AN ARGUMENT FOR JEWISH DOCTORS WITH BUDDHIST TENDENCIES, FOR BETTER HEALTH CARE

A JEWISH DOCTOR INCLINED TOWARDS BUDDHISM WITH ANTHROPOLOGICAL TRAINING MAY BE YOUR BEST BET IN HEALTH CARE

The four noble truths contain the essence of the Buddha's teachings. It was these four principles that the Buddha came to understand during his meditation under the Bodhi tree.

• The truth of suffering (Dukkha)

• The truth of the origin of suffering (Samudāya)

• The truth of the cessation of suffering (Nirodha)

• The truth of the path to the cessation of suffering (Magga)

The Buddha is often compared to a physician. In the first two noble truths he diagnosed the problem (suffering) and identified its cause. The third Noble Truth is the realization that there is a cure.

The fourth noble truth, in which the Buddha set out the Eightfold Path, is the prescription, the way to achieve a release from suffering.

Cecil Helman, an anthropologist, suggested that a patient with a problem comes to the doctor seeking answers to six questions:

1) What has happened happened? This includes organizing the symptoms and signs into a recognizable pattern, and giving it a name or identity.

2) Why has it happened? This explains the aetiology or cause of the condition.

3) Why has it happened to me? This tries to relate the illness to aspects of the patient, such as behaviour, diet, body-build, personality or heredity.

4) Why now? This concern the timing of the illness and its mode of onset (sudden or slow)

5) What would happen to me if nothing were done about it? This considers its likely course, outcome, prognosis and dangers.

6) What are its likely effects on other people (family, friends, employers, and workmates) if nothing were done about it? This includes loss of income or of employment, or a strain on family relationships.

7) What should I do about it – or to whom should I turn for further help? Strategies for treating the condition, including self-medication, consultation with friends or family, or going to see a doctor.

A prominent UCL GP Professor had written: about Cecil Helman

He stimulated me to ask those frequently important questions such as ‘what do you think is wrong with you?’ ‘Why do you think it happened?’ ‘What caused the illness?’ and ‘what do you think will help you to get better?’ etc.  It was his ground-breaking book, ‘Culture, health and illness’, which opened the eyes of many practitioners like me to the richness of a patient’s experience, concepts of illness and relationships with health professionals, when so much of the trajectory of modern medicine leads us towards ever greater specialisation, fragmentation and the molecularisation of healthcare.  Cecil’s perspective was a counterbalance to the domination of medicine by the physical and biological sciences and helped many health professionals to make sense of their day-to-day interactions with patients.

In contrast, look at the so called Scientific approach to the Western Disease Care model which the Asians are eager to copy

Subjective

Tell me what is wrong with you?

Also don't take too long telling me, don't tell me anything not related to why you came to see me

Preferably in a language I can understand

In a study it was found that American Doctors interrupt a patient just after 13 seconds. For the first of many times.

Objective

Let me find out what is wrong by examining you. More and more of the physicians are relegating this responsibility to others and the machine and “blood tests”

Assessment

This is what I think is wrong with you.

I want the machines and laboratory to help me be sure.

Plan

This is what I think you should do.

And then the advice is: Exercise More and Eat Less

Everything is self-cantered on the Doctor with very little input from the patient. Most of the pronouncements are quantitative and nothing qualitative, nothing about the suffering of the patient.

As you can see, it is as if the patient has left his personality mind and thinking when he changes into the hospital gown and just becomes a body over which man and machine would contemplate on a diagnosis, not a good contemplation since most of the chronic diseases are poorly taken care of in the richer countries, not to mention the copy cat Asian countries’ Doctors.

Even the American Diabetes Association admits that the majority of its members are not capable of giving good advice regarding nutritional management for their patients.

So you decide, who would you rather have, if you are unfortunate to have a chronic condition?

A western oriented doctor, European or Asian, who spends his allotted time with you and orders tests and prescribes medications for you

(In America, they would advertise Board Certified, which has no meaning whatsoever regarding the quality of the doctor, all who take the Board Examination pass it)

(also beware of doctors and more and more other auxiliary professionals who now sport many initials after their name, Beware, I say, they are trying to hide something! It is incongruous and out of order to put MBA after your name, a degree that is highly suspect if you are a health care provider)

Or

A Jewish doctor who is inclined to Buddhist values, with training in Anthropology who asks about your family before he begins to questions you on your symptoms?

