In Buddhist tradition, the first and primordial healer was the Buddha himself. In his first sermon at Sarnath, Gautam Buddha elucidated the Four Noble Truths – there is suffering (dukkha), the cause of suffering is clinging and ignorance (dukkha samudaya), it is possible to overcome suffering (dukkha nirodha) and the way to do so is the practice of the Eightfold Noble Path (dukkha nirodha marga).
And what have I taught? This is stress. This is the origination of stress. This is the cessation of stress. This is the path of practice leading to the cessation of stress
Both formerly and now, it is only stress that I describe, and the cessation of stress.
The Buddha’s Four Noble Truths are a path toward healing, for in them lies the recognition of disease, its etiology, its prognosis, and the remedy. These four components form the very basis of any physician’s practice. The Dictionary of Medical Ethics points out that “The principles governing Buddhism and the practice of medicine have much in common. Both focus on the alleviation and prevention of suffering.
Buddha has often referred to medicine as the most suitable analogy for the Noble Truths:
Know the sickness, Abandon the cause of the sickness, Aspire the cure and Rely upon the medical treatment.
Know the suffering, Abandon the cause, Obtain the cessation And follow the Path.
Indeed Buddha was considered a great physician and psychotherapist due to his compassion and wisdom to diagnose and treat the root cause of all mental and physical malaise. His teachings can be considered a course of therapy and Buddhist meditation techniques have been abundantly utilized in modern-day psychotherapy for several mental and other chronic illnesses.R L Soni writes “It is indeed a matter of supreme interest that the noble profession of medicine and the corpus of thought known as Buddhism are both concerned in their own way in the alleviation, control and ultimately the removal of human sufferings.
The health-care practitioner has a lot to learn from Buddha’s teachings and the practice of Buddhist precepts, which would aid him/her in not only fulfilling their role as a physician but also in living wholesome lives.
The medicine buddha/Bhaisajyaguru
The Medicine Buddha, Bhaisajyaguru, Yakushi Nyora, i or the Buddha of Healing is described in Mahayana Buddhist texts and usually represented seated with his right hand raised in vadra mudra (the hand and finger gesture symbolizing giving and compassion), and the left hand rested on his lap, holding a jar of medicine. In illustrations, he is shown surrounded by various healing plants and innumerable sages, depicted as the Paradise of the Medicine Buddha that represents an idealized universe where remedies exist for every ailment, something that modern medical research is ever striving to attain.
The Medicine Buddha is described as a healer who cures suffering and disease, both physical and mental. The Sutra of the Medicine Buddha is a common sutra to recite in Eastern Buddhist temples and monasteries. He is believed to have revealed the teachings which constitute the Four Medical Tantras of Buddhist medical literature. The Four Medical Tantras have elaborated on the cause, nature and signs of various ailments, the methods of healing and medicines, and precise explanations on medical ethics, delineating the qualities of a physician.
The health-care practitioner in Buddhism
The doctors, nurses, and others involved in care of the sick are held in high esteem in Buddhist cultures. The doctor is referred to as bhisakka, vejja, or tikicchaka. The Buddha saw the physician’s role as a vital one. The Buddha said:
“Those who tend the sick are of great benefit (to others).”
“Nursing the sick was much praised by the Great Compassionate One and is it a wonder that he would do so? For the Sage sees the welfare of others as his own and thus that he should act as a benefactor is no surprise. This is why attending to the sick has been praised by the Buddha. One practicing great virtue should have loving concern for others”.[9]
For over 2000 years, Buddhism has had a close involvement in the treatment of the sick and was instrumental in institutionalization of medicine in the East. The Pali Canon is replete with information about sickness and health, healing, medicine, medical care, and medical ethics. Practice of medicine was included as a scholastic discipline in the monasteries. Monasteries often served as hospices and infirmaries.
The three jewels: The physician as a guide
In Buddhism, an individual takes refuge in the Three Jewels– the Buddha (the spiritual guide), the Dharma (the practice), and the Sangha (the community). The role of the physician and spiritual guide are considered very similar. The one who guides individuals in overcoming negative states of the mind and develop positive potential is regarded as a Spiritual Master, and the one who takes care of the individual by giving them medical treatment to overcome their physical and mental ailments and stay healthy is referred to as a physician or medical doctor. The aim of both is to free individuals from their suffering.
The analogy given is that of a patient relying upon the right treatment.[10] It is said:
Take refuge in the Three Jewels, See Buddha as the most qualified physician, See the Dharma as a faultless medicine And the Sangha as medical attendants.
Just as one should be careful in seeking spiritual guidance from someone with true knowledge (the spiritual guide), in the field of medicine, it is crucial that the patient should not rely on quack practitioners but seek guidance from those adequately qualified (the healthcare practitioner). Moreover, it is the responsibility of the physician to be well-informed so that he/she can make the right decisions and also to take assistance from the Sangha. The Sangha in medical community would include other individuals involved in the care of the patient including other specialists, diet counselors and patient educators, psychologists, pharmacists, family members and friends, pharmaceutical companies, research groups and the civic society, institutions and government.
Buddha considered it a good practice to resolve conflicts or differences in ideas by discussion within the Sangha. To date, Buddhist monastic communities conduct their business and resolve disagreements by a majority vote. Similarly, medical community has sought the coming together of ideas and sharing of experiences with consensus meetings among experts and formulation of practice guidelines.
Holistic, patient-centered care, and the five great sciences
Within the Buddhist worldview, health and disease involve the overall state of a human being and are interwoven with many nonmedical factors, such as economics, education, social and cultural milieu, and ethics or morality. All of these conditional factors need to be seriously taken into account in the understanding of health and disease. Health is, therefore, to be understood in its wholeness. It is the expression of harmony-within oneself, in one’s social relationships, and in relation to the natural environment. To be concerned about a person’s health means to be concerned with the whole person: his or her physical, mental, and moral dimensions; social, familial, and work relationships; as well as the environment in which the person lives. Thus, the work of a physician is of a complete wholesome nature.
A Bodhisattva is someone who is driven by great compassion and is determined to attain enlightenment for the sake of all sentient beings. The central point of the teaching is not the Buddha or any divine being or philosophical entity, but sentient beings. Similarly, for a physician, the central point of attention and care is the patient. Everything must be formulated around the patient: most guidelines emphasize the need to move from a “paternalistic approach” in modern medicine to this “patient-oriented approach”. The Buddha taught that one must follow the Middle Path (madhyampratipada), avoiding extremes of indulgence and self-denial. The doctor–patient relationship too rests on seeking a middle ground between the physician’s knowledge and the patient’s perceptions and experiences. The physician must not only bear theoretical knowledge, but should be able to skillfully gather information about patient’s health, should be capable of analyzing that information and share it with the patient, and engage in informed decision-making process to determine the course of therapy.