dharmadoctors.org

J Altern Complement Med. 2010 Aug;16(8):867-73.

Zeidan F, Johnson SK, Gordon NS, Goolkasian P.

Department of Neurobiology and Anatomy, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. fzeidan@wfubmc.edu

PMID: 20666590

Behav Brain Funct. 2010 Jul 29;6:47.

Kaul P, Passafiume J, Sargent CR, O’Hara BF.

Department of Biology, University of Kentucky, Lexington, KY, USA.

PMID: 20670413

Percept Mot Skills. 2010 Jun;110(3 Pt 1):840-8.

Leite JR, Ornellas FL, Amemiya TM, de Almeida AA, Dias AA, Afonso R, Little S, Kozasa EH.

Behavioral Medicine Unit, Department of Psychobiology, Universidade Federal de São Paulo, Brazil.

PMID: 20681336

Holist Nurs Pract. 2010 Sep-Oct;24(5):277-83.

Teixeira E.

College of Nursing and Health Professions, Drexel University, 245 N 15th Street, Philadelphia, PA 19102, USA. met42@drexel.edu

PMID: 20706089

Hello Friends of Dharmadoctors,

I’ve taken some needed time away from all things medical after the completion of my residency at the University of Washington and have been remiss with my postings on this site. This shall be rectified soon, once I become more settled in my new job at The Polyclinic in Seattle. Starting in mid August, I’ve joined a wonderful group of doctors at the Downtown Clinic (509 Olive Way, Seattle, WA) where I am in the process of establishing a practice in General Internal Medicine. Please bear with me during this exciting transition!

Mark McCabe, MD

Cogn Process. 2010 Feb;11(1):9-20

Tagini A, Raffone A.

Department of Psychology, University of Milan-Bicocca, Piazza dell’Ateneo Nuovo, 1, 20126 Milan, Italy. angela.tagini@unimib.it

PMID: 19763648

Holist Nurs Pract. 2009 Nov-Dec;23(6):361-9.

Delaney C, Barrere C.

School of Nursing, University of Connecticut, Storrs, Connecticut, USA. Colleen.Delaney@uconn.edu

PMID: 19901611

In the process of establishing the scientific validity of key Buddhist philosophical ideas that have therapeutic relevance to western medicine, I claimed yesterday that a core element of such ideas has been omitted. That is to say, the idea of the sacred (the definition of which I hinted at), has not been something easily translatable by western science. Mindfulness, on the other hand, has received the lion’s share of translation–mainly because the medical benefits of this process are abundantly obvious. Compassion is another traditional Buddhist experience and expression that western science has been able to take into it’s hands and reshape into a meaningful, relevant and applicable idea. How interesting! I wonder what it is about these two ideas that make them so translatable? Perhaps there is a natural affinity between the practices of medicine and Buddhism in that both are motivated at their roots by mindfulness and compassion. Many doctor’s and nurses, for example, are innately motivated by these two qualities and that may be why when Buddhists talk about them it just seems so “right,” one says “of course–that is what we are all about too.”

Now that compassion and mindfulness have been established as such strong ties between the two traditions, what are other areas where Buddhism can inform medicine? I have mentioned this idea of “the sacred.” Actually, this is not a particularly technical Buddhist idea unique to that tradition at all. It is a word I am using that describes a simple experience one has during meditation when there is direct awareness of things as they are. Perhaps this experience is then taken into daily life and noted as an appreciation of the incredibly rich perceptual experience humans are capable of. Nothing mystical. No gods. Just being simply. In most Buddhist traditions, this fundamental experience, this ground, is utterly basic and a key element in “being on the path.” What, if anything, can science say about this? What are the therapeutic, clinical implications of this experience? Is mindfulness really just a tool to experience this?

In his book Daily Advice From The Heart, the Dalai Lama writes, “A clear distinction should be made between what is not found by science and what is found to be non-existent by science. What science finds to be non-existent we must accept as non-existent, but what science merely does not find is a completely different matter.” This seems to apply to the experience of being as uncovered during the process of meditation and mindfulness–science can examine and quantify the effects (and it should) of these practices and thereby draw conclusions about relevant associations which likely have clinical implications. But when it examines the ground itself, the reservoir out of which these effects seem to arise, then what? That seems to be the purview, perhaps, of cognitive science and physics. We are still waiting for those disciplines to weigh in and help describe, in western scientific language, what it is that meditators are tapping into that brings forth the medical benefits chronicled in these pages.