MINDFULNESS AND THE HUMBLE MAN OF BOGOR: PAK JOE

Today is September 28^th, 2012

I have just finished reading an interesting book by Murakami Haruki: What do I think when I am Running.

It has very little to do with Running.

In London, I had coffee with a Bulgarian Researcher who could enlighten me a little bit on how Being Conscious of the Present Moment can be helpful in my projects to Prevent Obesity, Prevent Diabetes and also to become more effective in counseling my patients about Exercise.

 More importantly, today is the 51^st birthday of a good friend of mine, who has become like a brother to me, since we have very many thoughts in common when it comes to our position in life with regard to helping others, Pak Joe of Bogor, Indonesia.

All the above have a thread in common…

Compassion

And of course, when you are with American Indians for a while, you understand how they practice compassion intuitively. No body needs to teach them.

No one taught Pak Joe about these things either. Born into a Chinese family, a fairly large one, life’s circumstances took him through a windy road to lead him now to the position he has: a small business, he told me on that plane from Denver to Los Angeles when we met in March of 2012.

The concepts of how to be a better human being has been thoroughly investigated over the millennia and to me it is always amazing how all ancient philosophies such as American Indian and Yogic, have so much in common. And if you want to practice Compassion, even though a strong Buddhist concept one does not have to be a Buddhist, to practice it.  For American Indians building a church or a mosque or an edifice to pray seems a foreign idea since spirituality has to be practiced on a daily basis and compassion.

To practice this on a daily basis one has to be aware of the present, be immersed in present without judging, viewing it from a distance, be aware of oneself.

American Indians never ask,” what are you?” Which in our European cultures takes precedence, the so-called Networking, But they are very interested in Who you are? And many a new comer to their culture is stumped by the question since they are HUMANS who have been Doing things and not paid attention to BEING a human.

The westerners have amalgamated these theories into practices to help the eager westerner: the monk Thay who is a Vietnamese Buddhist; Kabat-Zinn a Psychologist who is Jewish American; Mathieu Ricard, a French Buddhist Monk who lives in the Himalayas, he had obtained a PhD on Molecular Biology from Pasteur Institute in Paris. Having Jean Jacques Revel the French philosopher for a father and a Buddhist nun for a mother must certainly have influenced him?

The newest entry into this august circle is Chade-Meng Tan, an Engineer at Google who heads their Jolly Good Fellow programme, is from Singapour and a practicing Buddhist.

How do the various Mindfulness Training of your mind, appear in the character of our friend who is celebrating his birthday both in Bangkok and Bogor?

1.Openness

2.Non-Attachment to own views so that he can be more open to the views and opinions of others.

3. Allowing others to believe and practice what they would like, while be there to help and guide; including those in your family

4. Awareness of suffering. Pak Joe is aware of his fortunate life and he likes to alleviate the suffering of less fortunate ones

5. Simple, Healthy Living. He was able to give a lesson in healthy living to me, a doctor specializing in Metabolism. He is fortunate enough to live in Indonesia where good simple delicious meals are easy to come by. He is grateful for good food during his travels.

6. He has managed to control his anger; in fact I have not seen his tone of voice change or criticizing another person

7. Dwelling on the present moment. One of his favourite sayings is: Life is beautiful, and let us enjoys it. 

Attention to the present takes precedence to any future or past events or plans

8. Community and Communication

I have observed him at close quarters during my two visits to Bogor and one visit with him to Malaysia and Cambodia. I thought to myself, what kind of a businessman, gives so much free time to his managers so that they can exercise, pay attention to their health and eat healthy food as a group and discuss the social aspects of good living. Not once I have heard him discuss business with his associates including in Malaysia or Cambodia. He does excuse himself and goes away for a few hours when he is dealing with the business end of it of all, but he is very quick about it, no prolonged meetings and the decisions about business are made quickly.

9. Truthful and Loving speech. In our conversations he talks very gently about the people around him and even those who may not wish to listen to his philosophy of living well and keeping your mind and body healthy, he is not antagonistic or caustic. When he talks to me about his family his face is very cheerful.

