“Something we were withholding made us weak,
Until we found it was ourselves.”
Robert Frost
In ancient India, the doctor wore his money bag on his belt. As he made his rounds through the village, he visited each home. If every member of the family was healthy, the head of the household placed a coin in the doctor’s bag. If, however, someone in the home had fallen ill, the doctor was held responsible for not providing the necessary knowledge to the patient. The cost of herbs, special foods, or specific therapeutic treatments was paid for by the doctor. Thus was born the first health maintenance organization (HMO).
We are in the midst of a health revolution. With modern medical technology we can penetrate the genetic code to reveal the broken molecule that underlies an inherited illness, we can see changes in the brain’s metabolic activity that underlie thoughts and intentions, we can focus gamma rays to carve out a brain tumor without cutting the skin. Yet more than one in three Americans seeks out unconventional health care for illnesses ranging from chronic pain to cancer. There is a perplexing disparity between the amazing medical miracles we have available to us and the growing dissatisfaction with our modern health-care system.
Since entering medical school almost twenty-five years ago, I have felt discontent with our prevailing approach to health and disease. My expectations upon entering medical school were great, but I found my training disappointing. I wanted and expected to be taught the sacred principles of health. Instead, I learned about interesting aspects of disease. I expected to learn from professors of medicine who were models of humility and compassion, and instead I saw them revered mainly for their problem-solving skills, as if healing were a branch of mechanical engineering. At times I was deeply demoralized that the notion of human beings as fully conscious, spiritually aware creations had been totally lost from the medical model of life and health.
Over the last few years, however, I have been encouraged by the new awareness of health issues that is growing in our society. Increasingly, people are expecting their health-care providers to be more than master disease technicians. The concept of doctor as teacher is returning.
What do we really want from our healers? We want the best acute treatment available when needed. If a child develops a high fever and an earache at two in the morning, we want instant access to a competent physician and an effective antibiotic. If we are in a serious automobile accident, we want to have state-of-the-art X-ray equipment available to diagnose our broken bones and expert orthopedic doctors to set them straight. We want our providers to show compassion, whether we are suffering with cancer or an annoying muscle spasm. We want our doctors to practice what they preach, radiating health in their own lives. We want to be taught what we can do to avoid illness and the ravages of aging. And we want it all to be inexpensive and easy!
These are tall orders, and thus far we have had to accept compromises. We have paid an emotional price for the high-technology medicine of our time, sacrificing humane caring for efficiency. And we are paying an ever-increasing financial price as well. It is reassuring that our highly skilled surgeons can clean out or bypass blocked blood vessels to the heart, or transplant an organ, but now we are finding that there is often not enough money in the bank to provide these treatments. As a result, a vast transformation is underway in the way we look at health and health care.
One effort to change our approach to health is the rise of managed care. Although the theory behind health maintenance organizations (HMOs) is to provide incentives to doctors and hospitals to keep people healthy, there is growing concern that the effort to save money sometimes leads to withholding appropriate care. Although it will require a fundamental shift in the way both patients and physicians think about health care, I am convinced that an answer to these problems is now available. To put it succinctly, the solution lies in providing people with the means and the information they need to make lifestyle changes that will diminish the need for expensive medical care. Rather than rationing our limited resources, we can reduce the need for those resources by empowering human beings to lead healthier lives.
This doesn’t mean encouraging people to abandon medical care for alternative providers. Although I believe there is great potential value to acupuncture, massage, homeopathy, nutritional counseling, and other alternative approaches, I don’t think an alternative health-care system is going to solve all our problems. Throughout my exploration of healing technologies since my premed days, I have been struck by the fact that, in every system of health care, some people get better and some do not. The problem lies at the heart of almost every therapeutic approach in every tradition, from every historical period, and from every area of the globe: No matter where we look, the patient is always the passive recipient of the healer’s efforts. To use a metaphor from our own part of the world, the doctor always pitches and the patient always catches.
