Brotherhood Dharma, Destiny and the American Dream (39 page)

To begin with, the question is too broad. God is defined as infinite, eternal, and all-knowing. Such a being cannot possibly be a white-bearded patriarch sitting on a throne above the clouds. We must begin by throwing out the popular image of God as a person. Every religion gives a place to an impersonal God who is pure essence or presence. The Holy Spirit in Christianity, Shekinah in Judaism, Shiva in Hinduism—every spiritual tradition names God in his spiritual essence as light or Being. But this brings us to a new problem. Pure essence has no form, and being infinite and all-pervasive, it can’t be limited by images or thoughts in our minds.

To solve this dilemma, God has been shrunk to our size; the infinite became finite. We project human form onto God, but that is just a crude example. What we project at a subtler level is “God made in
the image of man.” This isn’t blasphemous; it’s just how the nervous system works. We experience love as human, and that gives us a way to view divine love. We want to feel safe, so we project God as a protective father. Our need for order instead of chaos makes us project God as a law giver. There are as many ways to project God as there are people. Still, God mirrors the needs of human beings in general. We need to feel safe, protected, and loved, and so God has those attributes.

For 90 percent of humanity, this is enough. If you add the intricate laws and rules that the ultraorthodox live by, whether Brahmins in India or Hasidic Jews in Brooklyn, God is already known. There is a kind of feedback loop, a circle that embraces God, creation, and the worshipper. The world you see, the deity you worship, and the person you see in yourself all fit together. Until history tore the circle apart—the Holocaust, a century of world wars, the Bomb, and totalitarian dictatorships made it impossible for believers to see how a loving, protective, very human deity could preside over a broken world and let evil run amok.

The only answer was to stop projecting, to rise above outworn conceptions and experience God’s essence directly. Most of
How to Know God
was devoted to mapping out how a seeker might exchange religion for the spiritual path. The fact was that the West knew very little about Eastern paths. The Buddha had a halo of prestige about him, but the rest of India was sacred cows and religious riots. I felt a deep urge to modernize Eastern spirituality, putting it in everyday language that could fit modern lives. This time I went much deeper than I had in
The Seven Spiritual Laws of Success,
trusting that the reader wanted to reconnect with the divine out of a yearning for meaning.

Moving from a book to real life provided many jolts. I was sure that everyone harbored the same yearning, but to get at it one had to pass through a great deal of pain and pathos. I gave a course on how to know God in Agra, literally under the shadow of the Taj Mahal, and one evening I held a sobbing American woman in my arms for two hours as she released what seemed like a lifetime of sorrow. My
role wasn’t to be her therapist or her guru. We were on the same journey, and my only advantage was that I had the peculiar talent of looking out the window and describing the passing scenery. Dante’s
Divine Comedy
begins with a man in the middle of his life lost in a dark wood. I had no authority to tell anyone what the absolute truth was, but I felt compelled to say, “We are all in the woods, and I can see up ahead. Believe it or not, we are safe.”

To me this was evidence of God in motion, an invisible guide that shows the way from darkness to the light.

22

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Miraculous Cures

Sanjiv

Sanjiv, with his immediate family, celebrating his daughter Kanika’s wedding to Sarat Sethi, New Delhi, 2001.

I
REMEMBER A STORY MY FATHER
had told Deepak and me about a patient of his, a man suffering from lung cancer. This patient, a wealthy businessman, heard about a Filipino faith healer who claimed he could perform bloodless surgery to remove the tumor.

“He insisted on going to see him for treatment,” my father explained. “He was rich, he could afford it, and there was nothing I could say to change his mind.”

When the man returned he said he felt much better, and he proudly showed my father an X-ray of his chest—and the lung mass was gone.

“Oh, come on,” I interrupted. “The guy is a charlatan. He gave him an X-ray from somebody else, and fooled the patient.”

My father continued his story. “A few weeks later he came to see me because he wasn’t feeling well. We did a CAT scan and, unfortunately, we saw that his tumor had grown. There was nothing more we could do for him.”

Any physician can understand this patient’s desperation. I suspect we’ve all known patients like this man, who had tried the best and latest of Western medicine and it was not enough to cure him. His desperate need to believe that there was something more that could be done to save his life caused him to reach out to a charlatan. Unfortunately the world of medicine is riddled with people who are willing to sell a promise for a price. There is, for instance, a vast, multibillion-dollar supplement industry that exists without any scientific evidence that most of its products do any good at all. So at least for a time, when I heard terms like “alternative,” “complementary,” or “holistic medicine,” I wondered about their value. And I worried that patients who might be helped by modern medicine would instead put their faith—and their money—into these unproven techniques.

But I have always been willing to listen and learn. In my current
position as faculty dean for continuing medical education at Harvard Medical School, I lecture to as many as fifty thousand health professionals annually. I’m also the director for a dozen courses each year, which means at the beginning of a conference I’m the first person to step up on the podium to welcome the attendings and give them a sense of what they are going to learn over the ensuing days. I also deliver a number of talks at each conference and make sure that I incorporate the latest evidence-based medicine. What are the studies that show that this particular medication works in this situation?

