Office Hours with Angelique and Toby, episode 8. Released August 20, 2025. 33 minutes.
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About this episode
Angelique Britt has just made her first home visit as an acupuncturist, after years of visiting nursing, and she shares what seeing a patient's home and family added to the picture. She offers practical precautions from her 17 years in nursing: a closed hard-plastic kit, a clean barrier under your equipment, asking before you set things down, packing light to protect your body, and paying attention to exits and your instincts about safety.
Toby Daly and Angelique then discuss how a nursing background helps her spot Western red flags, a Saam treatment she corrected in real time when the patient showed signs of distress, and how a patient seemed to brighten over sustained treatment. They close with what acupuncture schools could do better: more hands-on pulse training, diagnostic practice, clinical experience, tasting and handling herbs, and learning by doing.
Topics
A first acupuncture home visit
Home-visit kits, hygiene, and body mechanics
Personal safety on home visits
Western red flags and when to refer
Correcting a Saam treatment in real time
Changes over sustained treatment
What acupuncture education could do better
Orthopedic needling training and summer interns
Key terms
Saam acupuncture (舍岩): a Korean Buddhist monastic acupuncture tradition that treats imbalance on one channel system at a time, using combinations of the five transport points.
A note for listeners: this is a conversation between licensed practitioners, offered for education, not as medical advice. Patient details have been kept general to protect privacy.
Transcript
This transcript was generated automatically from the published audio and lightly edited for readability. It may contain errors in names and terms.
Welcome to Office Hours. Whether you're new to the acupuncture profession or have been at it for decades, this is the place where we discuss all things Chinese medicine and more. Join Toby Daly, a seasoned acupuncturist of the Saam tradition, and Angelique Britt, a nurse-turned acupuncturist who is brand new to the field as they explore topics in and around the world of acupuncture and Chinese medicine. There's something for everyone here. Drop in anytime. Welcome back to Office Hours, Toby. How are you?
Toby: Everything's going well with me. How's everything going with you, Angelique?
Angelique: Pretty good today, I would say. I did my first home visit today as an acupuncturist. Great. Yeah. It was nice. It went well. It went really well. It was a patient that was post op for a total knee replacement. And it's someone I'd been seeing at the clinic for a while now, a few months at least. And wanted acupuncture post operatively. So it brought me back to my visiting nursing days very much same vibe.
Toby: How did that how did that go?
Angelique: Being able to go in someone's house and honoring the privilege, like I really find it's it's a privileged place to be invited into someone's home, especially when they're vulnerable and in bed and, you know, not feeling all that well and being able to provide.
Toby: Yeah. Yeah. Did you do you get any special clues seeing that help with your diagnosis when you're in the patient's home? You know, usually we see them isolated, they just come by themselves. You got to see the whole house and the neighborhood and everything like that. Did that help with your diagnosis as well?
Angelique: From a Saam perspective, yes. Being able to see where they are and the things on their walls and what they paid attention to, and just listening to them interact with their family members. It was interesting. It was reinforcing of what I already knew about them. But yes. And that's what was great as a visiting nurse, too, being, you know, going into someone's home and being able to see them in their own environment. It's like you'd meet them at the hospital sometimes, and then you get a better sense of the dynamic and how to approach the people in that way. So it was it was interesting.
Toby: I was thinking about yeah, in the hospital, right? You only see patients like in the hospital gowns. You don't even see like the clothing or anything, right? So that's really isolated from their environment. So that's interesting, right? In their home with their family members, with the regular clothes and everything, and neighborhood. You can know a little bit about the neighborhood. I think that's again, that's valuable insights for us.
Angelique: Their pets and all of that.
Toby: How did your treatment go and what did you do when you had the needles in?
Angelique: What I did when I had the needles in. So I took her cue. I did a TCM treatment, not a Saam treatment. I've done both for her before. And she has she has sometimes requested it and other times been like, I don't want that today. And so I did a traditional like qi and blood building TCM, like qi stagnation moving treatment and listened to her. She basically cued me in a in a polite way to wait in the other room, you know, just by describing the space that her partner had prepared for me to sit. So I just hung out and waited and looked out her window and read some stories in the news, which I probably shouldn't have done. And then when she was done, I went back in and took her needles out and talked with her for a little while and then went on my merry way.
