Chip's Obituary: Journal of Chinese Medicine • Number 119 •February 2019

This article is an obituary for the East Asian medicine practitioner, author and teacher Charles ‘Chip’ Chace.

By: Dan Bensky & Craig Mitchell

The East Asian medical world lost one of its most extraordinary teachers and practitioners when Charles ‘Chip’ Chace passed away on 3rd November

2018 due to pancreatic cancer. Chip lived a well- considered and coherent life. Regardless of whether he was rope soloing a rock climbing route, sharing his knowledge and love for the traditions of East Asian medicine, or just sitting quietly, he always fully expressed his being. His strong centre allowed him to be a generous and caring soul, someone whocould be both self-e acing and yet memorable.His presence and thoughtful interactions have left a profound impression on everyone who had the good fortune to come into his sphere. His motto, ‘Grace and Power’, was an apt descriptions of who he was.

We had the honour and joy of knowing and working with Chip for many years. His mental fortitude and ability to be fully committed to whatever he was doing was a wonder. From the outside he had three main interests, but in fact he tied them together so closely that they made a steady three-legged stool that served as a platform for his life.

He had an intense love of the wild, which expressed itself in his connection to rock climbing, a passion that started in his mid-teens and continued throughout his life. Besides having climbed all over the world, he spent a few weeks almost every year in solitude among the peaks of the Wind River Mountain range in Wyoming. The years he missed were because he was doing things like long solo trips to very isolated locations, such as Mt. Asgardon Ba n Island in Canada. As amazing as this was,the ‘Chip twist’ is that he had a coterie of climbing friends that he had climbed with since the late 70’s, and who continued to be his be compadresright up to the end. In fact three of them were byhis side when he died. These friends, themselveswell-known xtures of the Boulder rock-climbingscene, all spoke about Chip’s intensity, his pursuit of

56 Grace and Power: In Memory of Charles ‘Chip’ Chace

Journal of Chinese Medicine • Number 119 •February 2019

excellence, and his utter lack of any interest in celebrity.Fine Jade, the Sound of One Hand Thrashing and Ziji (the pinyin for ‘self’ in Chinese) were some of the climbing routes that Chip pioneered. The names of these and other routes speak of Chip’s innate ability to stay connected at once to climbing, East Asian medicine, meditation practice and his own quirky sense of humour.

He was rigorous without the slightest rigidity, self-assured yet humble, and both very determined and very funny.

Chip was a kind and patient teacher on the rock wall, as well as in the classroom. He was free with input to lessexperienced climbers and was happy to o er suggestions when needed. He had a very speci c way of taping hishands for crack climbing to protect the skin and allow for the best use of the special techniques unique to that discipline. He often brought his meditative practice directly onto the rock, spending moments before, during and after climbs in quiet contemplation of the task athand. Yet, he could also be a ery competitor whileclimbing, although most often he was in competition only with himself.

He had an almost equally long and intense relationship with East Asian philosophy, Buddhism and meditation. This expressed itself not only in a daily practice, but in multiple long retreats and a sense that all of his time in the wild was a way of obtaining the same experience. This interest in East Asia took him to study the medicine.He saved up by working in the oil elds of Wyoming andwent to the New England School of Acupuncture in theearly 1980’s. After nishing these studies, he returnedto Boulder where he had a very successful practice until his death. We have had the opportunity to see quite a few of his patients who moved to Seattle. Chip had not only been extremely helpful to these people, but had made deep and lasting connections with them.

By force of will and dedication, Chip learned to read Chinese pretty much on his own, which as many peoplereading this will realiae, is an impressive feat. In additionto his own voluminous translation work that has madea major impact in the eld of East Asian medicine, hewas warmly welcomed at advanced seminars on such topics as medieval Daoism and Tang poetry. With his friend Antje Richter, a professor at Colorado University, he recently published a long article in a prestigious Sinological journal.

While the above were the three legs of the stool of Chip’s life, the seat that made it all solid was his relationship with Monika, his wife of more than 30 years. Originally they met around rock climbing, but their intimate connection went far beyond shared

interests and attraction, to become something special.They shared o ce spaces for much of their married life— that they did it successfully and stayed together is all anyone needs to know about the strength of their bond. Both intensely private people, they found refuge and true love in each other’s company.

Our personal connection with Chip revolved primarily around our shared interest in East Asian medicine ingeneral and the role of palpation speci cally. We spenthundreds of hours together discussing these topics and teaching together. Chip was a generous and demanding friend and teacher. He was always ready to encourage someone by referring to how ‘juicy’ a particular topic was, yet all who worked with him had to be ready for his special way of saying ‘Really?’ to call out some sloppy thinking or a half-baked idea. He was rigorous without the slightest rigidity, self-assured yet humble, and both very determined and very funny. He always took seriously whatever he was working on or whoever he was working with, yet never took himself seriously.

His ability to integrate all these facets into one being was what stood out the clearest to us. To most people,the ne and subtle approaches to using the hands informs of Japanese acupuncture like Toyo Hari [where many of the practitioners wear gloves whenever not seeing patients in order to protect their hands] would bediametrically opposed to rock climbing, where ngersare jammed into cracks and twisted tight [and therefore damaged] to provide a hold. Not to Chip. Not only didhe demonstrate clearly that rough and frankly dis guredhands could be capable of the subtlest of sensitivity, but he would practice some of the hand positions associated with those types of acupuncture while putting hisngers in the cracks used for rock climbing. Those whoreferred to his approach to acupuncture as ‘Chip-ohari’ were on the right track.

We mentioned above that Chip had climbing friends who went back decades. One of them summed up Chip succinctly by saying that ‘He was the most intense laid- back dude you’ll ever meet.’ His own epitaph says thesame thing in a slightly di erent way:

He arrived and departed as an empty vessel.

Pursued many summits in between, attaining some while others remained elusive

But found grace in his life and death.
Dan Bensky and Craig Mitchell were friends of Chip Chace.

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Way of the Silent Master: A Chip Chace Eulogy on The Runout Podcast

http://runoutpodcast.com/index.php/2018/12/14/runout-12-way-of-the-silent-master-a-chip-chace-eulogy/

Podcast from Andrew Bisharat & co-host Chris Kalous:

Chip Chace dedicated his life to the practice of climbing—which is to say, that he had dedicated his life to the practice of living. 

