Especially since the 14th Dalai Lama received the Nobel Peace Prize in 1989, the Tibetan tradition has gained center stage in the West. This book is a simple and well-written introduction to the Tibetan variant of Buddhism, a global religion that has garnered increasing interest in the United States since Zen textbooks became available in the 1950s. In folksy English, the book explains the basics of the belief system, including the concepts of impermanence, attachment, suffering, and "emptiness suffused with compassion." Emphasizing that the Buddhist idea of "empty mind" and compassion are essentially innate and indistinguishable, the book offers simple meditation practices and visualizations (mostly having to do with concentrating on breathing) as a direct way to cultivate "nonconceptual compassion." Even though the book does not specifically target health care providers (meditation and compassion seem to be good for everyone), there are plenty of insights that will be worthwhile for caregivers. We are told that even if we are saddened because we cannot cure everyone, we can find some joy if we make our effort to help 100 percent. We are told that treatment includes gestures and nonverbal communication of reassurance, caring, calmness, and help in removing fear. We are asked to remember that we are all "waiting in line to die." Medicine and Compassion is most interesting when it touches on Tibet's unique cultural traditions. For example, it provides a dramatic glimpse into another conceptual world in its descriptions of the process of dying, during which, according to Tibetan beliefs, the spirit moves through various bardo realms, where mind-consciousness is reincarnated. Originally developed as a radical rejection of Hinduism 2500 years ago, Buddhism has always had an intense and rigorous dialogue with other religions on such issues as non-self, non-theism, and immanence. Unfortunately, this dialogue has not often taken place in the West, where Buddhism often finds itself in the environs of New Age spiritual consumerism. Although the book's introduction claims that "this is not New Age stuff," the book merges into New Age unrestrained "dispensations" as it emphasizes Buddhism as a religion of unlimited abundance that accesses the unrestricted Buddha within. This Westernized Buddhism has little to do with demand, limitation, obligation, and responsibility. Reaching enlightenment -- the arduous effort of making no effort -- is watered down to being unafraid to take a "vacation" from our hectic lives with 15 minutes of daily meditation while working toward "relaxation" (a word rarely found in any Buddhist canon). Buddhism becomes indistinguishable from what, in 1902, William James called the emerging American "Gospel of Relaxation." The weakness of this book is most evident in its discussion of Tibetan medicine itself. In fact, recognizable Tibetan medicine is not 2500 years old, as the book claims. Rather, Tibetan medicine is an amalgam of Ayurvedic, Chinese, and Hippocratic thought, synthesized with indigenous shamanism in a series of conferences inaugurated during the consolidation of the Tibetan Empire between 634 and 755 A.D. This broad-minded acceptance of diverse traditions is a rare historical example of active medical pluralism. Scholars accept that translations of some Hippocratic texts are embedded in canonical Tibetan medical books. In reading Medicine and Compassion, one easily recognizes ideas from Hippocrates's On Decorum, which states that the physician should "bear in mind his manner of sitting, [maintain] . . . decisive utterance, brevity of speech, composure, diligence, care, replies to objections, calm self-control, concentration, readiness to do what has to be done. . . . Perform all this calmly." In a curious way, the journey to the East in this book brings the reader back to Western medicine's point of departure. Medicine and Compassion is a delightful book, but for accounts that are more intellectually challenging, I would recommend Edward Conze's classic Buddhism (1951); for Tibetan Buddhism, Chogyam Trungpa's Cutting through Spiritual Materialism (1974); and for Buddhist health care perspectives, Lawrence Sullivan's Healing and Restoring (1989). Ted J. Kaptchuk
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"In folksy English, this book explains the Tibetan belief system, including the concepts of impermanence, attachment, suffering, and emptiness." -- Ted Kaptchuk, in the New England Journal of Medicine