Tibetan Medicine: One Woman's Story

By Katherine Russell Rich

The New York Times; June 8, 1999 -- Last fall, when Dr. Yeshi Dhonden, formerly the personal physician to the Dalai Lama, came to New York, a friend called me. "He's specializing in breast cancer treatment," she said.

"I think you should go see him." I was surprised. Not that the Tibetans were treating cancer, but that word of it hadn't got out on the cancer grapevine.

In 11 years as a breast cancer patient, I've watched as any hint, the slightest whisper, of a cure is instantly broadcast through the cancer community, thanks largely to the Internet. The on-line forums are giant bazaars that trade in information, some fantastically advanced, some fantastic. The headers on the bulletin boards could be an index to a book called "Every Oncological Proposition Ever Advanced": "Bone Marrow Transplant," "Shark Cartilage," "Be Careful of Your Bras, Ladies."

But I hadn't seen one that said "Tibetan Medicine." Later, after traveling to the Tibetan Medical Center in Dharamsala, India, I would discover why.

Wary of exploitation, the Tibetans are protective of their medical system, which is intricately linked to their culture. After centuries of fending off the Chinese, they are having no trouble dispatching the marauding vitamin companies that have come sniffing around, hoping to strike it rich with the next big alternative medicine trend.

There is another reason we're not seeing an abundance of cheesy advertisements for Tibetan medicine in the back of New Age magazines. It is gentle and slow-acting, entwined with Buddhist belief -- the precise opposite of the quick, magic medical fix that Americans prize (and which I was half hoping for when I made an appointment with Dr. Dhonden last fall).

With his shaved head and maroon robes, Dr. Dhonden looked wonderfully out of context in the basement of a dingy Manhattan apartment. The examination was brief. He took my pulse, examined the vial of urine I'd been instructed to bring and, through an interpreter, asked about my medical history, including a few oddly pointed questions. Did I make frequent trips to the bathroom at night? Strangely, I had just seen a doctor for that complaint.

He then listed foods to avoid (barbecue, sugar, cantaloupe); provided me with four varieties of brown herbal pills (one of which had the distinct aroma of a barnyard), and, on my way out, barked one final observation in Tibetan. "Doctor says there's something wrong with your liver," the interpreter translated.

"The Tibetans always say it's the liver," my dinner companion at a party that night scoffed. After thinking it over, I joined her in smirking.

At Memorial Sloan-Kettering Cancer Center in New York, where I was a patient, I was regularly scanned upside and down. If my liver was off, I would know. But the next week, when a technician phoned with the results of my monthly blood work, he said: "Don't worry. Everything's fine. Well, except for one of your liver functions. It's a little high."

I took the pills, and two months later, the test results were normal again.

Last month, when I was making plans to go to India with a friend, Connie Harris Nagle, I asked if she'd be interested in making the trek to the Tibetan Medical and Astrological Center in Dharamsala, the former British hill station where the Tibetan Government has established itself in exile. Ms. Nagle worked with Tibetan refugees for three years and is researching a book on Tibetan metaphor. She is also a breast cancer survivor.

"Let's go," she said.

Before departing, I made inquiries about Tibetan medicine with several Western doctors, a few of whom were advocates.

"It's one of the most profound medical healing systems on the planet, because its focus is so much on spiritual practice," said Woodson C. Merrell, a doctor who helped organize last year's First International Congress on Tibetan Medicine, in Washington, which drew specialists from about 20 countries to discuss aspects of the practice: herbology, meditation, moxibustion (the burning of herbs into acupressure points in the skin), spiritual right action (spiritually desirable behavior, according to Buddhist precept), subtle body channels that cannot be detected by modern science and incantations to the blue (the color of healing) Medicine Buddha, the particularly Tibetan incarnation of the deity.

"In the West, we have organ-based disease categories," said Dr. Mehmet Oz, a co-founder of Complementary Care Services at New York Presbyterian Hospital.

"Their treatment is systemic. They don't just give everyone with diabetes the same herbs. Treatment is very different, depending on a person's 'humor,' on whether they have an imbalance of what they designate wind, bile or phlegm.' "

I also met a doctor who was not a wholesale proponent of Tibetan medicine. "People romanticize natural remedies," said Dr. Richard A. Friedman, the director of psychopharmacology at the New York Weill Cornell Center of New York Presbyterian Hospital.

"They think that if it goes under the rubric of 'natural,' it must be good. But nature also brings tornadoes," Dr. Friedman said, adding that "with untested natural treatments, there can be a big problem with drug interactions."

I also visited the one Tibetan doctor in New York, Choeying Phuntsok, a consultant at the Meridian Medical Center on East 30th Street in Manhattan.

"All disease is caused by ignorance," he said, when the conversation took a philosophical turn. "As long as you haven't achieved enlightenment, you're going to be driven by anger, ignorance and desire. Those three act on phlegm, bile and wind to produce illness."

And I phoned two educated observers. "Once all the legalities are sorted out, Tibetan medicine could be a very interesting boom," said Robert Thurman, the professor of Indo-Tibetan studies at Columbia University. Eliot Tokar, a lecturer on Tibetan medicine, said woefully: "It's the last great product line. The Gold Rush is starting. And as with any gold rush, it's bound to leave a few holes in the ground."

