He Named a Surgery He Couldn't See: A Doctor's Audit of 5,000 Years of Chinese Medicine
There’s a paper bag in my house I’m not allowed to open indoors.
Inside are eight packages of dried herbs, some tree bark shavings, and scorpions. Dried scorpions. I promise, this is real.
I brought it back from Beijing about eight years ago. A traditional Chinese medicine doctor gave me the prescription during a free afternoon on a work trip. I was supposed to boil everything into a broth and drink it. When my wife saw it, she took a careful sniff and decided that if I ever made it, I’d have to do it outside, in the garden, far from the kitchen.
I still haven’t done it. The bag is still there.
I went for one reason: curiosity. I often try things on myself before I can explain why. That afternoon, I got a tongue exam, a pulse reading on both wrists, a diagnosis that mentioned a shoulder surgery the doctor couldn’t have known about, two hours lying on a bench with needles, and a bag of scorpions I’ll probably never use.
Somewhere in that strange afternoon, a real question stuck with me. I finally spent a weekend digging into the research to find an answer.
The question is simple to ask but tough to answer. Is traditional Chinese medicine 5,000 years of wisdom that modern medicine ignores? Or is it just elaborate theater with ancient branding?
The truth is, it’s both, mixed together so closely that most people never separate them. Supporters focus on the successes and ignore the rest. Critics focus on the nonsense and ignore the successes. Neither approach really helps.
So I did what I always do when unsure about a treatment. I looked at the evidence rather than the reputation, kept what held up to a doctor’s review, and set aside what didn’t. You could call it the doctor’s edit.
Surprisingly, quite a bit holds up. But some of it can also land you in a cancer ward. It’s important to know the difference.
The 5,000-Year Story
Every brochure claims traditional Chinese medicine is 5,000 years old, but that number is mostly marketing. The oldest main text, the Huangdi Neijing or Yellow Emperor’s Inner Classic, was put together between 400 BCE and 260 CE [1]. So the written tradition is about 2,000 years old. Still old, just not 5,000.
What’s even more surprising is how recent the unified system is. The version of TCM we know today was mostly put together in the 1950s and early 1960s in communist China, under Mao [2]. There weren’t enough Western-trained doctors, so the government combined different classical and folk practices, settled the disagreements, and created a single curriculum. The tidy, “ancient” system sold to wellness tourists is mostly a product of mid-20th-century health policy.
But that hasn’t slowed its growth. Today, 170 World Health Organization member countries officially recognize that their people use traditional or complementary medicine [3]. In 2019, the WHO even added 150 traditional-medicine disorder categories, based on classical Chinese medicine, to the ICD-11, the global disease classification manual [4].
TCM is built on a few main ideas: qi, a vital energy said to flow through the body; yin and yang; the five phases; and a network of meridians, or channels for qi [5]. These ideas lead to the practices most people know: acupuncture, herbal formulas, cupping, tui na massage, tai chi, and qigong.
What Survives the Audit
Let’s start with the best thing TCM has given us, which is also one of the most important drugs of the last century.
In the 1960s, a Chinese chemist named Tu Youyou was asked to find a malaria treatment. She worked through hundreds of old texts and kept returning to one line from Ge Hong, written around 340 CE, which described soaking sweet wormwood in cold water and drinking the juice for fevers [6]. Every extraction she had tried with heat had failed. That detail, cold water, told her heat was destroying the active compound. She switched to a low-temperature extraction in 1971, and it worked [6]. The active molecule, isolated soon after, was artemisinin.
Today, it reduces malaria deaths by over 20% overall and more than 30% in children, saving more than 100,000 lives a year in Africa alone [7]. Tu Youyou won the Nobel Prize in 2015 [7]. The old text gave her the clue, and modern chemistry did the rest. That’s the best way to look at TCM: a huge, ancient list of ideas, most untested, with a few real gems.
Acupuncture is a trickier case. The biggest analysis combined 39 trials and 20,827 patients with chronic pain [8]. Acupuncture worked much better than doing nothing, and a little better than fake “sham” acupuncture [8]. The researchers, who supported the practice, said the effect is real but can’t be explained by needling alone [8]. It works, to some extent, but not for all the reasons its theory suggests. We’ll return to this later.
