The 300 Needles of Dr. Lau

"Hello. This Dr. Louis Lau speaking. You the Mr. Fox talk about acupuncture on radio? Tell all people want acupuncture come see me at Harkness Hospital?"

"Yes, Dr. Lau. I----"

"Please, terrible thing happen. Hospital administration no like sooo many people call up and ask for me to give them acupuncture treatment. They tell me I have to leave. Cannot finish studies here. I have to leave town. Maybe I even have to leave state to find another hospital. I dunno yet."

"I'm shocked to hear this...."

"Yes. Very bad thing. Very bad. Please, if more people ask you where to get some acupuncture treatments, no more send them to Harkness Hospital. Send them to my home, OK? I give you my address."

Dr. Lau is a short, vaguely plump man. He has a ready smile, and although his years among Westerners have robbed him of some of his natural inscrutability, he is generally still difficult to read. He lives in Berkeley in an old frame house with a steep flight of stone steps leading to the front door above the garage. The house is on a quiet side street in that faintly seedy residential area south of University Avenue below the campus. When I visited him, Dr. Lau had turned the whole ground floor and garage into an acupuncture clinic. It had to be the biggest in the country. There were 11 beds packed like mosaic into two treatment rooms (a men's and a women's) and half-a-dozen chairs scattered about for patients who need needling in the hands or face only. The entrance to the waiting room was at the back through the yard. On a pillar beside the door as you walked in was a handlettered sign: Please Take A Number, Treatments: Mon., Wed., Fri. 7-9 P.M. Cash Only.

Dr. Lau has been acupuncturing fellow Chinese-Americans, as a favor, since he went to California as an intellectual refugee from Hong Kong 14 years ago. It wasn't until President Nixon went to China and James Reston had his famous Peking appendectomy that a trickle of occidentals began to seek him out. The trickle soon became a torrent. Any doctor who looked remotely Oriental and had the faintest idea of what it was all about could hawk acupuncture seminars to fellow M.D.s for a fistful of dollars any time they had a free weekend. For the general public, do-it-yourself mail-order acupuncture kits appeared along with acupuncture correspondence courses--prompting the FDA to slow down interstate shipment of acupuncture needles with red-tape requirements.

Dr. Lau was not left behind. He was on TV and radio in the San Francisco Bay area, gave free lectures to doctors, organized seminars, ran the Berkeley clinic five nights a week and tried to keep up with his pathology studies. His pace certainly lends some credibility to the protests of his tutor at Harkness, Dr. Alfred Scottolini, head of the pathology department, who said that Dr. Lau was let go simply because "his performance as a pathologist had become marginal. It was a case of too much acupuncture and too little pathology." As an afterthought, he added: "Acupuncture seems to be almost a religion for him and I'm afraid he may be exploited."

For the moment, at least, Dr. Scottolini's fears seem singularly unfounded. In a vain attempt to save his job, Dr. Lau cut the Berkeley clinic back to three nights a week. Sitting in his petit bourgeois living room, shod in flip-flops and sipping green tea, he explained that he would still like to qualify as a pathologist and that he is not interested in making money from his acupuncture practice. He acupunctures 35 to 40 patients a night. He charges them ten dollars each for a 25-minute treatment: "Or whatever they want. If they want to pay twenty dollars, fifteen dollars, that's Ok. If they don't have any money, they just pay nothing. I don't care. I have plenty money. All I need."

He's equally candid about his training as an acupuncturist. "I not the greatest," he says. "I dunno all about acupuncture. I learn in Canton when I study Western medicine there at Kwang Wah Medical School from, ah, 1949 to, ah, 1954. They don't teach me acupuncture at the school, but everywhere in Canton I see people do it, so I watch them. I learn from them."

The standard textbook on the art, The Yellow Emperor's Classic of Internal Medicine, was written just before the birth of Christ, but acupuncture has been practiced for between four and five millennia. It is one of the two principal weapons in Chinese medicine's arsenal against organic disease. The other is herbs. The Chinese didn't develop surgery, because they held the body sacred. Their medicine is based on Taoist philosophy, which holds that harmony is the basis of order, both in the universe and in man--man being a microcosm of the living universe. A man's life energy force is composed of the two fundamental elements: yang the positive and yin the negative. When there is an excess or deficiency of yin or yang--whether from psychological stress or from excessive exposure to any one of the six external elements (heat, cold, wind, fire, humidity or dryness)--organic disease will follow unless the balance of energy is restored. This energy (the Chinese call it chi) flows along 12 meridians, or channels. Each meridian originates at a major internal organ and then surfaces to run along the body just below the skin. The balance of energy is determined by examining the patient and taking the pulse at the left and right wrists over the radial artery. Master acupuncturists are able to make extraordinarily accurate diagnoses using no other means. They then needle the body at precise points along the meridians, either quieting or stimulating the energy flow to redress the imbalance and allow the body to put its house in order and restore health.