I am suggesting that it is time for the patient to step up to bat. I have witnessed chiropractors who adjust spinal subluxations, homeopaths who choose the correct tincture, acupuncturists who place needles into blocked meridians, and herbalists who treat symptoms with specific botanical preparations. Although these alternative approaches to illness have demonstrable value, they do not represent a real shift in the doctor-patient relationship. While most natural-medicine traditions emphasize disease prevention through healthy life choices, the day-to-day practice of these healing arts often fails to make knowledge about health an important component. For the most part, the patient remains the passive recipient, relinquishing authority to an all-knowing healer.
I vividly remember my experience with an herbalist who was offering consultations at the rate of thirty people an hour. I waited along with one hundred others until I was ushered into the small office of the medicine man. Without asking me any questions, he felt my pulse for about twenty seconds. He whispered that I had “too many thoughts” and dictated a prescription to his assistant. I was escorted to the next room, where several bags of herbal tablets were filled for me. I paid about twenty-five dollars for the herbs—there was no charge for the visit—and I was sent on my way.
The most fascinating thing to me about this experience was listening to the other patients describe their own brief visits. Reactions like “He seemed able to thoroughly read me,” or “I felt better just by his touch,” impressed me because the most common complaint I was hearing about medical doctors was that they weren’t spending enough time with their patients. In some subtle yet profound way, and in just a few minutes, these people felt that a need had been met. It seemed to me that a spiritual connection had been made between patient and healer and that this experience had a powerful effect.
Although I understand the potent benefits of a visit with a medicine man, I doubt that this type of consultation will find widespread acceptance in the West. Increasingly, Westerners ask to be respected partners in their health care and I don’t believe my patients would be fully satisfied with a healing encounter without knowledge of how to sustain and expand the experience. However, the feeling of being accepted, understood, and acknowledged as a fellow human being must be an integral part of every exchange with a doctor. My vision of health care for the next millennium values the best of Western scientific medicine while embracing the essence of the great healing traditions. Acknowledging the integral link between healing and spirit, we also need to empower people with the knowledge and practical approaches to improve their own health.
To accomplish this, we need to make the experience of health care relevant to patients’ emotional lives. A visit with a healer/doctor ought to be inspirational and even spiritual on occasion. Here the ancient healing traditions have much to offer, for in their definitions of health they include not just body and mind, but spirit also. This is vitally important, because genuine good health means more than having normal laboratory studies. It’s a dynamic state of well-being in every sense. It’s joy in the gift of living a human life.
In this book, I want to share with you my experiences of the healer’s art as it has been understood around the world. In the ancient wisdom traditions of India, Tibet, and China I have found both profound philosophical concepts and practical techniques for combining concepts of body, mind, and spirit into a comprehensive definition of health. Throughout my medical career I have worked to integrate the theory and practice of these ancient health sciences into my medical practice in the West.
My first exposure to an Ayurvedic physician left a lasting impression on me. A gentle, humble vaidya (doctor of Ayurveda) had been visiting the United States for just a few weeks and intuitively seemed to understand the deeper needs of Westerners. His demeanor radiated compassion and I was surprised at how often his polite exploration of the issues underlying a person’s problem elicited tears. His kind-hearted nature encouraged trust, which allowed those seeking his counsel to gain a deeper understanding of the source and meaning of their concerns. With his simple explanations and encouragement, the steps to recovery seemed readily attainable.
Each patient was given basic advice about diet, exercise, and daily routine. A few Ayurvedic herbs were usually prescribed along with information on when and how to take them. He encouraged people to begin a daily spiritual practice and often suggested they spend time alone in nature.
The information he provided was at once simple and profound, but the most powerful aspect of his therapy was his own presence. Although he was seeing several patients each hour, there was a timelessness about him that made each person feel his only concern was for his or her well being. More than an expert on health, he seemed to be a living representative of a healthy person, balanced in body, mind, and spirit. In this man, I saw the possibility that a physician could be more than a technical master of pathology—a doctor could guide his patients to health through his actions, words, and being.
