IF NOT NOW, WHEN?

IF NOT NOW, WHEN?

A soft-spoken friend from Colombia recently wrote to me:

“Me encantaría verte, sigue disfrutando de todo lo que esta hermosa vida te da.”

(“I would love to see you. Continue enjoying all that this beautiful life gives you.”)

Around the same time, a dear friend from Iran sent me a verse from Hafez, Ghazal 101:

Forsat shomar ghanīmat mey khor ke dar jahān
Joz īn ghadar nemī-ravad az mā be yādegār.

“Cherish the opportunity, and drink the wine of the moment; for in this world, nothing else will remain of us as a memorial.”

The words of the Nobel Prize-winning writer V. S. Naipaul have also stayed with me over the years:

“Most people are not really free. They are confined by the niche in the world that they carve out for themselves. They limit themselves to fewer possibilities by the narrowness of their vision.”

People often praise nonconformity in theory, yet willingly queue for conformity when it is offered in practice. Whether one is in China, Taiwan, the United States, Suriname, India, or Cambodia, the desire to belong often outweighs the desire to think independently. Nationalities change; the words remain remarkably similar.

The prospect of what many call a “normal life” increasingly requires conformity. Young graduates in the United States and Britain are discovering what millions of university graduates elsewhere have known for decades: a university degree does not necessarily open the doors to prosperity. Only a few years ago, ambitious students flocked to study computer science and business. Today, many of those same professions are being reshaped by artificial intelligence.

Among the Native American communities with whom I work, my friend Luis LaRose of the Ho-Chunk Nation once jokingly referred to me as a “Talking Brown Sugar Doctor.” It was said with affection, and it reminded me that identity is often far more fluid and humorous than the rigid labels imposed by society.

Artificial intelligence is now forcing its way into our lives. We can resist it, or we can adapt to it, much as we adapted to word processors, online reading, social media, and smartphones. Unlike social media, which one can choose to ignore, AI is rapidly becoming woven into professional and social life. For me, it has become an invaluable tool for keeping pace with scientific advances and technological change.

One of the most memorable conversations of my life took place shortly after I arrived in Cuba in 1995.

Professor José Altshuler Gutwert, historian of science, former Vice-Rector of the University of Havana, and President of the Cuban Society for the History of Science and Technology.  Professor Altshuler, whose Polish Jewish immigrant father may have been among the founders of the Cuban Communist Party, offered an observation I have never forgotten:

“If you think primarily of yourself, go to a country where personal advancement is rewarded and you may prosper. But if your deepest concern is the welfare of others, then you have arrived in paradise.”

Whether or not one agrees with his conclusion, it captured something essential about the spirit I encountered during my época de oro in Cuba, both in Baracoa and Havana.

You do not have to die to find paradise.

The great Rabbi Hillel taught:

“If I am not for myself, who will be for me? But if I am only for myself, what am I? And if not now, when?”

And the beloved Omar Khayyam of Nishapur, whose verses have accompanied me since childhood, wrote:

“Ah, fill the Cup: what boots it to repeat
How Time is slipping underneath our Feet;
Unborn Tomorrow and dead Yesterday,
Why fret about them if Today be sweet?”

Last night, I enjoyed the excellent Khmer cuisine of Chef Kimsan Pol, accompanied by a glass of Australian Shiraz.

What do Hafez, Khayyam, Rabbi Hillel, Professor Altshuler, and even Naipaul have in common?

Each, in his own way, reminds us that happiness is not postponed to some distant future. It is not guaranteed by conformity, wealth, status, ideology, or the approval of others. Life is fleeting. We are called to think independently, care for others, embrace the present moment, and live with purpose.

Yet many people reject these lessons and then complain about their exclusion from happiness.

Perhaps the gate to happiness was never locked. Perhaps it simply required the courage to walk through it.

Greetings from Cambodia.

A HINDUSTANI BUTCHER SELLS HALAL MEAT TO BRASILIANS LIVING IN PARAMARIBO SURINAME

The Diversity of Suriname and the Genuine Warmth of its People

My health-conscious friend suddenly stopped at a shop selling meat. I wondered why. Then I noticed the sign: Halal Meat. This was Paramaribo, in Suriname. He explained that he was buying meat for his dog, Thor. I understood.

We were in the Brazilian neighborhood of Paramaribo, and the butcher was a Hindustani Muslim whose ancestors had arrived some 150 years ago from Bihar, India. The language of communication was Dutch. Such combinations are entirely natural in Suriname.

