Welcome to the second installment of Studying Advanced Chinese Medicine Abroad, a set of interviews with Diana Hermann, L.Ac. Last post, Diana shared her experience studying Chinese medicine in a hospital in Nanjing, China after graduating with her acupuncture Master’s degree.

Today I’m excited to pick Diana’s brain about her studies in London, England with world-renowned TCM dermatologist, Mazin Al-Khafaji. 

Many thanks again to Diana for sharing her experiences and incredible photos with us today. (Scroll down for the photo of the Connemarra pony in Ireland! To die for!) Of course, all photo credits go to Diana, including the cover photo.

I hope these interviews with Diana inspire you to let acupuncture take you around the world and to stay passionate about learning this complex, amazing medicine.

I’ll keep the intro brief today; let’s go!

So currently you’re traveling in and out of London several times a year to study with Mazin Al-Khafaji. Can you describe Mazin’s course for us?

I am currently taking the TCM Dermatology Diploma Course taught by Mazin Al-Khafaji in London, UK.  This program consists of five modules, each of which is three full days of learning.  We study the fundamentals of dermatology (lesions and symptoms) from both the biomedical perspective as well as the TCM understanding.

Because we are focusing mainly on the treatment and management of inflammatory skin diseases, we examine in-depth the TCM theory of Clearing Heat from the body (especially as it pertains to dermatology).  We learn how to recognize the most common skin diseases seen in the clinic and how to treat or manage them with Chinese Herbal Medicine (such as various forms of eczema, psoriasis, rosacea, acne, tinea, perioral dermatitis, seborrheic dermatitis, alopecia, lichen planus, warts, herpes, vitiligo and more). Mazin shares his mass collection of photos obtained from his own patients and we examine each one in fine detail as we go over case after case to gain experience with these oft-visually-confusing conditions.

His case studies are presented in a logical way that takes you from initial patient visit and follows the progression of herbal formulas and treatment outcome so you can understand the evolution of proper herbal formulation as the symptoms and condition of the patient change over the course of treatment.  It is a remarkably well-organized course and his clinical experience seems unparalleled.

The more I learn about dermatology, the more complex and challenging I realize these diseases are and the more grateful I am that I have this opportunity to take this amazing course to improve my skills as a clinician to achieve better treatment outcomes for my patients.

What made you pursue this course (which is pretty darn extensive!) over the other options out there for studying TCM dermatology?

I chose to take this particular course for 3 reasons:

1. It is the most comprehensive TCM training in dermatology outside of doctorate school in China.
2. I don’t speak Mandarin (the class is taught in English, thank goodness!).
3. Mazin’s clinical results speak for themselves. If I am going to be the best practitioner I possibly can be, I need to be trained by the best.

You are dedicating quite a bit of time to this course – not only to travel in and out of the country multiple times this year, but also (I’m presuming) for self-study at home. How many hours a week or month do you think you put towards Mazin’s course?

Fortunately for me, I see enough dermatology patients in my clinic that on a daily basis I put to practical use the material we are learning.  So I am constantly refining herbal formulas and diagnosing new dermatology cases based on what we have been taught in the diploma program.

Of course, each time I go over to London, we get tested on the material we learned in the previous Module.  Mazin’s tests are challenging, to say the least.  So I definitely devote several additional hours to purely studying the material and memorizing things each month.  But I have no idea how many hours specifically.   At least 10 hours or more per month, I’d say.

What is your favorite aspect of the course?

My favorite part of the course is that I have already learned more than I had hoped to about dermatology and I am much more confident in my skills as a practitioner. I am getting significantly better clinical results for my dermatology patients and that is what taking this course is all about.

I also love that I am studying with an elite group of TCM practitioners from around the world and I learn so much from their different perspectives on medicine and humankind each time we are together.  I feel honored to be part of this dedicated group of people.

Once you complete Mazin’s course, is there a final exam? Is there a practical (patient-treatment or case study) component? Then do you become certified?

There is a written exam after each Module and then there will also be a final exam at the end of all 5 modules.  I will receive a diploma and become a member of the Register of Chinese Medicine Dermatology.

Had you been to London before you began the course?

I was in London once prior to this diploma program.  I took a 3-day course in Autoimmune Diseases and Difficult Cases from Mazin in September 2013. At the time I thought I might never have the opportunity to complete the diploma program, but I wanted to learn from Mazin and I thought that class might be my only prospect.  It was a great class, but I am glad I was wrong about it being my only chance to study with him.