Toby: It's really nice. I done a little bit of house calls myself and I really enjoy that kind of interaction, right? And anyways it just feels like a little bit I don't know, just a little bit more special rather than in your clinic and the patients are just coming in and out like to actually go to see them and your soul focuses them. It's just a little bit special. How long did you do home nursing?
Angelique: Over the course of my years seventeen. So quite a few.
Toby: Any s any skills you think it would transfer over if acupuncturists want to do house calls, anything you'd really recommend for them?
Angelique: Yeah. Let's see. Cause some of the things I don't think they become so second nature. I would say, well, always make sure like if you're gonna bring a table, if you have to bring a table or not. So I was fortunate in this case that she was going to be in bed and she felt comfortable there. But making sure that you have a barrier to put down. So I know we learn clean needle technique. We have to use they taught us to use a paper towel. In visiting nursing, it was the same as having a barrier to put your things down on because you're in someone's home and all kinds of things can be in people's homes. So Including like bed bugs and things that you don't always think about or see, but that can definitely hitchhike. Having your kit, like having a kit that's a hard plastic kit that can be closed that you have exactly what you need, and asking the patient permission before you put things down or where they would like your things to be, just being respectful of the space. And then either asking directly or getting a sense of where they want you to be during that period of time. That was new for me. I wasn't quite sure what I was gonna do. I thought like maybe I would sit with her. Like I wanted to be able similar to in a clinic, I have a I have a call button that I give to folks. They don't they're pinned down, but I don't want them to feel in prison. You know, they can't move their they're without help. So they have call buttons. And so in home setting, was like, I don't know, maybe I'll just sit with her. But when she was like, and you know, he prepared a nice place for you out there. And I was like, Great. When if you need something, are you gonna holler? And she's like, and have a whistle too. It's like great. So I just I just went and sat at her kitchen table. So yeah, just like thinking of Thinking of things like that. And if folks don't make me bring a table, I don't charge them as much. So there's something else that's like incentivizing because it's a lot. I mean, I have a lightweight table, like the tables I bought from my clinic are portable, but they're still quite heavy. No. And so if you're doing a lot of home visits, there's going to be wear and tear on your joints. Like doing visiting nursing, I had to downgrade to a smaller bag and be very selective about what I took with me because these they had these giant luggage like Bags on wheels they wanted us to take with us and but putting that in and out of my car. I had I had epicondylitis, you know, like on a semi regular basis from having to lift it in and out. So being mindful of like body mechanics and things like that. Yeah. Off the top of my head, those are the quick tips.
Toby: I think that's helpful. What about in those seventeen years? Any really amazing things being in people's homes, anything that stands out?
Angelique: Such an open ended question. So doing hospice nursing you s you see a lot for better or worse. And I guess I would need some more specifics of what you're looking for to answer that question. Like from a clinical way or way people live or what?
Toby: I think just people more relaxed in their own environment. So do they, you know, i it was something, you know, really revealed, people are more relaxed and so they told you something they wouldn't tell you in clinic or anything like that? Maybe not.
Angelique: Well, in an home visits, I mean you meet people the first time you meet anybody, I think everyone's on their best behavior. And I think what's different in a hospice setting is that you're entering in crisis. And so that's out the window pretty immediately once you're in a home setting and you're coming into the home. And a lot of times I have found that folks regarded upon initial visitation because it was this new scary. We're admitting that death is coming and these people are coming into my house and we don't know them and there's It depends. Like I've had people warmly welcome and I've had others be very guarded. And I think in general, there's always somebody who's a little bit more guarded and protective in that way. But coming into the environment, you know, they can present one way in the hospital. And then when you see how they live, it's very different. So very, you know, well put together people in the hospital. And then you go to their house and their house is in complete disarray and there's way more people there than you anticipated. And there's, you know, a million animals or, you know, or vice versa. You have some people that look a little disheveled in the hospital because they've been going through it and you go to their home and it's like this immaculate place. Family dynamics are always really interesting. So when you're you're going into a person's home, it's like kind of getting a sense of where everyone's at. And also just for your own personal safety. So just making sure that you know you know where exits are and you listen to your instincts about when things are unsafe. Like there was one point when I was visiting somebody when there was a fairly aggressive family member that was kind of really coming into my bubble a little bit when I was trying to do some education and I basically like kept backing up toward the door toward the door and then finally I was like I can't stay here and I left and I called my office. Yeah. There's you know so just if you if you get a sense that you're in someone's home and things are closed up, like just kind of like know where you are and don't position yourself in a way if at all possible that you can't get away in case things go sideways. I don't anticipate stuff like that happening in an acupuncture setting, like coming to do acupuncture, but In that sort of heightened crisis time, people's emotions get the better of them sometimes and not everyone's super predictable.