The son of the owner asked my friend, “Where is your companion from?”

“Australia,” he replied.

I had entered the shop from an anthropological perspective, quietly observing who was buying what, and what foods were available. I did not expect what happened next. The owners warmly invited me behind the counter to see the meat-cutting area and the cold storage rooms where the fresh deliveries were kept.

I was touched by this spontaneous gesture of friendliness. Yet, as my days in Suriname pass, I realize this was not an isolated incident. The people here are genuinely warm, tolerant, open, and welcoming, expressing their kindness in many subtle ways, often through food itself.

Food plays a profound role in cultural communication — and, of course, in medicine. Only recently has the Western world begun rediscovering what indigenous peoples have understood for centuries: that food is deeply connected to health, healing, identity, and human relationships.

Before leaving, I noticed a curious collection of currencies at the cash counter — Brazilian reais, Cuban pesos, old Surinamese notes, even an occasional bill from the Emirates. It was a small museum of the journeys and histories that converge in this country. I added to their collection a twenty-peso Mexican note.

The world exists here in miniature — Africans, Indians, Javanese, Chinese, Brazilians, Indigenous peoples, Europeans — all woven together in a small tropical nation on the northern coast of South America. Yet what binds this diversity together is not merely history, but the unmistakable warmth of true Surinamese friendship.

THE SWEET ETHOS OF SURINAME

 

Suriname is a small country on the northern coast of South America, bordered by Guyana to the west, French Guiana to the east, and Brazil to the south. Its population of around 600,000 is made up largely of people of African, Indian, and Javanese origins, along with smaller communities from many other backgrounds. It is one of the few places in the world where Dutch is the principal language, while the cuisine reflects the remarkable diversity of its people. Nearly 93% of the country remains forested, and deep within these immense rainforests live indigenous communities whose cultures have endured for centuries.

I came to Suriname to explore whether I might contribute, in some small way, to warning indigenous communities about the dangers posed by industrialized food and the rapid spread of metabolic diseases.

What has overwhelmed me most, however, is the genuine friendliness of the people of this country, regardless of culture or ethnicity. It began quietly, with a lady in the hotel kitchen preparing something special for breakfast after noticing my interest in fresh food. Heavy rain disrupted our plans to visit the historic Jodensavanne, so when the skies finally cleared, I decided to walk through the streets of Paramaribo. Everywhere I went, people smiled warmly and had something pleasant to say.

At one point I noticed a sign for Tabiki Rum. Curious, I stepped closer, and someone immediately opened the door and invited me inside. As I examined copies of old maps dating back to 1599, we began speaking about the history of the region. The man turned out to be Rasmus, the co-owner and distiller of an original local rum. He invited me to taste it, and what followed was a long and fascinating conversation about Surinamese culture, the interior of the country, and its people. He showed me photographs from his journeys into the rainforest and spoke about the remarkable Werehpai caves, near the village of Kwamalasamutu in southern Suriname, where around 500 ancient petroglyphs have been discovered. The images, believed to be between 2,000 and 5,000 years old, were named by the local Trio people after an ancestral female hero.

While we talked, Surano, the bartender, prepared exotic cocktails with quiet enthusiasm. The “Tabiki Sizzle” was especially memorable; the freshness of mint mixed with the purity of the rum brought back memories of other tropical adventures across the world.

When I finally left, two hours later, I felt I had made a genuine new friend in this distant corner of South America. I walked back to the hotel buoyantly. The young receptionist, a university student, greeted me warmly and, knowing I would stay in for the evening, prepared a delicious meal for me herself.

What a day at Hotel Palacio.

CURING VS HEALING AN AFTERNOON AT AN INDIGENOUS CLINIC IN A RICH COUNTRY

 

Healing and curing are often used as if they were interchangeable, yet they arise from very different philosophical traditions. In Western biomedicine, curing usually means the elimination or control of disease through measurable intervention: a normal laboratory test, a smaller tumor, a repaired artery, a suppressed infection, a corrected blood sugar. It is objective, technological, quantifiable. The language of curing belongs to hospitals, radiology reports, pharmaceuticals, surgery, and evidence-based protocols.

Healing, however, is broader and older than modern medicine. Healing concerns the restoration of wholeness — physical, emotional, social, spiritual, relational, and cultural. A person may not be “cured” and yet may still experience healing. Likewise, a patient may be technically cured yet remain profoundly unhealed: anxious, alienated, fearful, lonely, culturally uprooted, or spiritually distressed.

