Dr. David R. Shlim, co-author of the book, Medicine & Compassion, Wisdom Publications, 2004, (see my blog review) was kind enough to take time from his extremely busy schedule to grant Phantom City an interview. With each passing year, it seems as if university researchers and the scientific community are looking deeper into human consciousness and the powers of mind, in large part because of the excellence and openness of Tibetan Buddhism. Medicine & Compassion is another example of the importance of Buddhism in augmenting high tech Western medicine. This book is being hailed as a veritable treasure by patients, physicians, and caregivers around the world.
Phantom City: Why did you become a doctor?
Dr. Shlim: My father was a doctor, and I grew up thinking that I would be a doctor. I always wanted to help people who were ill or injured. I went to college in 1967 and got caught up in protest and anti-technology thinking, and almost gave up my goal of becoming a doctor. I majored in English literature. I dropped out of medical school after one quarter, but went back a year later and finished. Still uncertain of what kind of career I wanted, I only did one year of internship, then went into general practice in northern California. From there, I took my first trip to Nepal to work as a volunteer doctor at a high altitude rescue post near the base of Mt. Everest. This work in the mountains with the Sherpas and mountain climbers helped me discover why I became a doctor, and led me to move to Nepal a few years later.
(PC) How did the Sherpas help you discover why you became a doctor?
Dr. Shlim: When I was an emergency room physician I often dealt with severe life-and-death situations. However, we were expected to be able to handle these, and the fact that we took care of a particular person and saved his or her life was really a matter of how we filled out the schedule each month. In other words, I just happened to be working a given night, and any of the other emergency room doctors presumably would have saved the person’s life if I hadn’t been scheduled that night. When I finally got up into the remote mountains of the Himalayas, I found that one person can really make a difference, and with no one else to consult, you had to make difficult decisions by yourself. When things worked out well for the patients, you felt as if you had really been able to contribute. So, it wasn’t specifically the Sherpas who helped me, but the fact that I could offer medical care in a remote, underserved area, and really make a difference.
(PC) Why did you become a Buddhist?
Dr. Shlim: I was raised in a Jewish family, and appreciated Jewish values of caring for others and preserving the culture. However, Judaism didn’t provide me any clear answers of why we are here, and what the main purpose of life is, or how to become more peaceful. I discovered yoga during a difficult period in my 20’s, and this gave me the first glimpse of how relaxing the mind could help one gain control over one’s emotions. However, after pursuing yoga for several years, I discovered that there was no apparent end point in yoga—what is enlightenment in hatha yoga? After visiting Nepal three times to work as a volunteer at the aid post mentioned above, I moved there in 1983 to work in a Western medical clinic that took care of all the foreigners in Nepal. A year later, I offered to help a Tibetan monastery with their medical care.
The monastery was headed by Chokyi Nyima Rinpoche, and we became friends in a rather casual way—sharing tea or lunch before or after the clinic that I ran at the monastery once a week. As I began to attend some of his teachings, and ask for personal advice, I found that what he was saying made practical sense in the problems I was dealing with in my life, and I began to get more motivated to learn to meditate, get more teachings, and even started to do some short retreats. Eventually I realized that Tibetan Buddhism offered a genuine insight into reality and consciousness, and the relationship between the two. Buddhism offers the viewpoint that compassion and wisdom are inherent within our consciousness (called “mind” in Buddhist philosophy), and that these qualities can be cultivated and expanded to a great degree. When I began to get more serious about Buddhist practice, I was able to experience that this was true, and that this had a positive effect on my medical practice. The understanding of Buddhist philosophy and the effect it had on taking better care of patients led to the Medicine and Compassion Project, of which the book, Medicine and Compassion, is the start.
So in answer to the question of why I became a Buddhist, I don’t feel I ever made a decision to become a Buddhist, per se. I met a Buddhist teacher, became friends with him, developed trust, and found that it was leading me in the way I had always hoped to be led. No decision was really necessary. I’m still comfortable referring to myself as Jewish, but if asked if I’m Buddhist, I will easily say, “yes.”
