by Bob Flaws

Based on e-mails and f2f discussions with other practitioners, I know it's not just me who sometimes is faced with patients nothing seems to help. Often I am just the most recent in a long list of previous practitioners who have tried and failed with these patients. In my experience as a teacher, I often find new practitioners beat themselves up for not being able to cure everyone. However, the truth of the matter is that not every disease or every patient can be cured. In other words, some diseases, such as epilepsy, are recalcitrant to treatment in general, while some patients suffering from ordinarily treatable conditions are personally not treatable. In cases such as these, I find it is useful to consider traditional Tibetan medicine's three levels of disease causation.

Follow up:

The first of these three levels is the naturalistic level analogous to Chinese medicine's five phases, viscera and bowels, qi and blood, external environmental evils, etc. This is the level to which standard professional Chinese medicine addresses itself. When treatment works on this level, it's great, and certainly Chinese medical treatment on this level is extremely effective in many, many cases. As a practicing Chinese doctor, this level of disease and treatment is my bread and butter, my metier.

The second of Tibetan medicine's three levels of the causation of disease is provocation or attack by noncorporeal entities, i.e., various types of spirits. Chinese medicine also had this idea at one time. However, as I have discussed in other blogs and Blue Poppy podcasts, the belief in spirit provocation has gradually died out within mainstream professional Chinese medicine. The Nei Jing itself is primarily a refutation of spirit-caused disease and is the locus classicus of the naturalistic stream of Chinese medicine. From the Han to the Tang dynasties, belief in spirit provocation as a cause of disease waxed and waned in the professional Chinese medical literature but is mostly absent from the Jin-Yuan dynasties to the present. Of course, some individual Chinese doctors have continued to believe in this idea to this day, but here I'm talking about the general trend within the profession in China.

In my 30-plus years clinical experience, I have had one case that clearly seemed to be due to spirit provocation. The little girl in question was a lesser version of the girl in the movie The Exorcist. One could clearly feel the presence of a powerful malign being inhabiting this young child. The parents had been told their child was possessed by a Nichiren Buddhist monk before me. Consequently, I referred this patient to a curandero in Denver who successfully exorcised the spirit and the girl was cured. Since most traditional Tibetan doctors were/are monks or Lamas,traditionally trained Tibetan doctors are trained how to recognize such spirit provocations and how to treat them on a spiritual level. However, this is not something included in the worldview of TCM or the standard training of TCM practitioners.

The third of Tibetan medicine's three levels of disease causation is karma from a previous life. In this case, the patient has literally been born to experience their disease. This means that the causes of the disease are built into the very fabric of a person's being. They are not some adventitious superimposition. This makes the treatment of such diseases difficult at best and impossible at worst.

Many years ago, in describing why a particular patient with epilepsy was impossible to treat, Old Doctor Max Wu of San Francisco said that the woman's disease was caused by former heaven causes as opposed to latter heaven causes. As Dr. Wu explained them, former heaven causes were things like genetic inheritance and factors affecting in utero development. Dr. Wu used the concept of former heaven diseases to explain how some people are simply hardwired or born to experience a particular disease and why appropriate Chinese medical treatment based on the patient's presenting pattern(s) is ineffective. Analogously, in Tibetan medicine, it is believed that negative actions performed in a former life may ripen as disease in this current life. Such karmically caused diseases are then also very difficult or impossible to treat. If they are treatable, the only way is to address them on the karmic or spiritual level, not on the naturalistic level. Even then, there are usually limits as to how much can be done to ameliorate the condition. By their very nature, karmic diseases are former heaven or "pre-natal" diseases.

Standard contemporary professional Chinese medicine also does not recognize karma or the idea of karmically caused disease. Back in the mid to late 1980s, I tried to popularize Dr. Wu's dichotomy of former and latter heaven disease causes, but the idea never caught on. Obviously, the idea would not have found traction with contemporary ethnic Chinese doctors trained in the PRC. Nevertheless, karma seems to be a good explanation of why some patients cannot seem to heal otherwise theoretically treatable conditions.

Within Tibetan medicine, knowing that a disease is karmic, one can deal with it in two ways. First, one can work on accepting it for what it is. Instead of railing against blind fate or the fiat of a supreme being, one accepts that this is the end result of having oneself created negative actions some time in the past. In other words, one takes personal responsibility for their condition; one "owns" it or "owns up to it." While this may or may not affect the physical condition itself, it does powerfully affect the mind that experiences the disease, going a long way to reducing the subjective suffering caused by the condition.

The second way Tibetan medicine seeks to remediate karmic disease is through spiritual practice. On the one hand, one consciously attempts to purify the bad karma from one's stream of being. On the other, one deliberately attempts to create good karma to negate or offset the bad. Because Tibetan medicine is part and parcel of Tibetan Vajrayana Buddhism, the Tibetan Buddhist patient has a whole panoply of spiritual practices potentially at their disposal with which to purify bad karma and make lots of good karma. If the doctor is also a highly trained and developed Lama, the doctor him or herself may be able to identify that a disease is a karmic one and to prescribe the appropriate spiritual remedies. Such remedies typically consist of the patient saying certain prayers and conducting certain ceremonies and/or commissioning others to say prayers and conduct ceremonies.

If the doctor is not personally capable of definitively diagnosing disease due to either provocation by spirits or past bad karmic, the doctor may refer the patient to a Lama who is trained in and skilled at various types of divination. Within Tibetan Buddhism, two main types of divination are called mo and ta. Mo are systems of divination similar to the Yi Jing (I Ching). They may consist of randomly counting beads on a rosary, throwing dice, reading auguries in the movements of animals, such as crows, reading palms, reading tea leaves, etc. Depending on the device being used, there are then manuals telling the diviner what outcomes mean what answers. Ta on the other hand refers to seeing the answer to a question as a vision in a mirror. Diviners using ta are literally seers or see-ers.

Lama Dawa Chodrak Rinpoche is one such Tibetan Lama-seer living in the U.S. Lama Dawa was identified as a potential seer from his early youth and then was trained specifically to fulfill that potential through a series of rigorous solitary retreats. Many high Tibetan Lamas regularly make use of Lama Dawa's abilities as a diviner. Luckily for us here in N. America, Lama Dawa also does mirror divinations for others in the general public. In particular, Lama Dawa is skilled at determining if a disease is due to spirit provocation or past-life karma and then can "write a prescription" for dealing with either of those. I regularly use Lama Dawa's services to help me with my own health conditions and have found his "readings" and advice to be spot-on and highly effective. In order to commission a reading by Lama Dawa, you can go to his website at http://www.lamadawa.com/divinations.html

Good luck & best wishes.

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