The Yale Journal for Humanities in Medicine
Spirituality, Religious Wisdom, and the Care of the Patient
Apathy in the Context of Illness: A Humanistic Buddhist Perspective
Venerable Yifa, Ph.D.
From a Buddhist point of view every action, no matter how minor, makes a difference. This also includes inaction. For when we chose not to act that too is an action. When an individual becomes disengaged from personal and social responsibilities it is often difficult for them to see the long- term effects of such behavior.
Not only does each of our individual choices affect our personal karma, but also due to the interconnectedness of all phenomena our choices are reflected in the world of which we are a part. This law of cause and effect is very precise and nothing is missed.
Our participation in this world is intimately bound to the overall process of our becoming. Who we are now and who we will become is the product of our intentions in every thought and deed. If we simply attempt to avoid action, and thus guard against negative behavior, we engage in an extreme that the Buddha himself found counterproductive to the goal of true happiness.
By realizing that all of our actions are intimately connected to our state of mind, the Buddha understood that by changing our mind we literally change our experience of reality. We begin to see things as they truly are, rather than as we have been imagining them. This is at the heart of the Buddhist practice of cultivating wisdom.
Our present human life is the optimal condition for the cultivation of wisdom. It is here that we can develop the compassion toward others that gives rise to the valid intention for developing wisdom. For we must understand that true wisdom is elusive to minds filled with selfish intention. The Bodhisattvas, the great compassionate beings, teach us this.
Since it is in this human form that we are able to cultivate the mind of enlightenment, it is important to be on guard against the affliction of apathy. This precious life should not be taken for granted. We should not sit idly by allowing events to simply take their course. This very world that seems overwhelming, confusing, and sometimes hopeless cannot transform of itself It relies on the direct participation of us.
Buddhism has been described by some as pessimistic and escapist towards the world, leading many to believe that Buddhism had abandoned the needs of society. However, an increasing number of people are becoming aware of Buddhism in a different light, Buddhism as a socially engaged and compassionate force for the improvement of society.
As a monastic of the Fo Guang Shan order I share this view of a socially engaged
Humanistic Buddhism. As our founding master, Hsing Yun, has pointed out, Humanistic Buddhism is not a new form of Buddhism, but rather "the Buddhism of the Buddha himself". The heart of Buddhist teachings is love, compassion, and wisdom.
We are not taught to turn away from the world, but instead to transform our understanding of the world so that we may find the lasting peace that comes from the removal of ignorance. The venerable Huineng, the sixth patriarch in the Chan (Zen) tradition, stated that, "Buddhism must be practiced in this world; enlightenment cannot be attained by leaving this world. Seeking enlightenment outside this world is like looking for a rabbit's horn"
It is plain to see that there is no place for apathy in Buddhism. This world, here and now, is the crucible in which we all must work out our salvation through the cultivation of wisdom and compassion. Remaining connected to society and assisting others in this quest is implicitly shown throughout the Buddha's own activities during his life, and is the defining element of what is called
Mahayana Buddhism, the Great Vehicle.
Precious Human Life
Of all the possible states of being, which in Buddhism includes the denizens of hell and hungry ghosts along with the insects and animals that creep, crawl, swim and fly, and all types of plants and fungi, we are fortunate enough to have attained this human incarnation. We have within our means the ability to become enlightened. Such a precious commodity should be recognized as quite rare. How shameful it would be to waste it in a state of apathy.
Realizing this we should develop compassion for all beings. For without fail each and every one of us has struggled and endured to arrive at this precious human form. This fundamental precept must be instilled so that no one takes his or her human form for granted.
No person should allow his or her innate ability to reach enlightenment to go untended. We should guard our health both physically and mentally in order that we can diligently cultivate our wisdom and develop our compassion, for that is what this precious human life is intended for. It is here and now that we should work toward attaining liberation from our own ignorance.
In Buddhism it is taught that nothing stands alone. All phenomena arise in complete dependence with all other phenomena. There is nothing in our universe that could be said to be a thing in itself. The whole of existence is a collection of parts, which are collections of parts ad infinitum. Thus, with no underlying reality, or self-nature, all phenomena are said to be empty.