(PC) Chokyi Nyima Rinpoche is listed as the co-author of your book, Medicine & Compassion. Obviously, he was a driving force in getting this important work into print. What’s his connection with Tibetan medicine – is he also a doctor? Secondly, the question that really intrigues me is how your book, which clearly explains the ancient ways of compassionate, patient care, is being received by Western physicians and caregivers.
Dr. Shlim: Chokyi Nyima Rinpoche is more than the co-author of the book—his teachings make up the entire book apart from my introduction. Therefore, this is really Chokyi Nyima Rinpoche’s heartfelt advice to Western medical practitioners. His teachings had helped me become a better, more compassionate doctor. I asked him to teach to Western health practitioners, and he took the time to do so.
Although the focus was on medicine and compassion, and there is much practical advice on taking care of difficult patients and situations in the book, Tibetan Buddhist philosophy already has the cultivation of compassion as its central focus. So, the breakthrough of this book was to tailor Tibetan Buddhist philosophy for a specific Western audience that could benefit from learning more about the possibilities of training in compassion. In fact, the two seminars that Chokyi Nyima Rinpoche taught to doctors represent the first time that Tibetan Buddhist teachings were directed toward an audience of Western health professionals.
Chokyi Nyima Rinpoche is a reincarnate lama in the Tibetan tradition, which means that he is considered the reincarnation of a specific head of a monastery in Tibet. He was forced into exile with his family in 1958, when he was 8 years old. He completed his monastic training in Sikkim, and later established his monastery in Katmandu, Nepal. Although all students of Tibetan Buddhism end up learning about Tibetan medicine, he is not specifically trained in Tibetan medicine. His apparent insight into the suffering of patients, and the key role that a physician can play in easing that suffering is based on his subtle and profound knowledge of compassion and wisdom in general. People who are suffering, or dying, often come to him for comfort and advice.
The book, Medicine & Compassion, is enthusiastically received wherever I have had the chance to talk about it. I just gave the first Grand Rounds talk at the University of California at San Diego that was devoted to compassion. I received very nice feedback from the audience, with good questions, and I got a note from the Director of the Emergency Department that quoted one of his residents as saying, “Work has been very emotionally draining in recent weeks and this talk helped to reinforce why I chose medicine and how privileged I am to practice.”
Any health professional or caregiver who would like to share in the experience of receiving insight into compassion directly from a Tibetan lama can attend the next Medicine and Compassion course that will be held in Boston, July 7-9, 2005 at the Harvard School of Public Health. Details about the course can be found at the Harvard School of Public Health’s website: http://www.hsph.harvard.edu/ccpe/programs/Compassion.html or you can learn more about the Medicine and Compassion project in general by visiting our website at: www.medicineandcompassion.com.
(PC) Do you see, as author, Dr. Larry Dossey suggests in his book, “Reinventing Medicine,” the eventual merging of Eastern and Western medicine?
Dr. Shlim: My book is about the benefit of more emphasis on compassion in medicine, and the possibilities of training to expand one’s capacity for compassion. As such, it is not directly about a new approach to medicine. However, the practice of medicine exists to relieve suffering in others. If one’s primary focus were the relief of suffering, one might be more open to whatever method is able to achieve this goal. In this way, we may be able to be more open to incorporating other forms of healing into our practice. The Tibetans are very open-minded in this way. They will use whichever form of medicine is most effective, whether it is Western or Tibetan.
(PC) Finally, what type of advice do you have for the readers regarding improving the mind-body connection, which seems so important in healing?
Dr. Shlim: I’m personally interested in the interface between fixing what’s fixable and accepting what’s not. When we first get sick, our main desire is to get better. This positive energy has been shown to be effective at helping to fight off disease and heal more quickly. That’s why it’s important for practitioners to encourage their patients, and let them know that they will try whatever it takes to make them better. However, because of the fact of impermanence, not all illness can always be cured. Our lives, after all, are finite. So, along with developing a positive mental attitude towards solving problems, we need to work on accepting the things over which we don’t have control. At a certain point, having peace of mind is more important than continuing to struggle against insurmountable odds, even if that struggle would seem to be heroic. Developing peace of mind is also a key ingredient in staying healthy, so it is not as if the effort will only pay off when it comes time to die!
I’d like to thank you for your time, Dr. Shlim. I also wish you and your book great success. It’s clear to me that the ideas you’ve presented are vital to the future of health care. I’m going to recommend Medicine & Compassion to my doctors at the VA, my readers, and those who ask me for help in healing.
