning, confronted by a distorted twin–the same but opposite–causing her to re-evaluate what she knew to be true. The double produces a menacing panic and vertigo (à la Hitchcock’s film about the subject), but simultaneously offers a new perspective and reckoning both for the protagonist and reality itself.

Freud speculated that the figure of the doppelgänger recurs in culture because the idea of duplicate selves stands in for the vast potentialities that our lives hold, and all the possibilities to which our imaginations still cling and hope to remember or integrate. The appearance of one’s doppelgänger, Klein suggests, “means that something important is being ignored or denied....and that further danger awaits if the warning is not heeded.”

I have come to see that in addition to treating modern anxiety, acupuncture–the philosophy and perspective we commonly refer to as “Chinese Medicine”– functions as the doppelgänger to the disease of modern life.

Regardless of specialty or school of training, all acupuncture holds an upside-down mirror to the inescapable tenor of modernity and is fundamentally a critique of contemporary existence: the sheer act of "pinning someone down" in silence, stillness, and rest is a commentary on the normalization of stress and exhaustion.

Acupuncturists are an argument against the manufactured, capitalist expectation that every nanosecond be productive, self-improving, and profitable. We are a denunciation of the culture that has assigned productivity, velocity, and utility as the only commodities of worth. We are a reminder that there was a time before everyone held mini computers–containing all the known information in the world–three inches from our faces, and then wonder why no one can’t sleep.

As with all doppelgängers, our presence represents potentiality; a parallel but countervailing viewpoint to how deranged and sick the modern world has become:

• Where the dominant attention economy trades in distraction, numbness and disassociation, acupuncture demands presence and embodiment and reframes them as purposive and foundational to health.

• Where grind culture views “rest” as the exclusive domain of the lazy, useless, and unsuccessful, acupuncturists deem it necessary, meaningful, and not a litmus test for one’s humanity.

• Where capitalism views sickness as a temporary aberration–relegating care to short-term imposition or extraneous work awaiting completion–we recognize the reality of chronic illness and the aging process, acknowledging that care is never “done”

• Where conventional medicine views health as something exogenously and efficiently performed on or injected into you, we frame healing as self-generated, paced, and personal.

• Where modernity can only see through limiting lens of anthropocentricism and human cycles of time, we embrace non-human centric perspective, which includes the totemic intelligence of seasons, plants, and the Earth itself.

• Where modernity prioritizes information, certainty, and didacticism, we prioritize mystery, unknowing, and awe. Acupuncture, like poetry and dreams, is a reminder that things don’t need to be understood to be felt.
  

Klein concludes that doppelgänger narratives typically resolve only when the protagonist surrenders to and embraces her double, shedding the separateness between them, finally seeing herself clearly. “What began as a form of self-defense becomes a form of self- release,” she says. Recognizing our double existence–even with a distorted, vertiginous twin– can quench our deep desire to connect, to enmesh into others, and to feel the edges of the self dissolve.

And what do we do, as acupuncturists? Precisely this.

The act of piercing the skin with a needle is about breaking through the imagined boundary between what is outside you and what is inside you. Where the skin acts as the impermeable barrier we all believe is holding us apart in our individual separateness: the acupuncture needle shatters right through it.

Acupuncture declares that there is no difference between everything you think you are and everything you think you aren’t: “there is no you, and there is no me. There is no wall between us. We are all one thing: the curiosity of the universe, given life.”

In suturing together self and other, acupuncture is a metaphor for unification, interconnectedness and wholeness. Its unspoken goal is the same as any doppelgängers’: to break the spell of confusion; to resolve the disconnection most of us have adopted as a default setting and to experience oneself as an undifferentiated part of the interdependent universe.

To fall back into the tide of unmediated kinship and shared fate with each other and all living things.

For my patients who are entrenched in capitalism, white supremacy, and the myth of individualism, the perspective of Chinese Medicine can be destabilizing and threatening, like all doppelgänger nightmares. And for them, I am glad. I hope it tears their reality apart.

They need more than medicine. They need new eyes. They need to see themselves through a distorting mirror. For what ails them, the only earnest healing must be foundationally anti-capitalist, matriarchal, non-Caucasian, and predate the Age of Reason. This is why acupuncture matters today.

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I think about the hopeful and open-hearted version of me who wrote that essay four years ago. I don’t totally recognize him. The person who writes this one is different: he is frustrated, humorless, isolated, nihilistic, and despairing. A doppelgänger took the old one’s place. I am fled down by another me.

The years of grief and compartmentalizing horrors–including patients being openly homophobic on the table while I tended to their pain–bore someone new who gave up on poetry and depth; who insists that words are meaningless and all “content” is garbage (even now he is shouting that I should put down the computer and go back to doom-scrolling on my phone.) He doesn’t believe healing pain is real and secretly thinks Instagram dopamine is the only substantive anodyne. When he puts his finger on our patients’ pulses, his diagnosis is always the same: “Nothing matters; acupuncture won’t help; everything is devolving.” I feel the vertigo. Maybe you have, too.

But on some quiet nights, I choose not to fight him. I take Klein’s advice: I soften to his rage and hopelessness. I break the skin between us and let him in.  I recall why he is here: to reflect me back, that I may see myself clearly again. His distorted mirror re-members me: it sews me back to my softness and openness. I exhale. I need acupuncture like everyone else.

There will no doubt come a day soon where the news will be so impossibly grim and the collective pain so overwhelming that you will fall to your knees and question why you should even bother. A dark, twin voice in your mind will doubt whether your work matters at all.

I hope when that day comes, you will be tender and permeable to the world, and find that, somehow, the meaningfulness and curiosity that led you here is still alive in you. I hope you will meet the despair as a spur rather than an anchor. The point is not to drown; it’s to learn to breathe underwater.

I love being an acupuncturist right now, in 2024.  I love it more than I ever have. I forget that more than I ever have, too.  I need reminding. We all do. I am so thankful for the perspective and poetry our medicine has brought to my life; and so proud to hold its upside-down mirror toward the impending darkness for my patients; to grip it with both hands and watch its refracting light radiate out in every direction.