East meets West: internist also practices acupuncture.

The 82-year-old woman hobbled into the clinic in the Malcolm Grow Medical Center at Andrews Air Force Base much as she had been going everywhere--hunched over a cane. Suffering from severe spinal stenosis, the woman--whom doctors had tried to help through conventional means--was considering giving up her well-loved job as a museum volunteer because it was so hard just to move.

Now the woman was hoping for pain relief from a nascent movement in Air Force medicine--acupuncture. Col. (Dr.) Arnyce Pock, Director of the U.S. Air Force Medical Corps and Chief of Medical Force Management at nearby Boiling Air Force Base in Washington, D.C., who had recently learned the practice of medical acupuncture, was one of the clinicians on the case.

What happened next totally amazed Pock--and cemented her belief in the promise of what was, for her, a completely new way of treating refractory ailments.

A couple of small needles were applied to strategic points in the patient's ear. In what seemed like no time, there was a dramatic change in her condition.

"Before my very eyes, she stood up, straightened up, and start walking down the hall, twirling her cane like the youthful cheer-leader she once was," Pock recalled. "Then she came back and gave me a huge hug. The incredible feeling of being able to help someone and alleviate their suffering is what medicine is all about."

"It had a tremendous impact on me. I felt like I was floating on air for the rest of the day!"

Finding life force

In her executive post, Pock, 48, works with the 3,500 active-duty Air Force doctors stationed around the world, along with Reservists and members of the Air National Guard, on issues from recruitment and retention to strategic planning to graduate medical education.

But when she is not traveling or attending to other duties in her main job, Pock spends one morning a week treating patients with acupuncture at the Andrews clinic. The marriage of her developing work in medical acupuncture with her longtime experience in internal medicine is an instructive story of East meets West.

Though it may be a new concept to physicians trained in Western medicine, acupuncture is an ancient practice, started in China before 2500 B.C. Needles are inserted at precise points in the body through which the life force, or "qi," is thought to flow.

Why does it work? According to the Web site of the American Academy of Medical Acupuncture, "the classical Chinese explanation is that channels of energy run in regular patterns through the body and over its surface. These energy channels, called meridians, are like rivers flowing through the body to irrigate and nourish the tissues. An obstruction in the movement of these energy rivers is like a dam that backs up in others."

Those obstructions cause pain, the site notes, and properly inserted acupuncture needles can clear the obstructions.

"The modern scientific explanation is that needling the acupuncture points stimulates the nervous system to release chemicals in the muscles, spinal cord, and brain," the site says. "These chemicals will either change the experience of pain, or they will trigger the release of other chemicals and hormones which influence the body's own internal regulating system."

The term "medical acupuncture" has been around since the 1970s--it is defined as acupuncture performed by a doctor trained and licensed in Western medicine with thorough training in acupuncture as a specialty practice. Such a doctor can use one or the other approach to treat an illness, or a combination of both--a way of using acupuncture that is known as "complementary" medicine.

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The World Health Organization has said acupuncture treatment can be effective for a variety of common disorders--from post-operative pain to nausea to stress and anxiety--with low side effects. According to the 2002 National Health Interview Survey conducted by the National Centers for Disease Control and the National Center for Health Statistics, an estimated 8.2 million U.S. adults had used acupuncture at some time, an estimated 2.1 million of them within the previous year.

Doctors are still divided about acupuncture, though their acceptance seems to be growing. In a 2005 survey of 700 physicians conducted by HCD Research and the Louis Finkelstein Institute for Religion and Social Studies of The Jewish Theological Seminary, 59 percent said they believed that acupuncture can be effective to some extent.

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Trips to China

Even after seeing the 82-year-old patient's pain evaporate so quickly with acupuncture treatment, Pock can understand why many physicians still have doubts.

"I have to admit I could not give you a Western-based explanation" for why the treatment worked, she said. "It is quite a different shift for today's scientific, precision-oriented culture to openly embrace techniques that we can't fully explain."