Chace was no household name in the climbing world, yet his contributions to climbing—such as the first ascent of Fine Jade, inarguably one of the best and most popular 5.11 desert towers—gave him a stature of respect and admiration within the core climbing community. 
Chace rarely spoke about his climbing, and yet you’d have to go really far to find a route he hadn’t done or an area he hadn’t explored. This silent passion, in which accomplishments speak for themselves, left an indelible mark among his closest friends and admirers. 
On November 3, at the age of 60 years old, Chace died of pancreatic cancer following a relatively short yet extremely painful battle with the disease. He died in his meditation room in his home in the mountains outside of Boulder, Colorado, surrounded by his closest friends and his wife, Monika. 

In the last weeks of his life, he wrote a letter to his friends and patients, whom he served as a practitioner of Chinese medicine. It’s a powerful letter that speaks to what an extraordinary spirit Chase embodied. Here’s an excerpt:

First and foremost, I want my death to be an act of creative transformation, that is to say, I want to die well. I’ve been training for this my entire life and I’m well prepared. I would have preferred to die in the mountains, and that is indeed what Monika and I had envisioned for me. I got this instead. Yet, here is precisely where I want to be. I cry from the raw wonder and intensity of the experience but never because I’m sad or afraid.

I’m grateful for every second I’ve lived so far and for whatever moments I have left. When I’m writhing in pain I scream thank you. When I’m puking my guts out I retch thank you…and sometimes FUCK!!!!!. I’ve been practicing more or less this way for a long time.

I think what Chace is saying here is that climbing might not just be a good way to practice living. Perhaps it might also be a way to prepare ourselves for the inevitability of death.

This is Andrew Bisharat, and I’m here with my co-host Chris Kalous. Today we have two guests: Jamie Logan and her son, Michael Logan. Jamie was a peer to Chace, a close friend and climbing partner. As a younger man, Michael considered Chace one of his most formative mentors. We invited Jamie and Michael on to do something that, ironically, might have caused Chace himself to grimace: put into words the significance of Chip Chace’s accomplishments as a climber. 


Our deepest condolences go out to all those who loved and admired Chip Chace.

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Chris Weidner on Chip: article in local Boulder paper

http://www.dailycamera.com/recreation/ci_32269361/chris-weidner-life-gratitude-death-beauty-chip-chace-climber

Chris Weidner: A life of gratitude, a death of beauty

Legendary climber Chip Chace passes on

By Chris Weidner

It's unusually chilly for Oct. 7 as I switchback up Fourmile Canyon to Chip Chace's house. Through the rainy windshield, cottonwoods are turning yellow. 

For the last few weeks Chace, a venerated doctor of Chinese medicine, has suffered restless nights, often in agonizing, almost unbearable pain. Driving the final miles I realize I'm nervous — acutely aware this will be the last time I ever see him. 

I'm also grateful that, among his countless friends, students, mentees and colleagues, he has made time to see me; he doesn't have much of it left. 

We sit together in his small cabin adjacent to the house he shares with Monika, his wife of 30 years, and their dog, Djinee.

"This is my home," he tells me, pointing to a photo he took in July of a utopian valley in Wyoming's Wind River range, where granite walls tower above lakes and wildflowers. Now 60, Chace has climbed in Titcomb Basin nearly every year since he was 20, and has rope-soloed every major feature there.

"It's the most beautiful place I've ever been," he says.

Chace recounts how he ended up there this summer: how he had just returned early from his second solo trip to Baffin Island in northeastern Canada. How after a punishing, multi-day approach he discovered his climbing gear cache had been stolen. How he was forced to bail, and how he suffered an overwhelming exhaustion he couldn't explain.

Back in the U.S. with extra time, Chace detoured to Titcomb Basin where he soloed Mount Helen, Titcomb's biggest climbing objective.

"It was a 17-hour moment of grace," he says softly. "The rock was perfect. It was just this bluebird day, Chris. It was like, 'Yeah, this is why I do this. This is why I'm going to continue doing this until I can't anymore.'"

"And then ..." he pauses. "I can't anymore." 

Immediately following his trip, Chace learned he was dying of pancreatic cancer.

"That's the last thing I'll ever climb," he says smiling wistfully, glassy-eyed. "It was just this amazing experience, this last gift of the mountains." 

After his first trip to Baffin Island last summer, Chace told me all of his climbing and rope-soloing — what he calls his "practice of the wild" — his mental training, his Zen practice ... everything had been preparing him for his dream climb: Mount Aasgard. 

"From the moment I decided to go to Baffin to the time I went to Baffin everything became brighter for me," he says. "Because it was like, you very well might get killed." 

Chace faced extreme isolation, a brutal climate, sketchy river crossings, crevasse hazard and hungry polar bears. And that's before the climbing began.

"We all know we're going to die," he continues, "but when you know you might die at some particular time, it amplifies it. You live in gratitude for every moment you have. That's what the practice of the wild is in its essence: it's a practice of gratitude."

Days earlier Chace was lying on a gurney in Urgent Care, "in this sea of pain," he says. "I was screaming, sobbing 'thank you!' I was practicing 'thank you,' surrendering to the 'thank you' of it. And Monika is on the gurney with me, spooned up against me, holding me. 

"It's how I want my death to be. I want to go into it with that openness and that gratitude Chris, that gratitude."

So now in his room, during a respite from the racking pain, he understands that his Baffin experience — that "extended flow state" he describes as stretching beyond both ends of his trip, into his past and into his future — was his final preparation.

"I thought Baffin was the big thing," he says. "This is the big thing." His cancer, his approaching death. "In a very real way Baffin was a trainer for this."

On Nov. 3, surrounded by eight of his closest friends, Chace passed away peacefully at home. 

"He died in a really beautiful way because of the people there," said Roger Briggs, Chace's climbing partner and close friend of 33 years. "And they were there because of the life he had lived. 

"There was so much love." 

Contact Chris Weidner at cweidner8@gmail.com. Follow him on Instagram: @christopherweidner and Twitter: @cweidner8

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Manuel Rodríguez Cuadras on Chip

A turning point. A European story.

