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Tibetan medical practices in America

By Ji Hyun Lim
AsianWeek Staff Writer

Faded prayer flags wave tranquilly by the doorway. Quiet murmurs of voices creep out of the hallway as the scent of burning incense wafts through the office. An album filled with colorful photographs of Tibet rests humbly in the reception area, while Dr. Dickey Paldon Nyerongsha confers with a patient behind closed doors.

When the door opens, Nyerongsha, with her hair tied back and dressed in a traditional Tibetan dress, smiles warmly. Colored bags containing herbs from the Himalayans are bundled behind her desk on a table. Her eyes are intense and analytical, her voice is soft and soothing. Indicating to a Tibetan medical anatomy chart behind her, she begins explaining that this energetic tantric chart, much different from a Western human anatomy chart, edifies and touches the core of where Tibetan medicine is rooted.

However, this is now changing. Tibetan-trained doctors are rapidly becoming a new alternative to Western allopathic doctors. Herbal medicine and spiritual counseling are favored over Western practices, because many patients claim Tibetan treatment leaves no physical side effects and that it has altered their perception of mental, physical and spiritual health.

Dr. Dickey Paldon Nyerongsha is the seventh generation of physicians from Tibet. Photos by Ji Hyun Lim.

Tibetan medicine is practiced in Tibet, China, Mongolia and Buddhist regions of Russia and Central Asia, as well as areas in the Himalayas, which include Nepal, Sikkim, Bhutan and Northern India. How Tibetan medicine differs from traditional Western medicine is the focus on curing the spiritual elements of the body versus treating its physical ailments. According to Dr. Raymond Chang, who serves as medical director of Meridian Medical Group, optimum treatment of ill patients requires the integrative use of Eastern and Western approaches. Terminal or chronic diseases such as cancer, multiple sclerosis and hepatitis are not amenable to treatment, and Chang points out that part of treating a patient is having them understand the illness, and eradicate the fear and anxiety of their states.

“Spirit is lacking,” Chang said. “Patients are so focused on their physical life, they ignore the spiritual aspect. If we can’t cure them from a physical death, I think spiritually, one can transcend this.”

Chang argues that ultimately, people can be more at peace with the spiritual body than the physical one. The goal is to reach a level of understanding of life and death so that the physical body can pass on, while the spiritual one lives on. Chang explains that unless the mind is in such a state where physical death is no longer of grave importance, it is difficult to subvert the fear of the diagnosis.

“There’s a difference between spirit and psychology,” Chang said. “There are very few doctors who emphasize the spirit. The modern Western treatment has nothing to do with the spirit. [All] it does is try to heal the psychological ailments.”

Thirty-three-year-old Nyerongsha was born in Tibet to a family of seven generations of doctors. A graduate of the Tibet Medical School in Lhasa, she has practiced the 2,000-year-old science since age 7. Learning the names of the herbal medicine and pounding ingredients from a young age, Nyerongsha has always been prepped to be a doctor. Now she travels around the country, with offices in both Southern California and Napa Valley.

“My uncle was a physician to the Dalai Lama for over 10 years,” she calmly explains. “Both my mother and father, grandfather, four uncles and a brother are doctors.”

Taking the tantric chart off the wall, she places it on the table as she explains the spiritual function of the body. Balance is key to good health. The chart shows two trunks — one healthy and the other unhealthy. The healthy trunk has fewer leaves than the disease trunk because the body is “balanced” from negativity. The disease trunk has more leaves because excess or depletion of energy causes “imbalance” and manifests itself mentally, physically and spiritually, she says.

“When someone’s state of mind is healthy, there are no complications,” she elucidates. “Colds, flu, sore throat, fever, pneumonia and bronchitis come from imbalance.”

Nyerongsha, whose medical role is parallel to a Western internist, claims she never treats symptoms but treats physical ailments as a result of an unhealthy spiritual state. And unlike traditional Chinese medicine, which deals with emotional states of illness, Tibetan medicine treats the spiritual health of the ill.

According to Mahayana Buddhism, disease is rooted in “ignorance” which in turn, causes “hatred,” “attachment” and “delusion.” These three states of rlung, tripa and badkan are what cause physical ailments.

The central channel, or rlung, represents wind. Blue is the color of the five rlungs, which correlate to the crown of the head, chest, heart, stomach and genital region. Complications of these areas are directly related to the imbalance of spiritual elements that affect the body.

Tripa, signified by the color red, is part of the right channel and represents fire. Similar to the Chinese concept of yang, an imbalance of the tripa results in emotional states such as stress, anxiety and depression.