Born in Chicago in March of 1959, Pock was drawn to medicine early, initially to her father's field of podiatry. In the early 1970s, her parents were among the first Americans allowed to visit China. Pock remembers stories her father told even then about a colleague who for years had suffered from a frozen shoulder. The colleague was skeptical of trying acupuncture, but the treatment dramatically improved his condition.

As Pock got closer to making decisions about her future career, her father noted that there were some limits associated with his line of work, and that there were certain conditions that might initially manifest as a podiatric (foot) disorder, but would require referral to a specialist--typically an internist--for full resolution. That eventually contributed to Pock's decision to embark on a career in internal medicine.

It also seemed natural for her to sign up as a cadet in the Reserve Officer Training Corps at the University of Illinois at Urbana-Champaign. She almost followed her father into the Navy, but ultimately signed on with the Air Force: "Maybe I just wanted to prove that I could do this on my own," she says.

Shortly after graduation she went on to the Uniformed Services University of the Health Sciences--run by the U.S. Department of Defense--for her medical degree, then to a residency in internal medicine at Keesler Air Force Base in Biloxi, Miss.

Pock quickly seized opportunities for leadership. Her first post-residency assignment was to the hospital at Chanute Air Force Base in Rantoul, Ill., where she became chief of internal medicine. She held positions of even greater responsibility at the Royal Air Force base, Upper Heyford, England, and at Misawa Air Force Base in Japan.

While stationed in Japan, Pock made two trips to China and saw firsthand how some acupuncture techniques were performed. But it would still be years before she would venture into the territory of practicing acupuncture herself.

She returned to the U.S. as a Fellow in the Clinical Quality Management Division of the Air Force Medical Operations Agency, Office of the Air Force Surgeon General in Washington, D.C. She subsequently became the Surgeon General's chief consultant for internal medicine and was later assigned as a squadron commander for the 347th Medical Group at Moody Air Force Base, Georgia, before returning to Washington in 2002.

Shortly after her return to the D.C. area, she met Air Force Col. (Dr.) Richard Niemtzow--leader of the acupuncture clinic at Malcolm Grow and a driving force in expanding the use of acupuncture in military medicine--when they sat together at a military function.

Niemtzow, a radiation oncologist, told her about a short, intensive course for doctors taught by Joseph M. Helms, founding president of the American Academy of Medical Acupuncture, through the UCLA School of Medicine. "The next day I called for some information," Pock said.

She took the course, which involved spending four days in California and six months of home study, followed by 10 days of intensive clinical work in Tucson, Ariz. That work included inserting needles in patients and fellow students, who also practiced on her.

"Not only did you learn to feel what the needles felt like going in, but the fact that we practiced on each other provided an extra incentive to rapidly improve one's needling technique." Pock said.

Still, it took time and experience, such as that encounter with the elderly patient, to fully convince Pock of acupuncture's promise. "She started off being very skeptical," Niemtzow said in a recent interview. "All the physicians I have trained in the beginning are skeptical, but curious."

That first patient has required some follow-up treatments, as do many others, Pock said, but in general, acupuncture has proved effective in managing her pain. Under Niemtzow's guidance, Pock also has used acupuncture to help patients lose weight (by inserting needles at a point thought to suppress the appetite), avoid hot flashes and manage arthritis and many other types of chronic pain. The treatment can be particularly effective in alleviating migraine headaches, sometimes within a few minutes, she says. "You can just see the patient's expression change from one of agony to a brilliant smile."

Acupuncture also has been effective in correcting xerostomia, a condition of severe dry mouth that can be a side effect of radiation treatment for cancer. Treatments with ultra-thin needles--"people hardly know they go in," Pock said--have enabled patients to begin producing their own saliva again, with lasting results for many.