I don’t remember the year, nor the day. I was in Berlín, in a Toyohari international workshop. Stephen Birch, a long time teacher and friend, approached Miguel Ángel –a friend and a colleague- and myself: ‘Look, I invited this friend of mine, Chip Chace, to give a seminar in Amsterdam, and I already booked the two of you in’. We immediately said ‘OK’, and after a moment asked: ‘What would be the seminar about?’. Steve was rather vague: ‘Something about palpation, I think… but Chip is a very interesting person and a real scholar’. Then, as we were in the middle of a struggle with writing a book together, he add: ‘Hey Manuel, perhaps you can talk with Chip about your herb’s chapter, I will send it to him and ask he get a look at it’. And that was it. 

This is as a good moment as any other in this story to confess that the name ‘Chip Chace’ didn’t evoke in me any special sense of awing or respect. Actually, Miguel Ángel reminded me that we have shared a workshop table the year before, and I still could only barely remember this mostly silent american with long, blond hair and somewhat deformed hand joints. Anyway, I agreed of Steve sending him my ongoing chapter, and mostly forgot about the whole thing up to the dates of the planned Amsterdam seminar

Days passed. Steve told me that Chip agreed on read ‘my chapter’, and he arranged we meet at his home the afternoon before the seminar start. And on this day and place I can say I really meet Chip. Meantime, I have got some basic information about him, and I was consequently grateful of a person of his fame and busy schedule agreeing to take a look of my writings. Not to say how afraid I was of being exposed to a scholar of his learning and knowledge, specially because I was acutely aware that ‘my chapter’ not only wasn’t as academically supported as it should be, but also put ahead some not so common ideas about herbalism in Chinese Medicine.  

Day D: I meet Chip at Steve’s home. He was calm, relaxed, a convival guy, the person, in sum, we all know he always was. After some friendly ‘a trio’ conversation with Steve, he went down to business, and asked me if it would be convenient to talk about ‘the chapter’ taking a walk… because he just arrived some few hours ago, and was suffering jet lag. This was my first personal glimpse of his generosity: he was devoiding to me some precious and needed rest time, just the day before starting teaching. And this was only the beginning. We walked and talked, and he very gently ‘grilled’ me about my concepts and knowledge on herbs, very delicately pointing out the weak points of both my reasonement and my academic formality on supporting them. And I want to underline the kindness which he displayed on all that. Chip was the first person in which I recognized what was to become what I think now is the hallmark of a true master: he was discussing with me over matters in which I was clearly inferior, and was able to do it in a manner that gave me the impression that I was almost at the same level than he. No crushing superiority, no the faintest reproach for my obvious lack of academic support, no. This person, who didn’t know me at all, not only was giving me his precious time, but he was also displaying a kindness and an intellectual generosity over whatever standard you might wish to measure them . Kindness, generosity, deep knowledge and intellectual rigor were the hallmark of this conversation, and the years to come will only show that these were virtues deeply ingrained in Chip’s personality 

The seminar started.  At that time ‘Engaging Vitality’ has no name, and his techniques and learnings were absolutely unknown in Europe. Chip, as you suppose, was brilliant. He made several presentations on different subjects: Extraordinary Vessels (I hardly understood their pulses…), the three basic concepts of  dynamics, tendency and incipiency, the shape of qi, the yang rhythm (then still called CRI) and other osteopathic ideas, always stressing the importance of palpation, and making all of us perceive thorough our hands. This was my turning point. Suddenly the ‘Axis’, the now famous paper on LS1 he did with Dan Bensky came alive, a torrent of new ideas was pouring over me, almost I would say drowning me. I felt at the same time that a rug has been pulled under my feet and that I was solidly grounded, stepping in the fundaments not only of the Chinese Medicine, but of a vision of humanity; I felt like falling down a chasm, and at the same time flying; at the same time I appreciated all the techniques aquired along the years and discard them to make place for this marvelous new world… and I realized I had to do something real with all  this

At the time I was teaching Chinese Medicine, already nuanced by the history and procedures taught by Steve, Junko and their team; but I had to do something more with this new material, this new feeling. I went to Chip and asked him for his presentations, telling him I wanted to use them in my classes, and again, this generous person, this very special teacher, gave me all his precious slides, withholding nothing, with the only proviso of not to publish them. These slides, which I translated and used in my classes, were the origin of what at the moment I called ‘Subtle needling’. I was always keeping Chip abreast of what I did with his material, and we warmly discussed the ways I evolved it, but this is maybe another story. Chip knows that the material I learned was and is treated as a legacy, not to be –as the parable in the Bible illustrate us- to be kept dusty and untouched, but to be alive, growing and developing. The new vision of Chinese Medicine, the use of palpation and how all that influenced both my practice and my teachings, were a clear turning point, an before-and after point in my life

But I still did another thing: when coming back to my practice in Barcelona I told Rayen she had to go to the next Chip’s seminar. Again the ironies of life: she was very, very reluctant to go, mostly because she was more or less recently trained in Toyohari, and was enjoying his marvelous procedures, but also because she had glimpse Chip in one of the Toyohari workshops and formed a very poor opinion of him. I got her going to Chip’s next workshop anyway, probably out of the respect she had for me at the time, and again Chip’s magic worked. Rayen came back to Barcelona ‘converted’. It would be inconvenient to talk about her experience, it is a subject which has to be addressed by her when and if she cares for, but I can say that she was saying: ‘With Toyohari I found my hand; with Chip I found my other hand’. She worked together with Miguel Ángel to bring Chip to Barcelona to teach, which he did, and when he came, Rayen put to herself the duty of getting him to come at least once a year, aiming to make a kind of permanent base for the development of what we learned. As the books usually say: ‘and the rest is history’. Other people came here, were interested in Chip’s teachings, and proposed seminars in other countries. Marguerite and Dan were also considering setting a foot in Europe and came here to teach. The name of Engaging Vitality was born, teaching was –somewhat reluctantly- getting structured, study groups were functioning, and more and more people were, and is, getting committed to EV principles and practice