Westerners have numerous theories about how acupuncture works. The most widely held is that it's a form of hypnosis. However, this doesn't explain the success the Chinese have had in using it on animals. There is also the "pain-gate theory," which, simply put, suggests that acupuncture needling somehow shortcircuits the autonomic nervous system and prevents pain signals from reaching the brain. But this doesn't explain acupuncture's ability not merely to stop pain but actually to cure disease in certain instances.

The popular assumption is that acupuncture somehow works through, or on, the body's autonomic nervous system. But no one truly understands the system, and the meridians, although traceable with electronic measuring devices (at least on the skin), are invisible even under a microscope and don't follow the known nerve channels exactly. Not surprisingly, then, researchers in the West, East and the Soviet Union have so far been unable to explain acupuncture in Western terms.

What is known is that acupuncture doesn't work where organic damage is too far advanced, nor does it work where there has been excessive damage to the meridians--surgery will often curtail its effectiveness. Otherwise, it has proved a most effective system of internal medicine.

By his own admission, Dr. Lau is a needle doctor, not a master acupuncturist. That's to say he doesn't use the pulse but goes by symptoms. By traditional definition, the master acupuncturist is one who prevents illness by reading the pulse and correcting any imbalance before it produces any symptoms. But needle doctors get results, too.

Last December, Dr. Lau was invited to Miami Beach with his family for an all-expense-paid week of demonstrations and discussion at St. Francis and St. Joseph hospitals. "While I am there," he said, "I treat maaany doctors and also their wives. Also, I treat Mr. Jack Dreyfus, veeery rich man, and his friend Mr. Jack Cooper. All the time they play tennis and I treat them for tennis elbow. They get well quick and Mr. Dreyfus is sooo happy he offers me money for clinic. I thank him. I find maaany people want to give me money to build clinic."

At this point, Dr. Lau really began hitting his stride. Excitedly, he told me that he has devised a streamlined teaching system he calls "the new acupuncture." Using it, he claims he can teach M.D.s the basics of the art in ten minutes. He is anxious to teach as many doctors as possible, but preferably outside his area. For the price of an air ticket, he will travel any reasonable distance to conduct a seminar free of charge. All he asks is that a one- or two-day supply of patients be brought to the seminar for him to treat. He accepts donations but not fees.

A month after returning from Miami, Dr. Lau got his biggest break yet. Bob Balmer, the pit boss on the day shift at the Carson City Nugget casino, went down to Berkeley with an old back pain. Balmer, a large, placid, middle-aged man, started in the gambling business in Idaho in 1937. He went to Nevada when Idaho cleaned up its act in 1952. He had a 40 percent disability pension from the Army and was having trouble staying on his feet eight hours a day. Dr. Lau relieved the problem in a couple of treatments. Balmer exultantly wheeled back to Carson City to tell his friend Bob Norton. Norton had fallen off a mountain while demonstrating rock-climbing to a Y.M.C.A. group and was still in pain seven years later. The two men invited Dr. Lau to Carson City for a weekend of fun.

Carson City is a town of 26,000 that sits under the lee of the Sierra Nevada beside the Carson River on the brink of the (continued on page 164)Needles of Dr. Lau(continued from page 82) desert, a few miles south of Reno. Norton and Balmer told just six friends that Dr. Lau was coming, but 37 people showed up at Norton's home on Saturday asking for treatment. Norton's pain had nearly vanished after the first session. The following weekend, 102 people were waiting and the weekend after that, Norton had a turnaway crowd and a complaint lodged against him by a neighborwoman (prompted, Dr. Lau maintains, by a local M.D.) for operating a business without a license.

Norton was approached by the district attorney. To escape the heat, he and Balmer suggested to Dr. Lau that they open a clinic in Tahoe Paradise, just over the state line in California, where Dr. Lau could practice as a licensed physician. The Tahoe clinic was open only on weekends until Dr. Lau pressed his brother Ek-Meng into service. Ek-Meng had been a dentist in Burma for years. Dr. Lau says his brother learned some acupuncture when he arrived in Berkeley. Ek-Meng became the resident acupuncturist at the 17-bed Tahoe Paradise clinic. He kept the clinic open six days a week and treated between 80 and 100 patients a day at 15 dollars each before opening another clinic in Truckee, California. Handling the administration is Norton and Balmer's newly formed company: Marlita Treatment Centers, Inc.