Then there’s tai chi, which I’ve come to respect most. A New England Journal of Medicine trial found it worked better than wellness education and stretching for fibromyalgia, a tough pain condition [9]. A bigger BMJ study showed tai chi was as effective as aerobic exercise [10]. A Cochrane review, our strictest evidence, found tai chi reduced falls in older adults by 19% [11]. For an aging executive or parent, fewer falls can mean the difference between staying independent and a hip fracture.
What Fails the Audit
After 2,000 years of searching, no one has ever found a meridian. Anatomists have looked for the channels where qi is supposed to flow and found nothing. Even acupuncture researchers agree there’s no physical structure matching the meridian map [12]. The lines on the chart aren’t in the body.
The data on needling tells a similar story. In a large German trial, 1,162 patients with chronic back pain got either real acupuncture or fake acupuncture, with needles placed randomly and shallowly [13]. Both groups improved, and both did better than standard drugs and physiotherapy. The difference between real and fake was just 3.4%, which wasn’t statistically significant [13]. If the “wrong” points work as well as the “right” ones, meridian theory isn’t the reason. Something else is at play.
There’s another issue for anyone who relies on Chinese research. A review of controlled trials found that 99% of studies published in China said the treatment worked [14]. Not just most.. almost all. When almost nothing ever fails, the research stops showing whether treatments actually work.
What Can Hurt You
The risks are real, and this is where the appeal of tradition has to end.
Some Chinese herbs contain aristolochic acid, a potent carcinogen so distinctive it leaves its own signature mutation in your DNA. In Taiwan, where these herbs were widely prescribed, researchers studying patients with upper urinary tract cancer found that 60% carried the chemical’s fingerprint in their DNA and 31% carried its signature mutation [15]. Taiwan has the world’s highest rate of that cancer [15]. These herbs cause cancer, traceably, at the level of the gene.
Contamination is common. In one review, a Taiwan survey found that 24% of Chinese herbal products contained undeclared pharmaceutical drugs, like corticosteroids, anti-inflammatories, and sedatives [16]. You might think you’re taking a gentle plant remedy, but you could be getting an unregulated dose of something else.
Some herbs are simply dangerous on their own. Ma huang, or ephedra, caused strokes, seizures, and heart problems so severe that the FDA banned it from supplements in 2004 [17].
The harm goes beyond the clinic. Demand for traditional remedies has pushed animals like the pangolin, rhino, and tiger toward extinction for their scales, horns, and bones. China banned the medicinal trade in tiger bone and rhino horn in 1993, but the pressure continues. The pangolin is now the most trafficked mammal in the world.
Where Our Own Medicine Runs Out
So why does any of this last? Why did a fairly skeptical doctor bring home a bag of scorpions and a story he still tells?
Part of the answer is uncomfortable, because it’s really about us.
When I was in that Beijing clinic, the doctor spent almost an hour with me before prescribing anything. He checked my tongue, held both wrists, and asked about my work, sleep, and previous illnesses. Compare that to today’s reality: in 67 countries, doctors in 18 of them, covering about half the world’s population, spend five minutes or less with each patient [18]. Even in well-funded places, an American study found doctors spend only 27% of their day with patients, and 49% on paperwork and screens [19].
Then there was my shoulder. He guessed a surgery he couldn’t have seen, and for years, I thought of it as a small miracle. But the more likely explanation is more interesting. He was a skilled observer who had examined thousands of bodies, looking at someone my age and build, with the signs of old contact sports and a guarded injury. He made some confident guesses; the ones that hit stand out, and the misses are forgotten. And he spent more time looking at me, calmly, than any doctor had in years. When you give someone that much attention, you notice things too.
Here’s something modern medicine is only now admitting: the attention itself is a treatment. In a Harvard trial, patients with irritable bowel syndrome were split into three groups: a waiting list, fake acupuncture alone, and fake acupuncture given by a warm, attentive practitioner [20]. Relief rates went from 28% on the waiting list, to 44% with the ritual, to 62% when a caring person delivered it [20]. The needles were fake in both groups, but the relationship made the difference.
The benefit came from simple things: time, ritual, and a caring person. Our five-minute, screen-focused system has quietly stopped offering all three. Now, Western medicine is trying to bring them back with new names like systems medicine, whole-person care, and the P4 model of prevention over rescue [21]. We’re reinventing the bedside manner we once cut to save time.