For the past four years I have had the privilege and opportunity of devoting my full time to the development of The Chopra Center for Well Being. This program is unique in its mission of integrating holistic concepts and practices into a mainstream health-care system. We are finding growing acceptance of these holistic principles as complementary, not alternative, to standard medical care. Patients are no longer acquiescing to a passive role in their recovery processes, but are actively seeking every possible means to activate their internal healing systems. It has been my experience that a combination of mind body approaches and best-quality, appropriately administered medical care provides the optimal opportunity for healing. And when there is not an effective standard medical approach to a problem, mind body medicine offers hope and options at minimal cost with often surprising results.
This new view of health seeks to expand, not overthrow, the prevailing paradigm. Contemporary health science sees the human body as a physical machine that has inexplicably learned to manufacture thoughts. But if we think of the human body that way, as a flesh-and-bone thought-manufacturing machine, then we are viewing consciousness as a side effect of matter. Feelings, desires, instincts, falling in love, being moved by poetry or music—all are understood as by-products of biochemistry. Moreover, just as emotions are seen as by-products of molecules, so are sickness and health.
Science has attempted to understand the mechanics of disease in the hope that by disrupting those mechanics, disease can be eradicated. Thus, if we can learn how bacteria multiply, we can presumably use antibiotics to interfere with that process and before long there won’t be any more infections. If we know how cancer cells replicate their DNA, we can interfere with that process too, and then we won’t have cancer anymore. If we know how cholesterol is manufactured in the liver, we can intervene in the process of cholesterol development, and heart disease will soon follow cancer into the dustbin of history.
While this model of the body has been extremely useful in acute intervention, has saved many lives, and has made great improvements in the general state of public health, it has only partly fulfilled our intentions. For example, the mechanical or materialistic model has not significantly affected morbidity and mortality from chronic disease in society at large, nor has it influenced the age-adjusted mortality from illness. It has very effectively succeeded in getting rid of certain epidemics, but other epidemics have appeared in their place. We no longer have polio, smallpox, and malaria, but we do have cardiovascular disease, stroke, cancer, degenerative disorders, AIDS, drug addiction, and alcoholism.
It is now also clear that treating illness with a purely mechanistic approach very frequently sows the seeds of illness for the future. It has been estimated that over 1.5 million people develop hospital-acquired infections each year in the United States, and many thousands die from antibiotic-resistant bacteria.1 The cost of caring for these iatrogenic, or treatment-related, infections is estimated to reach to three billion dollars per year.2,3 More than one-half of all antimicrobial drugs may be prescribed inappropriately.4 This has created a situation in which problems that recently were considered easily treated, such as common staph or strep infections, are now resistant to antibiotics and are striking with lethal force in immunocompromised patients.
Since 1928, when Alexander Fleming’s observation of a mold that contaminated his bacterial cultures led to the discovery of penicillin, we have proceeded under the assumption that there is a “pill for every ill.” Recent studies have shown that between fifty and eighty percent of the adult population in the United States and England swallows a medically prescribed chemical every twenty-four to thirty-six hours.5,6 Over one-third of patients in a university hospital may be suffering from iatrogenic diseases.7 If a study of hospital-acquired injuries from New York is typical of the United States, 180,000 people die each year of iatrogenic injury, the equivalent of three jumbo-jet crashes every two days.8 It is known that the number one cause of drug addiction in the world is not street drugs, but medical prescriptions legally prescribed by physicians. And, despite our presumption that the standard practice of Western medicine is scientifically based, studies suggest that less than half of medical interventions are supported by solid scientific evidence.9,10
The materialist model of the body focuses on disease mechanisms rather than the basic life functions of the human mind body system. These life functions are simply what we do every day, eating, breathing, digesting, metabolizing, and eliminating. Mind body medicine emphasizes the crucial influence of consciousness on each and every one of these processes. If they are effortless and spontaneous, there is health; and conversely, the origins of disease can be found in a disruption of the spontaneity and effortlessness with which the life functions occur.