Now my part of the story is almost over. All these years I enjoyed Chip’s teachings, wit, and company, and now I am teaching not only Engaging Vitality, but also an acupuncture style were I do a kind if preview of it, with the idea of serving as a bridge towards EV for the people who never learned that a body and its vitality are a palpable reality. All that started in a not so far past, when Steve invited Chip to Amsterdam, and when I was deeply impressed by the quality and generosity of the man who called me ‘his brother on yi’.  Now his material presence is over, but as we all know, his spirit and legacy is and will be developing healthy, alive and luminous. A big hug and a deep bow to you, Chip

Manuel Rodríguez Cuadras

Medicina Clásica Oriental, Barcelona, Spain

www.mataifu.org 

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Chip Chace’s 2 Playlists: Soundtrack To My Life & Final Passage

Chip’s Playlist: Soundtrack To My Life (made by Chip)

All Along the Watchtower Jimi Hendrix Voodoo Child: The Jimi Hendrix Collection

Voodoo Child (Slight Return)Angélique Kidjo Oremi

Taboo Santana Santana III

Comfortably Numb (Live) Pink Floyd Live At Knebworth 1990

Angry Eyes Loggins & Messina The Best: Loggins & Messina Sittin' In Again

Dambalou Issa Bagayogo Timbuktu

Tangled Up In Blue Bob Dylan Blood On the Tracks

Wicked Game Phillip Phillips The World From the Side of the Moon (Deluxe Version)

Easy to Slip Little Feat Sailin' Shoes

Love Reign O'er Me The Who Quadrophenia (Super Deluxe)

Dambalou Issa Bagayogo Timbuktu

Goin' Home Malcolm Holcombe The RCA Sessions

High on a Mountain Nikki Matheson Invisible Angel

Over the Edge Sarah Jarosz Build Me Up From Bones

Chip’s Playlist: Final Passage (made by Chip)

The Lightning Strike (What If This Storm Ends?) Snow Patrol Greatest Hits

Destiny (feat. Sia) Zero 7 & Sophie Barker Record

Glowing Heart Aoife O'Donovan Fossils

Hejira Joni Mitchell The Studio Albums (1968-1979)

I Think I See the Light Cat Stevens Mona Bone Jakon

You're My Flame (feat. Sia) Zero 7 Record

Take It to the Limit Eagles Selected Works 1972-1999

Lady Luck Corinne West & Kelly Joe Phelps Magnetic Skyline

Brothers In Arms Dire Straits What Just Happened? (Music from the Motion Picture)

Ramble On Led Zeppelin Led Zeppelin II (Remastered)

Release Pearl Jam Ten

Voodoo Child (Slight Return) Angélique Kidjo Oremi

Feels So Different Sinead O'Connor I Do Not Want What I Haven't Got

High on a Mountain Nikki Matheson Invisible Angel

Done Got Old Buddy Guy Sweet Tea

A-500 Klaus Badelt & Mark Batson Miami Vice (Original Motion Picture Soundtrack) Part of Me, Part of You Glenn Frey Thelma & Louise Soundtrack

Old Friend The Allman Brothers Band Hittin' the Note

Goin' Home Malcolm Holcombe The RCA Sessions

Lateralus Break of Reality Covers

Walking Man Zoë Keating One Cello x 16 (EP)

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Chip Chace obituary in Rock and Ice Magazine

https://rockandice.com/climbing-news/chip-chace-author-of-fine-jade-and-many-major-climbs-dies-at-60/

Chip Chace, Author of “Fine Jade” and Many Major Climbs, Dies at 60

Chace died in Boulder on November 3.

By Jamie Logan | November 5th, 2018

Chip Chace lived his whole life as an extended spiritual practice. “Somehow my climbing practice is not substantively different from my Chinese medical practice, from my meditation practice, from my marriage practice. They inform one another,” Chip said. He was a prolific climber, one of the best all-around of his generation. He came to Boulder at 17, already a 5.11 climber, and soon was climbing with Pat Ellinwood, Steve Levin and Roger Briggs. They would all climb together for forty years. Chip and Pat did the first ascent of Fine Jade and Chip had over 50 ascents of the Diamond with all of them. Chip could lead hard aid, 5.13 free climbing, and many of his climbs had an R rating for minimal protection.

He felt in the later years of his life that his solo climbs, when he was often out for many days at a time in the mountains, were the most important part of his spiritual practice, because it caused him to be fully aware the whole time. He was doing hard climbs all over the country by himself, and never really came back and told anybody, or certainly never wrote about any of it.

We went to Yosemite two years ago, and I helped him carry gear up to the base of the Regular Northwest Face of Half Dome for a rope solo. He started at 3:00 in the afternoon and climbed all through the night because he didn’t want to have to interact with other parties, finishing the next morning.

Recently he felt like he was getting older and he couldn’t climb as well as he had been. He could no longer onsight 5.13, but he could still climb alone in the mountains and he felt that was his place. He had always wanted to solo Mt. Asgard on Baffin Island. On Asgard there was a rockfall that cut his rope, so he came down and decided to tackle Mt. Freya. He was climbing that by himself, and was up in an icy gully when he fell thirty feet and broke his ribs. His comment was, “To the extent that there was a ‘me’ at all—which is a whole other thing, right?—I was completely comfortable.”

Chip was one of America’s foremost scholars and practitioners of classical Chinese medicine. With a small group of colleagues, he was involved in developing a new cutting-edge approach to Chinese medicine diagnostics and treatment. He had many deeply appreciative students and patients.

Chip met his wife Monika in 1987 and they were married soon after. They were very independent from one another, but they still were a tight team. They both loved being in the mountains and the desert and there was quite a long period when they climbed together, doing first ascents in Indian Creek up to 5.12. Monika is a remarkable healer herself, and the two of them had a combined medical practice that really fit together well. After 30 years they were still deeply in love.

Chip died Saturday, November 3, 2018, at the age of 60, in his meditation room at home in the mountains outside Boulder, after a short and intensive course with pancreatic cancer. He always held a deep sense of loyalty towards his close friends. He died surrounded by those friends and of course with Monika. The climbing community, the Chinese medicine community and the Zen community—we are all in grief for the loss of this amazing human being.

In the last weeks of his life, Chip Chace wrote several pieces focused on, among other topics, facing his own mortality and the joys of his life. To read them, visit https://stillwaterhealthboulder.com/charles-site/.

