Sunday, May 14, 2017

Medicine and Mysticism

Even before I knew that Guanyin was the Bodhisattva of Compassion I was drawn to her image in the Boston Museum of Fine Art. (In Buddhist tradition, Bodhisattvas are beings who delay reaching nirvana out of the wish to alleviate human suffering.)

My own recent experience with medical care leads me to see concepts like Bodhisattva and Guardian Angel as telling us something important about medicine.


   
                                         Guanyin - 
                          Bodhisattva of Compassion

Two months ago I wrote about the condition that had given me many months of pain, severely disturbed sleep, and difficulty walking (see here and here). My primary care physician referred me to a hematologist who made a presumptive diagnosis of a platelet dysfunction and prescribed a medication that acts on the bone marrow to slow down the platelet production process.

Prior to the diagnosis I'd assumed that the mysterious condition was not going to go away, but now, two months after starting the medication, the symptoms have almost entirely cleared up. I'll have to take the medication for the rest of my life, and some complications could emerge, but I feel like "myself" again.

So what do these experiences have to do with Guanyin?

The medication I'm taking requires careful monitoring to make sure it's doing what it's supposed to do with the platelets, but not causing too much decrease in white & red blood cells, which the bone marrow is also busy producing. We've checked the blood nine times between the day I started the medication and this week. The results go to my hematologist who writes to me on the secure email her practice uses to interpret the results and suggest how to handle the medication.

I counted her messages in my inbox: 13 messages and a total of 386 words. That's less than 50 words/week.

From my own experience as a physician I doubt that our exchanges required much time. But in addition to the instrumental importance of the guidance I received, I was aware of a strong sense of emotional support and of being cared for that the 386 words conveyed. I identified two sources for that feeling. The promptness and reliability of the hematologist's response after my blood tests elicited a sense of security. And the happiness she expressed as my symptoms improved elicited a sense that my well-being mattered.

That's what Guanyin stands for in Buddhist culture, and likewise for Guardian Angels since they first appeared in the Hebrew Bible. Within the theologies, Bodhisattvas and Guardian Angels were vehicles for conveying divine love to us vulnerable mortals.

Health care workers tap into the same psychological and cultural substrate. The feelings I've had as a patient are the reciprocal of the sense of mission I had as a physician. Recently, at the end of an appointment, a patient said "thank you," to which I replied with the same two words. When my patient asked me why I said "thank you," I explained that being a physician (or a nurse, social worker, physical therapist...) is a privilege, and that the act of healing required collaboration between the involved parties.

I believe that if we could interview Guanyin and Guardian Angels, they would tell us that they were grateful for their opportunity to minister. There's a "mystical" element in health care that market concepts like "consumer" and "provider" are woefully inadequate for understanding.

(See here for a post about why secular clinicians might want to use religious language in their practices, and here for a post about love in the patient-doctor relationship.)