Buddhism as practiced in the SGI places a great deal of emphasis on benefit and botsu (via slander), obstacles and punishment, karma and tenju-kyoju. Lessening the effects of heavy karma is the proverbial “carrot on a stick” that impels us to challenge our oft-times bitter destiny. The idea is that when we take up the “correct practice,” obstacles will emerge, one after another, to impede our faith and stop our practice. This Devil King is no external phenomena, but a function of the fundamental darkness of our lives and the universe that must be subdued in our quest to realize absolute happiness and enlightenment. Our heavy karma carried over from countless previous lifetimes is a necessary expedient to prove the greatness of the Mystic Law. Showing actual proof through accruing inconspicuous and conspicuous benefit is the mandate of correct practice. To give up halfway is to revert back to angst-ridden flotsam tossed about on the seas of suffering. At what point does one conclude that their ship is going down? When does one finally realize that it’s time to abandon ship?
Recently I received a disturbing call from an old friend. There have been three similar calls in the past year from different members that I fought with on the front lines of faith activities. It was his Gohonzon anniversary. Twenty-nine years earlier, I had brought him to the Chicago community center to receive the Gohonzon. For the next two years, I trained him to become a youth division leader. In those days, there seemed to be more leaders than members, but I digress.
It was apparent that he wanted to talk about more than his appreciation for receiving the Gohonzon and the training he received from me. “What’s the real reason for calling?” I asked. “It’s been more than twenty-five years since you last called,” I said. He proceeded to explain that his life was in Hell. He had lost his job, his son had joined a street gang, his Mom had recently died, and his brother was suffering the after effects of open-heart surgery. I listened without interjection as he continued to describe his tale of woe.
Earlier in the summer, a childhood friend that I had introduced to the practice traveled 200 miles for a visit and guidance, telling me a remarkably similar story of unhappiness, pain, and loss. His thirty-first anniversary of sincere practice is coming up in July. The more he practiced it seemed, the greater his losses and psychological agony. “Why am I so unhappy?” he asked. He spoke of suicide. I’ve received other calls from old youth division comrades in the throes of anguish – unable to confide in their own senior leaders because the guidance they received of hallow SGI clichés did not work and only made them suffer more. I’ve received emails from sincere members from other countries who have been driven to deep despair by the organization and unrelenting personal loss. I’ve seen many members discontinue their practice because the promise of happiness, benefit, and enlightenment, as extolled by the SGI, never materialized, even after decades of practice. One might argue that by giving up they would never attain their goal or that their breakthrough and victory was just around the corner.
It would be ludicrous to say that people in the SGI or Nichiren Shoshu don’t receive benefit. Anyone who has practiced knows that chanting has uncanny effects and can empower you. Our karma is mysterious and difficult to know and even more difficult to change. Why then, is there so much apparent contradiction in what is promised and what people experience, even after decades of wholehearted effort in the three ways of practice? Devoted SGI members may be quick to refute my observations, claiming their extraordinary good fortune and accrued benefits. I don’t dispute their rewards or spiritual attainments. Yet, my observations clearly indicate that once the bravado and BS is shoveled away, there is frequently more suffering than reward. Is that because Nam-myoho-renge-kyo is ineffective? No. There are two reasons. I submit that the suffering, loss, and unrealized benefits that I see emerge from the sphere of doctrinal heresy and misinterpretation of Nichiren’s teachings to perpetuate a spurious agenda. Secondly, the crap of life happens to everyone regardless of sect or religion. Although we have been taught that there are shoten-zenjin – those natural forces inherent in our life and the universe – ever ready to protect us from peril in direct proportion to the strength of our faith, life and death still happen, no matter how much we chant. I was shocked and appalled when I learned that a member and friend had been killed on September 11th. Where was the shoten-zenjin when David Aoyama’s plane hit the world trade center? I don’t think that my question is unfair and it’s certainly not intended to impugn his faith, as I knew David quite well and admired him. My point is that accident, disease, and misfortune happen to everyone at some point and we should be damn careful about ascribing blame or taking credit for missing tragedy because of our faith.