This doctrine of emptiness while simple at the surface has proven to be a difficult and widely misunderstood concept. Many have been led to believe that this emptiness equates to a void, or nothingness. This kind of understanding could very well lead one toward apathy. Yet, this would be incorrect. For though all phenomena are said to be empty of self-nature, this does not mean that we live in an empty universe.
On the contrary, we live in a dynamic and ever changing flux of becoming that acts according to the law of cause and effect. We are part of a beginingless and endless interconnected whole of dependent arising. Every atom, in fact every quantum of every atom, arises in relation to the whole and in turn reflects and contains the conditions of the whole. Therefore, we are intimately connected to all beings and as such eternally bound to their well being.
An analogy of this is found in the Garland Sutra (Hua Yen Jing) in the description of Indra's Net. Indra's Net can be imagined in the mind's eye by picturing a vast network of threads, something like a spider's web, stretching out through infinite space. Located at every crossing of every thread is a crystal gem. By gazing at any one gem the reflection of the entire network is seen. Each gem contains the reflection of the whole. What can be seen in one can be seen in all, and what can be seen in all can be seen in one.
Likewise, the individual and society are interdependent parts of the whole. The condition of the society is directly related to the condition of the individual and vice versa. How we regard ourselves in relation to this universe, along with every action we make, defines our very existence at any moment. If we would like to elevate the overall state of ourselves we must not only work on our own shortcomings, but we must show good will in assisting others to work out theirs.
By cultivating compassion and diligently working for the upliftment of all, the individual can raise their awareness to the point where they reflect the purity of the Buddha mind. This purity is known when we achieve a selfless state. When the grasping for personal gain is transcended our efforts then become motivated by compassion for others and our selfish desires are sublimated. It is in such a state we begin to see a transformation of the world that can only be seen by the wise.
To those who have gained complete wisdom the world appears as it truly is, no longer a place of imprisonment and attachment. This very world is experienced as identical with nirvana, the enlightened mind. To the unenlightened this vision goes unnoticed as they wrestle with their longings, desires, and selfish attachments. This is the paradox that only the awakened can truly understand.
This world, right now, is nirvana, a place of lasting peace and radiant beings visible to the dharma eye of great Bodhisattvas. Yet, to the unenlightened the world is a mix of events ranging from innocent joy to crushing sorrow, from flashy novelty to imprisoning repetition.
Apathy is the affliction of those who, jaded by disappointments and unfulfilled in their desires, surrender to the negative aspects of the world and seek safety from the storm in their withdrawal. Even the Buddha encountered a similar situation when he withdrew to the forest to practice with the ascetics.
Yet, it is very important to realize his next step. After much contemplation, he realized that the middle way between extremes must be followed. Leaving the seclusion of the forest he came upon the great realization. Sitting under the Bodhi tree he saw all as it truly is. He experienced the interconnectedness of all phenomena. He was filled with great compassion for all sentient beings.
It is then that he resolved to remain in the world and teach. His actions speak to us not of a man who was indifferent to the plight of the world, or disengaged from society. Rather, he was a tireless advocate for transforming ignorance into wisdom. He taught to the simple and learned alike, and laid out a path of righteous behavior and ethics for both laypeople and monastics to live on long after his passing.
The Buddha demonstrated that it is through compassion for all living beings that complete enlightenment is available. Buddhist practitioners are committed to selflessly act for the improvement of all living beings toward their eventual enlightenment. This is at the heart of what is called the Bodhisattva vow. It is an intense compassion and conviction to free all sentient beings from suffering in samsara.
Continuity of Lives
There may be some of us that are unfamiliar with the term samsara. Samsara is the cycle of birth, death, and rebirth, or what is called reincarnation. This has also been called the wheel of life in order to depict a constant revolution of endless cycles of reincarnation.
One way for the modem person to think of reincarnation is through a definition of the scientific law of thermodynamics. This physical law declares that energy is neither created nor destroyed, it merely changes forms. The constituents that make up our bodies, our world, and our minds are forever in a continuous cycle of birth, decay, and renewal as energy changes forms.
