Discovering the Benefit of Traditional Chinese Medicine for Pediatrics

An Interview with Dr. Stephen Cowan

Stephen Cowan, M.D., F.A.A.P, is a board-certified pediatrician and certified medical acupuncturist with more than fifteen years of clinical experience with children. He is a fellow in the American Academy of Pediatrics (AAP), a member of the AAP Section on Child Development, and a member of the Autism Research Institute's Defeat Autism Now practitioners. He cofounded Riverside Pediatrics and is a member of the Center for Health and Healing of Northern Westchester. Dr. Cowan specializes in pediatric problems such as ADD, autistic spectrum disorders, migraine, Tourette's syndrome, asthma, and allergies.

Harmony: How do you view the convergence of Eastern and Western medicine?

Dr. Stephen Cowan: I think about it in terms of bridges and this whole idea of what bridges mean. If you think about how you build a bridge, at the beginning it's a little unstable. You have to start at two sides, and they don't have anything holding them up. It takes the very final point to get to a connection. So there's a little discomfort initially from both sides when you start encountering each other's views of healing.

Yet our whole history is about bridges. The primordial bridge we have is the umbilical cord that links us to the mother's energy. The heart is a bridge; the lungs are bridges to the outside world. Western medicine studies these all the time, though it doesn't necessarily frame them in those terms. If you look from a cellular point of view, all the cells in your body have bridges. They don't just go from the outside to the membranes, they go from the insides of the cells, communicating with each other—a very Taoist principle, as far as I'm concerned. And so there's this idea of two sides connecting that is this concept of "bridge." In Chinese philosophy we think of it in this form, which is a more organic form. In fact in Chinese medicine we think of the connection between heaven and earth as the human, as the bridge between the two. This is a very basic principle, but it's very important. Even the psyche and the soma, the shen [spirit] and the jing [energy-essence], are bridged by this amazing phenomenon we call Qi [life energy]. In Tibetan medicine and Buddhism the idea of blessing is this concept of transformation. Building bridges is about transformation and the blessing that happens when things transform. And that can only happen if you walk a bridge.

Harmony: From your perspective, what is a barrier to Western practitioners accepting Eastern medicine?

SC: Qi is one of these ideas that blows the mind of Western doctors because they don't know what to do with it. They want to hold it; they want to dissect it; they want to handle it. After years of watching my colleagues dismiss it or not understand it, I came to understand that Qi is not a noun, it's a verb! And you can't hold a verb; you can't dissect a verb. We get into this problem over and over in the West, of thinking that if you can't hold it, it doesn't exist. When I've taught Eastern principles in classes of Western doctors, I've watched certain people in the audience open up once they recognize or experience Qi in some form.

Harmony: How do the principles of traditional Chinese medicine (TCM) inform your own practice of pediatrics?

SC: I'm taking the path of how the spirit of TCM can enter into clinical medical practice. I work with developmentally disabled children, and I do acupuncture and other modalities with them. Working with children is an amazing experience because they are little bundles of Qi. They're constantly transforming right before my eyes. Once I understood these principles it was very obvious for me: I was constantly being a witness to this miracle, and in fact, every phase of their development is a bridge to the next stage. When we start thinking in terms of verbs instead of nouns in medicine, it changes our whole way of thinking, so that our lives recapitulate this concept of bridges, of transitions, of transformations, from one step to the other. I'm very interested in that in terms of child development.

When I started out in pediatrics I was really excited. Here are these amazing, miraculous babies that I'm dealing with, and I then was taught to treat them like they're these little machines that if I just know the right part, I can fix. In our Western model we get into this very disappointing assembly line mentality of all kids are the same and if you can just see where the standard is off, you can fix that, or that's your challenge to fix. And that doesn't quite fit because they're not all the same! It's a reductionist idea that we can standardize human worth, expression and personality into one kid who is the ideal kid. You see that there are Wood types, Fire types, Earth types, Metal types, and Water types. When you explain it to parents their heart opens up. They become more tolerant because their kid doesn't have to be just like them or like some standardized ideal. And when you open that heart of a parent, your job is done basically. Parents are the medicine for their kids. It's not about a pill; it's about the parent being present. Chinese medicine has shown me there is the connection—that bridge—between the child and the family, or the home.

So I began to get very interested in one of the principles in Chinese medicine, which is, you're treating people, not organs, not diseases. The danger of Western philosophy is that if there's one generic kid then there is only one generic treatment. It certainly makes it easy for pharmaceutical companies to sell one product that fits all. But to me, you get the most diluted level of treatment that way. This approach is based on the work we did in the West which is basically work on dead people to understand living people. In Chinese medicine that makes no sense at all. Qi is a verb—it's moving, it's alive! It's constantly, actively reinventing itself, re-nourishing. And it's not just in me, it's not just in you, it's everywhere. In Chinese philosophy this is what's embodied in the concept of the Tao—this movement, the Path. The idea that nothing is fixed in time or space. And that's what intrigued me, what drew me in. I'm very interested in that clinically in my practice.

This is what Chinese medicine taught me in terms of how to look at a patient. I started thinking about development more in terms of streams of development, with an origin and where things change. It's on a path; it's traveling. If you take a snapshot of just one moment, that doesn't tell you much about the nature of the stream. It's the interaction, that bridge in the encounter, that's alive. If you are present for that, it's a whole different story. Essentially I'm really talking about being present with your patient. If you can be mindful when you're there—I believe, because I've experienced this—it's the actual paying attention that has a healing power. It has a power to change and alter the course of events. Chinese medicine really does stress that. It really brings it to the forefront of the whole power of healing.

And so for me the question really becomes, can you be the bridge to your patient? One of my teachers always taught me that the acupuncture needle is really just the bridge between you and your patient. In some ways I get more from these experiences, I think, than the patient sometimes because to me, children are my Qi source. It's not like I'm treating them or they're treating me, it's this bridge. It's all about walking the bridge and taking that chance of really exploring something new and opening yourself up to something. Chinese medicine has the capacity to think outside the box so big that if you can infuse it into your practice or your work with children you can make big, big changes.

Don't miss Dr. Stephen Cowan at the 2006 Building Bridges Conference! He will be a highlight among many engaging, insightful and cutting-edge TCM and Western speakers. The 2006 conference will be held October 6–8 at the Sheraton Meadowlands in East Rutherford, New Jersey, easily accessible from New York City. For more information and to register, contact the Traditional Chinese Medicine World Foundation at www.tcmconference.org or call toll-free at 1.888.TCM.6909.