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55. Medicine and the Dalai Lama

Medicine and the Dalai Lama have very different attitudes to suffering - this week's tip looks at how those attitudes affect our day to day lives and how a bit of balance between the two might bring us more peace and happiness. I read an article in a public health journal the other day, by Richard Smith, a doctor and once long-time editor of the British Medical Journal. He tells a story of when he was a student in Edinburgh and Ivan Illich came to give a lecture. Ivan Illich was an Austrian philosopher who gained notoriety in the 70s for his detailed and trenchant attack on medicine in his book Medical Nemesis, claiming that, on balance, it does more harm than good. When Illich made his case that day in Edinburgh, Richard Smith became so disillusioned with medicine that he left medical school there and then, and started to pace the streets of Edinburgh. This was a Monday and he did in fact return on the Tuesday and finish his training, but he says that that lecture profoundly affected him and his future career. Personally I think that the problem that so many people have with modern medicine is not so much to do with medicine itself, but to do with the fact that our society has allowed and encouraged it to be the only real source of help for ill health. Western society, as evidenced from its individual or collective outrage whenever anything goes wrong, has a very low tolerance of discomfort. Problems of all kinds, mental, physical, circumstantial, are seen as unacceptable, to be resolved at all costs, and preferably by someone else. So what better for this kind of society than a profession that sets itself up as being the answer, that takes all the responsibility for your health, and that you can blame if things go wrong? Modern society and doctors, were they to encountered each other for the first time, would surely look at each other and say 'Ahhhhh!'. It is rather like a marriage - we choose our spouses in the hope that they are going to solve all our problems, and then we spend the ensuing decades bemoaning the fact that they haven't. Society chose modern, scientific medicine because it promised to rid us of disease, and we've spent the ensuing decades furious whenever it fails us. As a result of putting all our eggs in this basket, says Illich, we have lost aspects from our culture that used to help us to deal with illness and unhappiness, and so, ironically, we are worse off than we ever were. Admittedly medicine has eradicated smallpox, antibiotics prevent many deaths, and surgery can cure cancer, but Illich would say that we have paid too high a price for these things. This brings me to a book that I have been re-reading recently, The Art of Happiness, by the Dalai Lama and a US west coast psychiatrist, Howard Cutler. If you never read another book about happiness, I urge you to read this one. Howard Cutler spent many hours over many months with the Dalai Lama, picking his enlightened brain about human happiness and how to achieve it, and he wrote it all down in this book, alongside his western perspective. There is so much of value in it, but the piece that comes to mind in relation to medicine is what the Dalai Lama says about our attitude to suffering: 'If your basic outlook is that suffering is negative and must be avoided at all costs, and in some sense is a sign of failure, this will add a distinct psychological component of anxiety and intolerance when you encounter difficult circumstances, a feeling of being overwhelmed. On the other hand, if your basic outlook accepts that suffering is a natural part of your existence, this will undoubtedly make you more tolerant towards the adversities of life. And without a certain degree of tolerance towards your suffering, your life becomes miserable: it's like having a very bad night. That night seems eternal; it never seems to end.' Try this: 1. Think of something that is not going well in your life at the moment. Perhaps to do with work, money, relationships, health, disappointment, loss of some kind. Or it may be to do with feeling a particular way - anxious, sad or low. Notice your attitude to the problem. Is it something you are accepting as an inevitable part of life, or is it something that you reject and are trying to resolve or move away from? 2. If you see it as something bad and to be rectified as soon as possible, and most of us do, notice the way that attitude makes you feel. Notice also what it drives you to do or not do. 3. Now try thinking about it in that other, Dalai Lama, kind of way. The nature of relationships, for example, is that they are difficult. It's a pity that fairy tales taught us so early in life that they could be perfect. They can be good one day and fraught the next. Friends who are right for you at some stages in your life become less so at others. Other people can be unkind, unthinking and exasperating, and so can we. Dealing with difficulties in relationships is a natural and integral part of life. Loss and change are also inevitable. 4. If you are able to see your problem as an integral part of being human, and yourself as one of many millions who have suffered in this way, what difference does that make to the way you feel? And what difference might it make to the way you handle the problem? Would love to know what you think.

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