Life-changing treatment

With Niemtzow and two other doctors, Pock wrote a case study, published in March in the journal Medical Acupuncture, that described how auricular acupuncture changed the life of a 55-year-old woman. The woman had suffered from chronic disequilibrium with periods of disabling vertigo for 30 years.

After needles were placed in her scalp and each ear, the doctors wrote, "the patient reported a dramatic resolution of all vertiginous symptoms. In fact, for the first time in 10 years, she was able to walk briskly, with her gaze forward and without any need to rely on her husband or the adjacent wall."

Pock lives in Alexandria, Va., with her husband of nearly 12 years, Gary Adams, who works in the Airman and Family Readiness program at the Pentagon. Both avid travelers, they first met on a group trip to Finland and Sweden. They have no children, but they do have an 8-year-old West Highland White Terrier, and Pock has recently become interested in whether the dog's arthritic symptoms could be helped with veterinary acupuncture.

When she attended medical school in the 1980s, there was very little introduction to complementary medicine, Pock said. Now, she said, "many traditional medical schools are starting to change."

So is the military. Niemtzow, Pock's mentor, has proposed using a mobile version of acupuncture to help alleviate pain on the battlefield. Niemtzow also has used medical acupuncture to treat phantom pain in amputees returning home from the war in Iraq at Walter Reed Army Medical Center in nearby Washington.

Pock is one player in this movement, says Niemtzow, but her interest and participation in acupuncture treatment while holding a post in senior management is unique.

"I think what is interesting is that a woman like Dr. Pock, who decided to go into (executive) medicine, has been captivated by alternative medicine," Niemtzow said. "Even in that once-a-week setting, she's able to help patients and achieve self-satisfaction ... she's helping her fellow man."

Being open to these new clinical approaches has also helped Pock in her administrative responsibilities, one of which has been to help Air Force doctors across the globe navigate the local cultures in which they work. That's important to the larger mission of the Air Force, as "sometimes 'medical diplomacy' can build bridges in places where traditional diplomatic efforts may not."

"I really enjoy patient care. I also think it's important that I spend some time in the clinic. It helps maintain a degree of credibility ... and taking care of patients is what attracted us all to medicine in the first place."

Also, she said, "Just doing some clinical practice has helped me keep my personal sense of balance and perspective." (Her main job, which involves representing and responding to doctors around the globe, "can very easily become a very encompassing, never-ending task.")

She isn't likely to leave the leadership track, or to consider medical acupuncture as a complete replacement for many of the techniques she has learned in years of practicing conventional internal medicine.

"I'm still a very firm believer in Western medicine," Pock said. "But I really think that for certain conditions, a combination of Western and Eastern practices can be a benefit. The real advantage is in synergy, not in one replacing the other.

"It certainly has broadened the array of treatments I can offer a patient."

Kate Shatzkin is a journalist in Baltimore, Md.

RELATED ARTICLE: Col. Arnyce R. Pock

Age: 48. Married to Gary Adams. Lives in Alexandria, Va.

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Current positions:

* Director, U.S. Air Force Medical Corps and Chief, Medical Force Management

* Office of the Air Force Surgeon General, Bolling Air Force Base, Washington, D.C

* Assistant Professor of Medicine, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Md.

Education:

* Bachelor's degree in biology, University of Illinois at Urbana-Champaign, 1981. Distinguished Graduate, Air Force ROTC.

* Doctor of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md., 1985

* Residency in internal medicine, USAF Medical Center, Keesler Air Force Base, Biloxi, Miss., 1985-1988

* Training in medical acupuncture; UCLA School of Medicine, Medical Acupuncture for Physicians Course, 2004

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Hobbies: Horseback riding, travel

On her career: "I really enjoy patient care and think it's important that I continue to spend at least some time in the clinic, taking care of patients. Doing so not only helps me maintain a degree of credibility, but it helps preserve my own sense of balance and perspective. Even more, it allows me to attain first-hand awareness of the challenges faced by my colleagues."