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Practicing the Dharma While Ill

Being diagnosed with a disease, patients need to receive treatment and may have to enter and leave the hospital multiple times. How do patients live peacefully with the disease, and how do they communicate with their family members and the medical staff? When our life is coming to an end, how do we prepare for death? We can emulate Dharma Drum Mountain founder Master Sheng Yen's attitude towards illness: "Leave your illness to the doctor, and your life to the Buddha and Bodhisattvas (or to your own beliefs). In doing so, you'll be a healthy person with nothing to worry about."

Waiting for a diagnosis: accepting the fact of sickness with a mind of equanimity

Before the diagnosis is confirmed, the anxiety of waiting for a diagnosis can be tormenting. When the result reveals a severe disease, most people will react as if being sentenced to death: feeling shocked, uncertain, and terrified. In this way, not only is our physical body sick, but our mind also feels distressed too. In the process of looking after Master Sheng Yen during his treatment of illness, Ven. Chang Kuan, the Master's former attendant, witnessed the mentality and practice methods demonstrated by the Master when facing different stages of his illness. This can certainly be inspirational and motivational for many.

1. Do not sentence yourself to death when being notified of a cancer diagnosis or other serious condition. This will only scare you, deepen your fear, and increase your worries.

2. Many patients are resistant to accept the fact that they are sick. To counter this tendency, they should communicate rationally with the medical staff and seek medical advice, without being frightened by the doctor's comments or rejecting their advice. Indeed, they should take medicine if necessary, and schedule a check-up when needed.

3. Be neither overly optimistic nor overly pessimistic about your condition. Do not harbor  excessive expectations for recovery, but do not give up on yourself either.

4. Settle your mind first, and you will have peace of body. The mind affects the body. If you have a religious faith, use the power of your faith to help calm your mind. Do not take medical advice from unqualified individuals.

5. Family support is very important, especially for the patient. Be frank with the patient; they have the right to be informed of their condition. Engage more in discussion, and make necessary arrangements in advance.

Although it's normal to find being diagnosed with a serious illness hard to accept, we mustn't allow ourselves to indulge in an unfair emotion, thinking, "Why me?" Buddhists should acknowledge impermanence and the law of cause and effect, as well as the fact that everything happens for a reason. As Ven. Chang Kuan mentioned, when Master Sheng Yen learned that he had a tumor, his mood did not fluctuate, and he adopted the attitude of "Four Steps for Handling a Problem: Face it; Accept it; Deal with it; and Let it go." Do your best while preparing for the worst. We must realize that impermanence is a factor in life, which is beyond our control. Only by being mentally prepared can we better adapt and accept misfortune.

Starting treatment: embracing empathy reduces physical and mental discomfort

Once the diagnosis is confirmed, the next step is to start to receive treatment, which will certainly have a great impact on one's life. Ven. Chang Kuan shared that, after Master Sheng Yen had started his treatment, he also began to make changes, such as adjusting his daily schedule and moving from Jinshan to a downtown location in Taipei near the hospital.

The treatment is a process that can put the patient, family members, physicians, and nurses to test. Over the course of treatment, the patient may feel increasingly uncomfortable, which leads to emotional instability, thus indirectly affecting the doctors and nurses. In fact, a harmonious relationship between doctors and patients is crucial, which can, in fact, influence the patient's condition. Patients should try to contemplate and reflect on their own body and mind. For this purpose, sympathy is very important. Here, the term "sympathy" does not refer to its general meaning of showing pity for the sick. "The Buddhist idea of sympathy is to relate to the other person's feelings —‘I can relate to how you're feeling.’" Ven. Chang Kuan went on to share that both doctors and patients should embrace an empathetic mind, by putting themselves in others' shoes and being more considerate towards each other.

1. Patients should try to clearly express their discomfort, instead of using emotional language, such as "I'm hurting to death. Don't touch me!", "You don't even know how much pain I am in!" "It's easy for you to say; you're not the one who is getting sick!"

2. You don't need to put up with the sensation of pain, but it's unnecessary to magnify it either. Try to relax, and don't focus your attention on the sensation of pain. If you have learned meditation, use practice methods to relax your whole body.

3. When the caregivers hear the patient crying in pain, they should first apply a caring attitude to find out how much the patient is experiencing through attentive listening and communication. In doing so, they can then deal with the patient's pain properly. For example, when patients often complain about the constant pain in their whole body, it could be that they are only magnifying their pain. When this happens, you can first try to touch their body to help them identify the pain spots, and then use massage or apply a  hot compress to relieve their discomfort.

4. To divert their attention, patients can try to engage in things they like to do, such as painting, reading, or observing plants. In addition, Buddhists can recite the Buddha's name, dharanis (or mantras), and sutras. Concentrating on a method of practice can help us forget about the illness and the sensation of pain.

5. Patients should try to move more often. Even if they have to lie in the hospital bed most of the time, they can adjust the height of the pillow and bed to change their posture while lying in bed. If they can get out of bed, they can do some simple exercises. They can try to take a walk along the ward, as this helps uplift their mood instead of keeping them feeling isolated.

6. Once we are sick, we need to be good patients and accept the care of others with peace of mind. Caregivers, on the other hand, should look to and accommodate the patient's needs, rather than involving or imposing their own subjective opinions.

Coexisting with illness: generating gratitude and enhancing vitality

During the course of treatment, an illness may come and go, and thus patients may enter and leave the hospital multiple times. Many of them are prone to depression and may even complain about their situation. At this time, patients should cultivate more gratitude, knowing that there are so many people working hard for them. Patients should feel grateful to the family members, doctors, and nurses who take care of them. Master Sheng Yen once mentioned in his book " Ascending the Summit (抱疾遊高峯, in Chinese)": "With a body like mine, I have been sick for a lifetime, and I have lived past the age of seventy. Of course, I deserve to be happy to be able to continue walking on the Bodhisattva path!"

