Suffering in the Real World

In the real world, suffering seems to have no limit. According to the Buddhist scriptures, when the Buddha Sakyamuni was a prince, he did not know the suffering of the real world. It was only after he walked out of the royal palace and saw the suffering of the real world that he decided to go into the forest to seek the path of liberation.

These past few months I have been rushing about everywhere, most of the time rescuing patients whom a crowd of physicians had already been unable to help. What I have heard and seen has all exceeded the bounds of what I previously knew. I have seen patients with huge tumors that have ulcerated, maggots in the wound; I have seen patients whose bodies have festered into holes through which their internal organs could be seen; I have seen patients whose bodies have rotted until flesh and blood were blurred and human tissues could not be distinguished. The psychological impact of such sights and experiences is enormous.

Because I am busy with clinical practice, and also because what I have seen and heard is too shocking, I have gradually, in this recent period, had little time and little heart to write. My feeling is that human suffering has no lower limit. These patients fill me with deep sympathy, and I am ashamed that I cannot cure them with a touch of the hand and quickly ease the torment they endure.

No one comes into this world of his own will; nature has played a joke on us by bringing us into the world. When a person is attached to life, he is yet not allowed to control his own fate, and must face death. After contracting a dire disease, he cannot even die as painlessly as he might wish. Before such a fate, I deeply endorse what Laozi said: "Heaven and earth are not benevolent; they treat the ten thousand things as straw dogs." A straw dog is a sacrifice. We are indeed the sacrifices of natural law. If I had never been born, whence would this suffering come?

If I were not now already married with children, I probably would not be willing to have any more. To bring a new life into this world and let him or her go through all the myriad sufferings of life is truly cruel. The so-called joy of life is often like a flash of epiphyllum, gone in an instant, while the various physical and spiritual sufferings a person must undergo follow like a shadow, never leaving for a moment.

What a physician faces most of all is fellow human beings sunk in suffering. This deep recognition of suffering fills my heart with constant compassion for those I serve. The physician is not a god, yet the expectations humanity places in the physician are no different from those placed in a god. In the minds of patients and their families, the physician is one of the last hopes of saving them from the sea of suffering. As physicians, we feel deeply ashamed before such expectations, because we often cannot meet them. But as humanitarian workers, we must fulfill our calling and do our utmost to meet them.

Before this real suffering, I have deeply realized the smallness and inadequacy of human medicine, and the smallness and inadequacy of the self. Unless one is deliberately trying to deceive patients, I think most physicians of rich clinical experience will turn humble. Because too many patients, in the course of our treatment, have let go of life and departed in pain. All human inventions and all the wealth in the world, before the final terminal illness, are mocked into utter confusion. We are so powerless, unable to ease the deep suffering of our loved ones, of our fellow human beings.

An extremely tormented patient once said to me, emotionally, that for him, the very fact that there was one doctor in this world who understood the suffering he had endured and the physical and spiritual torment he was bearing made him feel much better. But for us physicians, facing such suffering and being helpless, our own hearts are not at peace.

There was once a young physician who, after only a few years of work, gave up his job and went everywhere seeking skilled doctors from whom to learn medicine. The two of us met on a road of seeking a teacher. He told me that when he saw patients pushed into his ward in pain and, some time later, leave his ward in even greater pain, he felt his mind would collapse. The pride of saving the dying and healing the wounded that he had pursued was shattered by this real experience, and his faith in medicine tottered.

I think his experience is one most of us who chose medicine will go through. We walked into the physician's post bearing the ideal of saving the dying and healing the wounded, and watched most patients unable, even with our help, to escape the torment of disease; the rich ideal shattered against this cruel reality. However proud a person may be, once he takes up the physician's post it is hard to remain proud, because the defeats our profession experiences may be the most numerous of any; we have no reason to be proud. The suffering we see is probably also the greatest of any profession; it is hard for us to turn a deaf ear to it.

A qualified physician must undergo at least twenty years of tempering before he can mature. Everything we must experience, we must experience slowly. Only these experiences can truly grow us into qualified physicians. The road of medicine is long; just walk it slowly forward.