For example, the ever-fawning interviewer/lawyer, Star Jones recently made the comment that God had protected her from the tsunami because she had had her honeymoon in that region a month earlier. Hundreds of thousands of mostly devout people were killed but God was watching out for Star Jones. As comedian John Stewart commented, “That was a big oversight on God’s part.” We constantly hear insipid and reckless comments of the same genre from athletes who praise God for their victory, as if He took time from patrolling His trillions of worlds to help win one for the Gipper.
The idea that we receive some special protection because of our correct faith seems deluded and arrogant to me. Can our faith and practice put us at the right place and the right time - or perhaps have tragedy pass us by? Based on the life events that are evident through our association with others, I find that special protection based on believing in a certain religion or sect is superstition and myth, not based on any kind of empirical evidence. To my way of thinking, it’s another example of misreading metaphors as literal truths. If our faith causes us to be more cautious, live more aware of self and surroundings, and fosters a healthier lifestyle, that is not some mystical protection as much as it is living a smarter, more practical life. When out leaders assert that misfortune that visits a Nichiren Shoshu believer is punishment while the same misfortune for an SGI member is lessening karmic retribution or an obstacle, we show our ignorance to the entire world. I remember a few years ago reading in one of our publications the mocking comments of an SGI VP ridiculing an old NS priest that had some neurological disease that left him with dementia, unable to speak or care for himself. The SGI leader was so cruel. His comments, when read objectively just proved his ignorance. He was really saying that the priest was being punished and SGI members don’t suffer such fates. In all fairness, I also read official comments by the NS priesthood who attributed the great Kobe earthquake to the slander of the SGI. But in fact, no one, regardless of sect or religion is immune to illness or accident. The SGI is a glass sangha and the steam is starting to evaporate.
Just look around at the leaders and membership. One of PI’s sons died of cancer, and both senior leaders and members have been killed in traffic accidents, plane crashes, and freak occurrences. Some of our most famous and beloved have died hideous, painful, protracted deaths. The truth is that we’re all on the same wheel of samsara and as Jim Morrison of the Doors said, “No one gets out of here alive.”
So, what are we to do or think? My advice to my longtime friends was candid. In fact, I was very reluctant to tell them what I thought about their situation. I could only offer my own observations, experience, and conclusions. I told them both that they needed to find their own answers and not follow my example. I explained that I didn’t think their practice was strong enough or adequately self-motivated to leave their peer group. Some people, I told them, need the group to prop them up and give them support in time of need – and that’s fine. There’s no shame in wanting to belong to a large group and gaining strength through that dynamic.
In my case, after decades of unhappiness, loss, psychological abuse, and outright betrayal by my own sect, I checked to see if I still had a set of balls. Finding out that I wasn’t completely emasculated, I cut my ties with the organization and began my study and practice over again, without the mumbo jumbo superstition that holds you firmly like the jaws of steel trap on a small critter. For lack of a better image, I chewed my own leg off to survive. What followed was benefits of the mind, the body, the storehouse, and the heart. I received more robust, conspicuous benefit in one year than in all thirty years of previous practice combined. My mental health, physical health, financial health, and power of faith improved beyond all expectation. I recognized that I had accepted ideas and doctrine that had more holes than a block of Swiss cheese the size of Gibraltar. As I told my friends, what worked for me might not work for you because my level of development is different and the discipline of my practice is not the same. I continued to explain that I don’t want to be responsible for what they do. I told them that I had no animosity toward the SGI whatsoever. SGI doctrine proved to be false to me. Once I purged it out of my life, I rediscovered myself. From a career standpoint, as an author, I realized that the SGI was more like bondage than absolute freedom. For the first time in my life, I’m happy.
After being discharged from the Army, in 1970, I began to hitchhike around the country looking for my purpose in life. It was a turbulent time. Acid had opened my mind, although my parents thought my brain had been deep-fried. A few years prior to that, I began to practice yoga and meditate. In 1971, I found myself living in an ashram in LA, practicing kundalini yoga and trying to suppress a twenty-year-old libido. After months of effort, Shiva won out and I bid farewell to the sterile austerities of cult life.