Toby: So yeah. And that's that's a good point too. You may know the patient well, but then the family members, right? A whole new variables after going to people's homes. So yeah. That's interesting.
Angelique: I would say if your spidey senses are tingling at all when someone asks for a home visit, just don't do it. Like we have that wiring for a reason. If you're freaked out in any capacity or like maybe I shouldn't, then just don't explain that you can't or you don't have availability or whatever feels proper. Because I think we all are wired to tell that sort of thing.
Toby: I wanted to check in with you how your nursing brain and your Chinese medicine brain are getting along.
Angelique: I mean, they're they're, you know, they still tussle from time to time. I think I'm I'm becoming a little bit more comfortable in the Chinese medicine brain realm. I find myself thinking a little bit more in that way, primarily for certain people. But if I see red flags from the Western side, it still comes up. But they're no they're they're get they're getting along for the most part. Occasional tussles, but getting along.
Toby: Any examples of any recent tussles?
Angelique: Yeah, there's this the one patient that I that I've been seeing for almost since the inception of my practice. And they have very a very damp presenting person the in the PSOM way. They are lung excess, so they're insides very moist and their outsides dry a lot of the time. But the internal damp sides are pretty the signs are fairly significant and they also present with gallbladder excess quite often. But they have this symptom constellation, which really makes me worry about a neurological condition. They have these fatigue episodes that come on all of a sudden and they're they're down for the count for a few days and they have it coupled with brain fog and things that we would think of like brain fog, lethargy, heaviness. It's like a combination of qi deficiency and dampness. But I'm like, I want you to see a neurologist, you know, because I'm just like, this doesn't sit right with me. And so I've brought it up to them a couple of times and I've told them that like the last time was the last time I was gonna bring it up, but I was concerned clinically as a nurse that there might be a neurological issue just because of the way it was presented.
Toby: Think that last time saying something to him, do you think they're gonna go or you feel like
Angelique: I don't think so. Yeah, I kind of think it was on deaf ears. Yeah. And I don't want to be that person that's constantly being like, go to the neurologist, go to the neurologist, you I'm pushing my own agenda. You know, again at the end of the day, people have the right to make whatever decisions they're gonna make.
Toby: On deputy. It feels like as a healthcare provider with your experience, right? That's some real valuable advice. So yeah, again, patients can take it or leave it, but I think that's that's nice to at least let them know what you're seeing. Didn't sound like a tussle. It sounds like you're really able to flip the lenses back and forth, right? The look through the w western lens for red flags and then flip over to Chinese medicine lens. Do you do you really feel like that was a conflict or you feel like you're you're smoothly moving between those lenses?
Angelique: It felt like less of a tussle than in previous conversations with this person because I was feeling a little bit more urgency around the need for Western intervention. And this time it didn't feel as urgent. And they're open to some herbal medicine as well. So I'm gonna be working on a formula for them. Maybe it will help. I don't know. I just don't want to see them in a degenerative place and not have what they need. And there's also this piece that I think is the most I guess it's not like a tussle, it's just there it's I don't know if it's like old nursing trauma or whatever, but they train us to recognize and document to cover our rears for everything. And so it's like we're trained to look for things that are problematic and know to delegate upward, you know, to the doctor, being able to, you know, and so finding like, did you do this? Did you do this? And I'm trying to think of another example and I can't at this moment, but just when you when you see certain medical things, like maybe with like Patients with diabetes and like feet. Like I always check feet to make sure they're all right. Cause sometimes folks can't feel their feet and then things get lodged in their feet. Or if I notice that there's a skin integrity impairment in their feet, like I eyeball that on a regular basis and I make sure that I check it. Like there's just there's certain nursing things that I just do. And I guess it's not a bad thing per se, but I it comes it comes from a place of due diligence just to making sure that I've checked all of the right things. Like for example on this patient, like I checked her petal pulse. On her operative leg to make sure she had a solid petal pulse and that she could wiggle her toes. You know, it's a CMS check circulation. What's CMS stand for? God, circulation, motion, and sensitivity, I think. Where you check and make sure that everything is, you know, they've got good circulation that they can wiggle and they can feel everything. And so I did that. And that's not a Chinese medicine thing. That's a nursing thing, but I
Toby: Value that sounds like value added.
