Read an Excerpt

From
the Introduction: Singing Bowls

In
1991, I was asked by another attending physician at New York Hospital to
evaluate a new patient in the Intensive Care Unit. I was immediately drawn to
Odsal, a Tibetan monk in his late thirties, a gentle, soft-spoken man, whose
warmth and humility were tinged with a sense of sorrowful stoicism. Odsal had a
rare disease called cardiomyopathy, an enlargement of the heart that normally
results in congestive heart failure. As is typical of people with this
life-threatening ailment, he had developed progressive anemia and was extremely
ill. He urgently needed a heart transplant but was having no success finding a
match.

Having
been brought in for a hematology consultation, I proceeded to conduct a battery
of tests and started him on the appropriate drug regimen to combat his anemia.
Because I subscribe to the belief—well researched by mind-body
scientists—that what happens to us on the emotional and spiritual levels
affects us physiologically, I asked Odsal to tell me something about his
background and how he had grown up.

He
explained that he had fled his native Tibet as a young child with his parents
and brother after the Chinese invaded his country in 1950. He vividly recalled
the searing sense of dislocation and poverty that he and his family experienced
as exiles in India. The family lived a hand-to-mouth existence; there was
barely enough money for food. When he was three years old, his parents decided
to leave him and his brother at an orphanage rather than watch the two children
starve to death. All these years later, his pain was still fresh when he
described his feelings of abandonment, how he called out to his mother and
father as they said good-bye and walked away.

The
orphanage was run by Tibetan monks who raised him to be a monk, educating him
in the Buddhist religion and Tibetan culture. He was also an extraordinary
artist whose drawings of mandalas impressed me with their intricacy and beauty.
But his heart had been forever shattered from the grief of separation from his
parents, who could afford to visit him only once a year. Each time they left,
he said, he felt his anguish as sharply as if he were experiencing it for the
very first time.

His
suffering was compounded by an overwhelming sense of hopelessness that his
country would ever free itself of China's brutal domination. I began to see
that his stoicism stemmed from a place of dark despair; it was not the stoicism
of detachment that the Buddhists try to cultivate but rather one of deep
pessimism about the future of Tibet.

My
initial sense upon meeting Odsal was that his severe heart condition was, to
some degree, a physical manifestation of an equally acute state of psychic
distress. His life story bore out my impression. I could address the physical
symptoms: Odsal responded well to the medication and was soon feeling strong
enough that he was able to leave the hospital. But I knew that Odsal's disease
ran much deeper, that he was literally suffering from a broken heart. My
medical intervention, useful as it was, could not heal his underlying wound.

Because
he was a Tibetan monk who had spent his life in meditation, I felt it would be
presumptuous of me to undertake the kind of healing work I'd been doing with my
other patients.

Nevertheless,
I spent a great deal of time talking to him about his childhood experiences and
expressing my care in whatever way I could. Then one of my colleagues told
Odsal about my Essence Guided Imagery, and Odsal asked me to teach him the
technique. Although I felt somewhat insecure about explaining guided imagery
techniques to a monk who had spent his life practicing meditation, I
reluctantly agreed. Odsal liked the imagery, which was very different from the
kind of meditation he was used to practicing, and I could feel a lessening of
the burden of sadness he had carried since childhood.

The
next week, when he came to my office for a follow-up visit, he brought me a
Tibetan dahi, a metal cylinder similar to a bell. I was deeply touched by his
unexpected and generous gift and very taken by the sound it produced. I had
already begun to study various Eastern and Western spiritual practices, so I
asked Odsal whether he would teach me some of the sacred Tibetan chants he had
learned as a youngster at the monastery. He agreed to come to my apartment
several days later, and when he arrived, I saw that he had brought with him a
Tibetan singing bowl of the sort that the monks of his lineage commonly used to
accompany their chanting and meditation.