I learned many valuable lessons from my yogic adventures. Prayers are easy to learn, piety is a gift. The mind, youthful passions, and the body are difficult to master – while kneeling on a prayer rug is easy. It became clear after a while that the celibate way of life and surviving on a strict vegetarian diet were not for me. My mind was tepid and a natural curiosity cast me in a contemptuous light before the temple masters. I was a violent and power hungry lad who had more in common with Aleister Crowley than Mahatma Gandhi. In retrospect, there were some very valuable lessons learned. Perhaps the most important things learned were how to meditate and use a mantra. Over the long course of life, those disciplines served me well.
Nichiren Buddhism as practiced in the Soka Gakkai was appealing to me because it did not try and stamp out desire. Conversely, one of the valid criticisms of the SGI method is that it is materialistic, encouraging people to chant for whatever they desire. In the beginning, people chant for money, possessions, sex, love, drugs, and the entire gamut of human desires, some nobler than others. I still recall a nasty expose of the SGI-USA perpetrated by an expelled member, the former Chicago World Tribune Bureau Chief, Frank Ross. The Chicago CBS affiliate brought a hidden camera into the culture center and one of the investigative reporters posed as a potential member. I was not one bit surprised by the footage that recorded – for all Chicago land to see – a long time member telling the shakubuku that she could chant for whatever she wanted, “sex, drugs, or money.” Hell, I used that line myself a few times. Frank Ross was expelled for revealing the truth.
The beauty of chanting for anything you want (or need) is that no one is turned away because their desire, no matter how lofty, is obscure, idiotic or selfish. The problem with that approach however, is that over time, people chant about their petty desires or sorrows constantly, instead of delving into the deeper areas of prayer and meditation. We don’t really teach that at meetings and we ought to. The idea seems to be, that we learn to pray for ourselves and others, while we naturally pray for the great goal of kosen-rufu. Our prayers are me, me, me; you, you, you; and it, it, it (as in kosen-rufu). There is no silence, no end to our requests or demands, no shame in our materialism. One might think that prayers of this kind are the ultimate. But is meditation/prayer for material things the true aspect of prayer, or is there something deeper for the mind? This business of prayer for personal desires and organizational objectives caused me to meditate on the subject, and I came up with - well, nothing – or rather, nothingness. And that’s a good thing.
Who are you? What are you? Why do you exist? You’re more than your career, more than a parent, your gender, individuality, politics, or desires. As the Upanishads state, “Thou Art That!” No, you’re more than the person reading this. You’re it! But, what is “that” – what is “it”?
A swami posed the following question to Joseph Campbell. “Where are you now? Where are you between two thoughts?” To understand this question, we must pause and ponder our thoughts that race like a rapid river. We must slow our thoughts down to a trickle, then stop them completely, like the last drop melting from an icicle when the hard freeze comes. Yet, no matter how hard we try and suppress thought, new ones emerge from nowhere, like trapped air bubbles, rising to the surface. Our minds seem compelled to generate new thoughts no matter how inane. Just pondering the discipline of slowing the thought process is in itself a thought. We glimpse between them for what seems a moment. There, silence dwells like the pause between two echoes. Our minds are not trained to remain there long. Sense impressions blow with blizzard force. Riding on sensory winds, bursts of egoistic trivialities flash like lightning on the ground of our awareness. The “you” between two thoughts is the sun reappearing from behind the clouds.
When we finally experience our true self – that “you” between two thoughts - a tranquil emptiness is perceived – it exists like a dream, but it is in fact, the true reality of our being. All aspects and potentials of the universe are inherent in our life, regulated by what Aldous Huxley termed “the minds reducing valve.” What’s perceived depends on how we’re able to transcend the ego that feeds on thoughts, generates thoughts, and clings to thoughts. The “you” between two thoughts is Buddha, cloaked in the Mind At Large.
“I know my body. My body is an object. I am the witness, the knower of the object. I am therefore not my body.” Next: I know my thoughts. I am not my thoughts.” And so on: I know my feelings; I am not my feelings.” You can back yourself out of the room that way. And the Buddha then comes along and adds: “You are not the witness either. There is no witness. So where are you now?” Where are you between two thoughts?”
I pose the question to you, who or what are you between daimoku – between each sound of the mantra? If we stop chanting for “things” or “goals” long enough to ponder this, we might just be surprised by what we find out.