Angelique: I think so. Yeah. I guess maybe I just change my mindset about it. It doesn't have to be an either or, it can be a both and. Yeah.
Toby: Anyway, it's it sounds like from those examples, it's it sounds like it really is, like I said, smoothly flipping from lens to lens. Yeah. I think that's great. What about anything else interesting going on with you in the clinic, the last week or so?
Angelique: Boy. Yes. Yes. Let's talk about a case of wrong treatment. So I am about, I don't know, I would say half my treatments now are Som. I'd say roughly half. And so this is a patient that had been coming in initially for they had broken their fifth metatarsal and they had sprained, they had a eversion sprain with a broken bone in their foot. And so they had come in for treatment. Just to help speed their recovery. And then they recovered from that. And then as soon as they recovered from that, they developed lateral epochondylitis from overuse. So when she came in this week, I was telling her about PSOM and how I would really like to try it. And she said sure. And telling this to you, it's going to seem capped and obvious. Like, why did you why? But I'm going to tell you how it is anyway. So this person has a spleen body type pain localized at small intestine eight. Although there were some areas that she had in the lung three, four area and also right around, like heart three. Definitely having hot flashes, but they come in spurts, so she wasn't currently in a hot flash phase, feeling so tired, just so tired. That was one of her other main issues that she was coming in with, just like her energy. She's requiring 10, 12 hours of sleep to feel good. When she gets that, she does feel well, but she hasn't felt energized in quite a while. I would say. She doesn't have a super symmetrical face, but it's not super asymmetrical either. No varicosities, very smooth medial heels. And she was also complaining of some shoulder pain. And when she grabbed, it was in like the SI 1415 area of the shoulder. And sounds like a small intestine excess person, right? Yes. Guess what I supplemented though? Small intestine. Because I was like, it's gonna help all her sites of pain. Like maybe this will be fine. So this is one of these people that's one of those super responders to acupuncture. And I love these people. I wish I could have them all. They're amazing. I love it. I learned so much. So I told her, you know, I put the needles in, small intestine. And I checked in with her and I and her eyes were huge. And I was immediately I was like, no. So I checked in, I'm like, how you doing? And she's like, you know? She's like, my shoulder got real tight. And I was like, okay. I was like, how you feeling on the inside? Is it you feeling like you're able to relax? She's like, actually, I'm feeling like a little bit of flight and flight. And I'm like, okay, here's what we're gonna do. We're gonna take those needles out. So I took those out and then I supplemented kidney on the other side. And she's like, as soon as I took the needles out of the small intestine supplementation, her shoulder relaxed. And then once I got the kidney needles in, she said that she immediately relaxed. And then at the end of treatment, the pain at SI eight was much, much less. So yes. So I it's really funny because when I was looking at her, I was like, I should supplement kidney, but then I was like, no, it's not I was talking myself out of all the reasons why I shouldn't. And I learned. So that was neat. But
Toby: Anyways, y you had you had symptoms and signs on both sides, small intestine and kidney. So why do you feel like it was so obvious that it to supplement kidney?
Angelique: It wasn't I mean it because she was a small intestine excess person, I think. Like if you whenever I when I consider the Som channels, I literally picture scales and all of the signs for small intestine were like weighing higher than kidney. Sure, she was on the small intestine channel, which could have been either, but just like her face being really neither Like leaning more toward asymmetrical versus symmetrical. Do you know what I mean? Like kind of an average face, absolutely no varicosities whatsoever. Very smooth medial heels. She's a warm person, like she didn't have the psychological self loathing necessarily that a small intestine access person would have that I'm aware of unless she's masking really well. But it just seemed that those things seemed a little more obvious to me after I needled and she was like them.
Toby: For kidney excess, the heels are good and smooth. So that's a kidney excess.
Angelique: That is a kidney excess sign. So okay. I guess I can be a little more relaxed with myself. Yeah. That's a little bit more mixed. Okay. See in my mind I had mixed up the field. She's in her late thirties.