10. Compassion

11. Generosity

12. Respectful way of treating others.

The last three characteristics is well known to any one in his circle

So obviously, intelligent people can come to the same conclusion about good human behaviour whether they live in an Indian reservation in Nebraska or in the verdant city of Bogor under Gunung Salak.

So your friendship is the gift to me, Pak Joe, in the traditional Indian manner, when they have something to celebrate they give away their precious possessions. You do that on a daily basis.

These universal concepts are the foundation of Spirituality. It is better than most organized religions in the world today where ideology and mindless belonging and self-centeredness are stressed, the east or the west.

So on this day, my brother and friend, Pak Joe, have series of celebrations, beginning in Bangkok in the morning, then on to Bogor and end up in the company of friends who want to show their love and appreciation for you.

I send you my best wishes from Paris and we will see each other in less than one month!

HAPPY BIRTHDAY.

COMPASSION IS SPIRITUALITY

Compassion is a path to spirituality whereas being religious may not be, when ideologies may serve various masters, and not necessarily other human beings.

To serve Fellow human beings is superior to praying for one self, this applies to followers of all religions.

I had planned to arrive at my abode in Paris, just in time to observe Yom Kippur, the Jewish Day of Atonement. Celebration is a wrong concept when it comes to this holiest day in the Jewish calendar since it is a day of looking inside, atoning for ones behaviour with a hope of becoming aware of ourselves and our relationships with others.

On the Eurostar from London, I was imagining how this evening and tomorrow would be. I had planned to fast as is the custom.

Something happened to derail (pardon the context) my plans.

As I arrived at the gates, an older algerienne lady came out with her fingers wrapped up with signs of bleeding. She had cut her finger with a shard and had been bleeding since it had happened few hours earlier. She is an immigrant, is illiterate and is very afraid of the French institutions.

The nearest hospital Emergency Room (Casualty Dept.) is only a few kilometres away yet she was reluctant to go. Gentle persuasion and bundled her into a taxi and reached the crowded waiting room.

Someone or other is chanting Kol Nidrei. Last year after a lovely dinner at Soyka in Miami, I listened the beautiful voice of the Chazan at Temple Israel in the company of my dear friends Mark and Greta and company. Other places, other countries, but the same song. Malmo, Sweden; Melbourne, Australia, Kingston, Jamaica, so many Beth Midrashim. Ashkenazy. Sephardi. Oriental as in Cochin.

As if someone was mysteriously assisting us, the old lady was attended to pretty soon, given a surgeon’s appointment for the next morning, given antibiotics and discharged. By the time we were reunited at the house, it was well past 11 pm.

This is France, no shortage of a good bottle of wine. But Food at this hour? What about the fast?

I thought of Ian Berger, at whose house in Corpus Christi I had arrived on the day of one Yom Kippur, after some voluntary work at a remote location.

There is no guilt about not having fasted, not having listened to Kol Nidrei, not having lit the candle at the hour of the appearance of the stars.

In context (merci beaucoup, Meurice Merleau-Ponty), I have a great sensation, elation. Doing something for another human being is what I have learned by being a good Jew, not a religious one, but definitely very strongly attached to the culture and history of my people.

Yom Kippur couldn't have begun any other better way!

This morning, this lovely photo of my Omaha family arrives.

Thanks very much.

I have had a delightful day. Immense pleasures and great satisfaction

It is good to sacrifice oneself for the welfare of others, while being centred on the present state of who you are. And enjoying each moment, being there and being present…and conscious of being present.

At the age of 3, slightly older than the little Indian girl pictured above, I was taken to a dwelling of a learned man: he wrote a letter on the chalkboard and then exhorted me to repeat after him. And after each word or sound, he would hand me something sweet, and say

May all your learning be as sweet as this?

May all the coming days of the year 5773 be filled of this content, delightful feeling, sweet as the special honey the Cochin Jews horde for the New Year.

L’Shanah Tovah Tikkatevu

To my mischpochim all over the world.

and welcome all of you, L shanah Habaah B Bruselas..