We
removed our shoes and settled ourselves cross-legged on the living room floor.
Odsal took out a small wooden baton and moved it lightly around the rim of the
bowl, in much the same way that you might trace the lip of a wineglass with
your finger. The clamor of the New York City streets, so audible outside my
window, fell away as the eerie, otherworldly tones of the bowl filled the space
around us. The sound—a rich, deep note with a strong vibrato that resembled
nothing I had ever heard before—was so exhilarating that tears of joy sprang
to my eyes. I could feel the vibration physically resonating through my body,
touching my core in such a way that I felt in harmony with the universe. I did
not, at that moment, make a conscious decision to further explore the singing
bowls. It was almost as if I didn't have a choice in the matter, because I
immediately intuited that playing the bowls would change my life, and the lives
of many of my patients.

Beyond
Medical School:
A
Doctor's
Awakening

If
somebody had told me when I was a medical student in Dallas, Texas, that one
day I would be teaching my patients to use singing bowls to heal themselves, I
would have thought he or she was crazy. Yet today, only fifteen years later,
prominently displayed in my consultation room at the renowned Strang Cancer
Prevention Center, where I am Director of Oncology and Integrative Medicine, is
a beautiful ten-inch quartz crystal bowl, which plays a key role in my busy
practice of oncology and internal medicine. Although I once prescribed only the
traditional remedies for the treatment of cancer and other ailments, I no
longer see a contradiction between chanting and chemotherapy, between
visualization and radiation. In fact, just the opposite: I openly advocate for
what has come to be known as holistic medicine—combining allopathic regimens
with complementary therapies that include nutritional supplements of herbs and
algae as well as regular visits to acupuncturists and energy healers. You'll
notice that I refer to these modalities as "complementary," rather
than "alternative." I have long since come to accept nontraditional,
holistic approaches as necessities, rather than potential options, that must be
integrated with the care and treatment of my patients.

Given
my rather innovative paradigm for healing, some might label me a bit
unconventional. I assure you that one doesn't necessarily follow the other. I
attended the University of Texas–Southwestern Medical School, one of the
most rigorous and competitive institutions in the country, where class rankings
and grade point averages are figured to the thousandth of a decimal point. I
did well enough there that when I graduated I was accepted as an intern at New
York Hospital, the prestigious teaching hospital affiliated with Cornell
University Medical School, where I eventually became a clinical fellow in
hematology and oncology. I later spent a year as a postdoctoral fellow in
molecular biology at Rockefeller University, then completed my training with an
appointment at New York Hospital as the chief medical resident. In other words,
I had the best possible educational foundation in Western medicine, one that
gave me a rock-solid grounding in all the state-of-the-art lifesaving
techniques that medical science has to offer in this last decade of the
twentieth century.

But
something was missing—the amalgam of psychology and spirituality that would
satisfy my patients' needs to be treated as whole human beings. I first felt
this void as a medical student, eager to absorb every lesson our instructors
had to offer. At the busy county hospital where I did my rotations, the
patients were the occasional butt of jokes among the medical staff. Perhaps the
humor was a necessary antidote to the life-or-death demands of the job, but it
reinforced for me the sense that we students were being taught to divorce
ourselves from our emotions. We were often reprimanded for talking too long to
patients. We were criticized for feeling sad or sympathetic because we were
"getting too involved." We were rewarded, on the other hand, for
being fast and efficient, for treating and releasing patients as quickly as
possible, for walling ourselves off from our hearts.

If
this absence of feeling was the model for my medical school experience, it

was
even more the prevailing ethos during my internship and residency. The emphasis
was placed almost exclusively on information and knowledge: How many papers
could we quote from? Did we have the most up-to-date facts and figures
memorized and ready to spit out on command? Could we cite the latest set of
statistics on any given study?

No
one ever urged us to empathize with our patients. The men and women we treated
were seen as cases, rather than human beings. Never mind that they brought with
them the totality of their life experiences—all their anguish and joy, fear
and hope, past traumas and future ambitions. We were discouraged from
considering the possible underlying causes of disease, other than proven
cause-and-effect links such as family history, disease pathogens, or
environmental factors. We were to concern ourselves only with the symptoms,
diagnosis, and medical treatment of whatever illness had landed them in their
hospital bed.