Toby: Yeah, that's a little bit more mixed. Yeah. Yeah, so that's the again the age and the heels i that's a little bit hard to make that call actually.
Angelique: Yeah. So I tried a thing and then it didn't work and then I tried it and it worked. So that was the first time 'cause the last time I did the treatment that did not go well, she went home and then I had to correct it the following week when she came in. So it was actually interesting to correct it in real time. Yeah.
Toby: Yes, it's it's so rewarding to do that, right? Be and then and then you can recognize from the eyes open, the report from the patient, right, that's definitely the wrong direction. Sometimes even the presentation's mixed. The pain's gone, but the eyes are open. You sometimes that's mixed, but that was that was clearly you started her down the wrong path. So that's recognizing.
Angelique: And her face, she got super red in like three spots on her face specifically, like on the apples of her cheeks and her chin got super red. And then once I took the needles out and I put the kidney points in, it evened out. She got pinker in those areas. So that was also really cool.
Toby: Yeah. The tradition says that what happened then it's nice to see that too. So that's good.
Angelique: Well, that's when we have talked about the we've talked about the face. That was where my tunnel vision had been, you know, on was just the complexion. And now I'm looking at people slightly differently and seeing what else. And to that end, what's interesting is that there's another patient that I have been treating against for a long time. She comes every two weeks pretty reliably. And she was so he she was one who I thought I would never be able to do some on because of how needle sensitive she was. But I kind of talked her into it, kind of selling like the potency of the treatment and really hoping that it would work for her. And so I she allowed it. She's one that will put numbing cream on the points. Like she'll anticipate where I'm gonna put stuff and she'll like pre-numb her skin, even when I was using sarens, just from just not liking the sensation. I use the 40 by 30s with her and I did I've been using Som with her exclusively now. And she is somebody who came in like with a very liver excess face. And I mean like A darker comp like her complexion was just sort of darker, her eyes were very like dim. She was always prompt for appointments, but very direct to the point of being rude, you know? And she's so much more pleasant now. And she's brighter. Like her affect is just brighter. Her face is brighter. I mean, I feel like I don't think the sim she just seems I'm always loath to say this, although it's how we teach it, right? But she's like her face just seems more attractive. Do you know what I mean? She just seems different. And I didn't correlate that to the treatment until after we've had these discussions about face. So that has been pretty interesting watching that happen. Her eyes are brighter, like they sparkle different. Like it's just the whole, the whole thing. Cause I had noticed, I was like, there's something different about her. Like, what is it? And I was like, my God, her like whole face is just more of a beacon instead of being this like inner sort of guarded individual.
Toby: Did the patient or any patients around the like family, friends, they notice anything different with her? Because sometimes I like that, I feel like that's that's a true report, right? If a close family member starts saying, not knowing anything about acupuncture or psalm, your face is so much more bright or warm or open or something like that. Did anybody give that patient any feedback?
Angelique: Not that she shared openly. She mentioned that her friends told her that she looked better. Like that she just looked better. Like specific to the face. Yeah. But interesting.
Toby: I was gonna ask you a transmessine school question, can I? Okay. If you were gonna if you were in charge of redesigning a Chinese medical school, anything or two things that you would really change now that you're a little over a year in, right? Something that if you could put back into the school that you would like to have gotten anything?
Angelique: My answer, I guess, is a double edged sword. So the pace is really fast. And although I am grateful to have gotten it done in three years, the pace is really grueling. And I don't think you get enough time to really work with the medicine on a level that is helpful. And I think we graduate being largely insecure in our skill sets. Like knowing that we can we can do the thing, but we're not like I think there's a weakness in diagnosis and I would love to have more hands on pulse training. We didn't really do a whole lot of that. It was very piecemeal. I think that's so important. It's such a nuanced skill that takes forever. And so I mean, I think I can recognize a slippery pulse and wiry pulse and a full pul pulse versus a deficient pulse, but When I think about what they talked about at Taoist Traditions, you know, the Jeffrey Wen style, you know, pulse taking and feeling the different levels and the nuances and how one pulse feeds the other. I was I was blown away and felt very much out of my league listening to the discussion around pulse. I my fingers do not have that level of sensitivity. And so that I think would be hugely helpful. So if we could slow it down and slow life down so there's not this urgency to get through school in three years, nine semesters, if it could be a little bit stretched in a realistic way for the world. It would require a world change and a school change. And also I think adding minimally, I guess, a pulse, like more focus on pulse. I think that would be great.