In the introduction and welcome I always say the following: “I’m delighted to see you here. I’d like to begin by all of us taking a moment to reflect on our medical profession. Justice Louis Brandeis once said there are three attributes of a profession and for the medical profession the first attribute is that there is a specialized body of knowledge, known primarily to its practitioners. The second attribute is that we practice medicine more for the benefit of society than for personal gain. So, all of us make a decent living, some specialists make a pretty handsome living, but we’re all here to serve society. And the third attribute is that society in return grants the profession great autonomy. Hence, we make the rules. How many years of medical school? How many years of internship or residency? How many years of fellowship to be a cardiologist? What about relicense, recertification, CME credits? So these are the three seminal attributes.

“Some years ago, Dr. Dan Federman, who was the first dean of CME at Harvard Medical School and one of my mentors, added a fourth: For the medical profession there has to be an encompassing moral imperative. And I would like to take the liberty of adding a fifth attribute: Learning. Learning is a lifelong privilege, not a process; pursue it with passion and zeal and see the wonder fill your world. We are in the most amazing profession where it is our moral obligation, our duty and dharma to engage in lifelong learning. We learn every single day, and we do so from textbooks and conferences, from medical journals. We learn from our colleagues, our students, the nurses and pharmacists we work with, and importantly we learn from our patients.”

As I learned, for most people in the medical profession learning never stops. It’s invigorating. It becomes a passion. Although it did take me some time to accept the value of complementary medicine. Admittedly Amita embraced it long before I did. Ayurveda had always intrigued her; she wanted to study it. But she never had the time she needed. As she explained, “I was so busy taking care of my patients that I really didn’t have the time to go into any of the Eastern disciplines. But I finally got the opportunity when I was at a large group practice in Cambridge. We had as many as five hundred physicians at fourteen different health centers, and we decided to incorporate alternative medicine, which later came to be called complementary or integrative medicine.

“We started a pilot program at the Cambridge Center, which included chiropractic, massage therapy, and acupuncture, and we integrated those with modern medicine and it was so successful many other centers quickly adopted it. That was a beginning.

“I’m retired now, and when I think about it I would still love to integrate
Pranayama,
breathing techniques, into treating various physical disorders. For example, I’d like to teach breathing exercises to children with asthma.”

The difficulty for a physician like me, who practices and teaches evidence-based medicine, is that there are many instances of dramatic benefits that can’t be explained by modern science. These are the so-called miracle cures that can’t be explained by the knowledge we have and often can’t be replicated. We know there is something more than we can fathom taking place.

I once had a patient with metastatic osteosarcoma, a terminal bone cancer, who developed an infection in the lining of his lung. We suspected he had a condition called empyema. There was a spirited discussion among the students, interns, residents, and attendings whether we should even treat this patient or just make him as comfortable as possible and explain the dire situation to his family. And if we did treat him, should we use antibiotics, put him in the intensive care unit, insert a tube into his chest to drain the pus? We decided that since he likely had an infection, we would insert a chest tube to
drain the pus and give him powerful antibiotics. We inserted a needle into his pleural space and sure enough out came pus. He did indeed have empyema. We treated him with broad-spectrum antibiotics.

The infection cleared up; he got remarkably better and he was released from the hospital. And then the miraculous happened: Six weeks later he said he felt great, his skin color looked healthy, and he was no longer in pain. A bone scan revealed that the multitude of metastatic cancerous bone lesions had disappeared. He was indeed cured, somehow. He was alive years later.

There is no good scientific explanation for this. The hypothesis is that it’s somehow related to the empyema and that his body, in its infinite wisdom, mounted an impressive immune response to fight the infection, and while doing so eradicated his bone cancer. What is the actual mechanism? How did it happen? We really don’t know. There is no clear answer.

I had another patient with chronic hepatitis C, which can evolve into cirrhosis or liver cancer. I happen to be considered one of the leading experts in America about this disease and have participated in clinical trials, written many chapters, and presented at prestigious national symposiums to educate physicians about this viral disorder. I’ve seen hepatitis C in all of its guises. It is a disease that at the time I saw him could be cured in about 20 percent of cases, but it took a year-long treatment with weekly injections and lots of side effects, some of them pretty debilitating. There are several options when it comes to treatment. In this case the patient had a mild disease, as ascertained by his liver biopsy. Given the 20 percent success rate and the difficulty of treatment, he and I decided the best course of action was to monitor him closely and simply wait for further advances in treatment. Over a ten-year period his disease remained stable; he was not drinking alcohol and he consumed at least two cups of regular coffee a day. So a conservative approach was very reasonable.

Then this patient went on a vacation to Martha’s Vineyard and apparently was bitten by a tick. When he was admitted to the ICU he was deathly ill. He had a high fever; he had profound anemia, a
high white cell count; and his red cells were being destroyed. He was seen by the infectious disease consultant, who correctly diagnosed Lyme disease; ehrlichiosis, a bacterial infection transmitted by a tick bite; and babesiosis, a malaria-like syndrome. It turned out he had all three conditions! This is most unusual and was testimony to the skills and acumen of the infectious disease consultant. He received transfusions and the treatment recommended by that doctor.

A week later, as his condition improved, I received an e-mail from the intern taking care of him informing me that this patient’s liver enzymes, which had been abnormal for the past decade, were now completely normal. That was interesting, I answered, but suggested we repeat the liver enzyme test to make sure this was not a lab error. If they came back normal again we would send off a test called hepatitis C virus RNA by PCR (polymerase chain reaction).

Three weeks later the patient came to see me. When he walked into my office he looked quite healthy.

“Dr. Chopra,” he asked. “What happened to my test? I hope my virus level didn’t go up.”