As the corporate name implies, Norton and Balmer, along with Dr. Lau and his growing family of acupuncturists (he says he has taught his wife, is teaching his sister and recruiting other acupuncturists from San Francisco's Chinatown), are planning to expand--especially since their forced retreat from Nevada now seems to have been only a temporary setback.

Although Dr. Lau didn't realize it at the time, when he first appeared on the scene in Carson City, he found himself at the epicenter of perhaps the most significant and certainly the mostly oddly lopsided power struggle in American medical history. At issue was the legalization of the practice of Chinese medicine in Nevada as a separate branch of the healing arts; after all, acupuncture was uncontrolled, unlicensed and unsupervised by establishment medicine--to wit, the Nevada State Medical Association and its big brother, the A.M.A.

The point was raised by a semiretired 65-year-old New York attorney named Arthur Steinberg, a bushy-eyebrowed patriarch with an unwavering gaze and a fine aquiline nose. For over 30 years, Steinberg sat at the bargaining table for the Shoe Retailers' League in New York; he made his fortune in real estate, through a company he ran with his brother. Real-estate litigation first took him to Las Vegas 20 years ago. He kept going back. He bought the land The Mint stands on, the biggest casino on the downtown strip. Eight years ago, he brought his family out from New York and stayed. Steinberg's wife, Bia, is Mandarin, an elegant woman with exquisite classical features. For years she suffered from migraine headaches. The best doctors could tell her only that she was too tense. So a couple of years ago, Steinberg took her on a lengthy trip through the Orient. In Hong Kong they went to a master acupuncturist they'd heard of, Professor Lok Yee Kung. He treated Bia and she apparently got much better. "I saw a lot of miracles which Professor Lok regarded as commonplace," Steinberg later said, "and I decided acupuncture, handled correctly, would be a good thing to have in America." So he had a 150-minute documentary film shot and went back to Nevada at the end of August 1972, to show everyone what he'd seen.

"My wife warned me not to trust them, but I felt that logically our own doctors were the first people to turn to." Steinberg was rapidly disillusioned. It seemed that the more prominent the doctor he invited to see the film, the less likely he was to show up. Finally, one at least had the grace to tell Steinberg he was wasting his time. "I was disappointed," Steinberg said thoughtfully, "but I wasn't worried. I learned years ago that the power of the people is greater than any other; it's only a question of organizing them.

"I felt Nevada was a good place to start, because there aren't many people there. Fewer than half a million. You can reach them easily and they have a close relationship with their legislators."

But on the face of it, Steinberg had a very tough fight ahead of him. With the first flurry of public interest in acupuncture a couple of years ago, the A.M.A. moved to pin the fledgling therapy. By the time Steinberg discovered it, acupuncture was virtually outlawed in Kansas. New York State had moved to close up a booming Manhattan acupuncture clinic, despite desperate pleas from hundreds of patients that it was helping them where nothing else had. New York's State Board for Medicine, guided by the state medical association, ruled: "At this time, acupuncture is not sufficiently understood to be accepted for use" and that only licensed physicians associated with a recognized research facility could wield a needle. State boards in Connecticut and New Jersey agreed with New York, while legislators in California passed a law to that effect. Minnesota, Michigan, Florida, Texas and Indiana simply decreed that only licensed physicians could practice acupuncture. It seemed the A.M.A. had a firm grip on the situation. Certainly, it had no reason to suspect that Nevada would kick up.

It may be true that Nevadans have long made a good living by giving other Americans what they can't legally get elsewhere in the country; but as Bryn Armstrong, dean of Nevada's legislative reporters and executive editor of the Las Vegas Sun, points out, "Since it legalized gambling and six-week divorce and did away with inheritance tax in 1925, the Nevada legislature has grown increasingly conservative. It's very unusual to see Nevada pioneer anything anymore.

"This is a strong law-and-order state, very antiwelfare. Chiropractors had a hell of a tough time getting recognition here and osteopaths are still second-class citizens, medically speaking. On the other hand, politics here is still very personal. Personality overrides party in this state. There are no party machines and organized labor plays a small role. The trend is conservative, but the legislature has a very independent attitude; it believes strongly in states' rights."

Steinberg had to move quickly. The Nevada legislature meets every other year and only four months were left to him before it convened in Carson City on January 15, 1973. First he retained May Advertising in Las Vegas, an agency that harbors the best political lobbyists in the state. To soften the ground, May Advertising cut Steinberg's film to 30 minutes and began running it on TV in Vegas and Reno. Steinberg tapped into the media and spoke at Rotary luncheons and receptions at Las Vegas country clubs and at the Las Vegas Public Library.