This distinction becomes particularly visible when working among Indigenous peoples. In wealthy countries, Indigenous communities may have access to MRI scanners, advanced liver elastography, genomic medicine, insulin pumps, GLP-1 agonists, and sophisticated laboratories. Yet despite this abundance of technology, many patients still seek something beyond curing. They seek reassurance, meaning, trust, relationship, continuity, dignity, and relief from fear. They seek healing.

The elder who came to see me  illustrates this beautifully.

From the biomedical perspective, much had already been “cured” or at least dramatically improved:

• weight loss,
• reduction in hepatic fibrosis,
• normalization of liver enzymes,
• improved diabetes markers,
• better metabolic health.

Yet he remained anxious. The right-sided discomfort became, in his mind, the symbolic return of liver disease. The elevated blood pressure at the clinic reflected not merely vascular physiology but emotional tension and existential fear.

The healing occurred not through another scan or another laboratory test, but through presence.

I sat with him for 45 minutes.
I explained his success.
I interpreted the pain within the context of his lived experience.
I transformed frightening symptoms into understandable bodily sensations.
I restored confidence in his own body.

By the end of the encounter, his blood pressure fell from 132/78 to 118/68 — not because of antihypertensive medication, but because anxiety dissolved into trust. In many traditional Indigenous populations, blood pressures around 110–120 systolic are historically normal, especially among people living closer to ancestral dietary and social patterns. His body recognized safety.

That is healing.

Healing often contains several characteristics absent from purely curative medicine:

1. Relationship
   Healing is relational. It depends upon trust between healer and patient. The physician is not merely a technician but a witness and companion.
2. Meaning
   Healing gives suffering an intelligible narrative. Pain becomes understandable rather than terrifying.
3. Presence
   Time itself becomes therapeutic. The hurried biomedical model often underestimates the physiological effect of calm attention.
4. Cultural resonance
   Healing acknowledges the patient’s worldview, symbols, fears, traditions, and collective memory. Indigenous patients often interpret illness not only biologically but socially and spiritually.
5. Restoration of agency
   Healing allows the patient to feel again that they possess control over their body and destiny.
6. Reduction of fear
   Fear amplifies suffering. Reassurance grounded in truth can measurably alter physiology: blood pressure, pulse, cortisol levels, even pain perception.
7. Wholeness rather than eradication
   Healing asks: “Is this person at peace?” rather than merely “Has the pathology disappeared?”
   
   
   

The linguistic problem is fascinating because Romance languages often blur these distinctions.

In Spanish:

• Curar can mean both “to cure” and “to heal.”
• Sanar more closely approaches healing in the deeper sense of restoration and wholeness.

Thus:

• Curar una infección = to cure an infection.
• Sanar el alma or sanar una herida emocional = to heal the soul or an emotional wound.

Yet ordinary speech frequently mixes them.

In French:

• Guérir usually means both cure and heal.
• But la guérison in French can still carry emotional and existential overtones absent in English biomedical language.
• Sometimes expressions like soigner (to care for, to treat) better convey the ongoing process of attending to suffering rather than merely eliminating disease.

In Portuguese:

• Curar again often implies biomedical cure.
• Sarár or cicatrizar may imply recovery or healing in a broader or more organic sense.
• In Brazilian Portuguese especially, healing can also carry spiritual and communal meanings linked to Afro-Brazilian, Indigenous, and Catholic traditions.

English, paradoxically, preserves the distinction more sharply:

• Cure derives from the technical-medical tradition.
• Heal comes from Old English roots related to “whole,” the same linguistic family as health, hale, and holy.
  
  
  

Anthropologically, many Indigenous traditions never separated healing from community, spirituality, land, ritual, memory, and identity. Western medicine achieved astonishing success in curing disease but sometimes fragmented the human being into organs, laboratory values, and billing codes.

The ideal physician integrates both worlds:
to cure whenever possible,
and to heal always.

The encounter at the Wellness Centre reflects precisely this integration of culture into medical practice. Three clinicians working in metabolic medicine ( me, the diabetes educator and the dietitian) did more than manage fibrosis scores and blood pressure readings. we restored equilibrium between fear and understanding. The elder left not simply with improved numbers, but with restored inner calm, visible relief, and renewed trust in his own future.

That is the anthropology of medicine at its finest.