Toby: More real world clinical experience and more diagnostic here. Yeah. Including the
Angelique: Including that too, yes.
Toby: I think that's true. Anything you think you could jettison from the your program that make room for that?
Angelique: We could jettison. Well, I don't know if it would be one particular thing. It might be a certain style. I think stylistically things could be jettisoned, for example. And I don't mean to be throwing shade.
Toby: Speak honestly. And then I again I'm I'm really thinking about like school's gotta change. So I thought I would you're so fresh out of it. I thought I would ask you about how if you had magic wand, how you would change school. So if as long as you feel comfortable
Angelique: I would change professors' reading from PowerPoints. Okay. I don't like that. There's certain, listen, there's certain ways to make it dynamic. There was a professor in school that taught herbs and their PowerPoints presentations were very interesting. They were interactive, kept us on our toes because they would whip out poll questions every now and again to keep us engaged. It was a remote class. So I really appreciated that because I knew like I was going to get called to the carpet and the pressure of that helped me pay attention. But also it wasn't just reading from slides. There was a lot more engagement, interaction. There was another course that I took which was important, but it was literally reading from the slide and then reading the point prescription, reading the herbal formulas. And then when we would ask questions about why the point prescription was the way that it was, we'd get an answer like, well, that's because that's what Giovanni said. Or, you know, that's what McLean and Littleton have to say about that. There was not a lot of critical thinking. Like if I could read if I could redo those clinical classes in that way, it would be a lot more of an engagement. It would be like, okay, we're going to be studying like the neurological diseases and all the patterns of the neurological diseases, for example, and then giving it to the students to be like, here's the case. What would your point prescription be and why? What would your oral formula be and why? And then have a discussion about that. And then maybe discuss what the, you know, the textbooks say and be able to. You know, add a little bit more nuance versus just being like, well, that's what he says in the book, you know? And that kind of thing was hard to pay attention to. It was hard to not just check out because I can read a PowerPoint myself. You know, I don't I don't need to be held captive for three hours for someone to read me a PowerPoint presentation. I can I can do that independently with some more engagement and helping us come out of our shells and talk and engage with the material in an active way, I think would have been a much greater benefit. So In the intro to herbs courses, actually having herbs be part of it. So being a part of the COVID cohort, there's lots of things that couldn't have been possible. And so they did the best they could in that regard. But if the introduction to herbs course was one that was actually hands-on, where we talked about it live and in person and then passed around the bitter herbs and passed around the sweet herbs and passed around just to be able to taste them and smell them and discuss like this is why, you know, bitter parches and down bears. This is, you know, why bland is. The tonifying flavor, the draining flavor or whatever, like going through the qualities and giving us tactile ways of connecting with it. I think a lot more people would have taken herbs from my cohort specifically. And I think from others too, because I think you don't know what you don't know. And so when you're given the, you know, hands-on instruction, I think it changes things. And it's similar with orthopedic needlings. Had I been given the option, I wouldn't have done it. And I have found it to be very valuable. So we there was a track, you could take an orthopedic track and then they folded it into the curriculum so that everyone had to do it. And I learned so much. I learned so, so much from being able to do that. And there are certain people I have found that just want you to focus on their knee or just want you to focus on their elbow. They don't care about everything else. And though I know we can do that with some now, prior, like I wouldn't have I wouldn't have felt very confident in just doing like a TCM diagnosis of an orthopedic problem. But then with that orthopedic piece. You can blend them both together. So that was that was a good example of something that I would have opted out of not knowing any better. And I'm glad that I was opted into because I feel like my skill sets better as a result of it. I guess. Yeah.