As late as mid-November, Steinberg was still not convinced that the bill should be presented without the cooperation of Nevada's medical establishment. By this time, Professor Lok agreed to stage a closed demonstration for Nevada's medical fraternity and Steinberg had Bob Brown, then president of May Advertising, apply to the State Board of Medical Examiners for a special license to put on the demonstration. The board voted unanimously against the request and the board's attorney finally told Brown, "We are not going to license your Chinaman."

It was this insult that decided the Steinberg camp. They would pass a bill legalizing Chinese medicine and keep it totally out of the hands of the medical establishment. Steinberg appeared on TV, told of the rebuff and called for public support for the bill. He got it. By the time the legislature convened, an army of volunteers had collected 17,000 pro-acupuncture signatures and legislators from Governor Mike O'Callaghan on down were being bombarded by mail and phone. Brown had put James Joyce, his leading lobbyist, on the case. "I went up to the legislature in January feeling like a fool," Joyce remembers. "When I told them I had a bill to legalize Chinese medicine and started talking about acupuncture, herb medicine and energy flows, they roared with laughter and I went home very depressed. Then I realized the only way to do it was to put up or shut up. If acupuncture was as great as I'd been telling these guys, why not show them? Put on a demonstration for the legislators in Carson City."

With the help of a private demonstration by Professor Lok, Joyce persuaded an old friend, Lee Walker, Democratic senator from North Las Vegas and chairman of the senate's Health, Welfare and State Institutions Committee, to sponsor a bill that Steinberg himself drafted. With Walker's help, emergency legislation was pushed through, overriding the State Board of Medical Examiners and granting Professor Lok a license to stage a two-week demonstration. The legislators and the press were invited.

At this point, the doctors began to panic. Dr. Robert Broadbent, Republican assemblyman from Reno and the only physician in the legislature, suddenly proposed a bill to legalize acupuncture on a research basis under the supervision of state-licensed doctors. It was clearly a concession to the strength of the opposition, since Dr. Broadbent's personal opinion of acupuncture was, "It's a lot of phonus bolonus. It's the same as wart healing, foot rubbing and hypnosis."

Dr. Broadbent's bill never got out of committee and on March fifth, Professor Lok began the demonstration. Although Joyce felt far more confident of success at this point, he was also distressed. "What we did in Carson City," he said, "was the equivalent of sending our best surgeon to Hong Kong and giving him two weeks to prove himself and Western medicine by performing 25 heart transplants in a motel room."

The motel room in this instance was actually a conference room in the Ormsby House, a new hotel/casino--"the largest anything in Carson City"--across the street from the Legislative Building. Over 1000 people volunteered themselves as patients. About 70 were chosen, but a lot more came uninvited and Professor Lok ended up treating people from eight in the morning until midnight, six days a week.

The opposition immediately charged that the patients chosen had been hired to fake cures. Certainly the results were spectacular. As 30 legislators, TV crews, radio reporters and newspapermen watched, a 61-year-old Las Vegas woman, who'd had two operations for a broken hip, had been told she needed a third and had been unable to walk for seven months, took one treatment and walked about unaided until she was restrained. A Chicago man flew in uninvited. He had uncontrollable spastic head movement. He said that treatments over ten years had cost him $23,000 in medical bills. "This," he said, "is absolutely my last hope." The spasms were relieved a few minutes after Professor Lok inserted his needles. It went on and on.

Meanwhile, across the street, the legislators were busy bringing back the death penalty, keeping out liberalized abortion (regardless of the U.S. Supreme Court) and introducing 100 or so law-and-order bills.

For Joyce, the big break came the following night. Senator Stanley Drakulich, a Democrat from Washoe County, abruptly asked if Professor Lok could treat him. "I haven't been able to lift my arm higher than my shoulder for years," he said.

"The next thing," said Joyce, "there was a state senator lying on the couch with needles in him and the following day he's walking about the legislature showing everyone how much better his arm is." Drakulich went back for four more treatments. The dam was broken. Newsman Armstrong was treated for Ménière's disease, which he'd had since 1956. The results produced front-page stories supporting the bill. According to Armstrong, his brother-in-law, Edgar Hollingsworth, had had his hearing damaged in a mine explosion years before. After 12 treatments, he threw away his hearing aid. Before the demonstration was over, about 20 legislators were treated for everything from back pain to ulcers.

