Swiss doctor brings alternative medicine out of the closet

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Dr Eduard Klarer's practice, in the Swiss mountain town of St Moritz, is modern, minimalist and pristine.

On his desk sits a preserved seahorse in a jar of formaldehyde.

Klarer is one of a rare species: a Western practitioner of traditional Chinese medicine (TCM).

In Zhengzhou city of China's Henan Province, Klarer studied intensively for three years at the Henan College of Chinese Medicine.

Under the special tutelage of Dr Si Fuchun, he completed courses in both herbology and acupuncture, and is now a fully qualified practitioner of TCM.

During his years of training, and in regular return trips to Zhengzhou, Klarer has spent a lot of time on duty in the university hospital.

As a Westerner, practising in a Chinese hospital was not easy. Patients were reluctant to see him initially, he recalled.

"'Look at his nose,' they said, 'he can't possibly be a good doctor!' "

Hard work and time, however, proved Klarer's skill, and eventually Chinese patients were asking for him.

Back in Europe, he is having to start again in winning the confidence of his patients. Swiss patients are also somewhat wary of what Klarer has to offer. There is rising interest in TCM, but certain aspects of it are taking time to get used to.

A TCM cure often involves a wide range of ingredients. Here in China, TCM pharmacies are stuffed with strange fungi, dried geckos and seahorses, but as yet, Klarer cannot prescribe these; Swiss patients would refuse to take them.

What he gives to his patients are ingredients in granulated form, that are completely unidentifiable.

"Sometimes I put things into the recipes without telling people, like scorpions, which are very good for rheumatism. They don't see it and they think it's OK. For me, that's fine as long as I see them getting better."

"Another reason for the granules is that they are soluble: add a teaspoon to a cup of hot water and your medicine is ready."

In China, the patient has his work cut out once he arrives home with his bag of ingredients. Remedies typically require lengthy preparation, with boiling and steaming, at the end of which the entire house is infused with often unpleasant smells. Chinese medicine is notoriously offensive often bitter to the taste buds.

In Switzerland, this is out of the question, said Klarer. "People would say, 'You're crazy, what about my neighbours?'"

Certain traditional therapies such as acupuncture are also having problems gaining acceptance.

Klarer recollected problems he has had using the ancient technique of guasha. This is a treatment so commonplace in China that it is mostly done at home by a family member. It involves gentle rubbing of the skin with a smooth object.

For a patient suffering from too much heat in the body, this produces red patterns on the skin which are totally painless and disappear after a short time, but which can look quite dramatic.

Klarer related how this can provoke a violent reaction when people aren't used to it: "Once, a lady I treated with guasha said that her husband hadn't spoken to her for two days after the treatment. He thought she had been beaten!"

Now he always shows pictures to patients before starting the treatment, and makes sure they know what will happen.

Despite the obstacles, demand for TCM in Switzerland is rising, as more and more Swiss consider it as a serious alternative to Western medicine. His own small ward manages to supply around 80 per cent of Klarer's patients.

On the professional level, Klarer and other practitioners of TCM are still facing some resistance.

Better understanding

Klarer has found that his experiences in China have put some distance between himself and his colleagues in Western medicine. Learning the concepts of Chinese medicine gradually came to change the understanding of the world that he had learned from life and study in Europe.

Klarer initially qualified as a psychiatrist in Switzerland. He has carried out an extensive study of psychology in Switzerland, and has also learned the basics of Western medicine.

Surveying the two medical traditions, he remarked, "Chinese medicine is thousands of years old, it is built upon experience. Western medicine is built on science."

"My Western colleagues here in Switzerland think very analytically, whereas the Chinese are holistic. They try to find the balance."

The balance Klarer refers to is that between yin and yang, the omnipresent opposing but complementary forces of ancient Chinese philosophy, and a pivotal concept of Chinese medicine.

"When you understand yin and yang, you understand Chinese medicine," he said.

Klarer has found in Western culture equivalent concepts to yin and yang, and explains them in terms of Logos and Eros from classical Greek philosophy: the head and the heart, or the left and right brain.

He applies this to his understanding of society. Existence in Western culture, Klarer believes, is dominated by the activity of the Logos, or yang. People think a great deal, giving little space to their emotions, and have strong creative and controlling impulses.

The importance of methodical thought and explanation in Western medicine renders some of Chinese medicine's important concepts, such as yin yang and qi, too abstract to be acceptable to Western physicians.

Klarer has often found that his Western colleagues are wary of what he does, and are reluctant to refer their patients to him, warning them to be careful.

What exacerbates the problem, according to Klarer is that the study of TCM is still not taken seriously enough. Many Swiss are now choosing to learn it at home, through weekend or correspondence courses, and the level of proficiency they can reach by doing this is not high.

Klarer believes that trying to learn the science of TCM away from its natural context is a hopeless endeavour. It is important to be absorbed by Chinese culture if you are to really understand the philosophical outlook behind Chinese medicine, he explained.

Potential development

TCM may not yet have really taken off in Switzerland, but it is by no means a trivial phenomenon.

According to the Swiss Professional Organisation of Traditional Chinese Medicine (SPOTCM), there are currently around 550 qualified practitioners of Chinese Medicine in Switzerland, and around 500 more in training, and this is in a country of 7.5 million people.

Many of those practitioners are of Swiss origin, but there is also a significant number of Chinese origin. The International Centre for Traditional Chinese Medicine operates a programme in collaboration with the Chinese Ministry of Health, which brings experienced Chinese practitioners to Europe.

TCM treatments are no more expensive than Western treatments in Switzerland, moreover thanks to the efforts of SPOTCM, there are now three out of 26 cantons in Switzerland where TMC treatment is available on insurance, and the organization hopes that this will be the case in all cantons before long.

For Klarer, it is almost certain that TCM will soon undergo rapid growth in Switzerland, for the simple fact that it works.

TCM cannot provide the right cure for every disorder, of course; Klarer recognizes that there are many cases, such as clogged arteries, which require the more invasive techniques of Western medicine.

Klarer pointed out that in China, the two approaches are now happily coexisting. The fact that this is not yet the case in Switzerland, he attributes to the way society functions there.

"In China, they are more open to change. When they come across a concept that they like, they adopt it overnight," he said.

"Here, we have to look, think, analyze, we take a much longer time."

For now, Klarer will continue to administer prescriptions in powder form, and keeps his preserved seahorse in the cupboard when there are patients around.

By Louisa Winkler