This belongs in the Recover pillar of my Upward ARC framework, and it matters more than most high performers admit. Recover means bringing the nervous system back to baseline: giving unhurried attention, resetting stress, and treating stress as a real factor, not just a personality trait. Movement, like tai chi, fits in Activate, alongside the one proven molecule from the tradition. The metaphysics doesn’t fit anywhere. That’s my edit.
Try This Today
The Enforced Stillness. The most helpful thing in that clinic was being forced to stay still for two hours. Most high performers never plan rest, so set up something that makes you rest. Try one 90-minute block a week with no screen, no phone, and no agenda. A long walk without headphones counts. Lying on the floor counts. The key is to have a break from input.
The Tai Chi Floor. Of all the traditional practices, tai chi has real studies behind it: it helps with pain, balance, fewer falls, and lower stress [9][10][11]. The studies used it twice a week. It’s gentle enough for anyone from 50 to 80, and it trains both balance and a calm nervous system. Try a class or a video, and give it eight weeks before deciding if it works for you.
The Long Consult Rule. What worked in Beijing was unhurried attention, and you can get that at home if you ask. When something matters, book the longest appointment you can, write down your three main questions ahead of time, and don’t let the visit end with the doctor typing. If your system only gives you 7 minutes, find a way to get at least 45 once a year.
The Natural-Label Audit. If you use herbal or traditional supplements, remember that “natural” is just a marketing term, not a safety guarantee. A quarter of these products contain undeclared pharmaceutical drugs [16], and some have a known carcinogen [15]. Only buy from suppliers who share third-party testing for contaminants. If a product can’t tell you exactly what’s in it, don’t take it.
The Bag in the Garden
The bag of scorpions is still in my house. Every so often, I move it, think about making the broth, imagine my wife’s reaction, and put it back.
I think about that afternoon more than I expected. The needles were probably just theater. The meridians weren’t real. The diagnosis was a skilled man making good guesses about a tired executive. But he did something no doctor had done for me in years: he made me lie still, doing nothing, for two hours. He saw a stressed, overworked man with a bad back and prescribed the one thing I’d never give myself.
That’s the part worth keeping: the stillness, the attention, the unhurried hour. The scorpions and the qi can be left behind.
Here’s my doctor’s edit on 5,000 years: keep the one proven molecule, keep the movement that’s backed by studies, and keep the unhurried hour that modern medicine lost. The rest can go out in the garden, where it belongs.
Stay healthy.
Andre
PS: I still try things on myself that I can’t fully explain, and I keep that bag as a reminder. If you know someone who swears by all of this, or someone who dismisses it, share this with them. Both are half right, and that’s what makes it interesting.
References
[1] Unschuld, P. U. (2003). Huang Di nei jing su wen: Nature, knowledge, imagery in an ancient Chinese medical text. University of California Press.
[2] Taylor, K. (2005). Chinese medicine in early communist China, 1945-1963: A medicine of revolution. RoutledgeCurzon.
[3] World Health Organization. (2019). WHO global report on traditional and complementary medicine 2019. World Health Organization.
[4] World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.), Chapter 26: Supplementary chapter traditional medicine conditions, Module I. World Health Organization.
[5] Zhang, Q., et al. (2021). An introduction to traditional Chinese medicine, including acupuncture. The Anatomical Record, 304(11), 2675-2682.
[6] Su, X.-Z., & Miller, L. H. (2015). The discovery of artemisinin and the Nobel Prize in Physiology or Medicine. Science China Life Sciences, 58(11), 1175-1179.
[7] The Nobel Assembly at Karolinska Institutet. (2015). The Nobel Prize in Physiology or Medicine 2015 [Press release]. NobelPrize.org.
[8] Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., Irnich, D., Witt, C. M., Linde, K., & Acupuncture Trialists’ Collaboration. (2018). Acupuncture for chronic pain: Update of an individual patient data meta-analysis. The Journal of Pain, 19(5), 455-474.
[9] Wang, C., Schmid, C. H., Rones, R., Kalish, R., Yinh, J., Goldenberg, D. L., Lee, Y., & McAlindon, T. (2010). A randomized trial of tai chi for fibromyalgia. New England Journal of Medicine, 363(8), 743-754.