Toby: I think I there's two things I'm thinking about that from my undergraduate degree, the motto of my university was learn doing. So we had little pilot plants of everything throughout the like the engineers designed the school and the architects designed the plant the buildings and everything like that, built it and things like that because they always wanted to do like really practical things. So especially like interacting with the herbs, doing the orthopedic needling, you know, like really engaging the students with it. I think that's really how you learn. And then the other thing about like you were saying about the about the PowerPoint, right? Just reading the PowerPoint, Makiot just said, right? We never remember anything unless there's some kind of emotional balance. So like you're you're one where you feel like you have a little bit of fear or you might be called on about a poll or something like that. Again, that triggers your ability to remember that. If it's just bland and just coming at you, it's not going to stick. So I think those two things like trying to learn by doing and then also to have some emotional balance. I think if Chinese medical schools would take on those two ideas, I think yeah it would Everything would be a lot, a lot stickier rather than memorize this table and then regurgitate on exam. Of course you have to do those kind of things because we have the passports, but also I mean you have to be able to practice medicine emotional valence and like actually trying to do it and then, you know, getting some guidance about that. I think that's really valuable.
Angelique: Yes, definitely.
Toby: Right. So when you're gonna start your Chinese medical school?
Angelique: Right after you start yours. Okay. I wonder if there is some value to someone like yourself being far away from school, having the beginner mind and approaching it fresh, not knowing how things currently are, and being able to implement what you think they should be without the brainwashing of the current system coming in completely fresh. I think there's probably even greater value to that. Yeah.
Toby: Think I think it's a there's a little bit of value this perspective, right? Especially since now I am doing some teaching, right? I can see what sticks with the patients, with the with the participants in the classes. And again, I feel like those two things involve specifically involved in trying to do things, you know, learn by doing, and then also emotional valence. I don't know if you remember, but I tried to make some emotional valence in the classes you've been in, right? I tried to really again I feel bad. I feel bad for the participants. But I really want them to learn. So I try and I try and make them nervous and excited at the same time. So they so they can remember, right? Yeah. Again, I feel slightly bad about doing it, but my overall goal is for people to and he was really engage with the material. So
Angelique: Yes, have that be a warning to any of you that learn live with Toby. No one is safe. No one is safe. You will get called on. It'll happen.
Toby: Anyways, I try and make the class my personal nightmare. Because I was didn't like being called on. So I try and bring everyone to that world. So again, because with your same experience, right? If you know someone's gonna be asking you something, it just makes it makes you engage with the material. And then again, it's not just the philosophical some kind of entertainment for education, right? It's really we want people to be able to help their patients. So especially with that in mind, the participants being a little bit uncomfortable, I feel like that's a small price.
Angelique: And it's rooted in neuroscience. There's whole science behind the emotional component to learning. And if you have an emotion, particularly one like anxiety or fear, you will remember. It's it is known.
Toby: Right, where they're just sitting there blankly looking at a PowerPoint, it's nothing's gonna s it's just gonna just ping on the surface and go out.
Angelique: Exactly. As you drool for tubers on your keyboard. Anything interesting happen in your clinic this week?
Toby: I've been having summer interns and that's been really interesting. A lot of things that I don't see then the interns see. So that's been really great to have a second set of eyes in the treatment room with me. It's nice to again, I just place needles and then somebody really critiques my needle placement, why I did things with diagnosis. So that's been really valuable. Usually we're such individual practitioners, it's just we are the team, just us, right? We go in, we diagnose, we treat. We assess everything like that. So it's it's been really valuable. You know, a dozen or so people spending time with me in the summer are really anyways. They get quite a bit out of it, but I get quite a bit out of it too, as they tell me what they see, what they perceive in the clinic in the in the patient encounter. That's been really valuable. So that's been interesting for me this summer, right? To get some other feedback on what I've just mostly been doing by myself.
Angelique: And are folks that have I do have them across the continuum of experience with some from like new folks to people who've been doing it for years?
Toby: Yeah. Yeah. Some people come back for the summer interns, right? Because they really they got a lot out of it. So then they come back again and then yeah, it's it's a mix of people that have never come before. And it was interesting. This time somebody I never met in person just watching like recordings and so knew a lot about it and a lot of things I taught, but I never had any, you know, personal communication with them at all. So then it was great for them to come spend a couple of days, you know, it was really Anyways, it was a really interesting experience, right? A whole bunch of things I'd said on recording that I'd forgotten about, but this person had just watched, so then they knew about. So anyways it was a little asynchronous, but interesting. Interesting to do that. Cool. Anything else for today or should we let it go?
Angelique: I don't think so. Do you have anything else on your mind?
Toby: I've I've got a whole bunch of things but they're big topics. Let's put it for next time. Okay. Great talking to you, Angel.
Angelique: Sounds good. Good talking to you too. All right. Goodbye, everybody.
Toby: Bye.
