I’ve brought up pain and I would like to diverge slightly away from Chih-I for a moment. Over the past several years doctors and nurses have been asking people to rate their pain on a scale, usually 1-10. Some people are not quite sure about how they are supposed to rate pain, it hurts and they want it to stop. Some fear if they say it is too low, then their pain will be ignored. Other don’t want to be thought of as weak and so they fear rating their pain too high.
Here is how I measure my pain. You may find it helpful or you may not, it’s just my way of figuring out how to rate something that hurts and I want it to stop. If the pain prevents me from sleeping, doing normal activities, inhibits my doing and engaging in things that add value to my life then I rate the pain high from 8-10 or so. If the pain makes doing those things difficult but not impossible then I’ll rate my pain at 6-8. If the pain is constant and causes me to be aware of it frequently to always then I rate the pain at 6-8. If the pain is an annoyance, bearable and present but not always thought of then I rate it 4-6. If there is pain and it is off and on and never debilitating or limiting then I rate it 2-5.
These are not hard and fast ratings, merely a reference point for where I start looking for numbers to answer their question. I always briefly in only a few words indicate what I based the measure on. For example the other day when I went to the physical therapy evaluation for my fractured neck vertebrae I said the pain was 9-10 based upon it interrupts and interferes with sleep and prevents me from doing important life fulfilling activities. The nurse nodded her head and said yes, those would be a 10. I shared my range of numbers and what my rating was based upon and then she could fine tune the scale to the degree she needed to record my pain.
Does that make sense to you. I know sometimes it is challenging to communicate with medical providers. Pain is one of those areas. Because we have no effective way to measure pain, see pain, analyze pain the 1-10 scale is an attempt at providing a reasonable tool for discussing this very vague and yet real phenomena.
There is another murky area which is hard to measure and that is dizziness. I don’t know about you, but when I get dizzy I get dizzy. What is there the doctor doesn’t understand about being dizzy. Well they don’t, and the reason is because there are lots of different manifestations of being dizzy. So just a word of advice. If you are having dizzy spells and you go to a doctor it will be helpful perhaps if you can describe the experience in word other than dizzy. For example, does the room spin around in your vision? Or does the room spin part way in one direction and then reverse and continue reversing? Is the dizziness one of blurred vision which blurs and then refocuses and back and forth? Do you feel like you are tipping over, like continually falling forward or even back wards?
I know when you are dizzy you just want it to stop and perhaps the last thing you want to do is try to figure out what you are experiencing. Dizzy is dizzy right? Now make it go away. Unbeknownst to us lay people the various manifestations of the dizzy experience can provide clues as to what might be the cause of the dizziness. There are a lot of options for the doctor to look at and your clues can help them possibly get to the solution faster. Of course it may not, but information from the patient makes the job for the doctor who is pressured to see patients faster and faster easier and more effective.
We are truly in an environment where patient knowledge about their symptoms, their body, their experiences is crucial. You will get more value out of your doctor visit the more you can succinctly tell them what is going on. Please refer back to the chapter on Your Visit. I really can’t stress the importance of your preparation prior to your doctor visit.
Continuing with Objects as Inconceivable Chih-I mentions specifically difficult and serious diseases as those for which one should most definitely seek the wisdom a wise person and the medical advise of a physician. The wise person in this case is your Buddhist teacher, or for a non-Buddhist reading this the advice of your spiritual provider. In ancient times these two roles frequently if not always were the same person, especially in Eastern societies and throughout tribal enclaves in the Americas, Africa, Middle East and early European societies. This action encompasses the other nine of these ten modes of contemplations.
We humans have adopted many delusions about the nature of reality following mistaken views and conceptions and so we drown in samsara. Because we place greater emphasis on material over spiritual, or spiritual over material we create imbalance and pursue objective while ignoring important considerations for a balanced life. The drive towards personal gain and comfort ceases the flow of compassion, the drive for accumulation of resources ceases the flow of good deeds.
If we are able to arouse deep compassion and desire to share bliss of the true nature of reality, non-duality, dependent origination, we can overcome mistaken views in self and others in this way a person who is experiencing illness can arouse the realm of bodhisattva through their illness. In this realm the bodhisattva contemplates the emptiness of disease which allows for the healing and elimination of dis-ease. While the dis-ease is overcome and healed the bodhisattva is able to arouse tentative illness.
Recall from the beginning of this book that tentative illness or disease are those that are taken on by the bodhisattva in order to teach other how to live in illness and through disease and dis-ease.
Arousing deep compassion for others even while suffering form illness leads to the cultivation of the mind of the emptiness of the non-substantiality of the dis-ease. The illness having not true independent nature ceases to exist as a substantive thing. It is still present but it is inconceivable. In this state then the illness is transformed into a teaching device for the bodhisattva to lead by his life. The illness is transformed into the realm of bodhisattva. As Chih-I says this becomes the way of the “bodhisattva [of the Tripitaka Teachings] who have disease and heals by ‘analyzing the essence’ [of things as empty]”
Not everyone however, is able to achieve this contemplation of emptiness, and it is important to understand the consequences of the emptiness of disease. Those who dwell primarily in the realm of Sravaka being unaware of this emptiness follow the flow of ignorance being unable to make distinctions concerning dis-ease and so are unable to realize the Buddha Dharma and this limits their ability to hep sentient beings attain enlightenment. It is as if they are stuck in the intellectual analysis of the manifestation, experiences, why’s and wherefore’s, the size and shape of the illness and so forth. I compare it to the doctor who comes in takes your temperature, pulse, looks in your eyes, your throat, your ears even before saying hello or asking why you are in his office. Then when you begin to speak he cuts you off and starts telling you how you feel. Have you ever had a doctor do that to you? I have, its like you aren’t even in the room. One time I told the doctor whenever you’re finished telling me how I feel let me know when you are ready to hear from me how I feel, meanwhile I’ll just hang out here and ignore you.
So the mind of facts, figures, analysis, data is not always the most conducive to being able to cultivate and undetand the empty nature of dis-ease or even disease and illness. Also the factual oriented, logical, thinking only with little to no feeling is not generally oriented to compassion since compassion is vague and feeling oriented lacking data and statistics. The mechanical doctor is better suited to fixing robots than humans.
If however your care provider is capable of looking you in the eye, asking about you feelings as well as your symptoms then the diagnosis is generally going to head in a direction where treatment is more important than the statistics of medical journals. It is more likely you will be treated as a human and not a machine. It is more likely you won’t experience the sensation of your doctor being bored to death not listening to you because you are too ordinary and just another humdrum sick person consuming oxygen in their office.
It is the same in Buddhism. When a person is unable to move beyond the technical details of doctrine and religious jargon then bridging the gap between lives is difficult if not impossible. When however we can share doctrine from the heart without relying on cliche or pat short cut phrases we can communicate as humans. Machines are more efficient with data sets, and short expressions that always mean the same thing. For humans no expression ever means the exact same thing to any two people and often it may vary according to the mood or mind state each person is in.
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