At Forty-Six, Beholding the Five Skandhas as Empty

When the Bodhisattva Avalokitesvara practiced the deep Prajna Paramita, he beheld the five skandhas as empty and transcended all suffering. Sariputra, form does not differ from emptiness, emptiness does not differ from form; form is emptiness, emptiness is form. The same is true of sensation, perception, impulse, and consciousness. Sariputra, all dharmas are marked with emptiness: they are neither produced nor destroyed, neither defiled nor pure, neither increasing nor decreasing. Therefore in emptiness there is no form, no sensation, perception, impulse, or consciousness; no eye, ear, nose, tongue, body, or mind; no form, sound, smell, taste, touch, or mind-object; no realm of sight, up to and including no realm of consciousness. No ignorance and also no ending of ignorance, up to and including no old age and death and no ending of old age and death. No suffering, origin, cessation, or path; no wisdom and also no attainment. Because there is nothing to attain, the bodhisattva, relying on Prajna Paramita, has no hindrance in mind. Because there is no hindrance, there is no fear, and he is far reversed dreams and reaches ultimate nirvana.

—The Heart Sutra (Prajnaparamita Hridaya Sutra)

My 46th birthday was curiously arranged: my lunar and solar birthdays fell on the same day. I was born on the 18th day of the 7th lunar month of 1979; that date in 1979 corresponded to September 9 in the solar calendar, and this year it does again. It feels like a cycle: the ring turned and turned and has returned to its starting point. For me it seems a fated coincidence. Just after I had tasted all the winds and rains of the world, on September 7 of this year I once again set foot on a university campus, becoming an older student studying medicine alongside children younger than my own son, beginning a possibly six-year course of full-time study.

I attend a medical school somewhere in the north—To protect my privacy and to let me study in peace, please understand that I cannot name the school before graduation. Before filling in my application, I visited the schools I most wanted to attend. After careful comparison and considering my exam score, I made this school my main choice and was successfully admitted to its clinical medicine program. I was genuinely happy when the admission notice arrived.

I previously studied TCM through an apprenticeship model. Apprenticeship and institutional education are the two legally recognized paths to learning TCM in China; graduates of either may take the TCM physician licensing exam and practice legally. But for learning Western medicine there is only the institutional path. Now that I have chosen to study clinical medicine here, once I finish I can fulfill my wish of being a general practitioner of integrated Chinese and Western medicine. After graduating in clinical medicine, if possible I will spend a few more years studying acupuncture and tuina at another medical school.

People with both TCM and Western-medicine backgrounds, and both apprenticeship and institutional training, like me, are rare. Among physicians there are all sorts of pecking orders: TCM doctors look down on Western doctors, Western doctors on TCM doctors, apprentices on institutional graduates, institutional graduates on apprentices, and the "divine healers" look down on everyone but themselves.

I still cannot understand why people indulge in such snobbery. And I personally think that the many prejudices patients now hold against doctors, and the frequent doctor-patient disputes, are partly due to doctors' despising and attacking one another. Some of the most extreme remarks about TCM or Western medicine originally came from doctors' own mouths—truly digging their own graves collectively.

I personally believe that rather than spending energy on mutual contempt and abuse, medical learners should settle down and study more. Studying more builds a holistic view of medicine across time and place, so that in practice we can choose what is best to use. Most diseases are hard to treat and may defeat every method; the more techniques we master, the more composed we are at the bedside.

Studying medicine was my boyhood dream, once delayed. But thanks to the country's good policies, I could still follow the apprenticeship path and retake the college entrance examination, striving in middle age for an unrealized youthful dream. Not only that, I can study more broadly than the average medical learner. People who are striving and learning tend to stay positive and optimistic, which objectively also slows brain aging.

By and large I am an optimist. I keep thinking I will most likely live past 90 (perhaps even 100), and be able to write and work past 90, so I have never much cared about my current age. Given that so much time remains, biting off a hard problem is no big deal.

I now study in a class of children younger than my son. Before registration I contacted my advisor, asking her to see whether the school could bend the rules to let me rent off campus and be exempt from military training; neither was granted. The school's rules are strict and would not make an exception for me. That is fine: living in the dorm saves rent, and I can take military training as exercise. Eating, living, and studying alongside eighteen- and nineteen-year-olds is actually rather interesting. I am easygoing and get on with them; within three days of enrollment, my classmates were already affectionately calling me "Uncle" and greeting me warmly. Spending time with young people also lets me understand the next generation's thinking, which may benefit my future work.

School discipline is strict, but it has not made me uncomfortable. For years I have lived a simple, self-disciplined life, so I adapt well to this highly regular campus routine. Before leaving home, worried that no one would work the fields after I left, I took some time to transplant seedlings, dig furrows, weed, and top-dress. Such physical labor, if not excessive, is a very beneficial change for a mental worker.