If you are tired of the BRITISH MUSEUM, your curiosity has fallen dormant

The rain had been falling, as forecast and when it seemed to stop, i bought an umbrella and walked towards the British Museum. Many of the streets are familiar or with a faint nostalgia: Euston Street, Gower Street, then Tavistock Square. British medical Association has their offices here so I popped in to say Hello. The settings remain unchanged and still very british, and proper.
Russel Square, went to see the facade of Russel Square tube station where I had to alight a lot of times to go lectures at Queen Square Hospital. Buildings with the names of their architects: Nash, Yates.. publishing houses and offices of quaint associations  Association of Women Pharmacists..
Then the gigantic columns of the British Museum swelling with crowds, you can tell that the visitors have made this a point to visit: japanese with their audiophones, school children ready to have a history lesson on Greece. The crowd, apart from the Japanese, was mainly European with a sprinkling of Chinese. Didnt see many young asians but heard lots and lots of Spanish, Italian, other languages foreign to my ears..
If you have only one hour what would you do?
In fact British Museum, which to me, is the vast and perhaps the best museum in the world, has devised shorter visits, and also a study of history of mankind through 100 different objects.
It was good to see this very short glimpse of the wealth of the British Museum, even though I had to pass through exhibits which I had gone especially to see many times: the egyptian room,the african room, the persian room, the near east and the Persian room..
This is what you can search out and see in one hour at the British museum, gives you a glimpse of the variety of this place..

The Lewis Chessman, found at Isle of Lewis, prompting the Norway-Scotland trade. Did Norway conquer Greenland for the tusks of the Walrus?

The Exquisite metalwork from Ancient Persia is displayed

Believe it or not, they are more than two thousand years old!

Part of the Oxus Treasure.

What was the popular game among the Royals of Ur?

What was interesting was the long held belief among the Cochin Jews that the local game called ASHA is descended from this royal game of Ur and that the jewish migrants 2000 years ago brought this game to India!

 This is the Roman Inspiration for modern Wedgewood, bought from an Italian merchant by Duke of Portland. it is dated around the first century of the Common Era.

 In a separate section, Japanese history is depicted including the coming of Buddhism. This is a fine example of the Samurai Armour.

Cloisonne Jar with Dragons

from the Ming Dynasty

The Chinese dynasties are well represented with objects and I think one should concentrate one visit just to the China, Korea and Japan section.

There is a fairly large gallery of African Art and artifacts (not as big as Branley in Paris). This detailed carving of the head of a Queen Mother from the Benin Province of current day Nigeria ..

 I looked at this Moai from Rapa Nui with a sweet sensation of nostalgia, thought about my friends Fatima and Pedro from Rapa Nui and the lone medical student from Rapa Nui at U of Havana.. also the Japanese tourist I had met there, who shyly admitted to speaking a little Spanish..
It is truly a privilege to have visited Rapa Nui..

 British Museum has a good collection of Egyptian Antiquities, and this piece of Stelae is just an appetizer. School students were milling around the sacrophagi, the Egyptian Mummies...
By the way Rosetta Stone, found in that ancient city was helpful in deciphering Hieroglyphics since the translation was also written down in both the popular language of that time Greek.. Demotic was the language of the common man which appears here.

The Lion Hunts of the Assyrian kings depicted on wall tiles are very detailed. Only Royals were allowed to hunt Lions which symbolised the victory over nature and protection of the populace..

 The hour long quest to see some of the best examples are ending and you reach the grandiose but polemic Parthenon Sculptures.
The history is of immense interest.
Darius had it in his temple at Persopolis and when Xerxes could avenge the defeat of the Persians at the Battle of marathon, he erased the Acropolis and erected a temple with Parthenon. A temple dedicated to Greek Godess Athena was built and it flourished until about 500 AD, when it became a church and decrepitude.. then abandoned, later a gun ammunition factory and later a mosque.. all but destroyed the grand glory of the Acropolis. The remaining sculptures can be found a the Greek National museum.

 The Impressive Lord Elgin (British Ambassador to the Ottoman Empire) collection of the Parthenon.

Now to walk back in nostalgia and satisfaction, through the sumerican section and these gate keepers whom i had said hello a hundred times, just a peek into the 

 Egyptian section, to say hello to the Horus, the Falcon.. In reverence to the American Indians, I nodded my head to this supreme bird spirit..

 The rain had stopped. Walking along streets that had never left my memory.. Great Ormond Road.. Woburn on to Grays Inn Road (thought of two good Malaysians who studied there, different epochs of course: Tengku Abdul Rahman as well Lee Kwan Maung, who was a student leader )

Time for Lunch and in London it is never problems, like mushrooms, the cafes and sandwich places dot the scenery.