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Chip Update #3

Dear Friends, 

Since my last update, I spent 10 days at home under the loving care of Monika, and David Cooks, my dear friend from Bend. Monika is plugging along, trying to maintain whatever normalcy she can in her life when she’s not here just holding me in her arms.

Cooks is some sort of a cross between a superhero and a saint. He’s stayed with me pretty much 24/7, and shepherded me through a bunch a nasty pain crises in addition to managing an unimaginable amount of logistical work. At one point he was my student but he’s become a far better acupuncturist than I ever was, and I’ve been benefitting from those skills on a daily basis as well. Monika and I would be lost with out him.

Roger Briggs is my social director and the other arm of my logistics team. He’s managing a large amount of email that I’m receiving, and coordinating the input I get, which isn’t much. A few other dear friends have been close by, but I’m unable to see many visitors. The pain and nausea characteristic of this disease have been an ongoing challenge. We are constantly adjusting the meds, which work for a day or two but then become virtually ineffective. Nighttime is the most difficult for pain, though the last two nights were considerably better due to a dilaudid pain pump. I only have a few hours each day when I’m lucid enough to read, write, or talk much, so please forgive me for not responding to the many messages that have been sent to me.  

Last weekend brought two midnight visits to urgent care with unmanageable pain. This landed me back to the hospital a few days ago for a new round of pain management strategies. First, we tried a nerve block procedure, but it proved ineffective, probably because the cancer has spread so much. Today I am being transferred to an acute hospice care facility in Longmont. The plan is to stay there a few days until we are confident that the pain meds are working, then to go home. We are not pursuing any heroic, life-­‐extending treatments. My goal is to die well.  

In the time I have left I need to finish my part of a textbook concerning the synthesis of acupuncture and osteopathic palpatory techniques. To do this work, the meds have to be working well enough to help me manage the pain without leaving me incoherent and nodding off.  

A number of my closest colleagues have flown in to provide support for this project. Rayen Anton traveled from Barcelona and is collaborating with me on several chapters. Rayen and I worked together as much as I could manage and made good progress while she was here. Dan Bensky, my longtime friend and coauthor of this book, arrives today and will spend parts of the next four days working with me. After Dan leaves, Kailey Brennan, one of my students from Denver, will coordinate some 2-­‐hour scribing sessions. I need to spend whatever time and energy I can summon to finish this up. 

Last week I had a visit from Miki Shima, an elder brother in the practice of Traditional East Asian Medicine and a very close friend.  About 10 years ago I asked Miki why he had gone back to practicing Shinto, the ancestral religion of Japan. We all love nature, rocks and trees, but do they really have to have a spirit that we must propitiate? He explained that Shinto was really about gratitude. We don’t so much worship rocks and streams as we express our gratitude for the gift of our being part of the universe in whatever way, good or bad. This insight has shaped my own Zen practice ever since.  

It was good to have Miki here to help me further catalyze this practice, because now it is game on.  I offer my sincere gratitude for my 30-­‐year marriage to a magnificent woman; for a lifetime of wandering in the mountains; for the many patients and students I have had the privilege to have worked with; and for the love and support that so many of you have expressed.  

Perhaps most difficult of all I am trying to fully embrace the reality of my situation with gratitude. I want to go beyond just coping with it all, to a place where there is nowhere else I would rather be. My deepest thanks to all of you for helping me to work toward that.  

Love, 
Chip

To see Chip’s earlier Updates go to:   
https://stillwaterhealthboulder.com/charles-site/

Please send all correspondence to:
Iamchipspancreas@gmail.com

Update #2 from Chip

Dear Friends, September 27, 2018

First and foremost, thank you for your kind and healing communications. There is no way I can respond to all these but please know how much I appreciate the love and support that has been expressed to me.

I left the hospital on Monday Sept 24 and came home. This is a much better environment for me and I have a core team of friends and loved ones taking care of me. The pain is generally under control and the side effects of the opiates are improved but still need work. But I am in good spirits.

One of the many challenges is dealing with all of the communications that are still coming in by email, text, and voice. We have more than 300 people from all over the world on our contact list and it’s very draining for me to process this, so I have a communications team receiving everything and making decisions about when to reply and what I need to see. Please direct all communications to: Iamchipspancreas at gmail.com.

Now that I’m settled in I can begin attending to a few things that I would like to complete in the time I have left. This means that I need space and energy in my life to complete these goals, and sadly I have very little of either. It is a difficult decision to make but with the exception of a few members of my extended family who will be flying in during the next month or so, I will not be receiving visitors. As Monika and I have specific support needs, we will reach out to any of you who may be willing and able to help us out.

Deep thanks for your support.

Love, Chip

Chip’s Saga 2018 September

Chip Chace’s Saga, 2018 September

Greetings friends,
Sorry for taking so long to respond to your missives.
As you may have heard, I’ve had a rather challenging summer culminating in a diagnosis of adenocarcinoma of the pancreas.

Those of you uninterested in the following back-story can skip this bit.
Back in April 2018, I trapped a testicle in my climbing harness and experienced a mild strain injury. The pain persisted and did not seem to improve. In late May, I had a colonoscopy, which was normal. Shortly thereafter, I developed symptoms of gastritis while teaching in Europe. I was unable to consume wine or eat like normal. I experienced persistent gastric upset accompanied by pain radiating between the left flank and both testicles.

I saw my Primary Care Doc at the end of June and we decided to treat for H. Pylori with a berberine-based formula and an iteration of Wen Dan Tang, a Chinese herbal formula. Things improved considerably on this regimen.

I left for Canada on July 8th on a return tip to Baffin Island, while continuing on my gut meds. I flew for two days followed by a one-day boat ride, then a two-day walk, including two sketchy river crossings only to discover that my gear cache had been stolen and that an attempt to solo Mt. Asgard would not be possible.

I made my way back to Boulder by July 20-21. I sought solace in the Wind River range in Wyoming. I’ve been soloing there for the past 40 years and its my home range. Ten miles west of Rollins, I was rear-ended by a semi trailer that was going 40 miles per hour faster than I was. I totaled my Toyota FJ, but was miraculously unscathed otherwise. Monika came up and got me so that I could regroup back in Boulder. I returned to the Winds with a rental car and spent another two weeks climbing. I still had to be very careful about caloric intake and continued on my meds. I did have a 17-hour moment of grace during which I soloed the 1800 west face of Mt. Helen. All the while, I was juggling the gut and testicular discomfort as best as I could.