Badkan, signified by the color yellow, is similar to the Chinese concept of yin. This water and earth element, when imbalanced, can cause the body to have desires, resulting in problems with addictions.

“There are seven visible, bodily constituents,” Nyerongsha explains. “In Western medicine doctors look at nutritional essence — blood, bone, flesh, bone marrow, fat and [the] reproductive [system]. In Tibetan medicine, we look for energetic imbalance.”

Energetic tantric chart.

Nyerongsha sees between 100 to 150 patients a week. Each patient goes through a pre-consultation where she explains their dietary restrictions. Coffee, medicine or supplements must be avoided prior to an appointment. Meanwhile, Nyerongsha discusses medical history, reads the pulse, tongue and eyes, and analyzes the urine sample.

“We’re looking for a person’s natural condition,” Nyerongsha says, “whether the constitution is hot or cold. [Everyone undergoes] the process of detoxification, purification and rejuvenation.”

Phuntsok Chonying, a pupil of the personal doctor of His Holiness Dalai Lama, also grew up in Tibet and has studied Tibetan medicine since he was 15. He graduated in 1988 from Tibetan Medical Institute in India, studied at the pharmaceutical department for three years and worked in pharmacy for seven years. He came to the U.S. in 1998 and has been seeing patients and giving advice in behavior, diet and supplements ever since. His office is located in New York.

Like Nyerongsha, Chonying believes that the patient’s problems are 50 percent emotional and 50 percent environmental. He believes that if spiritual elements are imbalanced, a person will be sick. He also believes illness is not disease but an unsettled spiritual state.

“Everybody has behavioral differences and some anger and desire,” Chonying explains. “Emotional health is tied to physical health. If you desire too much, the wind energy is going to be imbalanced. Stress also comes from desire. People stress because people desire many things and think too much. That’s not good for the body.”

Behavior changes are one of the ways to treat patients. Diet, Tibetan supplements and spiritual counseling are other ways. Before Chonying sees a patient, he advises them not to eat heavy, raw foods, foods with additives or foods fortified with Western vitamin supplements. Patients are also advised not to engage in sexual activity the night before analysis, and they must provide urine samples from the morning.

“Tibetan medicine is tailormade to a particular body or nervous system,” said Marcia Gross, a 66-year-old patient of Chonying’s who suffered from radiation therapy side effects. “There’s so much delicacy of the body. He could tell what was off. He took away certain foods, and he could tell what was out of balance and bring them to alignment.”

Gross, diagnosed with breast cancer, had a lumpectomy and endured one month of radiation therapy. She complained of having a metallic taste while eating food, inability to sleep well, fatigue and depression. She decided to visit Chonying, and he prescribed different herbal medicines, advising her to grind them up and drink them an hour before breakfast, half an hour before lunch and half an hour after dinner. Chonying also took her off a diet of raw and fermented foods, alcohol, caffeine and sugar.

Within three months, Gross claims to feel changes. Her lethargy went away, and color has reappeared in her skin. She works and exercises regularly now.

“His acute ability to diagnose from body pulse system is different from regular doctors,” said Gross. “By taking the different pulses, he could detect the imbalances of the circulatory, digestive and respiratory systems. If it didn’t work, I would have stopped. It’s too laborious in the beginning to change your habits.”

A chart that shows the spiritual imbalances of an ill patient. Diseases are rooted in “ignorance.” Click image for larger view.

With a growing interest in Tibetan medical practice, George Washington University Medical Center held the First International Congress of Tibetan Medicine Nov. 7-9, 1998, that extolled the virtues of the holistic approach.

In His Holiness the Dalai Lama’s message, he said: “As an integrated system of healthcare, Tibetan medicine can offer allopathic medicine a different perspective on health. However, like other scientific systems, it must be understood in its own terms, as well as in the context of objective investigation. In practice it can also offer Western people another approach to achieving happiness through health and balance.”

The conference brought together the Tibetan medicine community to discuss legal and regulatory issues affecting the practice of Tibetan medicine, the status of Tibetan medicine in different countries, research methodology in Tibetan medicine, integrating death and dying concepts, utilization and conservation of medicinal plant and many other topics. The second such conference will be held Nov. 6-8, 2003.

Meanwhile, Chonying and Nyerongsha continue to build up their practices through word of mouth and traditional healing networks.

“We believe any religion helps with compassion,” Chonying says. “[But] you don’t need to be a Buddhist.”

Nyerongsha adds, “Our culture has a long history. There’s a lot our culture can offer not only dharma but healthcare, using natural products. Western medicine is going to Tibet. There’s interest there, and we could learn a lot from both.”

Reach Ji Hyun Lim at jlim@asianweek.com.