Physician, Heal Thyself

Chinese medicine is filled with images of "The Great Physician." Mostly a mythical entity, the good doctor is usually depicted as a wise and humble man, filled with compassion for his fellow creatures, while employing effective and often mysterious methods to cure them. He knows more than he says, yet his silence speaks volumes. He is the universal healing role model.

We find him in the form of Chi Po, the Yellow Emperor's doctor, who instructs his powerful patient on the ways of heaven and earth, thereby taking the dual role as doctor and court advisor. So, too, does Confucius make comment on how each individual should act in relationship to every conceivable role they might play in society. In fact, Confucius made his a full practice in clarifying roles. In his view, adhering to prescribed and specific relationships was necessary for one to live a healthy life.

Lao Tse was less concerned about others and more about a right relationship with the cosmos. As an astute observer of the laws of nature, this man (considered the grandfather of Taoist practice) cast a mythic shadow that has likely affected millions. Some of the Taoist notions of energy create a strong underpinning for the practice of medicine, healing and meditation.

Though very different in their approaches, we see all these epitomes of health and wisdom sending us the same message: "Know more than you say. Help those that need it. Keep learning. Keep refining your knowledge. Influence society. Teach. Maintain balance. And PRACTICE."

North American practitioners of Chinese medicine intrinsically live in two civilizations. Most of us are at least equally influenced by Western sources as we have been inspired by Oriental thinking. Hippocrates, an early Greek doctor, swore himself to a practice of holiness and study, which led to helping the sick and "doing no harm." Portions of his credo have inspired physicians throughout the ages. Maimonides, a 12^th-century Jewish doctor, combined a career as a rabbi (literally translated as "teacher") with the practice of medicine and philosophy. Debate still ensues as to whether "Rambam" (Maimonides' nickname among devotees) was a doctor or a spiritual teacher, so broad was his influence. In the U.S., we have the former Surgeon General C. Everett Koop, who is the doctor generally credited with raising public awareness about our society's smoking epidemic. Koop's courage and conviction broke a social taboo by overtly confronting corporate interests that sought to hide the side effects of smoking. This former pediatric surgeon's most famous act changed public policy, saving countless lives.

These Great Physicians who provide examples for us have a message: "Be influential. Help many people. Find a balance between your practice, your quest for learning and your place in society." Though most of these worthies are long since dead, these men inspire great actions. It's a tall order to live up to and follow the model they set. In my private moments, I wonder if they ever got tired.

Think about spending all those hours treating patients, studying, teaching, listening, observing, treating more patients and preparing medicine, influencing leaders, convincing those in power that health is a virtue, writing tomes (or at least prescriptions) or maybe op-ed pieces used by the media to change minds. Whether in Asia, the Near East, Spain, Greece, Egypt or Washington D.C., these were busy fellows. We only know them professionally. We'll never know if they shared responsibility for child care or home care, cared for aging parents, or if they did community service. We also never hear about their health. Did they, like we, suffer from genetic weaknesses that hit in middle age? Did they have athletic injuries that ached more over time? Did this flurry of activity ever wear them down? Or did their zeal for their work carry them like the endless movement of the oceans? Did the vast seas provide them limitless energy to do good works?

In our generation, the oceans are shrinking. Reserves of ice are melting, and patterns of water are not predictable. We are the generation left to guard the world's reserves after a century of reckless expenditure. Likewise, we are also responsible, now more than ever, to replenish ourselves.

I am impressed that all the great healing traditions agree that the role of the doctor is, in fact, a mixture of roles: teacher, student, philosopher and, yes, physician. Four roles to one person could create the conditions for overwork, unless you consider that teachers, students and philosophers all allow for ample time off for reflection. The notion of "sabbatical" goes back to biblical times and has been adopted as an assumed right of academics.

Yet doctors in our culture are expected to work constantly, be "on call," use beepers and treat the sick as the sick need us. The more patient-focused you are, the more likely your reputation will bring you more patients. In fact, the better you are as a healer, the more likely it is that you have to guard your free time. Every really good practitioner I ever met is more than fully booked.

The phenomenon of overwork extends beyond medicine. Evidence suggests that Americans have worked steadily more each year for the past 40 years. In contrast, between 1850 and 1940, measured hours of work actually declined in the U.S.! Since the 1960s, however, workloads have gradually increased, marking the U.S. as distinct from our European neighbors. As Harvard University economist Dr. Juliet Schor put it in her breakthrough best seller, The Overworked American, "After progressing in tandem for nearly a century, the United States veered off into a trajectory of declining leisure; while in Europe, work has been disappearing. Forty years later, the differences are large. U.S. manufacturing employees currently work 320 more hours - the equivalent of over two months - than their counterparts in West Germany or France."

Schor's work demonstrated the reduction in leisure time during post-WWII in America, as well as provided evidence that the problem will not be solved by developing "work-life balance solutions," but rather by addressing the society's increased demand of employees.

Western tradition can help us find replenishment, even as modern American society grows more out of control. Consider the notion of the Sabbath - a biblical mandate. One day out of seven completely devoted to rest. Radical, no? No e-mail, no returning calls, not even housework. Now extend that right to an imperative to take a season off every seven years and a year off every 49 years.

I recently studied a passage in Leviticus (Leviticus 25) called "B'har Sinai," translated as "On Sinai," which tells an important story. Imagine thousands of people leaving slavery in Egypt under duress, pursued by an army of an offended king, frightened, fleeing and crossing the Red Sea only to find - nothing - vast desert, no food and no rules for societal functioning. Forty years wandering in the desert taught faith; but then the people, led by a stuttering prophet, Moses, came to Sinai when God revealed that the wandering would end and land would soon be given.

Not unlike Confucius' writings, Leviticus is filled with what to do, how to live, who does what and when it should be done, down to the last detail. Actions and more actions are commanded to live on the earth in a spiritual way. God dictates rules and then threatens innumerable punishments for transgressors.

However, this passage near the end of the book of Leviticus, advocates for less to do. In fact, nothing to do - in fact, no action at all every 49 years! The passage says that every 49 years, you (as an entire people) should take a "Sabbath of the Land." We are commanded to "let the land rest and rest with it!" Imagine a collective sabbatical, where all slaves are freed, debts are forgiven and the land is given a chance to replenish itself.

Take a moment to imagine all of us, for one year at sometime in our lives, doing less by societal decree: equalizing our resources and loving the land; watching sunrises and sunsets because we can and they are always there; observing the miracle of life as plants, trees and children grow throughout a year; watching rains transform to mists, then to snow and back to soft water in the spring; sitting at the side of a river and knowing how it flows; letting nature love us back by slowing down enough, all at once, to love the Earth.

Freed of the dictate to do, we have one year to be - a sabbatical year. A biblical mandate. Following the example set by the Great Physicians, I write this essay from my sabbatical in New Mexico. Contrary to the title of my column, I have taken my body from work, rather than brought my body to work. I think that my work will benefit immeasurably from the rest. I think Lao Tse might be smiling.

Resource

Schor J. The Overworked American: The Unexpected Decline of Leisure. New York: Basic Books, 1992.