The school is also humane: on weekends and holidays it lets older students like me go home on leave, which makes university life easier. I feel my current life is not much different from boarding at school in junior and senior high, when I could also go home on weekends and holidays; only now I take the train home and it takes a little longer.

My inborn temperament plus half a lifetime of experience leave me unruffled by events. I do not crave novelty and excitement; I prefer to focus on the work I love. I also dislike arguing with anyone; whoever argues wins, and I am willing to give way, because it avoids needless drain and lets me concentrate on what I want to do. Giving people a few steps is no big deal; yielding is not cowardice but the wisdom of "maitri, karuna, mudita, upekkha." If we have our own life goals, we should not waste precious time on verbal or ego-driven disputes.

I was born into a deeply Buddhist family and memorized sutras with my grandmother from childhood; over my life these sutras have influenced me imperceptibly. Many things have tried to disturb my mind, but those sutras I knew by heart as a child keep echoing in my ears. After seeing the world, revisiting the classics I once swallowed whole gives me deeper insight each time.

Buddhists pursue the state of using the light of wisdom to behold the five skandhas as empty, recognizing that the essence of all things is emptiness and that various "dependent arising" conditions give rise to various "forms"—the famous Buddhist doctrine of "dependent origination and intrinsic emptiness." One who deeply understands this can remain unmoved by all greed, anger, delusion, pride, and doubt in the world, rising above the mess of daily life and living apart from worldly strife. No longer drawn into disputes and afflictions, this is a very happy state—in Buddhist terms, blessed merit.

Buddhism often says "cultivating the mind against circumstances," and all life experiences are circumstances. My experience is rich and my life unusual. Again and again in life I "cultivate the mind against circumstances," until imperceptibly I enter an inner state of "utter emptiness." Emptiness is not bad; when empty there is no "hindrance of views" or "hindrance of consciousness," and no prejudices or bad moods spawn various bad mental states. An empty heart can contain all things, gladly accept new knowledge, and not be shackled by prejudice and dogma.

Most people, unable to escape desire, prejudice, and delusion, suffer endless pains of "separation from the beloved, union with the hated, failure to obtain what one seeks, and the flourishing of the five skandhas," their hearts full of greed, anger, delusion, pride, and doubt, with little peace, tormented day by day. So after middle age I am especially grateful to my grandmother for giving me this childhood training. Much of what she taught me as a child has become sheer instinct, and that instinct has benefited me greatly.

"When the heart is far, the place itself is remote." To leave the three realms, hiding in deep mountains is useless. Only when the mind is unruffled will the fires of the three realms not burn us. I cannot define happiness, but I know that a mind constantly swayed by outside influences and in turmoil is certainly not happy. Living inwardly yet fearing no contact with the world, able at any time to be calm as still water and also to move freely among beings—perhaps this is how to escape that unhappiness.

On my 46th birthday, the third day after I entered university for the second time and began my second university career, our school held the opening ceremony for the class of 2025. That ceremony was a new starting point in my life, and it chanced to fall on my birthday—on both the lunar and solar calendar, the very day I came into the world 46 years earlier. It is as if it hinted that I, after wandering half a lifetime in the human world, have finally returned to my original intention.

What makes a medical-school opening ceremony special is that it ends with all the new medical students taking a common oath. The oath reads:

"Health is entrusted to us; life itself is placed in our care. At the moment I enter this sacred school of medicine, I solemnly swear: I am willing to devote myself to medicine, to love my country, be loyal to the people, honor medical ethics, respect teachers and abide by rules, study diligently, persevere unceasingly, strive for excellence, and develop in all ways. I am determined to do my utmost to eliminate human suffering, help perfect health, and preserve the sanctity and honor of the healing art; to rescue the dying and heal the wounded, untiring in hardship, steadfast in pursuit; and to devote my whole life to the development of the nation's medical and health cause and to the physical and mental health of humankind."

This oath is exactly my own wish. In Buddhist terms it is also a new "dependent arising" in my life, one that will shape my second half. The penultimate hexagram of the Book of Changes is Jiji (Completion), and the last is Weiji (Not Yet Complete). Our ancestors were so wise: they vividly used these hexagrams to describe the essence of life. Life is an unceasing process; every end is a new beginning, and only by pressing steadily forward can life continue endlessly.

After the opening ceremony, I sat in the school library's study room and wrote this article; many of my future pieces may be written here. It is not as grand as the National Library, but it is quiet and comfortable. I am gradually blending into this new environment and embarking on a new journey.

I offer this essay in memory of this unforgettable 46th birthday. Finally, happy birthday to me!May all my remaining days be free of sorrow and free of fear.