The recognition of consciousness or spirit as a central factor in the etiology of an illness is the fundamental distinction between the healing traditions of the East and conventional Western health care. Although I’ve found much that is valuable in all the healing traditions, what ultimately attracted me to the Ayurvedic medicine of India was its all-inclusiveness, its willingness to put the welfare of the patient above any doctrinal or ideological imperatives. Simply put, Ayurveda advocates whatever restores or strenghtens the health of the patient and whatever retards or eliminates the process of disease.
One of the first patients I saw at The Chopra Center was a delightful man who worked as a massage therapist at the Esalen Institute in northern California. For several years he had been troubled by a tingling sensation in his face, and as someone who was thoroughly at ease with alternative approaches to health care he had sought help from chiropractors, acupuncturists, and homeopaths. Each doctor had prescribed a course of treatment that provided temporary relief, but his symptoms invariably returned.
This patient now came to us hoping to try an Ayurvedic approach—but as I listened to his story, I became increasingly concerned that he might have a rare brain tumor. After providing his history and allowing me to examine him, he asked me for my thoughts as an Ayurvedic physician. I replied that I fully supported the use of natural approaches when appropriate, but in this instance I recommended a brain MRI scan as soon as possible. Although the massage therapist was understandably dismayed, he agreed to the study because he trusted me as a holistically oriented doctor. In fact, the scan did show a small tumor on his hearing nerve, which was successfully removed neurosurgically without any complications.
To me, this was a successful application of mind body medicine. There is a saying that runs, “If the only tool you own is a hammer, everything looks like a nail,” and all too often this is true of health care. For medical doctors, the hammer is a prescription pad; for chiropractors, it is a spinal adjustment; for acupuncturists, it is a needle; for homeopaths, a miasmic tincture. My concept of truly holistic health care is ensuring that the correct tool is available for the task at hand, and using that tool, whatever it may be. And very often—but not always, as illustrated by the case described above—the most powerful tool is not anything on the outside, but rather the healing powers of the patient’s own body, mind, and spirit.
It is encouraging to note that the World Health Organization has defined health as not merely the absence of disease, but as a state of physical, mental, and emotional well being.11 It is now time to add a fourth element: spiritual well being. We could even go further and redefine health as a higher state of consciousness—a state in which we open ourselves to entirely new categories of creativity and vitality, including the ability to influence biological processes through the power of our own awareness.
The idea that something as subtle as our attention can influence something as concrete as our physical body may at first be difficult to accept. Yet, our whole concept of what is “real” is changing today. Our technology—fax machines, cordless phones, computers, and television—is based on a new understanding of reality. All these technologies have evolved from one paradoxical idea: that the essential nature of the physical world is that it is not ultimately physical; that the atom, for example, which is the basic unit of matter, can also be seen as a network of information and energy.
A flower, for example, is made up of information and energy. The energy is the raw electromagnetic, gravitational, and atomic forces that allow the flower to be perceived by our senses; the color, shape, texture, and fragrance are the specific packages of information that are available to our consciousness. Consciousness is also information and energy, but it is more than that. Consciousness is alive—it is living information and energy. We can refer to it as intelligence, although the intelligence manifested by a flower is in many respects different from that of an animal or human being.
Ayurveda teaches that intelligence is information and energy that is self-referral. Self-referral means the ability to learn through experience to reinterpret and influence one’s choices. When, through our intelligence, we make different choices, we change the energy and information that enters our mind and body and by so doing, we transform who we are.
The human body is really a river of intelligence. And like a river that is always changing despite the appearance that it is the same, our human bodies are undergoing continuous transformation. We replace almost all the atoms in our body each year. From reconstituting our stomach lining every week to the calcium and phosphate in our bones every few months, our physical structure is in constant and dynamic exchange with the world around us.
This may not be the way we are used to perceiving our bodies, but sensory experience is often unreliable. Our senses tell us that the earth is flat, yet we know that it is round. Sensory experience informs me the earth is the center of the universe, yet I know that it is just a tiny speck of matter in a remote corner of the galaxy. If we could see the human body as it truly is, rather than through the filter of human sensory experience, we would see it as a field of energy and information.
