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Teaching Medicine: West meets East

Medical BuddahThe Emory-Tibet Medical Sciences Initiative began a 3-year pilot program in 2013. The first 3 years of funding was provided by Dr. Ray Schinazi.  Co-Directors, Dr. Carol Worthman and Dr. Mike Iuvone, led this initiative that provided Emory Medicine Faculty the opportunity to teach students at Men-Tsee-Khang Tibetan Medical Institute.   This interaction, along with the work going on in Dr. Schinazi's lab, gradually led to a request from Men-Tsee-Khang for assistance developing more comprehensive instruction in human physiologyanatomy, modern medical treatments, and research methodology to Tibetan medical students and doctors.

Over the last couple of years, several Emory SOM faculty members have made the long trek to Dharamsala, India with the intent to teach these students in their specialties.  Despite the funding having ended, this year 6 faculty members and 13 students ventured to Dharamsala.  It's an incredible journey to Dharamsala, India.  Faculty lecturers in 2016 were:  Dr. Douglas Ander, Dr. Jennifer Goedken, Dr. Alex Isakov, Dr. Jaffar Khan, Dr. Mary Jo Lechowicz, and Dr. Ted Pettus.  Student participants:  Kara Alceguierre, Kayley Alden, Erica Crosley, Eileen Dilks, Hadley Eichengreen, Rachel Gluck,  Zayan Mahmooth, Steve Phillips, Alix Pijeaux, Nate Reuter, Joey Sharp, John White, and Jasper Yan.

For the students, the two-week summer program included three primary components:

  1. Daily practice of guided meditation in a group setting to continue the development of introspection and compassion, as introduced through the Cognitive Based Compassion Training (CBCT)
  2. Classes on the basic tenets of Tibetan Medicine (e.g., pulse reading, medicine mixing, etc) led by Men Tsee Khang medical professors
  3. Cultural, philosophical, and educational exchange between Men Tsee Khang and Emory medical students

Dr. Douglas Ander, Dept. of Emergency medicine and Rachel Gluck & Nate Reuter, Class of 2019, share some of their experiences here.

The faculty were supposed to teach our Tibetan medical colleagues “western” medicine. We did our best to meet that goal within the context of a completely different way of visualizing disease. Their view of disease and its source can best be exemplified by the questions they asked. For instance, “Can your heart have a fever as the cause of the medical illness?”  -- meaning if I am correct that a problem with emotions or something that you did to upset the balance within yourself can cause disease. Or, “in order for the sperm and egg to fertilize do you need to add consciousness?”  Each of these questions would force us as faculty to view our topic from a different perspective, reminding us of the emotional and personal aspects of disease and treatment.

There were other lessons to be learned from our Tibetan hosts. They begin every clinic with physicians and staff praying to the Medicine Buddha to show them the way. We all need some help and guidance in our care for patients and families. They also believe in balance with diet and lifestyle being a key to health. Finally, diagnosis and treatment for them involves spending time talking to your patient, discerning the underlying cause of the problem, “The key is to cut the root of the trees versus the branches; better to cut the root to cure the disease”. 

~Douglas Ander, Professor of Emergency Medicine




DharamsalaAs soon as we landed we were hustled into jaunty little cabs, and zig-zagged our way through narrow, crowded, winding roads until we at last arrived at the Library for Tibetan Works and Archives, our home for the next two weeks. We were appointed rooms in the newly built scholars quarters, finished just in time for our arrival, only steps away from the ancient scrolls and manuscripts carried by foot over the Himalayan mountains from ancient Buddhist Tibet, maintained for posterity in the Library. 

Though many of us were familiar with the concept of meditation and a few of us had even participated in the CBCT course offered by the Emory-Tibet partnership for the medical students, none of us were prepared for what was to come.  Over the next two weeks we awoke each morning for a 6:30 AM meditation class, followed by breakfast, Introductory Buddhism class, a break to read, journal, exercise, and then a class on Introduction to Tibetan Medicine, all before lunchtime.

After lunch at Men Tsee Khang’s canteen with the Tibetan medical students. While they were learning Hem/Onc, OB/Gyn, EM, and Neurology from our visiting Emory faculty, we toured the Men Tsee Khang pharmacy, observed traditional Tibetan physicians during clinic hours, and facilitated a PBL on disaster triaging with the Tibetan medical students. 

As a medical student, I can’t help but think of meditation in terms of organ system.  Too often, in Allopathic medicine we treat medication and surgery as first line therapies, and ignore the healing powers of a good diet and regular exercise. Balancing the three main energies of the mind through first diet and lifestyle, and failing that, pharmaceuticals and surgical intervention, are the mainstays of Tibetan medicine. 

The emphasis on the mind-body connection cannot be overstated.  The two fields are largely divorced in the allopathic tradition, but their union is necessary for the health and wellness of our patients. 

How can we, as future physicians, find a balance in our energies, in our practice, to heal our patients as whole humans?  To get to where we are, we have demonstrated responsibility, determination, and dedication; we are always planning, always keeping schedule, always racing. To get here, we have given full reign to our over-achieving, ambitious, Type-A tendencies, and we have been successful.  These are, by in large, good things.  But to be able to sit in the middle of our chaotic lives and feel calm, mindful, and compassionate is a tall order.  How can we prescribe balance to our patients when we are so unbalanced ourselves?  How can we be both ambitious yet compassionate, hard-working yet present?

It is this question, I believe, that I traveled across the world to answer.                               

~Rachel Gluck & Nate Reuter


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