1. Every day when you open your eyes, you can be grateful that you are still alive.

2. In the process of treatment, you can replace complaints with expressions of gratitude, as well as empathize with the hard work and efforts of your medical staff and caregivers. When communicating with them, you should understand that what is being discussed is the illness itself, without involving your emotions.

3. Don't forget your sense of humor when you are sick. Joy can be contagious. Whether it's the patient, the caregivers, or the medical staff, anyone can use humorous words to make people physically and mentally relax. In doing so, one is providing subtle spiritual encouragement to others.

4. Don't forget to be grateful to yourself, telling yourself that you are also a warrior of life, and thus can live peacefully with the disease.

5. Every day, before going to bed, be grateful that you have had another safe and sound day.

Extending loving care to patients: using compassion to spread warmth in the world

In addition to the support of medical staff and family members, mutual support among patients is also an invisible supporting force in the process of treating an illness. Patients' sharing of their experiences can inspire even more confidence and empathy. Every time Master Sheng Yen returned to the hospital for a physical examination or hemodialysis, he would extend actively loving care to the patients who were also undergoing these treatments, making them feel warmhearted and even forget about their physical pain. It is mentioned in the book "A Wonderful Life in My Late Years (美好的晚年, in Chinese)" that, prior to entering the operating room, Master Sheng Yen never forgot to make a vow and prayed: "May all patients in the world who enter the operating room be free from fear and worries, and may they recover as soon as possible after the operation; may no one in the world need to have an operation."

1. Although you are sick, when you extend sincere loving care to other fellow patients, be it a smile or a simple greeting, you can encourage each other.

2. When you don't place attention on yourself, but extend loving care to others from the bottom of your heart, you will find that your physical pain seems more manageable. This is the compassion that benefits both yourself and others.

3. There is a practice of compassion in Buddhism: Imagine a person who is suffering in front of you. When you generate compassion towards this person, imagine you're sending peace and joy to that person in pain. When you're sick, you wish that all sentient beings are at peace and do not have to suffer from illness.

Facing death: preparing in advance and saying goodbye properly

Even if the patients are seriously ill, most of them still hold the hope of recovery. However, life is impermanent, and death is inevitable. Therefore, whether you are a patient, a doctor, or a caregiver, you must be mentally prepared for death to arrive at any time. One should prepare well for death, say goodbye well, and leave no regrets. Prior to his passing, Master Sheng Yen made a will in advance and arranged the funeral himself. In doing so, he gave people the message that "death is neither tragic, nor joyful, but the occasion for solemn Buddhist ceremony and practice."

1. Buddhism maintains that "all conditioned phenomena are impermanent". When we are healthy, we don't feel this deeply, but when we are seriously ill, we feel that death is very close. Therefore, the sick can "practice death" well and prepare for death in advance.

2. Don't shy away from talking about death. Most people consider death to be a taboo conversational topic, and therefore often avoid talking about it. Patients and caregivers can try to discuss the issue of death. On the other hand, the occasional habit of  avoiding talking about death will increase mental distress for both parties.

3. Love should be expressed in a timely manner by openly discussing death, asking the patient about his funeral arrangements, or expressing gratitude or apology. This ensures that there will be no regrets in the final stage of life.

4. The most difficult thing for people to let go of is family affection. Caregivers must also be mentally prepared not to let the patient cling to their loved ones, which would make them unable to leave with peace of mind.

5. Remind yourself that "impermanence" is ever-present. Biologically, it takes the forms of birth, aging, sickness, and death; psychologically, it takes the forms of arising, abiding, changing and perishing; and, finally, in the realm of physics, it takes the forms of creation, continuation, destruction, and emptiness. (four phases of a world cycle or four medium kalpas)

6. Death only happens when all its causes and conditions are present. However, even if you recover from illness, death inevitably will come one day, so you should be mentally prepared.

Master Sheng Yen often teaches patients not to "scare themselves"—that is, not to add to the "pain of illness" by generating suffering from the pain itself, which in turn will give rise to mental afflictions. In this case, patients should always use methods to relax the body and mind.
For caregivers, the illness of a loved one is an opportunity to practice loving kindness and let go. The caregivers put a lot of effort into taking care of the patient, but they shouldn't fall into the emotional trap of "I'm doing it for your own good", let alone indulge themselves in the grief of "loss".
Doctors and nurses should try their best to take care of patients and "treat patients as if they were their loved ones". They can consider what they would do if the patients were their loved ones who are sick. In doing so, the communication and interaction between doctors and patients will improve considerably.

Extended Reading:

Taking illness as teacher and learning to live well with illness

Buddha's Teachings on Suffering from Illness

Practicing the Dharma While Ill

Q1: Why am I getting this illness?

Q2: I've been in and out of the hospital so many times. When will I recover?

Q3: Why do some infants get sick immediately after birth? How does Buddhism view this?

Q4: What can be done if someone is sick in bed for a very long time and feels hopeless about life?

Q5: I have recited the Buddha's name, practiced generosity, and performed good deeds, so why do I still get sick?

Q6: When a family member of mine is suffering from an illness, what can I do to alleviate his fear and pain?

Q7: If the body is in unbearable pain, isn't reciting Buddha's name an additional burden?

Q8: My health is deteriorating, and I feel like there is not much time left for me. How should I prepare myself for death?

Resource: Issue 380 of Life Magazine, Dharma Drum Publishing Corporation
Photos: Issue 380 of Life Magazine, Dharma Drum Publishing Corporation 
(Photos painted by 劉建志)
Translation: Christina
Editing: Keith Brown, Chiacheng Chang, YKL