If we conceive of our bodies as fixed physical structures, it makes sense to intervene with surgery to remove broken parts or add medications to alter the body’s chemistry. If, however, we begin to grasp the nature of a human life as a magnificent network of intelligence, entirely new possibilities for healing can be considered. From this perspective, we can influence health through our choices and interpretations: through the food we ingest, the emotions we experience, the sensory input we are exposed to, the daily patterns and rhythms of our lives. We can re-create ourselves by changing the quality of our experiences.
Although these concepts may have been discredited in some circles as being “New Age,” the roots of mind body medicine are in time-honored healing traditions from around the world. As I learned in medical anthropology classes in college, as long as human beings have existed, we have sought means to offset the suffering caused by injury, illness, and aging. In prehistoric times extended families came together into clans and tribes, enabling the emergence of specialized roles, of which the medicine man was among the earliest. Traditional healers had to begin by resolving their own health issues, through which they gained firsthand experience about sickness and recovery. The knowledge of how to utilize nature’s gifts to heal was passed down from generation to generation, eventually becoming systematized in the great ancient healing traditions.
Medical historians recognize a number of major traditional health systems whose roots go back thousands of years. The medical science of ancient Greece is identified with Hippocrates, who was born about 450 B.C. He considered health to be a natural state that could be lost through forsaking a balanced lifestyle. Hippocrates emphasized moderation as the road to a sound mind and body and resolutely preached the need to be in harmony with nature. Although many medical students recite the Hippocratic oath at the time of graduation, the basic principles of Greek medicine that integrated body, mind, and spirit have been relegated to footnote status in today’s medical schools.
The major healing traditions of the East are intimately interwoven, sharing many common principles and therapeutic interventions. Tibetan medicine’s origins go back approximately twenty-five hundred years to the time of the Buddha. Medicine provided an opportunity for Buddhist monks to practice compassion, help relieve suffering, and convert the comforted to their spiritual path. The classical Tibetan medical treatise, Tantra of Secret Instruction on the Eight Branches, the Essence of the Elixir of Immortality, is commonly known as The Four Tantras. Magnificent pictorial texts that depict a detailed Tibetan understanding of anatomy, physiology, and embryology expound the origin, diagnosis, and treatment of disease. Virtuous conduct, a healthy diet, and regular daily and seasonal routines are promoted for a long and healthy life. If you fall ill, Tibetan medicine includes a vast herbal pharmacopoeia. Although under severe threat from Chinese occupation, Tibetan medicine is still widely practiced in its native land and has spread to Nepal, India, and recently to the West. Tibetan medicine is a rich and elegant healing system that deserves the attention of healers around the world.
Traditional Chinese Medicine (TCM) became familiar to Americans after President Richard Nixon’s visit to China in 1972. Although most widely known for acupuncture, TCM includes an extensive herbal pharmacy. The earliest known oriental medical text, The Yellow Emperor’s Classic of Internal Medicine, dates back as far as 2600 B.C. Westerners were exposed to acupuncture in the seventeenth century when Jesuit missionaries to China returned with amazing accounts of doctors curing patients by placing needles in their skin. Oriental medical doctors hypothesize that life energy, called chi, flows throughout the body within specific pathways, or meridians. This vital force circulates as a result of opposite forces, known as yin and yang, that are continuously seeking a dynamic balance. Illness results when the life force is obstructed or when the polar principles become imbalanced. Traditional Chinese Medical practitioners have gained considerable credibility in the West and are now commonly members of pain-treatment teams. Although Western scientists may have difficulty with the concept of chi traveling through invisible channels, there is a growing body of evidence supporting the role of TCM in the treatment of neuromuscular and arthritic pain, post-surgical pain, menstrual cramps, nausea from chemotherapy, and drug addiction.12,13,14,15,16
Ayurveda, which means “science of life” in Sanskrit, may be as ancient as humankind. Although its precise origins have been lost in the mists of history, one thing can be said with certainty about this comprehensive, philosophical, eminently practical system of health science: Ayurveda is very old. The Rig Veda, a collection of more than one thousand poetic hymns that includes many of the central concepts of Ayurveda, was composed between 1200 and 900 B.C. Thus, the Ayurvedic system was already centuries old during the time of Charaka, the most celebrated of the ancient physicians of India, who lived around 700 B.C.