Have you made significant friends during the course? How many people are you currently studying with?

I think there are 42 (?) medical practitioners in the class (from all over Europe, the U.S. and even Australia!).  Now that we have been to 3 Modules, we are getting to know each other better.  We spend the vast majority of our time in class paying attention to every word that comes out of Mazin’s mouth, so there is little chance to get to know each other during class.  Lunch breaks and dinner after class are when small groups of us can hang out together and socialize.

There are some really cool people in this program and I am honored to get to know them; and yes, I have made some wonderful new friends!  Facebook helps some of us keep in touch between Modules.  I think I am going to be disheartened when we finish this course because I won’t get to see these fine folks regularly in person anymore.  It’s been sweet looking forward to getting together with new friends in addition to being excited about learning more each time.

What’s been your favorite part of studying with Mazin so far?

The best thing that has come from studying with Mazin is the greater understanding I have gained about dermatology and using TCM to effectively treat dermatological conditions.  I have been able to help more patients and get better results for them.  I have a greater confidence in my clinical skills and I look forward to being able to help so many more people.

Mazin (by the way, his name is pronounced “MAH-zin”) is brilliant and his courses are so logically designed and well-organized.  He holds himself and his students to very high standards.  Learning from him has changed the way I practice.  For this dermatology diploma course, we learn to recognize the diseases (I have already successfully diagnosed and treated conditions that were wrongly diagnosed by dermatologists or that went previously undiagnosed), how to treat them, how to interpret changes in the patient and monitor progress, and what to expect for the time frame in which these conditions evolve/resolve.  In addition, his style of herbal formula development/evolution can be extrapolated into the treatment of any type of condition (i.e., not just for dermatology but for gynecology, digestive complaints, autoimmune diseases, etc.).

Traveling to London to take this course has been expensive and definitely requires much time out of my personal and business life, but it has been more than worth the sacrifices.  I am not a city girl but I love London.  Experiencing the people, culture, lifestyle, food, weather, scenery, architecture of a new city/country makes me a better person.  It has expanded my view point of worldly issues and helped me see my own country in a new light.  London is such an international city – walk down any street or pop into any café or pub and you will hear more accents and different languages spoken than anywhere I can imagine.  So the city itself has been a big part of my experience in addition to the dermatology training.  Studying alongside physicians and TCM practitioners from the UK, Europe and Australia has also broadened my image of our medicine in the grand scheme of medicine in the world.  Learning about the cultures and customs of other countries directly from my fellow students opens my mind to thinking in new ways.  I am thrilled I decided to take this course and to pursue it in London (as opposed to waiting for Mazin to bring the program to the U.S. – which he hopes to do in 2016).

Least favorite part?

Jet lag. Oof. I have never experienced it before in my life.  I thought people were being wussies when they complained of having jet lag.  Now I understand how exhausting it can be.  It takes me a full week to get my body on London time.  Fortunately on the return, my body slips right back into Mountain Time Zone and I experience no jet lag when I come home.

When you travel to Mazin’s courses, do you often go with a specific difficult patient in mind, to pick his brain? Is there ever time for that kind of one-on-one case study with Mazin while you’re there?

Yes, I often have cases in mind, but really there is no time for that. And with almost 50 students in the class it would be very unfair of any one of us to monopolize his valuable time like that.  Instead, I am a member of the Avicenna Forum, a free online group that Mazin moderates where TCM practitioners can present difficult cases and get feedback from colleagues all over the world.  Though there is a section specific for dermatological cases, members can post about any conditions they are treating with Chinese Medicine (mostly relative to herbal treatment).  Learn more and get details on how to join here.

Do you feel pretty comfortable getting around in foreign countries in general, or did it take some getting used to? Is it easy now that you’ve been several times?

I like adventure, so even if a new place seems daunting at first, I look forward to exploring and figuring it out.  The nice thing about these frequent trips to London is that I stay in the same neighborhood each time, so I’ve gotten to know the area well.  I know how to get around on public transportation (the London Underground, buses, trains, walking), I know where to get a good latte, a cheap meal and where all the best croissants are made fresh.