[10] Wang, C., Schmid, C. H., Fielding, R. A., Harvey, W. F., Reid, K. F., Price, L. L., Driban, J. B., Kalish, R., Rones, R., & McAlindon, T. (2018). Effect of tai chi versus aerobic exercise for fibromyalgia: Comparative effectiveness randomized controlled trial. BMJ, 360, k851.
[11] Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., Clemson, L., Hopewell, S., & Lamb, S. E. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, (1), CD012424.
[12] Longhurst, J. C. (2010). Defining meridians: A modern basis of understanding. Journal of Acupuncture and Meridian Studies, 3(2), 67-74.
[13] Haake, M., Müller, H.-H., Schade-Brittinger, C., Basler, H. D., Schäfer, H., Maier, C., Endres, H. G., Trampisch, H. J., & Molsberger, A. (2007). German Acupuncture Trials (GERAC) for chronic low back pain. Archives of Internal Medicine, 167(17), 1892-1898.
[14] Vickers, A., Goyal, N., Harland, R., & Rees, R. (1998). Do certain countries produce only positive results? A systematic review of controlled trials. Controlled Clinical Trials, 19(2), 159-166.
[15] Chen, C.-H., Dickman, K. G., Moriya, M., Zavadil, J., Sidorenko, V. S., Edwards, K. L., Gnatenko, D. V., Wu, L., Turesky, R. J., Wu, X.-R., Pu, Y.-S., & Grollman, A. P. (2012). Aristolochic acid-associated urothelial cancer in Taiwan. Proceedings of the National Academy of Sciences, 109(21), 8241-8246.
[16] Ernst, E. (2002). Adulteration of Chinese herbal medicines with synthetic drugs: A systematic review. Journal of Internal Medicine, 252(2), 107-113.
[17] Haller, C. A., & Benowitz, N. L. (2000). Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. New England Journal of Medicine, 343(25), 1833-1838.
[18] Irving, G., Neves, A. L., Dambha-Miller, H., Oishi, A., Tagashira, H., Verho, A., & Holden, J. (2017). International variations in primary care physician consultation time: A systematic review of 67 countries. BMJ Open, 7(10), e017902.
[19] Sinsky, C., Colligan, L., Li, L., Prgomet, M., Reynolds, S., Goeders, L., Westbrook, J., Tutty, M., & Blike, G. (2016). Allocation of physician time in ambulatory practice: A time and motion study in 4 specialties. Annals of Internal Medicine, 165(11), 753-760.
[20] Kaptchuk, T. J., Kelley, J. M., Conboy, L. A., Davis, R. B., Kerr, C. E., Jacobson, E. E., Kirsch, I., Schyner, R. N., Nam, B. H., Nguyen, L. T., Park, M., Rivers, A. L., McManus, C., Kokkotou, E., Drossman, D. A., Goldman, P., & Lembo, A. J. (2008). Components of placebo effect: Randomised controlled trial in patients with irritable bowel syndrome. BMJ, 336(7651), 999-1003.
[21] Hood, L., & Flores, M. (2012). A personal view on systems medicine and the emergence of proactive P4 medicine: Predictive, preventive, personalized and participatory. New Biotechnology, 29(6), 613-624.
A note for new readers:
I’m a trained reconstructive facial surgeon, medical doctor, and dentist. Before launching this newsletter, I had a varied career: competitive freestyle wrestler, management consultant (McKinsey), entrepreneur (Zocdoc, Thermondo, and docdre ventures), and corporate executive (Sandoz). Today, I’m a Managing Director and Partner at BCG.
Husband of one. Father of three. Split between Berlin’s urban pulse and our Baltic Sea retreat. I’d rather be moving than sitting. Not just hobbies. Research. My body is my primary laboratory; I’ve been conducting experiments for decades.
If this is your first time here, welcome. I’m excited to share what I’ve learned and will continue to learn with you.
DISCLAIMER:
Let’s get one thing straight: None of this, whether text, graphics, images, or anything else, is medical or health advice. This newsletter is here to inform, educate, and (hopefully) entertain you, not to diagnose or treat you.
Yes, I’m a trained medical doctor and dentist. No, I’m not your doctor. The content here isn’t a replacement for professional medical advice, diagnosis, or treatment.
If you have questions about your health, talk to your physician or a qualified health professional. Don’t ignore their advice or delay getting care because of something you read in The Upward ARC. Be smart. Do your research. And, as always, take care of yourself.