"I suddenly found the roles reversed." said Joyce. "The legislators were coming to me and asking if I could do them a favor and get Professor Lok to treat their wives or mothers-in-law or some old lady who'd been generous at election time. I tell you, I went to Carson City as a lobbyist for this bill and ended up a missionary."

Doctors testifying against the bill met with a very chilly reception. "When I went before the senate subcommittee, I could feel the hostility," said Dr. John Sande, who was then president of the Nevada State Medical Association. "After I argued that not enough was known about acupuncture, that it was unproven and should be studied, I was told by one senator, 'You doctors have been dragging your feet. We legislators are going to show you how this is done.'" Dr. Sande got another blast when he appeared before the assembly subcommittee. "Before I stood up to speak, the chairman said to me, 'You've got thirty minutes. Get up and blow to the wind.'"

The description was apt. While "the miracle across the street"--as Professor Lok's demonstration became known--was still going on, the state senate passed the bill to applause from a packed gallery, 20 to zilch.

It was introduced in the assembly by the chairman of the Health and Welfare Committee, the Reverend Marion Bennett, a black Democrat from Las Vegas. Reverend Bennett, who had been treated himself, stood up and said, "Mr. Speaker, the bill we are about to debate is unique. The very people who will testify in its favor are living examples of what it can do: This is the sick man's hope, the poor man's dream. I urge that it be passed." It was, 34 to 2.

While the bill awaited the governor's signature, the A.M.A. declared that the Nevada legislators "have absolutely ignored all reason." When Dr. Sande appealed to the governor to veto the bill, he was told, "You've come to me with too little, too late."

The doctors' journal, Medical World News, attacked it from another angle:

Relieve your aching joints in fabulous Las Vegas! Don't gamble with pain when you can find relief. For just one low price you get: four days and three nights in a glamorous hotel, two casino shows, free blackjack lessons, plus daily acupuncture treatments by our world-famous specialist.

No, it hasn't happened yet, but a packaged acupuncture tour is bound to turn up as soon as Nevada becomes the first state to permit the practice of Chinese medicine--primarily acupuncture--by medically unsupervised nonphysicians.

Governor O'Callaghan shrugged off the suggestion that Nevada was springing another tourist trap. "We have enough tourists here, enough shows. We drew 29,000,000 visitors here last year. The city of Las Vegas alone drew more than Hawaii or Florida. We don't need more visitors. This bill was passed to help people. To relieve pain. People who call Nevada a gimmick state either are jealous or simply don't understand."

Ironically, it was a lack of understanding that allowed Chinese medicine, complete and unabridged, into Nevada. In retrospect it seems that, had any of the opposing doctors bothered to investigate what they were so vigorously opposing, they would likely have been more receptive to Steinberg's initial overtures, and so ended up in control. Since they didn't, acupuncture will soon be widely available in Nevada, supervised by a board that will set the standards high.

Dr. Broadbent was right when he said that the passage of the Nevada bill was a vote of no confidence in our own doctors; that overreliance on technology, overspecialization and profiteering have created feelings of neglect and mistrust among the public for the medical profession; that to heal this rift doctors would have to "get back to the people" through increased general practice. And yet he and the majority of his colleagues exhibited a curious lack of sensitivity, curiosity and flexibility over acupuncture, further widening the credibility gap.

As the graffiti on the subway walls in Manhattan have it, Acupuncture Lives and Acupuncture Works. There is ample evidence that the Chinese understood the power of the mind over the body millennia before psychosomatic medicine was discovered in the West. Yet for all their talk of the need for "personalizing" medicine, our doctors tend to dismiss with ridicule the humanistic philosophy from which Chinese medicine evolved. And the A.M.A.'s holy crusade to "protect" the public from this "unknown, unproven" therapy must seem faintly absurd in light of the fact that so many elements of approved Western medicine are not understood. There is a strong taint of parochialism in all this. There is much we could learn from the Chinese, but, unfortunately, many occidentals still regard them as "little yellow men." There is also a strong trace of arrogance. Americans in particular tend to feel that they "own" all the sciences--there's no doubt it came as a rude shock when the Russians were the first to reach outer space.

The Chinese, on the other hand, have learned much from the Americans: When Dr. Lau learned that Governor O'Callaghan had signed the bill into law, he was overjoyed. He and his colleagues, Norton and Balmer, immediately advanced plans to open clinics all over Nevada. And Dr. Lau, leaning forward in his seat intently, eyes glazed and voice rising a note or two, speaks of "a clinic in every big city in this country." There's no doubt that he looks forward to becoming the Colonel Sanders of the new American acupuncture.

Such ambitions, such ideas, he didn't pick up in Canton.