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Medicine and Compassion: A Tibetan Lama's Guidance for Caregivers Hardcover – September 25, 2004

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Editorial Reviews

From The New England Journal of Medicine

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
Copyright © 2005 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.


"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

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Product Details

  • Hardcover: 192 pages
  • Publisher: Wisdom Publications (September 25, 2004)
  • Language: English
  • ISBN-10: 0861714784
  • ISBN-13: 978-0861714780
  • Product Dimensions: 7 x 0.8 x 9.2 inches
  • Shipping Weight: 14.4 ounces
  • Average Customer Review: 5.0 out of 5 stars  See all reviews (8 customer reviews)
  • Amazon Best Sellers Rank: #598,138 in Books (See Top 100 in Books)

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19 of 20 people found the following review helpful By Charles R. Atkins on December 2, 2004
Format: Hardcover
Medicine & Compassion is an important book. It should be required reading for physicians, medical students, nurses, caregivers, and hospice staff. Every family should have it on their bookshelf. Christians, Muslims, Jews, Hindus, Buddhists, and even non-religious people will benefit from this book because the ideas are about the human condition which transcends all differences of faith. In a word, this book is a treasure.

We all grow old, get sick, and die. Impermanence, uncertainty, and sorrow permeate our very existence. Chokyi Nyima Rinpoche and David R. Shlim, M.D., answer the important questions of why we get sick and to how to respond with compassion and mercy, when illness or impending death are at hand. One could say that it is a manual to understanding our own nature and mortality.

The narrative tone of the book is intelligent and merciful - never sugary or overdone. I could really feel the subtle, yet vibrant life energy of the book as it conjured forgotten images and feelings. It caused me to reflect on the end of life care that I administered for my parents and brother. I was able to see what was good and what was lacking in my care for them, without feeling a sense of regret. In fact, I gained a sense of optimism for the future.

As a writer on Buddhist healing, I found this to be a perfectly cut gem. Its words and inferences reflected the light of wisdom. I found it an invaluable tool for encouraging the sick and suffering. I was especially impressed with the author's end of life guidance in the chapter "Easing the Process of Dying." As a Buddhist for more than 30 years, I've read many works on death, dying, and the bardos. Chokyi Nyima Rinpoche and Dr. Shlim explain this subject in a way that can satisfy the average person or the spiritually advanced.
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13 of 14 people found the following review helpful By Stephen Bezruchka on October 28, 2004
Format: Hardcover
I've been practicing medicine for over 30 years and been a patient as well. What is it that you want in a 'healer.' Compassion. But it doesn't come in a pill bottle, nor at the end of an endoscope, nor between the scalpel and the skin. Compassion is the critical part of caring that helps people get better. For those of you who take care of patients, this book provides a perspective you won't find in print anywhere else. Would that this book was required reading in medical school, residency, and at all continuing medical education courses! Then the US might become a little healthier than the sorry state it is in now.
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9 of 10 people found the following review helpful By Nancy Piper Jenks on October 30, 2004
Format: Hardcover
Chokyi Nyima Rinpoche and David Shlim have articulated beautifully an invaluable lesson in learning how to encompass compassion into our encounters with patients. As nurses and physicians we work with great dedication and energy to help our patients move toward a healthier state of being. The process sometimes seems very easy and gratifying however, sometimes we are stuck and not sure why. This book offers practical advice to the reader of how to more effectively approach each patient with kindness, wisdom and care. Since reading the book, I have noticed subtle changes in my own approach to patients and have felt a new energy and insight.
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3 of 4 people found the following review helpful By David Hykes on October 17, 2005
Format: Hardcover
Chokyi Nyima Rinpoche is a highly-respected Tibetan lama who heads a large monastery in Nepal and has active Dharma centers in a number of Western countries

(see He is a pure-hearted and open-minded teacher who indeed embodies the Buddhist ideal of compassion and wisdom combined. The ongoing "meetings of the minds" (the Mind and Life seminars with H.H the Dalai Lama being probably the best-known example), focussing on Mind and Meditation, are attracting wide interest; the theme of Mind, Meditation and Medecine may resonate even more, given the number of books appearing in that general area, of which this one is surely among the best.
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