MEDICAL ACUPUNCTURE

Volume 30, Number 2, 2018

EDITORIAL
# Mary Ann Liebert, Inc.
DOI: 10.1089/acu.2018.29077.rcn

Battlefield Acupuncture:
My Story

Richard C. Niemtzow, MD, PhD, MPH

B attlefield Acupuncture (BFA) is now an international technique for addressing acute and chronic
Downloaded by Australian National University from www.liebertpub.com at 04/26/18. For personal use only.

pain, and is still evolving in its usage. I never expected BFA would achieve such popularity. I have
Terry Oleson, PhD, to thank for introducing me to Zang-Hee Cho, PhD, who, at that time, was researching
acupuncture at the University of California at Irvine. He helped me elucidate the role of the cingulate
gyrus. Professor Cho is the father of the positron emission tomography scanner. What an honor it was to
meet him! Reviewing his functional magnetic resonance imaging data brought to my attention the im-
portance of the cingulate gyrus and thalamus areas of the brain for pain processing. During the months
prior, I had been evaluating the other points: Omega 2, Shen Men, and Point Zero. And voila, in August
2001, I determined how I would sequence all these points in the ear. Prior to my visit with Professor Cho, I
had made a visit to David Alimi, MD, in France, who introduced me to the ‘‘Aiguille D’Acupuncture
Semi-Permanente’’ needles, popularly known as ASP semipermanent needles. Unfortunately, they did not
exist in the United States back in 2001.
When the awful event of 9/11 occurred, I decided to name this technique ‘‘Battlefield Acupuncture.’’
During that time, I was the first full-time acupuncturist in the armed forces as an Air Force physician and
guest of the United States Naval Medical Center (USNMC-SD) in San Diego. BFA was forgotten quickly,
as there was no interest from physicians. In fact, many of them wished that acupuncture would go away.
However, this mood began to change as BFA proved itself slowly in the clinic. When I was scheduled to
transfer from the USNMC-SD to Andrews Air Force Base, my colleagues at the USNMC-SD petitioned
the Commanding Officer to request that I would remain at the Center. I was told this never happened
before. With some regret, I moved to the East Coast not expecting to stay there for a long time. I am still at
Andrews and ‘‘an airman for life.’’
In the early years, BFA truly started to gain momentum. Joseph M. Helms, MD, had the foresight to
take me on, and I taught BFA at his 300-hour Medical Acupuncture course. I do not think anyone
expected interest to last. However, during the height of the Iraq and Afghanistan wars, as wounded
warriors arrived in large numbers to Walter Reed Army Hospital, BFA began to be noticed quite a bit.
Western medicine was great for helping these patients but had its failures. I introduced BFA at the bedside
of these heroic patients, and the demands from both patients, families, and physicians skyrocketed.
Teaching BFA suddenly became a high priority.
Captivated by the success of acupuncture, Stephen M. Burns, MD, an Air Force physician on an
executive medicine military path decided to become a medical acupuncturist. He gave up his executive
medicine career potential in order to join me in the ‘‘one-man’’ acupuncture clinics that I was holding at
Andrews Air Force Base, the Pentagon, Walter Reed, and Bethesda Naval Medical Center. During the Iraq
and Afghanistan military actions, many military physicians and special force medics were instructed in
BFA. Around 2009, the Air Force Surgeon, Lieutenant General Bruce Green decided to send Air Force
physicians to the 300-hour Helms course in 2009 and 2010. It was well into 2012 that the Army, Navy, and
Air Force began sending physicians to the Helms Medical Institute’s semiannual civilian programs.

The opinions and assertions contained herein are the private views of the author and are not to be construed as
official or as reflecting the views of the United States Air Force Medical Corps, the Air Force at large, or the
Department of Defense. The author indicates that he does not have any conflicts of interest.

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The most important event for BFA happened with the awarding of $5.4 million to teach BFA to the
health care providers of the Army, Navy, Air Force, and Department of Veterans Affairs (VA). This was a
joint incentive fund initiated by myself and John Baxter, MD, that spanned *2.5 years. The best part of
this project was treating patients for acute and chronic pain. In my opinion, it was the start of impacting
the opioid crisis and pushing acupuncture’s interest throughout the Armed Forces and VA. On February
23, 2018, at the Air Warfare Symposium in Rosen Shingle Creek, Orlando, FL, the Chief of Staff of the
United States Air Force, General David Goldfein announced that BFA should be taken to the point of
injury on the battlefield and also throughout the Air Force.
From 2001 to 2018, it had taken almost 17 years to push BFA against much resistance to finally have a
four-star Air Force General recognize its value, and announce that this innovation should become part of
Air Force medicine. It was like a dream come true. He also announced that I was treating him for Bell’s
Palsy with acupuncture, the best treatment available. This is a tribute to all of us, as acupuncture is more
alive than ever.
Seventeen years seems like a long time in terms of an individual’s career, but it is actually a very short
time in the history of acupuncture. What happens next with acupuncture and what we accomplish depends
on you. I repeat the recipe of success: read the Medical Acupuncture journal, attend the American
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Academy of Medical Acupuncture symposiums, meet your colleagues, practice and practice, and follow
your hunches to produce new and innovative treatments. Do not be afraid; you will have your story, too.

—Richard C. Niemtzow, MD, PhD, MPH