Until then we are left with Wittgenstein’s oft-quoted remark that “whereof man cannot speak, thereon he must be silent” (Tractatus). For now at least …

Continuing the discussion from yesterday, l would like to start by acknowledging how different an entry this and yesterday’s are, as compared to almost all previous entries to Dharmadoctors. Up until now the main thrust of the website has been to look at the ways Medicine has incorporated Buddhist truths and practices and studied their applicability to human disease. Now I am trying to broaden the discussion and explore the question of what happens now that many of the ideas of Buddhism in general and Mindfulness in particular have become accepted, even mainstream.

In Buddhism there is the idea of “The Turning of the Wheel of Dharma.” The First Turning was said to occur when the Buddha attained enlightenment and began teaching the Four Noble Truths. In his lifetime there were at least two other such “turnings.” These were times he revealed further truths about the nature of reality to his students, ideas pertaining to “emptiness” and “compassion” (shunyata and karuna), bodhicitta and buddha-nature. Each time these major ideas were taught to the students, it is said that the Wheel of Dharma turned.

Given the far-reaching power of the scientific world view and its evolution over the last few centuries, from a Buddhist point of view the very notion that after all this time the teachings of the Buddha himself are being validated and incorporated into the western mainstream may in fact constitute another Turning of the Wheel of Dharma. Looked at this way, someone like the Dalai Lama (and many other great Buddhist teachers as well), are catalyzing such a turning. This most recent turning is the joining of our most modern scientific understanding of the nature of the world as described by physics with Buddhist philosophy of mind and reality. In fact, in some quarters, this is really not news at all and has been going on since sometime in the middle of the 20th century. For some, this discussion is really a platitude, even old hat.

But in the field of medicine (at least in western, allopathic medicine), what were once the fringe ideas of naturopathists and alternative healers have now seeped into our very language. There is no question that at this point there is cross-pollenization of ideas; what is left to be further delineated, however, is how the languages of these two disciplines will evolve. There still are many obstacles in creating a common language for both fields.

One such area where there remains a barrier is with the idea of the sacred. What is it? From a Buddhist point of view, I would suggest that the sacred is simply an experience. An experience of things how they are, unfiltered by concept or emotional/intellectual overlay, an experience of the “isness” of things, an experience that is pre-cognitive and yet perceptually rich. This is a vast discussion, obviously. But in its simplest expression the sacred is a return to the ground of being. Meditation is the experience that returns us to this simple, sacred ground. (For an excellent, inspiring discussion of this, see Chogyam Trungpa Rinpoche’s Shambhala, The Sacred Path of the Warrior).

As far as I can tell, western scientific research (and medical research in particular), has not been able to bring the idea of the sacred into its lexicon. Thus far, research has sanitized such things out. In the re-languaging of Buddhism it has simply avoided this core experience, an experience, I believe, that can have key clinical implications for physicians and patients. This is something I would like to continue to discuss in the future.

Hello Friends of Dharmadoctors,

It’s been almost a year and a half since this project started and it seems like a good time to take stock of what this has all been about. When the site was initiated, the goal was to attempt to join the two great practice traditions of Medicine and Buddhism in a way that made it clear that many commonalities and bridges between the two exist. In many ways, one thing that seems evident thus far is that such shared aspects are abundant. In fact, thanks to the science behind mindfulness (as reported here over and over again), one could almost venture to say that meditation, mindfulness and Buddhism in fact, have become mainstream. This is incredible! When I started my residency a mere three years ago, the idea that meditation might have real, practical and scientifically validated benefit was an eccentric, fringe idea, especially at major academic teaching hospitals. The situation is now radically different.

So if all of this eccentric stuff is now somewhat mainstream, now what? Originally there was a sense (at least in my mind) that the purpose of this endeavor was to convince, or at least show, my colleagues in medicine that the ideas of Buddhist meditation were not so far fetched after all. And now, much to my surprise, it is not uncommon to hear topics such as those covered here, bandied about the wards of teaching hospitals. One is forced to wonder if, in the course of the last few years, the dharma has officially landed into the mainstream consciousness of medicine.

One reason this has been so successful has been through the work of the people who have created completely secularized, mindfulness training programs to address the numerous medical afflictions that are known to benefit from this approach. In some ways the dharma has been re-languaged into a vernacular that modern physician-scientists can use. (The upcoming Stanford project to further define this language is taking this to a new level–see post from earlier this week). Overall, this fits with the age-old Buddhist idea that the Buddha himself gave a multitude of teachings to different audiences who were ready for those specific ideas. It was never a “one size fits all approach,” and this is no exception.

The concern I have, however, is that during this process of re-languaging and secularizing the dharma to fit into our scientific view, there is the possibility that something very important may be lost. What this something is I would like to explore in the coming months, and it has to do with an idea that usually medicine is very uncomfortable with: the sacred. I’ll end this post with the question, what is the sacred and is there a place for it either in evidence-based medicine or at least in the care-giver/patient encounter? Stay tuned …