Upon returning home the upper GI symptoms began to diminish, although the left flank pain persisted, as did the radiating pain into the pelvic floor. I continued working, but was doing very little else. The flank pain became increasingly prevalent and unresponsive to anything that I tried.

I was admitted to Boulder Community Hospital on Saturday 9/8 at midnight with left-sided flank pain that was unresponsive to pain relievers. They ruled out the possibility of a kidney stone via CT scan. This they followed with a CT scan with contrast dye, which identified pancreatic adenocarcinoma and hydronephrosis.

Presumably the tumor or an adjacent lymph node is compressing my left ureter and this is causing the pain.

I continued to have a difficult time with adequate pain control. I received morphine and dilaudid via IV every hour, plus oxycodone every two to three hours and atavan every three hours, which helped with sleep. They also put on a fentanyl patch since I was still getting inadequate pain control. This helped a great deal with the pain. They put in a nephrostomy tube on the left, which helped to decrease pain from the ureter. At some point, I developed intractable hiccoughs, which persisted for 5 days. None of the drugs for this were especially helpful.

I became less responsive to all the pain meds. At some point last night on Friday, 9/14, Monika worked on me while I was in the midst of my barely conscious delirium and this seems have mitigated the hiccoughs significantly but not entirely. The fentanyl made me delirious and I rapidly improved after the removal of the fentanyl patch. By Saturday afternoon, 9/15, I was alert and the pain briefly abated Though by the next day I was again began experiencing nocturnal pain that was off the charts. Two days ago that shifted to nearly severe pain accompanied by intensive wrenching and vomiting fatigue, weakness, and mental fogginess.

The Intensity Scale

Pain is often graded on a scale of 1-10 with 10 being unbearable. For me it’s useful to grade other experiences based on their raw intensity using a similar scale. Uncontrollable vomiting, retching, chills, weakness and muscle twitching may rate a 9 or even a 10 even though actual pain involved. In Baffin last year, I embodied the wild in the midst of a level-10 intensity experience and catalyzed a lasting moment of transformational grace. My death deserves no less than that.

Current Status

My diagnosis is adenocarcinoma of the pancreas and hydronephrosis in the left kidney. There is currently a tube draining that kidney. My biggest medical issue is extreme pain, followed by vomiting, nausea, and mental fogginess. They have not yet staged this extent of the cancer as this requires a PET scan, an outpatient procedure. I still need IV meds for the pain, which requires me to be inpatient. Catch-22. On the other hand, no one is in much of a hurry for me to get the PET scan as all other signs point to significant metastases.

Prognosis is poor. The immediate goal is palliative care - get me home and functional on oral pain meds. Now that I’m marginally lucid, I’ve begun doing Chinese medicine, acupuncture and osteopathy to help me recover whatever strength I can.

Goals

First and foremost, I want my death to be an act of creative transformation, that is to say, I want to die well. I’ve been training for this my entire life and I’m well prepared. I would have preferred to die in the mountains, and that is indeed what Monika and I had envisioned for me. I got this instead. Yet, here is precisely where I want to be. I cry from the raw wonder and intensity of the experience but never because I’m sad or afraid.

I’m grateful for every second of I’ve lived so far and for whatever moments I have left. When I’m writhing in pain I scream thank you. When I’m puking my guts out I retch thank you...and sometimes FUCK!!!!!. I’ve been practicing more or less this way for a long time.

I want to optimize my time with Monika and Djinni.
I also want to nudge my students along as best I can.
If possible, I want to finish up a couple of writing projects,

To achieve these goals, I need to ration my time carefully. We’ve set up this gmail email account: IamChipsPancreas at gmail dot com so that we can keep you updated in a manner that creates the least amount of hassle for everyone.

I’m not seeing visitors just now, but if you want to get together or talk on the phone then please email us back at this email address and we will contact you with information (but DO NOT REPLY ALL because there are about 300 people on this list). That way we can have meaningful conversation with as few interruptions as possible. Please do not just stop by, as virtually every hour of my day is schedule. I know many of you have already expressed interest in getting together. We’re just getting organized here so please write again now if you’re still interested.

A thousand thanks for your love and support Love, Power, Grace and Gratitude to you all.

Chip

Chip on Palpation as Practice

Palpation as Practice: Part I

Learning to palpate is a lot like learning to meditate. The two skills are similar enough that the road signs commonly used to navigate the meditation landscape are also useful on the path to palpatory competency.  I want to talk about palpation from this perspective. We should be clear at the beginning that they are different things, although there is most probably some cross over benefit in practicing both meditation and palpatory awareness. Most importantly you don’t have to be in a deep meditative state to palpate effectively.

Perhaps the most significant commonality between meditation, palpation and for that matter, medicine is that they are all practices. At the beginning, the expectation is not so much that we will be good at these disciplines as that we know how to practice them. They are skills that are cultivated over time. At least in terms of meditation and palpation, we don’t really know the limit to what it is possible for us to experience. 

In learning to meditate, sooner or later we will have a fleeting experience of open awareness. At this point, we can’t really say anything about it. Even acknowledging that it is happening, “hey, look at that, my mind is quiet,” is enough to derail the experience. The early stages of cultivating any form of palpatory awareness can be very much like this as well. It too, may be very fleeting, and just as you think you’ve caught it, it may be gone. Even once you are consistently feeling something, the experience will initially be pre-verbal. It is new and vague enough we have no words for it. Nevertheless, the process of progressively fine-grained articulation builds from this fundamental binary apprehension. I feel something or I don’t. 

After a while perception stabilizes, and we start to be able to look around. As we more consciously experience our experience, we are increasingly able to say things about what we are experiencing. In meditation we may simply witness the moment- to-moment play of our emotions. A common observation for palpators at a similar stage is “well definitely I feel something, but is that me or my patient?”  In more general terms, we might ask whether this input is self or other. Meditators spend a lot of time on the cushion trying to break down the bounds of self and other, just as we are cultivating a capacity to appreciate qi beyond the perimeter of our own skin. Yet, in both cases, no matter how effectively we extend our perception into our environment, we cannot really function without simultaneously being able to distinguish between what is outside and what is inside. 