In his book known as the Samhita, which is the principle source for our knowledge of his thinking, Charaka described a gathering of the most learned men of India who came together in the foothills of the Himalayas to discuss the problem of disease. They agreed that disease was spreading misery and death and was standing in the way of humanity’s achieving spiritual enlightenment, the true purpose of existence. In the Charaka Samhita, the sages elected a delegate to call upon the celestial being known as Indra, who then revealed the science of life to the great sage, Bhardwaja. In this way the principles of Ayurveda are described as coming to mankind directly from the gods. From the very beginning Ayurveda was intended to serve spiritual as well as physical purposes.
For anyone reading the Samhita and other ancient Ayurvedic texts today, many of the books’ ideas seem amazingly sophisticated and up-to-date. The Charaka Samhita, for example, includes a carefully formulated classification of diseases and their treatments, as well as sections on anatomy and embryology, nutrition, and herbology. In all, Ayurveda’s understanding of human health is every bit as comprehensive as the healing systems of ancient Greece and China, though these have, until recently, received far more attention from Western historians.
It would be wrong, however, to imagine that there was rivalry or competition between the health sciences of the various ancient civilizations. Early physicians were eager to learn from one another, and the extensive trade routes of the ancient world made it surprisingly easy for them to do so. Ayurvedic texts had probably been translated into Greek by the time of Hippocrates, who would have been familiar with the work of Indian physicians. The expansion of medical knowledge that occurred during the Han dynasty in China (circa 200 B.C.) must also have been influenced by the earlier developments in India.
It’s unfortunate that the ancient world’s willingness to share and accept medical knowledge from various cultures did not extend into more recent times. During the medieval period Ayurvedic medicine began to be forcibly replaced by alternative systems imposed by the ruling classes, and its decline accelerated after the conquest of India by Moslem invaders in the twelfth and thirteenth centuries. Later, beginning in the eighteenth century, Ayurveda was almost completely suppressed by India’s British rulers. Tragically, one conqueror after another has seen Ayurvedic learning as a threat to his political control, rather than as a resource for linking the Indian nation with its proud heritage and for bettering the health of its people.
When India gained independence from Britain in 1947, the way was opened for a revival of Ayurveda’s long-suppressed tradition. It is only very recently, however, that the science of life has at last begun to receive the interest that it deserves, not only in India but around the world. Western medicine is now beginning to acknowledge that we must treat the person as well as the disease, that we must recognize the underlying causes of ill health and try to address them even before symptoms appear, and that good nutrition, appropriate exercise, emotional well being, and spiritual fulfillment are as important to human health as drugs or surgery. These principles, of course, were well understood by even the earliest Ayurvedic physicians. While it’s regrettable that their insights have been cast aside for many hundreds of years, it’s also heartening to see how the situation is beginning to change for the better. Through The Wisdom of Healing, I hope to accelerate this change by offering detailed knowledge of Ayurvedic medicine to an audience of both laypeople and health-care practitioners. Moreover, by integrating Ayurvedic insights with the most advanced concepts of Western science, I hope to at last make possible the physical, emotional, and spiritual well being that was the highest purpose of Charaka and the ancient sages of India.
The new model for health offered in this book embraces the best of the objective, scientific interventions of Western medicine with the subjective, holistic approaches of the ancient healing traditions. It empowers and honors the inherent healing power within us all, acknowledging the imperishable linkage between body, mind, and spirit. Health is then understood as the return of the memory of wholeness. Healing is a lifelong process of unfolding, without clear beginnings and with no anticipated end. For me, coming to understand this has been a journey of discovery, and in these pages I hope you will find the fruits of that journey.