VIPASSANA MEDITATION. A REFLECTION

 

The widely quoted saying, "Yesterday is gone, tomorrow is not here, pay attention to today," is a modern summary of Buddhist teachings on mindfulness, heavily popularized by contemporary teachers like Thich Nhat Hanh, rather than a direct, word-for-word quote from the ancient Pali Canon. 

However, it perfectly reflects the core Buddhist philosophy found in the Bhaddekaratta Sutta (The Sutra on Knowing the Better Way to Live Alone). 

Here are the authentic teachings of the Buddha and modern interpretations of this wisdom:

1. The Core Teaching (Bhaddekaratta Sutta)

In the Bhaddekaratta Sutta (Majjhima Nikaya 131), the Buddha says: 

"Do not pursue the past.
Do not lose yourself in the future.
The past no longer is.
The future has not yet come.
Looking deeply at life as it is
In the very here and now,
The practitioner dwells in stability and freedom."

2. "Pay Attention to Today" (Heedfulness)

The Buddha emphasized that today is the only time we can act, cultivating what is known as appamāda (heedfulness or diligence). 

• The urgency of now: "Only try the hardest what needs to be done today. Who knows what death will bring tomorrow?"
• Not ignoring the future: Being present does not mean ignoring future needs, but rather doing today's work—including planning—with total awareness and attention, rather than anxiety. 

3. Why Dwell in the Present?

• Regret and Worry: The Buddha taught that dwelling on the past brings regret, while obsessing over the future creates anxiety.
• True Life: Life is only available in the present moment.
• Actionable Change: The only place where we can change our karma and make positive choices is the present. 

4. Popularized Interpretations

While often attributed simply to "Buddha" on social media, the specific phrasing is frequently associated with Thich Nhat Hanh and sometimes modern Tibetan teacher Tulku Lobsang Rinpoche, who taught that "life is just one day"—today is our whole life, from birth to death.

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VIPASSANA MEDITATION — A Reflection

I was drawn to Vipassana meditation after learning how much time Yuval Noah Harari dedicates to the practice. His teacher, S. N. Goenka, a Burmese practitioner in the lineage of Sayagyi U Ba Khin of Mandalay, brought this ancient technique into modern global consciousness.

The opening verses of the Bhaddekaratta Sutta (Majjhima Nikaya 131) express its essence:

Atītaṃ nānvāgameyya,
Nappaṭikaṅkhe anāgataṃ;
Yadatītaṃ pahīnaṃ taṃ,
Appattañca anāgataṃ.
Paccuppannañca yo dhammaṃ,
Tattha tattha vipassati;
Asaṃhīraṃ asaṅkuppaṃ,
Taṃ vidvā manubrūhaye.

“Do not pursue the past.
Do not lose yourself in the future.
The past no longer is.
The future has not yet come.
Looking deeply at life as it is,
In the very here and now,
The practitioner dwells in stability and freedom.”

For an admirer of Omar Khayyam of Nishapur, this teaching resonates deeply. His famous quatrain echoes the same wisdom:

Original Persian:
ای دوست بیا تا غم فردا نخوریم
وین یکدم عمر را غنیمت شمریم
فردا که ازین دیر کهن درگذریم
با هفت‌هزارسالگان هم‌سفریم

Transliteration:
Ey dūst biyā tā gham-e fardā nakhorīm
Vīn yek-dam-e omr rā ghanīmat shemarīm
Fardā ke azīn deyr-e kohan dargozerīm
Bā haft-hezār-sālegān ham-safarīm

FitzGerald’s rendering:
“Ah, my Beloved, fill the Cup that clears
To-day of past Regrets and future Fears:
To-morrow!—Why, To-morrow I may be
Myself with Yesterday’s Sev’n thousand Years.”

Across centuries and cultures, a shared insight emerges:

• Past regrets weigh us down — both the Buddha and Khayyam urge release.
• Future anxieties distract and distort — both counsel against their grip.
• The present moment is the only true field of experience — what Khayyam calls ghanīmat, a gift to be seized.

Another quatrain captures this succinctly:

“Unborn To-morrow, and dead Yesterday,
Why fret about them if To-day be sweet?”

In Vipassana, this is not merely philosophy but practice: the disciplined observation of reality as it unfolds, breath by breath, sensation by sensation. In Khayyam, it becomes poetry—lyrical, intoxicating, yet grounded in the same existential clarity.

Two voices—one from the forests of ancient India, the other from the gardens of Persia—converge on a single truth:
the art of living lies in inhabiting the present, fully and without illusion.