I feel at home in that neighborhood and that is a comfort when I am traveling solo so often.  I like to run to stay fit and running in a foreign city is a fabulous way to get to know a small area really well on foot.  Though every time I go to London I notice new places (shops, restaurants, points of interest, etc) and that keeps it exciting.

What is your favorite place to stay in London while you’re studying with Mazin? Favorite place to eat? Pictures?

I’m not sharing my favorite place to stay until I am done staying there – I don’t want anyone else to rent the cheap room out from under me ;).  But I stay in the Marylebone neighborhood of Westminster, as it is a nice area close to Regent’s University in Regent’s Park, where class is held.

This program and the associated travel are taking all my financial resources so I’m usually on a really tight budget when I go over there.  As such, I don’t eat in fancy restaurants…I try to eat yummy but affordable food.  Each morning I usually start off with a latte and a fresh ham and cheese croissant from one of 3 patisseries I pass on the way to class (and Patisserie Valerie on Marylebone High Street makes an amazing Eggs Florentine that is my favorite).

Lunch is usually from Pret A Manger (a chain of shops with locations all over the city that makes fresh sandwiches to grab-n-go). I have had dinner in a few nice restaurants but at this moment I cannot recall their names! There are quaint pubs on just about every corner, so lots of nice places to meet up with friends after class for a pint or glass of wine.

Do you have any advice (do and don’ts) for people traveling in London?

1.  If you are traveling to London from far away, try to get a nonstop flight if at all possible. The longer your travel time (hanging out in airports, catching connecting flights, etc.) the more jet lag will affect you once you arrive at your destination.
2.  Try not to arrive at Heathrow airport at the 7am hour. So many international flights arrive at that time and Border Patrol/Customs is a long wait when it is that crowded.
If you can’t get a direct flight, do not return via a connecting flight at JFK International Airport in New York. You will have to collect your luggage, wait in a massive line to go through Customs, recheck your luggage, go through security again, and then make your way to proper terminal to catch your connecting flight home.  It is a ridiculously disorganized mess and it makes it easy to miss your connection.
3.  Public transportation is easy and efficient. Get an Oyster Card once you are there because it makes getting around so simple. It’s a prepaid credit card that you simply tap on a pad at turnstiles to pay for trips on the Tube (the Underground) or on local buses.  You can purchase it and easily “top it up” (add money to it) at every Underground station.
Bring only what you can fit in a rolling suitcase that would fit in the carry-on overhead bins of a plane (or in a medium-sized backpack). If you are taking the Tube to/from the airport, you will be lugging that suitcase up/down long staircases and across cobblestone streets and you’ll get pissed off every time you have to lift a bulky or heavy bag.
4.  Pack/wear comfortable shoes that you can walk in all day.
5.  I’ve never needed to use my umbrella but don’t be without one. This is London.

6.  For women, pack a large scarf or Pashmina. It will dress up casual outfits for an evening out, it acts as a blanket or pillow on your flight, it might be all you need to keep you warm at night in the summer and it will keep you toasty in the damp winter there (it doesn’t usually get really hot or really cold, so the versatile Pashmina is very useful).
7.  People in London dress a tad fancier than people in say, Colorado. Pack comfortable clothes, but maybe choose outfits nicer than a Hawaiian shirt and shorts with flip-flops (i.e. don’t dress like a tourist).
8.  The electrical adaptor used in Europe is NOT the same one used in the UK. You can buy one before you embark on your trip, but you can purchase one almost anywhere once you are in London (the airport, Boots pharmacy, souvenir vendors on the street). They were even cheaper to buy at Heathrow Airport than they were to buy in my home town in the U.S.
9.  There are Boots pharmacies all over London. You can buy personal care products, umbrellas, electrical adaptors, sunglasses and all sorts of things you might forget to pack.
10.  Waitrose is a nice local grocery (lots of locations all over the city) where you can buy wine and food to prepare on your own.
11.  Be kind to people and they will help you out with anything you need from restaurant recommendations to which line to take on the Underground.
12.  Have a pint at any of the neighborhood pubs when the locals get off work (4 – 6pm). Chat some people up and learn a lot about life in England.
13.  Walk from Oxford Circus to Picadilly Circus to Trafalgar Square and then to Big Ben and Parliament. Cross the bridge, walk along the Thames riverside and stop for a pint outside on one of the barges turned pubs along the river.
14.  Take an early morning run through Hyde Park, Regent’s Park or along the Regent’s Canal.
See Queen Mary’s Garden in Regent’s Park and enjoy a latte or a pint on the outdoor patio at the café in the park.
15.  Sit on the top level of a double-decker bus as you ride down Oxford Street.
16.  Eat croissants.