Mindfulness meditation practices concern themselves with an examination of our internal environment and our responses to external stimuli of one sort or another. 

In learning any new palpatory technique, it similarly helpful to identify that phenomena in oneself. If you know what it feels like in your own body, it is easier to identify it someone else. It is also easier to tell whether that palpatory information is coming from you or your patient. For instance, what does your own yang rhythm feel like? Knowing that will help you to differentiate it from your patient’s yang rhythm.  You can also palpate an inanimate object. If you find that the treatment table has a yang rhythm then you either have a very special treatment table or you are feeling your own qi?” All this can take some time and experimentation to sort out for oneself.  The good news is that the difficulty in distinguishing between self and other fades with experience and generally becomes less of an issue with every new palpation technique you learn. 

Meditation is about learning how our mind in particular works and in using that insight to exert some productive control over that process. Although we all share a human nervous system, each of us is wired a little differently. No one’s palpatory antenna is without a few unique bends and kinks. Learning the quirks of our particular apparatus is an essential part of learning to appreciate qi. For instance, is one hand more sensitive than the other when listening to the yang rhythm or doing channel listening? Does it help cross-reference your findings by switching hands? Which hand is best for manual thermal evaluation and which for local listening. Our own acute or chronic injuries may influence the accuracy of our listening. Even problems in our ankle may influence how we stand, subtly influencing the way our hands receive information.  

Some days we may be able to sustain our attention and awareness on the cushion better than others. Its best not to label our meditation sessions as good or bad, we just practice. Just as it is counterproductive to beat yourself up when you catch your mind wandering, it is also unhelpful to fret over the fact that you’re not feeling anything. Just move on and keep practicing. 

Most experienced clinicians will acknowledge that their palpatory capacities vary from day to day, and even over the course of a single day. In meditation, pulse diagnosis, yang rhythm or general listening, our baseline competencies generally improve as we gain experience. We gradually get to the point where our palpatory input is clinically useful even on our off days. Some days we may be more confident in our local listening than in our channel listening. At other times the opposite may be true. We simply do our best to make use of whatever information we can glean at any given moment. Our receptivity is inherently variable for reasons including but by no means limited to our own competency. Sometimes our patients are just not communicating with us on a particular palpatory wavelength.  Cultivating our comfort in working with whatever information we have is a skill in itself. A key to all of this is to try with just the right amount of effort. If we don’t try seriously enough or often enough, we will never learn the skill. Yet working too hard will just as surely subvert the learning process. 

Once we are reasonably confident that we are feeling something, and that what we are feeling is coming from the patient and not ourselves, the issue is no longer whether we can feel qi but what specifically we should be filtering for. 

We will pick up this thread in a subsequent blog. 

Clinical Case #1 by Chip Chace

The Engaging Vitality approach is based  on the idea that enhancing engagement with our patients’ qi enhances clinical efficacy. Part of this comes about from expanding our repertoire of techniques for appreciating the qi while another important aspect is to learn how to weigh and cross-reference this input.  This is central to the diagnostic process whether we are working exclusively with the familiar TEAM methods of tongue, pulse, abdomen, and symptoms, or incorporating a broader range of assessment methods. 

I have used the following case in a few Module IV trainings to illustrate the application of the listening to the fluids in Chinese herbal prescribing. Here, fluid-body palpation worked for me as a sort of diagnostic tiebreaker. I think the case works pretty well on that level. In the course of presenting the case again, however, it recently struck me that it also exemplifies the more general process by which we creatively apply and cross-reference a variety of diagnostic input. The case may actually be more informative in this regard, as it speaks to the challenges of dealing with vague, ambiguous, and even irrelevant information. 

IW, a petite, female yoga teacher in her late 40’s experienced what she described as an “asthmatic cough” subsequent to a bout of bronchitis she had contracted after a trip to India three month’s previously. The cough was predominantly dry and unproductive. It was worse in the morning and evening, or when teaching or speaking, and drinking water helped to soothe it. She also complained of a burning, inflamed sensation in her chest. 

Prior to her trip to India, we had briefly worked together in treating some perimenopausal symptoms, addressing them with at least partial success in the context of a liver and kidney deficiency. She now only had night sweats once a week, though she remarked that her recent menstruation was preceded by an outbreak of acne. She was also prone to joint pain. IW mentioned that she had been very busy since her return from India made a point of reminding me that she was very sensitive to stimulants. 

General Listening localized to her posterior left diaphragm with a confidence level of +++ out of ++++ . Her tongue was slightly red and dry (+++),  and her pulse was rapid and fine  (++++). Pulmonary auscultation revealed clear but slightly tight lungs (++++). I was confident that her yang rhythm felt unremarkable (+++).  Here I had a fairly high confidence level in my palpatory findings. 

IW’s dry cough, burning sensation in her chest, dry tongue, and fine rapid pulse suggested a straightforward though fairly entrenched case of dry heat in the lungs. I didn’t think that there was sufficient evidence to consider her background liver and kidney pattern a significant factor in her present situation. My plan was to drain deficiency heat/fire with bitter and sweet flavors, secondarily moisten the lungs, and downbear the lung qi to stop cough. I gave her 3 packets of the following prescription. 

  • Mori Cortex (sāng bái pí) 15
  • Lycii Cortex (dì gǔ pí)
  • Anemarrhenae Rhizoma (zhī mǔ) 12 
  • Lilii Bulbus (bǎi hé)
  • Trichosanthis Pericarpium (guā lóu pí)  6
  • Stemonae Radix (bǎi bù) 9
  • Armeniacae Semen (xìng rén) 9
  • dry fried Scutellariae Radix (huáng qín) 4.5
  • Glycyrrhizae Radix (gān cǎo) 6

She was instructed to sip 1 ½ cups of this in decoction over the course of each day. 