Every
day I struggled with a medical culture that insisted I keep my distance from
patients, and my inclination to get more deeply involved with them. Perhaps my
perspective was skewed because as a young child, I had watched my mother die of
cancer. I knew about pain and loss. I knew about the will to live, the impulse
to keep on fighting to survive, the need to surrender and grieve when every
viable medical intervention has been exhausted. I wanted to know more about the
people I was treating: What mattered to them? What were they about? Who were
they beyond their most obvious identity as "cancer patient"?

In
college I had developed an interest in world religions and philosophy. I had
also begun to meditate on an almost daily basis. Through meditation, I had
learned to take deep breaths and stay calm when I was studying for finals or
writing papers. The practice had also improved my ability to concentrate. On a
deeper level, meditation had given me treasured moments of realization that I
was part of, rather than alone in, the universe—a comforting recognition for a
college student who was away from home for the first time and living in a much
bigger city than Plainview, the small town in northwestern Texas where I had
spent my childhood.

The
time constraints of medical school and my postgraduate studies had forced me to
give up this practice, but I knew from firsthand experience that meditation
was, at the very least, soothing and relaxing. Yet my esteemed
physician-professors never recommended the use of relaxation techniques and
meditation, which studies had proven could help alleviate many of the worst
side effects of chemotherapy, including anticipatory nausea and vomiting.

I
remember my frustration verging on despair as time and again one of the more
seasoned oncologists under whom I did my postresidency training delivered the
cold-blooded diagnosis of, for example, lung cancer: "You'll very likely
experience hair loss, nausea, vomiting, and/or fatigue. You will also probably
need a blood transfusion. The statistics tell us that most people live three to
four months with your type of cancer. I'll see you in two weeks to start
chemotherapy."

It
was incredible to me that these brilliant and highly skilled physicians seemed
to screen out their patients' inevitable reactions of devastation and
bewilderment after hearing such news. The cancer diagnosis was terrifying
enough. Now they also had to anticipate treatments that promised potentially
punishing side effects and an uncertain future. Yet nothing was being offered
to relieve their stress or pain. Nor was there nearly enough kindness on the
part of the doctors who—from their patients' perspective—suddenly seemed to
hold in their hands all the power to heal and give life. I realized, even then,
that in the midst of so many discussions about radiation, chemo regimens, and
bone marrow transplants, many deeper, perhaps more subtle words were left
unspoken.

I
will never forget one patient I met while I was in medical school, an
orthopedic surgeon who had metastatic lung cancer (i.e., the cancer had spread
beyond the primary tumor to other parts of the body). Opinionated and
imperious, he clearly reveled in the authority conferred on him by his medical
degree. Now, suddenly, the tables had been turned. This stern, headstrong man
lay helpless and scared in the hospital bed, desperately searching his doctors'
faces for signs of reassurance and hope. He wept uncontrollably, hardly able to
believe that such a fate could befall him. "Why is this happening to
me?" he asked repeatedly. "What did I do to deserve this?"

His
agonizing questions echoed those put to me by many other patients. The common
motif was the distorted assumption that they did indeed deserve their disease;
they must have committed some terrible wrong or hurt someone badly, to be so
cruelly punished. The therapists and psychiatrists who visited them in the
hospital tried to help, but they usually focused on the more obvious problems:
Who would take care of their family? Were they worried about how they'd look
after they lost their hair? Certainly, these were matters worth talking about,
but even these mental health professionals were sidestepping any real
investigation into the deeper realms of the psyche or spirit.

I
like to think that I brought a broader, more open-minded approach to
alleviating my patients' emotional anguish. I tried to listen when they talked
about their grief and fear. I made a concerted effort to give them the warmth
and sensitivity they so plainly needed. But I cannot take credit for deciding
to teach them about meditation, visualization, and other relaxation techniques.
Quite the contrary. It was my patients who taught me to believe in and trust
these methods.