Each of us represents a particular psychic attachment that has developed in connection with these forms that leads to a defined sense of self, or ego. It is this sense of self that clings7, continues, and becomes associated with form after form after form. This continuity of lives, or incarnations, is part of a great chain of karma (intentional action) that assures the reaping of the fruits of this life, good, bad, and neutral, in the conditions of next.
To gain understanding of our actions in past lives we should simply examine the physical and mental conditions of our lives night now. To gain an understanding of what we will become in the future we should carefully observe the actions of our current lives.
There is no reprieve from a life spent in ignorance and apathy. This fact alone should shake one out of their state of lethargy and indifference.
After many lifetimes of clinging to this form or that form the wise discover the nature of impermanence. Just as we cannot grasp space, we cannot stop time from stealing away all that has been and will be. Even the great Himalayan Mountains had a time when they were not, and will someday cease to be present again.
Faced with this discovery of impermanence some choose to cultivate hope for something lasting, something permanent that can be held in the heart as a kind of security blanket. Some simply succumb to despair, indifference, or as we are here to discuss, apathy.
There is a third choice. This is the choice to become enlightened, to see things the way they really are. Rather than clinging to an ideal of permanence born of faith, or surrendering to unknown forces, the Buddha taught a path in which one can arise to a clear understanding or reality. This clear understanding is the remedy for fear, doubt, despair and suffering.
Buddhist teachings point not toward an escape from the world, but rather a revealing of its true nature. Samsara and nirvana exist simultaneously. The unenlightened see things according to their unclear minds, and thus encounter a variety of unsatisfactory events. The enlightened see things as they actually are and thus have no fear, no clinging, and no attachment. The enlightened abide in peace while the unenlightened continue in uncertainty.
Impermanence is not a doctrine that teaches us to be stoic toward phenomena as if to protect ourselves from the pain of loss, but rather a doctrine that teaches us to act without grasping. Moment by moment we must make positive choices and utilize our talents for we are truly participants in the very creation of the world we discover ourselves in at every second.
Truly the world is a manifestation of one's own consciousness. If the mind is sick, the world appears sick. When the mind is clear so too is one's vision of the world. Cultivation of wisdom, compassion, and selfless service are the path to this realization. Each moment makes a difference, for it is the condition that creates the next.
At any moment we can find ourselves completely overwhelmed by the demands of our world. Adding to these demands the task of finding enlightenment could be viewed as just another burden. When someone is feeling defeated already by mundane worldly issues they are likely to think that they are not capable of something as lofty as enlightenment.
However, each individual should keep in mind that what they choose to dwell on shapes their reality. If we sink into negativity we are destined to live in a world shaped by such thoughts. Cultivating wisdom and selfless compassion is the surest way to transform our experience of this world.
There is a common saying that we don't really know someone until we observe him or her in a crisis. How proud we all were of the men and women that responded so selflessly and bravely to the crisis on 9/11. They were able to step outside themselves and respond with true compassion.
The burdens they were carrying the moment prior to that event vanished as they moved to respond to the needs of their fellow human beings. This should serve as an example of how quickly things can change and of our capacity to summon the energy to respond and transcend our own self centered concerns.
If we could but find that kind of compassion within ourselves daily, without the necessity of a crisis to shake us out of our slumber, then we could transform our world to become a place of peace, freedom, and happiness.
By replacing meditations on fear, attachment, and despair with meditations on precious human life, interdependence, and compassion we can practice the path toward enlightenment. We
change our world by changing our minds. There is no alternative. We are bound to act, for action is continuous. It is where we focus that action that counts.
We do not have to be a soldier or a fireman to begin to cultivate the kind of courage that is born of selfless sacrifice. We can begin practicing this kind of courage through selfless compassion daily in all of our actions. This is the most important step toward cultivating wisdom. This path of selfless compassion is accepted in all spiritual traditions as a sure way to affect our world and our selves in a positive and transformitive way.
Published: September 17, 2004