Do you try to do a little sightseeing each time you visit, or is there just not enough time? I would imagine money could be prohibitive as well. Have you hopped over to mainland Europe at all before/after the course?

(I am going to go off on a tangent for this answer, but I think it is an important one.)

I always make time for sightseeing on these trips.  I figure, I am already taking time away from my clinic and my home so what’s a few more days here and there to experience more of the world?  Yes, it can get costly, but if I already flew 3,000 miles (10-hour direct flight) to be in London, I might as well visit other nearby places while I am so close.  When might such an opportunity arise again?  I will not squander my chances for new experiences.  There are lyrics to a Dierks Bentley song that I always think about when I am making travel (and life) decisions:

“There’s times I’ve wasted money
‘Cause I know that I can always make more cash…
But wasted time is something, man,
When it’s gone, you can’t get it back”

I couldn’t afford to pay for all my travel up front so I pay for each leg of my London trips just in advance of traveling (meaning, I did not pay for all my plane tickets and accommodations in the beginning of this year, I buy them a month or two before I go each time).  And then I work my ass off to recover the expenses when I get back (including the days of lost income in the clinic since I do not get paid time off).  But I have zero regrets and it has never been a waste of money.  I remember several years ago when I first heard about this dermatology diploma program; I ruled it out as an option for me simply because it was in England.  WTF?  Why was that my mindset?  Why was I so quick to limit my opportunities in life?  I limited myself because I was listening to other people who have put such limits on their own lives. Now I realize that I CAN do things like this even when everyone else tells me I am nuts or they flat out exclaim definitively: “You can’t do that!”  Screw you, yes I can!  I recall the exact moment when I realized I could indeed allow myself this career- (and life-) changing opportunity even though it seemed so far out of my reach:

In February 2014, my best friend Marla (also an acupuncturist) and I flew down to Austin, Texas for a 3-day seminar Mazin was teaching at the Southwest Symposium (golly, I am starting to sound like a groupie!).  Sitting outside at a picnic table one night, we were deep in conversation over a pint at Banger’s Sausage House & Beer Garden.   I was talking about how I really wished I could take that dermatology diploma course in London (I talked about it all the time to anyone who would listen because Bruce Springsteen says in the song Badlands: “Talk about a dream, try to make it real…”).  We also talked about my uncle who had recently passed away.  He was drafted to Vietnam in the seventies and after a couple years in service, he was issued a short leave and planned to visit Australia.  But just before his trip, he was discharged so he wasted no time getting straight back home to the U.S.  He always said he would someday visit Australia but he never did.  “Someday” is a dangerous word.  The prospect of “someday” allows us the laziness to defer action until some unforeseeable time in the future… a future that may never come to us.  It was that moment that I said to Marla, “F*ck it.  I am going to London.”

So back to your original question: During my jaunts to the London, I’ve taken side trips to southern England, Scotland and most recently Ireland.  I will visit Scotland again when I return in September.  I have not hopped over to mainland Europe yet, much to the chagrin of my relatives in Germany who keep urging me to visit.  To stick to my limited budget for these trips, I use AirBnB.com to find inexpensive but interesting lodging.  I seek out restaurants/pubs that serve excellent local food (typically whatever the comfort food is for the region) because these places are usually not expensive or fancy and I want to experience the food of that region.  In other words, there might be awesome French cuisine served in a 5-star restaurant, but if I am in Inverness I am going to try the local free range Highland beef with a haggis appetizer.  In Ireland, I had the freshest mouth-watering seafood chowder of my life and it was the cheapest thing on the menu.  A nice perk about renting a room found on AirBnB.com is that the local owners will give you the local insight to restaurants, pubs, and tourist attractions.  This saves you valuable time trying to figure that stuff out on your own by trial and error.

Anything else you want to add about the course?

It has been worth every penny.

Thank you again for sharing, Diana! I hope you guys are inspired to keep learning, travel as much as you can, and make connections with other talented practitioners around the world.

Have questions or thoughts for Diana? Leave them in the comments below!