IW e-mailed me 6 days later and reported that she was 60% improved after taking the first packet of the prescription and 75% improved after taking all three packets over the course of 6 days. Although she was happy with her rapid response, she now complained of mild jaw pain she described as “TMJ” (temporomandibular joint syndrome). Unable to actually see her, as I was in Europe at the time, I had to rely on her short written report. The most likely pathodynamic involved in the jaw discomfort seemed to be a counterflow of yang, though I was unsure precisely where it was coming from or why it was happening. I asked her to take another 2 packets of the same prescription with the addition of 12 grams of Ostreae Concha (mǔ lì) to more aggressively downbear this counterflow. 

IW returned for an office visit 4 days later and reported that her lungs were now 90% improved. She mentioned that she had experienced a tight cough and a slight tightness in her chest for one day though this was now gone. Thinking that this might be a sign of constrained qi I asked her about her moods but she reported that if anything, she was less irritable than usual. On the other hand, Spring had sprung and her usual seasonal allergies were bothering her. IW’s eustacian tubes felt blocked and there was no change in her jaw discomfort.

IW’s lungs were clear upon auscultation with no sign of the tightness I had heard previously (++++). Her pulse when sitting was soft (+++) and possibly slippery (+). When prone, her pulse was wiry on the left, esp. in guan and proximal positions (++++). Her tongue was significantly better overall, but I could imagine that there might be a hint of blueness in the center (+). Her yang rhythm was again unremarkable but again, I could imagine that there was a slight restriction in the cranium (+)

None of this suggested a definitive course of action. Was her jaw pain actually linked to her seasonal allergies, an external pathogenic factor complicating a pre-existing condition? Her pulse when sitting suggested the presence of dampness and possibly phlegm, presumably attributable to the allergies, though the pulse was clearly not superficial. Was there a deeper counterflow phenomena at play arising from her underlying liver and kidney yin deficiency? It was certainly possible to read her prone pulse presentation in this way. Yet it was equally plausible that her wiry pulse reflected an element of qi constraint. Moreover, she complained of no tightness in her chest, no irritability and her tongue only “possibly” (+) blue. The restriction in the yang rhythm in her head, if it was there at all, did not contribute to a differential diagnosis.  Did I need to nourish her fluids at a deeper level, relieve constraint, or perhaps even open the exterior and clear her sensorium?  Some other diagnostic criteria was needed, so I listened to her fluids. 

Based on the prominence of the left guan and proximal pulse findings, I needled left Ki 2 and right Liv 8, the side determined by channel listening and the points themselves determined by manual thermal evaluation. Since her current chief complaint were in her head, and though vague, her cranium was the most prominent listening post, I found GV 23 using manual thermal evaluation and also needled that. This settled her system sufficiently to allow me to listen to her fluid body. 

I could imagine that fluids felt somewhat dry (+) . More significant, however, was a slight but clear tightness on the outside(+++). This suggested a significant element of superficial constraint, though I remained unconvinced that an exterior pathogen was anything more that an adjunctive concern. I decided to continue clearing deficiency heat and moistening the lungs but to more directly open the chest and relieve constraint there. In retrospect, perhaps she could have done with a little more lung diffusion from the very start. Because her pulse as a little soft I included an adjunctive component for awaken the spleen and opening the sensorium, if only to mitigate the potentially cloying nature of the sweet moistening flavors. 

  • Anemarrhenae Rhizoma (zhī mǔ) 9
  • Glehniae/Adenophorae Radix (shā shēn) 9
  • Platycodi Radix (jié gěng)
  • Curcumae Radix (yù jīn) 4.5 
  •       Acori tatarinowii Rhizoma (shí chāng pǔ) 3

IW took 1 packet of this preparation in decoction over two days and all of her symptoms disappeared. 

Vague and ambiguous information is often all we have to work with. Dan, Marguerite and I typically use some form of confidence level scale to help us weigh the influence of of each diagnostic parameter. Here, I used a scale of 1+ to 4+. Of course, any bit of information can have multiple meanings. Here, even the most unambiguous aspects of the pulse image could plausibly have been interpreted in a few very different ways.  Cross referencing those possible pulse interpretations with the tongue, auscultation and patient history helped to narrow the differential diagnosis though not sufficiently to make a definitive diagnosis.  Although listening to the fluids was the diagnostic tie-breaker even this metric was somewhat ambiguous. The fluids did “perhaps” (+) feel a bit dry, but I was more confident (+++) that they felt tight and that distinction was the difference that made the difference, leading to an effective course of action. 

As we are learning the Engaging Vitality palpatory techniques, our findings will almost certainly feel vague and ambiguous, particularly when compared with diagnostic parameters we may be more familiar with such as the pulse and tongue. This is even more the case, if we gravitate towards a particular style of diagnosis or treatment where a particular finding yields an “if X then treat Y” answer. More often than not, however, the diagnostic process is characterized by some degree of ambiguity, regardless of the system we may be orienting to. When applied carefully and critically, low confidence findings can nevertheless help to clarify these situations and guide us to effective clinical outcomes.

 

Connecting to the Whole: The Role of Tong in the Engagement of Qi by Chip Chace & Dan Bensky

Here is an excerpt from an article in The Lantern Dan and Chip wrote about the Chinese concept of tong and its relation to East Asian medicine.
Now published 2018 Feb. Available for $5AU
To Order from The Lantern Volume: XV, Issue: 1, 2018
For more information, go to www.thelantern.com.au

[O]penness, denotes in this context our translation of tong 通. For us, tong is the fundamental thing that acupuncture accomplishes. As we will demonstrate in this essay, we understand tong as far more than a synonym for moving the qi. We are not in any way proposing an orientation to practice based on drainage as opposed to tonification. Tong is a principle that lies even deeper than the elementary ideas of excess and deficiency, tonification and drainage. If the system is tong, a great many of the issues regarding when and where to tonify and drain become moot. This is because once the body is tong it can fully utilize its inherent capacity for self regulation.

To us, tong is a synonym for one aspect the body’s own self-healing abilities, that is for health. As A.T. Still, the founder of osteopathy put it, “To find health should be the object of the doctor. Anyone can find disease.” A tong body knows better than any physician how best to rid itself of a surplus or pathogenic qi, and to replenish regions of insufficiency. A crucial aspect of our job as physicians is simply to help the human system express its inherent tong-ness. This article explores the concept of tong and how it can be applied to the practice of medicine.