Any prospectors will have to contend with the trip to Dharamsala, which is winding, long and wearying. There are no flights in, no airport. After landing in Delhi at 10 P.M., we scrambled to board a bus leaving at 1 A.M., then sat bolt upright through the night as our driver, a washcloth draped over his head, sang loud Hindu chants and kept time with the horn.

Through my window, smeared with the coconut hair oil of previous passengers, I could make out many holes in the ground, although they seemed like the product of disrepair, rather than any stampede. A few cradled nesting sacred cows.

Eight hours later, after crossing the Punjab, we reached our terminus, Jalandhar. It was another three hours before we arrived at the foothills of the Himalayas, and Dharamsala.

Tibet was known as the "country of medicine," Terry Clifford notes in her book "Tibetan Buddhist Medicine and Psychiatry" (Weiser), and it doesn't take long in Dharamsala to realize that the exiles have reconstructed as much of the old country as possible.

Once your eyes have adjusted to the astonishing color and sights -- monkeys perched on low-slung roofs, maroon-and-orange robed monks dodging rickshaws -- you notice the signs everywhere for medical practices: Delek Western-style hospital, Dr. Sant Marwah Clinic.

They're scattered up and down the hilly roads that lead to Men-Tsee-Khan, the sprawling white Tibetan Medical and Astrological complex that was founded in 1961 by the Dalai Lama. From our lodgings at the placid Kashmir Cottage, run by the Dalai Lama's younger brother, we could see the white prayer flags that fluttered from the roof.

The pungent smell of herbs drying, combined with the altitude, made me light-headed on our first morning's tour, through the room where our astrologers filled orders for star charts, through the clinic where nuns and students lined up beside a condom dispenser for free consultations, in the plain, sea-green ward where six men lay on cots.

One's eyes were yellow with hepatitis. Another, a boy who had recently escaped from Tibet, was shaking with abdominal pain. "Doctor's planning to keep him for nine days," our guide, Tseten Dorjee, the assistant to the clinic's director, said. "If he doesn't get better, we'll move him across the street to Delek hospital."

"But what if it's appendicitis?" my friend whispered, and lagging behind, we considered the advantages of Western medicine.

The tour ended in Dorjee's office. On the computer behind him, three ovals with the Dalai Lama's face swirled on the screen saver. We talked about how knockoff artists were peddling bootleg "precious pills," the highly valued Tibetan mixtures of as many as 153 herbs and minerals, including gold. To try and thwart them, Men-Tsee Khan had begun stamping all containers with holograms of the myroban plant, Dorjee said.

He pulled out a notebook fat with requests from drug and vitamin companies. So far, one pharmaceutical firm, Padma A.G., a Swiss concern, was making headway. Otherwise, "We say, 'Send us proposal,' " he said. "We say, 'We have to look into the legalities.'

"There are not enough herbs for ourselves," he continued. "How can we collaborate with them?"
On the way out, we met with Tenzin Choedrak, the Dalai Lama's current personal physician.
Dr. Choedrak, 73, was stooped and looked frail. He had a cauliflower nose, bunched and flat. For 22 years, he had been imprisoned and tortured by the Chinese. After he escaped, he lectured about how he had survived psychologically.

We spoke briefly, then made plans to meet the next morning for a medical consultation.
We arrived at 9. Outside, children shrieked in the courtyard.

Inside, the air smelled like cloves.

From his daybed, Dr. Choedrak motioned me to sit, clasped my wrist.

"How long you stay?" he asked through the interpreter, and for a moment, I was worried that he was considering sending me to the ward. His voice was shaky, but the pressure of his fingers on my wrist was surprisingly firm.

No sweet, no sour, no meat, the interpreter informed me, before handing over packets of herbs, including one that contained six silk-wrapped precious pills. "To prevent chemicals and for sleep and for blood purification," she explained. "And to improve energy. Your hemoglobin is low." I raised one eyebrow.

At Sloan Kettering, they'd just recently detected mild anemia.

In context, the experience was impressive. But later I found myself reflecting on whether Tibetan medicine could be transported out of context, to the United States. One night we had dinner with Jempa Kalsan, the center's senior astrologer. "I forecast best time for treatment, when the best time to pick herbs is," he said, and I tried to imagine what the Food and Drug Administration's position on medical astrology would be.

But the differences between East and West became most apparent to me one afternoon during a conversation with Nawang Dorjee, a Fulbright scholar, director of education at the Tibetan Children's Village in Dharamsala, and an old friend of my travel mate's from her Tibetan Refugee Project days.

"When I was diagnosed with breast cancer six years ago," Connie said, catching Dorjee up on her life, "I went to a Tibetan doctor. 'Prepare for your death,' he told me. 'Prepare for your death!' But I've been fine."

"Oh, that's so Tibetan," Dorjee, who is not related to Tseten Dorjee, said, smiling. "What he meant was, stop collecting bad deeds. Start praying. Be at peace -- because we believe in reincarnation. Become ready for your next life."

Not bad advice, we agreed.

"But can you imagine a doctor at Sloan-Kettering telling a patient that: 'Prepare for your death?' " I said, and the image made us laugh so hard we doubled over.

"Prepare for your death" became a running punch line for the rest of the trip. "Prepare for your death!" one of us would say, and the other would collapse in laughter.

And maybe it was the pills, or maybe the magnificent rise of the Himalayas above us, but funny thing was, we both agreed, we'd never felt more alive.

Copyright, The New York Times